[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3713 Introduced in House (IH)]







105th CONGRESS
  2d Session
                                H. R. 3713

 To amend title XXI of the Social Security Act to prevent conflicts of 
interest in the use of administrative vendors in the administration of 
                State Children's Health Insurance Plans.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 22, 1998

     Mr. Stark (for himself, Mr. Waxman, Mr. Matsui, Mr. Miller of 
 California, Mr. Brown of Ohio, Ms. Eshoo, and Mr. Lantos) introduced 
  the following bill; which was referred to the Committee on Ways and 
                                 Means

_______________________________________________________________________

                                 A BILL


 
 To amend title XXI of the Social Security Act to prevent conflicts of 
interest in the use of administrative vendors in the administration of 
                State Children's Health Insurance Plans.

    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 ``State Children's Health Insurance 
Program Integrity Act of 1998''.

SEC. 2. LIMITATION ON USE OF ADMINISTRATIVE VENDORS IN THE 
              ADMINISTRATION OF STATE CHILDREN'S HEALTH INSURANCE 
              PLANS.

    (a) In General.--Section 2105(c) of the Social Security Act (42 
U.S.C. 300aa-5(c)) is amended by adding at the end the following new 
paragraph:
            ``(8) Limitation on expenditures for administrative 
        vendors.--Amounts expended by a State for the use of an 
        administrative vendor in marketing health benefits coverage to 
        low-income children under this title or in administering 
        otherwise part or all of the State child health plan under this 
        title shall be considered, for purposes of subsection 
        (a)(2)(D), to be reasonable costs to administer the plan but 
        only if the following conditions are met with respect to the 
        vendor:
                    ``(A) The vendor is independent of any entity 
                offering the coverage and of any health care providers 
                (whether or not any such provider participates in the 
                plan under this title) that provide coverage of 
                services in the same State in which the vendor is 
                conducting enrollment or administrative activities.
                    ``(B) No person who is an owner, employee, 
                consultant, or has a contract with the vendor either 
                has any direct or indirect financial interest with such 
                an entity or health care provider or has been excluded 
                from participation in the program under this title or 
                title XVIII or XIX or debarred by any Federal agency, 
                or subject to a civil money penalty under this Act.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to expenditures made on or after the date of the enactment of 
this Act.
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