[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[H.R. 43 Introduced in House (IH)]
103d CONGRESS
1st Session
H. R. 43
To provide health insurance benefits to certain former employees at
defense nuclear facilities of the Department of Energy for injuries
caused by exposure to ionizing radiation.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
January 5, 1993
Mr. Skaggs (for himself, Mr. Schiff, Mrs. Schroeder, Mr. Richardson,
Mr. Stark, Mr. Evans, Mr. Sanders, Mrs. Lloyd, and Mr. Owens)
introduced the following bill; which was referred to the Committee on
Energy and Commerce
_______________________________________________________________________
A BILL
To provide health insurance benefits to certain former employees at
defense nuclear facilities of the Department of Energy for injuries
caused by exposure to ionizing radiation.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Defense Nuclear Workers' Health
Insurance Act of 1993''.
SEC. 2. HEALTH INSURANCE PROGRAM FOR CERTAIN FORMER DEPARTMENT OF
ENERGY EMPLOYEES EXPOSED TO IONIZING RADIATION.
(a) Establishment of Program.--The Secretary of Energy shall
provide in accordance with this section for payment to (or on behalf
of) certain former Department of Energy employees (described in
subsection (b)) for all reasonable expenses for certain health care
services (described in subsection (c)) incurred (whether through
insurance or out-of-pocket) above the threshold dollar amount specified
in subsection (d).
(b) Former Employees Covered.--An employee described in this
section is an individual who--
(1) was (but is no longer) employed at a Department of
Energy defense nuclear facility (as defined in subsection
(g)(3));
(2) while employed at that facility--
(A) received 10 REM or more total exposure to
ionizing radiation or 10 percent or more of the maximum
permissible body burden exposure to ionizing radiation,
or
(B) was employed for 5 years or more in a building
or facility in which radioactive materials were
regularly stored, handled, processed, or disposed of;
and
(3) is not entitled to benefits under the Medicare Program.
(c) Reasonable Expenses for Certain Health Care Services Covered.--
(1) In general.--Reasonable expenses for certain health
care services described in this subsection are expenses in a
reasonable amount for health care services which are medically
reasonable and necessary for treatment of--
(A)(i) leukemia or cancer of the blood-forming
tissues (excluding chronic lymphocytic leukemia),
(ii) multiple myeloma or muscle cancer affecting
the spinal cord, or lymphoma (other than Hodgkin's
disease), or
(iii) cancer of the thyroid, lung, breast, brain or
nervous system, bone, skin, prostate, parathyroid
glands, stomach, colon or rectum, esophagus, bladder,
urinary tract, pharynx, pancreas, small intestine, bile
ducts, gall bladder, or liver (except if cirrhosis or
hepatitis B is indicated); or
(B) another disease if the Secretary of Energy (in
consultation with the Secretary of Health and Human
Services) determines that there is a reasonable medical
certainty that such disease could have been directly or
indirectly caused by an illness referred to in
subparagraph (A).
(2) Determination of reasonable amount.--In applying
paragraph (1)--
(A) health care expenses shall be treated as being
``in a reasonable amount'' based on a typical payment
methodology used under FEHBP plans, and
(B) treatment of an illness shall be considered to
be medically reasonable and necessary if payment for
such treatment can be expected to be made under either
an FEHBP plan or under the Medicare Program.
(3) Health services defined.--In paragraph (1), the term
``health care services'' means health care items and services
that are the type of items and services for which benefits are
made available either under an FEHBP plan or under the Medicare
Program and includes hospital services, physicians services,
outpatient prescription drugs, hospice care, home health
services, skilled nursing facility services, and rehabilitation
(inpatient and outpatient) services.
(d) Threshold Dollar Amount.--The threshold dollar amount specified
in this subsection is $25,000 with respect to any individual during the
individual's lifetime, not counting expenses incurred before the date
of the enactment of this Act.
(e) Administration.--The Secretary of Energy may carry out this
section directly, through a memorandum of understanding with an
appropriate Federal department or agency, or through a contract with an
appropriate health insurance carrier or administrator.
(f) Effective Date.--The Secretary of Energy shall establish the
insurance program under this section by not later than 6 months after
the date of the enactment of this Act. The program shall apply to
expenses incurred for services furnished on or after the date the
program first becomes effective.
(g) Definitions.--In this section:
(1) The term ``FEHBP plan'' means a health plan typical of
the health plans offered to Federal employees and annuitants
under chapter 89 of title 5, United States Code.
(2) The term ``medicare program'' means the program under
title XVIII of the Social Security Act.
(3) The term ``Department of Energy defense nuclear
facility'' means--
(A) a production facility or utilization facility
(as defined in section 11 of the Atomic Energy Act of
1954 (42 U.S.C. 2014)) that is under the control or
jurisdiction of the Secretary of Energy and that is
operated for national security purposes (including the
tritium loading facility at Savannah River, South
Carolina; the 236 H facility at Savannah River, South
Carolina; and the Mound Laboratory, Ohio), but the term
does not include any facility that does not conduct
atomic energy defense activities;
(B) a nuclear waste storage or disposal facility
that is under the control or jurisdiction of the
Secretary of Energy;
(C) a testing and assembly facility that is under
the control or jurisdiction of the Secretary of Energy
and that is operated for national security purposes
(including the test site facility in Nevada; the
Pinnellas Plant, Florida; and the Pantex facility,
Texas);
(D) a nuclear weapons research facility that is
under the control or jurisdiction of the Secretary of
Energy (including the Lawrence Livermore, Los Alamos,
and Sandia National Laboratories); or
(E) any facility described in subparagraphs (A)
through (D) that--
(i) is no longer in operation;
(ii) was under the control or jurisdiction
of the Department of Defense, the Atomic Energy
Commission, or the Energy Research and
Development Administration; and
(iii) was operated for national security
purposes.
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