I
104TH CONGRESS
2D SESSION
H. R. 3937
To amend title XIX of the Social Security Act with respect to preventing
the transmission of the human immunodeficiency virus (commonly known
as HIV), and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
AUGUST 1, 1996
Mr. COBURN (for himself, Ms. MOLINARI, Mr. DELAY, Mrs. FOWLER, Mr.
WELDON of Florida, Mr. NORWOOD, Mr. HUTCHINSON, Mr. LARGENT,
Mr. SOUDER, Mr. STOCKMAN, Mr. DORNAN, and Mr. HOSTETTLER) in-
troduced the following bill; which was referred to the Committee on Com-
merce
A BILL
To amend title XIX of the Social Security Act with respect
to 
preventing 
the 
transmission 
of 
the 
human
immunodeficiency virus (commonly known as HIV), and
for other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘HIV Prevention Act
of 1996’’.
SEC. 2. FINDINGS.
The Congress finds as follows:
(1) The States should recognize that the terms
‘‘acquired 
immune 
deficiency 
syndrome’’ 
and
‘‘AIDS’’ are obsolete. In the case of individuals who
are infected with the human immunodeficiency virus
(commonly known as HIV), the more important
medical fact for the individuals and for the protec-
tion of the public health is the fact of infection, and
not just the later development of AIDS (the stage at
which the infection causes symptoms). The term
‘‘HIV disease’’, meaning infection with HIV regard-
less of whether the infection has progressed to
AIDS, more correctly defines the medical condition.
(2) The medical, public health, political, and
community leadership must focus on the full course
of HIV disease rather than concentrating on later
stages of the disease. Continual focus on AIDS rath-
er than the entire spectrum of HIV disease has left
our Nation unable to deal adequately with the epi-
demic. Federal and State data collection efforts
should focus on obtaining data as early as possible
after infection occurs, while continuing to collect
data on the symptomatic stage of the disease.
(3) Recent medical breakthroughs may enable
doctors to treat HIV disease as a chronic disease
rather than as a terminal disease. Early intervention
in the progression of the infection is imperative to
prolonging and improving the lives of individuals
with the disease.
(4) The Centers for Disease Control and Pre-
vention has recommended partner notification as a
primary prevention service. The health needs of the
general public, and the care and protection of those
who do not have the disease, should be balanced
with the needs of individuals with the disease in a
manner that allows for the infected individuals to re-
ceive optimal medical care and for public health
services to protect the uninfected.
(5) Individuals with HIV disease have an obli-
gation to protect others from being exposed to HIV
by avoiding behaviors that place others at risk of be-
coming infected. Each of the States should have in
effect laws that provide that the intentional or reck-
less exposure of others to HIV is a felony, even if
the infection is not transmitted.
SEC. 3. ESTABLISHMENT OF HIV-RELATED REQUIREMENTS
IN MEDICAID PROGRAM.
(a) IN GENERAL.—Title XIX of the Social Security
Act (42 U.S.C. 1396 et seq.) is amended—
(1) in section 1902(a)—
(A) in paragraph (61), by striking ‘‘and’’
after the semicolon at the end;
(B) in paragraph (62), by striking the pe-
riod at the end and inserting ‘‘; and’’; and
(C) by inserting after paragraph (62) the
following paragraph:
‘‘(63) meet the requirements of section 1930A
(relating to the prevention of the transmission of the
human immunodeficiency virus, commonly known as
HIV).’’; and
(2) by inserting after section 1930 the following
section:
‘‘PREVENTION OF TRANSMISSION OF HIV
‘‘SEC. 
1930A. 
(a) 
For 
purposes 
of 
section
1902(a)(63), a State plan meets the requirements of this
subsection if the plan demonstrates to the satisfaction of
the Secretary that the law or regulations of the State are
in accordance with the following:
‘‘(1) The State requires that, in the case of a
health professional or other entity that provides for
the performance of a test for HIV on an individual,
the entity confidentially report positive test results
to the State public health officer, together with any
additional necessary information, in order to carry
out the following purposes:
‘‘(A) The performance of statistical and
epidemiological analyses of the incidence in the
State of cases of such disease.
‘‘(B) The performance of statistical and
epidemiological analyses of the demographic
characteristics of the population of individuals
in the State who have the disease.
‘‘(C) The assessment of the adequacy of
preventive services in the State with respect to
the disease.
‘‘(2)(A) The State requires that the public
health officer of the State carry out a program to
inform individuals that the individuals may have
been exposed to HIV (referred to in this paragraph
as ‘partner notification’). For purposes of this para-
graph, the term ‘partner’ includes the sexual part-
ners of individuals with HIV disease, and the part-
ners of such individuals in the sharing of hypo-
dermic needles for the intravenous injection of
drugs.
‘‘(B) The State requires that any information
collected for purposes of partner notification be suf-
ficient for the following purposes:
‘‘(i) To provide the partners of the in-
dividual with HIV disease with an appro-
priate opportunity to learn that the part-
ners have been exposed to HIV.
‘‘(ii) To provide the partners with
counseling and testing for HIV disease.
‘‘(iii) To provide the individual who
has the disease with information regarding
therapeutic measures for preventing and
treating the deterioration of the immune
system and conditions arising from the dis-
ease, and to provide the individual with
other preventive information.
‘‘(iv) With respect to an individual
who undergoes testing for HIV disease but
does not seek the results of the testing, to
recall and provide the individual with coun-
seling, therapeutic information, and other
information regarding preventative health
services appropriate for the individual.
‘‘(C) The State cooperates with the Director of
the Centers for Disease Control and Prevention in
carrying out a national program of partner notifica-
tion, including the sharing of information between
the public health officers of the States.
‘‘(3) With respect to a defendant against whom
an information or indictment is presented for a
crime in which by force or threat of force the per-
petrator compels the victim to engage in sexual ac-
tivity, the State requires as follows:
‘‘(A) That the defendant be tested for HIV
disease if—
‘‘(i) the nature of the alleged crime is
such that the sexual activity would have
placed the victim at risk of becoming in-
fected with HIV; or
‘‘(ii) the victim requests that the de-
fendant be so tested.
‘‘(B) That if the conditions specified in
subparagraph (A) are met, the defendant un-
dergo the test not later than 48 hours after the
date on which the information or indictment is
presented, and that as soon thereafter as is
practicable the results of the test be made avail-
able to the victim; the defendant (or if the de-
fendant is a minor, to the legal guardian of the
defendant); the attorneys of the victim; the at-
torneys of the defendant; the prosecuting attor-
neys; the judge presiding at the trial, if any;
and the principal public health official for the
local governmental jurisdiction in which the
crime is alleged to have occurred.
‘‘(C) That, if the results of the test indi-
cate that the defendant has HIV disease, such
fact may, as relevant, be considered in the judi-
cial proceedings conducted with respect to the
alleged crime.
‘‘(4)(A) With respect to a patient who is to un-
dergo an invasive medical procedure that would
place the health professionals involved at risk of be-
coming infected with HIV, the State—
‘‘(i) authorizes such health professionals to
provide that the procedure will not be per-
formed unless the patient undergoes a test for
HIV disease and the health professionals are
notified of the results of the test; and
‘‘(ii) requires that, if such test is per-
formed and the patient has positive test results,
the patient be informed of the results.
‘‘(B) The State authorizes funeral-services
practitioners to provide that invasive procedures will
not be performed unless the body involved undergoes
a test for HIV disease and the practitioners are no-
tified of the results of the test.
‘‘(5) The State requires that, if a health care
entity (including a hospital) transfers a body to a fu-
neral-services practitioner and such entity knows