I
104TH CONGRESS
2D SESSION
H. R. 2883
To amend title XIX to the Social Security Act to eliminate the requirement
for States to seek recovery of medical assistance properly paid and
to restrict the use of liens and such recovery in any MediGrant program
and any other future medical assistance programs, and for other pur-
poses.
IN THE HOUSE OF REPRESENTATIVES
JANUARY 25, 1996
Mr. BRYANT of Texas introduced the following bill; which was referred to the
Committee on Commerce
A BILL
To amend title XIX to the Social Security Act to eliminate
the requirement for States to seek recovery of medical
assistance properly paid and to restrict the use of liens
and such recovery in any MediGrant program and any
other future medical assistance programs, 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 ‘‘Family Farm and
Home Protection Act’’.
SEC. 2. REVISION OF STATE AUTHORITY IN IMPOSING
LIENS AND RECOVERING FOR MEDICAL AS-
SISTANCE PROPERLY MADE.
(a) ELIMINATING MEDICAID MANDATE FOR STATE
RECOVERIES.—Subsection (b)(1) of section 1917 of the
Social Security Act (42 U.S.C. 1396p) is amended by
striking ‘‘except that’’ and all that follows and inserting
the following: ‘‘except—
‘‘(A) in the case of an individual described in
subsection (a)(1)(B), from the individual’s estate or
upon sale of the property, subject to a lien imposed
on account of medical assistance paid on behalf of
such individual, and
‘‘(B) in the case of any other individual who is
65 years of age or older, when the individual re-
ceived such assistance, from the individual’s estate.’’.
(b) REVISION OF DEFINITION OF ESTATE.—Section
1917(b)(4) of such Act (42 U.S.C. 1396p(b)(4)) is amend-
ed—
(1) by striking ‘‘deceased individual’’ and all
that follows through ‘‘(A) shall’’ and inserting ‘‘de-
ceased individual shall’’, and
(2) by striking subparagraph (B).
(c) EFFECTIVE DATE.—The amendment made by
subsection (a) shall apply to medical assistance furnished
on or after the date of the enactment of this Act and the
amendments made by subsection (b) shall apply to individ-
uals dying on or after such date of enactment.
SEC. 3. RESTRICTING RECOVERY OF MEDICAL ASSISTANCE
PROPERLY PAID IN OTHER FEDERALLY AS-
SISTED MEDICAL ASSISTANCE PROGRAMS.
(a) IN GENERAL.—Notwithstanding any other provi-
sion of law, no Federal funds shall be paid to a State
under a State medical assistance program (as defined in
subsection (d)) unless the conditions of subsections (b)
and (c) are met.
(b) LIMITATION ON IMPOSITION OF LIENS.—
(1) IN
GENERAL.—No lien may be imposed
against the property of any individual prior to his
death on account of medical assistance paid or to be
paid on his behalf under the State medical assist-
ance program, except—
(A) pursuant to the judgment of a court
on account of benefits incorrectly paid on behalf
of such individual, or
(B) in the case of the real property of an
individual—
(i) who is an inpatient in a nursing
facility, intermediate care facility for the
mentally retarded, or other medical institu-
tion, if such individual is required, as a
condition of receiving services in such insti-
tution under the State program, to spend
for costs of medical care all but a minimal
amount of his income required for personal
needs, and
(ii) with respect to whom the State
determines, after notice and opportunity
for a hearing (in accordance with proce-
dures established by the State), that he
cannot reasonably be expected to be dis-
charged from the medical institution and
to return home,
except as provided in paragraph (2).
(2) ADDITIONAL LIMITATION.—No lien may be
imposed under paragraph (1)(B) on such individ-
ual’s home if—
(A) the spouse of such individual,
(B) such individual’s child who is under
age 21 and is blind or disabled as defined in
section 1614 of the Social Security Act, or
(C) a sibling of such individual (who has
an equity interest in such home and who was
residing in such individual’s home for a period
of at least one year immediately before the date
of the individual’s admission to the medical in-
stitution),
is lawfully residing in such home.
(3) DISSOLUTION OF LIENS.—Any lien imposed
with respect to an individual pursuant to paragraph
(1)(B) shall dissolve upon that individual’s discharge
from the medical institution and return home.
(c) LIMITATION ON ADJUSTMENT OR RECOVERY.—
(1) IN GENERAL.—No adjustment or recovery
of any medical assistance correctly paid on behalf of
an individual under the State medical assistance
program may be made, except—
(A) in the case of an individual described
in subsection (b)(1)(B), from the individual’s
estate or upon sale of the property, subject to
a lien imposed on account of medical assistance
paid on behalf of such individual, and
(B) in the case of any other individual who
is 65 years of age or older, when the individual
received such assistance, from the individual’s
estate.
(2) LIMITATION.—Any adjustment or recovery
under paragraph (1) may be made only after the
death of the individual’s surviving spouse, if any,
and only at a time—
(A) when he has no surviving child who is
under age 21, or (with respect to States eligible
to participate in the State program established
under title XVI of the Social Security Act) is
blind or permanently and totally disabled, or
(with respect to States which are not eligible to
participate in such program) is blind or dis-
abled as defined in section 1614 of such Act;
and
(B) in the case of a lien on an individual’s
home under subsection (b)(1)(B), when—
(i) no sibling of the individual (who
was residing in the individual’s home for a
period of at least one year immediately be-
fore the date of the individual’s admission
to the medical institution), and
(ii) no son or daughter of the individ-
ual (who was residing in the individual’s
home for a period of at least two years im-
mediately before the date of the individ-
ual’s admission to the medical institution,
and who establishes to the satisfaction of
the State that he or she provided care to
such individual which permitted such indi-
vidual to reside at home rather than in an
institution),
is lawfully residing in such home and has law-
fully resided in such home on a continuous
basis since the date of the individual’s admis-
sion to the medical institution.
(3) PROCEDURES.—The State agency respon-
sible for administration of the State medical assist-
ance program shall establish procedures (in accord-
ance with standards specified by the Secretary of
Health and Human Services) under which the agen-
cy shall waive the application of this subsection
(other than paragraph (1)(C)) if such application
would work an undue hardship as determined on the
basis of criteria established by the Secretary.
(4) ESTATE DEFINED.—For purposes of this
subsection, the term ‘‘estate’’, with respect to a de-
ceased individual, shall include all real and personal
property and other assets included within the indi-
vidual’s estate, as defined for purposes of State pro-
bate law.
(d) DEFINITIONS.—In this section:
(1) STATE.—The term ‘‘State’’ includes the
District of Columbia, Puerto Rico, the Virgin Is-
lands, Guam, American Samoa, and the Northern
Mariana Islands.
(2) STATE MEDICAL ASSISTANCE PROGRAM.—
The term ‘‘State medical assistance program’’
means the MediGrant program (under title XXI of
the Social Security Act) or other program of Federal
assistance to States for medical assistance expendi-
tures.
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