(2) ensures that, after December 31 of the last 
calendar year ending before the first calendar year 
in which coverage under a HAPI plan begins, each 
such individual continues to receive medical assist-
ance under State Medicaid programs in a manner 
that— 
(A) is provided in coordination with, and 
as a supplement to, the coverage provided the 
individual under the HAPI plans in which the 
individual is enrolled; 
(B) does not supplant the individual’s cov-
erage under a HAPI plan; and 
(C) ensures that the individual receives 
any items or services that are not available 
under the HAPI plan in which the individual is 
enrolled but that the individual would have re-
ceived under the Medicaid program of the State 
in which the individual resides if the Healthy 
Americans Act had not been enacted. 
(b) DEFINITIONS.—In this section— 
(1) the term ‘‘institutionalized care’’ means the 
health care provided under the Medicaid plan of the 
State of residence of an elderly or disabled individual 
who is a patient in a hospital, nursing facility, inter-
mediate care facility for the mentally retarded, or an 
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institution for mental diseases (as such terms are 
defined for purposes of such plan); and 
(2) the term ‘‘home and community-based serv-
ices’’ means any services which may be offered 
under the Medicaid plan of the State of residence of 
an elderly or disabled individual under a home and 
community-based waiver authorized for a State 
under section 1115 of the Social Security Act (42 
U.S.C. 1315) or under subsection (c), (d), or (i) of 
section 1915 of such Act (42 U.S.C. 1396n). 
TITLE IV—HEALTHIER 
MEDICARE 
Subtitle A—Authority To Adjust 
Amount of Part B Premium To 
Reward Positive Health Behav-
ior 
SEC. 401. AUTHORITY TO ADJUST AMOUNT OF MEDICARE 
PART B PREMIUM TO REWARD POSITIVE 
HEALTH BEHAVIOR. 
Section 1839 of the Social Security Act (42 U.S.C. 
1395r) is amended— 
(1) in subsection (a)(2), by striking ‘‘and (i)’’ 
and inserting ‘‘(i), and (j)’’; and 
(2) by adding at the end the following new sub-
section: 
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‘‘(j)(1) With respect to the monthly premium amount 
for months after December 2008, the Secretary may ad-
just (under procedures established by the Secretary) the 
amount of such premium for an individual based on 
whether or not the individual participates in certain 
healthy behaviors, such as weight management, exercise, 
nutrition counseling, refraining from tobacco use, desig-
nating a health home, and other behaviors determined ap-
propriate by the Secretary. 
‘‘(2) In making the adjustments under paragraph (1) 
for a month, the Secretary shall ensure that the total 
amount of premiums to be paid under this part for the 
month is equal to the total amount of premiums that 
would have been paid under this part for the month if 
no such adjustments had been made, as estimated by the 
Secretary.’’. 
Subtitle B—Promoting Primary 
Care for Medicare Beneficiaries 
SEC. 411. PRIMARY CARE SERVICES MANAGEMENT PAY-
MENT. 
Title XVIII of the Social Security Act (42 U.S.C. 
1395 et seq.) is amended by inserting after section 1807 
the following new section: 
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‘‘SEC. 1807A. PRIMARY CARE MANAGEMENT PAYMENT FOR 
COORDINATING CARE. 
‘‘(a) PAYMENT.— 
‘‘(1) IN GENERAL.—Not later than January 1, 
2008, the Secretary, subject to paragraph (2), shall 
establish procedures for providing primary care and 
participating providers with a management fee (as 
determined appropriate by the Secretary, in con-
sultation with the Medicare Payment Advisory Com-
mission established under section 1805) that reflects 
the amount of time spent with a Medicare bene-
ficiary, and the family of such beneficiary, providing 
chronic care disease management services or other 
services in assisting in coordinating care. 
‘‘(2) REQUIREMENT
FOR
DESIGNATION
AS 
HEALTH HOME.—The management fee under para-
graph (1) shall not be provided to a primary care 
provider with respect to a Medicare beneficiary un-
less the provider has been designated (under proce-
dures established by the Secretary) as the health 
home by the beneficiary. 
‘‘(b) DEFINITIONS.—In this section: 
‘‘(1) HEALTH HOME.—The term ‘health home’ 
means a health care provider that a Medicare bene-
ficiary has designated to monitor the health and 
health care of the beneficiary. 
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‘‘(2) 
MEDICARE
BENEFICIARY.—The 
term 
‘Medicare beneficiary’ means an individual who is 
entitled to, or enrolled for, benefits under part A, 
enrolled under part B, or both. 
‘‘(3) PRIMARY CARE PROVIDER.— 
‘‘(A) IN
GENERAL.—The term ‘primary 
care provider’ means a primary care physician 
(as defined in subparagraph (B), a nurse prac-
titioner (as defined in section 1861aa(5)(A)), or 
a physician assistant (as so defined). 
‘‘(B) PRIMARY CARE PHYSICIAN.—In sub-
paragraph (A), the term ‘primary care physi-
cian’ means a physician, such as a family prac-
titioner or internist, who is chosen by an indi-
vidual to provide continuous medical care, who 
is able to give a wide range of care, including 
prevention and treatment, and who can refer 
the individual to a specialist.’’. 
Subtitle C—Chronic Care Disease 
Management 
SEC. 421. CHRONIC CARE DISEASE MANAGEMENT. 
Title XVIII of the Social Security Act (42 U.S.C. 
1395 et seq.), as amended by section 411, is amended by 
inserting after section 1807A the following new section: 
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‘‘SEC. 1807B. CHRONIC CARE DISEASE MANAGEMENT PRO-
GRAM. 
‘‘(a) ESTABLISHMENT.— 
‘‘(1) IN GENERAL.—Not later than January 1, 
2008, the Secretary shall develop and implement a 
chronic care disease management program (in this 
section referred to as the ‘program’). The program 
shall be designed to provide chronic care disease 
management to all Medicare beneficiaries with re-
spect to at least the 5 most prevalent diseases within 
the population of such beneficiaries (as determined 
by the Secretary). 
‘‘(2) DEVELOPMENT.—In developing and imple-
menting the program under paragraph (1), the Sec-
retary shall— 
‘‘(A) take into consideration— 
‘‘(i) the results of chronic care im-
provement programs conducted under sec-
tion 1807, including the independent eval-
uations of such programs conducted under 
section 1807(b)(5) and any outcomes re-
ports 
submitted 
under 
section 
1807(e)(4)(A); and 
‘‘(ii) the results of the payments to 
primary care providers under section 
1807A; and 
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‘‘(B) consult individuals with expertise in 
chronic care disease management. 
‘‘(b) IDENTIFICATION AND ENROLLMENT.—The Sec-
retary shall establish procedures for identifying and enroll-
ing Medicare beneficiaries who may benefit from participa-
tion in the program. 
‘‘(c) CHRONIC CARE DISEASE MANAGEMENT PAY-
MENT FOR NON-PRIMARY CARE PHYSICIANS.— 
‘‘(1) IN GENERAL.—Under the program, a non- 
primary care physician shall receive a chronic care 
disease management payment if the physician serves 
the Medicare beneficiary by assuring the beneficiary 
receives appropriate and comprehensive care, includ-
ing referral of the individual to specialists, and as-
suring the beneficiary receives preventive services. 
‘‘(2) AMOUNT OF PAYMENT.—The amount of 
the management payment under the program shall 
be an amount determined appropriate by the Sec-
retary, in consultation with the Medicare Payment 
Advisory Commission established under section 
1805. Such amount shall reflect the amount of time 
spent with a Medicare beneficiary, and the family of 
such beneficiary, providing chronic care disease man-
agement services. 
‘‘(d) DEFINITIONS.—In this section: 
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‘‘(1) 
MEDICARE
BENEFICIARY.—The 
term 
‘Medicare beneficiary’ means an individual who is 
entitled to, or enrolled for, benefits under part A, 
enrolled under part B, or both. 
‘‘(2) NON-PRIMARY
CARE
PHYSICIAN.—The 
term ‘non-primary care physician’ means a physician 
who— 
‘‘(A) is not a primary care physician (as 
defined in section 1807A (b)(3)(B)); and 
‘‘(B) provides chronic care disease manage-
ment services to a Medicare beneficiary under 
the program.’’. 
SEC. 422. CHRONIC CARE EDUCATION CENTERS. 
(a) ESTABLISHMENT.—The Secretary shall establish 
Chronic Care Education Centers. 
(b) PURPOSE.—The Chronic Care Education Centers 
established under subsection (a) shall serve as clearing-
houses for information on health care providers who have 
expertise in the management of chronic disease. 
(c) USE OF CERTAIN INFORMATION.—In developing 
the information described in subsection (b), the Secretary 
shall utilize— 
(1) information on the performance of providers 
in chronic disease demonstration projects and pay 
for performance efforts; and 
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(2) additional information determined appro-
priate by the Secretary. 
Subtitle D—Improving Quality in 
Hospitals for All Patients 
SEC. 431. IMPROVING QUALITY IN HOSPITALS FOR ALL PA-
TIENTS. 
(a) IMPROVING HEALTHCARE QUALITY FOR ALL PA-
TIENTS.— 
(1) IN GENERAL.—Section 1866(a)(1) of the 
Social Security Act (42 U.S.C. 1395cc(a)(1)) is 
amended— 
(A) in subparagraph (U), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (V), by striking the 
period at the end and inserting ‘‘, and’’; and 
(C) by inserting after subparagraph (V) 
the following new subparagraph: 
‘‘(W) in the case of hospitals, to demonstrate to 
accrediting bodies measurable improvement in qual-
ity control with respect to all patients and to have 
in place quality control programs that are directed 
at care for all patients and that include— 
‘‘(i) rapid response teams that can assist 
patients with unstable vital signs; 
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‘‘(ii) heart attack treatments with proven 
reliability; 
‘‘(iii) procedures that reduce medication 
errors; 
‘‘(iv) aggressive infection prevention, with 
special focus on surgeries and infections with 
the highest death rates; 
‘‘(v) procedures that reduce the threat of 
pneumonia, with special focus on the incidence 
of ventilator-related illness; and 
‘‘(vi) such other elements as the Secretary 
determines appropriate.’’. 
(2) EFFECTIVE DATE.—The amendments made 
by paragraph (1) shall apply to hospitals as of the 
date that is 4 years after the date of enactment of 
this Act. 
(b) PANEL OF INDEPENDENT EXPERTS.—Beginning 
not later than the date that is 4 years after the date of 
enactment of this Act, in order to ensure that hospitals 
practice state-of-the-art quality control, the Secretary 
shall convene a panel of independent experts to update the 
measures of quality control and the types of quality con-
trol programs, including the elements of such programs, 
required under section 1866(a)(1)(W) of the Social Secu-
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rity Act, as added by subsection (a), not less frequently 
than on an annual basis. 
Subtitle E—Additional Provisions 
SEC. 441. ADDITIONAL COST INFORMATION. 
(a) IN GENERAL.—Section 1857(e) of the Social Se-
curity Act (42 U.S.C. 1395w–27(e)) is amended by adding 
at the end the following new paragraph: 
‘‘(4) ADDITIONAL COST INFORMATION.—A con-
tract under this section shall require a Medicare Ad-
vantage Organization to aggregate claims informa-
tion into episodes of care and to provide such infor-
mation to the Secretary so that costs for specific 
hospitals and physicians may be measured and com-
pared. The Secretary shall make such information 
public on an annual basis.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply to contracts entered into on or 
after the date of enactment of this Act. 
SEC. 442. REDUCING MEDICARE PAPERWORK AND REGU-
LATORY BURDENS. 
Not later than 18 months after the date of enactment 
of this Act, the Secretary shall provide to Congress a plan 
for reducing regulations and paperwork in the Medicare 
program under title XVIII of the Social Security Act (42 
U.S.C. 1395 et seq.). Such plan shall focus initially on 
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regulations that do not directly enhance the quality of pa-
tient care provided under such program. 
TITLE V—STATE HEALTH HELP 
AGENCIES 
SEC. 501. ESTABLISHMENT. 
As a condition of receiving payment under section 
503, a State shall, not later than the date that is 4 years 
after the date of enactment of this Act, establish or des-
ignate a State agency, to be known as the State ‘‘Health 
Help Agency’’ (referred to in this Act as a ‘‘HHA’’) to— 
(1) carry out the administration of HAPI plans 
to individuals in such State; and 
(2) carry out the functions described in section 
502. 
SEC. 502. RESPONSIBILITIES AND AUTHORITIES. 
(a) PROMOTION OF PREVENTION AND WELLNESS.— 
Each HHA shall promote prevention and wellness for all 
State residents, including through the implementation of 
programs that— 
(1) educate residents about responsibility for in-
dividual health and the health of children; 
(2) upon request, distribute information to cov-
ered individuals regarding the availability of wellness 
programs; 
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(3) make available to the public, with respect to 
each health insurance issuer and each HAPI plan, 
the number of covered individuals who have des-
ignated a health home described in section 111(b); 
and 
(4) promote the use and understanding of 
health information technology. 
(b) ENROLLMENT OVERSIGHT.—Each HHA shall 
oversee enrollment in HAPI plans by— 
(1) providing standardized, unbiased informa-
tion on HAPI plans and supplemental health insur-
ance options; 
(2) not less than once per year, administering 
open enrollment periods for individuals; 
(3) allowing a covered individual to make en-
rollment changes during a 30-day period following 
marriage, divorce, birth, adoption or placement for 
adoption, and other circumstances; 
(4) establish procedures for health insurance 
issuers to report to the HHA of each State in which 
the issuer offers a HAPI plan, the health insurance 
status of State residents in order for the HHA to 
report annual on the number of uninsured and other 
relevant data; 
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(5) establish procedures for default enrollment 
of uninsured individuals into low-cost HAPI plans 
for individuals or families who do not enroll, are not 
covered under a health plan offered through a pro-
gram described in paragraphs (1)(A) of section 
102(a), and are not described in paragraph (1)(B) 
of such section; 
(6) establish procedures for hospitals and other 
providers to report to the HHA if an individual 
seeks care and is uninsured or does not know his or 
her health insurance status; 
(7) ensure that the enrollment of all individuals 
into HAPI plans, including those individuals assisted 
by an employer, insurance agent, or other person, is 
administered by the HHA; 
(8) develop standardized language for HAPI 
plan terms and conditions and require participating 
health insurance issuers to use such language in 
plan information documents; 
(9) provide prospective enrollees with a com-
parative document that describes all the HAPI plans 
in which the individual may enroll; and 
(10) to assist consumers in choosing a HAPI 
plan, publish information that includes loss ratios, 
outcome data regarding wellness programs, disease 
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detection and chronic care management programs 
categorized by health insurance issuer, and other 
data as the HHA determines appropriate. 
(c) DETERMINATION
AND
ADMINISTRATION
OF 
HAPI PLAN SUBSIDIES.—Each HHA shall oversee the 
determination and administration of HAPI plan subsidies 
by— 
(1) informing State residents about how subsidy 
eligibility determinations are made; 
(2) obtaining necessary information about in-
come from individuals and Federal and State agen-
cies; 
(3) making eligibility determinations on an indi-
vidual basis and informing individuals of such deter-
minations; 
(4) establishing a process by which an indi-
vidual may appeal an eligibility determination; 
(5) collecting from health insurance issuers an 
administrative fee for joining the HHA system and 
offering a HAPI plan in a State; 
(6) collecting premium payments made by, or 
on behalf of, covered individuals, and remitting such 
payments to the HAPI plans; and 
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(7) collecting Federal premium subsidies for 
covered individuals and remitting such subsidies to 
HAPI plans. 
(d) PREMIUM RATING RULES.—Each HHA shall en-
sure that the premium payments for each HAPI plan are 
determined in accordance with the rating rules described 
in section 111(d). 
(e) EMPOWERMENT
OF
INDIVIDUALS
TO
MAKE 
HEALTH CARE DECISIONS.—Each HHA shall, upon en-
rollment of an individual in a HAPI plan, provide such 
individual with information regarding— 
(1) the right of individuals to refuse treatment 
and to make end-of-life care decisions; 
(2) State laws relating to end-of-life care, in-
cluding applicable State law with respect to health 
care proxies, advanced directives, living wills, and 
other documentation by which individuals may make 
their care decisions known; 
(3) contact information for any State end-of-life 
care advocates; and 
(4) applicable State forms on health proxies, 
advanced directives, living wills, and other such doc-
umentation. 
(f) DETERMINATION OF PLAN COVERAGE AREAS.— 
Each HHA shall establish, and may revise, HAPI plan 
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coverage areas for the State in which the HHA is located. 
The service area of a HAPI plan shall consist of an entire 
coverage area established under the preceding sentence. 
(g) COOPERATION AMONG STATES.—States that 
share 1 or more metropolitan statistical area may enter 
into agreements to share administrative responsibilities 
described under this section. 
(h) TRANSITION FROM MEDICAID AND SCHIP; CO-
ORDINATION OF SUPPLEMENTAL MEDICAL ASSISTANCE 
FOR ELDERLY AND DISABLED MEDICAID ELIGIBLES.— 
Each HHA shall work with the Secretary to ensure that 
the requirements of section 301 of this Act, section 1941 
of the Social Security Act (as added by section 673(a) of 
this Act), and subsections (a) and (b) of section 1940 of 
the Social Security Act (as added by section 311 of this 
Act) are met. 
SEC. 503. APPROPRIATIONS FOR TRANSITION TO STATE 
HEALTH HELP AGENCIES. 
(a) APPROPRIATION.—There is authorized to be ap-
propriated and there is appropriated, for each of the 4 
full fiscal years immediately following the date of enact-
ment of this Act, such sums as may be necessary for the 
purpose of enabling each State to carry out the purposes 
of this title. The sums made available under this section 
shall be used for making payments to States that have 
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submitted, and had approved by the Secretary, an HHA 
plan under this section. 
(b) SUBMISSION OF STATE HHA PLAN.—Each HHA 
plan submitted by a State shall provide for— 
(1) the establishment of an HHA within such 
State by the date that is 4 years after the date of 
enactment of this Act; 
(2) the administration by with State of such 
HHA in accordance with the requirements described 
under this Act; and 
(3) the compliance by the State of the require-
ments described under section 631. 
(c) PAYMENT TO STATES.—From the sums appro-
priated under subsection (a), the Secretary shall pay to 
each State that has an HHA plan approved under this 
section, an amount necessary for the State to implement 
such plan for the applicable fiscal year. 
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TITLE VI—SHARED 
RESPONSIBILITIES 
Subtitle A—Individual 
Responsibilities 
SEC. 601. INDIVIDUAL RESPONSIBILITY TO ENSURE HAPI 
PLAN COVERAGE. 
(a) OPEN SEASON.—An adult individual, on behalf 
of such individual and the dependent children of such indi-
vidual, shall— 
(1) enroll in a HAPI plan through the HHA of 
the individual’s State of residence during an open 
enrollment period; and 
(2) submit necessary documentation to the ap-
plicable HHA so that such HHA may determine in-
dividual eligibility for premium and personal respon-
sibility contribution subsidies. 
An adult individual may carry out the activities described 
under paragraphs (1) and (2) on behalf of the spouse of 
such adult individual. 
(b) DURING PLAN YEAR.—A covered individual 
shall— 
(1) submit any required monthly premium pay-
ments; 
(2) submit any personal responsibility contribu-
tions as required; and 
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(3) inform such HHA of any changes in the 
family status or residence of such individual. 
Subtitle B—Employer 
Responsibilities 
SEC. 611. HEALTH CARE RESPONSIBILITY PAYMENTS. 
(a) PAYMENT REQUIREMENTS.— 
(1) IN GENERAL.—Subtitle C of the Internal 
Revenue Code of 1986 is amended by inserting after 
chapter 24 the following new chapter: 
‘‘CHAPTER 24A—HEALTH CARE 
RESPONSIBILITY PAYMENTS 
‘‘SUBCHAPTER A—EMPLOYER SHARED RESPONSIBILITY PAYMENTS 
‘‘SUBCHAPTER B—INDIVIDUAL SHARED RESPONSIBILITY PAYMENTS 
‘‘SUBCHAPTER C—GENERAL PROVISIONS 
‘‘Subchapter A—Employer Shared 
Responsibility Payments 
‘‘Sec. 3411. Payment requirement. 
‘‘Sec. 3412. Instrumentalities of the United States. 
‘‘SEC. 3411. PAYMENT REQUIREMENT. 
‘‘(a) EMPLOYER
SHARED
RESPONSIBILITY
PAY-
MENTS.—Every employer shall pay an employer shared re-
sponsibility payment for each calendar year in an amount 
equal to the product of— 
‘‘(1) the number of full-time equivalent employ-
ees employed by the employer during the preceding 
calendar year, multiplied by 
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‘‘(2) the applicable percentage of the average 
HAPI plan premium amount for such calendar year. 
‘‘(b) APPLICABLE PERCENTAGE.—For purposes of 
subsection (a)(2)— 
‘‘(1) IN GENERAL.—The applicable percentage 
shall be determined as follows: 
Revenue per employee national percentile of the 
taxpayer for the preceding calendar year: 
Large em-
ployer: 
Small em-
ployer: 
0–20th percentile ....................................................
17% 
2%
21st–40th percentile ...............................................
19% 
4%
41st–60th percentile ...............................................
21% 
6%
61st–80th percentile ...............................................
23% 
8%
81st–99th percentile ...............................................
25% 
10%. 
‘‘(2) APPLICABLE PERCENTAGE FOR CERTAIN 
NON-REVENUE PRODUCING ENTITIES.—In the case 
of an employer which is a nonprofit entity, a State 
or local government, or any other type of entity for 
which the Secretary determines that calculating rev-
enue per employee is not appropriate, the applicable 
percentage shall be— 
‘‘(A) in the case of a large employer, 17 
percent, and 
‘‘(B) in the case of a small employer, 2 
percent. 
‘‘(3) ADDITIONAL RATE FOR CERTAIN SMALL 
EMPLOYERS.— 
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‘‘(A) IN GENERAL.—In the case of a small 
employer, the applicable percentage determined 
under paragraph (1) shall be increased by 0.1 
percent for each full-time equivalent employee 
employed by the employer during the preceding 
calendar year in excess of 50. 
‘‘(B) MAXIMUM ADDITIONAL RATE.—The 
increase in the applicable percentage deter-
mined under this paragraph shall not exceed 15 
percent. 
‘‘(4) REVENUE PER EMPLOYEE NATIONAL PER-
CENTILE RANK.—At the beginning of each calendar 
year, the Secretary, in consultation with the Sec-
retary of Labor, shall publish a table, based on sam-
pling of employers, to be used in determining the na-
tional percentile for revenue per employee amounts 
for the preceding calendar year. 
‘‘(5) INCREASED
TRANSITIONAL
RATES
FOR 
LARGE EMPLOYERS.—In the case of any employer 
who did not provide health insurance coverage for 
employees on the day before the date of enactment 
of the Healthy Americans Act, the table contained in 
paragraph (1) shall be applied by substituting ‘28%’ 
for ‘23%’ and by substituting ‘30%’ for ‘25%’ with 
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respect to each of the first 4 calendar years to which 
this section applies. 
‘‘(c) TEMPORARY ADDITIONAL PAYMENT FOR CER-
TAIN EMPLOYERS.—In the case of the first 4 calendar 
years to which this section applies— 
‘‘(1) IN GENERAL.—In the case of any employer 
who provided health insurance coverage for employ-
ees on the day before the date of enactment of the 
Healthy Americans Act, the employer shared respon-
sibility payment shall be increased by an amount 
equal to the excess of— 
‘‘(A) 100 percent of the designated em-
ployee health insurance premium amount of 
such employer, over 
‘‘(B) the employee salary investment 
amount. 
‘‘(2) 
EMPLOYEE
SALARY
INVESTMENT 
AMOUNT.—For purposes of this subsection— 
‘‘(A) IN
GENERAL.—The term ‘employee 
salary investment amount’ means the lesser 
of— 
‘‘(i) the excess of the amount of aver-
age yearly wages paid to all employees for 
such year over the amount of average year-
ly wages paid to such employee for the 
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year before the first year this section ap-
plies, or 
‘‘(ii) the designated employee health 
insurance premium amount of such em-
ployer. 
‘‘(B) 
NONDISCRIMINATION
RULES.—No 
amount paid by an employer shall be treated as 
an employee salary investment amount unless 
such amount is distributed to all employees on 
a basis that is proportional to the amount of 
wages paid to such employee before such dis-
tribution. 
‘‘(C) NOTICE REQUIREMENT.—No amount 
paid by an employer shall be treated as an em-
ployee salary investment amount unless the em-
ployer gives each employee notice of the amount 
of the designated employee health insurance 
premium amount paid by the employer with re-
spect to the employee. 
‘‘(D) TREATMENT OF AMOUNT.—An em-
ployee salary investment amount shall not be 
treated as income or otherwise taken into ac-
count for purposes of determining any individ-
ual’s eligibility for benefits or assistance under 
any governmental assistance program. 
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