SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare Patient Safeguards Act of
2009''.

SEC. 2. FINDINGS.

    The Congress finds the following:
            (1) The 2009 Medicare Trustees Report estimates that
        Medicare spending could grow from 3.2 percent of the U.S.
        economy to 11.4 percent during the next 75 years and warns of
        the significant cost burden growth of this magnitude would
        place on workers, Medicare beneficiaries, and the Federal
        budget.
            (2) In 2009, Congress provided $1,150,000,000 for
        comparative effectiveness research, including cost-
        effectiveness analysis.
            (3) The Medicare Payment and Advisory Commission suggested
        that the Centers for Medicare & Medicaid Services use cost
        effectiveness analysis to look at groups of services used to
        treat specific illnesses that have small differences in quality
        but large differences in cost.
            (4) MedPAC has reported concerns that the rigid use of cost
        effectiveness analysis might limit Medicare beneficiaries'
        access to certain services, ration rather than promote
        appropriate care, slow innovation, and interfere with the
        practice of medicine.
            (5) MedPAC has listed methodological and reporting
        shortcomings of cost effectiveness analysis, including not
        using all available clinical evidence, not sufficiently
        reporting on the extent to which the results are applicable to
        the general population, selectively reporting results, and
        placing undue emphasis on certain results of such analysis.
            (6) While serving as the head of Congressional Budget
        Office, White House Budget director Peter Orszag said
        determining which treatment was most cost effective for a given
        population would involve placing a dollar value on an
        additional year of life.
            (7) While serving as the head of Congressional Budget
        Office, White House Budget director Peter Orszag suggested the
        possibility of limiting Medicare coverage for more effective
        but more expensive services.
            (8) CMS recently described cost effectiveness analysis
        expertise as one of its most critical needs to Medicare
        Evidence Development & Coverage Advisory Committee, which
        advises CMS on national coverage determinations (NCDs).
            (9) CMS, through proposed rule making, has twice failed in
        attempts to formally incorporate cost effectiveness analysis
        into NCDs.
            (10) CMS officials report that the agency considers
        potential cost savings before deciding to make changes to a NCD
        that narrows coverage under the Medicare program.
            (11) AARP has stated that comparative effectiveness
        research is intended to help consumers and providers determine
        the best treatment, not just the least costly treatment. AARP
        warned that this information from comparative effectiveness
        research should not be used as a means to deny individuals
        access to appropriate therapeutic options.
            (12) The Congressional Black Caucus, focusing in particular
        on the exacerbating of health inequities across subpopulation
        groups, expressed concerns that comparative effectiveness
        research should not be used as rationale for limiting care to
        the care that works best for the average patient, rather than
        providing coverage for the care that works best for each
        individual patient.
            (13) Congressional New Democrats--
                    (A) argued that any application of comparative
                effectiveness research must protect against the use of
                this research to deny access to care solely based on
                cost; and
                    (B) urged Congress to ensure that clinical
                effectiveness and medical outcomes are the focus of
                comparative effectiveness research funding.
            (14) The American Heart Association--
                    (A) urges Congress to include patient safeguards in
                legislation to prevent the misuse of cost effectiveness
                analysis; and
                    (B) argues that the primary focus of comparative
                effectiveness research should be optimizing clinical
                outcomes and value for patients and society and not for
                the purpose of minimizing costs.

SEC. 3. SENSE OF CONGRESS.

    It is the sense of the Congress that--
            (1) efforts to make the Medicare program financially
        sustainable, including the application of comparative
        effectiveness research, should not--
                    (A) deprive patients of medically necessary care
                solely due to the cost of such care; or
                    (B) limit access to needed health care services due
                to a patient's age, gender, ethnicity, or disability
                status; and
            (2) Congress should protect patients' access to needed care
        by ensuring that the Administrator of CMS relies on adequate
        clinical expertise when the Administrator proposes to narrow
        coverage for a product or service under the Medicare program
        under title XVIII of the Social Security Act.

SEC. 4. PROCESS FOR CERTAIN NATIONAL COVERAGE DETERMINATIONS.

    (a) Requirements for the Issuance of Certain Medicare National
Coverage Determinations.--Unless all of the conditions under subsection
(b) are met, the Administrator may not issue a final national coverage
determination (referred to in this Act as a NCD)--
            (1) if the NCD restricts local or national coverage for an
        item or service that, before the date of the issuance of such
        NCD, was routinely covered under the Medicare program under
        title XVIII of the Social Security Act;
            (2) if the NCD would result in significant cost savings for
        the Medicare program;
            (3) if there is controversy in the available peer-reviewed
        medical and scientific literature about the evidence supporting
        the NCD;
            (4) if the NCD restricts local or national coverage for an
        item or service that--
                    (A) is supported by current clinical practice
                guidelines--
                            (i) included in the National Guideline
                        Clearinghouse maintained by the Agency for
                        Healthcare Research and Quality; or
                            (ii) maintained by a State medical society;
                        or
                    (B) is endorsed by the National Quality Forum or by
                another national organization that evaluates voluntary
                consensus-based provides quality measures and is
                designated by the Secretary for purposes of making an
                endorsement under this subparagraph; or
            (5) if the Administrator determines that--
                    (A) significant differences in opinion exist among
                experts concerning--
                            (i) what evidence should be reviewed in
                        developing the NCD; or
                            (ii) how data should be interpreted for
                        purposes of developing the NCD; and
                    (B) an independent analysis of the evidence and
                data analysis would be valuable in developing the final
                NCD.
    (b) Required Conditions.--The conditions under this subsection are
as follows:
            (1) Request for review.--Before the start of the public
        comment period for a proposed NCD that contains all the
        restrictions on the coverage of products and services included
        in the final NCD, the Administrator makes a formal request to
        MEDCAC for a review of the scientific and clinical evidence
        supporting and opposing the NCD.
            (2) MEDCAC review subcommittee.--
                    (A) In general.--MEDCAC convenes a subcommittee
                to--
                            (i) review the evidence supporting the
                        proposed NCD (including clinical practice
                        guidelines published by medical specialty
                        societies), taking into account--
                                    (I) the evidence related to
                                subpopulations of beneficiaries
                                (including men, women, racial and
                                ethnic minorities, the elderly,
                                individuals with disabilities, and
                                individuals with genetic variations);
                                and
                                    (II) the extent to which patient
                                preference is a factor in the use of
                                the item or service that is the subject
                                of the NCD;
                            (ii) conduct an evaluation of the clinical
                        and scientific evidence relating to the
                        clinical benefits and risks of a technology
                        affected by such NCD; and
                            (iii) determine if the NCD will limit the
                        access of Medicare beneficiaries to medically
                        necessary care.
                    (B) Membership.--The subcommittee under
                subparagraph (A) shall have 15 members, each of whom--
                            (i) shall be a clinical expert in the
                        medical specialty or specialties that are most
                        relevant to the topic of the NCD; and
                            (ii) to the extent feasible, shall have
                        expertise in the development of clinical
                        practice guidelines.
                    (C) Outside experts allowed.--MEDCAC may include
                individuals who are not members of MEDCAC in the
                membership of the subcommittee convened under
                subparagraph (A).
            (3) Subcommittee comment.--
                    (A) In general.--Not later than the last day of the
                period under paragraph (1), the subcommittee convened
                under paragraph (3)(A) shall submit to the
                Administrator a public comment on the NCD that contains
                an evaluation of whether--
                            (i) the NCD is appropriate based on the
                        subcommittee's activities under paragraph
                        (2)(A);
                            (ii) the NCD is consistent with clinical
                        guidelines;
                            (iii) the NCD would adversely impact the
                        access of subpopulations to items or services
                        which may benefit such subpopulations; or
                            (iv) the NCD would adversely impact access
                        to treatment options that are primarily
                        selected by patients, with their physicians,
                        based on patient preference and quality of life
                        criteria.
                    (B) Ncds that prevent access to care.--If MEDCAC
                determines that the proposed NCD could prevent Medicare
                patients from receiving medically necessary care, the
                MEDCAC panel shall include in such public comment a
                recommendation that the proposed NCD not be issued as a
                final NCD.
    (c) Restriction on Additional Limitation on Coverage.--The
Administrator may not issue a final NCD that contains any restrictions
on the coverage of products and services that were not included in the
proposed NCD reviewed under subsection (b).
    (d) Construction.--Nothing in this Act shall be construed as
preventing a Medicare beneficiary from using private funds to purchase
supplemental health insurance coverage or to directly purchase
medically necessary care.

SEC. 5. DEFINITIONS.

    For purposes of this Act:
            (1) Administrator.--The term ``Administrator'' means the
        Administrator of CMS.
            (2) CMS.--The term ``CMS'' means the Centers for Medicare &
        Medicaid Services.
            (3) MEDCAC.--The term ``MEDCAC'' means the Medicare
        Evidence Development & Coverage Advisory Committee established
        by the Secretary of Health and Human Services pursuant to
        section 222 of the Public Health Service Act.
            (4) Medically necessary services.--The term ``medically
        necessary care'' means health care services or products that a
        prudent physician would provide to a patient for the purpose of
        preventing, diagnosing, treating or rehabilitating an illness,
        injury, disease or its associated symptoms, impairments or
        functional limitations in a manner that is--
                    (A) in accordance with generally accepted standards
                of medical practice;
                    (B) clinically appropriate in terms of type,
                frequency, extent, site and duration; and
                    (C) not primarily for the convenience of the
                patient, physician, or other health care provider.
            (5) MedPAC.--The term ``MedPAC'' means the Medicare Payment
        Advisory Commission established under Section 1805 of the
        Social Security Act.
            (6) National coverage determination.--The term ``national
        coverage determination'' has the meaning given such term in
        section 1869(f)(1)(B) of the Social Security Act.


SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare Telemedicine and Medical
Informatics Demonstration Act of 1996''.

SEC. 2. INFORMATICS, TELEMEDICINE, AND EDUCATION DEMONSTRATION PROJECT.

    (a) Purpose and Authorization.--
            (1) In general.--Under section 1142 of the Social Security
        Act and consistent with this section, the Secretary of Health
        and Human Services, through the Agency for Health Care Policy
        and Research, shall make a grant to an eligible grantee to
        provide for a project to demonstrate the application of high-
        capacity computing and advanced networks to the provision of
        health care to both residents of medically underserved rural
        areas and residents of medically underserved inner-city areas.
            (2) Focus.--The project shall focus on--
                    (A) improvements in primary care (and prevention of
                complications) for those residents with diabetes
                (mellitus), and
                    (B) those residents who are Medicare beneficiaries.
            (3) Duration of project.--The project shall be conducted
        over a 4-year period.
            (4) Authorization of appropriations; medicare and medicaid
        waiver authority.--The total amount of Federal expenditures
        that may be provided pursuant to this section under the project
        shall not exceed $30,000,000. Subject to such limitation, the
        Secretary may waive such provisions of title XVIII and XIX of
        the Social Security Act as may be appropriate in order to
        permit and demonstrate the provision of Medicare and Medicaid
        funding under the project.
    (b) Objectives of Project.--The objectives of the project include
the following:
            (1) Improving patient access to and compliance with
        appropriate care guidelines for chronic diseases through direct
        telecommunications link with information networks in order to
        improve patient quality-of-life and reduce overall health care
        costs.
            (2) Developing a curriculum to train, and providing
        standards for credentialing and licensure of, health
        professionals (particularly primary care health professionals)
        in the use of medical informatics and telecommunciations.
            (3) Demonstrating the application of advanced technologies,
        such as video-conferencing from a patient's home, remote
        monitoring of a patient's medical condition, interventional
        informatics, and applying individualized, automated care
        guidelines, to assist primary care providers in assisting
        patients with chronic illnesses in a home setting.
            (4) Application of medical informatics to residents with
        limited English language skills.
            (5) Developing standards in the application of telemedicine
        and medical informatics.
            (6) Developing a model for the cost-effective delivery of
        primary and related care both in a managed care environment and
        in a fee-for-service environment.
    (c) Eligible Grantee.--For purposes of this section, the term
``eligible grantee'' means a consortium that includes at least one
tertiary care hospital, at least one medical school, and at least one
regional telecommunications provider and that meets the following
requirements:
            (1) The consortium is located in an area with a high
        concentration of medical schools and tertiary care facilities
        and has appropriate arrangements (within or outside the
        consortium) with such schools and facilities, universities, and
        telecommunications providers, in order to conduct the project.
            (2) The consortium submits to the Secretary an application
        at such time, in such manner, and containing such information
        as the Secretary may require, including a description of the
        use to which the consortium would apply any amounts received
        under the project and the source and amount of non-Federal
        contribution towards the project.
            (3) The consortium demonstrates that it will provide for a
        contribution toward the project from non-Federal funds or
        resources in an amount that is not less than 50 percent of the
        total amount to be expended in carrying out the project.
    (d) Use of Funds.--
            (1) In general.--Federal payments made available to an
        eligible grantee under this section shall be used for the
        development and operation of telemedicine and medical
        informatics systems and related activities under the project.
            (2) Specific uses permitted.--Such payments may be used for
        any of the following:
                    (A) The acquisition of telemedicine equipment for
                use in patients' homes (but only in the case of
                patients located in medically underserved areas).
                    (B) Curriculum development and training of health
                professionals in medical informatics and telemedicine.
                    (C) Payment of telecommunications costs (including
                salaries and maintenance of equipment), including costs
                of telecommunications between patients' homes and the
                eligible grantee and between the grantee and other
                entities under the arrangements described in subsection
                (c)(1).
                    (D) Payments to practitioners and providers under
                the Medicare and Medicaid programs.
            (3) Prohibited uses.--Such payments may not be used for any
        of the following:
                    (A) The purchase or installation of transmission
                equipment (other than such equipment used by health
                professionals to deliver medical informatics services
                under the project).
                    (B) The establishment or operation of a
                telecommunications common carrier network.
                    (C) Construction (except for minor renovations
                related to the installation of reimbursable equipment)
                or the acquisition or building of real property.
    (e) Reports.--The Secretary shall submit to the Committees on Ways
and Means and Commerce of the House of Representatives and the
Committees on Finance and Labor and Human Resources of the Senate
interim reports on the project and a final report on the project within
6 months after the conclusion of the project. The final report shall
include an evaluation of the impact of the use of telemedicine and
medical informatics on improving access of medicare and medicaid
beneficiaries to health care services, on reducing the costs of such
services, and on improving the quality of life of such beneficiaries.
    (f) Definitions.--For purposes of this section:
            (1) Interventional informatics.--The term ``interventional
        informatics'' means using information technology and virtual
        reality technology to intervene in patient care.
            (2) Medical informatics.--The term ``medical informatics''
        means the storage, retrieval, and use of biomedical and related
        information for problem solving and decision-making through
        computing and communications technologies.
            (3) Project.--The term ``project'' means the demonstration
        project under this section.
            (4) Secretary.--The term ``Secretary'' means the Secretary
        of Health and Human Services.


SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Mercury Health Advisory Act of
2003''.

SEC. 2. FINDINGS AND PURPOSES.

    (a) Findings.--Congress makes the following findings:
            (1) Mercury is a persistent, bioaccumulative heavy metal
        that poses a significant risk to human health, wildlife, and
        the environment.
            (2) Mercury discharges into the atmosphere and surface
        oceans have increased two-to-five fold since the beginning of
        the industrialized period due to human activities.
            (3) Substantial evidence is accumulating that exposure to
        methyl-mercury is widespread in the general public and
        occurring at higher than health-based levels of concern
        according to the Food and Drug Administration, the
        Environmental Protection Agency, and the World Health
        Organization. Fish and seafood caught or sold in the United
        States are contaminated with methyl-mercury, a toxic element
        that may cause neurological damage and other health-related
        problems as a result of fish or seafood consumption.
            (4) According to the 1997 Environmental Protection Agency
        Mercury Report to Congress, mercury levels in the following
        fish, at least occasionally, exceeded the Food and Drug
        Administration's ``action level'' limit of 1 part per million:
        tilefish, king mackerel, shark, swordfish, tuna, lobster, red
        snapper, saltwater and freshwater bass, bluefish, bluegills,
        catfish, crappie, groupers, hake, halibut, northern pike,
        walleye, largemouth bass, pompano, snook, sunfish, and other
        finfish.
            (5) The Food and Drug Administration advises pregnant women
        and women of childbearing age not to eat shark, king mackerel,
        tilefish, and swordfish and to limit consumption of all other
        fish to 12 ounces per week. The Food and Drug Administration
        advises other persons to limit their consumption of shark and
        swordfish to no more than 7 ounces per week.
            (6) The Environmental Protection Agency recommends that
        women who are pregnant or who may become pregnant, nursing
        mothers, and young children limit fish consumption to 6 meals
        per week of cooked fish or an 8-ounce meal per week for
        uncooked fish for adults and 2 meals per week of cooked fish or
        a 3-ounce meal per week of uncooked fish for young children.
            (7) In 2003, 44 States issued health advisories that warned
        the public about consuming mercury-tainted fish, as compared to
        27 States that issued such advisories in 1993.
            (8) Eleven States warn pregnant women and young children to
        limit consumption of canned tuna, the most consumed fish in the
        United States, to 1 or 2 cans per week and some States warn
        that the ``white'' albacore canned tuna has significantly
        higher mercury levels than the ``light'' tuna, based upon Food
        and Drug Administration testing.
            (9) Data from the National Health and Nutrition Examination
        Survey Centers indicates that 7.8 percent of women of
        childbearing age have blood mercury levels in their bodies
        above what is considered safe for the developing fetus,
        translating into over 300,000 babies born each year in the
        United States at risk of mercury poisoning.
            (10) Between 30 percent and 50 percent of women of
        childbearing age are not aware of the methyl-mercury exposure
        risks from ingestion of mercury-contaminated fish, according to
        the Food and Drug Administration.
            (11) A January 2001 report by the United States General
        Accounting Office (GAO) criticized the Food and Drug
        Administration for not providing guidance to the fishing
        industry to identify and prevent fish contaminated with mercury
        from reaching consumers, even though the Agency's own
testing found that, for example, over half of the swordfish exceeded
its action level of one part per million (ppm).
            (12) Evidence is continuing to emerge linking increased
        risk of coronary heart disease to mercury exposure, as
        presented in at least 2 peer reviewed studies.
            (13) Health advisory information on mercury-contaminated
        fish, which is necessary to protect public health, is not
        widely known by the State or Federal Government. This lack of
        awareness potentially threatens tens of millions of Americans
        who may unknowingly ingest harmful amounts of mercury because
        they are not aware of exposure risks from consumption of
        freshwater fish and seafood.
    (b) Purposes.--The purposes of this Act are to--
            (1) ensure that the public is adequately informed about the
        potential adverse effects of mercury exposure through the
        consumption of fish products;
            (2) require the Secretary of Health and Human Services to
        work cooperatively with other Federal and State agencies, as
        well as nonprofit organizations, to create appropriate
        advisories for the distribution to the public of explanations
        of the potential adverse effects of mercury exposure from fish
        consumption;
            (3) require the Administrator of the Environmental
        Protection Agency to work cooperatively with State fish and
        game officials to create an informative guide for distribution
        to the public about the dangers of the consumption of
        recreationally-caught fish;
            (4) require the Food and Drug Administration to resume its
        seafood methyl-mercury monitoring program to better document
        mercury levels in various fish species sold in commerce;
            (5) require the Secretary of Health and Human Services, in
        cooperation with private and public organizations, to design
        and implement a National Public Education Program regarding the
        presence of methyl-mercury in seafood and fish consumption
        advisories for methyl-mercury; and
            (6) require the Administrator of the Environmental
        Protection Agency to annually prepare a report on the impacts
        of mercury on human health and the environment.

SEC. 3. DEFINITIONS.

    In this Act:
            (1) Administrator.--The term ``Administrator'' means the
        Administrator of the Environmental Protection Agency.
            (2) Commissioner.--The term ``Commissioner'' means the
        Commissioner of Food and Drugs.
            (3) Health professional.--The term ``health professional''
        means any licensed professional in the dental and medical
        profession.
            (4) Secretary.--The term ``Secretary'' means the Secretary
        of Health and Human Services.

SEC. 4. ADVISORY NOTICES.

    (a) Consumer Mercury Advisory Notice.--
            (1) In general.--The Administrator and the Commissioner
        shall jointly develop fish consumption advisories for methyl-
        mercury in fish. Such advisories shall be based on the
        Environmental Protection Agency's Reference Dose for--
                    (A) the general population;
                    (B) sensitive populations; and
                    (C) populations consuming above average amounts of
                fish.
            (2) Consumer's notice.--The Secretary, in consultation with
        the Administrator and the heads of State environmental agencies
        and health departments, shall prepare a consumer's mercury
        advisory notice. Such notice shall be distributed widely by the
        Secretary, at no cost, to health professionals, particularly
        medical offices that provide gynecological, obstetrical, or
        pediatric care, and to the extent practicable shall be made
        available and posted in the patient or client areas of all
        maternal and child health and nutrition program offices, and
        shall be made available to health care providers, Federal,
        State, and local government agencies, and the general public
        upon request.
            (3) Criteria.--The advisories developed under this
        subsection shall--
                    (A) explain, in an easily understandable manner,
                the dangers of mercury exposure through the consumption
                of mercury contaminated fish to women of childbearing
                age, women who expect to become pregnant, women who are
                pregnant or breast feeding their children, and young
                children and their parents;
                    (B) describe, in an easily understandable manner,
                in detail the most current mercury health advisories
                prepared by the Federal Government concerning fish
                consumption, contain the toll free number established
                under paragraph (4), and contain such other information
                as the Secretary determines appropriate; and
                    (C) be printed in large type in English, Spanish,
                and other languages determined by the Secretary to be
                culturally and linguistically appropriate.
            (4) Toll-free telephone number.--The Secretary shall
        establish a toll-free telephone number to enable individuals to
        obtain additional information about the health advisories
        developed under this subsection concerning exposure to mercury
        from consumption of fish and seafood, as well as exposure from
        other sources.
            (5) Updating of information.--The information provided
        under this subsection shall be updated periodically as
        determined necessary by the Secretary.
    (b) Mercury Warning Consumer's Guide.--
            (1) In general.--The Administrator, in consultation with
        the Secretary, shall prepare a consumer's guide to mercury and
        health advisory for the consumption of recreationally-caught
        fish. Such guide shall be distributed, at no cost, to--
                    (A) State departments of fisheries, wildlife, and
                environmental law enforcement;
                    (B) all applicants for a fishing license at the
                time the license is issued; and
                    (C) to public upon request.
            (2) Criteria.--The guide developed under paragraph (1)
        shall--
                    (A) be printed in large type in English, Spanish,
                and other languages determined by the Secretary to be
                culturally and linguistically appropriate;
                    (B) contain the toll free telephone number
                established by the Environmental Protection Agency that
                residents may call for further information about the
                health advisories contained in the guide.
            (3) Updating of information.--The guide developed under
        paragraph (1) shall be updated periodically as determined
        necessary by the Secretary.
    (c) Consumption Advisory.--
            (1) In general.--The Secretary, in consultation with the
        Secretary of Agriculture and the Administrator, shall work with
        the States and other appropriate entities to--
                    (A) develop and distribute regional and national
                advisories concerning the presence of methyl-mercury in
                seafood;
                    (B) develop standardized formats for written and
                broadcast advisories regarding methyl-mercury in
                seafood;
                    (C) develop and periodically upgrade information
                related to mercury fish tissue test results and fish
                consumption advisories for methyl-mercury;
                    (D) coordinate State and local advisories in the
                formation of the National Public Education Program
                under subsection (d)(1); and
                    (E) coordinate with that sector of the retail food
                industry that is engaged in the sale of any fresh,
                packaged, or frozen fish or seafood products intended
                for human consumption, concerning the posting of such
                advisories in their place of business where fish are
                sold to inform women of childbearing age, pregnant, and
                nursing women and the parents of young children on the
                potential dangers of mercury that is present in certain
                fish or seafood.
            (2) Criteria.--The advisories and notices developed under
        paragraph (1) shall include information both on limiting the
        consumption of certain high level fish and seafood to the
        general population and, for sensitive populations such as women
        of childbearing age and children, stress the importance of
        limiting consumption of frequently consumed fish that may
        exceed the Environmental Protection Agency's Reference Dose.
            (3) Consumption advisory.--
                    (A) In general.--Based on information compiled by
                the Environmental Protection Agency, the National
                Marine Fisheries Services, and the Food and Drug
                Administration, shall work with State health, fish and
                wildlife, and environmental agencies to develop and
                periodically update a consumption advisory for any
                fresh, packaged, or frozen fish or seafood products
                intended for human consumption for posting by retail
                food establishments and restaurants pursuant to this
                Act. The advisory shall provide information about the
                potential dangers from the ingestion of mercury from
                the consumption of fish and seafood by women of
                childbearing age, pregnant women, and young children
                and other at-risk groups as determined by the
                Department, including populations consuming above-
                average quantities of fish and seafood.
                    (B) Distribution.--The Secretary shall make copies
                of the advisory developed under subparagraph (A)
                available to State boards of health or other State and
                local governmental entities that have the same
                authority as a State board of health for distribution
                to the public and to local retail food establishments
                and restaurants.
            (4) Requirements.--The advisories and notices developed
        under this subsection shall be printed in large type in
        English, Spanish, and other languages determined by the
        Secretary to be culturally and linguistically appropriate.
    (d) Public Education and Advisory System.--
            (1) Public education.--The Secretary, in consultation with
        public and nonprofit private entities (including cooperative
        extension services and appropriate State entities), shall
        design and implement a national public education program
        regarding the presence of methyl-mercury in seafood.
            (2) Features.--The program developed under paragraph (1)
        shall provide--
                    (A) information to the public regarding--
                            (i) Federal standards and good practice
                        requirements relating to methyl-mercury in
                        seafood; and
                            (ii) the promotion of public awareness,
                        understanding, and acceptance of such standards
                        and requirements;
                    (B) information to health professionals so that
                health professionals may improve the diagnosis and
                treatment of mercury-related illness and advise
                individuals whose health conditions place those
                individuals at particular risk; and
                    (C) such other information or advice to consumers
                and other individuals as the Secretary determines will
                promote the purposes of this section.
    (e) Sampling and Monitoring.--
            (1) In general.--The Commissioner shall resume the seafood
        methyl-mercury monitoring sampling program of the Food and Drug
        Administration to assist in documenting mercury levels in
        various fish species.
            (2) Monitoring.--The sampling program described in
        paragraph (1) shall be conducted so as to provide statistically
        valid monitoring data with respect to mercury levels in fish
        and seafood (including market-basket studies) including
        documenting the extent to which fish with mercury levels in
        excess of the action level are sold in commerce. Such
        information, along with information gathered by the
        Environmental Protection Agency, shall be compiled into an
        annual report by the Commissioner to track changes in dietary
        exposure to mercury from fish and seafood.
            (3) Avoidance of duplication of effort.--To the extent
        practicable, the sampling program described in paragraph (1)
        shall be consistent with, and shall be coordinated with, other
        seafood sampling programs that are in use, so as to avoid
        duplication of effort.

SEC. 5. HAACP ASSESSMENT.

    Not later than 1 year after the date of enactment of this Act, the
Secretary shall finalize the Hazard Analysis and Critical Control Point
assessment to determine whether or not methyl-mercury exposure through
fish consumption is a public health hazard.

SEC. 6. AUTHORIZATION OF APPROPRIATIONS.

    (a) Public Education and Advisory System.--There is authorized to
be appropriated to develop and implement the public education and
advisory system under section 3(d), $500,000 for each fiscal year.
    (b) Sampling.--There is authorized to be appropriated to carry out
sampling under section 3(e), $1,000,000 for each fiscal year.
    (c) State Support.--
            (1) In general.--There is authorized to be appropriated to
        support the efforts of States to sample noncommercial fish and
        inland waterways for mercury and to produce State-specific
        health advisories related to mercury, $2,000,000 for each
        fiscal year.
            (2) Equitable distribution.--The Administrator shall
        distribute amounts made available under paragraph (1) equitably
        among the States through programs in existence on the date of
        enactment of this Act.


SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Metro Accountability and Investment
Act''.

SEC. 2. REAUTHORIZATION OF FUNDS.

    Section 601(f) of the Passenger Rail Investment and Improvement Act
of 2008 (Public Law 110-432; 122 Stat. 4970) is amended to read as
follows:
    ``(f) Amount.--
            ``(1) In general.--
                    ``(A) Original funding.--There are authorized to be
                appropriated to the Secretary of Transportation for
                grants under this section an aggregate amount not to
                exceed $1,500,000,000 to be available in increments
                over 10 fiscal years beginning in fiscal year 2009, or
                until expended.
                    ``(B) Continuation of funding.--Subject to
                paragraphs (2) and (3), there are authorized to be
                appropriated to the Secretary of Transportation for
                grants under this section $2,000,000,000 to be
                available in increments over 10 fiscal years beginning
                in fiscal year 2020, or until expended.
            ``(2) Restriction on use.--
                    ``(A) Operating expenses.--$500,000,000 of the
                amount described in paragraph (1)(B) may only be used
                for operating expenses of the Transit Authority.
                    ``(B) Inspector general.--$100,000,000 of the
                amount described in subparagraph (A) may only be used
                for the Office of Inspector General of the Transit
                Authority.
            ``(3) Required modifications.--The Secretary may not
        provide grants pursuant to paragraph (1)(B) unless the
        Secretary certifies that the Board of Directors of the Transit
        Authority has passed a resolution, and is making progress
        implementing such a resolution, that--
                    ``(A) establishes an independent budget authority
                for the Office of Inspector General of the Transit
                Authority;
                    ``(B) establishes an independent procurement
                authority for the Office of Inspector General of the
                Transit Authority;
                    ``(C) establishes an independent hiring authority
                for the Office of Inspector General of the Transit
                Authority;
                    ``(D) ensures the inspector general of the Transit
                Authority can obtain legal advice from a counsel
                reporting directly to the director of such office;
                    ``(E) requires the inspector general of the Transit
                Authority to submit recommendations for corrective
                action to the General Manager, the Board of Directors
                of the Transit Authority, and the appropriate
                congressional committees; and
                    ``(F) requires the inspector general of the Transit
                Authority to publish any recommendation described in
                subparagraph (E) on the website of the Office of
                Inspector General of the Transit Authority, except that
                the Inspector General may redact personally
                identifiable information and information that, in the
                determination of the Inspector General, would pose a
                security risk to the systems of the Transit Authority.
            ``(4) Special rule for certain funds.--The amounts
        described in paragraph (2) are not subject to the requirements
        of paragraphs (2) and (3) of subsection (b).
            ``(5) Definition.--In this subsection, the term
        `appropriate congressional committees' means the Committee on
        Transportation and Infrastructure, the Committee on Oversight
        and Government Reform, and the Committee on Appropriations of
        the House of Representatives and the Committee on Banking,
        Housing, and Urban Affairs and the Committee on Appropriations
        of the Senate.''.

SEC. 3. ADDITIONAL GRANTS.

    (a) In General.--In addition to other funding provided to the
Transit Authority pursuant to any other provision of law, the Secretary
of Transportation may make grants to the Transit Authority for the
purpose of funding the capital and preventive maintenance projects
included in the Capital Improvement Program approved by the Board of
Directors of the Transit Authority.
    (b) Use of Funds.--A grant made pursuant to this section shall be
subject to the following limitations and conditions:
            (1) The work for which such grant is authorized shall be
        subject to the provisions of the Compact, including any future
        amendments to the Compact.
            (2) Each such grant shall be for 50 percent of the net
        project cost of the project involved, and shall be provided in
        cash from sources other than Federal funds or revenues from the
        operation of public mass transportation systems. Consistent
        with the terms of the amendment to the Compact, or any future
        amendments to such Compact, any funds so provided shall be
        solely from undistributed cash surpluses, replacement or
        depreciation funds of reserves available in cash, or new
        capital.
    (c) Applicability of Requirements for Mass Transportation Capital
Projects Receiving Funds Under Federal Transportation Law.--Except as
specifically provided in this section, the use of any amounts
appropriated pursuant to the authorization under this section shall be
subject to the requirements applicable to capital projects for which
funds are provided under chapter 53 of title 49, United States Code,
except to the extent the Secretary determines that the requirements are
inconsistent with this Act, its purposes, or any subsequent rules of
guidance issued pursuant to this Act.
    (d) Amount and Requirement for First Period.--
            (1) Amount.--There is authorized to be appropriated to the
        Secretary of Transportation for grants under this section
        $500,000,000 to be available in increments over 5 fiscal years
        beginning in fiscal year 2020, or until expended.
            (2) Requirements.--The Secretary may not award a grant
        authorized under this subsection unless the Secretary
        certifies, on an annual basis, that the Transit Authority is
        making progress toward goals and metrics for system performance
        established by the Secretary in collaboration with the
        signatories to the Compact on safety, reliability, and
        operation costs as measured by vehicle revenue hours.
    (e) Amount and Requirement for Second Period.--
            (1) Amount.--There is authorized to be appropriated to the
        Secretary of Transportation for grants under this section
        $1,500,000,000 to be available in increments over 15 fiscal
        years beginning in fiscal year 2025, or until expended.
            (2) Requirements.--The Secretary may not award a grant
        authorized under this subsection unless the Secretary
        certifies, on an annual basis, that--
                    (A) the Transit Authority is making progress toward
                goals and metrics for system performance established by
                the Secretary in collaboration with the signatories to
                the Compact on safety, reliability, and operation costs
                as measured by vehicle revenue hours; and
                    (B) the signatories to the Compact have established
                a dedicated funding source for capital projects for the
                Transit Authority that is expected to raise, in total,
                at least $300,000,000 annually.
    (f) Availability.--Amounts appropriated pursuant to the
authorization under this section shall remain available until expended.
    (g) Definitions.--In this section--
            (1) the term ``Transit Authority'' means the Washington
        Metropolitan Area Transit Authority established under Article
        III of the Compact; and
            (2) the term ``Compact'' means the Washington Metropolitan
        Area Transit Authority Compact (Public Law 89-774; 80 Stat.
        1324).


SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Michelle's Law''.

SEC. 2. COVERAGE OF DEPENDENT STUDENTS ON MEDICALLY NECESSARY LEAVE OF
              ABSENCE.

    (a) Amendments of ERISA.--Subpart A of part 7 of title I of the
Employee Retirement Income Security Act of 1974 (29 U.S.C. 1181 et
seq.) is amended by adding at the end the following:

``SEC. 704. COVERAGE OF DEPENDENT STUDENTS ON MEDICALLY NECESSARY LEAVE
              OF ABSENCE.

    ``(a) Medically Necessary Leave of Absence.--In this section, the
term `medically necessary leave of absence' means a leave of absence
from a postsecondary educational institution (including an institution
of higher education as defined in section 102 of the Higher Education
Act of 1965) that--
            ``(1) is due to a severe illness or injury, as certified by
        the attending physician of the dependent child involved; and
            ``(2) causes the dependent child involved to lose full-time
        student status.
    ``(b) Requirement To Continue Coverage.--
            ``(1) In general.--In the case of a dependent child
        described under paragraph (2), a group health plan (or health
        insurance coverage offered in connection with such a plan)
        shall not terminate coverage of such child due to a medically
        necessary leave of absence before the date that is the earlier
        of--
                    ``(A) the date that is 1 year after the first day
                of the medically necessary leave of absence; or
                    ``(B) the date on which such coverage would
                otherwise terminate under the terms of the plan.
            ``(2) Child described.--A dependent child described in this
        paragraph is a child who--
                    ``(A) is a dependent of a participant or
                beneficiary of the plan or coverage;
                    ``(B) is 18 years of age or older;
                    ``(C) was enrolled in the plan or coverage as of
                the first day of the medically necessary leave of
                absence involved; and
                    ``(D) was enrolled as a full-time student at a
                postsecondary educational institution (as described in
                subsection (a)) until the first day of the medically
                necessary leave of absence involved.
            ``(3) Certification by physician.--Paragraph (1) shall not
        apply to a group health plan (or health insurance coverage
        offered in connection with such a plan) unless the dependent
        child submits to the plan or issuer and the postsecondary
        educational institution involved, documentation and
        certification by the child's attending physician stating that
        the leave of absence involved is a medically necessary leave of
        absence.
    ``(c) No Loss of Full-Time Status Due to Break in Semester.--Any
breaks in the school semester shall not disqualify a dependent child
described under subsection (b) from coverage under this section.
    ``(d) No Additional Coverage.--A dependent child described under
subsection (b) shall be entitled to an extension under this section of
only those benefits to which the child was entitled under the terms of
the plan or coverage as of the first day of the medically necessary
leave of absence involved.
    ``(e) Coverage Under Successor Plan.--If an employer or health
insurance issuer changes group health plans after the first day of a
medically necessary leave of absence of dependent child described in
subsection (b) but before the date described under subsection (b)(1),
and such new group health plan offers coverage of dependent children,
such new group health plan shall be subject to this section in the same
manner as the group health plan coverage in effect on the first day of
the medically necessary leave of absence of such dependent child.
    ``(f) Presumption.--For purposes of administrative or judicial
proceedings, there shall be a rebuttable presumption that the
documentation and certification under subsection (b)(3) entitles the
dependent child involved to coverage as described under this
section.''.
    (b) Amendments to the Internal Revenue Code.--Subchapter B of
chapter 100 of the Internal Revenue Code of 1986 (26 U.S.C. 9811 et
seq.) is amended--
            (1) in the table of sections, by inserting after the item
        relating to section 9812 the following new item:

``Sec. 9813. Coverage of dependent students on medically necessary
                            leave of absence.'';
    and
            (2) by inserting after section 9813 the following:

``SEC. 9813. COVERAGE OF DEPENDENT STUDENTS ON MEDICALLY NECESSARY
              LEAVE OF ABSENCE.

    ``(a) Medically Necessary Leave of Absence.--The term `medically
necessary leave of absence' means a leave of absence from a
postsecondary educational institution (including an institution of
higher education as defined in section 102 of the Higher Education Act
of 1965) that--
            ``(1) is due to a severe illness or injury, as certified by
        the attending physician of the dependent child involved; and
            ``(2) causes the dependent child involved to lose full-time
        student status.
    ``(b) Requirement To Continue Coverage.--
            ``(1) In general.--In the case of a dependent child
        described under paragraph (2), a group health plan (or health
        insurance coverage offered in connection with such a plan)
        shall not terminate coverage of such child due to a medically
        necessary leave of absence before the date that is the earlier
        of--
                    ``(A) the date that is 1 year after the first day
                of the medically necessary leave of absence; or
                    ``(B) the date on which such coverage would
                otherwise terminate under the terms of the plan.
            ``(2) Child described.--A dependent child described in this
        paragraph is a child who--
                    ``(A) is a dependent of a participant or
                beneficiary of the plan or coverage;
                    ``(B) is 18 years of age or older;
                    ``(C) was enrolled in the plan or coverage as of
                the first day of the medically necessary leave of
                absence involved; and
                    ``(D) was enrolled as a full-time student at a
                postsecondary educational institution (as described in
                subsection (a)) until the first day of the medically
                necessary leave of absence involved.
            ``(3) Certification by physician.--Paragraph (1) shall not
        apply to a group health plan (or health insurance coverage
        offered in connection with such a plan) unless the dependent
        child submits to the plan or issuer and the postsecondary
        educational institution involved, documentation and
        certification by the child's attending physician stating that
        the leave of absence involved is a medically necessary leave of
        absence.
    ``(c) No Loss of Full-Time Status Due to Break in Semester.--Any
breaks in the school semester shall not disqualify a dependent child
described under subsection (b) from coverage under this section.
    ``(d) No Additional Coverage.--A dependent child described under
subsection (b) shall be entitled to an extension under this section of
only those benefits to which the child was entitled under the terms of
the plan or coverage as of the first day of the medically necessary
leave of absence involved.
    ``(e) Coverage Under Successor Plan.--If an employer or health
insurance issuer changes group health plans after the first day of a
medically necessary leave of absence of dependent child described in
subsection (b) but before the date described under subsection (b)(1),
and such new group health plan offers coverage of dependent children,
such new group health plan shall be subject to this section in the same
manner as the group health plan coverage in effect on the first day of
the medically necessary leave of absence of such dependent child.
    ``(f) Presumption.--For purposes of administrative or judicial
proceedings, there shall be a rebuttable presumption that the
documentation and certification under subsection (b)(3) entitles the
dependent child involved to coverage as described under this
section.''.


SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Microenterprise and Youth
Entrepreneurship Development Act of 2011''.

SEC. 2. MICROENTERPRISE TECHNICAL ASSISTANCE AND CAPACITY BUILDING
              PROGRAM.

    (a) Definitions.--Section 172(5) of the Riegle Community
Development and Regulatory Improvement Act of 1994 (15 U.S.C. 6901(5))
is amended--
            (1) in subparagraph (B) by striking ``or'' at the end;
            (2) in subparagraph (C) by striking the period at the end
        and inserting ``; or''; and
            (3) by adding at the end the following:
                    ``(D) an entrepreneur that operates a business or
                intends to operate a business in an investment area (as
                such term is defined in section 103(16) of this
                Act).''.
    (b) Uses of Assistance.--Section 174 of the Riegle Community
Development and Regulatory Improvement Act of 1994 (15 U.S.C. 6903) is
amended--
            (1) in paragraph (3) by striking ``and'' at the end;
            (2) by redesignating paragraph (4) as paragraph (5); and
            (3) by inserting after paragraph (3) the following:
            ``(4) to advertise in print, electronic, and other media
        the training and technical assistance provided under paragraph
        (1); and''.
    (c) Targeted Assistance.--Section 176(b) of the Riegle Community
Development and Regulatory Improvement Act of 1994 (15 U.S.C. 6905(b))
is amended by striking ``50 percent'' and inserting ``60 percent''.
    (d) Matching Requirements.--Section 177(c) of the Riegle Community
Development and Regulatory Improvement Act of 1994 (15 U.S.C. 6906(c))
is amended by adding at the end the following:
            ``(3) Consideration.--In determining whether to reduce or
        eliminate matching requirements under paragraph (1), the
        Administrator shall consider the impact of the economic crisis
        of 2007 through 2009 on the geographic area in which an
        applicant operates.''.
    (e) Report.--Not later than 180 days after the date of enactment of
this Act, the Administrator of the Small Business Administration shall
submit to the Committee on Small Business of the House of
Representatives and the Committee on Small Business and
Entrepreneurship of the Senate a report describing recommendations for
improving the application and grant making process of the
microenterprise technical assistance and capacity building grant
program (carried out under subtitle C of title I of the Riegle
Community Development and Regulatory Improvement Act of 1994),
including recommendations, developed in consultation with stakeholders,
for streamlining the application and grant making process of that
program.
    (f) Microenterprise Coordinator.--
            (1) Establishment.--Not later than 1 year after the date of
        enactment of this Act, the Administrator shall establish in the
        Small Business Administration the position of Microenterprise
        Coordinator.
            (2) Duties.--The Microenterprise Coordinator shall--
                    (A) work to ensure that the contributions of
                microenterprises to the economy are maximized;
                    (B) work to enhance, support, and coordinate the
                programs of the Federal Government providing assistance
                to microenterprises, including Federal technical
                assistance programs;
                    (C) work to ensure that underserved entrepreneurs
                are included in the programs of the Federal Government
                providing assistance to microenterprises;
                    (D) make available to the public annually a
                comprehensive list and description of each Federal
                program that provides assistance to microenterprises;
                and
                    (E) encourage public-private partnerships that
                support entrepreneurship.
            (3) Microenterprise defined.--In this subsection, the term
        ``microenterprise'' has the meaning given that term in section
        172(10) of the Riegle Community Development and Regulatory
        Improvement Act of 1994 (15 U.S.C. 6901(10)).

SEC. 3. OFFICE OF YOUTH ENTREPRENEURSHIP.

    (a) Establishment.--Not later than 1 year after the date of
enactment of this Act, the Administrator of the Small Business
Administration shall establish an Office of Youth Entrepreneurship (in
this section referred to as the ``Office'') in the Small Business
Administration.
    (b) Director.--The Administrator shall appoint a Director of Youth
Entrepreneurship (in this section referred to as the ``Director'') to
serve as the head of the Office.
    (c) Duties.--The Director shall--
            (1) carry out the youth entrepreneurship technical
        assistance grant program described in subsection (d);
            (2) carry out the youth entrepreneurship curriculum grant
        program described in subsection (e);
            (3) promote the growth of youth entrepreneurship by
        establishing public-private partnerships and carrying out
        advertising campaigns;
            (4) sponsor and support State and national youth
        entrepreneurship competitions that raise awareness of the
        importance of small business development;
            (5) study and promote Federal activities that support
        entrepreneurship education; and
            (6) support the establishment of public and private youth
        entrepreneurship education and mentoring opportunities.
    (d) Youth Entrepreneurship Technical Assistance Grant Program.--The
Director shall establish a program under which the Director may make
grants to assist entities, including nonprofit microenterprise
development organizations, to provide individuals under 25 years of age
with technical assistance related to entrepreneurship.
    (e) Youth Entrepreneurship Curriculum Grant Program.--
            (1) In general.--The Director shall establish a program
        under which the Director may make grants to a covered entity to
        assist the development, improvement, or implementation of a
        youth entrepreneurship curriculum that includes information on
        the topics of--
                    (A) securing capital and borrowing;
                    (B) business plan conception and drafting;
                    (C) accounting;
                    (D) management; and
                    (E) marketing.
            (2) Application process.--To be eligible for a grant
        described in paragraph (1), a covered entity shall submit to
        the Director an application at such time, in such manner, and
        containing such information as the Director may require, except
        that the application shall include at least--
                    (A) a description of the curriculum to be
                developed, improved, or implemented;
                    (B) a description of how grant funds will be used;
                    (C) a description of goals relating to the use of
                grant funds and the curriculum to be developed,
                improved, or implemented; and
                    (D) a description of how progress will be measured
                with respect to the goals described in subparagraph
                (C).
            (3) Covered entity defined.--In this subsection, the term
        ``covered entity'' means a local educational agency in any of
        the several States, the District of Columbia, or a territory or
        possession of the United States and a local educational agency
        of a federally recognized Indian tribe.
    (f) Investment Areas.--
            (1) In general.--The Director shall ensure that at least 25
        percent of the amounts made available to carry out the Office
        each fiscal year are used to assist youth in investment areas.
            (2) Investment area defined.--In this subsection, the term
        ``investment area'' has the meaning given that term in section
        103(16) of the Riegle Community Development and Regulatory
        Improvement Act of 1994 (12 U.S.C. 4702(16)).
    (g) Student Loan Assistance.--Not later than 180 days after the
date of enactment of this Act, the Director, in consultation with the
Secretary of Education, shall submit to Congress a report that includes
detailed recommendations for legislation--
            (1) establishing a program to forgive student loans in a
        manner that assists youth entrepreneurship by making available
        capital for business formation; and
            (2) establishing a program to defer student loan repayments
        in a manner that assists youth entrepreneurship by making
        available capital for business formation.

SEC. 4. GAO STUDY AND REPORT.

    (a) Study.--The Comptroller General of the United States shall
conduct a study on--
            (1) the economic impact of allowing youth entrepreneurs to
        defer student loan repayments to make available capital for
        business formation;
            (2) the economic impact of increasing the participation of
        individuals under 25 years of age in the microloan program of
        the Small Business Administration (carried out under section
        7(m) of the Small Business Act (15 U.S.C. 636(m)),
        notwithstanding the limited collateral and formal business
        experience of such individuals;
            (3) alternative methods for measuring creditworthiness that
        may assist youth entrepreneurship; and
            (4) actions Congress should consider to promote youth
        entrepreneurship.
    (b) Report.--Not later than 180 days after the date of enactment of
this Act, the Comptroller General shall submit to the Committee on
Small Business of the House of Representatives and the Committee on
Small Business and Entrepreneurship of the Senate a report on the
results of the study conducted under subsection (a).


SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Migratory Bird Hunting and
Conservation Stamp Promotion Act of 1998''.

SEC. 2. PROMOTION OF STAMP SALES.

    (a) In General.--Section 4 of the Act of March 16, 1934 (commonly
known as the ``Migratory Bird Hunting and Conservation Stamp Act'') (16
U.S.C. 718d), is amended--
            (1) in subsection (b), by striking ``subsection (c) of this
        section'' and inserting ``subsections (c) and (d)''; and
            (2) by adding at the end the following:
    ``(d) Promotion of Stamp Sales.--
            ``(1) In general.--Subject to approval of an annual
        marketing plan by the Migratory Bird Conservation Commission
        established by section 2 of the Migratory Bird Conservation Act
        (16 U.S.C. 715a), the Secretary of the Interior may use from
        receipts from the sale of migratory bird hunting and
        conservation stamps an amount not to exceed $1,000,000 for each
        of fiscal years 1999 through 2003 for the promotion of
        additional stamp sales.
            ``(2) Annual report.--The Secretary of the Interior shall--
                    ``(A) include in each report under section 3 of the
                Migratory Bird Conservation Act (16 U.S.C. 715b) a
                statement of all expenditures under paragraph (1); and
                    ``(B) provide a copy to the Migratory Bird
                Conservation Commission, the Committee on Environment
                and Public Works of the Senate, and the Committee on
                Resources of the House of Representatives.''.
    (b) Technical Amendments.--
            (1) Short title.--
                    (A) The Act of March 16, 1934 (16 U.S.C. 718 et
                seq.), is amended by adding at the end the following:

``SEC. 11. SHORT TITLE.

    ``This Act may be cited as the `Migratory Bird Hunting and
Conservation Stamp Act'.''.
                    (B) Section 4(d)(2) of the National Wildlife Refuge
                System Administration Act of 1966 (16 U.S.C.
                668dd(d)(2)) is amended in the last sentence by
                striking ``Migratory Bird Hunting Stamp Act'' and
                inserting ``Migratory Bird Hunting and Conservation
                Stamp Act''.
                    (C) Section 102 of the Sikes Act (16 U.S.C. 670b)
                is amended by striking ``Migratory Bird Hunting Stamp
                Act as amended'' and inserting ``Migratory Bird Hunting
                and Conservation Stamp Act (16 U.S.C. 718 et seq.)''.
                    (D) Section 203(b)(4)(A) of the Sikes Act (16
                U.S.C. 670i(b)(4)(A)) is amended by striking ``Act of
                March 16, 1934, commonly referred to as the Migratory
                Bird Hunting Stamp Act'' and inserting ``Migratory Bird
                Hunting and Conservation Stamp Act''.
                    (E) Section 2 of Public Law 87-383 (16 U.S.C. 715k-
                4) is amended by striking ``Migratory Bird Hunting
                Stamp Act of March 16, 1934, as amended'' and inserting
                ``Migratory Bird Hunting and Conservation Stamp Act''.
                    (F) Section 201 of the Emergency Wetlands Resources
                Act of 1986 (16 U.S.C. 3911) is amended--
                            (i) in subsection (b)(1)(A), by striking
                        ``Act of March 16, 1934 (16 U.S.C. 718b)
                        (commonly known as the Duck Stamp Act)'' and
                        inserting ``Migratory Bird Hunting and
                        Conservation Stamp Act (16 U.S.C. 718b)''; and
                            (ii) in subsection (c)(B), by striking
                        ``Act of March 16, 1934'' and inserting
                        ``Migratory Bird Hunting and Conservation Stamp
                        Act''.
                    (G) Section 203 of the Emergency Wetlands Resources
                Act of 1986 (16 U.S.C. 3912) is amended by striking
                ``Act of March 16, 1934'' and inserting ``Migratory
                Bird Hunting and Conservation Stamp Act''.
                    (H) Clause (ii) of section 504(1) of title 18,
                United States Code, is amended by striking ``Migratory
                Bird Hunting Stamp Act of 1934'' and inserting
                ``Migratory Bird Hunting and Conservation Stamp Act (16
                U.S.C. 718 et seq.)''.
                    (I) Section 28(f) of the Act of August 13, 1954 (25
                U.S.C. 564w-1(f) is amended--
                            (i) in the second sentence, by striking
                        ``Migratory Bird Hunting Stamp Act of March 16,
                        1934, as amended (16 U.S.C. 718)'' and
                        inserting ``Migratory Bird Hunting and
                        Conservation Stamp Act (16 U.S.C. 718 et
                        seq.)''; and
                            (ii) in the third sentence, by striking
                        ``section 4 of the Act of March 16, 1934 (48
                        Stat. 451), as amended or supplemented'' and
                        inserting ``section 4 of the Migratory Bird
                        Hunting and Conservation Stamp Act (16 U.S.C.
                        718d)''.
            (2) Migratory bird hunting and conservation stamp.--
                    (A) The first section and section 10 of the Act of
                March 16, 1934 (16 U.S.C. 718a, 718j), are amended by
                striking ``migratory-bird hunting and conservation
                stamp'' each place it appears and inserting ``migratory
                bird hunting and conservation stamp''.
                    (B) Section 2(a) of the Act of March 16, 1934 (16
                U.S.C. 718b(a)), is amended in the fifth sentence by
                striking ``migratory-bird hunting stamps'' and
                inserting ``migratory bird hunting and conservation
                stamps''.
                    (C) Sections 4(a) and 5(c) of the Act of March 16,
                1934 (16 U.S.C. 718d(a), 718e(c)), are amended by
                striking ``migratory bird hunting stamps'' each place
                it appears and inserting ``migratory bird hunting and
                conservation stamps''.
                    (D) Section 5(a) of the Act of March 16, 1934 (16
                U.S.C. 718e(a)), is amended by striking ``migratory-
                bird hunting stamp'' and inserting ``migratory bird
                hunting and conservation stamp''.
                    (E) Section 2(4) of the Act of September 28, 1962
                (16 U.S.C. 460k-1(4)), is amended by striking
                ``migratory bird hunting stamps'' and inserting
                ``migratory bird hunting and conservation stamps''.
                    (F) Section 203(b)(4)(A) of the Sikes Act (16
                U.S.C. 670i(b)(4)(A)) is amended by striking
                ``migratory bird hunting stamp'' and inserting
                ``migratory bird hunting and conservation stamp''.
                    (G) Section 3(a) of the Act of July 30, 1956 (16
                U.S.C. 718b-1), is amended by striking ``migratory-bird
                hunting stamps'' and inserting ``migratory bird hunting
                and conservation stamps''.


SECTION 1. FINDINGS.

    Congress finds that--
            (1) the Cape Fox Corporation (referred to in this Act as
        ``Cape Fox'') is a Village Corporation for the Native Village
        of Saxman, Alaska, organized pursuant to the Alaska Native
        Claims Settlement Act (43 U.S.C. 1601 et seq.);
            (2) similar to other Village Corporations in southeast
        Alaska, under section 16 of that Act (43 U.S.C. 1615), Cape Fox
        could select only 23,040 acres from land withdrawn for the
        purpose of that selection;
            (3) under section 22(l) of that Act (43 U.S.C. 1621(l))--
                    (A) the Village Corporations in southeast Alaska,
                other than Cape Fox, were restricted with respect to
                the selection of land within 2 miles of a home rule
                city (as that term is used in that Act); and
                    (B) to protect the watersheds in the vicinity, Cape
                Fox was restricted with respect to the selection of
                land within 6 miles of the boundary of the home rule
                city of Ketchikan, Alaska;
            (4) the 6-mile restriction described in paragraph (3)(B)
        precluded Cape Fox from selecting valuable timber land,
        industrial sites, and other commercial property located--
                    (A) within the townships in which the Native
                Village of Saxman is located, more particularly
                described as T.75 S., T.76 S., R.91 E., Copper River
                Meridian; and
                    (B) on surrounding land that is far removed from
                Ketchikan, Alaska, and its watersheds;
            (5) as a result of that 6-mile restriction, only the
        remote, mountainous, northeast corner of the property described
        in paragraph (4)(A), which is nonproductive and has no known
        economic value, was available for selection by Cape Fox, as
        required under section 16(b) of the Alaska Native Claims
        Settlement Act (43 U.S.C. 1615(b));
            (6) land selections by Cape Fox under that Act were further
        limited by the fact that--
                    (A) the Annette Island Indian Reservation is
                located within the applicable selection area; and
                    (B) land of that reservation is unavailable for
                selection by Cape Fox;
            (7) Cape Fox is the only Village Corporation affected by
        the restrictions described in paragraphs (3)(B) and (6);
            (8) the Secretary of the Interior (referred to in this Act
        as the ``Secretary'') has advised Congress that the predicament
        of Cape Fox is sufficiently unique to warrant the legislative
        remedy provided by this Act; and
            (9) the adjustment of the selections available and
        conveyances of land to Cape Fox under the Alaska Native Claims
        Settlement Act (43 U.S.C. 1601 et seq.), and the related
        adjustment of selections available and conveyances of land to
        the Regional Corporation for Sealaska established pursuant to
        that Act, are in accordance with--
                    (A) the purposes of that Act; and
                    (B) the public interest.

SEC. 2. WAIVER OF CORE TOWNSHIP REQUIREMENT FOR CERTAIN LAND.

    Notwithstanding section 16(b) of the Alaska Native Claims
Settlement Act (43 U.S.C. 1615(b)), Cape Fox shall not be required to
select or receive conveyance of the approximately 160 acres of
unconveyed Federal land located within sec. 1, T.75 S., R.91 E., Copper
River Meridian.

SEC. 3. SELECTION OUTSIDE EXTERIOR SELECTION BOUNDARY.

    (a) Selection and Conveyance of Surface Estate.--Not later than 90
days after the date of enactment of this Act, in addition to land made
available for selection under the Alaska Native Claims Settlement Act
(43 U.S.C. 1601 et seq.), Cape Fox may select, and, on receiving
written notice of the selection, the Secretary shall convey, the
approximately 99 acres of the surface estate of Tongass National Forest
land located outside the exterior selection boundary of Cape Fox (as in
existence on the day before the date of enactment of this Act) and more
particularly described as follows:
            (1) T.73 S., R.90 E., Copper River Meridian.
            (2) Of land located in sec. 33--
                    (A) the 38 acres located within the SW\1/4\SE\1/4\;
                    (B) the 13 acres located within the NW\1/4\SE\1/4\;
                    (C) the 40 acres located within the SE\1/4\SE\1/4\;
                and
                    (D) the 8 acres located within the SE\1/4\SW\1/4\.
    (b) Conveyance of Subsurface Estate.--On conveyance to Cape Fox of
the surface estate to the land identified in subsection (a), the
Secretary shall convey to Sealaska Corporation the subsurface estate to
the land.
    (c) Timing.--The Secretary shall complete the conveyances to Cape
Fox and Sealaska Corporation under this section as soon as practicable
after the date on which the Secretary receives a notice of the
selection of Cape Fox under subsection (a).
    (d) Entitlement Fulfilled.--
            (1) Definition of approved conveyance.--The term ``approved
        conveyance'' means the conveyance of the 40 acres described as
        the SW\1/4\NE\1/4\ of sec. 10, T.74 S., R.90 E., Copper River
        Meridian, selected and approved for conveyance by the decision
        of the Bureau of Land Management dated May 3, 2000.
            (2) Treatment as full entitlement.--The conveyance of land
        to Cape Fox and Sealaska Corporation pursuant to subsection (a)
        and the approved conveyance shall be considered to fulfill the
        entitlement of--
                    (A) Cape Fox under section 16 of the Alaska Native
                Claims Settlement Act (43 U.S.C. 1615); and
                    (B) Sealaska Corporation to any subsurface interest
                in the land under section 14(f) of that Act (43 U.S.C.
                1613(f)).


SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Military Call-Up Relief Act''.

SEC. 2. WAIVER OF EARLY WITHDRAWAL PENALTY FOR DISTRIBUTIONS FROM
              QUALIFIED RETIREMENT PLANS TO INDIVIDUALS CALLED TO
              ACTIVE DUTY DURING THE NATIONAL EMERGENCY DECLARED BY THE
              PRESIDENT ON SEPTEMBER 14, 2001.

    (a) Waiver For Certain Distributions.--
            (1) In general.--Section 72(t)(2) of the Internal Revenue
        Code of 1986 (relating to 10-percent additional tax on early
        distributions from qualified retirement plans) is amended by
        adding at the end the following:
                    ``(G) Distributions to individuals performing
                national emergency active duty.--Any distribution to an
                individual who, at the time of the distribution, is a
                member of a reserve component called or ordered to
                active duty pursuant to a provision of law referred to
                in section 101(a)(13)(B) of title 10, United States
                Code, during the period of the national emergency
                declared by the President on September 14, 2001.''.
            (2) Waiver of underpayment penalty.--Section 6654(e)(3) of
        such Code (relating to waiver in certain cases) is amended by
        adding at the end the following:
                    ``(C) Certain early withdrawals from retirement
                plans.--No addition to tax shall be imposed under
                subsection (a) with respect to any underpayment to the
                extent such underpayment was created or increased by
                any distribution described in section 72(t)(2)(G).''.
            (3) Effective date.--The amendments made by this subsection
        shall apply to distributions made to an individual after
        September 13, 2001.
    (b) Catch-up Contributions Allowed.--
            (1) Individual retirement accounts.--Section 219(b)(5) of
        the Internal Revenue Code of 1986 (relating to deductible
        amount) is amended by adding at the end the following:
                    ``(D) Catch-up contributions for certain
                distributions.--In the case of an individual who has
                received a distribution described in section
                72(t)(2)(G), the deductible amount for any taxable year
                shall be increased by an amount equal to--
                            ``(i) the aggregate amount of such
                        distributions (not attributable to earnings)
                        made with respect to such individual, over
                            ``(ii) the aggregate amount of such
                        distributions (not attributable to earnings)
                        previously taken into account under this
                        subparagraph or section 414(w).''.
            (2) Roth iras.--Section 408A(c) of such Code (relating to
        treatment of contributions) is amended by redesignating
        paragraph (7) as paragraph (8) and by inserting after paragraph
        (6) the following:
            ``(7) Catch-up contributions for certain distributions.--
        Any contribution described in section 219(b)(5)(D) shall not be
        taken into account for purposes of paragraph (2).''.
            (3) Employer plans.--Section 414 of such Code (relating to
        definitions and special rules) is amended by adding at the end
        the following:
    ``(w) Catch-up contributions for certain distributions.--
            ``(1) In general.--An applicable employer plan shall not be
        treated as failing to meet any requirement of this title solely
        because the plan permits an applicable participant to make
        additional elective deferrals in any plan year.
            ``(2) Limitation on amount of additional deferrals.--
                    ``(A) In general.--A plan shall not permit
                additional elective deferrals under paragraph (1) for
                any year in an amount greater than the lesser of--
                            ``(i) the applicable dollar amount, or
                            ``(ii) the excess (if any) of--
                                    ``(I) the participant's
                                compensation (as defined in section
                                415(c)(3)) for the year, over
                                    ``(II) any other elective deferrals
                                of the participant for such year which
                                are made without regard to this
                                subsection.
                    ``(B) Applicable dollar amount.--For purposes of
                this paragraph, the applicable dollar amount with
                respect to a participant shall be an amount equal to--
                            ``(i) the aggregate amount of distributions
                        described in section 72(t)(2)(G) (not
                        attributable to earnings) made with respect to
                        such participant, over
                            ``(ii) the aggregate amount of such
                        distributions (not attributable to earnings)
                        previously taken into account under this
                        subsection or section 219(b)(5)(B).
            ``(3) Treatment of contributions.--Rules similar to the
        rules of paragraphs (3) and (4) of subsection (v) shall apply
        with respect to contributions made under this subsection.
            ``(4) Definitions.--For purposes of this subsection, the
        terms `applicable employer plan' and `elective deferral' have
        the same meanings given such terms in subsection (v)(6).''.
            (4) Conforming amendment.--Section 414(v)(2)(A)(ii)(II) of
        such Code (relating to limitation on amount of additional
        deferrals) is amended by inserting ``(other than deferrals
        under subsection (w))'' after ``deferrals''.
            (5) Effective date.--The amendments made by this subsection
        shall apply to contributions in taxable years ending after
        December 31, 2001.


SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Military Commissions Act of 2004''.

SEC. 2. USE OF MILITARY COMMISSIONS FOR OFFENSES UNDER LAW OF WAR OR IN
              FURTHERANCE OF TERRORISM.

    (a) In General.--Subchapter XI of chapter 47 of title 10, United
States Code (the Uniform Code of Military Justice), is amended by
inserting after section 935 (article 135) the following new section:
``Sec. 935a. Art. 135a. Military commissions for offenses against the
              law of war or in furtherance of terrorism
    ``(a) A military commission covered by this section may be
appointed only by the President or a person designated by the President
for such purpose.
    ``(b) A military commission appointed under subsection (a) may try
any person, not a citizen of the United States, for one or more
offenses against the law of war or in furtherance of terrorism.
    ``(c) A military commission shall consist of not less than three
members and not more than seven members. However, in a case in which
the accused may be sentenced to a penalty of death, the commission
shall consist of seven members. The commission may also include not
more than two alternate members. Each member and alternate member shall
be a commissioned officer of the armed forces.
    ``(d) A military commission shall have a presiding officer, who
shall be appointed from among the members. The presiding officer shall
be a judge advocate and shall preside over the proceedings of the
commission to ensure a full, fair, and expeditious trial. The presiding
officer shall rule upon all questions of law and all interlocutory
questions arising during the proceedings. A majority of the members may
overrule the presiding officer on any ruling that excludes evidence on
the merits.
    ``(e) Trial and defense counsel shall be detailed for a military
commission on the same basis as such counsel are detailed for a general
court-martial under section 827 (article 27).
    ``(f) Members of a military commission shall deliberate and vote in
closed conference. Voting on the findings and on the sentence shall be
by secret written ballot.
    ``(g) A military commission covered by this section may not find a
person guilty of an offense, and may not determine a sentence, except
by the concurrence of two-thirds of the members present at the time the
vote is taken. The commission may not sentence a person to suffer death
except by the concurrence of all the members as to the findings and as
to the sentence.
    ``(h) A military commission may, under such limitations as the
President may prescribe, adjudge any punishment permitted by the law of
war, including death, imprisonment for life or for any lesser term,
payment of a fine or restitution, or such other lawful punishment or
punishments as the commission shall determine to be proper. The
sentence of death may be adjudged only if the accused has been found
guilty of spying or an offense causing the death of one or more
persons. A commission may not sentence any person to suffer death for
an offense committed before the person attained the age of eighteen
years. A sentence of death may not be executed until approved by the
President.
    ``(i) Pursuant to section 936 (Article 36) of the chapter, the
President may prescribe rules of evidence and procedure for trial by a
military commission. The accused in a military commission shall be
given the following minimum rights and protections:
            ``(1) The accused shall have the right to a fair trial,
        without adverse distinction based upon race, color, gender,
        language, religion, birth, wealth, or any similar criteria.
            ``(2) The accused shall be presumed innocent until proven
        guilty. The burden of proof shall be upon the prosecution to
        prove each element of an offense beyond a reasonable doubt.
            ``(3) The accused shall be informed of the charges against
        him in a language he understands as soon as practicable prior
        to trial.
            ``(4) The accused shall have the right to a public trial,
        unless the appointing authority determines that a closed trial,
        or any portion thereof, is necessary to the national security
        of the United States.
            ``(5) The accused may not be compelled to testify or
        present evidence against himself.
            ``(6) No adverse inference will be drawn against him by
        reason of a decision not to testify on his own behalf.
            ``(7) Evidence obtained through the use of torture (as
        defined in section 2340 of title 18), will not be admitted in
        evidence at trial by a military commission.
            ``(8) The accused shall be entitled to assistance of
        counsel at all stages of proceedings and shall have adequate
        time and facilities available for the preparation of his
        defense. The accused shall have the right to represent himself
        in trail by military commission, subject to the discretion of
        the presiding officer.
            ``(9) The accused shall have the right to present evidence
        and to cross-examine each witness.
            ``(10) The accused shall have equal opportunity to obtain
        witnesses and other evidence in accordance with such
        regulations as the President may prescribe.
            ``(11) The accused shall have access to all evidence that
        trial counsel intends to offer at trial and all evidence known
        to trial counsel or to the commission that tends to exculpate
        him.
            ``(12) The accused shall have the right to be present at
        each stage of the proceedings, unless he engages in conduct
        that the presiding officer determines to be disruptive.
            ``(13) The accused shall not be tried a second time for the
        same offense.
    ``(j) A person found guilty by military commission shall have a
right to review of that finding and any adjudged sentence in accordance
with this section.
    ``(k)(1) After trial, the presiding officer shall promptly
authenticate a verbatim transcript and record of trial.
    ``(2) The appointing authority shall, within a reasonable period of
time, carry out an administrative review of the transcript and record
of trial and take such administrative actions as the authority
considers appropriate, which may include directing the commission to
conduct any necessary supplemental proceedings.
    ``(3) The Secretary of Defense shall review the record of trial
and, within a reasonable period of time, take one or more of the
following actions of the case:
            ``(A) Approve, disapprove, commute, mitigate, or suspend
        the sentence in whole or in part.
            ``(B) Approve or disapprove a finding of guilty, or change
        a finding of guilty to a charge or specification to a finding
        of guilty to a lesser included offense of the offense stated in
        the charge.
    ``(4)(A) Following action by the Secretary of Defense, the Court of
Appeals for the Armed Forces shall review the record of a military
commission--
            ``(i) in any case in which the sentence extends to death or
        to confinement in excess of five years; and
            ``(ii) in any other case that the President may prescribe.
    ``(B) In any case reviewed by it under this subsection, the Court
of Appeals for the Armed Forces may act only with respect to the
findings and sentence as in effect after review by the convening
authority and the Secretary of Defense under subsection (k)(3).
    ``(C) The Court of Appeals for the Armed Forces shall take action
only with respect to matters of law and shall take such action as is
permitted under section 867 (Article 67) of this chapter.
    ``(5) The Supreme Court of the United States shall have
jurisdiction to review, by writ of certiorari, an action of the Court
of Appeals for the Armed Forces under this subsection.
    ``(l) The Secretary of Defense shall submit to Congress each order,
rule, and regulation prescribed under this section. Such order, rule,
or regulation may not take effect until 30 days after it is so
submitted.
    ``(m) Not later than March 15 of each year, the Secretary of
Defense shall submit to Congress a report on the use of military
commissions covered by this section during the preceding calendar year.
The report shall set forth a summary of each case covered by this
section during such year, together with the disposition and current
status of that case. The report shall also set forth a detailed
description of the activities of the Department with respect to
military commissions, a copy of all current rules and regulations
relating to the use of military commissions, and an accounting of all
funds expended on matters relating to the use of military
commissions.''.
    (b) The table of sections at the beginning of such subchapter is
amended by adding at the end the following new item:

``935a. Art. 135a. Military commissions for offenses against the law of
                            war or in furtherance of terrorism.''.