Health Partnership Act - Requires the Secretary of Health and Human Services to establish a State Health Innovation Commission. Requires the Commission to: (1) provide states with reform options for state health care expansion and improvement programs; (2) establish minimum performance measures and goals with respect to coverage, quality, and cost of state programs; (3) review state applications and determine whether to submit a state proposal to Congress; and (4) submit to Congress a list of state applications that the Commission recommends for approval. Deems such proposals to be approved unless a joint resolution has been enacted disapproving such proposal. Sets forth rules for congressional consideration of such proposals.
Requires the Secretary to: (1) provide a grant to a state that has an application approved to enable such state to carry out an innovative state health program; (2) give priority to those state programs that the Commission determines have the greatest opportunity to succeed in providing expanded health insurance coverage and improving health access; and (3) link state allocations to the meeting of the goals and performance measures established under this Act.
Prohibits states from: (1) failing to maintain the same level of expenditures for health care coverage; (2) changing eligibility criteria for state medical assistance programs; or (3) permitting the imposition of any preexisting condition exclusion for covered benefits, with exceptions.
[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 2772 Introduced in Senate (IS)]
109th CONGRESS
2d Session
S. 2772
To provide for innovation in health care through State initiatives that
expand coverage and access and improve quality and efficiency in the
health care system.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 9, 2006
Mr. Voinovich (for himself, Mr. Bingaman, Mr. DeWine, and Mr. Akaka)
introduced the following bill; which was read twice and referred to the
Committee on Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To provide for innovation in health care through State initiatives that
expand coverage and access and improve quality and efficiency in the
health care system.
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 ``Health Partnership Act''.
SEC. 2. STATE HEALTH REFORM PROJECTS.
(a) Purpose; Establishment of State Health Care Expansion and
Improvement Program.--The purposes of the programs approved under this
section shall include, but not be limited to--
(1) achieving the goals of increased health coverage and
access;
(2) ensuring that patients receive high-quality,
appropriate health care;
(3) improving the efficiency of health care spending; and
(4) testing alternative reforms, such as building on the
public or private health systems, or creating new systems, to
achieve the objectives of this Act.
(b) Applications by States, Local Governments, and Tribes.--
(1) Entities that may apply.--
(A) In general.--A State, in consultation with
local governments, Indian tribes, and Indian
organizations involved in the provision of health care,
may apply for a State health care expansion and
improvement program for the entire State (or for
regions of the State) under paragraph (2).
(B) Regional groups.--A regional entity consisting
of more than one State may apply for a multi State
health care expansion and improvement program for the
entire region involved under paragraph (2).
(C) Definition.--In this Act, the term ``State''
means the 50 States, the District of Columbia, and the
Commonwealth of Puerto Rico. Such term shall include a
regional entity described in subparagraph (B).
(2) Submission of application.--In accordance with this
section, each State desiring to implement a State health care
expansion and improvement program may submit an application to
the State Health Innovation Commission under subsection (c)
(referred to in this section as the ``Commission'') for
approval.
(3) Local government applications.--
(A) In general.--Where a State declines to submit
an application under this section, a unit of local
government of such State, or a consortium of such units
of local governments, may submit an application
directly to the Commission for programs or projects
under this subsection. Such an application shall be
subject to the requirements of this section.
(B) Other applications.--Subject to such additional
guidelines as the Secretary may prescribe, a unit of
local government, Indian tribe, or Indian health
organization may submit an application under this
section, whether or not the State submits such an
application, if such unit of local government can
demonstrate unique demographic needs or a significant
population size that warrants a substate program under
this subsection.
(c) State Health Innovation Commission.--
(1) In general.--Within 90 days after the date of the
enactment of this Act, the Secretary shall establish a State
Health Innovation Commission that shall--
(A) be comprised of--
(i) the Secretary;
(ii) four State governors to be appointed
by the National Governors Association on a
bipartisan basis;
(iii) two members of a State legislature to
be appointed by the National Conference of
State Legislators on a bipartisan basis;
(iv) two county officials to be appointed
by the National Association of Counties on a
bipartisan basis;
(v) two mayors to be appointed by the
United States Conference of Mayors on a
bipartisan basis;
(vi) two individuals to be appointed by the
Speaker of the House of Representatives;
(vii) two individuals to be appointed by
the Minority Leader of the House of
Representatives;
(viii) two individuals to be appointed by
the Majority Leader of the Senate;
(ix) two individuals to be appointed by the
Minority Leader of the Senate; and
(x) two individuals who are members of
federally-recognized Indian tribes to be
appointed on a bipartisan basis by the National
Congress of American Indians;
(B) upon approval of \2/3\ of the members of the
Commission, provide the States with a variety of reform
options for their applications, such as tax credit
approaches, expansions of public programs such as
medicaid and the State Children's Health Insurance
Program, the creation of purchasing pooling
arrangements similar to the Federal Employees Health
Benefits Program, individual market purchasing options,
single risk pool or single payer systems, health
savings accounts, a combination of the options
described in this clause, or other alternatives
determined appropriate by the Commission, including
options suggested by States, Indian tribes, or the
public;
(C) establish, in collaboration with a qualified
and independent organization such as the Institute of
Medicine, minimum performance measures and goals with
respect to coverage, quality, and cost of State
programs, as described under subsection (d)(1);
(D) conduct a thorough review of the grant
application from a State and carry on a dialogue with
all State applicants concerning possible modifications
and adjustments;
(E) submit the recommendations and legislative
proposal described in subsection (d)(4)(B);
(F) be responsible for monitoring the status and
progress achieved under program or projects granted
under this section;
(G) report to the public concerning progress made
by States with respect to the performance measures and
goals established under this Act, the periodic progress
of the State relative to its State performance measures
and goals, and the State program application
procedures, by region and State jurisdiction;
(H) promote information exchange between States and
the Federal Government; and
(I) be responsible for making recommendations to
the Secretary and the Congress, using equivalency or
minimum standards, for minimizing the negative effect
of State program on national employer groups, provider
organizations, and insurers because of differing State
requirements under the programs.
(2) Period of appointment; representation requirements;
vacancies.--Members shall be appointed for a term of 5 years.
In appointing such members under paragraph (1)(A), the
designated appointing individuals shall ensure the
representation of urban and rural areas and an appropriate
geographic distribution of such members. Any vacancy in the
Commission shall not affect its powers, but shall be filled in
the same manner as the original appointment.
(3) Chairperson, meetings.--
(A) Chairperson.--The Commission shall select a
Chairperson from among its members.
(B) Quorum.--A majority of the members of the
Commission shall constitute a quorum, but a lesser
number of members may hold hearings.
(C) Meetings.--Not later than 30 days after the
date on which all members of the Commission have been
appointed, the Commission shall hold its first meeting.
The Commission shall meet at the call of the
Chairperson.
(4) Powers of the commission.--
(A) Negotiations with states.--The Commission may
conduct detailed discussions and negotiations with
States submitting applications under this section,
either individually or in groups, to facilitate a final
set of recommendations for purposes of subsection
(d)(4)(B). Such negotiations shall include
consultations with Indian tribes, and be conducted in a
public forum.
(B) Hearings.--The Commission may hold such
hearings, sit and act at such times and places, take
such testimony, and receive such evidence as the
Commission considers advisable to carry out the
purposes of this subsection.
(C) Meetings.--In addition to other meetings the
Commission may hold, the Commission shall hold an
annual meeting with the participating States under this
section for the purpose of having States report
progress toward the purposes in subsection (a)(1) and
for an exchange of information.
(D) Information.--The Commission may secure
directly from any Federal department or agency such
information as the Commission considers necessary to
carry out the provisions of this subsection. Upon
request of the Chairperson of the Commission, the head
of such department or agency shall furnish such
information to the Commission if the head of the
department or agency involved determines it
appropriate.
(E) Postal services.--The Commission may use the
United States mails in the same manner and under the
same conditions as other departments and agencies of
the Federal Government.
(5) Personnel matters.--
(A) Compensation.--Each member of the Commission
who is not an officer or employee of the Federal
Government or of a State or local government shall be
compensated at a rate equal to the daily equivalent of
the annual rate of basic pay prescribed for level IV of
the Executive Schedule under section 5315 of title 5,
United States Code, for each day (including travel
time) during which such member is engaged in the
performance of the duties of the Commission. All
members of the Commission who are officers or employees
of the United States shall serve without compensation
in addition to that received for their services as
officers or employees of the United States.
(B) Travel expenses.--The members of the Commission
shall be allowed travel expenses, including per diem in
lieu of subsistence, at rates authorized for employees
of agencies under subchapter I of chapter 57 of title
5, United States Code, while away from their homes or
regular places of business in the performance of
services for the Commission.
(C) Staff.--The Chairperson of the Commission may,
without regard to the civil service laws and
regulations, appoint and terminate an executive
director and such other additional personnel as may be
necessary to enable the Commission to perform its
duties. The employment of an executive director shall
be subject to confirmation by the Commission.
(D) Detail of government employees.--Any Federal
Government employee may be detailed to the Commission
without reimbursement, and such detail shall be without
interruption or loss of civil service status or
privilege.
(E) Temporary and intermittent services.--The
Chairperson of the Commission may procure temporary and
intermittent services under section 3109(b) of title 5,
United States Code, at rates for individuals which do
not exceed the daily equivalent of the annual rate of
basic pay prescribed for level V of the Executive
Schedule under section 5316 of such title.
(6) Funding.--For the purpose of carrying out this
subsection, there are authorized to be appropriated $3,000,000
for fiscal year 2006 and each fiscal year thereafter.
(d) Requirements for Programs.--
(1) State plan.--A State that seeks to receive a grant
under subsection (f) to operate a program under this section
shall prepare and submit to the Commission, as part of the
application under subsection (b), a State health care plan that
shall have as its goal improvements in coverage, quality and
costs. To achieve such goal, the State plan shall comply with
the following:
(A) Coverage.--With respect to coverage, the State
plan shall--
(i) provide and describe the manner in
which the State will ensure that an increased
number of individuals residing within the State
will have expanded access to health care
coverage with a specific 5-year target for
reduction in the number of uninsured
individuals through either private or public
program expansion, or both, in accordance with
the options established by the Commission;
(ii) describe the number and percentage of
current uninsured individuals who will achieve
coverage under the State health program;
(iii) describe the minimum benefits package
that will be provided to all classes of
beneficiaries under the State health program;
(iv) identify Federal, State, or local and
private programs that currently provide health
care services in the State and describe how
such programs could be coordinated with the
State health program, to the extent
practicable; and
(v) provide for improvements in the
availability of appropriate health care
services that will increase access to care in
urban, rural, and frontier areas of the State
with medically underserved populations or where
there is an inadequate supply of health care
providers.
(B) Quality.--With respect to quality, the State
plan shall--
(i) provide a plan to improve health care
quality in the State, including increasing
effectiveness, efficiency, timeliness, patient
focused, equity while reducing health
disparities, and medical errors; and
(ii) contain appropriate results-based
quality indicators established by the
Commission that will be addressed by the State
as well as State-specific quality indicators.
(C) Costs.--With respect to costs, the State plan
shall--
(i) provide that the State will develop and
implement systems to improve the efficiency of
health care, including a specific 5-year target
for reducing administrative costs (including
paperwork burdens);
(ii) describe the public and private sector
financing to be provided for the State health
program;
(iii) estimate the amount of Federal,
State, and local expenditures, as well as, the
costs to business and individuals under the
State health program;
(iv) describe how the State plan will
ensure the financial solvency of the State
health program; and
(v) provide that the State will prepare and
submit to the Secretary and the Commission such
reports as the Secretary or Commission may
require to carry out program evaluations.
(D) Health information technology.--With respect to
health information technology, the State plan shall
provide methodology for the appropriate use of health
information technology to improve infrastructure, such
as improving the availability of evidence-based medical
and outcomes data to providers and patients, as well as
other health information (such as electronic health
records, electronic billing, and electronic
prescribing).
(2) Technical assistance.--The Secretary shall, if
requested, provide technical assistance to States to assist
such States in developing applications and plans under this
section, including technical assistance by private sector
entities if determined appropriate by the Commission.
(3) Initial review.--With respect to a State application
for a grant under subsection (b), the Secretary and the
Commission shall complete an initial review of such State
application within 60 days of the receipt of such application,
analyze the scope of the proposal, and determine whether
additional information is needed from the State. The Commission
shall advise the State within such period of the need to submit
additional information.
(4) Final determination.--
(A) In general.--Not later than 90 days after
completion of the initial review under paragraph (3),
the Commission shall determine whether to submit a
State proposal to Congress for approval.
(B) Voting.--
(i) In general.--The determination to
submit a State proposal to Congress under
subparagraph (A) shall be approved by \2/3\ of
the members of the Commission who are eligible
to participate in such determination subject to
clause (ii).
(ii) Eligibility.--A member of the
Commission shall not participate in a
determination under subparagraph (A) if--
(I) in the case of a member who is
a Governor, such determination relates
to the State of which the member is the
Governor; or
(II) in the case of member not
described in subclause (I), such
determination relates to the geographic
area of a State of which such member
serves as a State or local official.
(C) Submission.--Not later than 90 days prior to
October 1 of each fiscal year, the Commission shall
submit to Congress a list, in the form of a legislative
proposal, of the State applications that the Commission
recommends for approval under this section.
(D) Approval.--With respect to a fiscal year, a
State proposal that has been recommended under
subparagraph (B) shall be deemed to be approved, and
subject to the availability of appropriations, Federal
funds shall be provided to such program, unless a joint
resolution has been enacted disapproving such proposal
as provided for in subsection (e). Nothing in the
preceding sentence shall be construed to include the
approval of State proposals that involve waivers or
modifications in applicable Federal law.
(5) Program or project period.--A State program or project
may be approved for a period of 5 years and may be extended for
subsequent 5-year periods upon approval by the Commission and
the Secretary, based upon achievement of targets, except that a
shorter period may be requested by a State and granted by the
Secretary.
(e) Expedited Congressional Consideration.--
(1) Introduction and committee consideration.--
(A) Introduction.--The legislative proposal
submitted pursuant to subsection (d)(4)(B) shall be in
the form of a joint resolution (in this subsection
referred to as the ``resolution''). Such resolution
shall be introduced in the House of Representatives by
the Speaker, and in the Senate, by the Majority Leader,
immediately upon receipt of the language and shall be
referred to the appropriate committee of Congress. If
the resolution is not introduced in accordance with the
preceding sentence, the resolution may be introduced in
either House of Congress by any member thereof.
(B) Committee consideration.--A resolution
introduced in the House of Representatives shall be
referred to the Committee on Ways and Means of the
House of Representatives. A resolution introduced in
the Senate shall be referred to the Committee on
Finance of the Senate. Not later than 15 calendar days
after the introduction of the resolution, the committee
of Congress to which the resolution was referred shall
report the resolution or a committee amendment thereto.
If the committee has not reported such resolution (or
an identical resolution) at the end of 15 calendar days
after its introduction or at the end of the first day
after there has been reported to the House involved a
resolution, whichever is earlier, such committee shall
be deemed to be discharged from further consideration
of such reform bill and such reform bill shall be
placed on the appropriate calendar of the House
involved.
(2) Expedited procedure.--
(A) Consideration.--Not later than 5 days after the
date on which a committee has been discharged from
consideration of a resolution, the Speaker of the House
of Representatives, or the Speaker's designee, or the
Majority Leader of the Senate, or the Leader's
designee, shall move to proceed to the consideration of
the committee amendment to the resolution, and if there
is no such amendment, to the resolution. It shall also
be in order for any member of the House of
Representatives or the Senate, respectively, to move to
proceed to the consideration of the resolution at any
time after the conclusion of such 5-day period. All
points of order against the resolution (and against
consideration of the resolution) are waived. A motion
to proceed to the consideration of the resolution is
highly privileged in the House of Representatives and
is privileged in the Senate and is not debatable. The
motion is not subject to amendment, to a motion to
postpone consideration of the resolution, or to a
motion to proceed to the consideration of other
business. A motion to reconsider the vote by which the
motion to proceed is agreed to or not agreed to shall
not be in order. If the motion to proceed is agreed to,
the House of Representatives or the Senate, as the case
may be, shall immediately proceed to consideration of
the resolution without intervening motion, order, or
other business, and the resolution shall remain the
unfinished business of the House of Representatives or
the Senate, as the case may be, until disposed of.
(B) Consideration by other house.--If, before the
passage by one House of the resolution that was
introduced in such House, such House receives from the
other House a resolution as passed by such other
House--
(i) the resolution of the other House shall
not be referred to a committee and may only be
considered for final passage in the House that
receives it under clause (iii);
(ii) the procedure in the House in receipt
of the resolution of the other House, with
respect to the resolution that was introduced
in the House in receipt of the resolution of
the other House, shall be the same as if no
resolution had been received from the other
House; and
(iii) notwithstanding clause (ii), the vote
on final passage shall be on the reform bill of
the other House.
Upon disposition of a resolution that is received by
one House from the other House, it shall no longer be
in order to consider the resolution bill that was
introduced in the receiving House.
(C) Consideration in conference.--Immediately upon
a final passage of the resolution that results in a
disagreement between the two Houses of Congress with
respect to the resolution, conferees shall be appointed
and a conference convened. Not later than 10 days after
the date on which conferees are appointed, the
conferees shall file a report with the House of
Representatives and the Senate resolving the
differences between the Houses on the resolution.
Notwithstanding any other rule of the House of
Representatives or the Senate, it shall be in order to
immediately consider a report of a committee of
conference on the resolution filed in accordance with
this subclause. Debate in the House of Representatives
and the Senate on the conference report shall be
limited to 10 hours, equally divided and controlled by
the Speaker of the House of Representatives and the
Minority Leader of the House of Representatives or
their designees and the Majority and Minority Leaders
of the Senate or their designees. A vote on final
passage of the conference report shall occur
immediately at the conclusion or yielding back of all
time for debate on the conference report.
(3) Rules of the senate and house of representatives.--This
subsection is enacted by Congress--
(A) as an exercise of the rulemaking power of the
Senate and House of Representatives, respectively, and
is deemed to be part of the rules of each House,
respectively, but applicable only with respect to the
procedure to be followed in that House in the case of a
resolution, and it supersedes other rules only to the
extent that it is inconsistent with such rules; and
(B) with full recognition of the constitutional
right of either House to change the rules (so far as
they relate to the procedure of that House) at any
time, in the same manner, and to the same extent as in
the case of any other rule of that House.
(4) Limitation.--The amount of Federal funds provided with
respect to any State proposal that is deemed approved under
subsection (d)(3) shall not exceed the cost provided for such
proposals within the concurrent resolution on the budget as
enacted by Congress for the fiscal year involved.
(f) Funding.--
(1) In general.--The Secretary shall provide a grant to a
State that has an application approved under subsection (b) to
enable such State to carry out an innovative State health
program in the State.
(2) Amount of grant.--The amount of a grant provided to a
State under paragraph (1) shall be determined based upon the
recommendations of the Commission, subject to the amount
appropriated under subsection (k).
(3) Performance-based funding allocation and
prioritization.--In awarding grants under paragraph (1), the
Secretary shall--
(A) fund a diversity of approaches as provided for
by the Commission in subsection (c)(1)(B);
(B) give priority to those State programs that the
Commission determines have the greatest opportunity to
succeed in providing expanded health insurance coverage
and in providing children, youth, and other vulnerable
populations with improved access to health care items
and services; and
(C) link allocations to the State to the meeting of
the goals and performance measures relating to health
care coverage, quality, and health care costs
established under this Act through the State project
application process.
(4) Maintenance of effort.--A State, in utilizing the
proceeds of a grant received under paragraph (1), shall
maintain the expenditures of the State for health care coverage
purposes for the support of direct health care delivery at a
level equal to not less than the level of such expenditures
maintained by the State for the fiscal year preceding the
fiscal year for which the grant is received.
(5) Report.--At the end of the 5-year period beginning on
the date on which the Secretary awards the first grant under
paragraph (1), the State Health Innovation Advisory Commission
established under subsection (c) shall prepare and submit to
the appropriate committees of Congress, a report on the
progress made by States receiving grants under paragraph (1) in
meeting the goals of expanded coverage, improved quality, and
cost containment through performance measures established
during the 5-year period of the grant. Such report shall
contain the recommendation of the Commission concerning any
future action that Congress should take concerning health care
reform, including whether or not to extend the program
established under this subsection.
(g) Monitoring and Evaluation.--
(1) Annual reports and participation by states.--Each State
that has received a program approval shall--
(A) submit to the Commission an annual report based
on the period representing the respective State's
fiscal year, detailing compliance with the requirements
established by the Commission and the Secretary in the
approval and in this section; and
(B) participate in the annual meeting under
subsection (c)(4)(B).
(2) Evaluations by commission.--The Commission, in
consultation with a qualified and independent organization such
as the Institute of Medicine, shall prepare and submit to the
Committee on Finance and the Committee on Health, Education,
Labor, and Pensions of the Senate and the Committee on Energy
and Commerce, the Committee on Education and the Workforce, and
the Committee on Ways and Means of the House of Representatives
annual reports that shall contain--
(A) a description of the effects of the reforms
undertaken in States receiving approvals under this
section;
(B) a description of the recommendations of the
Commission and actions taken based on these
recommendations;
(C) an evaluation of the effectiveness of such
reforms in--
(i) expanding health care coverage for
State residents;
(ii) improving the quality of health care
provided in the States; and
(iii) reducing or containing health care
costs in the States;
(D) recommendations regarding the advisability of
increasing Federal financial assistance for State
ongoing or future health program initiatives, including
the amount and source of such assistance; and
(E) as required by the Commission or the Secretary
under subsection (f)(5), a periodic, independent
evaluation of the program.
(h) Noncompliance.--
(1) Corrective action plans.--If a State is not in
compliance with a requirements of this section, the Secretary
shall develop a corrective action plan for such State.
(2) Termination.--For good cause and in consultation with
the Commission, the Secretary may revoke any program granted
under this section. Such decisions shall be subject to a
petition for reconsideration and appeal pursuant to regulations
established by the Secretary.
(i) Relationship to Federal Programs.--
(1) In general.--Nothing in this Act, or in section 1115 of
the Social Security Act (42 U.S.C. 1315) shall be construed as
authorizing the Secretary, the Commission, a State, or any
other person or entity to alter or affect in any way the
provisions of title XIX of such Act (42 U.S.C. 1396 et seq.) or
the regulations implementing such title.
(2) Maintenance of effort.--No payment may be made under
this section if the State adopts criteria for benefits, income,
and resource standards and methodologies for purposes of
determining an individual's eligibility for medical assistance
under the State plan under title XIX that are more restrictive
than those applied as of the date of enactment of this Act.
(j) Miscellaneous Provisions.--
(1) Application of certain requirements.--
(A) Restriction on application of preexisting
condition exclusions.--
(i) In general.--Subject to subparagraph
(B), a State shall not permit the imposition of
any preexisting condition exclusion for covered
benefits under a program or project under this
section.
(ii) Group health plans and group health
insurance coverage.--If the State program or
project provides for benefits through payment
for, or a contract with, a group health plan or
group health insurance coverage, the program or
project may permit the imposition of a
preexisting condition exclusion but only
insofar and to the extent that such exclusion
is permitted under the applicable provisions of
part 7 of subtitle B of title I of the Employee
Retirement Income Security Act of 1974 and
title XXVII of the Public Health Service Act.
(B) Compliance with other requirements.--Coverage
offered under the program or project shall comply with
the requirements of subpart 2 of part A of title XXVII
of the Public Health Service Act insofar as such
requirements apply with respect to a health insurance
issuer that offers group health insurance coverage.
(2) Prevention of duplicative payments.--
(A) Other health plans.--No payment shall be made
to a State under this section for expenditures for
health assistance provided for an individual to the
extent that a private insurer (as defined by the
Secretary by regulation and including a group health
plan (as defined in section 607(1) of the Employee
Retirement Income Security Act of 1974), a service
benefit plan, and a health maintenance organization)
would have been obligated to provide such assistance
but for a provision of its insurance contract which has
the effect of limiting or excluding such obligation
because the individual is eligible for or is provided
health assistance under the plan.
(B) Other federal governmental programs.--Except as
provided in any other provision of law, no payment
shall be made to a State under this section for
expenditures for health assistance provided for an
individual to the extent that payment has been made or
can reasonably be expected to be made promptly (as
determined in accordance with regulations) under any
other federally operated or financed health care
insurance program, other than an insurance program
operated or financed by the Indian Health Service, as
identified by the Secretary. For purposes of this
paragraph, rules similar to the rules for overpayments
under section 1903(d)(2) of the Social Security Act
shall apply.
(3) Application of certain general provisions.--The
following sections of the Social Security Act shall apply to
States under this section in the same manner as they apply to a
State under such title XIX:
(A) Title xix provisions.--
(i) Section 1902(a)(4)(C) (relating to
conflict of interest standards).
(ii) Paragraphs (2), (16), and (17) of
section 1903(i) (relating to limitations on
payment).
(iii) Section 1903(w) (relating to
limitations on provider taxes and donations).
(iv) Section 1920A (relating to presumptive
eligibility for children).
(B) Title xi provisions.--
(i) Section 1116 (relating to
administrative and judicial review), but only
insofar as consistent with this title.
(ii) Section 1124 (relating to disclosure
of ownership and related information).
(iii) Section 1126 (relating to disclosure
of information about certain convicted
individuals).
(iv) Section 1128A (relating to civil
monetary penalties).
(v) Section 1128B(d) (relating to criminal
penalties for certain additional charges).
(vi) Section 1132 (relating to periods
within which claims must be filed).
(4) Relation to other laws.--
(A) HIPAA.--Health benefits coverage provided under
a State program or project under this section shall be
treated as creditable coverage for purposes of part 7
of subtitle B of title I of the Employee Retirement
Income Security Act of 1974, title XXVII of the Public
Health Service Act, and subtitle K of the Internal
Revenue Code of 1986.
(B) ERISA.--Nothing in this section shall be
construed as affecting or modifying section 514 of the
Employee Retirement Income Security Act of 1974 (29
U.S.C. 1144) with respect to a group health plan (as
defined in section 2791(a)(1) of the Public Health
Service Act (42 U.S.C. 300gg-91(a)(1))).
(k) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
in each fiscal year. Amounts appropriated for a fiscal year under this
subsection and not expended may be used in subsequent fiscal years to
carry out this section.
<all>
Introduced in Senate
Sponsor introductory remarks on measure. (CR S4215-4216)
Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (text of measure as introduced: CR S4216-4219)
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