II

105TH CONGRESS

2D SESSION S. 1809

To improve the performance outcomes of the child support enforcement program in order to increase the financial stability and well-being of children

and families, and to require the Secretary of Health and Human Services

and the Secretary of Labor to jointly develop a National Standardized

Medical Support Notice and establish a working group to eliminate

existing barriers to the effective establishment and enforcement of medical child support.

IN THE SENATE OF THE UNITED STATES

MARCH 23, 1998

Mr. ROCKEFELLER (for himself, Ms. SNOWE, Mr. KERRY, Mr. KENNEDY, Mr.

DODD, Mr. JEFFORDS, and Mr. CHAFEE) introduced the following bill;

which was read twice and referred to the Committee on Finance

A BILL

To improve the performance outcomes of the child support

enforcement program in order to increase the financial

stability and well-being of children and families, and

to require the Secretary of Health and Human Services

and the Secretary of Labor to jointly develop a National

Standardized Medical Support Notice and establish a

working group to eliminate existing barriers to the effective establishment and enforcement of medical child support.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,
2

•S 1809 IS

1 SECTION 1. SHORT TITLE.

2 This Act may be cited as the ‘‘Child Support Per3 formance Improvement Act of 1998’’.

4 SEC. 2. INCENTIVE PAYMENTS TO STATES.

5 (a) IN GENERAL.—Part D of title IV of the Social

6 Security Act (42 U.S.C. 651–669) is amended by inserting

7 after section 458 the following:

8 ‘‘SEC. 458A. INCENTIVE PAYMENTS TO STATES.

9 ‘‘(a) IN GENERAL.—In addition to any other pay10 ment under this part, the Secretary shall, subject to sub11 section (f), make an incentive payment to each State for

12 each fiscal year in an amount determined under subsection

13 (b).

14 ‘‘(b) AMOUNT OF INCENTIVE PAYMENT.—

15 ‘‘(1) IN GENERAL.—The incentive payment for

16 a State for a fiscal year is equal to the incentive

17 payment pool for the fiscal year, multiplied by the

18 State incentive payment share for the fiscal year.

19 ‘‘(2) INCENTIVE PAYMENT POOL.—

20 ‘‘(A) IN GENERAL.—In paragraph (1), the

21 term ‘incentive payment pool’ means—

22 ‘‘(i) $422,000,000 for fiscal year

23 2000;

24 ‘‘(ii) $429,000,000 for fiscal year

25 2001;
3

•S 1809 IS

1 ‘‘(iii) $450,000,000 for fiscal year

2 2002;

3 ‘‘(iv) $461,000,000 for fiscal year

4 2003;

5 ‘‘(v) $454,000,000 for fiscal year

6 2004;

7 ‘‘(vi) $446,000,000 for fiscal year

8 2005;

9 ‘‘(vii) $458,000,000 for fiscal year

10 2006;

11 ‘‘(viii) $471,000,000 for fiscal year

12 2007;

13 ‘‘(ix) $483,000,000 for fiscal year

14 2008; and

15 ‘‘(x) for any succeeding fiscal year,

16 the amount of the incentive payment pool

17 for the fiscal year that precedes such suc18 ceeding fiscal year, multiplied by the per19 centage (if any) by which the CPI for such

20 preceding fiscal year exceeds the CPI for

21 the 2nd preceding fiscal year.

22 ‘‘(B) CPI.—For purposes of subparagraph

23 (A), the CPI for a fiscal year is the average of

24 the Consumer Price Index for the 12-month pe25 riod ending on September 30 of the fiscal year.
4

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1 As used in the preceding sentence, the term

2 ‘Consumer Price Index’ means the last Con3 sumer Price Index for all-urban consumers pub4 lished by the Department of Labor.

5 ‘‘(3) STATE INCENTIVE PAYMENT SHARE.—In

6 paragraph (1), the term ‘State incentive payment

7 share’ means, with respect to a fiscal year—

8 ‘‘(A) the incentive base amount for the

9 State for the fiscal year; divided by

10 ‘‘(B) the sum of the incentive base

11 amounts for all of the States for the fiscal year.

12 ‘‘(4) INCENTIVE BASE AMOUNT.—In paragraph

13 (3), the term ‘incentive base amount’ means, with

14 respect to a State and a fiscal year, the sum of the

15 applicable percentages (determined in accordance

16 with paragraph (6)) multiplied by the corresponding

17 maximum incentive base amounts for the State for

18 the fiscal year, with respect to each of the following

19 measures of State performance for the fiscal year:

20 ‘‘(A) The paternity establishment perform21 ance level.

22 ‘‘(B) The support order performance level.

23 ‘‘(C) The current payment performance

24 level.
5

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1 ‘‘(D) The arrearage payment performance

2 level.

3 ‘‘(E) The cost-effectiveness performance

4 level.

5 ‘‘(5) MAXIMUM INCENTIVE BASE AMOUNT.—

6 ‘‘(A) IN GENERAL.—For purposes of para7 graph (4), the maximum incentive base amount

8 for a State for a fiscal year is—

9 ‘‘(i) with respect to the performance

10 measures described in subparagraphs (A),

11 (B), and (C) of paragraph (4), 100 percent

12 of the State collections base for the fiscal

13 year; and

14 ‘‘(ii) with respect to the performance

15 measures described in subparagraphs (D)

16 and (E) of paragraph (4), 75 percent of

17 the State collections base for the fiscal

18 year.

19 ‘‘(B) DATA REQUIRED TO BE COMPLETE

20 AND RELIABLE.—Notwithstanding subpara21 graph (A), the maximum incentive base amount

22 for a State for a fiscal year with respect to a

23 performance measure described in paragraph

24 (4) is zero, unless the Secretary determines, on

25 the basis of an audit performed under section
6

•S 1809 IS

1 452(a)(4)(C)(i), that the data which the State

2 submitted pursuant to section 454(15)(B) for

3 the fiscal year and which is used to determine

4 the performance level involved is complete and

5 reliable.

6 ‘‘(C) STATE COLLECTIONS BASE.—For

7 purposes of subparagraph (A), the State collec8 tions base for a fiscal year is equal to the sum

9 of—

10 ‘‘(i) 2 times the sum of—

11 ‘‘(I) the total amount of support

12 collected during the fiscal year under

13 the State plan approved under this

14 part in cases in which the support ob15 ligation involved is required to be as16 signed to the State pursuant to part

17 A or E of this title or title XIX; and

18 ‘‘(II) the total amount of support

19 collected during the fiscal year under

20 the State plan approved under this

21 part in cases in which the support ob22 ligation involved was so assigned but,

23 at the time of collection, is not re24 quired to be so assigned; and
7

•S 1809 IS

1 ‘‘(ii) the total amount of support col2 lected during the fiscal year under the

3 State plan approved under this part in all

4 other cases.

5 ‘‘(6) DETERMINATION OF APPLICABLE PER6 CENTAGES BASED ON PERFORMANCE LEVELS.—

7 ‘‘(A) PATERNITY ESTABLISHMENT.—

8 ‘‘(i) DETERMINATION OF PATERNITY

9 ESTABLISHMENT PERFORMANCE LEVEL.—

10 The paternity establishment performance

11 level for a State for a fiscal year is, at the

12 option of the State, the IV–D paternity es13 tablishment percentage determined under

14 section 452(g)(2)(A) or the statewide pa15 ternity establishment percentage deter16 mined under section 452(g)(2)(B).

17 ‘‘(ii) DETERMINATION OF APPLICABLE

18 PERCENTAGE.—The applicable percentage

19 with respect to a State’s paternity estab20 lishment performance level is as follows:

‘‘If the paternity establishment performance level is: The applicable

percentage is: At least: But less than:

80% ...................................... .............................................. 100

79% ...................................... 80% ...................................... 98

78% ...................................... 79% ...................................... 96

77% ...................................... 78% ...................................... 94

76% ...................................... 77% ...................................... 92

75% ...................................... 76% ...................................... 90

74% ...................................... 75% ...................................... 88

73% ...................................... 74% ...................................... 86
8

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‘‘If the paternity establishment performance level is: The applicable

percentage is: At least: But less than:

72% ...................................... 73% ...................................... 84

71% ...................................... 72% ...................................... 82

70% ...................................... 71% ...................................... 80

69% ...................................... 70% ...................................... 79

68% ...................................... 69% ...................................... 78

67% ...................................... 68% ...................................... 77

66% ...................................... 67% ...................................... 76

65% ...................................... 66% ...................................... 75

64% ...................................... 65% ...................................... 74

63% ...................................... 64% ...................................... 73

62% ...................................... 63% ...................................... 72

61% ...................................... 62% ...................................... 71

60% ...................................... 61% ...................................... 70

59% ...................................... 60% ...................................... 69

58% ...................................... 59% ...................................... 68

57% ...................................... 58% ...................................... 67

56% ...................................... 57% ...................................... 66

55% ...................................... 56% ...................................... 65

54% ...................................... 55% ...................................... 64

53% ...................................... 54% ...................................... 63

52% ...................................... 53% ...................................... 62

51% ...................................... 52% ...................................... 61

50% ...................................... 51% ...................................... 60

0% ........................................ 50% ...................................... 0.

1 Notwithstanding the preceding sentence, if

2 the paternity establishment performance

3 level of a State for a fiscal year is less

4 than 50 percent but exceeds by at least 10

5 percentage points the paternity establish6 ment performance level of the State for the

7 immediately preceding fiscal year, then the

8 applicable percentage with respect to the

9 State’s paternity establishment perform10 ance level is 50 percent.

11 ‘‘(B) ESTABLISHMENT OF CHILD SUPPORT

12 ORDERS.—
9

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1 ‘‘(i) DETERMINATION OF SUPPORT

2 ORDER PERFORMANCE LEVEL.—The sup3 port order performance level for a State

4 for a fiscal year is the percentage of the

5 total number of cases under the State plan

6 approved under this part in which there is

7 a support order during the fiscal year.

8 ‘‘(ii) DETERMINATION OF APPLICABLE

9 PERCENTAGE.—The applicable percentage

10 with respect to a State’s support order per11 formance level is as follows:

‘‘If the support order performance level is: The applicable

percentage is: At least: But less than:

80% ...................................... .............................................. 100

79% ...................................... 80% ...................................... 98

78% ...................................... 79% ...................................... 96

77% ...................................... 78% ...................................... 94

76% ...................................... 77% ...................................... 92

75% ...................................... 76% ...................................... 90

74% ...................................... 75% ...................................... 88

73% ...................................... 74% ...................................... 86

72% ...................................... 73% ...................................... 84

71% ...................................... 72% ...................................... 82

70% ...................................... 71% ...................................... 80

69% ...................................... 70% ...................................... 79

68% ...................................... 69% ...................................... 78

67% ...................................... 68% ...................................... 77

66% ...................................... 67% ...................................... 76

65% ...................................... 66% ...................................... 75

64% ...................................... 65% ...................................... 74

63% ...................................... 64% ...................................... 73

62% ...................................... 63% ...................................... 72

61% ...................................... 62% ...................................... 71

60% ...................................... 61% ...................................... 70

59% ...................................... 60% ...................................... 69

58% ...................................... 59% ...................................... 68

57% ...................................... 58% ...................................... 67

56% ...................................... 57% ...................................... 66

55% ...................................... 56% ...................................... 65

54% ...................................... 55% ...................................... 64
10

•S 1809 IS

‘‘If the support order performance level is: The applicable

percentage is: At least: But less than:

53% ...................................... 54% ...................................... 63

52% ...................................... 53% ...................................... 62

51% ...................................... 52% ...................................... 61

50% ...................................... 51% ...................................... 60

0% ........................................ 50% ...................................... 0.

1 Notwithstanding the preceding sentence, if

2 the support order performance level of a

3 State for a fiscal year is less than 50 per4 cent but exceeds by at least 5 percentage

5 points the support order performance level

6 of the State for the immediately preceding

7 fiscal year, then the applicable percentage

8 with respect to the State’s support order

9 performance level is 50 percent.

10 ‘‘(C) COLLECTIONS ON CURRENT CHILD

11 SUPPORT DUE.—

12 ‘‘(i) DETERMINATION OF CURRENT

13 PAYMENT PERFORMANCE LEVEL.—The

14 current payment performance level for a

15 State for a fiscal year is equal to the total

16 amount of current support collected during

17 the fiscal year under the State plan ap18 proved under this part divided by the total

19 amount of current support owed during the

20 fiscal year in all cases under the State

21 plan, expressed as a percentage.
11

•S 1809 IS

1 ‘‘(ii) DETERMINATION OF APPLICABLE

2 PERCENTAGE.—The applicable percentage

3 with respect to a State’s current payment

4 performance level is as follows:

‘‘If the current payment performance level is: The applicable

percentage is: At least: But less than:

80% ...................................... .............................................. 100

79% ...................................... 80% ...................................... 98

78% ...................................... 79% ...................................... 96

77% ...................................... 78% ...................................... 94

76% ...................................... 77% ...................................... 92

75% ...................................... 76% ...................................... 90

74% ...................................... 75% ...................................... 88

73% ...................................... 74% ...................................... 86

72% ...................................... 73% ...................................... 84

71% ...................................... 72% ...................................... 82

70% ...................................... 71% ...................................... 80

69% ...................................... 70% ...................................... 79

68% ...................................... 69% ...................................... 78

67% ...................................... 68% ...................................... 77

66% ...................................... 67% ...................................... 76

65% ...................................... 66% ...................................... 75

64% ...................................... 65% ...................................... 74

63% ...................................... 64% ...................................... 73

62% ...................................... 63% ...................................... 72

61% ...................................... 62% ...................................... 71

60% ...................................... 61% ...................................... 70

59% ...................................... 60% ...................................... 69

58% ...................................... 59% ...................................... 68

57% ...................................... 58% ...................................... 67

56% ...................................... 57% ...................................... 66

55% ...................................... 56% ...................................... 65

54% ...................................... 55% ...................................... 64

53% ...................................... 54% ...................................... 63

52% ...................................... 53% ...................................... 62

51% ...................................... 52% ...................................... 61

50% ...................................... 51% ...................................... 60

49% ...................................... 50% ...................................... 59

48% ...................................... 49% ...................................... 58

47% ...................................... 48% ...................................... 57

46% ...................................... 47% ...................................... 56

45% ...................................... 46% ...................................... 55

44% ...................................... 45% ...................................... 54

43% ...................................... 44% ...................................... 53

42% ...................................... 43% ...................................... 52

41% ...................................... 42% ...................................... 51

40% ...................................... 41% ...................................... 50

0% ........................................ 40% ...................................... 0.
12

•S 1809 IS

1 Notwithstanding the preceding sentence, if

2 the current payment performance level of a

3 State for a fiscal year is less than 40 per4 cent but exceeds by at least 5 percentage

5 points the current payment performance

6 level of the State for the immediately pre7 ceding fiscal year, then the applicable per8 centage with respect to the State’s current

9 payment performance level is 50 percent.

10 ‘‘(D) COLLECTIONS ON CHILD SUPPORT

11 ARREARAGES.—

12 ‘‘(i) DETERMINATION OF ARREARAGE

13 PAYMENT PERFORMANCE LEVEL.—The ar14 rearage payment performance level for a

15 State for a fiscal year is equal to the total

16 number of cases under the State plan ap17 proved under this part in which payments

18 of past-due child support were received

19 during the fiscal year and part or all of the

20 payments were distributed to the family to

21 whom the past-due child support was owed

22 (or, if all past-due child support owed to

23 the family was, at the time of receipt, sub24 ject to an assignment to the State, part or

25 all of the payments were retained by the
13

•S 1809 IS

1 State) divided by the total number of cases

2 under the State plan in which there is

3 past-due child support, expressed as a per4 centage.

5 ‘‘(ii) DETERMINATION OF APPLICABLE

6 PERCENTAGE.—The applicable percentage

7 with respect to a State’s arrearage pay8 ment performance level is as follows:

‘‘If the arrearage payment performance level is: The applicable

percentage is: At least: But less than:

80% ...................................... .............................................. 100

79% ...................................... 80% ...................................... 98

78% ...................................... 79% ...................................... 96

77% ...................................... 78% ...................................... 94

76% ...................................... 77% ...................................... 92

75% ...................................... 76% ...................................... 90

74% ...................................... 75% ...................................... 88

73% ...................................... 74% ...................................... 86

72% ...................................... 73% ...................................... 84

71% ...................................... 72% ...................................... 82

70% ...................................... 71% ...................................... 80

69% ...................................... 70% ...................................... 79

68% ...................................... 69% ...................................... 78

67% ...................................... 68% ...................................... 77

66% ...................................... 67% ...................................... 76

65% ...................................... 66% ...................................... 75

64% ...................................... 65% ...................................... 74

63% ...................................... 64% ...................................... 73

62% ...................................... 63% ...................................... 72

61% ...................................... 62% ...................................... 71

60% ...................................... 61% ...................................... 70

59% ...................................... 60% ...................................... 69

58% ...................................... 59% ...................................... 68

57% ...................................... 58% ...................................... 67

56% ...................................... 57% ...................................... 66

55% ...................................... 56% ...................................... 65

54% ...................................... 55% ...................................... 64

53% ...................................... 54% ...................................... 63

52% ...................................... 53% ...................................... 62

51% ...................................... 52% ...................................... 61

50% ...................................... 51% ...................................... 60

49% ...................................... 50% ...................................... 59

48% ...................................... 49% ...................................... 58

47% ...................................... 48% ...................................... 57
14

•S 1809 IS

‘‘If the arrearage payment performance level is: The applicable

percentage is: At least: But less than:

46% ...................................... 47% ...................................... 56

45% ...................................... 46% ...................................... 55

44% ...................................... 45% ...................................... 54

43% ...................................... 44% ...................................... 53

42% ...................................... 43% ...................................... 52

41% ...................................... 42% ...................................... 51

40% ...................................... 41% ...................................... 50

0% ........................................ 40% ...................................... 0.

1 Notwithstanding the preceding sentence, if

2 the arrearage payment performance level

3 of a State for a fiscal year is less than 40

4 percent but exceeds by at least 5 percent5 age points the arrearage payment perform6 ance level of the State for the immediately

7 preceding fiscal year, then the applicable

8 percentage with respect to the State’s ar9 rearage payment performance level is 50

10 percent.

11 ‘‘(E) COST-EFFECTIVENESS.—

12 ‘‘(i) DETERMINATION OF COST-EF13 FECTIVENESS PERFORMANCE LEVEL.—The

14 cost-effectiveness performance level for a

15 State for a fiscal year is equal to the total

16 amount collected during the fiscal year

17 under the State plan approved under this

18 part divided by the total amount expended
15

•S 1809 IS

1 during the fiscal year under the State plan,

2 expressed as a ratio.

3 ‘‘(ii) DETERMINATION OF APPLICABLE

4 PERCENTAGE.—The applicable percentage

5 with respect to a State’s cost-effectiveness

6 performance level is as follows:

‘‘If the cost-effectiveness performance level is: The applicable

percentage is: At least: But less than:

5.00 ...................................... .............................................. 100

4.50 ...................................... 4.99 ...................................... 90

4.00 ...................................... 4.50 ...................................... 80

3.50 ...................................... 4.00 ...................................... 70

3.00 ...................................... 3.50 ...................................... 60

2.50 ...................................... 3.00 ...................................... 50

2.00 ...................................... 2.50 ...................................... 40

0.00 ...................................... 2.00 ...................................... 0.

7 ‘‘(F) MEDICAL SUPPORT.—Subject to sec8 tion 2(d)(2)(C) of the Child Support Perform9 ance Improvement Act of 1998, the medical

10 support performance level for a State for a fis11 cal year, and the applicable percentage for a

12 State with respect to such level, shall be deter13 mined in accordance with regulations imple14 menting the recommendations required to be in15 cluded in the report submitted under section

16 2(d)(2)(B) of such Act.

17 ‘‘(c) TREATMENT OF INTERSTATE COLLECTIONS.—

18 In computing incentive payments under this section, sup19 port which is collected by a State at the request of another
16

•S 1809 IS

1 State shall be treated as having been collected in full by

2 both States, and any amounts expended by a State in car3 rying out a special project assisted under section 455(e)

4 shall be excluded.

5 ‘‘(d) ADMINISTRATIVE PROVISIONS.—The amounts

6 of the incentive payments to be made to the States under

7 this section for a fiscal year shall be estimated by the Sec8 retary at or before the beginning of the fiscal year on the

9 basis of the best information available, as obtained in ac10 cordance with section 452(a)(12). The Secretary shall

11 make the payments for the fiscal year, on a quarterly basis

12 (with each quarterly payment being made not later than

13 the beginning of the quarter involved), in the amounts so

14 estimated, reduced, or increased to the extent of any over15 payments or underpayments which the Secretary deter16 mines were made under this section to the States involved

17 for prior periods and with respect to which adjustment has

18 not already been made under this subsection. Upon the

19 making of any estimate by the Secretary under the preced20 ing sentence, any appropriations available for payments

21 under this section are deemed obligated.

22 ‘‘(e) REGULATIONS.—

23 ‘‘(1) IN GENERAL.—The Secretary shall pre24 scribe such regulations as may be necessary govern25 ing the calculation of incentive payments under this
17

•S 1809 IS

1 section, including directions for excluding from the

2 calculations certain closed cases and cases over

3 which the States do not have jurisdiction, and regu4 lations excluding from the calculations of the current

5 payment performance level and the arrearage pay6 ment performance level any case in which the State

7 used State funds to make such payments for the pri8 mary purpose of increasing the State’s performance

9 levels in such areas.

10 ‘‘(2) REGULATIONS IMPLEMENTING THE MEDI11 CAL SUPPORT PERFORMANCE LEVEL.—Subject to

12 section 2(d)(2)(C) of the Child Support Performance

13 Improvement Act of 1998, the Secretary shall pre14 scribe regulations implementing the recommenda15 tions required to be included in the report submitted

16 under section 2(d)(2)(B) of such Act. To the extent

17 necessary to ensure that the implementation of such

18 recommendations does not result in total Federal ex19 penditures under this section in excess of the

20 amount of such expenditures in the absence of such

21 implementation, such regulations may increase or

22 decrease the percentages specified in clauses (i) and

23 (ii) of subsection (b)(5)(A).

24 ‘‘(f) REINVESTMENT.—
18

•S 1809 IS

1 ‘‘(1) IN GENERAL.—Until such time as the

2 State qualifies for the maximum incentive amount

3 possible, as determined under subsection (b)(5), pay4 ments under this section and section 458 shall sup5 plement, not supplant, State child support expendi6 tures under the State program under this part to

7 the extent that such expenditures were funded by

8 the State in fiscal year 1997.

9 ‘‘(2) PENALTY.—Failure to satisfy the require10 ment of paragraph (1) shall result in a proportionate

11 reduction, determined by the Secretary, of future

12 payments to the State under this section and section

13 458.’’.

14 (b) PAYMENTS DURING TRANSITION PERIOD.—Not15 withstanding section 458A of the Social Security Act (42

16 U.S.C. 658A), as added by subsection (a), the amount of

17 an incentive payment for a State under such section shall

18 not be—

19 (1) in the case of fiscal year 2000, less than 80

20 percent or greater than 120 percent of the incentive

21 payment for the State determined under section 458

22 of the Social Security Act (42 U.S.C. 658) for fiscal

23 year 1999 (as such section was in effect for such fis24 cal year);
19

•S 1809 IS

1 (2) in the case of fiscal year 2001, less than 60

2 percent or greater than 140 percent of the incentive

3 payment for the State (as so determined);

4 (3) in the case of fiscal year 2002, less than 40

5 percent or greater than 160 percent of the incentive

6 payment for the State (as so determined); and

7 (4) in the case of fiscal year 2003, less than 20

8 percent or greater than 180 percent of the incentive

9 payment for the State (as so determined).

10 (c) REGULATIONS.—Within 9 months after the date

11 of enactment of this section, the Secretary of Health and

12 Human Services shall, in addition to the regulations re13 quired under section 458A(e) of the Social Security Act,

14 issue regulations governing the implementation of section

15 458A of the Social Security Act, when such section takes

16 effect, and the implementation of subsection (b) of this

17 section.

18 (d) STUDIES.—

19 (1) GENERAL REVIEW OF NEW INCENTIVE PAY20 MENT SYSTEM.—

21 (A) IN GENERAL.—The Secretary of

22 Health and Human Services (in this subsection

23 referred to as the ‘‘Secretary’’) shall conduct a

24 study of the implementation of the incentive

25 payment system established by section 458A of
20

•S 1809 IS

1 the Social Security Act, in order to identify the

2 problems and successes of the system.

3 (B) REPORTS TO CONGRESS.—

4 (i) REPORT ON VARIATIONS IN STATE

5 PERFORMANCE ATTRIBUTABLE TO DEMO6 GRAPHIC VARIABLES.—Not later than Oc7 tober 1, 2000, the Secretary shall submit

8 to Congress a report that identifies any de9 mographic or economic variables that ac10 count for differences in the performance

11 levels achieved by the States with respect

12 to the performance measures used in the

13 system, and contains the recommendations

14 of the Secretary for such adjustments to

15 the system as may be necessary to ensure

16 that the relative performance of States is

17 measured from a baseline that takes ac18 count of any such variables.

19 (ii) INTERIM REPORT.—Not later than

20 March 1, 2001, the Secretary shall submit

21 to Congress an interim report that con22 tains the findings of the study required by

23 subparagraph (A).

24 (iii) FINAL REPORT.—Not later than

25 October 1, 2003, the Secretary shall sub-
21

•S 1809 IS

1 mit to Congress a final report that con2 tains the final findings of the study re3 quired by subparagraph (A). The report

4 shall include any recommendations for

5 changes in the system that the Secretary

6 determines would improve the operation of

7 the child support enforcement program.

8 (2) DEVELOPMENT OF MEDICAL SUPPORT IN9 CENTIVE.—

10 (A) IN GENERAL.—The Secretary, in con11 sultation with State directors of programs oper12 ated under part D of title IV of the Social Se13 curity Act and representatives of children po14 tentially eligible for medical support, such as

15 child advocacy organizations, shall develop a

16 new medical support performance measure

17 based on the effectiveness of States in establish18 ing and enforcing medical support obligations,

19 and shall make recommendations for the incor20 poration of the measure, in a revenue neutral

21 manner, into the incentive payment system es22 tablished by section 458A of the Social Security

23 Act.

24 (B) REPORT.—Not later than October 1,

25 1999, the Secretary shall submit to the Com-
22

•S 1809 IS

1 mittee on Ways and Means of the House of

2 Representatives and the Committee on Finance

3 of the Senate, a report that describes the per4 formance measure and contains the rec5 ommendations required under subparagraph

6 (A).

7 (C) CONGRESSIONAL DISAPPROVAL RE8 QUIRED.—

9 (i) IN GENERAL.—The Secretary

10 shall, by regulation, implement the rec11 ommendations required to be included in

12 the report submitted under subparagraph

13 (B) unless a joint resolution is enacted, in

14 accordance with subparagraph (D), dis15 approving such recommendations before

16 the end of the 1-year period that begins on

17 the date on which the Secretary submits

18 such report.

19 (ii) EXCLUSION OF CERTAIN DAYS.—

20 For purposes of clause (i) and subpara21 graph (D), the days on which either House

22 of Congress is not in session because of an

23 adjournment of more than 3 days to a day

24 certain shall be excluded from the com25 putation of the period.
23

•S 1809 IS

1 (D) CONGRESSIONAL CONSIDERATION.—

2 (i) TERMS OF THE RESOLUTION.—

3 For purposes of subparagraph (C)(i), the

4 term ‘‘joint resolution’’ means only a joint

5 resolution that is introduced within the 1-

6 year period described in such subpara7 graph and—

8 (I) that does not have a pre9 amble;

10 (II) the matter after the resolv11 ing clause of which is as follows:

12 ‘‘That Congress disapproves the rec13 ommendations of the Secretary of

14 Health and Human Services regarding

15 the implementation of a medical sup16 port performance measure submitted

17 on llll’’, the blank space being

18 filled in with the appropriate date;

19 and

20 (III) the title of which is as fol21 lows: ‘‘Joint resolution disapproving

22 the recommendations of the Secretary

23 of Health and Human Services re24 garding the implementation of a medi25 cal support performance measure.’’.
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1 (ii) REFERRAL.—A resolution de2 scribed in clause (i) that is introduced—

3 (I) in the House of Representa4 tives, shall be referred to the Commit5 tee on Ways and Means; and

6 (II) in the Senate, shall be re7 ferred to the Committee on Finance.

8 (iii) DISCHARGE.—If a committee to

9 which a resolution described in clause (i) is

10 referred has not reported such resolution

11 by the end of the 20-day period beginning

12 on the date on which the Secretary sub13 mits the report required under subpara14 graph (B), such committee shall be, at the

15 end of such period, discharged from fur16 ther consideration of such resolution, and

17 such resolution shall be placed on the ap18 propriate calendar of the House involved.

19 (iv) CONSIDERATION.—On or after

20 the third day after the date on which the

21 committee to which a resolution described

22 in clause (i) has reported, or has been dis23 charged from further consideration of such

24 resolution, such resolution shall be consid25 ered in the same manner as a resolution is
25

•S 1809 IS

1 considered under subsections (d), (e), and

2 (f) of section 2908 of the Defense Base

3 Closure and Realignment Act of 1990 (10

4 U.S.C. 2687 note).

5 (e) TECHNICAL AMENDMENTS.—

6 (1) IN GENERAL.—Section 341 of the Personal

7 Responsibility and Work Opportunity Reconciliation

8 Act of 1996 (42 U.S.C. 658 note) is amended—

9 (A) by striking subsection (a) and redesig10 nating subsections (b), (c), and (d) as sub11 sections (a), (b), and (c), respectively; and

12 (B) in subsection (c) (as so redesig13 nated)—

14 (i) by striking paragraph (1) and in15 serting the following:

16 ‘‘(1) CONFORMING AMENDMENTS TO PRESENT

17 SYSTEM.—The amendments made by subsection (a)

18 of this section shall become effective with respect to

19 a State as of the date the amendments made by sec20 tion 103(a) (without regard to section 116(a)(2))

21 first apply to the State.’’; and

22 (ii) in paragraph (2), by striking

23 ‘‘(c)’’ and inserting ‘‘(b)’’.

24 (2) EFFECTIVE DATE.—The amendments made

25 by this subsection shall take effect as if included in
26

•S 1809 IS

1 the enactment of section 341 of the Personal Re2 sponsibility and Work Opportunity Reconciliation

3 Act of 1996.

4 (f) ELIMINATION OF PREDECESSOR INCENTIVE PAY5 MENT SYSTEM.—

6 (1) REPEAL.—Section 458 of the Social Secu7 rity Act (42 U.S.C. 658) is repealed.

8 (2) CONFORMING AMENDMENTS.—

9 (A) Section 458A of the Social Security

10 Act (42 U.S.C. 658a) is redesignated as section

11 458.

12 (B) Paragraphs (1) and (2) of section

13 458(f) (as so redesignated) are each amended

14 by striking ‘‘and section 458’’.

15 (C) Subsections (c) and (d) of this section

16 are each amended by striking ‘‘458A’’ each

17 place it appears and inserting ‘‘458’’.

18 (3) EFFECTIVE DATE.—The amendments made

19 by this subsection shall take effect on October 1,

20 2003.

21 (g) GENERAL EFFECTIVE DATE.—Except as other22 wise provided in this section, the amendments made by

23 this section shall take effect on October 1, 1999.
27

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1 SEC. 3. DATA INTEGRITY.

2 (a) DUTY OF THE SECRETARY TO ENSURE RELI3 ABLE DATA.—Section 452(a) of the Social Security Act

4 (42 U.S.C. 652(a)) is amended—

5 (1) in paragraph (10), by striking ‘‘and’’ at the

6 end;

7 (2) in paragraph (11), by striking the period

8 and inserting ‘‘; and’’; and

9 (3) by adding at the end the following:

10 ‘‘(12) ensure that data required for the oper11 ation of State programs under this part is complete

12 and reliable by providing Federal guidance, technical

13 assistance, and monitoring.’’.

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

15 subsection (a) shall take effect on the date of enactment

16 of this Act.

17 SEC. 4. ELIMINATION OF BARRIERS TO THE EFFECTIVE ES18 TABLISHMENT AND ENFORCEMENT OF MEDI19 CAL CHILD SUPPORT.

20 (a) PROMULGATION OF NATIONAL STANDARDIZED

21 MEDICAL SUPPORT NOTICE.—Section 452(a) of the So22 cial Security Act (42 U.S.C. 652(a)), as amended by sec23 tion 3(a), is amended—

24 (1) in paragraph (11), by striking ‘‘and’’ at the

25 end;
28

•S 1809 IS

1 (2) in paragraph (12), by striking the period

2 and inserting ‘‘; and’’; and

3 (3) by adding at the end the following:

4 ‘‘(13)(A) develop jointly with the Secretary of

5 Labor—

6 ‘‘(i) a National Standardized Medical Sup7 port Notice that satisfies the requirements of

8 section 609(a)(3) of the Employee Retirement

9 Income Security Act of 1974 (29 U.S.C.

10 1169(a)(3)) and the requirements of this part

11 and shall be used by States to enforce medical

12 support orders; and

13 ‘‘(ii) appropriate procedures for the trans14 mission of such Notice to employers by State

15 agencies administering the program established

16 under this part;

17 ‘‘(B) not later than 90 days after the date of

18 enactment of this paragraph, establish with the Sec19 retary of Labor, a medical support working group,

20 not to exceed 20 individuals, that shall—

21 ‘‘(i) identify the impediments to the effec22 tive enforcement of medical support by State

23 agencies administering the program established

24 under this part; and

25 ‘‘(ii) be composed of representatives of—
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•S 1809 IS

1 ‘‘(I) the Department of Labor;

2 ‘‘(II) the Department of Health and

3 Human Services;

4 ‘‘(III) State directors of programs

5 under this part;

6 ‘‘(IV) State directors of the medicaid

7 program under title XIX;

8 ‘‘(V) employers, including owners of

9 small businesses;

10 ‘‘(VI) plan administrators and plan

11 sponsors of group health plans (as defined

12 in section 607(1) of the Employee Retire13 ment Income Security Act of 1974 (29

14 U.S.C. 1167(1));

15 ‘‘(VII) children potentially eligible for

16 medical support, such as child advocacy or17 ganizations; and

18 ‘‘(VIII) State public welfare pro19 grams;

20 ‘‘(C) require the working group established in

21 accordance with subparagraph (B) to—

22 ‘‘(i) not later than 18 months after the

23 date of enactment of this paragraph, submit to

24 the Secretary and Congress a report containing

25 recommendations for appropriate measures to
30

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1 address the impediments to the effective en2 forcement of medical support by State agencies

3 administering the program established under

4 this part identified by the working group, in5 cluding—

6 ‘‘(I) appropriate measures that estab7 lish the priority of withholding of child

8 support obligations, medical support obli9 gations, arrearages in such obligations,

10 and, in the case of a medical support obli11 gation, the employee’s portion of any

12 health care coverage premium, by the

13 State agency administering the program

14 established under this part in light of the

15 restrictions on garnishment provided under

16 title III of the Consumer Credit Protection

17 Act (15 U.S.C. 1671–1677);

18 ‘‘(II) appropriate procedures for co19 ordinating the provision, enforcement, and

20 transition of health care coverage under

21 the State programs established under this

22 part, title XIX, and title XXI;

23 ‘‘(III) appropriate measures to im24 prove the enforcement of alternate types of

25 medical support that are aside from health
31

•S 1809 IS

1 coverage offered through the noncustodial

2 parent’s health plan and unrelated to the

3 noncustodial parent’s employer, including

4 measures that establish a noncustodial

5 parent’s responsibility to share the cost of

6 a copayment, deductible, or a payment for

7 services not covered under a child’s exist8 ing health coverage; and

9 ‘‘(IV) appropriate measures for elimi10 nating any other impediments to the effec11 tive enforcement of medical support orders

12 that the working group deems necessary;

13 and

14 ‘‘(D) issue, under the authority of the Sec15 retary—

16 ‘‘(i) not later than 180 days after the date

17 of enactment of this paragraph, a proposed reg18 ulation that specifies that the National Stand19 ardized Medical Support Notice shall be used

20 by State agencies administering the program

21 under this part to enforce medical support or22 ders, and that includes such procedures for

23 transmission of the Notice to employers that

24 the Secretary determines are appropriate; and
32

•S 1809 IS

1 ‘‘(ii) not later than 1 year after the date

2 of enactment of this paragraph, a final regula3 tion that specifies that the National Standard4 ized Medical Support Notice shall be used by

5 State agencies administering the program under

6 this part to enforce medical support orders and

7 the procedures for the transmission of that No8 tice to employers.’’.

9 (b) REQUIRED USE OF NOTICE BY STATES.—

10 (1) STATE PROCEDURES.—Section 466(a)(19)

11 of the Social Security Act (42 U.S.C. 466(a)(19)) is

12 amended to read as follows:

13 ‘‘(19) HEALTH CARE COVERAGE.—Procedures

14 under which—

15 ‘‘(A) all child support orders enforced pur16 suant to this part include a provision for the

17 health care coverage of the child that, not later

18 than October 1, 2000, is enforced, where appro19 priate, through the use of the National Stand20 ardized Medical Support Notice promulgated

21 pursuant to section 452(a)(13);

22 ‘‘(B) in any case in which a noncustodial

23 parent is required to provide such health care

24 coverage and the employer of such noncustodial

25 parent is known to the State agency, the State
33

•S 1809 IS

1 agency shall use the National Standardized

2 Medical Support Notice to transfer notice of the

3 provision for the health care coverage of the

4 child to the employer in conjunction, where ap5 propriate, with an income withholding notice

6 within 2 days of the date that information re7 garding a newly hired employee is entered in

8 the State Directory of New Hires pursuant to

9 section 453A(e), and to any subsequent em10 ployer if the parent changes employment or ob11 tains additional employment and the subsequent

12 employer of such noncustodial parent is known

13 to the State agency;

14 ‘‘(C) not later than 7 business days after

15 the date the National Standardized Medical

16 Support Notice is issued, the Notice shall oper17 ate to enroll the child in the noncustodial par18 ent’s employer’s health plan, and to authorize

19 the collection of any employee contributions re20 quired for such enrollment, unless the noncusto21 dial parent contests enforcement of the health

22 care coverage provision of the child support

23 order pursuant to the Notice to the State agen24 cy based on mistake of fact; and
34

•S 1809 IS

1 ‘‘(D) the employer shall, within 21 days

2 after the date the Notice is issued, notify the

3 State agency administering the program under

4 this part whether such health care coverage is

5 available and, if so, whether the child has been

6 enrolled in such coverage and the effective date

7 of the enrollment, and provide to the custodial

8 parent any necessary documentation to provide

9 the child with coverage.’’.

10 (2) CONFORMING AMENDMENTS.—Section

11 452(f) of the Social Security Act (42 U.S.C. 652(f))

12 is amended in the first sentence—

13 (A) by striking ‘‘petition for the inclusion

14 of’’ and inserting ‘‘include’’; and

15 (B) by inserting ‘‘and enforce medical sup16 port’’ before ‘‘whenever’’.

17 (c) NATIONAL STANDARDIZED MEDICAL SUPPORT

18 NOTICE DEEMED A QUALIFIED MEDICAL CHILD SUP19 PORT ORDER.—

20 (1) AMENDMENT TO ERISA.—Section 609(a)(5)

21 of the Employee Retirement Income Security Act of

22 1974 (29 U.S.C. 1169(a)(5)) is amended by adding

23 at the end the following:

24 ‘‘(C) NATIONAL STANDARDIZED MEDICAL

25 SUPPORT NOTICE DEEMED TO BE A QUALIFIED
35

•S 1809 IS

1 MEDICAL CHILD SUPPORT ORDER.—If a group

2 health plan administrator receives a completed

3 National Standardized Medical Support Notice

4 promulgated pursuant to section 452(a)(13) of

5 the Social Security Act (42 U.S.C. 652(a)(13)),

6 and the notice meets the requirements of para7 graphs (3) and (4), the notice shall, not later

8 than 7 business days after the date the Na9 tional Standardized Medical Support Notice is

10 issued, be deemed to be a qualified medical

11 child support order and the plan administrator

12 shall comply with the notice.’’.

13 (2) RULE OF CONSTRUCTION.—The amendment

14 made by paragraph (1) shall not be construed as re15 quiring an employer to provide or expand any health

16 benefits coverage provided by the employer that the

17 employer is not, as of the date of enactment of this

18 section, required to provide, or to modify or change

19 the eligibility rules applicable to a group health plan

20 (as defined in section 607(1) of the Employee Re21 tirement Income Security Act of 1974 (29 U.S.C.

22 1167(1))).

23 (d) REPORT AND RECOMMENDATIONS REGARDING

24 THE ENFORCEMENT OF QUALIFIED MEDICAL SUPPORT

25 ORDERS UNDER ERISA.—Not later than 1 year after the
36

•S 1809 IS

1 date of enactment of this Act, the Secretary of Labor, in

2 consultation with the Secretary of Health and Human

3 Services, shall submit to the Committee on Labor and

4 Human Resources and the Committee on Finance of the

5 Senate, and the Committee on Education and the Work6 force and the Committee on Ways and Means of the House

7 of Representatives, a report containing recommendations

8 for appropriate legislation to improve the effectiveness of,

9 and enforcement of, qualified medical child support orders

10 under the provisions of section 609 of the Employee Re11 tirement Income Security Act of 1974 (29 U.S.C. 1169).

Æ