Permits a State to receive funds on both accounts. Allows funds to go to States, local governments, hospitals, or other providers in a State, including providers of services received through an Indian Health Service facility (presently funds go only to States). Permits reimbursement to providers for the uncompensated provision of emergency health services to aliens who have been allowed to enter the United States for the sole purpose of receiving such services.
Directs the Secretary to ensure that fraudulent payments are not made from allotments under this Act. Allows for the reallotment of unused funds.
Declares that this Act constitutes budget authority in advance of appropriations Acts.
[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 819 Introduced in House (IH)]
108th CONGRESS
1st Session
H. R. 819
To amend the Balanced Budget Act of 1997 to extend and modify the
reimbursement of State and local funds expended for emergency health
services furnished to undocumented aliens.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 13, 2003
Mr. Kolbe (for himself, Mr. Flake, Mr. Shadegg, Mr. Hayworth, Mr.
Renzi, Mr. Pastor, Mr. Grijalva, and Mr. Reyes) introduced the
following bill; which was referred to the Committee on Appropriations,
and in addition to the Committee on Energy and Commerce, for a period
to be subsequently determined by the Speaker, in each case for
consideration of such provisions as fall within the jurisdiction of the
committee concerned
_______________________________________________________________________
A BILL
To amend the Balanced Budget Act of 1997 to extend and modify the
reimbursement of State and local funds expended for emergency health
services furnished to undocumented aliens.
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 ``Local Emergency Health Services
Reimbursement Act of 2003''.
SEC. 2. FEDERAL REIMBURSEMENT OF EMERGENCY HEALTH SERVICES FURNISHED TO
UNDOCUMENTED ALIENS.
Section 4723 of the Balanced Budget Act of 1997 (8 U.S.C. 1611
note) is amended to read as follows:
``SEC. 4723. FEDERAL REIMBURSEMENT OF EMERGENCY HEALTH SERVICES
FURNISHED TO UNDOCUMENTED ALIENS.
``(a) Total Amount Available for Allotment.--There is appropriated,
out of any funds in the Treasury not otherwise appropriated,
$1,450,000,000 for each of fiscal years 2004 through 2008, for the
purpose of making allotments under this section to States described in
paragraph (1) or (2) of subsection (b). Funds appropriated under the
preceding sentence shall remain available until expended.
``(b) State Allotments.--
``(1) Based on percentage of undocumented aliens.--
``(A) In general.--Out of the amount appropriated
under subsection (a) for each fiscal year, the
Secretary shall use $957,000,000 of such amount to make
allotments for each such fiscal year in accordance with
subparagraph (B).
``(B) Formula.--The amount of the allotment for
each State for a fiscal year shall be equal to the
product of--
``(i) the total amount available for
allotments under this paragraph for the fiscal
year; and
``(ii) the percentage of undocumented
aliens residing in the State with respect to
the total number of such aliens residing in all
States, as determined by the Statistics
Division of the Immigration and Naturalization
Service, as of January 2003, based on the 2000
decennial census.
``(2) Based on number of undocumented alien apprehension
states.--
``(A) In general.--Out of the amount appropriated
under subsection (a) for a fiscal year, the Secretary
shall use $493,000,000 of such amount to make
allotments for each such fiscal year for each of the 6
States with the highest number of undocumented alien
apprehensions for such fiscal year.
``(B) Determination of allotments.--The amount of
the allotment for each State described in subparagraph
(A) for a fiscal year shall bear the same ratio to the
total amount available for allotments under this
paragraph for the fiscal year as the ratio of the
number of undocumented alien apprehensions in the State
in the fiscal year bears to the total of such numbers
for all such States for such fiscal year.
``(C) Data.--For purposes of this paragraph, the
highest number of undocumented alien apprehensions for
a fiscal year shall be based on the 4 most recent
quarterly apprehension rates for undocumented aliens in
such States, as reported by the Immigration and
Naturalization Service.
``(3) Rule of construction.--Nothing in this section shall
be construed as prohibiting a State that is described in both
of paragraphs (1) and (2) from receiving an allotment under
both paragraphs for a fiscal year.
``(c) Use of Funds.--
``(1) Authority to make payments.--From the allotments made
for a State under subsection (b) for a fiscal year, the
Secretary shall pay directly to local governments, hospitals,
or other providers located in the State (including providers of
services received through an Indian Health Service facility
whether operated by the Indian Health Service or by an Indian
tribe or tribal organization) that provide uncompensated
emergency health services furnished to undocumented aliens
during that fiscal year, and to the State, such amounts
(subject to the total amount available from such allotments) as
the local governments, hospitals, providers, or State
demonstrate were incurred for the provision of such services
during that fiscal year.
``(2) Limitation on state use of funds.--Funds paid to a
State from allotments made under subsection (b) for a fiscal
year may only be used for making payments to local governments,
hospitals, or other providers for costs incurred in providing
emergency health services to undocumented aliens or for State
costs incurred with respect to the provision of emergency
health services to such aliens.
``(3) Inclusion of costs incurred with respect to certain
aliens.--Uncompensated emergency health services furnished to
aliens who have been allowed to enter the United States for the
sole purpose of receiving emergency health services may be
included in the determination of costs incurred by a State,
local government, hospital, or other provider with respect to the
provision of such services.
``(d) Applications; Advance Payments; Reallotment of Unused
Funds.--
``(1) Deadline for establishment of application process.--
``(A) In general.--Not later than July 31, 2003,
the Secretary shall establish a process under which
States, local governments, hospitals, or other
providers located in the State may apply for payments
from allotments made under subsection (b) for a fiscal
year for uncompensated emergency health services
furnished to undocumented aliens during that fiscal
year.
``(B) Inclusion of measures to combat fraud.--The
Secretary shall include in the process established
under subparagraph (A) measures to ensure that
fraudulent payments are not made from the allotments
determined under subsection (b) or from amounts
reallotted under paragraph (3).
``(2) Advance payment; retrospective adjustment.--The
process established under paragraph (1) shall allow for making
payments under this section for each quarter of a fiscal year
on the basis of advance estimates of expenditures submitted by
applicants for such payments and such other investigation as
the Secretary may find necessary, and for making reductions or
increases in the payments as necessary to adjust for any
overpayment or underpayment for prior quarters.
``(3) Reallotment of unused funds.--
``(A) In general.--With respect to allotments made
under subsection (b) for a fiscal year, the amount of
any allotment to a State for a fiscal year that the
Secretary determines will not be expended during that
fiscal year or the succeeding fiscal year shall be
available for reallotment during the second succeeding
fiscal year, on such date as the Secretary may
determine, to other States with allotments under that
subsection that the Secretary determines will use such
excess amounts during that second succeeding fiscal
year.
``(B) Determination of reallotments.--Reallotments
under subparagraph (A) shall be made in the same manner
as allotments are determined under paragraphs (1) and
(2) of subsection (b) but only with respect to those
States that the Secretary determines qualify for a
reallotment for a fiscal year under that subparagraph.
``(C) Treatment.--Any amount reallotted under
subparagraph (A) to a State is deemed to be part of its
allotment under subsection (b) for the fiscal year in
which the reallotment occurs.
``(e) Definitions.--In this section:
``(1) Hospital.--The term `hospital' has the meaning given
such term in section 1861(e) of the Social Security Act (42
U.S.C. 1395x(e)).
``(2) Indian tribe; tribal organization.--The terms `Indian
tribe' and `tribal organization' have the meanings given such
terms in section 4 of the Indian Health Care Improvement Act.
``(3) Provider.--The term `provider' includes a physician,
any other health care professional licensed under State law,
and any other entity that furnishes emergency health services,
including ambulance services.
``(4) Secretary.--The term `Secretary' means the Secretary
of Health and Human Services.
``(5) State.--The term `State' means the 50 States and the
District of Columbia.
``(f) Entitlement.--This section constitutes budget authority in
advance of appropriations Acts and represents the obligation of the
Federal Government to provide for the payment of amounts provided under
this section.''.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Appropriations, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Appropriations, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Appropriations, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Health, for a period to be subsequently determined by the Chairman.
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