SEC. 194. VOLUNTEER SERVICES PROVIDED BY HEALTH PROFESSIONALS AT FREE CLINICS.
Title[ Title I\Subtitle C Contents
Section 224 of the Public Health Service Act (42 U.S.C. 233) is
amended by adding at the end the following subsection:
``(o)(1) For purposes of this section, a free clinic health
professional shall in providing a qualifying health service to an
individual be deemed to be an employee of the Public Health Service for
a calendar year that begins during a fiscal year for which a transfer
was made under paragraph (6)(D). The preceding sentence is subject to
the provisions of this subsection.
``(2) In providing a health service to an individual, a health care
practitioner shall for purposes of this subsection be considered to be a
free clinic health professional if the following conditions are met:
``(A) The service is provided to the individual at a free
clinic, or through offsite programs or events carried out by the
free clinic.
``(B) The free clinic is sponsoring the health care
practitioner pursuant to paragraph (5)(C).
``(C) The service is a qualifying health service (as defined
in paragraph (4)).
``(D) Neither the health care practitioner nor the free
clinic receives any compensation for the service from the
individual or from any third-party payor (including
reimbursement under any insurance policy or health plan, or
under any Federal or State health benefits program). With
respect to compliance with such condition:
``(i) The health care practitioner may receive
repayment from the free clinic for reasonable expenses
incurred by the health care practitioner in the
provision of the service to the individual.
``(ii) The free clinic may accept voluntary
donations for the provision of the service by the health
care practitioner to the individual.
``(E) Before the service is provided, the health care
practitioner or the free clinic provides written notice to the
individual of the extent to which the legal liability of the
health care practitioner is limited pursuant to this subsection
(or in the case of an emergency, the written notice is provided
to the individual as soon after the emergency as is
practicable). If the individual is a minor or is otherwise
legally incompetent, the condition under this subparagraph is
that the written notice be provided to a legal guardian or other
person with legal responsibility for the care of the individual.
``(F) At the time the service is provided, the health care
practitioner is licensed or certified in accordance with
applicable law regarding the provision of the service.
``(3)(A) For purposes of this subsection, the term `free clinic'
means a health care facility operated by a nonprofit private entity
meeting the following requirements:
``(i) The entity does not, in providing health services
through the facility, accept reimbursement from any third-party
payor (including reimbursement under any insurance policy or
health plan, or under any Federal or State health benefits
program).
``(ii) The entity, in providing health services through the
facility, either does not impose charges on the individuals to
whom the services are provided, or imposes a charge according to
the ability of the individual involved to pay the charge.
``(iii) The entity is licensed or certified in accordance
with applicable law regarding the provision of health services.
``(B) With respect to compliance with the conditions under
subparagraph (A), the entity involved may accept voluntary donations for
the provision of services.
``(4) For purposes of this subsection, the term `qualifying health
service' means any medical assistance required or authorized to be
provided in the program under title XIX of the Social Security Act,
without regard to whether the medical assistance is included in the plan
submitted under such program by the State in which the health care
practitioner involved provides the medical assistance. References in the
preceding sentence to such program shall as applicable be considered to
be references to any successor to such program.
``(5) Subsection (g) (other than paragraphs (3) through (5)) and
subsections (h), (i), and (l) apply to a health care practitioner for
purposes of this subsection to the same extent and in the same manner as
such subsections apply to an officer, governing board member, employee,
or contractor of an entity described in subsection (g)(4), subject to
paragraph (6) and subject to the
following:
``(A) The first sentence of paragraph (1) applies in lieu of
the first sentence of subsection (g)(1)(A).
``(B) This subsection may not be construed as deeming any
free clinic to be an employee of the Public Health Service for
purposes of this section.
``(C) With respect to a free clinic, a health care
practitioner is not a free clinic health professional unless the
free clinic sponsors the health care practitioner. For purposes
of this subsection, the free clinic shall be considered to be
sponsoring the health care practitioner if--
``(i) with respect to the health care practitioner,
the free clinic submits to the Secretary an application
meeting the requirements of subsection (g)(1)(D); and
``(ii) the Secretary, pursuant to subsection
(g)(1)(E), determines that the health care practitioner
is deemed to be an employee of the Public Health
Service.
``(D) In the case of a health care practitioner who is
determined by the Secretary pursuant to subsection (g)(1)(E) to
be a free clinic health professional, this subsection applies to
the health care practitioner (with respect to the free clinic
sponsoring the health care practitioner pursuant to subparagraph
(C)) for any cause of action arising from an act or omission of
the health care practitioner
occurring on or after the date on which the Secretary makes such
determination.
``(E) Subsection (g)(1)(F) applies to a health care
practitioner for purposes of this subsection only to the extent
that, in providing health services to an individual, each of the
conditions specified in paragraph (2) is met.
``(6)(A) For purposes of making payments for judgments against the
United States (together with related fees and expenses of witnesses)
pursuant to this section arising from the acts or omissions of free
clinic health professionals, there is authorized to be appropriated
$10,000,000 for each fiscal year.
``(B) The Secretary shall establish a fund for purposes of this
subsection. Each fiscal year amounts appropriated under subparagraph (A)
shall be deposited in such fund.
``(C) Not later <<NOTE: Reports.>> than May 1 of each fiscal year,
the Attorney General, in consultation with the Secretary, shall submit
to the Congress a report providing an estimate of the amount of claims
(together with related fees and expenses of witnesses) that, by reason
of the acts or omissions of free clinic health professionals, will be
paid pursuant to this section during the calendar year that begins in
the following fiscal year. Subsection (k)(1)(B) applies to the estimate
under the preceding sentence regarding free clinic health professionals
to the same extent and in the same manner as such subsection applies to
the estimate under such subsection regarding officers, governing board
members, employees, and contractors of entities described in subsection
(g)(4).
``(D) Not later than December 31 of each fiscal year, the Secretary
shall transfer from the fund under subparagraph (B) to the appropriate
accounts in the Treasury an amount equal to the estimate made under
subparagraph (C) for the calendar year beginning in such fiscal year,
subject to the extent of amounts in the fund.
``(7)(A) This <<NOTE: Effective date.>> subsection takes effect on
the date of the enactment of the first appropriations Act that makes an
appropriation under paragraph (6)(A), except as provided in subparagraph
(B)(i).
``(B)(i) Effective on the date of the enactment of the Health
Insurance Portability and Accountability Act of 1996--
``(I) the Secretary may issue regulations for carrying out
this subsection, and the Secretary may accept and consider
applications submitted pursuant to paragraph (5)(C); and
``(II) reports under paragraph (6)(C) may be submitted to
the Congress.
``(ii) For the first fiscal year for which an appropriation is made
under subparagraph (A) of paragraph (6), if an estimate under
subparagraph (C) of such paragraph has not been made for the calendar
year beginning in such fiscal year, the transfer under subparagraph (D)
of such paragraph shall be made notwithstanding the lack of the
estimate, and the transfer shall be made in an amount equal to the
amount of such appropriation.''.
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