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103D CONGRESS

1ST SESSION H. R. 1580

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

individuals entitled to medicare benefits or enrolled in a State medicaid

plan be provided with notice of their rights to accept or refuse medical

care and the right to formulate advance directives.

IN THE HOUSE OF REPRESENTATIVES

APRIL 1, 1993

Mr. DOOLEY (for himself, Mr. HOYER, and Mr. BARRETT of Wisconsin) introduced the following bill; which was referred jointly to the Committees on

Ways and Energy and Commerce

A BILL

To amend titles XVIII and XIX of the Social Security Act

to require that individuals entitled to medicare benefits

or enrolled in a State medicaid plan be provided with

notice of their rights to accept or refuse medical care

and the right to formulate advance directives.

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 ‘‘Advance Directive Ex5 pansion Act of 1993’’.
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1 SEC. 2. PROVIDING NOTICE OF RIGHTS REGARDING MEDI2 CAL CARE TO INDIVIDUALS ENTERING MEDI3 CARE OR MEDICAID.

4 (a) NOTICE TO MEDICARE BENEFICIARIES.—

5 (1) IN GENERAL.—Section 1804 of the Social

6 Security Act (42 U.S.C. 1395b–2) is amended—

7 (A) in paragraph (2), by striking ‘‘and’’ at

8 the end;

9 (B) in paragraph (3), by striking the pe10 riod at the end and inserting ‘‘, and’’; and

11 (C) by inserting after paragraph (3) the

12 following new paragraph:

13 ‘‘(4) a description of an individual’s rights

14 under State law to make decisions concerning medi15 cal care, including the right to accept or refuse med16 ical or surgical treatment and the right to formulate

17 advance directives (as defined in section

18 1866(f)(3)).’’.

19 (2) EFFECTIVE DATE.—The amendment made

20 by paragraph (1) shall apply to notices provided

21 under section 1804 of the Social Security Act on or

22 after January 1, 1994.

23 (b) NOTICE TO INDIVIDUALS ENROLLED IN STATE

24 MEDICAID PLANS.—

25 (1) IN GENERAL.—Section 1902(a) of the So26 cial Security Act (42 U.S.C. 1396a(a)) is amended
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1 in the paragraph (58) added by section

2 4751(a)(1)(C) of the Omnibus Budget Reconciliation

3 Act of 1990 by striking the period at the end and

4 inserting the following: ‘‘, and that would be pro5 vided by the State to each individual enrolled in the

6 State plan.’’.

7 (2) EFFECTIVE DATE.—(A) Except as provided

8 in subparagraph (B), the amendment made by para9 graph (1) shall apply to calendar quarters beginning

10 on or after January 1, 1994, without regard to

11 whether or not final regulations to carry out such

12 amendments have been promulgated by such date.

13 (B) In the case of a State plan for medical as14 sistance under title XIX of the Social Security Act

15 which the Secretary of Health and Human Services

16 determines requires State legislation (other than leg17 islation appropriating funds) in order for the plan to

18 meet the additional requirements imposed by the

19 amendments made by paragraph (1), the State plan

20 shall not be regarded as failing to comply with the

21 requirements of such title solely on the basis of its

22 failure to meet these additional requirements before

23 the first day of the first calendar quarter beginning

24 after the close of the first regular session of the

25 State legislature that begins after the date of the en-
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1 actment of this Act. For purposes of the previous

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

3 legislative session, each year of such session shall be

4 deemed to be a separate regular session of the State

5 legislature.

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