[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2883 Introduced in House (IH)]







104th CONGRESS
  2d Session
                                H. R. 2883

    To amend title XIX to the Social Security Act to eliminate the 
requirement for States to seek recovery of medical assistance properly 
    paid and to restrict the use of liens and such recovery in any 
MediGrant program and any other future medical assistance programs, and 
                          for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 25, 1996

 Mr. Bryant of Texas introduced the following bill; which was referred 
                      to the Committee on Commerce

_______________________________________________________________________

                                 A BILL


 
    To amend title XIX to the Social Security Act to eliminate the 
requirement for States to seek recovery of medical assistance properly 
    paid and to restrict the use of liens and such recovery in any 
MediGrant program and any other future medical assistance programs, 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.

    This Act may be cited as the ``Family Farm and Home Protection 
Act''.

SEC. 2. REVISION OF STATE AUTHORITY IN IMPOSING LIENS AND RECOVERING 
              FOR MEDICAL ASSISTANCE PROPERLY MADE.

    (a) Eliminating Medicaid Mandate for State Recoveries.--Subsection 
(b)(1) of section 1917 of the Social Security Act (42 U.S.C. 1396p) is 
amended by striking ``except that'' and all that follows and inserting 
the following: ``except--
            ``(A) in the case of an individual described in subsection 
        (a)(1)(B), from the individual's estate or upon sale of the 
        property, subject to a lien imposed on account of medical 
        assistance paid on behalf of such individual, and
            ``(B) in the case of any other individual who is 65 years 
        of age or older, when the individual received such assistance, 
        from the individual's estate.''.
    (b) Revision of Definition of Estate.--Section 1917(b)(4) of such 
Act (42 U.S.C. 1396p(b)(4)) is amended--
            (1) by striking ``deceased individual'' and all that 
        follows through ``(A) shall'' and inserting ``deceased 
        individual shall'', and
            (2) by striking subparagraph (B).
    (c) Effective Date.--The amendment made by subsection (a) shall 
apply to medical assistance furnished on or after the date of the 
enactment of this Act and the amendments made by subsection (b) shall 
apply to individuals dying on or after such date of enactment.

SEC. 3. RESTRICTING RECOVERY OF MEDICAL ASSISTANCE PROPERLY PAID IN 
              OTHER FEDERALLY ASSISTED MEDICAL ASSISTANCE PROGRAMS.

    (a) In General.--Notwithstanding any other provision of law, no 
Federal funds shall be paid to a State under a State medical assistance 
program (as defined in subsection (d)) unless the conditions of 
subsections (b) and (c) are met.
    (b) Limitation on Imposition of Liens.--
            (1) In general.--No lien may be imposed against the 
        property of any individual prior to his death on account of 
        medical assistance paid or to be paid on his behalf under the 
        State medical assistance program, except--
                    (A) pursuant to the judgment of a court on account 
                of benefits incorrectly paid on behalf of such 
                individual, or
                    (B) in the case of the real property of an 
                individual--
                            (i) who is an inpatient in a nursing 
                        facility, intermediate care facility for the 
                        mentally retarded, or other medical 
                        institution, if such individual is required, as 
                        a condition of receiving services in such 
                        institution under the State program, to spend 
                        for costs of medical care all but a minimal 
                        amount of his income required for personal 
                        needs, and
                            (ii) with respect to whom the State 
                        determines, after notice and opportunity for a 
                        hearing (in accordance with procedures 
                        established by the State), that he cannot 
                        reasonably be expected to be discharged from 
                        the medical institution and to return home,
                except as provided in paragraph (2).
            (2) Additional limitation.--No lien may be imposed under 
        paragraph (1)(B) on such individual's home if--
                    (A) the spouse of such individual,
                    (B) such individual's child who is under age 21 and 
                is blind or disabled as defined in section 1614 of the 
                Social Security Act, or
                    (C) a sibling of such individual (who has an equity 
                interest in such home and who was residing in such 
                individual's home for a period of at least one year 
                immediately before the date of the individual's 
admission to the medical institution),
        is lawfully residing in such home.
            (3) Dissolution of liens.--Any lien imposed with respect to 
        an individual pursuant to paragraph (1)(B) shall dissolve upon 
        that individual's discharge from the medical institution and 
        return home.
    (c) Limitation on Adjustment or Recovery.--
            (1) In general.--No adjustment or recovery of any medical 
        assistance correctly paid on behalf of an individual under the 
        State medical assistance program may be made, except--
                    (A) in the case of an individual described in 
                subsection (b)(1)(B), from the individual's estate or 
                upon sale of the property, subject to a lien imposed on 
                account of medical assistance paid on behalf of such 
                individual, and
                    (B) in the case of any other individual who is 65 
                years of age or older, when the individual received 
                such assistance, from the individual's estate.
            (2) Limitation.--Any adjustment or recovery under paragraph 
        (1) may be made only after the death of the individual's 
        surviving spouse, if any, and only at a time--
                    (A) when he has no surviving child who is under age 
                21, or (with respect to States eligible to participate 
                in the State program established under title XVI of the 
                Social Security Act) is blind or permanently and 
                totally disabled, or (with respect to States which are 
                not eligible to participate in such program) is blind 
                or disabled as defined in section 1614 of such Act; and
                    (B) in the case of a lien on an individual's home 
                under subsection (b)(1)(B), when--
                            (i) no sibling of the individual (who was 
                        residing in the individual's home for a period 
                        of at least one year immediately before the 
                        date of the individual's admission to the 
                        medical institution), and
                            (ii) no son or daughter of the individual 
                        (who was residing in the individual's home for 
                        a period of at least two years immediately 
                        before the date of the individual's admission 
                        to the medical institution, and who establishes 
                        to the satisfaction of the State that he or she 
                        provided care to such individual which 
                        permitted such individual to reside at home 
                        rather than in an institution),
                is lawfully residing in such home and has lawfully 
                resided in such home on a continuous basis since the 
                date of the individual's admission to the medical 
                institution.
            (3) Procedures.--The State agency responsible for 
        administration of the State medical assistance program shall 
        establish procedures (in accordance with standards specified by 
        the Secretary of Health and Human Services) under which the 
        agency shall waive the application of this subsection (other 
        than paragraph (1)(C)) if such application would work an undue 
        hardship as determined on the basis of criteria established by 
        the Secretary.
            (4) Estate defined.--For purposes of this subsection, the 
        term ``estate'', with respect to a deceased individual, shall 
        include all real and personal property and other assets 
        included within the individual's estate, as defined for 
        purposes of State probate law.
    (d) Definitions.--In this section:
            (1) State.--The term ``State'' includes the District of 
        Columbia, Puerto Rico, the Virgin Islands, Guam, American 
        Samoa, and the Northern Mariana Islands.
            (2) State medical assistance program.--The term ``State 
        medical assistance program'' means the MediGrant program (under 
        title XXI of the Social Security Act) or other program of 
        Federal assistance to States for medical assistance 
        expenditures.
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