I

104TH CONGRESS

1ST SESSION H. R. 2790

To amend titles XVIII and XIX of the Social Security Act to authorize

States to impose fees for the initial certification and survey of health

care facilities in order to provide for timely certification of these facilities

under the Medicare and Medicaid Programs.

IN THE HOUSE OF REPRESENTATIVES

DECEMBER 15, 1995

Mrs. LINCOLN introduced the following bill; which was referred to the Committee on Commerce, and in addition to the Committee on Ways and

Means, 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 titles XVIII and XIX of the Social Security Act

to authorize States to impose fees for the initial certification and survey of health care facilities in order to

provide for timely certification of these facilities under

the Medicare and Medicaid Programs.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,
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•HR 2790 IH

1 SECTION 1. AUTHORIZING STATES TO IMPOSE FEES FOR

2 INITIAL FACILITY CERTIFICATION AND SUR3 VEY UNDER THE MEDICARE AND MEDICAID

4 PROGRAMS.

5 (a) MEDICARE PROGRAM.—Section 1864(e) of the

6 Social Security Act (42 U.S.C. 1395aa(e)) is amended—

7 (1) by inserting ‘‘(1)’’ after ‘‘(e)’’, and

8 (2) by adding at the end the following new

9 paragraph:

10 ‘‘(2)(A) Nothing in paragraph (1) shall be construed

11 as preventing a State from imposing a fee on any facility

12 or entity for conducting an initial determination referred

13 to in paragraph (1) or a survey relating to such initial

14 determination, so long as such determination or survey is

15 made by a qualified entity consistent with subsection (a)

16 and the fee does not exceed an amount equal to the

17 amount of the expenses (or average of the expenses) of

18 the State in conducting such a determination and survey.

19 Such fees may vary by State and by type of entity con20 cerned and may only be used toward the expenses of such

21 initial determinations and surveys.

22 ‘‘(B) The Secretary shall not pay a State under sub23 section (b) for costs of making such determinations and

24 surveys to the extent fees under this paragraph cover the

25 reasonable costs of the State in performing such activi26 ties.’’.
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1 (b) MEDICAID PROGRAM.—Section 1902 of such Act

2 (42 U.S.C. 1396a) is amended by adding at the end the

3 following new subsection:

4 ‘‘(aa)(1) Nothing in this title shall be construed as

5 preventing a State from imposing a fee on any facility or

6 entity for conducting an initial determination or survey

7 related to such a determination as to whether the facility

8 or entity meets requirements under this title, so long as

9 such determination or survey is made by a qualified entity

10 and the fee does not exceed an amount equal to the

11 amount of the expenses (or average of the expenses) of

12 the State in conducting such a determination and survey.

13 Such fees may vary by type of entity concerned and may

14 only be used toward the expenses of such initial deter15 minations and surveys.

16 ‘‘(2) The Secretary shall not pay a State under sec17 tion 1903(a) for State expenditures in making such deter18 minations and surveys to the extent the fees under this

19 subsection cover the reasonable costs of the State in per20 forming such activities.’’.

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