[Congressional Record Volume 155, Number 78 (Wednesday, May 20, 2009)]
[Senate]
[Pages S5727-S5728]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. REID (for Mr. Rockefeller):
  S. 1111. A bill to require the Secretary of Health and Human Services 
to enter into agreements with States to resolve outstanding claims for 
reimbursement under the Medicare program relating to the Special 
Disability Workload project; to the Committee on Finance.
  Mr. ROCKEFELLER. Mr. President, I rise today to introduce the Special 
Disability Workload Liability Resolution Act, legislation that will 
resolve Medicare's longstanding liability to state Medicaid programs 
for individuals who were covered by Medicaid when they should have been 
covered by Medicare.
  For the past several decades, hundreds of thousands of disabled 
people have had their health care paid for by Medicaid; however, their 
health care was actually the responsibility of Medicare. Therefore, 
states have been left financially responsible for individuals whose 
care should have been paid for entirely by the Federal Government. Both 
the Centers for Medicare and Medicaid Services, CMS, and the Social 
Security Administration, SSA, acknowledge Medicare's responsibility for 
these beneficiaries. The Social Security Administration is in the 
process of correcting the cash insurance payments that were due to 
disabled individuals. However, CMS has not acted to establish a means 
of satisfying Medicare's liability.
  This is unacceptable. Nearly every state is struggling to balance its 
budget in the midst of this terrible economic crisis, and it is 
estimated that the Medicare program owes the states an estimated $4 
billion. This figure continues to grow as the SSA corrects additional 
cases. When it is determined that a state owes the Federal Government 
money for Medicaid expenses, states have only 60 days to pay this debt. 
Yet, now that the situation is reversed, the Federal Government has not 
even established a timeline with which to pay its debt to the States.
  The legislation I am introducing today, the Special Disability 
Workload Liability Resolution Act, would provide $4 billion in Federal 
funding to settle this debt to the States. It requires the Social 
Security Administration and CMS to develop an accurate payment 
methodology to reimburse states within 6 months of the bill's 
enactment. Resolving this Federal debt would inject critical funds into 
State and local economies and help maintain state jobs.
  This bill is based on language successfully included in the Senate-
passed American Recovery and Reinvestment Act, but it was dropped in 
conference. It is my hope that my colleagues will once again support 
this important legislation.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 1111

       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 ``Special Disability Workload 
     Liability Resolution Act of 2009''.

[[Page S5728]]

     SEC. 2. PAYMENT OF MEDICARE LIABILITY TO STATES AS A RESULT 
                   OF THE SPECIAL DISABILITY WORKLOAD PROJECT.

       (a) In General.--The Secretary, in consultation with the 
     Commissioner, shall work with each State to reach an 
     agreement, not later than 6 months after the date of 
     enactment of this Act, on the amount of a payment for the 
     State related to the Medicare program liability as a result 
     of the Special Disability Workload project, subject to the 
     requirements of subsection (c).
       (b) Payments.--
       (1) Deadline for making payments.--Not later than 30 days 
     after reaching an agreement with a State under subsection 
     (a), the Secretary shall pay the State, from the amounts 
     appropriated under paragraph (2), the payment agreed to for 
     the State.
       (2) Appropriation.--Out of any money in the Treasury not 
     otherwise appropriated, there is appropriated $4,000,000,000 
     for fiscal year 2010 for making payments to States under 
     paragraph (1).
       (3) Limitations.--In no case may the aggregate amount of 
     payments made by the Secretary to States under paragraph (1) 
     exceed $4,000,000,000.
       (c) Requirements.--The requirements of this subsection are 
     the following:
       (1) Federal data used to determine amount of payments.--The 
     amount of the payment under subsection (a) for each State is 
     determined on the basis of the most recent Federal data 
     available, including the use of proxies and reasonable 
     estimates as necessary, for determining expeditiously the 
     amount of the payment that shall be made to each State that 
     enters into an agreement under this section. The payment 
     methodology shall consider the following factors:
       (A) The number of SDW cases found to have been eligible for 
     benefits under the Medicare program and the month of the 
     initial Medicare program eligibility for such cases.
       (B) The applicable non-Federal share of expenditures made 
     by a State under the Medicaid program during the time period 
     for SDW cases.
       (C) Such other factors as the Secretary and the 
     Commissioner, in consultation with the States, determine 
     appropriate.
       (2) Conditions for payments.--A State shall not receive a 
     payment under this section unless the State--
       (A) waives the right to file a civil action (or to be a 
     party to any action) in any Federal or State court in which 
     the relief sought includes a payment from the United States 
     to the State related to the Medicare liability under title 
     XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) as 
     a result of the Special Disability Workload project; and
       (B) releases the United States from any further claims for 
     reimbursement of State expenditures as a result of the 
     Special Disability Workload project (other than 
     reimbursements being made under agreements in effect on the 
     date of enactment of this Act as a result of such project, 
     including payments made pursuant to agreements entered into 
     under section 1616 of the Social Security Act or section 
     211(1)(1)(A) of Public Law 93-66).
       (3) No individual state claims data required.--No State 
     shall be required to submit individual claims evidencing 
     payment under the Medicaid program as a condition for 
     receiving a payment under this section.
       (4) Ineligible states.--No State that is a party to a civil 
     action in any Federal or State court in which the relief 
     sought includes a payment from the United States to the State 
     related to the Medicare liability under title XVIII of the 
     Social Security Act (42 U.S.C. 1395 et seq.) as a result of 
     the Special Disability Workload project shall be eligible to 
     receive a payment under this section while such an action is 
     pending or if such an action is resolved in favor of the 
     State.
       (d) Definitions.--In this section:
       (1) Commissioner.--The term ``Commissioner'' means the 
     Commissioner of Social Security.
       (2) Medicaid program.--The term ``Medicaid program'' means 
     the program of medical assistance established under title XIX 
     of the Social Security Act (42 U.S.C. 1396a et seq.) and 
     includes medical assistance provided under any waiver of that 
     program approved under section 1115 or 1915 of such Act (42 
     U.S.C. 1315, 1396n) or otherwise.
       (3) Medicare program.--The term ``Medicare program'' means 
     the program established under title XVIII of the Social 
     Security Act (42 U.S.C. 1395 et seq.).
       (4) Secretary.--The term ``Secretary'' means the Secretary 
     of Health and Human Services.
       (5) Sdw case.--The term ``SDW case'' means a case in the 
     Special Disability Workload project involving an individual 
     determined by the Commissioner to have been eligible for 
     benefits under title II of the Social Security Act (42 U.S.C. 
     401 et seq.) for a period during which such benefits were not 
     provided to the individual and who was, during all or part of 
     such period, enrolled in a State Medicaid program.
       (6) Special disability workload project.--The term 
     ``Special Disability Workload project'' means the project 
     described in the 2008 Annual Report of the Board of Trustees 
     of the Federal Old-Age and Survivors Insurance and Federal 
     Disability Insurance Trust Funds, H.R. Doc. No. 110-104, 
     110th Cong. (2008).
       (7) State.--The term ``State'' means each of the 50 States 
     and the District of Columbia.
                                 ______