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Union Calendar No. 27

106TH CONGRESS

1ST SESSION H. R. 540

[Report No. 106–44]

To amend title XIX of the Social Security Act to prohibit transfers or

discharges of residents of nursing facilities as a result of a voluntary

withdrawal from participation in the Medicaid Program.

IN THE HOUSE OF REPRESENTATIVES

FEBRUARY 3, 1999

Mr. DAVIS of Florida (for himself, Mr. BILIRAKIS, Mr. DINGELL, Mr. BROWN

of Ohio, Mr. SHAW, Mr. WAXMAN, Mr. FOLEY, Mr. MARKEY, Mr. CANADY of Florida, Mr. DEUTSCH, Mrs. FOWLER, Mr. STUPAK, Mr. MCCOLLUM, Mr. BOUCHER, Mr. LAFALCE, Mr. PALLONE, Mr. LOBIONDO, Mr.

LEWIS of Georgia, Mr. GOSS, Mrs. THURMAN, Mr. WEXLER, Mr. RUSH,

Mr. SPRATT, Mr. STRICKLAND, Mr. GREEN of Texas, Mrs. MEEK of

Florida, Mr. HASTINGS of Florida, Ms. STABENOW, Mr. MORAN of Virginia, Mr. BISHOP, Mr. BENTSEN, Mr. BOYD, Mr. LANTOS, and Ms.

BROWN of Florida) introduced the following bill; which was referred to

the Committee on Commerce

MARCH 8, 1999

Additional sponsors: Mr. YOUNG of Florida, Ms. ROS-LEHTINEN, Mr. UPTON,

Mr. LATOURETTE, Ms. DEGETTE, Mr. SANDERS, Mr. MCHUGH, Mr.

PICKERING, Mr. BARRETT of Wisconsin, Mr. WYNN, Ms. ESHOO, Mr.

TOWNS, Mr. MICA, Mrs. CAPPS, Ms. KILPATRICK, Ms. SLAUGHTER, Mr.

PASCRELL, Mr. SMITH of New Jersey, Mrs. MYRICK, Mr. HALL of Texas,

Mr. LAZIO, Mr. PHELPS, Mr. SAWYER, Mr. SHOWS, Mr. BLAGOJEVICH,

Mr. FARR of California, and Ms. CARSON

MARCH 8, 1999

Committed to the Committee of the Whole House on the State of the Union

and ordered to be printed
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A BILL

To amend title XIX of the Social Security Act to prohibit

transfers or discharges of residents of nursing facilities

as a result of a voluntary withdrawal from participation

in the Medicaid Program.

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 ‘‘Nursing Home Resi5 dent Protection Amendments of 1999’’.

6 SEC. 2. RESTRICTIONS ON TRANSFERS OR DISCHARGES OF

7 NURSING FACILITY RESIDENTS IN THE CASE

8 OF VOLUNTARY WITHDRAWAL FROM PAR9 TICIPATION UNDER THE MEDICAID PRO10 GRAM.

11 (a) IN GENERAL.—Section 1919(c)(2) of the Social

12 Security Act (42 U.S.C. 1396r(c)(2)) is amended by add13 ing at the end the following new subparagraph:

14 ‘‘(F) CONTINUING RIGHTS IN CASE OF

15 VOLUNTARY WITHDRAWAL FROM PARTICIPA16 TION.—

17 ‘‘(i) IN GENERAL.—In the case of a

18 nursing facility that voluntarily withdraws

19 from participation in a State plan under

20 this title but continues to provide services

21 of the type provided by nursing facilities—
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1 ‘‘(I) the facility’s voluntary with2 drawal from participation is not an

3 acceptable basis for the transfer or

4 discharge of residents of the facility

5 who were residing in the facility on

6 the day before the effective date of the

7 withdrawal (including those residents

8 who were not entitled to medical as9 sistance as of such day);

10 ‘‘(II) the provisions of this sec11 tion continue to apply to such resi12 dents until the date of their discharge

13 from the facility; and

14 ‘‘(III) in the case of each individ15 ual who begins residence in the facil16 ity after the effective date of such

17 withdrawal, the facility shall provide

18 notice orally and in a prominent man19 ner in writing on a separate page at

20 the time the individual begins resi21 dence of the information described in

22 clause (ii) and shall obtain from each

23 such individual at such time an ac24 knowledgment of receipt of such infor25 mation that is in writing, signed by
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1 the individual, and separate from

2 other documents signed by such indi3 vidual.

4 Nothing in this subparagraph shall be con5 strued as affecting any requirement of a

6 participation agreement that a nursing fa7 cility provide advance notice to the State

8 or the Secretary, or both, of its intention

9 to terminate the agreement.

10 ‘‘(ii) INFORMATION FOR NEW RESI11 DENTS.—The information described in this

12 clause for a resident is the following:

13 ‘‘(I) The facility is not participat14 ing in the program under this title

15 with respect to that resident.

16 ‘‘(II) The facility may transfer or

17 discharge the resident from the facil18 ity at such time as the resident is un19 able to pay the charges of the facility,

20 even though the resident may have be21 come eligible for medical assistance

22 for nursing facility services under this

23 title.

24 ‘‘(iii) CONTINUATION OF PAYMENTS

25 AND OVERSIGHT AUTHORITY.—Notwith-
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1 standing any other provision of this title,

2 with respect to the residents described in

3 clause (i)(I), a participation agreement of

4 a facility described in clause (i) is deemed

5 to continue in effect under such plan after

6 the effective date of the facility’s voluntary

7 withdrawal from participation under the

8 State plan for purposes of—

9 ‘‘(I) receiving payments under

10 the State plan for nursing facility

11 services provided to such residents;

12 ‘‘(II) maintaining compliance

13 with all applicable requirements of

14 this title; and

15 ‘‘(III) continuing to apply the

16 survey, certification, and enforcement

17 authority provided under subsections

18 (g) and (h) (including involuntary ter19 mination of a participation agreement

20 deemed continued under this clause).

21 ‘‘(iv) NO APPLICATION TO NEW RESI22 DENTS.—This paragraph (other than sub23 clause (III) of clause (i)) shall not apply to

24 an individual who begins residence in a fa25 cility on or after the effective date of the
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1 withdrawal from participation under this

2 subparagraph.’’.

3 (b) EFFECTIVE DATE.—The amendment made by

4 subsection (a) applies to voluntary withdrawals from par5 ticipation occurring on or after the date of the enactment

6 of this Act.

Union Calendar No. 27

106TH CONGRESS

1ST SESSION H. R. 540

[Report No. 106–44]

A BILL

To amend title XIX of the Social Security Act to

gram.drawal from participation in the Medicaid Pronursing facilities as a result of a voluntary withprohibit transfers or discharges of residents of

MARCH 8, 1999

Committed to the Committee of the Whole House on the

State of the Union and ordered to be printed