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 reimburse-
ment 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.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. IDENTIFICATION OF ILLEGAL ALIENS WHO
CONSUME HEALTH RESOURCES.
(a) REQUIREMENT OF DISCLOSURE.—
(1) IN
GENERAL.—Each Federally-subsidized
health care provider (as defined in subsection (d)(1))
that provides health care services described in para-
graph (2) to an alien whom the provider knows, or
has reason to believe, is not lawfully present in the
United States shall report to an officer or employee
of the Immigration and Naturalization Service speci-
fied by the Attorney General such information relat-
ing to the identity of the alien as the Attorney Gen-
eral specifies. The information shall be reported at
or before the time of providing such services.
(2) HEALTH CARE SERVICES DESCRIBED.—The
health care services described in this paragraph are
health care items and services furnished in the
United States—
(A) by a tax-exempt health care provider,
or
(B) for which payment may be made under
a Federal health care program.
(3) ENFORCEMENT.—
(A) TAX-EXEMPT HEALTH CARE PROVID-
ERS.—If the Attorney General determines a
tax-exempt health care provider has failed to re-
port information under paragraph (1) in a
timely manner, the Attorney General shall no-
tify the Secretary of the Treasury, who shall
suspend the provider’s exemption from taxes
under section 501 of the Internal Revenue Code
of 1986 for a period of not less than 2 years.
(B) HEALTH CARE PROVIDERS RECEIVING
FUNDS UNDER FEDERAL HEALTH CARE PRO-
GRAMS.—If the Attorney General determines a
health care provider receiving payments under a
Federal health care program has failed to re-
port information under paragraph (1) in a
timely manner, the Attorney General shall no-
tify the Secretary of Health and Human Serv-
ices or other Federal official responsible for the
payment of funds under the program, who shall
(directly or through notice to the State or other
official making payments to the provider) dis-
qualify the provider from payments under the
program for a period of not less than 2 years.
(C) NOTICE AND HEARING.—The Attorney
General shall not make a determination under
this paragraph with respect to a health care
provider except after giving the provider notice
and opportunity for a hearing on the deter-
mination.
(4) PRIORITY IN DEPORTATION.—The Attorney
General shall give priority in enforcing deportation
provisions of the Immigration and Nationality Act to
the deportation of aliens who have been identified
under this subsection as being provided health care
services at public expense.
(b) ASSURING PAYMENT BY FOREIGN COUNTRIES.—
(1) IN
GENERAL.—Each Federally-subsidized
health care provider that provides health care items
and services in the United States to an alien who—
(A) is not lawfully present in the United
States, and
(B) fails to provide for payment on a time-
ly basis for any amounts owed for such services,
shall provide the Secretary of Health and Human
Services with such information regarding the nation-
ality of the alien, the items and services involved,
and the payment amounts owing as the Secretary
may specify in order to carry out this subsection.
(2) NOTICE
TO
FOREIGN
COUNTRY.—In the
case of an alien who is a national of a foreign coun-
try and who is identified under paragraph (1), the
Secretary shall provide notice to the foreign country
of the payment amounts owing and the withholding
provisions of paragraph (3).
(3) 
WITHHOLDING
OF
ASSISTANCE
FOR
AMOUNTS OWED.—Of the funds made available for
a foreign country under part I of the Foreign Assist-
ance Act of 1961, an amount equivalent to 110 per-
cent of the total amounts identified under paragraph
(1) as owing under this subsection on behalf of
aliens who are nationals of the foreign country shall
be withheld from obligation for such country until
the Secretary certifies and reports in writing to the
Congress that such amounts are fully paid.
(c) OVERRIDE OF ALIEN SHIELD LAWS.—
(1) FEDERAL LAW.—No Federal law shall pre-
vent a Federally-subsidized health care provider
from disclosing to employees and officers of the Im-
migration and Naturalization Service the identity of
individuals who appear to be aliens unlawfully in the
United States and who receive health care services
from such a provider.
(2) STATE LAW.—As a condition for the receipt
of Federal funds under title XIX of the Social Secu-
rity Act and under the Public Health Service Act for
fiscal years beginning with the first fiscal year that
begins more than 2 years after the date of the enact-
ment of this Act, each State shall repeal or other-
wise override any State law that has the effect of
preventing a Federally-subsidized health care pro-
vider from making a disclosure described in para-
graph (1).
(d) DEFINITIONS.—Except as otherwise specifically
provided, in this section:
(1) FEDERALLY-SUBSIDIZED
HEALTH
CARE
PROVIDER.—The term ‘‘Federally-subsidized health
care provider’’ means a health care provider that—
(A) is a tax-exempt health care provider,
(B) receives payments under a Federal
health care program (as defined in paragraph
(2)).
(2) FEDERAL HEALTH CARE PROGRAM.—The
term ‘‘Federal health care program’’ includes—
(A) the medicare program under title
XVIII of the Social Security Act,
(B) the medicaid program under title XIX
of such Act,
(C) the maternal and child health program
under title V of such Act, and
(D) programs under the Public Health
Service Act.
(3) SECRETARY.—The term ‘‘Secretary’’ means
the Secretary of Health and Human Services.
(4) STATE.—The term ‘‘State’’ has the mean-
ing given such term in section 101(a)(36) of the Im-
migration and Nationality Act.
(5) TAX-EXEMPT HEALTH CARE PROVIDER.—
The term ‘‘tax-exempt health care provider’’ means
a health care provider described in section 501(c)(3)
of the Internal Revenue Code of 1986.
(e) EFFECTIVE DATE.—
(1) IN GENERAL.—Except as provided in this
subsection, the provisions of this Act shall take ef-
fect on the first day of the first month beginning
more than 90 days after the date of the enactment
of this Act.
(2) STATE LAWS.—In the case of a State which
the Secretary determines requires State legislation
in order to meet the condition described in sub-
section (c)(2), the State plan of medical assistance
under title XIX of the Social Security Act shall not
be regarded as failing to comply with such condition
before the first day of the first calendar quarter be-
ginning after the close of the first regular session of
the State legislature that begins after the date of the
enactment of this Act. For purposes of the previous
sentence, in the case of a State that has a 2-year
legislative session, each year of such session shall be
deemed to be a separate regular session of the State
legislature.
Æ