I 

111TH CONGRESS 

1ST SESSION H. R. 2849 

To require the Secretary of Health and Human Services to enter into agreements with States to resolve outstanding claims for reimbursement under 

the Medicare Program relating to the Special Disability Workload project. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 12, 2009 

Ms. SCHWARTZ introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy 

and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To require the Secretary of Health and Human Services 

to enter into agreements with States to resolve outstanding claims for reimbursement under the Medicare 

Program relating to the Special Disability Workload 

project. 

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 ‘‘Special Disability 

5 Workload Liability Resolution Act of 2009’’. 


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1 SEC. 2. PAYMENT OF MEDICARE LIABILITY TO STATES AS A 

2 RESULT OF THE SPECIAL DISABILITY WORK3 LOAD PROJECT. 

4 (a) IN GENERAL.—The Secretary, in consultation 

5 with the Commissioner, shall work with each State to 

6 reach an agreement, not later than 6 months after the 

7 date of enactment of this Act, on the amount of a payment 

8 for the State related to the Medicare program liability as 

9 a result of the Special Disability Workload project, subject 

10 to the requirements of subsection (c). 

11 (b) PAYMENTS.— 

12 (1) DEADLINE FOR MAKING PAYMENTS.—Not 

13 later than 30 days after reaching an agreement with 

14 a State under subsection (a), the Secretary shall pay 

15 the State, from the amounts appropriated under 

16 paragraph (2), the payment agreed to for the State. 

17 (2) APPROPRIATION.—Out of any money in the 

18 Treasury not otherwise appropriated, there is appro19 priated $4,000,000,000 for fiscal year 2010 for 

20 making payments to States under paragraph (1). 

21 (3) LIMITATIONS.—In no case may the aggre22 gate amount of payments made by the Secretary to 

23 States under paragraph (1) exceed $4,000,000,000. 

24 (c) REQUIREMENTS.—The requirements of this sub25 section are the following: 


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1 (1) FEDERAL DATA USED TO DETERMINE

2 AMOUNT OF PAYMENTS.—The amount of the pay3 ment under subsection (a) for each State is deter4 mined on the basis of the most recent Federal data 

5 available, including the use of proxies and reasonable 

6 estimates as necessary, for determining expeditiously 

7 the amount of the payment that shall be made to 

8 each State that enters into an agreement under this 

9 section. The payment methodology shall consider the 

10 following factors: 

11 (A) The number of SDW cases found to 

12 have been eligible for benefits under the Medi13 care program and the month of the initial 

14 Medicare program eligibility for such cases. 

15 (B) The applicable non-Federal share of 

16 expenditures made by a State under the Med17 icaid program during the time period for SDW 

18 cases. 

19 (C) Such other factors as the Secretary 

20 and the Commissioner, in consultation with the 

21 States, determine appropriate. 

22 (2) CONDITIONS FOR PAYMENTS.—A State 

23 shall not receive a payment under this section unless 

24 the State— 


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1 (A) waives the right to file a civil action 

2 (or to be a party to any action) in any Federal 

3 or State court in which the relief sought in4 cludes a payment from the United States to the 

5 State related to the Medicare liability under 

6 title XVIII of the Social Security Act (42 

7 U.S.C. 1395 et seq.) as a result of the Special 

8 Disability Workload project; and 

9 (B) releases the United States from any 

10 further claims for reimbursement of State ex11 penditures as a result of the Special Disability 

12 Workload project (other than reimbursements 

13 being made under agreements in effect on the 

14 date of enactment of this Act as a result of 

15 such project, including payments made pursu16 ant to agreements entered into under section 

17 1616 of the Social Security Act or section 

18 211(1)(1)(A) of Public Law 93–66). 

19 (3) NO INDIVIDUAL STATE CLAIMS DATA RE20 QUIRED.—No State shall be required to submit indi21 vidual claims evidencing payment under the Med22 icaid program as a condition for receiving a payment 

23 under this section. 

24 (4) INELIGIBLE STATES.—No State that is a 

25 party to a civil action in any Federal or State court 


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1 in which the relief sought includes a payment from 

2 the United States to the State related to the Medi3 care liability under title XVIII of the Social Security 

4 Act (42 U.S.C. 1395 et seq.) as a result of the Spe5 cial Disability Workload project shall be eligible to 

6 receive a payment under this section while such an 

7 action is pending or if such an action is resolved in 

8 favor of the State. 

9 (d) DEFINITIONS.—In this section: 

10 (1) COMMISSIONER.—The term ‘‘Commis11 sioner’’ means the Commissioner of Social Security. 

12 (2) MEDICAID PROGRAM.—The term ‘‘Medicaid 

13 program’’ means the program of medical assistance 

14 established under title XIX of the Social Security 

15 Act (42 U.S.C. 1396a et seq.) and includes medical 

16 assistance provided under any waiver of that pro17 gram approved under section 1115 or 1915 of such 

18 Act (42 U.S.C. 1315, 1396n) or otherwise. 

19 (3) MEDICARE PROGRAM.—The term ‘‘Medicare 

20 program’’ means the program established under title 

21 XVIII of the Social Security Act (42 U.S.C. 1395 et 

22 seq.). 

23 (4) SECRETARY.—The term ‘‘Secretary’’ means 

24 the Secretary of Health and Human Services. 


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1 (5) SDW CASE.—The term ‘‘SDW case’’ means 

2 a case in the Special Disability Workload project in3 volving an individual determined by the Commis4 sioner to have been eligible for benefits under title 

5 II of the Social Security Act (42 U.S.C. 401 et seq.) 

6 for a period during which such benefits were not 

7 provided to the individual and who was, during all 

8 or part of such period, enrolled in a State Medicaid 

9 program. 

10 (6) SPECIAL DISABILITY WORKLOAD

11 PROJECT.—The term ‘‘Special Disability Workload 

12 project’’ means the project described in the 2008 

13 Annual Report of the Board of Trustees of the Fed14 eral Old-Age and Survivors Insurance and Federal 

15 Disability Insurance Trust Funds, H.R. Doc. No. 

16 110–104, 110th Cong. (2008). 

17 (7) STATE.—The term ‘‘State’’ means each of 

18 the 50 States and the District of Columbia. 

Æ 


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