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106TH CONGRESS

1ST SESSION H. R. 610

To amend title XIX of the Social Security Act to permit the Secretary

of Health and Human Services to waive recoupment of Federal Government Medicaid claims to tobacco-related State settlements if the State

uses the funds only for programs to reduce smoking and for public

health purposes.

IN THE HOUSE OF REPRESENTATIVES

FEBRUARY 4, 1999

Mr. WEYGAND introduced the following bill; which was referred to the

Committee on Commerce

A BILL

To amend title XIX of the Social Security Act to permit

the Secretary of Health and Human Services to waive

recoupment of Federal Government Medicaid claims to

tobacco-related State settlements if the State uses the

funds only for programs to reduce smoking and for public health purposes.

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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1 SECTION 1. PERMITTING WAIVER OF RECOUPMENT OF

2 MEDICAID TOBACCO-RELATED RECOVERIES

3 IF RECOVERIES USED TO REDUCE SMOKING

4 AND FOR PUBLIC HEALTH PURPOSES.

5 (a) IN GENERAL.—Section 1903(d)(3) of the Social

6 Security Act (42 U.S.C. 1396b(d)(3)) is amended—

7 (1) by inserting ‘‘(A)’’ before ‘‘The’’; and

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

9 ‘‘(B) Subparagraph (A) and paragraph (2)(B) shall

10 not apply to any amount recovered or paid to a State as

11 part of a settlement or judgment reached in litigation initi12 ated or pursued by a State against one or more manufac13 turers of tobacco products, as defined in section 5702(d)

14 of the Internal Revenue Code of 1986, if (and to the ex15 tent that) the Secretary finds that following conditions are

16 met:

17 ‘‘(i) The State has filed with the Secretary a

18 plan which specifically outlines how the Federal

19 share of the amounts so recovered will be spent con20 sistent with the following:

21 ‘‘(I) At least 40 percent of such amounts,

22 recovered in any fiscal year, will be spent on ef23 forts to reduce smoking using methods that

24 have been shown to be effective, such as smok25 ing cessation programs, anti-smoking enforce26 ment activities, community-based anti-smoking
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1 programs, and school-based education pro2 grams.

3 ‘‘(II) Such amounts not spent for the pur4 poses described in subclause (I) will be spent

5 only on essential public health services, includ6 ing (but not limited to) the public health activi7 ties described in subparagraph (C).

8 ‘‘(III) All such amounts will be spent only

9 in a manner that supplements (and does not

10 supplant) funds previously being spent by the

11 State (or local governments in the State) for

12 such or similar programs or activities.

13 ‘‘(ii) Before the beginning of each fiscal year,

14 the State files with the Secretary a report which de15 tails how the Federal share of the amounts so recov16 ered have been spent consistent with the plan de17 scribed in clause (i).

18 ‘‘(C) The public health activities described in this

19 subparagraph are as follows:

20 ‘‘(i) Monitoring health status to identify com21 munity health problems.

22 ‘‘(ii) Diagnosing and investigating health prob23 lems and health hazards in the community.

24 ‘‘(iii) Enforcing laws and regulations that pro25 tect public health.
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1 ‘‘(iv) Informing, educating, and empowering

2 people about health issues.

3 ‘‘(v) Mobilizing community partnerships to

4 identify and solve health problems.

5 ‘‘(vi) Linking people to needed personal health

6 services and assuring the provision of health care

7 when otherwise unavailable.

8 ‘‘(vii) Evaluating effectiveness, accessibility, and

9 quality of personal and population-based health serv10 ices.

11 ‘‘(viii) Assuring a competent public health and

12 personal health care workforce.

13 ‘‘(ix) Developing policies and plans that support

14 individual and community health efforts.

15 ‘‘(x) Conducting research for new insights and

16 innovative solutions to health problems.

17 ‘‘(D) If the Secretary determines that amounts de18 scribed in subparagraph (B) are not being spent in accord19 ance with the plan described in (and that meets the re20 quirements of) subparagraph (B)(i), subparagraph (A)

21 and paragraph (2)(B) shall apply to such amounts and

22 the Secretary shall take appropriate action to offset such

23 amounts from the amounts otherwise paid to the State

24 under this title.
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1 ‘‘(E) Amounts equivalent to the reductions in pay2 ments under this title which are attributable to recoveries

3 described in subparagraph (B) which are not recouped or

4 offset because of such subparagraph shall be deposited by

5 the Secretary into a separate fund in the Treasury which

6 shall be used and available to the Secretary, without fur7 ther appropriation, to carry out Federal grant-in-aid pro8 grams to reduce tobacco use among minors.’’.

9 (b) EFFECTIVE DATE.—The amendments made by

10 subsection (a) apply to amounts recovered or paid to a

11 State before, on, or after the date of enactment of this

12 Act.

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