II

106TH CONGRESS

2D SESSION S. 2981

To amend titles XVIII and XIX of the Social Security Act to provide bad

debt relief for facilities providing care to certain low-income medicare

beneficiaries and to amend title XIX of such Act to increase efforts

to provide medicare beneficiaries with medicare cost-sharing under the

medicaid program.

IN THE SENATE OF THE UNITED STATES

JULY 27, 2000

Mr. DURBIN introduced the following bill; which was read twice and referred

to the Committee on Finance

A BILL

To amend titles XVIII and XIX of the Social Security Act

to provide bad debt relief for facilities providing care

to certain low-income medicare beneficiaries and to

amend title XIX of such Act to increase efforts to provide medicare beneficiaries with medicare cost-sharing

under 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 ‘‘Medicare Bad Debt

5 Relief and Medicare Cost-Sharing Eligibility Act of 2000’’.
2

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1 SEC. 2. BAD DEBT RELIEF FOR FACILITIES PROVIDING

2 CARE TO CERTAIN LOW-INCOME MEDICARE

3 BENEFICIARIES.

4 (a) MEDICARE COST-SHARING UNCOLLECTIBLE AND

5 NOT COVERED BY MEDICAID STATE PLANS.—Section

6 1902(n)(3)(B) of the Social Security Act (42 U.S.C.

7 1396a(n)(3)(B)) is amended—

8 (1) by inserting ‘‘(i)’’ after ‘‘(B)’’; and

9 (2) by adding at the end the following new

10 clause:

11 ‘‘(ii) the amount of medicare cost-sharing that

12 is uncollectible from the beneficiary because of

13 clause (i) and that is not paid by any other indi14 vidual or entity shall be deemed to be bad debt for

15 purposes of title XVIII; and’’.

16 (b) RECOGNITION OF 100 PERCENT OF BAD

17 DEBT.—

18 (1) NONAPPLICATION OF REDUCTION.—Section

19 1861(v)(1)(T) of the Social Security Act (42 U.S.C.

20 1395x(v)(1)(T)) is amended by inserting ‘‘(other

21 than any amount deemed to be bad debt under sec22 tion 1902(n)(3)(B)(ii))’’ after ‘‘amounts under this

23 title’’.

24 (2) RECOGNITION WITH RESPECT TO CER25 TIFIED NURSE ANESTHETISTS, NURSE PRACTI26 TIONERS, AND CLINICAL NURSE SPECIALISTS.—Sec-
3

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1 tion 1833 of the Social Security Act (42 U.S.C.

2 1395l) is amended—

3 (A) in subsection (l)(5)(B), by striking

4 ‘‘No hospital’’ and inserting ‘‘Except as pro5 vided in section 1902(n)(3)(B)(ii), no hospital’’;

6 and

7 (B) in subsection (r)(2), by striking ‘‘No

8 hospital’’ and inserting ‘‘Except as provided in

9 section 1902(n)(3)(B)(ii), no hospital’’.

10 (c) EFFECTIVE DATE.—The amendments made by

11 this section shall apply to items and services furnished on

12 or after the date of enactment of this Act.

13 SEC. 3. INCREASED EFFORT TO PROVIDE MEDICARE BENE14 FICIARIES WITH MEDICARE COST-SHARING

15 UNDER THE MEDICAID PROGRAM.

16 (a) IN GENERAL.—Section 1902(a) of the Social Se17 curity Act (42 U.S.C. 1396a(a)) is amended—

18 (1) in paragraph (64), by striking ‘‘and’’ at the

19 end;

20 (2) in paragraph (65), by striking the period

21 and inserting ‘‘; and’’; and

22 (3) by inserting after paragraph (65) the fol23 lowing new paragraph:

24 ‘‘(66) provide for the determination of eligibility

25 for medicare cost-sharing (as defined in section
4

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1 1905(p)(3)) for individuals described in paragraph

2 (10)(E) and, if eligible for such medicare cost-shar3 ing, for the enrollment of such individuals at any

4 hospital, clinic, or similar entity at which State or

5 local agency personnel are stationed for the purpose

6 of determining the eligibility of individuals for med7 ical assistance under the State plan or providing

8 outreach services to eligible or potentially eligible in9 dividuals.’’.

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

11 this section shall take effect on the date of enactment of

12 this Act.

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