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1 H.R. 3607, a Bill to Authorize the Secretary of the Interior to Establish Fees for Medical Services Provided in Units of the National Park System, and for Other Purposes 1 (February 7, 2018)

handle is hein.congrec/intmdnps0001 and id is 1 raw text is: 




                    CONGRESSIONAL BUDGET OFFICE

C                              COST   ESTIMATE
                                                                   February 7, 2018


                                    H.R.   3607
     A  bill to authorize the  Secretary  of the Interior to establish  fees for
        medical  services provided   in units of the National  Park  System,
                              and  for other purposes

            As ordered reported by the House Committee on Natural Resources
                                on November  30, 2017


 H.R. 3607 would authorize (but not require) the National Park Service (NPS) to collect
 fees for medical services provided within the National Park System in addition to any
 payments it already receives for such services. The bill would establish a separate fund in
 the Treasury in which to deposit those new collections. Under the bill, the deposited
 amounts would be available to the NPS to the extent provided in advance by
 appropriation acts for medical services within the National Park System and to upgrade
 medical facilities and equipment.

 According to the NPS, the agency typically contracts out the operation of its medical
 clinics, but operates medical clinics in 11 system units where third parties choose not to
 compete for contracts to do that work. The NPS pays for medical costs at those facilities,
 which total about $4 million a year, using a mix of appropriated funds and direct
 spending of collections from park entrance fees and concession franchise fees. CBO
 expects that under the bill, the NPS would continue to operate clinics using funds from
 the same sources, in addition to any amounts that would be collected under this bill and
 thereafter appropriated.

 Under current law, the NPS does not have the authority to retain and spend payments it
 receives for medical services from people or insurance providers. Those offsetting
 receipts (about $2 million a year) are treated as reductions in direct spending and
 deposited into the general fund of the Treasury.

 Enacting H.R. 3607 could increase offsetting receipts. How or whether the proposed fees
 would be collected is unclear, however CBO estimates that those increases would not be
 significant. Because enacting the bill could affect direct spending, pay-as-you-go
 procedures apply. Enacting the bill would not affect revenues.

 CBO  expects that the NPS would incur administrative costs associated with collecting
 those fees. Based on the costs for similar activities, CBO estimates that those costs would

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