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RÉFORME DES SOINS DE SANTÉ - PROGRAMME EUGÉNIQUE - HEALTH CARE REFORM - (PARTIE 2)
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MessagePosté le: Sam 26 Jan - 18:45 (2013)    Sujet du message: KATHERINE ALBRECHT, Ed.D. IS LYING Répondre en citant

KATHERINE ALBRECHT, Ed.D. IS LYING

McGuffee Cathey This is America -

You can read it cover to cover and you won't find anything about microchip implants.

Some commentators are mistakenly referring to an old HOUSE VERSION of the health care bill, H.R. 3200, a 2,454-page mega-bill introduced in 2009 that did not pass. That bill contained a Section 2561 where "implantable medical devices" were mentioned in a section that called for the creation of a "National Medical Device Registry."

That section referred to FDA-approved Class II "implantable medical devices" that are in wide use today, such as pacemakers, artificial hips, drug delivery pumps, heart stents, and others. The defunct H.R. 3200 bill would simply have created a requirement to register those implanted medical devices in order to evaluate their post-market risk and evaluate patient safety over time. It made no mention of implantable microchips.

The FDA is charged with evaluating and approving medical devices before they can be offered for sale, but it does not currently have a way to follow up once they have been sold. The concern over the long-term safety of implantable devices is a real one, given that implanted foreign bodies have the potential to cause cancer. (See my cancer report and FAQ at
http://www.antichips.com/
as well as animal cases at http://www.chipmenot.com/ for evidence.) Nevertheless, this provision did not make it into the final version of the health care legislation.

A different bill numbered H.R. 3590 (not H.R .3200) is the version of health care legislation that President Obama actually signed into law on March 23, 2010. That bill did not contain a requirement for a "medical device registry," made no mention of implantable medical devices, and most assuredly did not mention implantable microchips.

In sum, as the nation's leading opponent of RFID and implantable microchips, I can categorically state that the Obamacare legislation does not contain a provision for implanting microchips into people. Nor did any previous versions of health care legislation introduced in Congress contain such language.

With all the other privacy-invading provisions in the health care legislation, I hate to see people spending their energy on something that isn't there. Hopefully we can now lay the rumor to rest.

In freedom and in truth,
Katherine Albrecht, Ed.D.


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MessagePosté le: Sam 26 Jan - 18:45 (2013)    Sujet du message: Publicité

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MessagePosté le: Mar 29 Jan - 03:15 (2013)    Sujet du message: NEW COPAYS FOR SOME TRICARE PHARMACY CUSTOMERS Répondre en citant


Under military rules - 10 regions

 NEW COPAYS FOR SOME TRICARE PHARMACY CUSTOMERS

1/28/2013

FALLS CHURCH, Va. – New copayments for prescription drugs covered by TRICARE will go into effect February 1, 2013. The Fiscal Year 2013 National Defense Authorization Act requires TRICARE to increase copays on brand name and non-formulary medications that are not filled at military clinics or hospitals. There is no increase to copays for generic medications.

TRICARE Pharmacy copays vary based on the class of drug and where beneficiaries choose to fill their prescriptions. The copay for generic medications stays at $5 when a prescription is filled at a network pharmacy. There is no co-pay when generic prescriptions are filled through TRICARE Home Delivery. The new copay for a 30-day supply of a brand name medication purchased at a retail network pharmacy will be $17, up from the current $12. Beneficiaries using TRICARE Home Delivery will pay $13 for brand name drugs, up from $9. However, the Home Delivery price is for a 90-day supply.

The greatest change in copays applies to non-formulary medications. The $25 copay for these drugs increases to $44 at retail pharmacies and $43 through Home Delivery. The TRICARE Uniform Formulary is a list of all the medications TRICARE covers.

For fiscal 2014 and beyond, the new law directs that copays increase annually by the same percentage as retiree cost-of-living adjustments. In years when a COLA increase would total less than a dollar, it will be delayed a year and combined with the next adjustment so increases will always be $1 or more.

Pharmacies at military hospitals and clinics will continue to provide medications with no copays. Visit www.TRICARE.mil/pharmacycosts for more details.

http://www.tricare.mil/CoveredServices/BenefitUpdates/Archives/PharmacyCopayChanges.aspx


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MessagePosté le: Sam 2 Fév - 01:45 (2013)    Sujet du message: IRS: CHEAPEST OBAMACARE PLAN WILL BE $20,000 PER FAMILY Répondre en citant

TYRANNICAL SLAVERY AND NEW KIND OF "CRIMINALITY"

IRS: CHEAPEST OBAMACARE PLAN WILL BE $20,000 PER FAMILY

January 31, 2013
By Matt Cover



President Barack Obama hugs HHS Secretary Kathleen Sebelius and then-House Speaker Nancy Pelosi after signing the Obamacare law on March 23, 2010. (White House photo/Pete Souza)

(CNSNews.com) – In a final regulation issued Wednesday, the Internal Revenue Service (IRS) assumed that under Obamacare the cheapest health insurance plan available in 2016 for a family will cost $20,000 for the year.

Under Obamacare, Americans will be required to buy health insurance or pay a penalty to the IRS.

The IRS's assumption that the cheapest plan for family will cost $20,000 per year is found in examples the IRS gives to help people understand how to calculate the penalty they will need to pay the government if they do not buy a mandated health plan.

The examples point to families of four and families of five, both of which the IRS expects in its assumptions to pay a minimum of $20,000 per year for a bronze plan.

“The annual national average bronze plan premium for a family of 5 (2 adults, 3 children) is $20,000,” the regulation says.

Bronze will be the lowest tier health-insurance plan available under Obamacare--after Silver, Gold, and Platinum. Under the law, the penalty for not buying health insurance is supposed to be capped at either the annual average Bronze premium, 2.5 percent of taxable income, or $2,085.00 per family in 2016.

In the new final rules published Wednesday, IRS set in law the rules for implementing the penalty Americans must pay if they fail to obey Obamacare's mandate to buy insurance.

To help illustrate these rules, the IRS presented examples of different situations families might find themselves in.

In the examples, the IRS assumes that families of five who are uninsured would need to pay an average of $20,000 per year to purchase a Bronze plan in 2016.
Using the conditions laid out in the regulations, the IRS calculates that a family earning $120,000 per year that did not buy insurance would need to pay a "penalty" (a word the IRS still uses despite the Supreme Court ruling that it is in fact a "tax") of $2,400 in 2016.

For those wondering how clear the IRS's clarifications of this new "penalty" rule are, here is one of the actual examples the IRS gives:

“Example 3. Family without minimum essential coverage.

"(i) In 2016, Taxpayers H and J are married and file a joint return. H and J have three children: K, age 21, L, age 15, and M, age 10. No member of the family has minimum essential coverage for any month in 2016. H and J’s household income is $120,000. H and J’s applicable filing threshold is $24,000. The annual national average bronze plan premium for a family of 5 (2 adults, 3 children) is $20,000.

"(ii) For each month in 2016, under paragraphs (b)(2)(ii) and (b)(2)(iii) of this section, the applicable dollar amount is $2,780 (($695 x 3 adults) + (($695/2) x 2 children)). Under paragraph (b)(2)(i) of this section, the flat dollar amount is $2,085 (the lesser of $2,780 and $2,085 ($695 x 3)). Under paragraph (b)(3) of this section, the excess income amount is $2,400 (($120,000 - $24,000) x 0.025). Therefore, under paragraph (b)(1) of this section, the monthly penalty amount is $200 (the greater of $173.75 ($2,085/12) or $200 ($2,400/12)).

"(iii) The sum of the monthly penalty amounts is $2,400 ($200 x 12). The sum of the monthly national average bronze plan premiums is $20,000 ($20,000/12 x 12). Therefore, under paragraph (a) of this section, the shared responsibility payment imposed on H and J for 2016 is $2,400 (the lesser of $2,400 or $20,000).”

http://cnsnews.com/news/article/irs-cheapest-obamacare-plan-will-be-20000-family


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MessagePosté le: Jeu 21 Fév - 21:29 (2013)    Sujet du message: WHO/WORLD BANK CONVENE MINISTERIAL MEETING TO DISCUSS BEST PRACTICES FOR MOVING FORWARD ON UNIVERSAL HEALTH COVERAGE Répondre en citant





THE MARK OF THE BEAST IS COMING!



WHO/WORLD BANK CONVENE MINISTERIAL MEETING TO DISCUSS BEST PRACTICES FOR MOVING FORWARD ON UNIVERSAL HEALTH COVERAGE


Joint WHO / World Bank statement
19 February 2013

Geneva -Top officials from health and finance ministries from 27 countries joined other high-level health and development stakeholders at a two-day meeting this week in Geneva to discuss ways that countries are progressing towards universal health coverage. The meeting was convened jointly by the World Health Organization (WHO) and the World Bank and took place just weeks after the United Nations General Assembly adopted a RESOLUTION SUPPORTING UNIVERSAL HEALTH COVERAGE.

Delegates at the Geneva meeting expressed strong support for the ideas underlying universal health coverage: that everyone, irrespective of their ability to pay, should have access to the health services they need, without putting their families at financial risk.

Many speakers stressed the importance of getting political commitment to universal health coverage at the highest level. Some countries described how they are focusing their limited resources initially on providing coverage to the poor and vulnerable, while others have taken a more universal approach from the start. The use of general revenues to provide such coverage was a recurrent theme; but there was also some discussion about using earmarked revenues such as "sin taxes."

Participants agreed that human resource shortages posed a challenge, but also pointed to the need for more focus on the distribution of health workers —between rural and urban areas, and between poor and more affluent areas. Some speakers indicated that more could be achieved using existing resources. The meeting also discussed strategies to ensure an adequate supply of good quality and affordable essential medicines and technologies, noting the value of using financial incentives to promote efficiency and quality of health services.

The participants agreed on the importance of improving information systems and holding governments and health care providers more accountable for delivering results. Several speakers raised the challenge many faced of how to balance ensuring people receive the care they need at a cost the government can afford.

The importance of monitoring progress towards universal health coverage was also a recurrent theme, as was the important role played by of researchers, civil society, and international agencies. Several delegates expressed the hope that universal health coverage would feature in the post-2015 development goals.

The WHO and the World Bank are working together at global, regional and country levels, and stand by ready to help countries confront the numerous challenges that the meeting highlighted in accelerating progress toward universal health coverage. In response to country demand, the WHO and the World Bank are already developing a monitoring framework that will help countries track their countries’ progress toward universal health coverage in a way that explicitly captures the potential importance of universal health coverage in achieving better health and higher living standards for everyone. The framework will be available for consultation with countries and other partners later this year.

The UN General Assembly resolution urges Member States to develop health systems that avoid significant direct payments at the point of care. It further encourages them to establish mechanisms for pooling risks to avoid catastrophic health expenditures that drive households into poverty.

For more information about WHO and WorldBank work on UHC:

Melanie Mayhew
Corporate Communications
World Bank
Telephone: +1 2024597115
Gregory Härtl
WHO Media Coordinator
Department of Communications
Director-General's Office
WHO, Geneva
Mobile: +41 79 203 6715
E-mail:

hartlg@who.int

http://www.who.int/mediacentre/news/statements/2013/uhc_20130219/en/index.html


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MessagePosté le: Lun 4 Mar - 16:24 (2013)    Sujet du message: RÉFORME DES SOINS DE SANTÉ - PROGRAMME EUGÉNIQUE - HEALTH CARE REFORM - (PARTIE 2) Répondre en citant

WHAT A CONCEPT: VA PITCHES ITS ELECTRONIC HEALTH RECORDS SYSTEM TO DEFENSE



Elizabeth McGrath said the department will conduct an analysis of VistA along with commercial systems for its next generation EHR. // Caitlin Fairchild/Nextgov.com


By Bob Brewin February 27, 2013

The Defense Department went shopping for a new electronic health record system on Feb. 8, just two days after plans to develop a $4 billion integrated electronic health record with the Veterans Affairs Department went south.

The Military Health System, in a notice to industry, said it wanted to deploy an electronic health record “with the most capability in the shortest period of time for the least cost.” Responses were due Wednesday.

VA submitted a white paper detailing how MHS can meet those goals by adopting one of the country’s best (and oldest) electronic health records system, its Veterans Health Information Systems and Technology Architecture (VistA) system.

Defense has resisted using VistA for decades, so I have my doubts it will now turn around and sign on, though the white paper makes a strong case for doing just that.

Hopefully this proposal gets some attention at Wednesday’s House Veterans’ Affairs Committee hearing on the integrated health record debacle.

http://www.nextgov.com/defense/whats-brewin/2013/02/what-concept-va-pitches…


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MessagePosté le: Mar 19 Mar - 04:15 (2013)    Sujet du message: DOD ANNOUNCES PILOT SITES FOR HEALTHY BASE INITIATIVE Répondre en citant

 




DOD ANNOUNCES PILOT SITES FOR HEALTHY BASE INITIATIVE

American Forces Press Service

March 18, 2013


WASHINGTON, March 18, 2013 – Thirteen pilot sites will participate in the Healthy Base Initiative, a demonstration project for the Defense Department’s Operation Live Well, Pentagon officials announced today.

Operation Live Well is aimed at increasing the health and wellness of the total force, including civilians and family members, officials said.

Eleven of the pilot sites participating in the Healthy Base Initiative assessment are military installations: Fort Bragg, N.C.; Fort Sill, Okla.; Joint Base Pearl Harbor-Hickam, Hawaii; Submarine Base New London, Conn.; Mountain Home Air Force Base, Idaho; Yokota Air Base, Japan; Marine Corps Air Ground Combat Center/Marine Air Ground Task Force Training Command, Twentynine Palms, Calif.; Marine Corps Base Quantico, Va.; Coast Guard Air Station Cape Cod, Mass.; March Air Force Base, Calif.; and Camp Dodge, Iowa.

The other two pilot sites are the Defense Logistics Agency at Fort Belvoir, Va., and Defense Health Headquarters, Falls Church, Va.

As part of the year-long demonstration project, participating installations will be examined for their ability to create environments that enable sustainable healthy lifestyles, officials said. Best practices across participants will be shared with the services for further implementation throughout the force, they added.

Health Care [News]

http://www.health.mil/News_And_Multimedia/News/detail/13-03-18/DOD_Announce…


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MessagePosté le: Mar 26 Mar - 16:08 (2013)    Sujet du message: FOR US, IT'S ALL ABOUT THE CARE Répondre en citant

FOR US, IT'S ALL ABOUT THE CARE

... It’s also plug-and-play technology—it can be installed in a mobile and or handheld device in less than 30 seconds. EVV is hardware agnostic. It doesn’t require the patient to have a landline, and it can be used on any cellphone with or without installed GPS. It also can be used to collect and monitor data from any existing EVV solution currently in place. The software allows multiple addresses per patient, so the provider can easily give services to the patient where they are—in their home, at a provider
facility, or at family and neighbors’ locations...

Pdf doc. : http://www.optuminsight.com/~/media/Ingenix/Resources/Downloads/Brochures/Electronic_Visit_Verification_Brochure_08_2012.pdf


MAKING THE HEALTH SYSTEM WORK BETTER FOR EVERYONE

Pdf doc. : http://www.optuminsight.com/~/media/Ingenix/Resources/Downloads/OptumInsightFederalGovernmentOverviewSept2011.pdf



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MessagePosté le: Lun 1 Avr - 17:56 (2013)    Sujet du message: OBAMA ADMIN. IGNORES NULLIFICATION: FEDERAL AGENTS WILL ENFORCE OBAMACARE Répondre en citant

OBAMA ADMIN. IGNORES NULLIFICATION: FEDERAL AGENTS WILL ENFORCE OBAMACARE
 

Monday, 25 March 2013 11:19
Written by Joe Wolverton, II, J.D.



President Obama will not wait on states to enforce ObamaCare. The Obama administration has announced its intent to disregard state laws and state constitutional amendments prohibiting the enforcement of ObamaCare. Federal agents from the Department of Health and Human Services will assume absolute control over states’ health insurance industry and regulation in states that refuse to comply with the federal healthcare mandates.

In an exclusive telephone interview with The New American, Oklahoma Insurance Commissioner John Doak reported that his office has received a letter from Center for Consumer Information and Insurance Oversight (CCIIO) Deputy Administrator and Director Gary Cohen informing him that the federal government will impose ObamaCare regulations on insurance companies in Oklahoma. The CCIIO is part of the Centers for Medicare and Medicaid Services (CMS).

According to a story in Politico, Doak’s colleagues in Missouri, Wyoming, and Texas have received these notifications, as well.

In a press release issue by his office after receiving Cohen’s letter, Doak writes that the “Oklahoma Insurance Department will not be participating in a collaborative effort with the Center for Consumer Information and Insurance Oversight (CCIIO) to enforce the Affordable Care Act (ACA).”

Doak’s statement continues:
The Oklahoma Insurance Department regulates the health insurance policies sold in the state and responds to consumer questions and complaints. Our consumer assistance team receives over 30,000 phone calls and our website receives over 1,000,000 visits each year. We will continue to serve these consumers by adhering to our duties under the State Constitution and Statutes. The consumers are the ones who are going to bear the costs of these unnecessary federal regulatory burdens.

In addition to adding new fees to health insurance products that will increase prices both inside and outside the exchange, the ACA requires plans to add expensive and often unnecessary coverage benefits. These costs will impact young adults most severely due to the law’s requirement that older Americans pay no more than three times the premium of young adults. A survey of insurers by the American Action Forum found that average premiums for young, healthy adults may triple going into 2014.

“This is yet another example of continued overreach of the federal government on states’ rights,” Doak told The New American, when asked about the conflict. “This is the first shot over the bow of states” which have chosen not to enforce ObamaCare’s myriad mandates, he added.

Apart from the assault on state sovereignty, the CMS announcement will be financially devastating, as well.

Tulsa World reports that “health insurance companies doing business in Oklahoma are receiving letters from Cohen telling them that enforcement of the law’s requirements will be handled by the federal agency.”

The way the system will work, apparently, is that any health insurance plan purchased through an ObamaCare healthcare exchange will be regulated and managed by a federal official (known in the language of ObamaCare as a “navigator”).

Plans sold through other companies, however, will continue to be under the purview of Doak and his office.

Insurance companies that provide plans through the ObamaCare exchange and outside of the government program will be subject to two radically different regulatory schemes: one created and enforced by Washington, D.C., and one administered out of Oklahoma City.

Doak warns that this duplicate regulatory scheme — state and federal — will result in increased costs for the consumer.
“Oklahomans should be alarmed,” he said.

If Oklahomans are ultimately subjected to the deprivations of ObamaCare, it will be at the hand of federal agents, as Doak says there is no enacting legislation empowering his office to enforce federal law in Oklahoma.

This situation will undoubtedly result in what Doak calls “lawsuits in many forms and fashions.” He says his department will look to Oklahoma state Attorney General Scott Pruitt to defend the Oklahoma constitution against challenges filed by the federal government.

The Obama administration has been trying for some time now to ignore the will of the people of Oklahoma and the Oklahoma constitution’s prohibition against enforcement of ObamaCare.

For example, documents provided to The New American include a letter from the federal Department of Health and Human Services inquiring as to why Oklahoma had yet to make the requisite steps toward implementing ObamaCare.

When it was informed that Oklahoma would not — in fact, legally could not — comply with ObamaCare mandates, HHS was not deterred, proposing instead the establishment of a “collaborative enforcement arrangement.” This deal would permit the feds to force ObamaCare on Oklahomans while allowing the Oklahoma Insurance Department (OID) to ostensibly keep its hands clean.

As if that weren’t insulting enough, included in the cache of documents provided to The New American was the letter mentioned above that was sent to Oklahoma insurance companies from HHS informing them that since Oklahoma cannot or will not enforce the Affordable Care Act (ObamaCare), this responsibility has been assumed by CMS.

Furthermore, as part of its oversight, CMS demands in the letter that insurance companies “submit all group and individual health insurance policy forms, certificates, riders, endorsements, and amendments, as well as any other requested material pertinent to the market reforms of the Affordable Care Act to CMS for review.”

Then, lest insurance companies in Oklahoma doubt who’s in charge of healthcare in the Sooner State, the letter declares that “a filing with the Oklahoma Insurance Department does not constitute a filing with CMS for these purposes.”

These letters reveal that is nothing more or less than an end run by the Obama administration around the sovereignty of Oklahoma (and presumably other states) and usurpation of power in defiance of the state constitution, the will of the people, and the laws passed by their elected representatives in the state legislature.

Doak promises to continue faithfully and fearlessly carrying out his duty to enforce the laws of Oklahoma, even if that means taking on the behemoth that is the federal ObamaCare bureaucracy.

“We must continue to fight for what’s right,” Doak said.

Joe A. Wolverton, II, J.D. is a correspondent for The New American and travels frequently nationwide speaking on topics of nullification, the NDAA, and the surveillance state. He can be reached at jwolverton@thenewamerican.comThis email address is being protected from spambots. You need JavaScript enabled to view it. .

http://www.thenewamerican.com/usnews/constitution/item/14892-obama-admin-ig…



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MessagePosté le: Lun 8 Avr - 20:38 (2013)    Sujet du message: H.R. 307: PANDEMIC AND ALL-HAZARDS PREPAREDNESS REAUTHORIZATION ACT OF 2013 Répondre en citant



H.R. 307: PANDEMIC AND ALL-HAZARDS PREPAREDNESS REAUTHORIZATION ACT OF 2013

by Simon Blackon March 11, 2013


...


Then there was H.R. 307, the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 http://www.govtrack.us/congress/bills/113/hr307/text . This 37-page bill awards the government with all sorts of additional powers in the event of what they deem to be a ‘public health emergency.’


This includes quite a number of Big Brother tactics like NATIONAL VACCINE TRACKING AND INITIATING BIOSURVEILLANCE OPERATIONS.


...

http://www.sovereignman.com/correspondents/four-new-bills-from-the-politica…

 H.R. 307: PANDEMIC AND ALL-HAZARDS PREPAREDNESS REAUTHORIZATION ACT OF 2013

113th Congress, 2013–2015. Text as of Apr 04, 2013 (Passed Congress/Enrolled Bill).
Status & Summary | PDF | Source: GPO


H.R.307
One Hundred Thirteenth Congress of the United States of America AT THE FIRST SESSION





Begun and held at the City of Washington on Thursday,

the third day of January, two thousand and thirteen

An Act

To reauthorize certain programs under the Public Health Service Act and the Federal Food, Drug, and Cosmetic Act with respect to public health security and all-hazards preparedness and response, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
    (a) Short Title- This Act may be cited as the ‘Pandemic and All-Hazards Preparedness Reauthorization Act of 2013’.
    (b) Table of Contents- The table of contents of this Act is as follows:
      Sec. 1. Short title; table of contents.
TITLE I--STRENGTHENING NATIONAL PREPAREDNESS AND RESPONSE FOR PUBLIC HEALTH EMERGENCIES
      Sec. 101. National Health Security Strategy.
      Sec. 102. Assistant Secretary for Preparedness and Response.
      Sec. 103. National Advisory Committee on Children and Disasters.
      Sec. 104. Modernization of the National Disaster Medical System.
      Sec. 105. Continuing the role of the Department of Veterans Affairs.
TITLE II--OPTIMIZING STATE AND LOCAL ALL-HAZARDS PREPAREDNESS AND RESPONSE
      Sec. 201. Temporary reassignment of State and local personnel during a public health emergency.
      Sec. 202. Improving State and local public health security.
      Sec. 203. Hospital preparedness and medical surge capacity.
      Sec. 204. Enhancing situational awareness and biosurveillance.
      Sec. 205. Eliminating duplicative Project Bioshield reports.
TITLE III--ENHANCING MEDICAL COUNTERMEASURE REVIEW
      Sec. 301. Special protocol assessment.
      Sec. 302. Authorization for medical products for use in emergencies.
      Sec. 303. Definitions.
      Sec. 304. Enhancing medical countermeasure activities.
      Sec. 305. Regulatory management plans.
      Sec. 306. Report.
      Sec. 307. Pediatric medical countermeasures.
TITLE IV--ACCELERATING MEDICAL COUNTERMEASURE ADVANCED RESEARCH AND DEVELOPMENT
      Sec. 401. BioShield.
      Sec. 402. Biomedical Advanced Research and Development Authority.
      Sec. 403. Strategic National Stockpile.
      Sec. 404. National Biodefense Science Board.
TITLE I--STRENGTHENING NATIONAL PREPAREDNESS AND RESPONSE FOR PUBLIC HEALTH EMERGENCIES
SEC. 101. NATIONAL HEALTH SECURITY STRATEGY.
    (a) In General- Section 2802 of the Public Health Service Act (42 U.S.C. 300hh-1) is amended--
      (1) in subsection (a)(1), by striking ‘2009’ and inserting ‘2014’; and
      (2) in subsection (b)--
        (A) in paragraph (1)(A), by inserting ‘, including drills and exercises to ensure medical surge capacity for events without notice’ after ‘exercises’; and
        (B) in paragraph (3)--
          (i) in the matter preceding subparagraph (A)--
            (I) by striking ‘facilities), and trauma care’ and inserting ‘and ambulatory care facilities and which may include dental health facilities), and trauma care, critical care,’; and
            (II) by inserting ‘(including related availability, accessibility, and coordination)’ after ‘public health emergencies’;

          (ii) in subparagraph (A), by inserting ‘and trauma’ after ‘medical’;
          (iii) in subparagraph (B), by striking ‘Medical evacuation and fatality management’ and inserting ‘Fatality management’;
          (iv) by redesignating subparagraphs (C), (D), and (E) as subparagraphs (D), (E), and (F), respectively;
          (v) by inserting after subparagraph (B), the following the new subparagraph:
        Citation:

        ‘(C) Coordinated medical triage and evacuation to appropriate medical institutions based on patient medical need, taking into account regionalized systems of care.’;

          (vi) in subparagraph (E), as redesignated by clause (iv), by inserting ‘(which may include such dental health assets)’ after ‘medical assets’; and
          (vii) by adding at the end the following:
        Citation:

        ‘(G) Optimizing a coordinated and flexible approach to the medical surge capacity of hospitals, other health care facilities, critical care, trauma care (which may include trauma centers), and emergency medical systems.’;


        (C) in paragraph (4)--
          (i) in subparagraph (A), by inserting ‘, including the unique needs and considerations of individuals with disabilities,’ after ‘medical needs of at-risk individuals’; and
          (ii) in subparagraph (B), by inserting ‘the’ before ‘purpose of this section’; and

        (D) by adding at the end the following:
      Citation:

      ‘(7) COUNTERMEASURES-
        ‘(A) Promoting strategic initiatives to advance countermeasures to diagnose, mitigate, prevent, or treat harm from any biological agent or toxin, chemical, radiological, or nuclear agent or agents, whether naturally occurring, unintentional, or deliberate.
        ‘(B) For purposes of this paragraph, the term ‘countermeasures’ has the same meaning as the terms ‘qualified countermeasures’ under section 319F-1, ‘qualified pandemic and epidemic products’ under section 319F-3, and ‘security countermeasures’ under section 319F-2.

      ‘(8) MEDICAL AND PUBLIC HEALTH COMMUNITY RESILIENCY- Strengthening the ability of States, local communities, and tribal communities to prepare for, respond to, and be resilient in the event of public health emergencies, whether naturally occurring, unintentional, or deliberate by--
        ‘(A) optimizing alignment and integration of medical and public health preparedness and response planning and capabilities with and into routine daily activities; and
        ‘(B) promoting familiarity with local medical and public health systems.’.


    (b) At-Risk Individuals- Section 2814 of the Public Health Service Act (42 U.S.C. 300hh-16) is amended--
      (1) by striking paragraphs (5), (7), and (8);
      (2) in paragraph (4), by striking ‘2811(b)(3)(B)’ and inserting ‘2802(b)(4)(B)’;
      (3) by redesignating paragraphs (1) through (4) as paragraphs (2) through (5), respectively;
      (4) by inserting before paragraph (2) (as so redesignated), the following:
      Citation:
      ‘(1) monitor emerging issues and concerns as they relate to medical and public health preparedness and response for at-risk individuals in the event of a public health emergency declared by the Secretary under section 319;’;


      (5) by amending paragraph (2) (as so redesignated) to read as follows:
      Citation:
      ‘(2) oversee the implementation of the preparedness goals described in section 2802(b) with respect to the public health and medical needs of at-risk individuals in the event of a public health emergency, as described in section 2802(b)(4);’; and


      (6) by inserting after paragraph (6), the following:
      Citation:
      ‘(7) disseminate and, as appropriate, update novel and best practices of outreach to and care of at-risk individuals before, during, and following public health emergencies in as timely a manner as is practicable, including from the time a public health threat is identified; and
      ‘(8) ensure that public health and medical information distributed by the Department of Health and Human Services during a public health emergency is delivered in a manner that takes into account the range of communication needs of the intended recipients, including at-risk individuals.’.




SEC. 102. ASSISTANT SECRETARY FOR PREPAREDNESS AND RESPONSE.


    (a) In General- Section 2811 of the Public Health Service Act (42 U.S.C. 300hh-10) is amended--
      (1) in subsection (b)--
        (A) in paragraph (3), by inserting ‘, security countermeasures (as defined in section 319F-2),’ after ‘qualified countermeasures (as defined in section 319F-1)’;
        (B) in paragraph (4), by adding at the end the following:
        Citation:
        ‘(D) POLICY COORDINATION AND STRATEGIC DIRECTION- Provide integrated policy coordination and strategic direction with respect to all matters related to Federal public health and medical preparedness and execution and deployment of the Federal response for public health emergencies and incidents covered by the National Response Plan developed pursuant to section 504(6) of the Homeland Security Act of 2002, or any successor plan, before, during, and following public health emergencies.
        ‘(E) IDENTIFICATION OF INEFFICIENCIES- Identify and minimize gaps, duplication, and other inefficiencies in medical and public health preparedness and response activities and the actions necessary to overcome these obstacles.
        ‘(F) COORDINATION OF GRANTS AND AGREEMENTS- Align and coordinate medical and public health grants and cooperative agreements as applicable to preparedness and response activities authorized under this Act, to the extent possible, including program requirements, timelines, and measurable goals, and in consultation with the Secretary of Homeland Security, to--
          ‘(i) optimize and streamline medical and public health preparedness and response capabilities and the ability of local communities to respond to public health emergencies; and
          ‘(ii) gather and disseminate best practices among grant and cooperative agreement recipients, as appropriate.

        ‘(G) DRILL AND OPERATIONAL EXERCISES- Carry out drills and operational exercises, in consultation with the Department of Homeland Security, the Department of Defense, the Department of Veterans Affairs, and other applicable Federal departments and agencies, as necessary and appropriate, to identify, inform, and address gaps in and policies related to all-hazards medical and public health preparedness and response, including exercises based on--
          ‘(i) identified threats for which countermeasures are available and for which no countermeasures are available; and
          ‘(ii) unknown threats for which no countermeasures are available.

        ‘(H) NATIONAL SECURITY PRIORITY- On a periodic basis consult with, as applicable and appropriate, the Assistant to the President for National Security Affairs, to provide an update on, and discuss, medical and public health preparedness and response activities pursuant to this Act and the Federal Food, Drug, and Cosmetic Act, including progress on the development, approval, clearance, and licensure of medical countermeasures.’; and


        (C) by adding at the end the following:
      Citation:

      ‘(7) COUNTERMEASURES BUDGET PLAN- Develop, and update on an annual basis, a coordinated 5-year budget plan based on the medical countermeasure priorities described in subsection (d). Each such plan shall--
        ‘(A) include consideration of the entire medical countermeasures enterprise, including--
          ‘(i) basic research and advanced research and development;
          ‘(ii) approval, clearance, licensure, and authorized uses of products; and
          ‘(iii) procurement, stockpiling, maintenance, and replenishment of all products in the Strategic National Stockpile;

        ‘(B) inform prioritization of resources and include measurable outputs and outcomes to allow for the tracking of the progress made toward identified priorities;
        ‘(C) identify medical countermeasure life-cycle costs to inform planning, budgeting, and anticipated needs within the continuum of the medical countermeasure enterprise consistent with section 319F-2; and
        ‘(D) be made available to the appropriate committees of Congress upon request.’;


      (2) by striking subsection (c) and inserting the following:
    Citation:

    ‘(c) Functions- The Assistant Secretary for Preparedness and Response shall--
      ‘(1) have lead responsibility within the Department of Health and Human Services for emergency preparedness and response policy coordination and strategic direction;
      ‘(2) have authority over and responsibility for--
        ‘(A) the National Disaster Medical System pursuant to section 2812;
        ‘(B) the Hospital Preparedness Cooperative Agreement Program pursuant to section 319C-2;
        ‘(C) the Biomedical Advanced Research and Development Authority pursuant to section 319L;
        ‘(D) the Medical Reserve Corps pursuant to section 2813;
        ‘(E) the Emergency System for Advance Registration of Volunteer Health Professionals pursuant to section 319I; and
        ‘(F) administering grants and related authorities related to trauma care under parts A through C of title XII, such authority to be transferred by the Secretary from the Administrator of the Health Resources and Services Administration to such Assistant Secretary;

      ‘(3) exercise the responsibilities and authorities of the Secretary with respect to the coordination of--
        ‘(A) the Public Health Emergency Preparedness Cooperative Agreement Program pursuant to section 319C-1;
        ‘(B) the Strategic National Stockpile pursuant to section 319F-2; and
        ‘(C) the Cities Readiness Initiative; and

      ‘(4) assume other duties as determined appropriate by the Secretary.’; and
      (3) by adding at the end the following:

    ‘(d) Public Health Emergency Medical Countermeasures Enterprise Strategy and Implementation Plan-
      ‘(1) IN GENERAL- Not later than 180 days after the date of enactment of this subsection, and every year thereafter, the Assistant Secretary for Preparedness and Response shall develop and submit to the appropriate committees of Congress a coordinated strategy and accompanying implementation plan for medical countermeasures to address chemical, biological, radiological, and nuclear threats. In developing such a plan, the Assistant Secretary for Preparedness and Response shall consult with the Director of the Biomedical Advanced Research and Development Authority, the Director of the National Institutes of Health, the Director of the Centers for Disease Control and Prevention, and the Commissioner of Food and Drugs. Such strategy and plan shall be known as the ‘Public Health Emergency Medical Countermeasures Enterprise Strategy and Implementation Plan’.
      ‘(2) REQUIREMENTS- The plan under paragraph (1) shall--
        ‘(A) describe the chemical, biological, radiological, and nuclear agent or agents that may present a threat to the Nation and the corresponding efforts to develop qualified countermeasures (as defined in section 319F-1), security countermeasures (as defined in section 319F-2), or qualified pandemic or epidemic products (as defined in section 319F-3) for each threat;
        ‘(B) evaluate the progress of all activities with respect to such countermeasures or products, including research, advanced research, development, procurement, stockpiling, deployment, distribution, and utilization;
        ‘(C) identify and prioritize near-, mid-, and long-term needs with respect to such countermeasures or products to address a chemical, biological, radiological, and nuclear threat or threats;
        ‘(D) identify, with respect to each category of threat, a summary of all awards and contracts, including advanced research and development and procurement, that includes--
          ‘(i) the time elapsed from the issuance of the initial solicitation or request for a proposal to the adjudication (such as the award, denial of award, or solicitation termination); and
          ‘(ii) an identification of projected timelines, anticipated funding allocations, benchmarks, and milestones for each medical countermeasure priority under subparagraph (C), including projected needs with regard to replenishment of the Strategic National Stockpile;

        ‘(E) be informed by the recommendations of the National Biodefense Science Board pursuant to section 319M;
        ‘(F) evaluate progress made in meeting timelines, allocations, benchmarks, and milestones identified under subparagraph (D)(ii);
        ‘(G) report on the amount of funds available for procurement in the special reserve fund as defined in section 319F-2(h) and the impact this funding will have on meeting the requirements under section 319F-2;
        ‘(H) incorporate input from Federal, State, local, and tribal stakeholders;
        ‘(I) identify the progress made in meeting the medical countermeasure priorities for at-risk individuals (as defined in 2802(b)(4)(B)), as applicable under subparagraph (C), including with regard to the projected needs for related stockpiling and replenishment of the Strategic National Stockpile, including by addressing the needs of pediatric populations with respect to such countermeasures and products in the Strategic National Stockpile, including--
          ‘(i) a list of such countermeasures and products necessary to address the needs of pediatric populations;
          ‘(ii) a description of measures taken to coordinate with the Office of Pediatric Therapeutics of the Food and Drug Administration to maximize the labeling, dosages, and formulations of such countermeasures and products for pediatric populations;
          ‘(iii) a description of existing gaps in the Strategic National Stockpile and the development of such countermeasures and products to address the needs of pediatric populations; and
          ‘(iv) an evaluation of the progress made in addressing priorities identified pursuant to subparagraph (C);

        ‘(J) identify the use of authority and activities undertaken pursuant to sections 319F-1(b)(1), 319F-1(b)(2), 319F-1(b)(3), 319F-1(c), 319F-1(d), 319F-1(e), 319F-2(c)(7)(C)(iii), 319F-2(c)(7)(C)(iv), and 319F-2(c)(7)(C)(v) of this Act, and subsections (a)(1), (b)(1), and (e) of section 564 of the Federal Food, Drug, and Cosmetic Act, by summarizing--
          ‘(i) the particular actions that were taken under the authorities specified, including, as applicable, the identification of the threat agent, emergency, or the biomedical countermeasure with respect to which the authority was used;
          ‘(ii) the reasons underlying the decision to use such authorities, including, as applicable, the options that were considered and rejected with respect to the use of such authorities;
          ‘(iii) the number of, nature of, and other information concerning the persons and entities that received a grant, cooperative agreement, or contract pursuant to the use of such authorities, and the persons and entities that were considered and rejected for such a grant, cooperative agreement, or contract, except that the report need not disclose the identity of any such person or entity;
          ‘(iv) whether, with respect to each procurement that is approved by the President under section 319F-2(c)(6), a contract was entered into within one year after such approval by the President; and
          ‘(v) with respect to section 319F-1(d), for the one-year period for which the report is submitted, the number of persons who were paid amounts totaling $100,000 or greater and the number of persons who were paid amounts totaling at least $50,000 but less than $100,000; and

        ‘(K) be made publicly available.

      ‘(3) GAO REPORT-
        ‘(A) IN GENERAL- Not later than 1 year after the date of the submission to the Congress of the first Public Health Emergency Medical Countermeasures Enterprise Strategy and Implementation Plan, the Comptroller General of the United States shall conduct an independent evaluation, and submit to the appropriate committees of Congress a report, concerning such Strategy and Implementation Plan.
        ‘(B) CONTENT- The report described in subparagraph (A) shall review and assess--
          ‘(i) the near-term, mid-term, and long-term medical countermeasure needs and identified priorities of the Federal Government pursuant to paragraph (2)(C);
          ‘(ii) the activities of the Department of Health and Human Services with respect to advanced research and development pursuant to section 319L; and
          ‘(iii) the progress made toward meeting the timelines, allocations, benchmarks, and milestones identified in the Public Health Emergency Medical Countermeasures Enterprise Strategy and Implementation Plan under this subsection.

    ‘(e) Protection of National Security- In carrying out subsections (b)(7) and (d), the Secretary shall ensure that information and items that could compromise national security, contain confidential commercial information, or contain proprietary information are not disclosed.’.


    (b) Interagency Coordination Plan- In the first Public Health Emergency Countermeasures Enterprise Strategy and Implementation Plan submitted under subsection (d) of section 2811 of the Public Health Service Act (42 U.S.C. 300hh-10) (as added by subsection (a)(3)), the Secretary of Health and Human Services, in consultation with the Secretary of Defense, shall include a description of the manner in which the Department of Health and Human Services is coordinating with the Department of Defense regarding countermeasure activities to address chemical, biological, radiological, and nuclear threats. Such report shall include information with respect to--
      (1) the research, advanced research, development, procurement, stockpiling, and distribution of countermeasures to meet identified needs; and
      (2) the coordination of efforts between the Department of Health and Human Services and the Department of Defense to address countermeasure needs for various segments of the population.

SEC. 103. NATIONAL ADVISORY COMMITTEE ON CHILDREN AND DISASTERS.


    Subtitle B of title XXVIII of the Public Health Service Act (42 U.S.C. 300hh et seq.) is amended by inserting after section 2811 the following:
Citation:

‘SEC. 2811A. NATIONAL ADVISORY COMMITTEE ON CHILDREN AND DISASTERS.
    ‘(a) Establishment- The Secretary, in consultation with the Secretary of Homeland Security, shall establish an advisory committee to be known as the ‘National Advisory Committee on Children and Disasters’ (referred to in this section as the ‘Advisory Committee’).
    ‘(b) Duties- The Advisory Committee shall--
      ‘(1) provide advice and consultation with respect to the activities carried out pursuant to section 2814, as applicable and appropriate;
      ‘(2) evaluate and provide input with respect to the medical and public health needs of children as they relate to preparation for, response to, and recovery from all-hazards emergencies; and
      ‘(3) provide advice and consultation with respect to State emergency preparedness and response activities and children, including related drills and exercises pursuant to the preparedness goals under section 2802(b).

    ‘(c) Additional Duties- The Advisory Committee may provide advice and recommendations to the Secretary with respect to children and the medical and public health grants and cooperative agreements as applicable to preparedness and response activities authorized under this title and title III.
    ‘(d) Membership-
      ‘(1) IN GENERAL- The Secretary, in consultation with such other Secretaries as may be appropriate, shall appoint not to exceed 15 members to the Advisory Committee. In appointing such members, the Secretary shall ensure that the total membership of the Advisory Committee is an odd number.
      ‘(2) REQUIRED MEMBERS- The Secretary, in consultation with such other Secretaries as may be appropriate, may appoint to the Advisory Committee under paragraph (1) such individuals as may be appropriate to perform the duties described in subsections (b) and (c), which may include--
        ‘(A) the Assistant Secretary for Preparedness and Response;
        ‘(B) the Director of the Biomedical Advanced Research and Development Authority;
        ‘(C) the Director of the Centers for Disease Control and Prevention;
        ‘(D) the Commissioner of Food and Drugs;
        ‘(E) the Director of the National Institutes of Health;
        ‘(F) the Assistant Secretary of the Administration for Children and Families;
        ‘(G) the Administrator of the Federal Emergency Management Agency;
        ‘(H) at least two non-Federal health care professionals with expertise in pediatric medical disaster planning, preparedness, response, or recovery;
        ‘(I) at least two representatives from State, local, territorial, or tribal agencies with expertise in pediatric disaster planning, preparedness, response, or recovery; and
        ‘(J) representatives from such Federal agencies (such as the Department of Education and the Department of Homeland Security) as determined necessary to fulfill the duties of the Advisory Committee, as established under subsections (b) and (c).

    ‘(e) Meetings- The Advisory Committee shall meet not less than biannually.
    ‘(f) Sunset- The Advisory Committee shall terminate on September 30, 2018.’.



SEC. 104. MODERNIZATION OF THE NATIONAL DISASTER MEDICAL SYSTEM.
    Section 2812 of the Public Health Service Act (42 U.S.C. 300hh-11) is amended--
      (1) in subsection (a)(3)--
        (A) in subparagraph (A), in clause (i) by inserting ‘, including at-risk individuals as applicable’ after ‘victims of a public health emergency’;
        (B) by redesignating subparagraph (C) as subparagraph (E); and
        (C) by inserting after subparagraph (B), the following:
        Citation:
        ‘(C) CONSIDERATIONS FOR AT-RISK POPULATIONS- The Secretary shall take steps to ensure that an appropriate specialized and focused range of public health and medical capabilities are represented in the National Disaster Medical System, which take into account the needs of at-risk individuals, in the event of a public health emergency.’.
        ‘(D) ADMINISTRATION- The Secretary may determine and pay claims for reimbursement for services under subparagraph (A) directly or through contracts that provide for payment in advance or by way of reimbursement.’; and


      (2) in subsection (g), by striking ‘such sums as may be necessary for each of the fiscal years 2007 through 2011’ and inserting ‘$52,700,000 for each of fiscal years 2014 through 2018’.


SEC. 105. CONTINUING THE ROLE OF THE DEPARTMENT OF VETERANS AFFAIRS.
    Section 8117(g) of title 38, United States Code, is amended by striking ‘such sums as may be necessary to carry out this section for each of fiscal years 2007 through 2011’ and inserting ‘$155,300,000 for each of fiscal years 2014 through 2018 to carry out this section’.
TITLE II--OPTIMIZING STATE AND LOCAL ALL-HAZARDS PREPAREDNESS AND RESPONSE
SEC. 201. TEMPORARY REASSIGNMENT OF STATE AND LOCAL PERSONNEL DURING A PUBLIC HEALTH EMERGENCY.


    Section 319 of the Public Health Service Act (42 U.S.C. 247d) is amended by adding at the end the following:
    Citation:
    ‘(e) Temporary Reassignment of State and Local Personnel During a Public Health Emergency-
      ‘(1) EMERGENCY REASSIGNMENT OF FEDERALLY FUNDED PERSONNEL- Notwithstanding any other provision of law, and subject to paragraph (2), upon request by the Governor of a State or a tribal organization or such Governor or tribal organization’s designee, the Secretary may authorize the requesting State or Indian tribe to temporarily reassign, for purposes of immediately addressing a public health emergency in the State or Indian tribe, State and local public health department or agency personnel funded in whole or in part through programs authorized under this Act, as appropriate.
      ‘(2) ACTIVATION OF EMERGENCY REASSIGNMENT-
        ‘(A) PUBLIC HEALTH EMERGENCY- The Secretary may authorize a temporary reassignment of personnel under paragraph (1) only during the period of a public health emergency determined pursuant to subsection (a).
        ‘(B) CONTENTS OF REQUEST- To seek authority for a temporary reassignment of personnel under paragraph (1), the Governor of a State or a tribal organization shall submit to the Secretary a request for such reassignment flexibility and shall include in the request each of the following:
          ‘(i) An assurance that the public health emergency in the geographic area of the requesting State or Indian tribe cannot be adequately and appropriately addressed by the public health workforce otherwise available.
          ‘(ii) An assurance that the public health emergency would be addressed more efficiently and effectively through the requested temporary reassignment of State and local personnel described in paragraph (1).
          ‘(iii) An assurance that the requested temporary reassignment of personnel is consistent with any applicable All-Hazards Public Health Emergency Preparedness and Response Plan under section 319C-1.
          ‘(iv) An identification of--
            ‘(I) each Federal program from which personnel would be temporarily reassigned pursuant to the requested authority; and
            ‘(II) the number of personnel who would be so reassigned from each such program.

          ‘(v) Such other information and assurances upon which the Secretary and Governor of a State or tribal organization agree.

        ‘(C) CONSIDERATION- In reviewing a request for temporary reassignment under paragraph (1), the Secretary shall consider the degree to which the program or programs funded in whole or in part by programs authorized under this Act would be adversely affected by the reassignment.
        ‘(D) TERMINATION AND EXTENSION-
          ‘(i) TERMINATION- A State or Indian tribe’s temporary reassignment of personnel under paragraph (1) shall terminate upon the earlier of the following:
            ‘(I) The Secretary’s determination that the public health emergency no longer exists.
            ‘(II) Subject to clause (ii), the expiration of the 30-day period following the date on which the Secretary approved the State or Indian tribe’s request for such reassignment flexibility.

          ‘(ii) EXTENSION OF REASSIGNMENT FLEXIBILITY- The Secretary may extend reassignment flexibility of personnel under paragraph (1) beyond the date otherwise applicable under clause (i)(II) if the public health emergency still exists as of such date, but only if--
            ‘(I) the State or Indian tribe that submitted the initial request for a temporary reassignment of personnel submits a request for an extension of such temporary reassignment; and
            ‘(II) the request for an extension contains the same information and assurances necessary for the approval of an initial request for such temporary reassignment pursuant to subparagraph (B).

      ‘(3) VOLUNTARY NATURE OF TEMPORARY REASSIGNMENT OF STATE AND LOCAL PERSONNEL-
        ‘(A) IN GENERAL- Unless otherwise provided under the law or regulation of the State or Indian tribe that receives authorization for temporary reassignment of personnel under paragraph (1), personnel eligible for reassignment pursuant to such authorization--
          ‘(i) shall have the opportunity to volunteer for temporary reassignment; and
          ‘(ii) shall not be required to agree to a temporary reassignment.

        ‘(B) PROHIBITION ON CONDITIONING FEDERAL AWARDS- The Secretary may not condition the award of a grant, contract, or cooperative agreement under this Act on the requirement that a State or Indian tribe require that personnel eligible for reassignment pursuant to an authorization under paragraph (1) agree to such reassignment.

      ‘(4) NOTICE TO CONGRESS- The Secretary shall give notice to the Congress in conjunction with the approval under this subsection of--
        ‘(A) any initial request for temporary reassignment of personnel; and
        ‘(B) any request for an extension of such temporary reassignment.

      ‘(5) GUIDANCE- The Secretary shall--
        ‘(A) not later than 6 months after the enactment of this subsection, issue proposed guidance on the temporary reassignment of personnel under this subsection; and
        ‘(B) after providing notice and a 60-day period for public comment, finalize such guidance.

      ‘(6) REPORT TO CONGRESS- Not later than 4 years after the date of enactment of the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013, the Comptroller General of the United States shall conduct an independent evaluation, and submit to the appropriate committees of the Congress a report, on temporary reassignment under this subsection, including--
        ‘(A) a description of how, and under what circumstances, such temporary reassignment has been used by States and Indian tribes;
        ‘(B) an analysis of how such temporary reassignment has assisted States and Indian tribes in responding to public health emergencies;
        ‘(C) an evaluation of how such temporary reassignment has improved operational efficiencies in responding to public health emergencies;
        ‘(D) an analysis of the extent to which, if any, Federal programs from which personnel have been temporarily reassigned have been adversely affected by the reassignment; and
        ‘(E) recommendations on how medical surge capacity could be improved in responding to public health emergencies and the impact of the reassignment flexibility under this section on such surge capacity.

      ‘(7) DEFINITIONS- In this subsection--
        ‘(A) the terms ‘Indian tribe’ and ‘tribal organization’ have the meanings given such terms in section 4 of the Indian Self-Determination and Education Assistance Act; and
        ‘(B) the term ‘State’ includes, in addition to the entities listed in the definition of such term in section 2, the Freely Associated States.

      ‘(8) SUNSET- This subsection shall terminate on September 30, 2018.’.



SEC. 202. IMPROVING STATE AND LOCAL PUBLIC HEALTH SECURITY.
    (a) Cooperative Agreements- Section 319C-1 of the Public Health Service Act (42 U.S.C. 247d-3a) is amended--
      (1) in subsection (b)(1)(C), by striking ‘consortium of entities described in subparagraph (A)’ and inserting ‘consortium of States’;
      (2) in subsection (b)(2)--
        (A) in subparagraph (A)--
          (i) by striking clauses (i) and (ii) and inserting the following:
          Citation:
          ‘(i) a description of the activities such entity will carry out under the agreement to meet the goals identified under section 2802, including with respect to chemical, biological, radiological, or nuclear threats, whether naturally occurring, unintentional, or deliberate;
          ‘(ii) a description of the activities such entity will carry out with respect to pandemic influenza, as a component of the activities carried out under clause (i), and consistent with the requirements of paragraphs (2) and (5) of subsection (g);’;


          (ii) in clause (iv), by striking ‘and’ at the end; and
          (iii) by adding at the end the following:
          Citation:
          ‘(vi) a description of how, as appropriate, the entity may partner with relevant public and private stakeholders in public health emergency preparedness and response;
          ‘(vii) a description of how the entity, as applicable and appropriate, will coordinate with State emergency preparedness and response plans in public health emergency preparedness, including State educational agencies (as defined in section 9101(41) of the Elementary and Secondary Education Act of 1965) and State child care lead agencies (designated under section 658D of the Child Care and Development Block Grant Act of 1990);
          ‘(viii) in the case of entities that operate on the United States-Mexico border or the United States-Canada border, a description of the activities such entity will carry out under the agreement that are specific to the border area including disease detection, identification, investigation, and preparedness and response activities related to emerging diseases and infectious disease outbreaks whether naturally occurring or due to bioterrorism, consistent with the requirements of this section; and
          ‘(ix) a description of any activities that such entity will use to analyze real-time clinical specimens for pathogens of public health or bioterrorism significance, including any utilization of poison control centers;’; and


        (B) in subparagraph (C), by inserting ‘, including addressing the needs of at-risk individuals,’ after ‘capabilities of such entity’;

      (3) in subsection (f)--
        (A) in paragraph (2), by adding ‘and’ at the end;
        (B) in paragraph (3), by striking ‘; and’ and inserting a period; and
        (C) by striking paragraph (4);

      (4) in subsection (g)--
        (A) in paragraph (1), by striking subparagraph (A) and inserting the following:
        Citation:
        ‘(A) include outcome goals representing operational achievements of the National Preparedness Goals developed under section 2802(b) with respect to all-hazards, including chemical, biological, radiological, or nuclear threats; and’; and


        (B) in paragraph (2)(A), by adding at the end the following: ‘The Secretary shall periodically update, as necessary and appropriate, such pandemic influenza plan criteria and shall require the integration of such criteria into the benchmarks and standards described in paragraph (1).’;

      (5) by striking subsection (h);
      (6) by redesignating subsections (i), (j), and (k) as subsections (h), (i), and (j), respectively;
      (7) in subsection (h), as so redesignated--
        (A) in paragraph (1)--
          (i) in subparagraph (A)--
            (I) by striking ‘$824,000,000 for fiscal year 2007, of which $35,000,000 shall be used to carry out subsection (h),’ and inserting ‘$641,900,000 for fiscal year 2014’; and
            (II) by striking ‘such sums as may be necessary for each of fiscal years 2008 through 2011’ and inserting ‘$641,900,000 for each of fiscal years 2015 through 2018’;

          (ii) by striking subparagraph (B);
          (iii) by redesignating subparagraphs (C) and (D) as subparagraphs (B) and (C), respectively; and
          (iv) in subparagraph (C), as so redesignated, by striking ‘subparagraph (C)’ and inserting ‘subparagraph (B)’;

        (B) in subparagraphs (C) and (D) of paragraph (3), by striking ‘(1)(A)(i)(I)’ each place it appears and inserting ‘(1)(A)’;
        (C) in paragraph (4)(B), by striking ‘subsection (c)’ and inserting ‘subsection (b)’; and
        (D) by adding at the end the following:
      Citation:

      ‘(7) AVAILABILITY OF COOPERATIVE AGREEMENT FUNDS-
        ‘(A) IN GENERAL- Amounts provided to an eligible entity under a cooperative agreement under subsection (a) for a fiscal year and remaining unobligated at the end of such year shall remain available to such entity for the next fiscal year for the purposes for which such funds were provided.
        ‘(B) FUNDS CONTINGENT ON ACHIEVING BENCHMARKS- The continued availability of funds under subparagraph (A) with respect to an entity shall be contingent upon such entity achieving the benchmarks and submitting the pandemic influenza plan as described in subsection (g).’; and


      (8) in subsection (i), as so redesignated--
        (A) in paragraph (1)(E), by striking ‘subsection (k)’ and inserting ‘subsection (j)’;
        (B) by striking paragraph (3).

    (b) Vaccine Tracking and Distribution- Section 319A(e) of the Public Health Service Act (42 U.S.C. 247d-1(e)) is amended by striking ‘such sums for each of fiscal years 2007 through 2011’ and inserting ‘$30,800,000 for each of fiscal years 2014 through 2018’.
    (c) Technical and Conforming Amendments-
      (1) Section 319C-1(b)(1)(B) of the Public Health Service Act (42 U.S.C. 247d-3a(b)(1)(B)) is amended by striking ‘subsection (i)(4)’ and inserting ‘subsection (h)(4)’.
      (2) Section 319C-2 of the Public Health Service Act (42 U.S.C. 247d-3b) is amended--
        (A) in subsection (i), by striking ‘(j), and (k)’ and inserting ‘(i), and (j)’; and
        (B) in subsection (j)(3), by striking ‘319C-1(i)’ and inserting ‘319C-1(h)’.



SEC. 203. HOSPITAL PREPAREDNESS AND MEDICAL SURGE CAPACITY.


    (a) All-Hazards Public Health and Medical Response Curricula and Training- Section 319F(a)(5)(B) of the Public Health Service Act (42 U.S.C. 247d-6(a)(5)(B)) is amended by striking ‘public health or medical’ and inserting ‘public health, medical, or dental’.
    (b) Encouraging Health Professional Volunteers-
      (1) EMERGENCY SYSTEM FOR ADVANCE REGISTRATION OF VOLUNTEER HEALTH PROFESSIONALS- Section 319I(k) of the Public Health Service Act (42 U.S.C. 247d-7b(k)) is amended by striking ‘$2,000,000 for fiscal year 2002, and such sums as may be necessary for each of the fiscal years 2003 through 2011’ and inserting ‘$5,000,000 for each of fiscal years 2014 through 2018’.
      (2) VOLUNTEERS- Section 2813 of the Public Health Service Act (42 U.S.C. 300hh-15) is amended--
        (A) in subsection (d)(2), by adding at the end the following: ‘Such training exercises shall, as appropriate and applicable, incorporate the needs of at-risk individuals in the event of a public health emergency.’; and
        (B) in subsection (i), by striking ‘$22,000,000 for fiscal year 2007, and such sums as may be necessary for each of fiscal years 2008 through 2011’ and inserting ‘$11,200,000 for each of fiscal years 2014 through 2018’.

    (c) Partnerships for State and Regional Preparedness To Improve Surge Capacity- Section 319C-2 of the Public Health Service Act (42 U.S.C. 247d-3b) is amended--
      (1) in subsection (a), by inserting ‘, including, as appropriate, capacity and preparedness to address the needs of children and other at-risk individuals’ before the period at the end;
      (2) in subsection (b)(1)(A)(ii), by striking ‘centers, primary’ and inserting ‘centers, community health centers, primary’;
      (3) by striking subsection (c) and inserting the following:
    Citation:

    ‘(c) Use of Funds- An award under subsection (a) shall be expended for activities to achieve the preparedness goals described under paragraphs (1), (3), (4), (5), and (6) of section 2802(b) with respect to all-hazards, including chemical, biological, radiological, or nuclear threats.’;

      (4) by striking subsection (g) and inserting the following:
    Citation:

    ‘(g) Coordination-
      ‘(1) LOCAL RESPONSE CAPABILITIES- An eligible entity shall, to the extent practicable, ensure that activities carried out under an award under subsection (a) are coordinated with activities of relevant local Metropolitan Medical Response Systems, local Medical Reserve Corps, the local Cities Readiness Initiative, and local emergency plans.
      ‘(2) NATIONAL COLLABORATION- Partnerships consisting of one or more eligible entities under this section may, to the extent practicable, collaborate with other partnerships consisting of one or more eligible entities under this section for purposes of national coordination and collaboration with respect to activities to achieve the preparedness goals described under paragraphs (1), (3), (4), (5), and (6) of section 2802(b).’;
      (5) in subsection (i)--
        (A) by striking ‘The requirements of’ and inserting the following:

      ‘(1) IN GENERAL- The requirements of’; and
        (B) by adding at the end the following:

      ‘(2) MEETING GOALS OF NATIONAL HEALTH SECURITY STRATEGY- The Secretary shall implement objective, evidence-based metrics to ensure that entities receiving awards under this section are meeting, to the extent practicable, the applicable goals of the National Health Security Strategy under section 2802.’; and
      (6) in subsection (j)--
        (A) by amending paragraph (1) to read as follows:

      ‘(1) IN GENERAL- For purposes of carrying out this section, there is authorized to be appropriated $374,700,000 for each of fiscal years 2014 through 2018.’; and
        (B) by adding at the end the following:

      ‘(4) AVAILABILITY OF COOPERATIVE AGREEMENT FUNDS-
        ‘(A) IN GENERAL- Amounts provided to an eligible entity under a cooperative agreement under subsection (a) for a fiscal year and remaining unobligated at the end of such year shall remain available to such entity for the next fiscal year for the purposes for which such funds were provided.
        ‘(B) FUNDS CONTINGENT ON ACHIEVING BENCHMARKS- The continued availability of funds under subparagraph (A) with respect to an entity shall be contingent upon such entity achieving the benchmarks and submitting the pandemic influenza plan as required under subsection (i).’.



SEC. 204. ENHANCING SITUATIONAL AWARENESS AND BIOSURVEILLANCE.


    (a) In General- Section 319D of the Public Health Service Act (42 U.S.C. 247d-4) is amended--
      (1) in subsection (b)--
        (A) in paragraph (1)(B), by inserting ‘poison control centers,’ after ‘hospitals,’;
        (B) in paragraph (2), by inserting before the period at the end the following: ‘, allowing for coordination to maximize all-hazards medical and public health preparedness and response and to minimize duplication of effort’; and
        (C) in paragraph (3), by inserting before the period at the end the following: ‘and update such standards as necessary’;

      (2) by striking subsection (c);
      (3) by redesignating subsections (d) through (g) as subsections (c) through (f), respectively;
      (4) in subsection (c), as so redesignated--
        (A) in the subsection heading, by striking ‘Public Health Situational Awareness’ and inserting ‘Modernizing Public Health Situational Awareness and Biosurveillance’;
        (B) in paragraph (1)--
          (i) by striking ‘Pandemic and All-Hazards Preparedness Act’ and inserting ‘Pandemic and All-Hazards Preparedness Reauthorization Act of 2013’; and
          (ii) by inserting ‘, novel emerging threats,’ after ‘disease outbreaks’;

        (C) by striking paragraph (2) and inserting the following:
      Citation:

      ‘(2) STRATEGY AND IMPLEMENTATION PLAN- Not later than 180 days after the date of enactment of the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013, the Secretary shall submit to the appropriate committees of Congress a coordinated strategy and an accompanying implementation plan that identifies and demonstrates the measurable steps the Secretary will carry out to--
        ‘(A) develop, implement, and evaluate the network described in paragraph (1), utilizing the elements described in paragraph (3);
        ‘(B) modernize and enhance biosurveillance activities; and
        ‘(C) improve information sharing, coordination, and communication among disparate biosurveillance systems supported by the Department of Health and Human Services.’;
        (D) in paragraph (3)(D), by inserting ‘community health centers, health centers’ after ‘poison control,’;
        (E) in paragraph (5), by striking subparagraph (A) and inserting the following:
        ‘(A) utilize applicable interoperability standards as determined by the Secretary, and in consultation with the Office of the National Coordinator for Health Information Technology, through a joint public and private sector process;’; and
        (F) by adding at the end the following:

      ‘(6) CONSULTATION WITH THE NATIONAL BIODEFENSE SCIENCE BOARD- In carrying out this section and consistent with section 319M, the National Biodefense Science Board shall provide expert advice and guidance, including recommendations, regarding the measurable steps the Secretary should take to modernize and enhance biosurveillance activities pursuant to the efforts of the Department of Health and Human Services to ensure comprehensive, real-time, all-hazards biosurveillance capabilities. In complying with the preceding sentence, the National Biodefense Science Board shall--
        ‘(A) identify the steps necessary to achieve a national biosurveillance system for human health, with international connectivity, where appropriate, that is predicated on State, regional, and community level capabilities and creates a networked system to allow for two-way information flow between and among Federal, State, and local government public health authorities and clinical health care providers;
        ‘(B) identify any duplicative surveillance programs under the authority of the Secretary, or changes that are necessary to existing programs, in order to enhance and modernize such activities, minimize duplication, strengthen and streamline such activities under the authority of the Secretary, and achieve real-time and appropriate data that relate to disease activity, both human and zoonotic; and
        ‘(C) coordinate with applicable existing advisory committees of the Director of the Centers for Disease Control and Prevention, including such advisory committees consisting of representatives from State, local, and tribal public health authorities and appropriate public and private sector health care entities and academic institutions, in order to provide guidance on public health surveillance activities.’;


      (5) in subsection (d), as so redesignated--
        (A) in paragraph (1), by striking ‘subsection (d)’ and inserting ‘subsection (c)’;
        (B) in paragraph (4)(B), by striking ‘subsection (d)’ and inserting ‘subsection (c)’; and
        (C) in paragraph (5)--
          (i) by striking ‘4 years after the date of enactment of the Pandemic and All-Hazards Preparedness Act’ and inserting ‘3 years after the date of enactment of the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013’; and
          (ii) by striking ‘subsection (d)’ and inserting ‘subsection (c)’;

      (6) in subsection (f), as so redesignated, by striking ‘such sums as may be necessary in each of fiscal years 2007 through 2011’ and inserting ‘$138,300,000 for each of fiscal years 2014 through 2018’; and
      (7) by adding at the end the following:
    Citation:

    ‘(g) Definition- For purposes of this section the term ‘biosurveillance’ means the process of gathering near real-time biological data that relates to human and zoonotic disease activity and threats to human or animal health, in order to achieve early warning and identification of such health threats, early detection and prompt ongoing tracking of health events, and overall situational awareness of disease activity.’.


    (b) Technical and Conforming Amendment- Section 319C-1(b)(2)(D) of the Public Health Service Act (42 U.S.C. 247d-3a(b)(2)(D)) is amended by striking ‘section 319D(d)(3)’ and inserting ‘section 319D(c)(3)’.


SEC. 205. ELIMINATING DUPLICATIVE PROJECT BIOSHIELD REPORTS.

    Section 5 of the Project Bioshield Act of 2004 (42 U.S.C. 247d-6c) is repealed.
TITLE III--ENHANCING MEDICAL COUNTERMEASURE REVIEW
SEC. 301. SPECIAL PROTOCOL ASSESSMENT.
    Section 505(b)(5)(B) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355(b)(5)(B)) is amended by striking ‘size of clinical trials intended’ and all that follows through ‘. The sponsor or applicant’ and inserting the following: ‘size--
    Citation:
      ‘(i)(I) of clinical trials intended to form the primary basis of an effectiveness claim; or
      ‘(II) in the case where human efficacy studies are not ethical or feasible, of animal and any associated clinical trials which, in combination, are intended to form the primary basis of an effectiveness claim; or
      ‘(ii) with respect to an application for approval of a biological product under section 351(k) of the Public Health Service Act, of any necessary clinical study or studies.


    The sponsor or applicant’.


SEC. 302. AUTHORIZATION FOR MEDICAL PRODUCTS FOR USE IN EMERGENCIES.


    (a) In General- Section 564 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb-3) is amended--
      (1) in subsection (a)--
        (A) in paragraph (1), by striking ‘sections 505, 510(k), and 515 of this Act’ and inserting ‘any provision of this Act’;
        (B) in paragraph (2)(A), by striking ‘under a provision of law referred to in such paragraph’ and inserting ‘under section 505, 510(k), or 515 of this Act or section 351 of the Public Health Service Act’; and
        (C) in paragraph (3), by striking ‘a provision of law referred to in such paragraph’ and inserting ‘a section of this Act or the Public Health Service Act referred to in paragraph (2)(A)’;

      (2) in subsection (b)--
        (A) in the subsection heading, by striking ‘Emergency’ and inserting ‘Emergency or Threat Justifying Emergency Authorized Use’;
        (B) in paragraph (1)--
          (i) in the matter preceding subparagraph (A), by striking ‘may declare an emergency’ and inserting ‘may make a declaration that the circumstances exist’;
          (ii) in subparagraph (A), by striking ‘specified’;
          (iii) in subparagraph (B)--
            (I) by striking ‘specified’; and
            (II) by striking ‘; or’ and inserting a semicolon;

          (iv) by amending subparagraph (C) to read as follows:
        Citation:

        ‘(C) a determination by the Secretary that there is a public health emergency, or a significant potential for a public health emergency, that affects, or has a significant potential to affect, national security or the health and security of United States citizens living abroad, and that involves a biological, chemical, radiological, or nuclear agent or agents, or a disease or condition that may be attributable to such agent or agents; or’; and

          (v) by adding at the end the following:
        Citation:

        ‘(D) the identification of a material threat pursuant to section 319F-2 of the Public Health Service Act sufficient to affect national security or the health and security of United States citizens living abroad.’;


        (C) in paragraph (2)--
          (i) in subparagraph (A), by amending clause (ii) to read as follows:
          Citation:
          ‘(ii) a change in the approval status of the product such that the circumstances described in subsection (a)(2) have ceased to exist.’;


          (ii) by striking subparagraph (B); and
          (iii) by redesignating subparagraph (C) as subparagraph (B);

        (D) in paragraph (4), by striking ‘advance notice of termination, and renewal under this subsection.’ and inserting ‘, and advance notice of termination under this subsection.’; and
        (E) by adding at the end the following:
      Citation:

      ‘(5) EXPLANATION BY SECRETARY- If an authorization under this section with respect to an unapproved product or an unapproved use of an approved product has been in effect for more than 1 year, the Secretary shall provide in writing to the sponsor of such product an explanation of the scientific, regulatory, or other obstacles to approval, licensure, or clearance of such product or use, including specific actions to be taken by the Secretary and the sponsor to overcome such obstacles.’;


      (3) in subsection (c)--
        (A) in the matter preceding paragraph (1)--
          (i) by inserting ‘the Assistant Secretary for Preparedness and Response,’ after ‘consultation with’;
          (ii) by striking ‘Health and’ and inserting ‘Health, and’; and
          (iii) by striking ‘circumstances of the emergency involved’ and inserting ‘applicable circumstances described in subsection (b)(1)’;

        (B) in paragraph (1), by striking ‘specified’ and inserting ‘referred to’; and
        (C) in paragraph (2)(B), by inserting ‘, taking into consideration the material threat posed by the agent or agents identified in a declaration under subsection (b)(1)(D), if applicable’ after ‘risks of the product’;

      (4) in subsection (d)(3), by inserting ‘, to the extent practicable given the circumstances of the emergency,’ after ‘including’;
      (5) in subsection (e)--
        (A) in paragraph (1)(A), by striking ‘circumstances of the emergency’ and inserting ‘applicable circumstances described in subsection (b)(1)’;
        (B) in paragraph (1)(B), by amending clause (iii) to read as follows:
        Citation:
          ‘(iii) Appropriate conditions with respect to collection and analysis of information concerning the safety and effectiveness of the product with respect to the use of such product during the period when the authorization is in effect and a reasonable time following such period.’;


        (C) in paragraph (2)--
          (i) in subparagraph (A)--
            (I) by striking ‘manufacturer of the product’ and inserting ‘person’;
            (II) by striking ‘circumstances of the emergency’ and inserting ‘applicable circumstances described in subsection (b)(1)’; and
            (III) by inserting at the end before the period ‘or in paragraph (1)(B)’;

          (ii) in subparagraph (B)(i), by inserting before the period at the end ‘, except as provided in section 564A with respect to authorized changes to the product expiration date’; and
          (iii) by amending subparagraph (C) to read as follows:
        Citation:

        ‘(C) In establishing conditions under this paragraph with respect to the distribution and administration of the product for the unapproved use, the Secretary shall not impose conditions that would restrict distribution or administration of the product when distributed or administered for the approved use.’; and


        (D) by amending paragraph (3) to read as follows:
      Citation:

      ‘(3) GOOD MANUFACTURING PRACTICE; PRESCRIPTION- With respect to the emergency use of a product for which an authorization under this section is issued (whether an unapproved product or an unapproved use of an approved product), the Secretary may waive or limit, to the extent appropriate given the applicable circumstances described in subsection (b)(1)--
        ‘(A) requirements regarding current good manufacturing practice otherwise applicable to the manufacture, processing, packing, or holding of products subject to regulation under this Act, including such requirements established under section 501 or 520(f)(1), and including relevant conditions prescribed with respect to the product by an order under section 520(f)(2);
        ‘(B) requirements established under section 503(b); and
        ‘(C) requirements established under section 520(e).’;


      (6) in subsection (g)--
        (A) in the subsection heading, by inserting ‘Review and’ before ‘Revocation’;
        (B) in paragraph (1), by inserting after the period at the end the following: ‘As part of such review, the Secretary shall regularly review the progress made with respect to the approval, licensure, or clearance of--
        Citation:
        ‘(A) an unapproved product for which an authorization was issued under this section; or
        ‘(B) an unapproved use of an approved product for which an authorization was issued under this section.’; and


        (C) by amending paragraph (2) to read as follows:
      Citation:

      ‘(2) REVISION AND REVOCATION- The Secretary may revise or revoke an authorization under this section if--
        ‘(A) the circumstances described under subsection (b)(1) no longer exist;
        ‘(B) the criteria under subsection (c) for issuance of such authorization are no longer met; or
        ‘(C) other circumstances make such revision or revocation appropriate to protect the public health or safety.’;


      (7) in subsection (h)(1), by adding after the period at the end the following: ‘The Secretary shall make any revisions to an authorization under this section available on the Internet Web site of the Food and Drug Administration.’;
      (8) by adding at the end of subsection (j) the following:
      Citation:
      ‘(4) Nothing in this section shall be construed as authorizing a delay in the review or other consideration by the Secretary of any application or submission pending before the Food and Drug Administration for a product for which an authorization under this section is issued.’; and


      (9) by adding at the end the following:
    Citation:

    ‘(m) Categorization of Laboratory Tests Associated With Devices Subject to Authorization-
      ‘(1) IN GENERAL- In issuing an authorization under this section with respect to a device, the Secretary may, subject to the provisions of this section, determine that a laboratory examination or procedure associated with such device shall be deemed, for purposes of section 353 of the Public Health Service Act, to be in a particular category of examinations and procedures (including the category described by subsection (d)(3) of such section) if, based on the totality of scientific evidence available to the Secretary--
        ‘(A) such categorization would be beneficial to protecting the public health; and
        ‘(B) the known and potential benefits of such categorization under the circumstances of the authorization outweigh the known and potential risks of the categorization.

      ‘(2) CONDITIONS OF DETERMINATION- The Secretary may establish appropriate conditions on the performance of the examination or procedure pursuant to such determination.
      ‘(3) EFFECTIVE PERIOD- A determination under this subsection shall be effective for purposes of section 353 of the Public Health Service Act notwithstanding any other provision of that section during the effective period of the relevant declaration under subsection (b).’.


    (b) Emergency Use of Medical Products- Subchapter E of chapter V of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb et seq.) is amended by inserting after section 564 the following:


Citation:
‘SEC. 564A. EMERGENCY USE OF MEDICAL PRODUCTS.
    ‘(a) Definitions- In this section:
      ‘(1) ELIGIBLE PRODUCT- The term ‘eligible product’ means a product that--
        ‘(A) is approved or cleared under this chapter or licensed under section 351 of the Public Health Service Act;
        ‘(B)(i) is intended for use to prevent, diagnose, or treat a disease or condition involving a biological, chemical, radiological, or nuclear agent or agents; or
        ‘(ii) is intended for use to prevent, diagnose, or treat a serious or life-threatening disease or condition caused by a product described in clause (i); and
        ‘(C) is intended for use during the circumstances under which--
          ‘(i) a determination described in subparagraph (A), (B), or (C) of section 564(b)(1) has been made by the Secretary of Homeland Security, the Secretary of Defense, or the Secretary, respectively; or
          ‘(ii) the identification of a material threat described in subparagraph (D) of section 564(b)(1) has been made pursuant to section 319F-2 of the Public Health Service Act.

      ‘(2) PRODUCT- The term ‘product’ means a drug, device, or biological product.

    ‘(b) Expiration Dating-
      ‘(1) IN GENERAL- The Secretary may extend the expiration date and authorize the introduction or delivery for introduction into interstate commerce of an eligible product after the expiration date provided by the manufacturer if--
        ‘(A) the expiration date extension is intended to support the United States ability to protect--
          ‘(i) the public health; or
          ‘(ii) military preparedness and effectiveness; and

        ‘(B) the expiration date extension is supported by an appropriate scientific evaluation that is conducted or accepted by the Secretary.

      ‘(2) REQUIREMENTS AND CONDITIONS- Any extension of an expiration date under paragraph (1) shall, as part of the extension, identify--
        ‘(A) each specific lot, batch, or other unit of the product for which extended expiration is authorized;
        ‘(B) the duration of the extension; and
        ‘(C) any other requirements or conditions as the Secretary may deem appropriate for the protection of the public health, which may include requirements for, or conditions on, product sampling, storage, packaging or repackaging, transport, labeling, notice to product recipients, recordkeeping, periodic testing or retesting, or product disposition.

      ‘(3) EFFECT- Notwithstanding any other provision of this Act or the Public Health Service Act, an eligible product shall not be considered an unapproved product (as defined in section 564(a)(2)(A)) and shall not be deemed adulterated or misbranded under this Act because, with respect to such product, the Secretary has, under paragraph (1), extended the expiration date and authorized the introduction or delivery for introduction into interstate commerce of such product after the expiration date provided by the manufacturer.
      ‘(4) EXPIRATION DATE- For purposes of this subsection, the term ‘expiration date’ means the date established through appropriate stability testing required by the regulations issued by the Secretary to ensure that the product meets applicable standards of identity, strength, quality, and purity at the time of use.

    ‘(c) Current Good Manufacturing Practice-
      ‘(1) IN GENERAL- The Secretary may, when the circumstances of a domestic, military, or public health emergency or material threat described in subsection (a)(1)(C) so warrant, authorize, with respect to an eligible product, deviations from current good manufacturing practice requirements otherwise applicable to the manufacture, processing, packing, or holding of products subject to regulation under this Act, including requirements under section 501 or 520(f)(1) or applicable conditions prescribed with respect to the eligible product by an order under section 520(f)(2).
      ‘(2) EFFECT- Notwithstanding any other provision of this Act or the Public Health Service Act, an eligible product shall not be considered an unapproved product (as defined in section 564(a)(2)(A)) and shall not be deemed adulterated or misbranded under this Act because, with respect to such product, the Secretary has authorized deviations from current good manufacturing practices under paragraph (1).

    ‘(d) Emergency Dispensing- The requirements of sections 503(b) and 520(e) shall not apply to an eligible product, and the product shall not be considered an unapproved product (as defined in section 564(a)(2)(A)) and shall not be deemed adulterated or misbranded under this Act because it is dispensed without an individual prescription, if--
      ‘(1) the product is dispensed during the circumstances described in subsection (a)(1)(C); and
      ‘(2) such dispensing without an individual prescription occurs--
        ‘(A) as permitted under the law of the State in which the product is dispensed; or
        ‘(B) in accordance with an order issued by the Secretary, for the purposes and duration of the circumstances described in subsection (a)(1)(C).

    ‘(e) Emergency Use Instructions-
      ‘(1) IN GENERAL- The Secretary, acting through an appropriate official within the Department of Health and Human Services, may create and issue emergency use instructions to inform health care providers or individuals to whom an eligible product is to be administered concerning such product’s approved, licensed, or cleared conditions of use.
      ‘(2) EFFECT- Notwithstanding any other provisions of this Act or the Public Health Service Act, a product shall not be considered an unapproved product and shall not be deemed adulterated or misbranded under this Act because of the issuance of emergency use instructions under paragraph (1) with respect to such product or the introduction or delivery for introduction of such product into interstate commerce accompanied by such instructions--
        ‘(A) during an emergency response to an actual emergency that is the basis for a determination described in subsection (a)(1)(C)(i); or
        ‘(B) by a government entity (including a Federal, State, local, or tribal government entity), or a person acting on behalf of such a government entity, in preparation for an emergency response.’.

    (c) Risk Evaluation and Mitigation Strategies- Section 505-1 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355-1), is amended--
      (1) in subsection (f), by striking paragraph (7); and
      (2) by adding at the end the following:

    ‘(k) Waiver in Public Health Emergencies- The Secretary may waive any requirement of this section with respect to a qualified countermeasure (as defined in section 319F-1(a)(2) of the Public Health Service Act) to which a requirement under this section has been applied, if the Secretary determines that such waiver is required to mitigate the effects of, or reduce the severity of, the circumstances under which--
      ‘(1) a determination described in subparagraph (A), (B), or (C) of section 564(b)(1) has been made by the Secretary of Homeland Security, the Secretary of Defense, or the Secretary, respectively; or
      ‘(2) the identification of a material threat described in subparagraph (D) of section 564(b)(1) has been made pursuant to section 319F-2 of the Public Health Service Act.’.

    (d) Products Held for Emergency Use- The Federal Food, Drug, and Cosmetic Act (21 U.S.C. 301 et seq.) is amended by inserting after section 564A, as added by subsection (b), the following:

‘SEC. 564B. PRODUCTS HELD FOR EMERGENCY USE.
    ‘It is not a violation of any section of this Act or of the Public Health Service Act for a government entity (including a Federal, State, local, or tribal government entity), or a person acting on behalf of such a government entity, to introduce into interstate commerce a product (as defined in section 564(a)(4)) intended for emergency use, if that product--
      ‘(1) is intended to be held and not used; and
      ‘(2) is held and not used, unless and until that product--
        ‘(A) is approved, cleared, or licensed under section 505, 510(k), or 515 of this Act or section 351 of the Public Health Service Act;
        ‘(B) is authorized for investigational use under section 505 or 520 of this Act or section 351 of the Public Health Service Act; or
        ‘(C) is authorized for use under section 564.’.



SEC. 303. DEFINITIONS.


    Section 565 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb-4) is amended by striking ‘The Secretary, in consultation’ and inserting the following:
    Citation:
    ‘(a) Definitions- In this section--
      ‘(1) the term ‘countermeasure’ means a qualified countermeasure, a security countermeasure, and a qualified pandemic or epidemic product;
      ‘(2) the term ‘qualified countermeasure’ has the meaning given such term in section 319F-1 of the Public Health Service Act;
      ‘(3) the term ‘security countermeasure’ has the meaning given such term in section 319F-2 of such Act; and
      ‘(4) the term ‘qualified pandemic or epidemic product’ means a product that meets the definition given such term in section 319F-3 of the Public Health Service Act and--
        ‘(A) that has been identified by the Department of Health and Human Services or the Department of Defense as receiving funding directly related to addressing chemical, biological, radiological, or nuclear threats, including pandemic influenza; or
        ‘(B) is included under this paragraph pursuant to a determination by the Secretary.

    ‘(b) General Duties- The Secretary, in consultation’.



SEC. 304. ENHANCING MEDICAL COUNTERMEASURE ACTIVITIES.


    Section 565 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb-4), as amended by section 303, is further amended--
      (1) in the section heading, by striking ‘technical assistance’ and inserting ‘countermeasure development, review, and technical assistance’;
      (2) in subsection (b), by striking the subsection enumerator and all that follows through ‘shall establish’ and inserting the following:
    Citation:

    ‘(b) General Duties- In order to accelerate the development, stockpiling, approval, licensure, and clearance of qualified countermeasures, security countermeasures, and qualified pandemic or epidemic products, the Secretary, in consultation with the Assistant Secretary for Preparedness and Response, shall--
      ‘(1) ensure the appropriate involvement of Food and Drug Administration personnel in interagency activities related to countermeasure advanced research and development, consistent with sections 319F, 319F-1, 319F-2, 319F-3, 319L, and 2811 of the Public Health Service Act;
      ‘(2) ensure the appropriate involvement and consultation of Food and Drug Administration personnel in any flexible manufacturing activities carried out under section 319L of the Public Health Service Act, including with respect to meeting regulatory requirements set forth in this Act;
      ‘(3) promote countermeasure expertise within the Food and Drug Administration by--
        ‘(A) ensuring that Food and Drug Administration personnel involved in reviewing countermeasures for approval, licensure, or clearance are informed by the Assistant Secretary for Preparedness and Response on the material threat assessment conducted under section 319F-2 of the Public Health Service Act for the agent or agents for which the countermeasure under review is intended;
        ‘(B) training Food and Drug Administration personnel regarding review of countermeasures for approval, licensure, or clearance;
        ‘(C) holding public meetings at least twice annually to encourage the exchange of scientific ideas; and
        ‘(D) establishing protocols to ensure that countermeasure reviewers have sufficient training or experience with countermeasures;

      ‘(4) maintain teams, composed of Food and Drug Administration personnel with expertise on countermeasures, including specific countermeasures, populations with special clinical needs (including children and pregnant women that may use countermeasures, as applicable and appropriate), classes or groups of countermeasures, or other countermeasure-related technologies and capabilities, that shall--
        ‘(A) consult with countermeasure experts, including countermeasure sponsors and applicants, to identify and help resolve scientific issues related to the approval, licensure, or clearance of countermeasures, through workshops or public meetings; and
        ‘(B) improve and advance the science relating to the development of new tools, standards, and approaches to assessing and evaluating countermeasures--
          ‘(i) in order to inform the process for countermeasure approval, clearance, and licensure; and
          ‘(ii) with respect to the development of countermeasures for populations with special clinical needs, including children and pregnant women, in order to meet the needs of such populations, as necessary and appropriate; and

      ‘(5) establish’; and
      (3) by adding at the end the following:

    ‘(c) Final Guidance on Development of Animal Models-
      ‘(1) IN GENERAL- Not later than 1 year after the date of the enactment of the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013, the Secretary shall provide final guidance to industry regarding the development of animal models to support approval, clearance, or licensure of countermeasures referred to in subsection (a) when human efficacy studies are not ethical or feasible.
      ‘(2) AUTHORITY TO EXTEND DEADLINE- The Secretary may extend the deadline for providing final guidance under paragraph (1) by not more than 6 months upon submission by the Secretary of a report on the status of such guidance to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate.

    ‘(d) Development and Animal Modeling Procedures-
      ‘(1) AVAILABILITY OF ANIMAL MODEL MEETINGS- To facilitate the timely development of animal models and support the development, stockpiling, licensure, approval, and clearance of countermeasures, the Secretary shall, not later than 180 days after the enactment of this subsection, establish a procedure by which a sponsor or applicant that is developing a countermeasure for which human efficacy studies are not ethical or practicable, and that has an approved investigational new drug application or investigational device exemption, may request and receive--
        ‘(A) a meeting to discuss proposed animal model development activities; and
        ‘(B) a meeting prior to initiating pivotal animal studies.

      ‘(2) PEDIATRIC MODELS- To facilitate the development and selection of animal models that could translate to pediatric studies, any meeting conducted under paragraph (1) shall include discussion of animal models for pediatric populations, as appropriate.

    ‘(e) Review and Approval of Countermeasures-
      ‘(1) MATERIAL THREAT- When evaluating an application or submission for approval, licensure, or clearance of a countermeasure, the Secretary shall take into account the material threat posed by the chemical, biological, radiological, or nuclear agent or agents identified under section 319F-2 of the Public Health Service Act for which the countermeasure under review is intended.
      ‘(2) REVIEW EXPERTISE- When practicable and appropriate, teams of Food and Drug Administration personnel reviewing applications or submissions described under paragraph (1) shall include a reviewer with sufficient training or experience with countermeasures pursuant to the protocols established under subsection (b)(3)(D).’.



SEC. 305. REGULATORY MANAGEMENT PLANS.


    Section 565 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb-4), as amended by section 304, is further amended by adding at the end the following:
    Citation:
    ‘(f) Regulatory Management Plan-
      ‘(1) DEFINITION- In this subsection, the term ‘eligible countermeasure’ means--
        ‘(A) a security countermeasure with respect to which the Secretary has entered into a procurement contract under section 319F-2(c) of the Public Health Service Act; or
        ‘(B) a countermeasure with respect to which the Biomedical Advanced Research and Development Authority has provided funding under section 319L of the Public Health Service Act for advanced research and development.

      ‘(2) REGULATORY MANAGEMENT PLAN PROCESS- The Secretary, in consultation with the Assistant Secretary for Preparedness and Response and the Director of the Biomedical Advanced Research and Development Authority, shall establish a formal process for obtaining scientific feedback and interactions regarding the development and regulatory review of eligible countermeasures by facilitating the development of written regulatory management plans in accordance with this subsection.
      ‘(3) SUBMISSION OF REQUEST AND PROPOSED PLAN BY SPONSOR OR APPLICANT-
        ‘(A) IN GENERAL- A sponsor or applicant of an eligible countermeasure may initiate the process described under paragraph (2) upon submission of a written request to the Secretary. Such request shall include a proposed regulatory management plan.
        ‘(B) TIMING OF SUBMISSION- A sponsor or applicant may submit a written request under subparagraph (A) after the eligible countermeasure has an investigational new drug or investigational device exemption in effect.
        ‘(C) RESPONSE BY SECRETARY- The Secretary shall direct the Food and Drug Administration, upon submission of a written request by a sponsor or applicant under subparagraph (A), to work with the sponsor or applicant to agree on a regulatory management plan within a reasonable time not to exceed 90 days. If the Secretary determines that no plan can be agreed upon, the Secretary shall provide to the sponsor or applicant, in writing, the scientific or regulatory rationale why such agreement cannot be reached.

      ‘(4) PLAN- The content of a regulatory management plan agreed to by the Secretary and a sponsor or applicant shall include--
        ‘(A) an agreement between the Secretary and the sponsor or applicant regarding developmental milestones that will trigger responses by the Secretary as described in subparagraph (B);
        ‘(B) performance targets and goals for timely and appropriate responses by the Secretary to the triggers described under subparagraph (A), including meetings between the Secretary and the sponsor or applicant, written feedback, decisions by the Secretary, and other activities carried out as part of the development and review process; and
        ‘(C) an agreement on how the plan shall be modified, if needed.

      ‘(5) MILESTONES AND PERFORMANCE TARGETS- The developmental milestones described in paragraph (4)(A) and the performance targets and goals described in paragraph (4)(B) shall include--
        ‘(A) feedback from the Secretary regarding the data required to support the approval, clearance, or licensure of the eligible countermeasure involved;
        ‘(B) feedback from the Secretary regarding the data necessary to inform any authorization under section 564;
        ‘(C) feedback from the Secretary regarding the data necessary to support the positioning and delivery of the eligible countermeasure, including to the Strategic National Stockpile;
        ‘(D) feedback from the Secretary regarding the data necessary to support the submission of protocols for review under section 505(b)(5)(B);
        ‘(E) feedback from the Secretary regarding any gaps in scientific knowledge that will need resolution prior to approval, licensure, or clearance of the eligible countermeasure and plans for conducting the necessary scientific research;
        ‘(F) identification of the population for which the countermeasure sponsor or applicant seeks approval, licensure, or clearance and the population for which desired labeling would not be appropriate, if known; and
        ‘(G) as necessary and appropriate, and to the extent practicable, a plan for demonstrating safety and effectiveness in pediatric populations, and for developing pediatric dosing, formulation, and administration with respect to the eligible countermeasure, provided that such plan would not delay authorization under section 564, approval, licensure, or clearance for adults.

      ‘(6) PRIORITIZATION-
        ‘(A) PLANS FOR SECURITY COUNTERMEASURES- The Secretary shall establish regulatory management plans for all security countermeasures for which a request is submitted under paragraph (3)(A).
        ‘(B) PLANS FOR OTHER ELIGIBLE COUNTERMEASURES- The Secretary shall determine whether resources are available to establish regulatory management plans for eligible countermeasures that are not security countermeasures. If resources are available to establish regulatory management plans for eligible countermeasures that are not security countermeasures, and if resources are not available to establish regulatory management plans for all eligible countermeasures for which requests have been submitted, the Director of the Biomedical Advanced Research and Development Authority, in consultation with the Commissioner, shall prioritize which eligible countermeasures may receive regulatory management plans.’.



SEC. 306. REPORT.


    Section 565 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb-4), as amended by section 305, is further amended by adding at the end the following:
    Citation:
    ‘(g) Annual Report- Not later than 180 days after the date of enactment of this subsection, and annually thereafter, the Secretary shall make publicly available on the Web site of the Food and Drug Administration a report that details the countermeasure development and review activities of the Food and Drug Administration, including--
      ‘(1) with respect to the development of new tools, standards, and approaches to assess and evaluate countermeasures--
        ‘(A) the identification of the priorities of the Food and Drug Administration and the progress made on such priorities; and
        ‘(B) the identification of scientific gaps that impede the development, approval, licensure, or clearance of countermeasures for populations with special clinical needs, including children and pregnant women, and the progress made on resolving these challenges;

      ‘(2) with respect to countermeasures for which a regulatory management plan has been agreed upon under subsection (f), the extent to which the performance targets and goals set forth in subsection (f)(4)(B) and the regulatory management plan have been met, including, for each such countermeasure--
        ‘(A) whether the regulatory management plan was completed within the required timeframe, and the length of time taken to complete such plan;
        ‘(B) whether the Secretary adhered to the timely and appropriate response times set forth in such plan; and
        ‘(C) explanations for any failure to meet such performance targets and goals;

      ‘(3) the number of regulatory teams established pursuant to subsection (b)(4), the number of products, classes of products, or technologies assigned to each such team, and the number of, type of, and any progress made as a result of consultations carried out under subsection (b)(4)(A);
      ‘(4) an estimate of resources obligated to countermeasure development and regulatory assessment, including--
        ‘(A) Center-specific objectives and accomplishments; and
        ‘(B) the number of full-time equivalent employees of the Food and Drug Administration who directly support the review of countermeasures;

      ‘(5) the number of countermeasure applications and submissions submitted, the number of countermeasures approved, licensed, or cleared, the status of remaining submitted applications and submissions, and the number of each type of authorization issued pursuant to section 564;
      ‘(6) the number of written requests for a regulatory management plan submitted under subsection (f)(3)(A), the number of regulatory management plans developed, and the number of such plans developed for security countermeasures; and
      ‘(7) the number, type, and frequency of meetings between the Food and Drug Administration and--
        ‘(A) sponsors of a countermeasure as defined in subsection (a); or
        ‘(B) another agency engaged in development or management of portfolios for such countermeasures, including the Centers for Disease Control and Prevention, the Biomedical Advanced Research and Development Authority, the National Institutes of Health, and the appropriate agencies of the Department of Defense.’.




SEC. 307. PEDIATRIC MEDICAL COUNTERMEASURES.


    (a) Pediatric Studies of Drugs- Section 505A of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355a) is amended--
      (1) in subsection (d), by adding at the end the following:
      Citation:
      ‘(5) CONSULTATION- With respect to a drug that is a qualified countermeasure (as defined in section 319F-1 of the Public Health Service Act), a security countermeasure (as defined in section 319F-2 of the Public Health Service Act), or a qualified pandemic or epidemic product (as defined in section 319F-3 of the Public Health Service Act), the Secretary shall solicit input from the Assistant Secretary for Preparedness and Response regarding the need for and, from the Director of the Biomedical Advanced Research and Development Authority regarding the conduct of, pediatric studies under this section.’; and


      (2) in subsection (n)(1), by adding at the end the following:
      Citation:
        ‘(C) For a drug that is a qualified countermeasure (as defined in section 319F-1 of the Public Health Service Act), a security countermeasure (as defined in section 319F-2 of the Public Health Service Act), or a qualified pandemic or epidemic product (as defined in section 319F-3 of such Act), in addition to any action with respect to such drug under subparagraph (A) or (B), the Secretary shall notify the Assistant Secretary for Preparedness and Response and the Director of the Biomedical Advanced Research and Development Authority of all pediatric studies in the written request issued by the Commissioner of Food and Drugs.’.


    (b) Addition to Priority List Considerations- Section 409I of the Public Health Service Act (42 U.S.C. 284m) is amended--
      (1) by striking subsection (a)(2) and inserting the following:
      Citation:
      ‘(2) CONSIDERATION OF AVAILABLE INFORMATION- In developing and prioritizing the list under paragraph (1), the Secretary--
        ‘(A) shall consider--
          ‘(i) therapeutic gaps in pediatrics that may include developmental pharmacology, pharmacogenetic determinants of drug response, metabolism of drugs and biologics in children, and pediatric clinical trials;
          ‘(ii) particular pediatric diseases, disorders or conditions where more complete knowledge and testing of therapeutics, including drugs and biologics, may be beneficial in pediatric populations; and
          ‘(iii) the adequacy of necessary infrastructure to conduct pediatric pharmacological research, including research networks and trained pediatric investigators; and

        ‘(B) may consider the availability of qualified countermeasures (as defined in section 319F-1), security countermeasures (as defined in section 319F-2), and qualified pandemic or epidemic products (as defined in section 319F-3) to address the needs of pediatric populations, in consultation with the Assistant Secretary for Preparedness and Response, consistent with the purposes of this section.’; and


      (2) in subsection (b), by striking ‘subsection (a)’ and inserting ‘paragraphs (1) and (2)(A) of subsection (a)’.

    (c) Advice and Recommendations of the Pediatric Advisory Committee Regarding Countermeasures for Pediatric Populations- Subsection (b)(2) of section 14 of the Best Pharmaceuticals for Children Act (42 U.S.C. 284m note) is amended--
      (1) in subparagraph (C), by striking the period and inserting ‘; and’; and
      (2) by adding at the end the following:
      Citation:
        ‘(D) the development of countermeasures (as defined in section 565(a) of the Federal Food, Drug, and Cosmetic Act) for pediatric populations.’.



TITLE IV--ACCELERATING MEDICAL COUNTERMEASURE ADVANCED RESEARCH AND DEVELOPMENT
SEC. 401. BIOSHIELD.


    (a) Procurement of Countermeasures- Section 319F-2(c) of the Public Health Service Act (42 U.S.C. 247d-6b(c)) is amended--
      (1) in paragraph (1)(B)(i)(III)(bb), by striking ‘eight years’ and inserting ‘10 years’;
      (2) in paragraph (2)(C), by striking ‘the designated congressional committees (as defined in paragraph (10))’ and inserting ‘the appropriate committees of Congress’;
      (3) in paragraph (5)(B)(ii), by striking ‘eight years’ and inserting ‘10 years’;
      (4) in subparagraph (C) of paragraph (6)--
        (A) in the subparagraph heading, by striking ‘DESIGNATED CONGRESSIONAL COMMITTEES’ and inserting ‘APPROPRIATE CONGRESSIONAL COMMITTEES’; and
        (B) by striking ‘the designated congressional committees’ and inserting ‘the appropriate congressional committees’; and

      (5) in paragraph (7)(C)--
        (A) in clause (i)(I), by inserting ‘including advanced research and development,’ after ‘as may reasonably be required,’;
        (B) in clause (ii)--
          (i) in subclause (III), by striking ‘eight years’ and inserting ‘10 years’; and
          (ii) by striking subclause (IX) and inserting the following:
          Citation:
            ‘(IX) CONTRACT TERMS- The Secretary, in any contract for procurement under this section--



Citation:
‘(aa) may specify--
‘(AA) the dosing and administration requirements for the countermeasure to be developed and procured;
‘(BB) the amount of funding that will be dedicated by the Secretary for advanced research, development, and procurement of the countermeasure; and
‘(CC) the specifications the countermeasure must meet to qualify for procurement under a contract under this section; and
‘(bb) shall provide a clear statement of defined Government purpose limited to uses related to a security countermeasure, as defined in paragraph (1)(B).’; and



        (C) by adding at the end the following:
        Citation:
          ‘(viii) FLEXIBILITY- In carrying out this section, the Secretary may, consistent with the applicable provisions of this section, enter into contracts and other agreements that are in the best interest of the Government in meeting identified security countermeasure needs, including with respect to reimbursement of the cost of advanced research and development as a reasonable, allowable, and allocable direct cost of the contract involved.’.


    (b) Reauthorization of the Special Reserve Fund- Section 319F-2 of the Public Health Service Act (42 U.S.C. 247d-6b) is amended--
      (1) in subsection (c)--
        (A) by striking ‘special reserve fund under paragraph (10)’ each place it appears and inserting ‘special reserve fund as defined in subsection (h)’; and
        (B) by striking paragraphs (9) and (10); and

      (2) by adding at the end the following:
    Citation:

    ‘(g) Special Reserve Fund-
      ‘(1) AUTHORIZATION OF APPROPRIATIONS- In addition to amounts appropriated to the special reserve fund prior to the date of the enactment of this subsection, there is authorized to be appropriated, for the procurement of security countermeasures under subsection (c) and for carrying out section 319L (relating to the Biomedical Advanced Research and Development Authority), $2,800,000,000 for the period of fiscal years 2014 through 2018. Amounts appropriated pursuant to the preceding sentence are authorized to remain available until September 30, 2019.
      ‘(2) USE OF SPECIAL RESERVE FUND FOR ADVANCED RESEARCH AND DEVELOPMENT- The Secretary may utilize not more than 50 percent of the amounts authorized to be appropriated under paragraph (1) to carry out section 319L (related to the Biomedical Advanced Research and Development Authority). Amounts authorized to be appropriated under this subsection to carry out section 319L are in addition to amounts otherwise authorized to be appropriated to carry out such section.
      ‘(3) RESTRICTIONS ON USE OF FUNDS- Amounts in the special reserve fund shall not be used to pay costs other than payments made by the Secretary to a vendor for advanced development (under section 319L) or for procurement of a security countermeasure under subsection (c)(7).
      ‘(4) REPORT- Not later than 30 days after any date on which the Secretary determines that the amount of funds in the special reserve fund available for procurement is less than $1,500,000,000, the Secretary shall submit to the appropriate committees of Congress a report detailing the amount of such funds available for procurement and the impact such reduction in funding will have--
        ‘(A) in meeting the security countermeasure needs identified under this section; and
        ‘(B) on the annual Public Health Emergency Medical Countermeasures Enterprise and Strategy Implementation Plan (pursuant to section 2811(d)).

    ‘(h) Definitions- In this section:
      ‘(1) The term ‘advanced research and development’ has the meaning given such term in section 319L(a).
      ‘(2) The term ‘special reserve fund’ means the ‘Biodefense Countermeasures’ appropriations account, any appropriation made available pursuant to section 521(a) of the Homeland Security Act of 2002, and any appropriation made available pursuant to subsection (g)(1).’.




SEC. 402. BIOMEDICAL ADVANCED RESEARCH AND DEVELOPMENT AUTHORITY.


    (a) Duties- Section 319L(c)(4) of the Public Health Service Act (42 U.S.C. 247d-7e(c)(4)) is amended--
      (1) in subparagraph (B)(iii), by inserting ‘(which may include advanced research and development for purposes of fulfilling requirements under the Federal Food, Drug, and Cosmetic Act or section 351 of this Act)’ after ‘development’; and
      (2) in subparagraph (D)(iii), by striking ‘and vaccine manufacturing technologies’ and inserting ‘vaccine-manufacturing technologies, dose-sparing technologies, efficacy-increasing technologies, and platform technologies’.

    (b) Transaction Authorities- Section 319L(c)(5) of the Public Health Service Act (42 U.S.C. 247d-7e(c)(5)) is amended by adding at the end the following:
    Citation:
        ‘(G) GOVERNMENT PURPOSE- In awarding contracts, grants, and cooperative agreements under this section, the Secretary shall provide a clear statement of defined Government purpose related to activities included in subsection (a)(6)(B) for a qualified countermeasure or qualified pandemic or epidemic product.’.


    (c) Fund- Paragraph (2) of section 319L(d) of the Public Health Service Act (42 U.S.C. 247d-7e(d)(2)) is amended to read as follows:
    Citation:
      ‘(2) FUNDING- To carry out the purposes of this section, there is authorized to be appropriated to the Fund $415,000,000 for each of fiscal years 2014 through 2018, such amounts to remain available until expended.’.


    (d) Continued Inapplicability of Certain Provisions- Section 319L(e)(1)(C) of the Public Health Service Act (42 U.S.C. 247d-7e(e)(1)(C)) is amended by striking ‘7 years’ and inserting ‘12 years’.
    (e) Extension of Limited Antitrust Exemption-
      (1) IN GENERAL- Section 405(b) of the Pandemic and All-Hazards Preparedness Act (42 U.S.C. 247d-6a note) is amended by striking ‘6-year’ and inserting ‘12-year’.
      (2) EFFECTIVE DATE- This subsection shall take effect as if enacted on December 17, 2012.

    (f) Independent Evaluation- Section 319L of the Public Health Service Act (42 U.S.C. 247d-7e) is amended by adding at the end the following:
    Citation:
    ‘(f) Independent Evaluation-
      ‘(1) IN GENERAL- Not later than 180 days after the date of enactment of this subsection, the Comptroller General of the United States shall conduct an independent evaluation of the activities carried out to facilitate flexible manufacturing capacity pursuant to this section.
      ‘(2) REPORT- Not later than 1 year after the date of enactment of this subsection, the Comptroller General of the United States shall submit to the appropriate committees of Congress a report concerning the results of the evaluation conducted under paragraph (1). Such report shall review and assess--
        ‘(A) the extent to which flexible manufacturing capacity under this section is dedicated to chemical, biological, radiological, and nuclear threats;
        ‘(B) the activities supported by flexible manufacturing initiatives; and
        ‘(C) the ability of flexible manufacturing activities carried out under this section to--
          ‘(i) secure and leverage leading technical expertise with respect to countermeasure advanced research, development, and manufacturing processes; and
          ‘(ii) meet the surge manufacturing capacity needs presented by novel and emerging threats, including chemical, biological, radiological, and nuclear agents.’.


    (g) Definitions-
      (1) QUALIFIED COUNTERMEASURE- Section 319F-1(a)(2)(A) of the Public Health Service Act (42 U.S.C. 247d-6a(a)(2)(A)) is amended--
        (A) in the matter preceding clause (i), by striking ‘to--’ and inserting ‘--’;
        (B) in clause (i)--
          (i) by striking ‘diagnose’ and inserting ‘to diagnose’; and
          (ii) by striking ‘; or’ and inserting a semicolon;

        (C) in clause (ii)--
          (i) by striking ‘diagnose’ and inserting ‘to diagnose’; and
          (ii) by striking the period at the end and inserting ‘; or’; and

        (D) by adding at the end the following:
        Citation:
          ‘(iii) is a product or technology intended to enhance the use or effect of a drug, biological product, or device described in clause (i) or (ii).’.


      (2) QUALIFIED PANDEMIC OR EPIDEMIC PRODUCT- Section 319F-3(i)(7)(A) of the Public Health Service Act (42 U.S.C. 247d-6d(i)(7)(A)) is amended--
        (A) in clause (i)(II), by striking ‘; or’ and inserting ‘;’;
        (B) in clause (ii), by striking ‘; and’ and inserting ‘; or’; and
        (C) by adding at the end the following:
        Citation:
          ‘(iii) a product or technology intended to enhance the use or effect of a drug, biological product, or device described in clause (i) or (ii); and’.


      (3) TECHNICAL AMENDMENTS- Section 319F-3(i) of the Public Health Service Act (42 U.S.C. 247d-6d(i)) is amended--
        (A) in paragraph (1)(C), by inserting ‘, 564A, or 564B’ after ‘564’; and
        (B) in paragraph (7)(B)(iii), by inserting ‘, 564A, or 564B’ after ‘564’.


SEC. 403. STRATEGIC NATIONAL STOCKPILE.


    Section 319F-2 of the Public Health Service Act (42 U.S.C. 247d-6b) is amended--
      (1) in subsection (a)--
        (A) in paragraph (1)--
          (i) by inserting ‘consistent with section 2811’ before ‘by the Secretary to be appropriate’; and
          (ii) by inserting before the period at the end of the second sentence the following: ‘and shall submit such review annually to the appropriate congressional committees of jurisdiction to the extent that disclosure of such information does not compromise national security’; and

        (B) in paragraph (2)(D), by inserting before the semicolon at the end the following: ‘and that the potential depletion of countermeasures currently in the stockpile is identified and appropriately addressed, including through necessary replenishment’; and

      (2) in subsection (f)(1), by striking ‘$640,000,000 for fiscal year 2002, and such sums as may be necessary for each of fiscal years 2003 through 2006. Such authorization is in addition to amounts in the special reserve fund referred to in subsection (c)(10)(A).’ and inserting ‘$533,800,000 for each of fiscal years 2014 through 2018. Such authorization is in addition to amounts in the special reserve fund referred to in subsection (h).’.


SEC. 404. NATIONAL BIODEFENSE SCIENCE BOARD.


    Section 319M(a) of the Public Health Service Act (42 U.S.C. 247d-f(a)) is amended--
      (1) in paragraph (2)--
        (A) in subparagraph (D)--
          (i) in clause (i), by striking ‘and’ at the end;
          (ii) in clause (ii), by striking the period and inserting a semicolon; and
          (iii) by adding at the end the following:
          Citation:
          ‘(iii) one such member shall be an individual with pediatric subject matter expertise; and
          ‘(iv) one such member shall be a State, tribal, territorial, or local public health official.’; and


        (B) by adding at the end the following flush sentence:
      Citation:

      ‘Nothing in this paragraph shall preclude a member of the Board from satisfying two or more of the requirements described in subparagraph (D).’; and


      (2) in paragraph (5)--
        (A) in subparagraph (B), by striking ‘and’ at the end;
        (B) in subparagraph (C), by striking the period and inserting ‘; and’; and
        (C) by adding at the end the following:
        Citation:
        ‘(D) provide any recommendation, finding, or report provided to the Secretary under this paragraph to the appropriate committees of Congress.’.



Speaker of the House of Representatives.

Vice President of the United States and

President of the Senate.

http://www.govtrack.us/congress/bills/113/hr307/text


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MessagePosté le: Sam 13 Avr - 16:31 (2013)    Sujet du message: USA TECHNO-NAZIS : LES « SOINS » DE « SANTE » PASSENT DEFINITIVEMENT AU LIBERTICIDE ET A L’ELECTRONIQUE !!! Répondre en citant



USA TECHNO-NAZIS : LES « SOINS » DE « SANTE » PASSENT DEFINITIVEMENT AU LIBERTICIDE ET A L’ELECTRONIQUE !!!

ENGLISH links down below about Digital Health 







Chers amis,

L’ARTICLE QUI SUIT, ET QUI EST DÉNUÉ DE TOUT ESPRIT CRITIQUE, VOUS SIGNALE QUE LES ETATS-UNIS SONT EN CE MOMENT MÊME EN TRAIN D’ADOPTER LE « TOUT À L’ÉLECTRONIQUE » DANS LEURS SOINS DE SANTÉ !

LES APPLICATIONS TIC (TECHNOLOGIES DE L’INFORMATION ET DE LA COMMUNICATION) APPARAISSENT UN PEU PARTOUT, ET SONT FINANCÉES VIA UN PROGRAMME TRÈS COÛTEUX, ET CE EN TEMPS DE CRISE ÉCONOMIQUE !

LE LIBERTICIDE REGISTRE DE SANTÉ ÉLECTRONIQUE, ÉVIDEMMENT, EN FAIT PARTIE. LA TÉLÉMÉDECINE AUSSI. ET LE BUT CONSISTE TOUJOURS À DÉVELOPPER UN MAXIMUM DE CES TECHNOLOGIES ÉLECTRONIQUES À MOINDRE COÛT… INUTILE DE VOUS SIGNALER QUE L’ON SE DIRIGE DONC VERS UN SYSTÈME PUREMENT CAPITALISTE, DE MOINS EN MOINS HUMAIN, GÉRÉ ESSENTIELLEMENT VIA DES MACHINES, ET QUI MENACE LA VIE PRIVÉE ET LE SECRET MÉDICAL.

Bien entendu, depuis le temps que je poste sur le sujet, vous savez aussi que les très dangereuses et cancérigènes puces implantables pour humains (sous-cutanées, neurales et cérébrales) font aussi partie des soi-disant « progrès » des ces TIC que les autorités imposent petit à petit dans ces prétendus « soins » de « santé » !

LA RECETTE POUR LE DÉSASTRE EST DONC BIEN EN PLACE. IL NE RESTE PLUS QU’À LAMINER À PRÉSENT LA POPULATION AMÉRICAINE…

Alors, oui : tout ceci se passe aux USA. MAIS N’OUBLIEZ JAMAIS QUE LES TRAÎTRES QUI DIRIGENT L’U.E. ONT PRÉVU UN BLOC EURO-ATLANTIQUE DÈS 2015, AVEC NOTAMMENT UN ACCORD DE LIBRE-ÉCHANGE U.E./USA !!!

Ceci signifie naturellement que nous allons voir surgir tôt ou tard les mêmes technologies liberticides dans nos propres soins de santé. Il serait grand temps de se bouger, ne croyez-vous pas ? A bon entendeur…

Je vous laisse à présent lire l’article de merde (qui encense ces technologies atroces et les considère comme un « fabuleux progrès »), ci-dessous… Vous remarquez que cet article trouve son origine à… l’ambassade de France aux Etats-Unis (il s’agit donc clairement d’une nouvelle contribution pour l’américanisation de la France !) !

BONNE RÉVOLUTION… OU BON ESCLAVAGE, BONNE TYRANNIE ET BONNE MORT ! Vic.

P.S. : un grand merci à la personne qui m’a signalé cet article !


Source :
http://www.bulletins-electroniques.com/actualites/72828.htm


12/04/2013

Innovation et valorisation de la recherche

LES TECHNOLOGIES DE L'INFORMATION ET DES COMMUNICATIONS DANS LE DOMAINE DE LA SANTÉ AUX ETATS-UNIS


LES TECHNOLOGIES DE L'INFORMATION ET DES COMMUNICATIONS (TIC) SONT EN PLEINE EXPANSION DANS LE DOMAINE DE LA SANTÉ AUX ETATS-UNIS. CES TECHNOLOGIES ONT INVESTI LE DOMAINE LÉGISLATIF EN 2009, quand le Congrès a adopté la loi sur les Technologies de l'Information de la Santé ou "Health Information Technology for Economic and Clinical Health (HITECH) Act" dans le cadre du plan de relance ARRA de 2009. LES SOMMES EN JEU SONT COLOSSALES : LE DÉPARTEMENT DE LA SANTÉ ET DES SERVICES SOCIAUX AUX ETATS-UNIS A AINSI PRÉVU DE DÉPENSER 25,9 MILLIARDS DE DOLLARS POUR PROMOUVOIR ET ÉTENDRE L'ADOPTION DES TIC DANS LE DOMAINE DE LA SANTÉ, NOTAMMENT AFIN DE METTRE EN PLACE UN "ELECTRONIC HEALTH RECORD" (EHR) OU DOSSIER MÉDICAL PERSONNEL ÉLECTRONIQUE.

La loi HITECH comprend de nombreuses DISPOSITIONS INCITANT AU DÉVELOPPEMENT DES INFRASTRUCTURES INFORMATIQUES DANS L'ENSEMBLE DES ÉTATS FÉDÉRAUX AMÉRICAINS, qui permettent entre autre d'améliorer la qualité des soins, de diminuer les disparités et de contribuer au développement de la médecine personnalisée. DEPUIS LORS, LES TIC INFLUENCENT l'organisation du système de soins, les relations entre professionnels de la santé et des structures hospitalières, ainsi que les rapports entre professionnels et usagers, tout en favorisant le développement de l'activité économique des prestataires de service.

1. Les produits TIC dans la santé

Les différents types d'applications et de technologies informatiques dans le domaine médical ne cessent de se développer et d'évoluer. D'APRÈS LA SECTION 3000 DE LA LOI HITECH, LES PRODUITS TIC DANS LA SANTÉ SONT DÉFINIS COMME LES "MATÉRIELS INFORMATIQUES, LOGICIELS, LES TECHNOLOGIES INTÉGRÉES OU DES LICENCES CONNEXES, DES MISES À JOUR, OU DES SOLUTIONS PACKAGÉES VENDUS COMME DES SERVICES QUI SONT CONÇUS POUR SOUTENIR L'UTILISATION PAR DES ENTITÉS DE SOINS DE SANTÉ OU DES PATIENTS POUR L'ÉLECTRONIQUE CRÉATION, LA MAINTENANCE, L'ACCÈS OU L'ÉCHANGE D'INFORMATION SUR LA SANTÉ". Les TIC comprennent également les applications qui sont utilisées par les clients et les applications qui FACILITENT LE PARTAGE ÉLECTRONIQUE D'INFORMATIONS entre patients et professionnels de santé [1].

Nous pouvons recenser ci-dessous les principaux produits et fonctionnalités TIC développés.


Principaux produits et fonctionnalités des TIC dans la santé
Crédits : MS&T avec la source [1]

2. Les jeunes entreprises innovantes et les accélérateurs d'entreprises

DE NOMBREUSES JEUNES ENTREPRISES INNOVANTES SE SONT CRÉÉES DANS LE SECTEUR DES TIC À DESTINATION DE LA SANTÉ, PORTÉES PAR L'ÉMERGENCE DE NOUVELLES TECHNOLOGIES INFORMATIQUES COMME LA TÉLÉPHONIE MOBILE DE TROISIÈME GÉNÉRATION. La loi HITECH de 2009 ainsi que le développement des Smartphones et des tablettes tactiles ont incité à la création d'accélérateurs de jeunes entreprises innovantes spécialisées dans les TIC dans le domaine de la santé. Nous pouvons citer comme exemple:

- Le New-York Digital Health Accelerator (NYDHA).

Ce programme a été créé en début d'année 2012 conjointement par le "New York eHealth Collaborative" et "Partnership Fund of New York City" POUR LES JEUNES ENTREPRISES SPÉCIALISÉES DANS LES TIC APPLIQUÉES À LA SANTÉ EN STADE PRÉCOCE DE DÉVELOPPEMENT [3]. C'EST L'ACCÉLÉRATEUR QUI PRÉSENTE LE PLUS DE MOYEN FINANCIER DANS LE DOMAINE DES TIC EN SANTÉ AUX ETATS-UNIS et qui permet aux jeunes entreprises d'accéder aux experts du domaine et aux professionnels de santé de New-York. Avec 4,2 millions de dollars initialement investis, le NYDHA envisage une création de 1500 emplois sur plus de 5 ans et s'attend à une levée de fond pour les jeunes entreprises innovantes qui ont suivi le programme entre 150 et 200 millions de dollars des capitaux-risqueurs.

LE PROGRAMME A REÇU 250 DOSSIERS DE CANDIDATURE PROVENANT DE 27 ÉTATS ET DE 10 PAYS. Les entreprises sont choisies après un long processus de sélection, qui favorise généralement les entreprises locales. Parmi les 8 jeunes entreprises innovantes sélectionnées [4] fin juillet 2012, 7 sont ainsi basées à New-York. Les 8 ENTREPRISES REÇOIVENT JUSQU'À 30.000 DOLLARS et bénéficient pendant 9 mois de l'expertise de spécialistes du domaine de la santé et des TIC. CHAQUE SOCIÉTÉ S'EST ENGAGÉE À OUVRIR UN BUREAU À NEW YORK [5].

- Le Dreamit Ventures de Philadelphie.

Dreamit, créé en 2008, est un accélérateur INTERNATIONAL pour les entreprises en phase d'amorçage spécialisées dans le domaine de la santé. Le programme, qui s'est ouvert à Philadelphie en décembre 2012, est co-sponsorisé par une entreprise d'assurance et l'université de médecine de Pennsylvanie. Il s'agit d'un programme de 4 mois qui permet d'accélérer le développement de très jeunes entreprises QUI DÉVELOPPENT DES OUTILS INFORMATIQUES EFFICACES ET À MOINDRES COÛTS POUR LES PROFESSIONNELS DE SANTÉ. Les entreprises sélectionnées reçoivent jusqu'à 50.000 dollars de financement. 10 entreprises développant des produits TICs ont été sélectionnées pour le programme démarrant avril 2013 [6] [7].

- Rockhealth.

C'est le premier accélérateur d'amorçage pour les jeunes entreprises de santé spécialisé dans le numérique. Il a été fondé il y a 5 ans par une jeune femme, Halle Tecco, juste après son MBA à Harvard. Rockhealth propose un programme de 5 mois de mentorat et un financement de 100.000 dollars. [8]

Nous n'avons cité que trois exemples, qui témoignent de l'essor des accélérateurs en TIC dans le domaine de la santé. Pour preuve, ROCKHEALTH PRÉVOIT DES RECORDS EN 2013 POUR LES NÉGOCIATIONS DANS LES ENTREPRISES DE SANTÉ NUMÉRIQUE [9].

3. La FDA et les applications pour Smartphone

Les TIC représentent une formidable opportunité de croissance pour de nombreuses jeunes entreprises innovantes dans le domaine de la santé, et leur émergence est actuellement observée avec attention par la Food and Drug Administration (FDA). La semaine du 21 mars 2013, trois jours d'auditions sur la réglementation de la FDA relative aux applications médicales pour Smartphones ont été organisés par le comité du commerce et de l'énergie de la Chambre des représentants des Etats-Unis [10]. L'évènement le plus important de cette session a été celui du jeudi 21 mars, où le Dr. Farzad Mostashari, directeur de l'ONC [11] et le directeur du bureau du centre de l'évaluation de dispositif pour les dispositifs médicaux et la radiologie de la FDA, Christy Foreman, ont été interrogés par le Congrès sur l'équilibre à adopter entre le RENFORCEMENT des réglementations pour la SÉCURITÉ des patients et l'encouragement de l'innovation [12].

En réponse aux PRÉOCCUPATIONS PERSISTANTES CONCERNANT LE PROJET DE DIRECTIVES DE LA FDA SUR LA RÉGLEMENTATION DE LOGICIELS MÉDICAUX EN TANT QUE DISPOSITIF, Mme Foreman a souligné que la FDA ne réglementerait pas les iPads ou les Smartphones de manière similaire aux dispositifs médicaux sous prétexte qu'ils contiennent des applications de santé ou parce qu'ils transmettent des informations médicales. LA FDA VA APPLIQUER UNE SURVEILLANCE SUR un "petit sous-ensemble des applications médicales mobiles présentant un RISQUE POTENTIEL POUR LES PATIENTS S'ILS NE FONCTIONNENT PAS COMME PRÉVU."

Sur la question concernant la publication des directives relatives aux applications médicales pour Smartphones, dont une ébauche a été publiée à la mi-année 2011, Mme Foreman a répondu que le rapport final sera publié avant la fin de l'exercice de cette année" [12]. Le Dr. Mostashari a rassuré l'audience sur l'adoption croissante de l'EHR et les progrès observés vers l'interopérabilité grâce à des incitations d'utilisation significatives.

Le message important qu'ont fait passer les deux interlocuteurs est que la FDA et l'ONC prennent des mesures appropriées pour l'amélioration de la sécurité des patients et que grâce à une surveillance adéquate et des mesures d'incitation envers les développeurs de TIC pour la santé, les erreurs médicales diminuent et les frais de soins de santé deviennent moins onéreux [13].

Conclusion

Depuis plusieurs décennies, les technologies de l'information et de la communication appliquées à la santé connaissent un développement rapide. LA LOI HITECH A ACCOMPAGNÉ LE DÉVELOPPEMENT DE NOMBREUSES NOUVELLES TECHNOLOGIES ET FAVORISÉ L'ÉMERGENCE DE NOUVELLES JEUNES ENTREPRISES INNOVANTES SOUVENT PORTÉES PAR DES ACCÉLÉRATEURS D'ENTREPRISES.

A L'HEURE ACTUELLE, LE GOUVERNEMENT FÉDÉRAL, PAR LE BIAIS NOTAMMENT DE LA FDA, CONTINUE DE METTRE EN OEUVRE DES PROGRAMMES VISANT À PROMOUVOIR L'UTILISATION DE L'IT PAR TOUS LES PROFESSIONNELS DE SANTÉ ET LES ASSURANCES...un secteur donc à suivre.

[11] ONC : "Office of the National Coordinator for Health Information technology". Le bureau du coordinateur national pour les TIC appliqués à la santé a été créé dans la cadre de la loi HITECH au sein du Département de la santé et des services sociaux aux Etats-Unis.

Pour en savoir plus, contacts :

- [5] Site internet de NYDHA :
http://digitalhealthaccelerator.com/about-nydha/

- [7] Site internet de Dreamit :
http://www.dreamitventures.com/

- [9] Rock Health predicts a record year for digital health deals,
http://redirectix.bulletins-electroniques.com/z2L0r

- [10] 10 threads from Congress' hearings on FDA regulation of medical apps, Mobihealthnews, Brian Dolan, Mar 21, 2013,
http://redirectix.bulletins-electroniques.com/3fRJQ

- [13]
http://redirectix.bulletins-electroniques.com/LrWjR

- BE Etats-Unis 325 du 22/03/2013:" Accélérateurs d'entreprises aux Etats-Unis : la pléthore suscite le doute -
http://www.bulletins-electroniques.com/actualites/72614.htm


Sources :

- [1] BRIEFING PAPER: Understanding the Impact of Health IT in Underserved Communities and those with Health Disparities, NORC at the University of Chicago, 10/29/2010,
http://redirectix.bulletins-electroniques.com/yn8tc

- [2]
http://redirectix.bulletins-electroniques.com/zsCrb

- [3] New York partnership aimed at health IT innovation, job creation, Healthcare IT News, 10/15/2012,
http://redirectix.bulletins-electroniques.com/75Q1I

- [4] New York Digital Health Accelerator announces inaugural class of startups, Brian Edwards, 10/19/2012,
http://redirectix.bulletins-electroniques.com/3yKiC

- [6] Improving outcomes, speeding up diagnoses among goals of Dreamit Venture's first health IT accelerator, 04/04/2013, Stephanie Baum, MedCity news,
http://redirectix.bulletins-electroniques.com/0WY8l

- [8] site internet de Rockhealth:
http://rockhealth.com/about/

- [12] Oversight and Investigations Subcommittee Hears from ONC, FDA Officials on Health Information Technologies, 03/22/2013 ,
http://redirectix.bulletins-electroniques.com/TkoDF

Rédacteurs :

- Lisa Treglia,
deputy-inno@ambascience-usa.org ;

- Retrouvez toutes nos activités sur
http://france-science.org .

Origine :

BE Etats-Unis numéro 328 (12/04/2013) - AMBASSADE DE FRANCE AUX ETATS-UNIS / ADIT -
http://www.bulletins-electroniques.com/actualites/72828.htm


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MessagePosté le: Sam 27 Avr - 20:34 (2013)    Sujet du message: POLITICIANS WHO PASSED OBAMACARE MOVE TO EXEMPT THEMSELVES FROM OBAMACARE… Répondre en citant

POLITICIANS WHO PASSED OBAMACARE MOVE TO EXEMPT THEMSELVES FROM OBAMACARE…



by Ulsterman on April 25, 2013

News like this makes me wonder how in the heck there are not tens of thousands of pi**ed off Americans marching on the White House and Capitol Hill at this very moment. These people pass a law that they sell as being of great benefit to all Americans, and then turn right around and are working (in secret mind you) to exempt themselves from that very same law. Hey Republicans – how about you step up on this one for once and just come out and say NO WAY. For God’s sake now – how do you people sleep at night?

(“Enjoy Obamacare America – but it’s not for me or my fellow politicians”)

_______________________________________


EXCERPT (via Politico)

Lawmakers, aides may get Obamacare exemption

Congressional leaders in both parties are engaged in high-level, confidential talks about exempting lawmakers and Capitol Hill aides from the insurance exchanges they are mandated to join as part of President Barack Obama’s health care overhaul, sources in both parties said.

Read more in News

« YES! The Return Of The Twinkie!

The talks — which involve Senate Majority Leader Harry Reid (D-Nev.), House Speaker John Boehner (R-Ohio), the Obama administration and other top lawmakers — are extraordinarily sensitive, with both sides acutely aware of the potential for political fallout from giving carve-outs from the hugely controversial law to 535 lawmakers and thousands of their aides. Discussions have stretched out for months, sources said.

Now here is the line that is really a hoot:

There is concern in some quarters that the provision requiring lawmakers and staffers to join the exchanges, if it isn’t revised, could lead to a “brain drain” on Capitol Hill, as several sources close to the talks put it.

The problem stems from whether members and aides set to enter the exchanges would have their health insurance premiums subsidized by their employer — in this case, the federal government. If not, aides and lawmakers in both parties fear that staffers — especially low-paid junior aides — could be hit with thousands of dollars in new health care costs, prompting them to seek jobs elsewhere. LINK

____________________________

D.C. politicians are now complaining that Obamacare will be TOO EXPENSIVE for their lower paid staff! And yet – it’s supposed to be just fine for the rest of America! REPEAL THE WHOLE DAMN THING. C’MON AMERICA – WAKE UP! THESE PEOPLE ARE PLAYING YOU FOR ABSOLUTE FOOLS.

OBAMACARE IS ABSOLUTE TYRANNY. A PLAN THE RULING CLASS DEEMS UNWORTHY OF THEM – BUT WILL BE MANDATED FOR YOU.

http://theulstermanreport.com/2013/04/25/politicians-who-passed-obamacare-m…


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MessagePosté le: Lun 29 Avr - 20:49 (2013)    Sujet du message: DEFENSE-VA AGREED TO E-HEALTH RECORD PLAN IN DECEMBER Répondre en citant

DEFENSE-VA AGREED TO E-HEALTH RECORD PLAN IN DECEMBER




Andrei Orlov/Shutterstock.com


By Bob Brewin April 22, 2013
The Defense and Veterans Affairs departments reached an agreement with the White House last December to develop an integrated electronic health record as well a Virtual Lifetime Electronic Record that would include personnel records and benefits information, according to an Office of Management and Budget memo provided to Nextgov.

The document focused on open standards and interoperability and was sent on Dec. 6 by White House Chief Information Officer Steve VanRoekel and Todd Park, White House chief technology officer.

The memo provides context for the announcement on Feb. 5 by then-Defense Secretary Leon Panetta and VA Secretary Eric Shinseki that they had scrapped plans to build an iEHR from scratch. Instead, Panetta said, the two departments would “focus our immediate efforts on integrating VA and DoD health data as quickly as possible, by focusing on interoperability and using existing solutions.”

The OMB memo said Defense, VA and the White House “agreed to work closely together over the next several months to resolve several key issues” with the iEHR and VLER and to set a tight timetable.

“The secretary of Defense and the secretary of Veterans Affairs have directed their staffs to accelerate the current iEHR program to meet or beat scheduled targets [limited deployment in 2014, full roll-out in 2017] using open architecture and non-proprietary design,” the memo said.

Various high level officials of both departments – including the secretaries – have testified numerous times to Senate and House committees since Dec. 6 and have never disclosed this memo and its plans for the iEHR.

The memo said Defense and VA committed to the following steps and schedule:
  • By Dec. 7, 2012, they would submit a detailed background document on VLER and the iEHR that includes achievements to date and any deviation from planned timelines; breakout of funding and software and services purchased; planned scale of iEHR in terms of patients and clinical sites; current and future capacities. This background document would delineate two VLER/iEHR milestones: those focused on open standards and data interoperability of current systems and full deployment of iEHR software. Defense and VA also agreed to provide a detailed project plan for VLER and iEHR milestones and objectives.
  • By Dec. 18, 2012, they would provide a status briefing on 2014 VLER and iEHR costs.
  • By Jan 15, 2013, they were to develop a strategy to “make rapid progress in 2013 on interoperability and exchange of health records” while continuing to pursue development of a common iEHR software platform “in a linked parallel effort.” The project was to include common data models and use of health IT standards developed by the Health and Human Services Department for content, vocabulary and transport. The departments were to detail efforts to share data directly with patients.
  • By Jan 15, 201, they were to develop a proposal on how to reconcile plans by Defense to acquire a new iEHR versus VA’s modular development approach, including plans on how to divide the work into chunks that could be defined, developed and deployed in months, not years.
  • Beginning Jan. 21, 2013, OMB and the Office of Science and Technology Policy were to establish a VLER/iEHR executive steering committee which would hold quarterly meetings with Defense and VA leadership “to facilitate discussion on issues of concern and help resolve matters that may be in contention between the two agencies.”
  • By Feb 4, 2013, Defense and VA would provide new, revised lifecycle cost estimates for the iEHR that take into account work already underway, overlapping capabilities and the range of private sector technologies that could be used.

The White House, Defense and VA did not respond to queries from Nextgov about whether or not the objectives contained in the memo are still operative and if the deadlines had been met.

(Image via Andrei Orlov/Shutterstock.com)

http://www.nextgov.com/defense/2013/04/defense-va-agreed-e-health-record-plan-december/62690/?oref=nextgov_defense_it


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MessagePosté le: Sam 11 Mai - 15:09 (2013)    Sujet du message: ALERTE ROUGE ! PUCE : USA 666 : LA LOI HR 4872 !!! Répondre en citant

ALERTE ROUGE ! PUCE : USA 666 : LA LOI HR 4872 !!!


En ces jours-là, les hommes chercheront la mort, et ils ne la trouveront pas; ils désireront mourir, et la mort fuira loin d'eux. (La Bible, Apocalypse, chapitre 9, verset 6).


Et elle faisait que tous, petits et grands, riches et pauvres, libres et esclaves, prenaient une marque en leur main droite, ou en leur front ;
Et qu'aucun ne pouvait acheter, ni vendre, s'il n'avait la marque ou le nom de la bête, ou le nombre de son nom.
Ici est la sagesse : que celui qui a de l'intelligence, compte le nombre de la bête ; car c'est un nombre d'homme, et son nombre [est] six cent soixante-six. (La Bible, Apocalypse, chapitre 13, versets 16 à 18 ).




Chers amis,

Il y a eu de nombreuses révisions de cette loi, mais la version finale que le président Barack Hussein Obama a signée et que le Juge en Chef John Roberts a confirmée, se nomme la loi HR 4872 "Reconciliation Act of 2010". Cette loi fait 2310 pages.

A noter : lorsque le Juge en Chef John Roberts a été nommé à son poste le 25 septembre 2005, le sénateur démocrate du Delaware, Joe Biden, lui avait dit : « Est-ce qu’un tag microscopique peut être implanté dans le corps d’une personne afin de pister chacun de ses mouvements ? Il y a en réalité une discussion à ce propos. Vous statuerez là-dessus, écoutez-moi bien, avant que vos 10 ans (de mandat) soient terminés.
Est-ce que des scanners du cerveau peuvent être utilisés afin de déterminer si une personne possède une inclination pour la criminalité ou les comportements violents ? Vous statuerez là-dessus. »

LE 28 JUIN 2012, JOHN ROBERTS A EFFECTIVEMENT « STATUÉ LÀ-DESSUS » EN SOUTENANT LE PROJET DE RÉFORME DES SOINS DE SANTÉ D’OBAMA ET EN LE DÉCLARANT « CONSTITUTIONNEL » !

A LA SECTION 2521 DE CETTE LOI HR 4872 (VOIR PAGES 2056 ET 2057), ON TROUVE LA PARTIE QUI PARLE DE CES « DISPOSITIFS IMPLANTABLES » QUI SERONT UTILISÉS DANS LES « SOINS » DE « SANTÉ » AMÉRICAINS.


Télécharger la loi HR 4872 :

http://www.gpo.gov/fdsys/pkg/BILLS-111hr4872rh/pdf/BILLS-111hr4872rh.pdf (source officielle)

http://housedocs.house.gov/rules/hr4872/111_hr4872_reported.pdf (source officielle)

http://www.mediafire.com/view/?jyo2s33kuuhnve9


Voici ce qui en est dit (p. 2056 et 2057) :


SEC. 2521. NATIONAL MEDICAL DEVICE REGISTRY.

(a) REGISTRY.—

(1) IN GENERAL.—Section 519 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360i) is amended—

(A) by redesignating subsection (g) as sub17
section (h); and

(B) by inserting after subsection (f) the following:

« National Medical Device Registry (g)(1) The Secretary shall ESTABLISH A NATIONAL MEDICAL DEVICE REGISTRY (in this subsection referred to as the « registry » ) to facilitate analysis of postmarket safety and outcomes data on each device that—

(A) is or has been used in or on a patient; and

(B) is— (i) A CLASS III DEVICE; OR (ii) A CLASS II DEVICE THAT IS IMPLANTABLE, LIFE-SUPPORTING, OR LIFE-SUSTAINING.

(2) In developing the registry, the Secretary shall, in consultation with the Commissioner of Food and Drugs,the Administrator of the Centers for Medicare & Medicaid Services, the head of the Office of the National Coordinator for Health Information Technology, and the Secretary of Veterans Affairs, determine the best methods for—

(A) including in the registry, in a manner consistent with subsection (f), appropriate information TO IDENTIFY each device described in paragraph (1) by type, model, and serial number or other unique identifier;

(B) validating methods for analyzing patient safety and outcomes data from multiple sources and FOR LINKING SUCH DATA WITH THE INFORMATION INCLUDED IN THE REGISTRY as described in subparagraph (A), including, to the extent feasible, use of—

(i) data provided to the Secretary under other provisions of this chapter; and

(ii) information from public and private sources identified under paragraph (3);


TRADUCTION :


SEC. 2521. REGISTRE NATIONAL DES DISPOSITIFS MEDICAUX.

(a) Registre. -

(1) En général. – La section 519 du Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360i) est modifiée -

(A) en renumérotant le paragraphe (g) en tant que paragraphe (h);

(B) en insérant, après le paragraphe (f), ce qui suit:

« Registre national des dispositifs médicaux (g) (1) Le Secrétaire établira un registre national des dispositifs médicaux (dénommé « le registre » dans ce paragraphe) afin de faciliter L'ANALYSE de la sécurité après la commercialisation et DES DONNEES des résultats CONCERNANT CHAQUE DISPOSITIF QUI --

(A) est ou a été utilisé DANS ou sur un patient, et

(B) est: (i) un dispositif de classe III, ou (ii) UN DISPOSITIF DE CLASSE II QUI EST IMPLANTABLE, qui soutient la vie ou la survie.

(2) En développant le registre, le secrétaire, en consultation avec le commissaire de la Food and Drugs, l'Administrateur des Centers for Medicare & Medicaid Services, le chef du Bureau du Coordonnateur national pour les technologies d’information sur la santé, et le secrétaire des affaires des Anciens Combattants, déterminera les meilleures méthodes pour -

(A) inclure dans le registre, d'une manière conforme au paragraphe (f), les informations appropriées afin d’ identifier chaque dispositif décrit au paragraphe (1) par type, modèle et numéro de série ou autre identificateur unique;

(B) valider les méthodes pour analyser la sécurité du patient et les données sur les résultats provenant de multiples sources et pour lier ces données aux renseignements inclus sur le registre tel que cela est décrit dans le paragraphe (A), y compris, dans la mesure du possible, l’utilisation -

(i) de données fournies au Secrétaire en vertu d'autres dispositions du présent chapitre, et

(ii) d’ informations provenant de sources publiques et privées identifiées sous le paragraphe (3);



VIDEO (en anglais) : http://www.youtube.com/watch?v=rWZvLQHiTtQ

Pour rappel, les puces implantables de type VeriChip, par exemple, ont été reconnues par la FDA des USA comme étant un « dispositif médical de classe II » (cf. http://www.accessdata.fda.gov/cdrh_docs/pdf3/k033440.pdf  et http://www.mediafire.com/view/?mfy0cycybx6pfmu  )!

CETTE FOIS, LE PUÇAGE EST DONC BIEN ENTRÉ DANS LA LOI AMÉRICAINE, VIA LES SOI-DISANT « RÉFORMES DE SANTÉ » D’OBAMA !


POUR RAPPEL, LE PATRIARCAT CATHOLIQUE BYZANTIN D’UKRAINE A RECONNU LES PUCES RFID ET LES PUCES IMPLANTABLES COMME ÉTANT LA MARQUE DE LA BÊTE (cf. http://vkpatriarhat.org.ua/en/?p=3845 ) !

LE POINT DE NON-RETOUR EST DÉSORMAIS ATTEINT, AUX USA. Y AURA-T-IL UNE OPPOSITION SÉRIEUSE À CES PUCES DU DIABLE DANS NOS PAYS !? TELLE EST LA QUESTION…

BONNE RÉVOLUTION… OU BON ESCLAVAGE, BONNE TYRANNIE, BON PUÇAGE… ET « BONNE » DAMNATION ! Vic.

  


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MessagePosté le: Lun 13 Mai - 14:50 (2013)    Sujet du message: YOUR MEDICAL LICENSE AND HOSPITAL PRIVILEGES ARE UNDER ATTACK Répondre en citant



YOUR MEDICAL LICENSE AND HOSPITAL PRIVILEGES ARE UNDER ATTACK

Jan 26, 2013

Plans by licensing boards and "non-profit" certification organizations, among others, threaten to require physicians to complete expensive, time consuming, and bureaucratic certification programs (at their own expense and the expense of time spent with patients) in order to simply keep their medical license or hospital privileges.

Under the guise of improving medical care, these schemes, in reality, serve to increase the power and balance sheets of their proponents and are counterproductive to quality patient care.

Last November we sent you an important action alert, copied below. In this new year, take action and help sustain the momentum building behind efforts to stop this growing threat.


Thank you! ~AAPS


Stopping MOC/OCC & MOLTake Action Today!

Take Action Today!

Physician-led activism to STOP onerous, expensive, and counterproductive Maintenance of Certification (MOC) / Maintenance of Licensure (MOL) is making a difference. In October, efforts led by Ohio physicians, including AAPS members Paul Kempen, MD, Ken Christman, MD, et al., helped deliver a blow to looming MOL in Ohio.

Continued physician vigilance is needed to stop the push for implementation in other states and to reverse the trend of MOC being increasingly required for hospital privileges and insurance participation.

Below is a letter Craig M. Wax, DO, another AAPS member, is sending to educate his allopathic and osteopathic colleagues about MOC/OCC (Osteopathic Continuous Certification) & MOL. Please read it, educate your colleagues (e.g. forward them this email) and take immediate action.

Additional action items and information sources are listed below his letter.




Dear physician colleague,

You've probably heard about, or experienced first hand, the additional time and expense needed to pursue Maintenance of Certification (MOC) / Osteopathic Continuous Certification (OCC). Even if you are lifetime certified, or not certified at all, read on because the push to tie MOC/OCC to Maintenance of Licensure (MOL) could effect your state medical license.

MOC/OCC will take countless hours from your patient care, personal health and family time, as well as more than $3000 in direct cost for each certification period plus extra thousands of dollars more in indirect costs. Physicians and patients are already suffering at the hands of insurance industry and government regulations, and now our own "non-profit" specialty boards are adding to physicians' burdens in response to government and industry pressure and profit.

In Ohio, during 2012, the State Medical Board of Ohio was working to require that ALL PHYSICIANS participate in these time and money intensive MOC/OCC programs in order for them to maintain their medical licenses. Other states are considering similar plans to tie MOC/OCC to MOL (Maintenance of Licensure) and this is why ALL PHYSICIANS must be active in rejecting these schemes. It was the active practicing physicians in Ohio that loudly objected to participation in the program and caused the state of Ohio to cease implementation.

The time is now to send a letter to the
American Board of Medical Specialties (ABMS) or AOA's Bureau of Osteopathic Specialists (BOS) and appropriate specialty board (ABMS member boards or AOA specialty boards) to let them know you will refuse participation in the MOC/OCC program. This goes for ALL PHYSICIANS no matter what your board certification circumstances are. Click here to read a short sample letter you can send to the certifying board and, click here to read my longer letter listing my specific reasons for not complying with MOC/OCC. Please use these examples as you see fit.

Please DO it now.

Sincerely,

Craig M. Wax, DO
Independent Physicians 4 Patient Independence (IP4PI)
http://Facebook.com/pages/Independent-Physicians-for-Patient-Independence-ip4pi/144169092313650

http://Twitter.com/ip4pi




Action Items

1. Voice your concern with your certifying specialty board by sending this sample letter:
https://ip4pi.wordpress.com/2012/11/19/sample-moc-occ-board-letter/.

Contact information can be found at the following links:
American Board of Medical Specialties (ABMS), AOA's Bureau of Osteopathic Specialists (BOS), ABMS member boards, and AOA specialty boards

2. Educate yourself about MOC/OCC & MOL at http://changeboardrecert.com. Tell your colleagues about this resource.

3. Introduce a resolution at your state medical society opposing MOC/OCC & MOL. A model resolution can be found by
clicking here.

4. Educate your state legislators about this issue and ask them to consider legislation to stop it. A model bill can be found on Page 78 of
http://www.jpands.org/vol17no3/christman.pdf.

5. Refuse to comply and cutoff the revenue stream to these "non-profit" boards.


Additional Information

Video: MOC/MOL: Moneymaking Machine for "Non-Profit" Boards? Ron Benbassat, MD
http://youtu.be/ph6OWbiVykQ

Video: What to do about MOC/MOL. Paul Kempen, MD, PhD http://youtu.be/WRS15Dmsk7E

Alert Sent to All Ohio Physicians: http://eepurl.com/jWb6r

Successful Opposition to Maintenance of Licensure: the Ohio Experience as an Educational Template, by Paul Martin Kempen, M.D., Ph.D. http://www.jpands.org/vol17no4/kempen.pdf

Maintenance of Certification (MOC), Maintenance of Licensure (MOL), and Continuing Medical Education (CME): the Regulatory Capture of Medicine, by Paul Martin Kempen, M.D., Ph.D. http://www.jpands.org/vol17no3/kempen.pdf

Maintenance of Certification (MOC), Maintenance of Licensure (MOL), and Continuing Medical Education (CME): How the Regulators Prosper, by Kenneth D. Christman, M.D. http://www.jpands.org/vol17no3/christman.pdf

Why Do Patients Select and Stay with Their Doctor? Implications Regarding Board Certification and Maintenance of Certification and of Licensure, by Paul Martin Kempen, M.D., Ph.D. http://www.jpands.org/vol17no2/kempen.pdf

Maintenance of Certification (MOC) and Now Maintenance of Licensure (MOL):Wrong Methodologies to Improve Medical Care, by Paul M. Kempen, M.D., Ph.D. http://www.jpands.org/vol17no1/kempen.pdf

Board Certification/Recertification/Maintenance of Certification: A Malignant Growth, by Martin Dubravec, M.D. http://www.jpands.org/vol16no2/dubravec.pdf

http://www.aapsonline.org/index.php/site/article/stopping_moc_occ_mol


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MessagePosté le: Mar 21 Mai - 18:56 (2013)    Sujet du message: DOCTORS INCREASINGLY DECLARING BANKRUPTCY AS OBAMACARE KICKS IN, CAUSING WIDESPREAD CARE SHORTAGES Répondre en citant

 
DOCTORS INCREASINGLY DECLARING BANKRUPTCY AS OBAMACARE KICKS IN, CAUSING WIDESPREAD CARE SHORTAGES

Monday, May 20, 2013 by: Jonathan Benson, staff writer

 

 



 
(NaturalNews) Just a few short years ago, Plantation, Fla.-based bankruptcy attorney David Langley did not have even one doctor as a client. But in the years that have followed, Langley has processed at least six bankruptcy cases involving physicians, and is currently working on two bankruptcy cases involving an orthopedic surgeon and an OB/GYN, according to CNNMoney.

Why this sudden increase in primarily private practice debacles? A changing healthcare environment prompted by the incremental installment of Obamacare is one major factor causing doctors to go belly-up all across the country, say experts. Other factors include decreasing insurance reimbursements, ever-rising medical malpractice insurance costs, and more expensive drugs, all of which are making it increasingly difficult for American doctors to survive.

As we have been saying here at NaturalNews for quite some time now, the so-called "healthcare" industry, at least as we currently know it, is really more of a sick-care industry driven by a highly unsustainable profit model. The costs associated with drugs, surgeries, and medical equipment, for instance, continue to skyrocket, and fraudulent insurance billing practices have only made the problem worse.

Economy woes driving many doctors out of practiceBut a much more serious issue in recent years appears to be the flailing economy, which many doctors are reporting has caused them to lose half or more of their patients. Many former patients who lost their jobs in recent years also lost their health insurance coverage, which has resulted in many of them being no longer able to pay for medical care, even if they need it. Consequently, many doctors have had to downsize their practices.

But even this is not enough for the hundreds, or even thousands, of doctors who have since struggled just to keep their doors open. As evidenced by the comment sections on articles discussing the issue, loss of patients has resulted in loss of staff, which for many doctors has ended in their practices having to be completely shut down.

"In 2008, my clinic lost 50 percent of our Account Receivables from patients," commented one
doctor on a CNNMoney piece. "Many patients lost their insurance and their jobs when the economy went into a recession, (and) it became worse in 2009. We had to downsize and never recovered. In 2010, the clinic which used to employ 25 people ... and treat over 5,000 patients a year closed."

Another commenter, a former patient, recollects how his own doctor was forced into
bankruptcy two years ago. He explains how the doctor was unable to meet even the minimum pay threshold he needed to stay in business, and thus had to close the practice. This same commenter also notes that under Obamacare, "it will only get worse."

"The reimbursements continue to fall," writes one bankrupted doctor. "Obamacare payments will be similar to Medicaid which is bankrupting most doctors."

Some doctors simply do not know how to run their businessOn the flip side, poor business practices may also be to blame for many doctors' practices failing. According to Dr. Kevin Pho, M.D., private practice medicine is small business, and small business can fail if it is not run correctly. Many private practice doctors excel at treating patients but are poor business managers, which means they are just as prone to failure as any other small business.

"Private practice medicine is running a small business," writes Dr. Pho. "And if it's managed poorly, it will go bankrupt, like any other business."

Sources for this article include:

http://money.cnn.com

http://money.cnn.com

http://www.kevinmd.com/blog/2012/01/doctors-ashamed-bankrupt.html

http://www.naturalnews.com/040416_medical_bankruptcy_obamacare_doctors.html


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MessagePosté le: Ven 24 Mai - 01:02 (2013)    Sujet du message: STATE OF EMERGENCY ISSUED IN OKLAHOMA Répondre en citant

 
 

 
STATE OF EMERGENCY ISSUED IN OKLAHOMA  
 
+ bracelet and/or microchip??? Tricare under military rules.

5/23/2013  
 
 Due to recent severe storms and tornadoes in Oklahoma, the Governor of Oklahoma has issued a State of Emergency. Due to this issuance, emergency prescription refills and referral waivers from some Prime beneficiaries are in effect.

Early Prescription Refills

Emergency Refill Too Soon Procedures have been implemented for through June 17, 2013 in the following counties: 

  • Cleveland
  • Lincoln
  • McClain
  • Oklahoma
  • Pottawatomie

To get an emergency refill, take your prescription bottle to any TRICARE retail network pharmacy. Contact Express Scripts at 1-877-363-1303 or search the network pharmacy locator to find the nearest network pharmacy. 
 
If possible, you should visit the pharmacy where the prescription was filled. You can request assistance at another pharmacy; however, help provided is at the pharmacy's discretion. If you use a retail chain, you can get medication from another store in that chain. If your primary care manager is available, he or she may call in a new prescription to any network pharmacy in the area.

Primary Care Manager Referral Waiver

The tornadoes impacted the areas around Tinker Air Force Base. Beneficiaries enrolled in TRICARE Prime or TRICARE Prime Remote are normally required to have a referral from their primary care manager (PCM) for any care provided by another physician, including urgent–or same day—care (with a few exceptions).
 
Because many beneficiaries may be displaced or unable to get to their PCM in the area around Tinker Air Force Base, the requirement to have a PCM referral has been waived. The waiver applies to care received between May 20, 2013 and June 19, 2013. During this period of time, TRICARE Prime beneficiaries living in the areas around Tinker Air Force Base may visit any provider for care without incurring additional point-of-service charges.
 
Please contact Humana Military Healthcare Services at 1-800-444-5445 to see if you qualify for the waiver. 
 
http://www.tricare.mil/DisasterInfo/DisasterAlerts/5_21_13_OklahomaTornado.… 


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MessagePosté le: Sam 25 Mai - 00:01 (2013)    Sujet du message: 2,137 IRS AGENTS GEARING UP TO ENFORCE OBAMACARE IN MIDST OF SCANDAL Répondre en citant



2,137 IRS AGENTS GEARING UP TO ENFORCE OBAMACARE IN MIDST OF SCANDAL 

 


by Wynton Hall 24 May 2013, 9:48 AM PDT   

Even as the Internal Revenue Service (IRS) political targeting scandal widens, an army of 2,137 IRS agents are gearing up to implement and police numerous aspects of Obamacare. Their enforcement of the law is under the leadership of Sarah Hall Ingram, the person in charge of the tax-exempt unit from 2009 to 2012 during the targeting.

House and Senate Republicans have introduced bills to stop IRS involvement in implementing Obamacare. Sen. John Cornyn introduced the “Keep the IRS Off Your Health Care Act of 2013” (S. 983) in the Senate, while Rep. Tom Price (R-GA) sponsored a bill by the same name in the House (H.R. 1990).

“The official who oversaw the targeting of tea party groups is now in charge of implementing Obamacare at the IRS,” said Cornyn. “Now more than ever, we need to prevent the IRS from having any role in Americans’ health care.

Cornyn added: “I do not support Obamacare, and after the events of last week, I cannot support giving the IRS any more responsibility or taxpayer dollars to implement a broken law.” 

The IRS says that Ingram “has been assigned full-time to ACA [Affordable Care Act—Obamacare] activities since December 2010.” However, as ABC News has pointed out, “Ingram maintained her title as commissioner of tax exempt and government entities, using it in testimony she delivered to congress in November 2011 and May 2012.”
 
As this official IRS chart shows, as of February 2011, Ingram remained the head of the tax exempt and government entities unit responsible for executing the IRS’s targeting of conservative groups. Indeed, from 2009 to 2012, Ingram received $103,390 in bonuses.
 
Ingram is not without her defenders, however. Disgraced former IRS Acting Commissioner Steven Miller says Sarah Hall Ingram is “a superb civil servant.” Asked whether Ingram was involved in the targeting scandal, Miller--who was forced to resign his post--said “I wouldn’t imagine so.”



http://www.breitbart.com/Big-Government/2013/05/24/2-137-IRS-Agents-Gearing… 


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MessagePosté le: Lun 27 Mai - 14:52 (2013)    Sujet du message: APRÈS LE CASIER JUDICIAIRE: LE CASIER MÉDICAL ! Répondre en citant

 APRÈS LE CASIER JUDICIAIRE: LE CASIER MÉDICAL !
 
Notre dossier à tous qui est maintenant géré par les militaires de Tricare et accessible à tous ceux qui travaillent en lien avec eux. Le casier médical sera utilisé comme tyrannie médicale contre le citoyen afin de le criminaliser et l'obliger à se soumettre à leurs expériences démoniaques et destructrices.



13/05/2013
 
La compilation et l''agrégation de données médicales sur dossiers informatiques présente d'immenses avantages ... et autant d'inconvénients.
 
A quand un medicalfileleaks ?
 
Le fait que le patient demeure en tout temps le maître de son propre fichier ne le met pas à l'abri d'indiscrétions. Le secret médical, tel qu'il est violé chaque jour en Suisse (notamment par les assurances-maladie, au nom de la protection de  l'économicité des traitements) préfigure le stade où un tel dossier médical, d'abord facultatif, deviendra obligatoire et livrés aux mains des autorités médicales et à celles des agents  de l'Etat.
 

 
On l'a vu dans le cas du "burnout" d'Yvan Perrin, conseiller national, le secret médical peut être violé par des adversaires politiques, toujours prompts à saisir la presse des faiblesses d'autrui pour le détruire.

Vous prenez des benzodiazépines depuis des années ? On vous a prescrit de "l'onguent gris" contre la blennorragie il y a 20 ans ?  Vous suivez une tri-thérapie ? Vous avez été évalué psychiquement au DSM IV  IV il y a 15 ans lors de votre dépression ? Vous êtes victime d'un faux diagnostic ? Vous avez avorté trois fois ? Vous avez des crises de malaria suite à un voyage exotique ? Vous êtes un "fumeur récalcitrant" ?
 
Pas un seul détail ne manquera à votre dossier médical, accessible à vos assurances, à vos divers médecins, au personnel des cabinets médicaux, des hôpitaux et cliniques ! Puis, en cas d'accident de la route, à la police et à la justice. Cela fait beaucoup de monde et autant de risques de "fuites".

Le patient traînera désormais derrière lui son "casier médical" comme d'autres leur casier judiciaire. La liste des diagnostics stigmatisants est longue...
 
Prudence ! Pas de quoi pavoiser, Pierre-François Unger, quand on sait avec quelle légèreté vous avez joué avec les statistiques et les media pour leur faire croire que l'interdiction de fumer dans les lieux publics à Genève aurait entraîné une baisse spectaculaire des crises cardiaques et maladies connexes  ! C'était, hélas,  un beau mirage. 
 
Vous comprendrez que les Genevois soient des plus circonspects à l'annonce de votre dossier médical informatisé "pour tous".
 
Cette innovation mirobolante risque, de surcroît, de plomber le coût de ... la médecine.
 
Il serait intéressant d'avoir l'opinion du Parti pirate, truffé de "geeks" de haut vol, sur la question. (jaw)

PS: L'avis du Parti pirate, le voici: Un dossier médical à étudier de plus prêt
 
http://humoresques.blog.tdg.ch/archive/2013/05/13/apres-la-casier-judiciair…


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MessagePosté le: Lun 27 Mai - 17:41 (2013)    Sujet du message: TRICARE ISSUES WAIVERS FOR OKLAHOMA TORNADO VICTIMS Répondre en citant

 
TRICARE ISSUES WAIVERS FOR OKLAHOMA TORNADO VICTIMS

 Posted by: Health.mil Staff

Monday, May 27, 2013

Disasters don’t split hairs over how many lives are affected. Such was the case with the May 20, EF5-strength tornado that ripped through Moore, Okla. As a result, the tragedy prompted TRICARE’s authorization of the primary care manager medical waiver and the “Emergency Refill Too Soon” waiver. Each is designed to ensure military families and retirees have access to health care services and medications as they work to restore balance to their lives.

The PCM waiver is effective from May 20 through June 19, 2013 in the Tinker Air Force Base Prime Service Area. Learn more about the
waiver here.

The “Emergency Refill Too Soon” waiver authorizes early prescription refills for affected beneficiaries through June 17 in Cleveland, Lincoln, McClain, Oklahoma and Pottawatomie counties. Additional information about early refills can also be found on the 
TRICARE website.

 http://www.health.mil/blog/13-05-27/TRICARE_Issues_Waivers_for_Oklahoma_Tornado_Victims.aspx


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MessagePosté le: Mer 29 Mai - 12:23 (2013)    Sujet du message: RAND PAUL ON OBAMACARE Répondre en citant

 RAND PAUL ON OBAMACARE 

Clipped from:Senator Paul at Iowa Lincoln Day Dinner
May 10, 2013


Senator*Rand Paul (R-KY) was the keynote speaker at the Iowa Republican Party’s Lincoln Dinner at The Hotel at Kirkwood Center in Cedar Rapids, Iowa on may 10, 2013

http://www.c-spanvideo.org/clip/4453678

 

 

 


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MessagePosté le: Mar 4 Juin - 01:09 (2013)    Sujet du message: IRS: CHEAPEST OBAMACARE PLAN WILL BE $20,000 PER FAMILY Répondre en citant

IRS: CHEAPEST OBAMACARE PLAN WILL BE $20,000 PER FAMILY

By Matt Cover  January 31, 2013

 

President Barack Obama hugs HHS Secretary Kathleen Sebelius and then-House Speaker Nancy Pelosi after signing the Obamacare law on March 23, 2010. (White House photo/Pete Souza) 
 
(CNSNews.com) – In a final regulation issued Wednesday, the Internal Revenue Service (IRS) assumed that under Obamacare the cheapest health insurance plan available in 2016 for a family will cost $20,000 for the year.
 
Under Obamacare, Americans will be required to buy health insurance or pay a penalty to the IRS.
 
The IRS's assumption that the cheapest plan for a family will cost $20,000 per year is found in examples the IRS gives to help people understand how to calculate the penalty they will need to pay the government if they do not buy a mandated health plan.
 
The examples point to families of four and families of five, both of which the IRS expects in its assumptions to pay a minimum of $20,000 per year for a bronze plan.
 
“The annual national average bronze plan premium for a family of 5 (2 adults, 3 children) is $20,000,” the regulation says.
 
Bronze will be the lowest tier health-insurance plan available under Obamacare--after Silver, Gold, and Platinum. Under the law, the penalty for not buying health insurance is supposed to be capped at either the annual average Bronze premium, 2.5 percent of taxable income, or $2,085.00 per family in 2016.
 
In the new final rules published Wednesday, IRS set in law the rules for implementing the penalty Americans must pay if they fail to obey Obamacare's mandate to buy insurance.
 
To help illustrate these rules, the IRS presented examples of different situations families might find themselves in.
 
In the examples, the IRS assumes that families of five who are uninsured would need to pay an average of $20,000 per year to purchase a Bronze plan in 2016.
 
Using the conditions laid out in the regulations, the IRS calculates that a family earning $120,000 per year that did not buy insurance would need to pay a "penalty" (a word the IRS still uses despite the Supreme Court ruling that it is in fact a "tax") of $2,400 in 2016.
 
For those wondering how clear the IRS's clarifications of this new "penalty" rule are, here is one of the actual examples the IRS gives:
“Example 3. Family without minimum essential coverage.
 
"(i) In 2016, Taxpayers H and J are married and file a joint return. H and J have three children: K, age 21, L, age 15, and M, age 10. No member of the family has minimum essential coverage for any month in 2016. H and J’s household income is $120,000. H and J’s applicable filing threshold is $24,000. The annual national average bronze plan premium for a family of 5 (2 adults, 3 children) is $20,000.
 
"(ii) For each month in 2016, under paragraphs (b)(2)(ii) and (b)(2)(iii) of this section, the applicable dollar amount is $2,780 (($695 x 3 adults) + (($695/2) x 2 children)). Under paragraph (b)(2)(i) of this section, the flat dollar amount is $2,085 (the lesser of $2,780 and $2,085 ($695 x 3)). Under paragraph (b)(3) of this section, the excess income amount is $2,400 (($120,000 - $24,000) x 0.025). Therefore, under paragraph (b)(1) of this section, the monthly penalty amount is $200 (the greater of $173.75 ($2,085/12) or $200 ($2,400/12)).
 
"(iii) The sum of the monthly penalty amounts is $2,400 ($200 x 12). The sum of the monthly national average bronze plan premiums is $20,000 ($20,000/12 x 12).
 
Therefore, under paragraph (a) of this section, the shared responsibility payment imposed on H and J for 2016 is $2,400 (the lesser of $2,400 or $20,000).”
   
CNSNews.com is not funded by the government like NPR. CNSNews.com is not funded by the government like PBS. 
 
CNSNews.com relies on individuals like you to help us report the news the liberal media distort and ignore. Please make a tax-deductible gift to CNSNews.com today. Your continued support will ensure that CNSNews.com is here reporting THE TRUTH, for a long time to come. It's fast, easy and secure. 

http://m.cnsnews.com/news/article/irs-cheapest-obamacare-plan-will-be-20000… 


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MessagePosté le: Mar 11 Juin - 17:46 (2013)    Sujet du message: DEFENSE STILL MULLING NEXT STEPS ON ELECTRONIC HEALTH RECORD Répondre en citant

 DEFENSE STILL MULLING NEXT STEPS ON ELECTRONIC HEALTH RECORD  

By Bob Brewin June 4, 2013
 
Last Wednesday I asked the Pentagon and the Defense/Veterans Affairs Interagency Program Office charged with integrated electronic health record development when they plan to start the contracting process for commercial systems announced by Secretary of Defense Chuck Hagel on May 21, and who would run them.


I also asked for them to explain how Defense/VA would end up with a “seamless” and integrated EHR by the year’s end, as promised by Frank Kendall, undersecretary of Defense for acquisition, technology and logistics, on May 22.

Today, Air Force Lt. Col. Melinda Morgan sent me a statement that shows the EHR and integration remains a work in progress:

She said Hagel has assigned AT&L “responsibility for developing and executing a plan to acquire and deploy interoperable health data records and to modernize the clinical software used throughout DoD. We will report on these plans when they are complete, to include program office roles, program names and IOC dates.”

The above, while appreciated, obviously does not provide much insight on the progress on a mega-billion project that has already been in the works for a decade.
 
http://www.nextgov.com/defense/whats-brewin/2013/06/defense-still-mulling-n… 


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MessagePosté le: Mar 18 Juin - 20:31 (2013)    Sujet du message: TricareOnline ADDS CONTINUITY OF CARE DOCUMENTS Répondre en citant

 

TricareOnline ADDS CONTINUITY OF CARE DOCUMENTS


Posted by: Health.mil Staff

Tuesday, June 18, 2013

TRICARE beneficiaries who regularly get their care at military clinics and hospitals now can download a summary of their personal health data from TricareOnline,

www.tricareonline.com.

TricareOnline, a secure Defense Department patient portal, has made available through its “blue button” feature a continuity of care document to include such information as lab results, medications, allergies and lists of medical problems.  

The document, known as the CCD, is an industry standard and is easy to share with other health care systems like RelayHealth and Microsoft Health Vault. Patients can download TOL Blue Button data into a CCD and share it with any health care system capable of accepting the file, including non-DoD health care systems. The CCD guarantees the complete and accurate transfer of Blue Button health data. 

Patients can download CCD data to their computers and upload it to their personal health record.  In some cases, it may not be possible to read the actual CCD data on a personal computer because of the file type, but the information can be downloaded as a PDF. 

To take advantage of the CCD, patients need to go to www.tricareonline.com and log in to their accounts. Once there, they need to:

§ Click “Blue Button”
§ Click “Blue Button Download My Data”
§ Select the data types and date range to down; click “Save as CCD”
§ In the dialog box, select “Save File,” select the location and click “OK”

More information about the CCD and how to upload it to a personal health record is available on the secure patient portal at www.tricareonline.com.

http://www.health.mil/blog/13-06-18/TricareOnline_Adds_Continuity_of_Care_Documents.aspx


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MessagePosté le: Mar 20 Aoû - 10:50 (2013)    Sujet du message: ‘CHILDREN OF GOD WILL DIE’: MSNBC HOST SAYS ONLY ‘PHONY CHRISTIANS’ OPOSE OBAMACARE Répondre en citant

‘CHILDREN OF GOD WILL DIE’: MSNBC HOST SAYS ONLY ‘PHONY CHRISTIANS’ OPOSE OBAMACARE

Aug. 18, 2013 12:29pm Oliver Darcy





MSNBC host Ed Schultz unleashed Saturday on Christians who oppose President Obama’s landmark healthcare law, branding them as “phony Christians” and saying the repeal of the law would certainly result in the death of innocent children.

Schultz, who hosts ‘The Ed Show” on weekends, said the new healthcare law “is the most moral thing this country has ever done” and hammered those who disagree.

“This is good for America and I won’t let them lie,” Schultz said. “They’re phony Christians. Phony Christians when they say that they are Christian but then they want to take away from their next door neighbor. They don’t want to be their brother’s keeper.”

“A growing number of right wing Christians are coming out day after day as a Christian,” he continued. “I think I have the right to expose their hypocrisy and call them out for all the things they are saying wrong and how misguided they are.”

The liberal host then said “it is a fact” that innocent Americans will die if the law is repealed.

“It is very simple. If ObamaCare is repealed, Americans will die. Children of God will die,” he said.

Schultz, who says he is a born again Christian, made the comments during a segment where he asked if the “Christian conservative campaign against Obamacare is dangerous for America.”

Watch the clip, courtesy of MSNBC:

http://www.theblaze.com/stories/2013/08/18/children-of-god-will-die-msnbc-host-says-only-phony-christians-oppose-obamacare/?utm_source=facebook&utm_medium=story&utm_campaign=Share+Buttons


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MessagePosté le: Mer 21 Aoû - 19:12 (2013)    Sujet du message: UPS TO DROP 15,000 SPOUSES FROM INSURANCE, CITES OBAMACARE Répondre en citant

UPS TO DROP 15,000 SPOUSES FROM INSURANCE, CITES OBAMACARE

Aug 21, 2013, 5:13am EDT Updated: Aug 21, 2013, 12:07pm EDT


Andrew Harrer / Bloomberg
A United Parcel Service Inc. (UPS) employee scans a package while making a delivery.

United Parcel Service Inc. plans to remove thousands of spouses from its medical plan because they are eligible for coverage elsewhere. The Atlanta-based logistics company points to the Affordable Care Act, or Obamacare, as a big reason for the decision, reports Kaiser Health News.

The decision comes as many analysts are downplaying the Affordable Care Act's effect on companies such as UPS, noting that the move reflects a long-term trend of shrinking corporate medical benefits, Kaiser Health News reports. But UPS repeatedly cites Obamacare to explain the decision, adding fuel to the debate over whether it erodes traditional employer coverage, Kaiser says.

Rising medical costs, “combined with the costs associated with the Affordable Care Act, have made it increasingly difficult to continue providing the same level of health care benefits to our employees at an affordable cost,” UPS said in a memo to employees.

According to Kaiser, UPS (NYSE: UPS) told white-collar workers two months ago that 15,000 working spouses eligible for coverage by their own employers would be excluded from the UPS plan in 2014.

UPS expects the move, which applies to non-union U.S. workers only, to save about $60 million a year, company spokesman Andy McGowan said.

The health law requires large employers to cover employees and dependent children, but not spouses or domestic partners, Kaiser adds.

Kaiser said the Obama administration would not respond directly to UPS' statements, but said that employer coverage increased when Massachusetts implemented its own version of the health overhaul.

"The health care law will make health insurance more affordable, strengthen small businesses and make it easier for employers to provide coverage to their workers," said Joanne Peters, spokeswoman for the U.S. Department of Health and Human Services.


Earlier this week, Forever 21 Inc. became the latest national company to cut employee hours to counter the impact of Obamacare, according to Policymic.com.

Atlanta-based AAA Parking, a parking garage operator that employs more than 1,600 companywide, moved about half of its 500 full-time hourly employees to part-time status on April 15, in response to the law.

http://www.bizjournals.com/atlanta/morning_call/2013/08/ups-to-drop-15000-spouses-from.html?ana=RSS&s=article_search&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+bizj_atlanta+%28Atlanta+Business+Chronicle%29




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MessagePosté le: Ven 23 Aoû - 12:52 (2013)    Sujet du message: EXCLUSIVE: FEDS ARE BUILDING A DETECTIVE SQUAD TO TARGET CONSUMERS AND COMPANIES THAT DON'T FOLLOW OBAMACARE'S RULES Répondre en citant

EXCLUSIVE: FEDS ARE BUILDING A DETECTIVE SQUAD TO TARGET CONSUMERS AND COMPANIES THAT DON'T FOLLOW OBAMACARE'S RULES
  • Post-Obamacare law hiring at the Department of Health and Human Services included 86 'criminal investigators,' but just two 'consumer safety' officers
  • On the day President Obama signed the Affordable Care Act into law in 2010, HHS received authority to make 1,814 new hires
  • The authorization included positions for 50 criminal investigators. The agency increased that number to 86
  • The agency was also authorized to hire  261 'consumer safety officers.' Only two such employees were hired

By David Martosko In Washington

PUBLISHED: 02:27 GMT, 22 August 2013 | UPDATED: 11:28 GMT, 22 August 2013

More than 1,600 new employees hired by the U.S. Department of Health and Human Resources in the aftermath of Obamacare's passage include just two described as 'consumer safety' officers, but 86 tasked with 'criminal investigating' – indicating that the agency is building an army of detectives to sleuth out violations of a law that many in Congress who supported it still find confusing.

On the day President Obama signed the Affordable Care Act into law in 2010, HHS received authority from the Office of Personnel Management (OPM) to make as many as 1,814 new hires under an emergency 'Direct Hiring Authority' order.

The Obama administration ordered that employment expansion despite a government-wide hiring freeze.


U.S. Secretary of Health and Human Services Kathleen Sebelius, left, discusses the Affordable Care Act at a news conference on Aug. 13, 2013

A total of 1,684 of those positions were filled. An analysis by MailOnline shows that at 2010 federal government salary rates, the new employees' salaries alone cost the U.S. at least $138.8 million every year.

Had the agency filled all its available jobs, that cost would have been a minimum of $159 million.

The hiring began in May 2010 and continued through June 2013, making the later hires eligible for higher salaries as a result of annual cost-of-living increases.

The difference between what HHS spent on new Obamacare-related employees and what it was authorized to spend is explained by its failure to hire most of the 261 'consumer safety officers' it was authorized to bring aboard. Only two such employees were hired.

But while OPM authorized HHS Deputy Assistant Secretary for Human Resources Denise Carter -- later renamed Denise Wells -- to hire 50 criminal investigators, the agency increased that number to 86 on its own.

After MailOnline lodged a Freedom Of Information Request with HHS, the agency sent a spreadsheet containing records of the positions it filled, along with the salary level for each one on the government's 'GS' hiring scale.


On the day President Obama signed the Affordable Care Act into law in 2010, HHS received authority to make 1,814 new hires. Obama is pictured here on August 15

The lowest salary on the list was for a single contracting officer at Grade 7, Step 1, an annual rate of about $42,350, including a so-called 'differential' payments. Those increases are given to all federal employees in order to adjust for regional cost-of-living differences.

The highest salary in 2010 dollars, including that differential payment, was about $161,450, earned by a total of 29 new employee. They include health insurance administrators, contracting officers and information technology managers.

The fleet of 86 new criminal investigators are earning a range of compensation between $51,800 and $89,350, according to the 2010 salary tables and differential payment guidelines.

Judicial Watch, a nonprofit that has told MailOnline it files 'hundreds' of FOIA requests, first published evidence in July of the HHS hiring binge.

'Sounds like we now have the Obamacare police,' said the group's president, Tom Fitton, after MailOnline showed him the new data.

'Given the confusion and problems of the law's implementation, we would need a small army to police all the waste, fraud, and abuse that is already evident.'

Heritage Action for America, a conservative lobby group that opposes implementation of the Affordable Care Act, told MailOnline that it sees the hiring of criminal investigators inside HHS as a sign that its position is more and more defensible.

'The Obama administration continues to assert near unilateral power when it comes to Obamacare,' said Dan Holler, the group's communications director.

'This blatant disregard for the rule of law raises serious questions as to how these new criminal investigators will behave, what guidelines they will follow and who will provide much-needed oversight.'

Heritage Action is circulating a letter this week, penned by freshman GOP Rep. Mark Meadows, calling on 100 House Republicans to 'take the steps necessary to defund Obamacare in its entirety, including on a year-end funding bill like a continuing resolution.'

The Department of Health and Human Services didn't immediately respond to a request for comment, but it responded to MailOnline's FOIA request within the number of days the statute permits.

http://www.dailymail.co.uk/news/article-2399612/Feds-building-detective-squ…


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MessagePosté le: Dim 1 Sep - 10:06 (2013)    Sujet du message: RÉFORME DES SOINS DE SANTÉ - PROGRAMME EUGÉNIQUE - HEALTH CARE REFORM - (PARTIE 2) Répondre en citant

OMS : LA RECHERCHE EN SANTE EST CRUCIALE POUR PROGRESSER VERS LA COUVERTURE SANITAIRE UNIVERSELLE


La Directrice générale de l’OMS, Margaret Chan. Photo: OMS

15 août 2013 – À l'occasion de la présentation du Rapport sur la santé dans le monde 2013 jeudi, l'Organisation mondiale de la Santé (OMS) a appelé les pays à continuer d'investir dans la recherche locale pour mettre au point un système de couverture sanitaire universelle adapté à leur propre situation. Grâce à la couverture sanitaire universelle, les pays peuvent mettre à la disposition de leurs habitants les services de santé dont ils ont besoin sans que le coût de ces services n'expose l'utilisateur à des difficultés financières.

« La couverture universelle est le meilleur moyen de consolider les acquis en santé des dix dernières années. C'est un facteur puissant d'égalité sociale et la forme la plus aboutie d'équité », a déclaré le Directeur général de l'OMS, Margaret Chan, lors du lancement du rapport à Beijing, en Chine.

Le rapport montre comment les pays, lorsqu'ils mettent en place un système de couverture sanitaire universelle, peuvent utiliser la recherche pour déterminer les problèmes de santé à prendre en compte, structurer le système de santé et mesurer les progrès accomplis en fonction de la situation sanitaire qui leur est propre.

Le rapport révèle qu'en moyenne, les investissements des pays à revenu faible ou intermédiaire dans la recherche augmentent de 5% par an. Cette tendance s'observe tout particulièrement dans les pays émergents comme le Brésil, la Chine et l'Inde, qui ont tous adopté le concept de couverture sanitaire universelle.

Les études de cas de nombreux pays soulignent l'importance de la recherche locale et mondiale pour améliorer la santé, qu'il s'agisse de lutter contre des maladies ou de rendre les systèmes de santé plus performants. Les résultats de ces études montrent que la recherche doit impérativement s'effectuer localement, là où les chercheurs peuvent étudier les facteurs spécifiques à chaque pays.

« La recherche pour la couverture sanitaire universelle n'est pas un luxe; elle est au contraire fondamentale pour la découverte, le développement et la prestation d'interventions dont les gens ont besoin pour rester en bonne santé », souligne le rapport.

Le rapport montre aussi que, grâce à la collaboration internationale, davantage de travaux de recherche sont publiés. Les scientifiques des pays à revenu faible ou intermédiaire participent de plus en plus nombreux à ces collaborations, même si les pays à haut revenu continuent à jouer un rôle prépondérant dans la plupart des études. La Chine en est un bon exemple: entre 2000 et 2010, la proportion de chercheurs chinois coauteurs d'études publiées est passée de 5% à 13% à l'échelle mondiale. La participation du Brésil, de l'Inde et d'autres pays aux travaux publiés augmente elle aussi. Cependant, bien que la recherche se développe en général, la croissance est inégale.

« Tous les pays devraient à la fois faire de la recherche et l'utiliser. La créativité et la compétence des chercheurs sont les piliers des programmes d'études et des programmes de santé publique », a affirmé le principal auteur du rapport, Christopher Dye, qui dirige le Bureau d'information sanitaire du Groupe VIH/sida, tuberculose, paludisme et maladies tropicales négligées de l'OMS. « Toute une panoplie de travaux de recherche fondamentale et appliquée sont nécessaires pour parvenir à la couverture sanitaire universelle, mais le fossé entre savoir et action se comble très lentement. Il faut accélérer le rapprochement entre scientifiques et décideurs pour améliorer la couverture des services de santé ».

La couverture sanitaire universelle exige un système de santé solide, efficace et bien géré, un système de financement des services de santé, l'accès aux médicaments et aux technologies essentiels ainsi qu'un personnel de santé en nombre suffisant, bien formé et motivé.

Pour relever le défi, l'OMS encourage les donateurs internationaux et les gouvernements à investir dans la recherche, mais aussi à soutenir les dispositifs d'échange d'informations et de données, à renforcer la formation à la recherche et les instituts de recherche et à mesurer les progrès accomplis à l'aune de leur propre détermination à instaurer la couverture sanitaire universelle.

http://www.un.org/apps/newsFr/storyF.asp?NewsID=30887&Cr=oms&Cr1=#.UiL0mn-QSmA



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MessagePosté le: Ven 13 Sep - 11:45 (2013)    Sujet du message: OBAMACARE DATA HUB SECURITY REVIEW BLASTED Répondre en citant

OBAMACARE DATA HUB SECURITY REVIEW BLASTED



Maksim Kabakou/Shutterstock.com

By Aliya Sternstein September 12, 2013

An Obamacare network that will transmit patient health, financial and other personal information between federal agencies and state health care marketplaces completed a requisite security test earlier than anticipated but the work was not provided to an internal watchdog.

On Wednesday afternoon, Kay Daly, Health and Human Services Department assistant inspector general, told lawmakers at a House hearing that a system security plan and risk assessment filed on July 16 was not made available to her office during a recent audit. The Data Services Hub, which is slated to open Oct.1, will verify personal information, when a patient visits a government website to enroll in health insurance plans.

The July review was part of an independent security test completed August 23, a week ahead of the expected finish date.

Former Social Security Administration Commissioner Michael Astrue noted that the review was due on July 15, and the IG audit report was from Aug. 2. "There must have been a draft at that point," Astrue, who observed the hub's development until he left government in Janauary, testified at the same hearing. "I'm just not used to the idea that the inspector general comes in and asks for things and you say, 'No.'"

The House Homeland Security Subcommittee on Cybersecurity, Infrastructure Protection and Security Technologies hearing called for the session.

Lawmakers have voiced concerns that the network could become a treasure map for hackers. Unauthorized users could use the information transmitted through the hub to determine a patient’s eligibility for enrollment – including income, citizenship, and immigration status data – to commit identity theft or alter health records, health information technology experts say.

Steve Parente, a University of Minnesota health data academic who testified at the hearing, echoed concerns about the availability of the security assessment plan, which was developed by one of many contractors working on the project.

"I personally find it unconscionable that this contractor is not at least going to have an executive summary that actually talks about . . .the safeguards that have been put in for vulnerability tests, for the white-hat types of operations that are supposed to be put in to place to make sure that all potential compromises have been taken into consideration" before HHS allows the hub to operate, Parente said.

HHS senior leaders on Sept. 6 authorized the hub to operate, department officials said on Wednesday.

Responding to criticisms about the IG audit, Daly said it is hard to evaluate technology that is still being built.

"We were provided the data that we had requested -- if it had been created. That's one of the challenges," she said. "You're doing something that doesn't exist yet."

HHS officials in a fact sheet released on Wednesday stressed that the hub is not a databank of personal information, but rather a conduit to separate federal and state databases that store the information. This setup, they said, eliminates doorways for hackers that would have existed otherwise. An alternative arrangement -- agency databases communicating separately with one another -- would have amounted to hundreds of separately installed connections, officials said.

The network will connect to databases maintained by the Centers for Medicare and Medicaid Services, Social Security Administration, Internal Revenue Service, Office of Personnel Management, departments of Homeland Security, Veterans Affairs and Health and Human Services, among others.

"It is important to point out that the hub will not retain or store personally identifiable information. Rather, the hub is a routing system that CMS is using to verify data against information contained in already existing, secure and trusted federal and state databases," CMS Administrator Marilyn Tavenner wrote in a Sept. 11 letter to Committee Ranking Democrat Rep. Bennie Thompson, D-Miss.

Going forward, HHS officials will require that systems accessing the hub use sensors and software to identify abnormal network behavior and unauthorized system changes, according to the fact sheet. Government officials also will continue monitoring security by conducting automated vulnerability and active Web application scans; tracking system configurations; and hiring professional hackers to find weaknesses through "penetration testing."

(Image via Maksim Kabakou/Shutterstock.com)

http://www.nextgov.com/cybersecurity/2013/09/obamacare-data-hub-security-re…



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MessagePosté le: Sam 14 Sep - 11:25 (2013)    Sujet du message: REJECTED: UNIONS WILL NOT GET A SPECIAL OBAMACARE EXEMPTIOM Répondre en citant

REJECTED: UNIONS WILL NOT GET A SPECIAL OBAMACARE EXEMPTIOM

The labor unions just suffered another powerful blow as they realized that they won’t be exempt from the Obamacare exchanges. This means that the perks of being in a union just took a hit. Ironically, Obamacare will now undermine unions that are already starting to collapse.

Remember, the unions have been campaigning against Obamacare since they found out it will hurt their members… this is after they campaigned for it. Most major unions have called for it to be either repealed or reformed, saying it hurts “millions of workers”.

This is a great development, because the idea that the unions should be able to be exempt from a law that they campaigned for the rest of us to be forced to follow is completely tyrannical — at best. The Obama administration was looking for a way to legally make the exemption, but it turns out… there isn’t one.

http://www.capitalisminstitute.org/unions-do-obamacare/


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MessagePosté le: Sam 21 Sep - 17:52 (2013)    Sujet du message: OBAMA ADMIN APPEALS TO SUPREME COURT TO FORCE HOBBY LOBBY TO COMPLY WITH ABORTION PILL MANDATE Répondre en citant

OBAMA ADMIN APPEALS TO SUPREME COURT TO FORCE HOBBY LOBBY TO COMPLY WITH ABORTION PILL MANDATE

September 20, 2013 | Filed under: Business & Finance,Law & Government,Life & Society,Top Stories | By: Heather Clark




WASHINGTON – The Obama administration has filed an appeal to the United States Supreme Court in an effort to force the popular craft chain Hobby Lobby to comply with the abortion pill mandate in Obamacare.

The 251-page petition was filed on Thursday by U.S. Solicitor General Donald B. Verilli, and bears the name of other government attorneys. The Obama administration is asking the court to overturn a preliminary injunction that was granted to the company this past July.

As previously reported, Hoby Lobby first began its fight last year, seeking to obtain an exemption from covering two contraceptives that its owners believe cause abortions: the morning-after and week-after pill. The company currently provides birth control coverage to its employees and takes no issue with contraceptives in general.

“These abortion-causing drugs go against our faith, and our family is now being forced to choose between following the laws of the land that we love or maintaining the religious beliefs that have made our business successful and have supported our family and thousands of our employees and their families,” CEO David Green wrote in a statement last year. “We simply cannot abandon our religious beliefs to comply with this mandate. … By being required to make a choice between sacrificing our faith or paying millions of dollars in fines, we essentially must choose which poison pill to swallow.”

Ater a long battle in the court system of continuous denials, the 10th Circuit Court of Appeals overturned the rejection of the injunction in June, ruling that Hobby Lobby’s status as a business does not disqualify its owners from living out their faith.

“A religious individual may enter the for-profit realm intending to demonstrate to the marketplace that a corporation can succeed financially while adhering to religious values,” the three-judge panel wrote. “As a court, we do not see how we can distinguish this form of evangelism from any other.”

It then remanded the matter back to the district court for further review, and U.S. District Judge Joe Heaton subsequently issued the injunction to the company and its owners. However, he stayed the case until October 1st in order to give the Obama administration time to consider an appeal.

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“There is a substantial public interest in ensuring that no individual or corporation has their legs cut out from under them while these difficult issues are resolved,” Heaton declared.

The Obama administration had argued that if the injunction is granted, Hobby Lobby would in essence be forcing its religious beliefs on its 13,000 employees.

“If you make an exemption for the employer, it comes at the expense of the employee,” Alisa Klein, who represented the U.S. Department of Justice, told the 10th Circuit.

“The United States government is taking the remarkable position that private individuals lose their religious freedom when they make a living,” Kyle Duncan of The Becket Fund for Religious Liberty, which has been representing Hobby Lobby in the courts, wrote in a news release on Thursday. “We’re confident that the Supreme Court will reject the government’s extreme position and hold that religious liberty is for everyone—including people who run a business.”

http://christiannews.net/2013/09/20/obama-admin-appeals-to-supreme-court-to…



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