I

103D CONGRESS

2D SESSION H. R. 3930

To identify illegal aliens who consume scarce health care resources in the

United States and who do not pay for such care and to seek reimbursement for this care from the home government of the aliens.

IN THE HOUSE OF REPRESENTATIVES

MARCH 1, 1994

Mr. HERGER introduced the following bill; which was referred jointly to the

Committees on Energy and Commerce, Ways and Means, the Judiciary,

and Foreign Affairs

A BILL

To identify illegal aliens who consume scarce health care

resources in the United States and who do not pay

for such care and to seek reimbursement for this care

from the home government of the aliens.

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

3 SECTION 1. IDENTIFICATION OF ILLEGAL ALIENS WHO

4 CONSUME HEALTH RESOURCES.

5 (a) REQUIREMENT OF DISCLOSURE.—

6 (1) IN GENERAL.—Each Federally-subsidized

7 health care provider (as defined in subsection (d)(1))

8 that provides health care services described in para-
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1 graph (2) to an alien whom the provider knows, or

2 has reason to believe, is not lawfully present in the

3 United States shall report to an officer or employee

4 of the Immigration and Naturalization Service speci5 fied by the Attorney General such information relat6 ing to the identity of the alien as the Attorney Gen7 eral specifies. The information shall be reported at

8 or before the time of providing such services.

9 (2) HEALTH CARE SERVICES DESCRIBED.—The

10 health care services described in this paragraph are

11 health care items and services furnished in the

12 United States—

13 (A) by a tax-exempt health care provider,

14 or

15 (B) for which payment may be made under

16 a Federal health care program.

17 (3) ENFORCEMENT.—

18 (A) TAX-EXEMPT HEALTH CARE PROVID19 ERS.—If the Attorney General determines a

20 tax-exempt health care provider has failed to re21 port information under paragraph (1) in a

22 timely manner, the Attorney General shall no23 tify the Secretary of the Treasury, who shall

24 suspend the provider’s exemption from taxes
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1 under section 501 of the Internal Revenue Code

2 of 1986 for a period of not less than 2 years.

3 (B) HEALTH CARE PROVIDERS RECEIVING

4 FUNDS UNDER FEDERAL HEALTH CARE PRO5 GRAMS.—If the Attorney General determines a

6 health care provider receiving payments under a

7 Federal health care program has failed to re8 port information under paragraph (1) in a

9 timely manner, the Attorney General shall no10 tify the Secretary of Health and Human Serv11 ices or other Federal official responsible for the

12 payment of funds under the program, who shall

13 (directly or through notice to the State or other

14 official making payments to the provider) dis15 qualify the provider from payments under the

16 program for a period of not less than 2 years.

17 (C) NOTICE AND HEARING.—The Attorney

18 General shall not make a determination under

19 this paragraph with respect to a health care

20 provider except after giving the provider notice

21 and opportunity for a hearing on the deter22 mination.

23 (4) PRIORITY IN DEPORTATION.—The Attorney

24 General shall give priority in enforcing deportation

25 provisions of the Immigration and Nationality Act to
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1 the deportation of aliens who have been identified

2 under this subsection as being provided health care

3 services at public expense.

4 (b) ASSURING PAYMENT BY FOREIGN COUNTRIES.—

5 (1) IN GENERAL.—Each Federally-subsidized

6 health care provider that provides health care items

7 and services in the United States to an alien who—

8 (A) is not lawfully present in the United

9 States, and

10 (B) fails to provide for payment on a time11 ly basis for any amounts owed for such services,

12 shall provide the Secretary of Health and Human

13 Services with such information regarding the nation14 ality of the alien, the items and services involved,

15 and the payment amounts owing as the Secretary

16 may specify in order to carry out this subsection.

17 (2) NOTICE TO FOREIGN COUNTRY.—In the

18 case of an alien who is a national of a foreign coun19 try and who is identified under paragraph (1), the

20 Secretary shall provide notice to the foreign country

21 of the payment amounts owing and the withholding

22 provisions of paragraph (3).

23 (3) WITHHOLDING OF ASSISTANCE FOR

24 AMOUNTS OWED.—Of the funds made available for

25 a foreign country under part I of the Foreign Assist-
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1 ance Act of 1961, an amount equivalent to 110 per2 cent of the total amounts identified under paragraph

3 (1) as owing under this subsection on behalf of

4 aliens who are nationals of the foreign country shall

5 be withheld from obligation for such country until

6 the Secretary certifies and reports in writing to the

7 Congress that such amounts are fully paid.

8 (c) OVERRIDE OF ALIEN SHIELD LAWS.—

9 (1) FEDERAL LAW.—No Federal law shall pre10 vent a Federally-subsidized health care provider

11 from disclosing to employees and officers of the Im12 migration and Naturalization Service the identity of

13 individuals who appear to be aliens unlawfully in the

14 United States and who receive health care services

15 from such a provider.

16 (2) STATE LAW.—As a condition for the receipt

17 of Federal funds under title XIX of the Social Secu18 rity Act and under the Public Health Service Act for

19 fiscal years beginning with the first fiscal year that

20 begins more than 2 years after the date of the enact21 ment of this Act, each State shall repeal or other22 wise override any State law that has the effect of

23 preventing a Federally-subsidized health care pro24 vider from making a disclosure described in para25 graph (1).
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1 (d) DEFINITIONS.—Except as otherwise specifically

2 provided, in this section:

3 (1) FEDERALLY-SUBSIDIZED HEALTH CARE

4 PROVIDER.—The term ‘‘Federally-subsidized health

5 care provider’’ means a health care provider that—

6 (A) is a tax-exempt health care provider,

7 (B) receives payments under a Federal

8 health care program (as defined in paragraph

9 (2)).

10 (2) FEDERAL HEALTH CARE PROGRAM.—The

11 term ‘‘Federal health care program’’ includes—

12 (A) the medicare program under title

13 XVIII of the Social Security Act,

14 (B) the medicaid program under title XIX

15 of such Act,

16 (C) the maternal and child health program

17 under title V of such Act, and

18 (D) programs under the Public Health

19 Service Act.

20 (3) SECRETARY.—The term ‘‘Secretary’’ means

21 the Secretary of Health and Human Services.

22 (4) STATE.—The term ‘‘State’’ has the mean23 ing given such term in section 101(a)(36) of the Im24 migration and Nationality Act.
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1 (5) TAX-EXEMPT HEALTH CARE PROVIDER.—

2 The term ‘‘tax-exempt health care provider’’ means

3 a health care provider described in section 501(c)(3)

4 of the Internal Revenue Code of 1986.

5 (e) EFFECTIVE DATE.—

6 (1) IN GENERAL.—Except as provided in this

7 subsection, the provisions of this Act shall take ef8 fect on the first day of the first month beginning

9 more than 90 days after the date of the enactment

10 of this Act.

11 (2) STATE LAWS.—In the case of a State which

12 the Secretary determines requires State legislation

13 in order to meet the condition described in sub14 section (c)(2), the State plan of medical assistance

15 under title XIX of the Social Security Act shall not

16 be regarded as failing to comply with such condition

17 before the first day of the first calendar quarter be18 ginning after the close of the first regular session of

19 the State legislature that begins after the date of the

20 enactment of this Act. For purposes of the previous

21 sentence, in the case of a State that has a 2-year

22 legislative session, each year of such session shall be

23 deemed to be a separate regular session of the State

24 legislature.

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