I

104TH CONGRESS

2D SESSION H. R. 2883

To amend title XIX to the Social Security Act to eliminate the requirement

for States to seek recovery of medical assistance properly paid and

to restrict the use of liens and such recovery in any MediGrant program

and any other future medical assistance programs, and for other purposes.

IN THE HOUSE OF REPRESENTATIVES

JANUARY 25, 1996

Mr. BRYANT of Texas introduced the following bill; which was referred to the

Committee on Commerce

A BILL

To amend title XIX to the Social Security Act to eliminate

the requirement for States to seek recovery of medical

assistance properly paid and to restrict the use of liens

and such recovery in any MediGrant program and any

other future medical assistance programs, and for other

purposes.

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

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Family Farm and

5 Home Protection Act’’.
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1 SEC. 2. REVISION OF STATE AUTHORITY IN IMPOSING

2 LIENS AND RECOVERING FOR MEDICAL AS3 SISTANCE PROPERLY MADE.

4 (a) ELIMINATING MEDICAID MANDATE FOR STATE

5 RECOVERIES.—Subsection (b)(1) of section 1917 of the

6 Social Security Act (42 U.S.C. 1396p) is amended by

7 striking ‘‘except that’’ and all that follows and inserting

8 the following: ‘‘except—

9 ‘‘(A) in the case of an individual described in

10 subsection (a)(1)(B), from the individual’s estate or

11 upon sale of the property, subject to a lien imposed

12 on account of medical assistance paid on behalf of

13 such individual, and

14 ‘‘(B) in the case of any other individual who is

15 65 years of age or older, when the individual re16 ceived such assistance, from the individual’s estate.’’.

17 (b) REVISION OF DEFINITION OF ESTATE.—Section

18 1917(b)(4) of such Act (42 U.S.C. 1396p(b)(4)) is amend19 ed—

20 (1) by striking ‘‘deceased individual’’ and all

21 that follows through ‘‘(A) shall’’ and inserting ‘‘de22 ceased individual shall’’, and

23 (2) by striking subparagraph (B).

24 (c) EFFECTIVE DATE.—The amendment made by

25 subsection (a) shall apply to medical assistance furnished

26 on or after the date of the enactment of this Act and the
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1 amendments made by subsection (b) shall apply to individ2 uals dying on or after such date of enactment.

3 SEC. 3. RESTRICTING RECOVERY OF MEDICAL ASSISTANCE

4 PROPERLY PAID IN OTHER FEDERALLY AS5 SISTED MEDICAL ASSISTANCE PROGRAMS.

6 (a) IN GENERAL.—Notwithstanding any other provi7 sion of law, no Federal funds shall be paid to a State

8 under a State medical assistance program (as defined in

9 subsection (d)) unless the conditions of subsections (b)

10 and (c) are met.

11 (b) LIMITATION ON IMPOSITION OF LIENS.—

12 (1) IN GENERAL.—No lien may be imposed

13 against the property of any individual prior to his

14 death on account of medical assistance paid or to be

15 paid on his behalf under the State medical assist16 ance program, except—

17 (A) pursuant to the judgment of a court

18 on account of benefits incorrectly paid on behalf

19 of such individual, or

20 (B) in the case of the real property of an

21 individual—

22 (i) who is an inpatient in a nursing

23 facility, intermediate care facility for the

24 mentally retarded, or other medical institu25 tion, if such individual is required, as a
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1 condition of receiving services in such insti2 tution under the State program, to spend

3 for costs of medical care all but a minimal

4 amount of his income required for personal

5 needs, and

6 (ii) with respect to whom the State

7 determines, after notice and opportunity

8 for a hearing (in accordance with proce9 dures established by the State), that he

10 cannot reasonably be expected to be dis11 charged from the medical institution and

12 to return home,

13 except as provided in paragraph (2).

14 (2) ADDITIONAL LIMITATION.—No lien may be

15 imposed under paragraph (1)(B) on such individ16 ual’s home if—

17 (A) the spouse of such individual,

18 (B) such individual’s child who is under

19 age 21 and is blind or disabled as defined in

20 section 1614 of the Social Security Act, or

21 (C) a sibling of such individual (who has

22 an equity interest in such home and who was

23 residing in such individual’s home for a period

24 of at least one year immediately before the date
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1 of the individual’s admission to the medical in2 stitution),

3 is lawfully residing in such home.

4 (3) DISSOLUTION OF LIENS.—Any lien imposed

5 with respect to an individual pursuant to paragraph

6 (1)(B) shall dissolve upon that individual’s discharge

7 from the medical institution and return home.

8 (c) LIMITATION ON ADJUSTMENT OR RECOVERY.—

9 (1) IN GENERAL.—No adjustment or recovery

10 of any medical assistance correctly paid on behalf of

11 an individual under the State medical assistance

12 program may be made, except—

13 (A) in the case of an individual described

14 in subsection (b)(1)(B), from the individual’s

15 estate or upon sale of the property, subject to

16 a lien imposed on account of medical assistance

17 paid on behalf of such individual, and

18 (B) in the case of any other individual who

19 is 65 years of age or older, when the individual

20 received such assistance, from the individual’s

21 estate.

22 (2) LIMITATION.—Any adjustment or recovery

23 under paragraph (1) may be made only after the

24 death of the individual’s surviving spouse, if any,

25 and only at a time—
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1 (A) when he has no surviving child who is

2 under age 21, or (with respect to States eligible

3 to participate in the State program established

4 under title XVI of the Social Security Act) is

5 blind or permanently and totally disabled, or

6 (with respect to States which are not eligible to

7 participate in such program) is blind or dis8 abled as defined in section 1614 of such Act;

9 and

10 (B) in the case of a lien on an individual’s

11 home under subsection (b)(1)(B), when—

12 (i) no sibling of the individual (who

13 was residing in the individual’s home for a

14 period of at least one year immediately be15 fore the date of the individual’s admission

16 to the medical institution), and

17 (ii) no son or daughter of the individ18 ual (who was residing in the individual’s

19 home for a period of at least two years im20 mediately before the date of the individ21 ual’s admission to the medical institution,

22 and who establishes to the satisfaction of

23 the State that he or she provided care to

24 such individual which permitted such indi-
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1 vidual to reside at home rather than in an

2 institution),

3 is lawfully residing in such home and has law4 fully resided in such home on a continuous

5 basis since the date of the individual’s admis6 sion to the medical institution.

7 (3) PROCEDURES.—The State agency respon8 sible for administration of the State medical assist9 ance program shall establish procedures (in accord10 ance with standards specified by the Secretary of

11 Health and Human Services) under which the agen12 cy shall waive the application of this subsection

13 (other than paragraph (1)(C)) if such application

14 would work an undue hardship as determined on the

15 basis of criteria established by the Secretary.

16 (4) ESTATE DEFINED.—For purposes of this

17 subsection, the term ‘‘estate’’, with respect to a de18 ceased individual, shall include all real and personal

19 property and other assets included within the indi20 vidual’s estate, as defined for purposes of State pro21 bate law.

22 (d) DEFINITIONS.—In this section:

23 (1) STATE.—The term ‘‘State’’ includes the

24 District of Columbia, Puerto Rico, the Virgin Is-
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1 lands, Guam, American Samoa, and the Northern

2 Mariana Islands.

3 (2) STATE MEDICAL ASSISTANCE PROGRAM.—

4 The term ‘‘State medical assistance program’’

5 means the MediGrant program (under title XXI of

6 the Social Security Act) or other program of Federal

7 assistance to States for medical assistance expendi8 tures.

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