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106TH CONGRESS
1ST SESSION
H. R. 610
To amend title XIX of the Social Security Act to permit the Secretary
of Health and Human Services to waive recoupment of Federal Govern-
ment Medicaid claims to tobacco-related State settlements if the State
uses the funds only for programs to reduce smoking and for public
health purposes.
IN THE HOUSE OF REPRESENTATIVES
FEBRUARY 4, 1999
Mr. WEYGAND introduced the following bill; which was referred to the
Committee on Commerce
A BILL
To amend title XIX of the Social Security Act to permit
the Secretary of Health and Human Services to waive
recoupment of Federal Government Medicaid claims to
tobacco-related State settlements if the State uses the
funds only for programs to reduce smoking and for pub-
lic health purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. PERMITTING WAIVER OF RECOUPMENT OF
MEDICAID TOBACCO-RELATED RECOVERIES
IF RECOVERIES USED TO REDUCE SMOKING
AND FOR PUBLIC HEALTH PURPOSES.
(a) IN GENERAL.—Section 1903(d)(3) of the Social
Security Act (42 U.S.C. 1396b(d)(3)) is amended—
(1) by inserting ‘‘(A)’’ before ‘‘The’’; and
(2) by adding at the end the following:
‘‘(B) Subparagraph (A) and paragraph (2)(B) shall
not apply to any amount recovered or paid to a State as
part of a settlement or judgment reached in litigation initi-
ated or pursued by a State against one or more manufac-
turers of tobacco products, as defined in section 5702(d)
of the Internal Revenue Code of 1986, if (and to the ex-
tent that) the Secretary finds that following conditions are
met:
‘‘(i) The State has filed with the Secretary a
plan which specifically outlines how the Federal
share of the amounts so recovered will be spent con-
sistent with the following:
‘‘(I) At least 40 percent of such amounts,
recovered in any fiscal year, will be spent on ef-
forts to reduce smoking using methods that
have been shown to be effective, such as smok-
ing cessation programs, anti-smoking enforce-
ment activities, community-based anti-smoking
programs, and school-based education pro-
grams.
‘‘(II) Such amounts not spent for the pur-
poses described in subclause (I) will be spent
only on essential public health services, includ-
ing (but not limited to) the public health activi-
ties described in subparagraph (C).
‘‘(III) All such amounts will be spent only
in a manner that supplements (and does not
supplant) funds previously being spent by the
State (or local governments in the State) for
such or similar programs or activities.
‘‘(ii) Before the beginning of each fiscal year,
the State files with the Secretary a report which de-
tails how the Federal share of the amounts so recov-
ered have been spent consistent with the plan de-
scribed in clause (i).
‘‘(C) The public health activities described in this
subparagraph are as follows:
‘‘(i) Monitoring health status to identify com-
munity health problems.
‘‘(ii) Diagnosing and investigating health prob-
lems and health hazards in the community.
‘‘(iii) Enforcing laws and regulations that pro-
tect public health.
‘‘(iv) Informing, educating, and empowering
people about health issues.
‘‘(v) Mobilizing community partnerships to
identify and solve health problems.
‘‘(vi) Linking people to needed personal health
services and assuring the provision of health care
when otherwise unavailable.
‘‘(vii) Evaluating effectiveness, accessibility, and
quality of personal and population-based health serv-
ices.
‘‘(viii) Assuring a competent public health and
personal health care workforce.
‘‘(ix) Developing policies and plans that support
individual and community health efforts.
‘‘(x) Conducting research for new insights and
innovative solutions to health problems.
‘‘(D) If the Secretary determines that amounts de-
scribed in subparagraph (B) are not being spent in accord-
ance with the plan described in (and that meets the re-
quirements of) subparagraph (B)(i), subparagraph (A)
and paragraph (2)(B) shall apply to such amounts and
the Secretary shall take appropriate action to offset such
amounts from the amounts otherwise paid to the State
under this title.
‘‘(E) Amounts equivalent to the reductions in pay-
ments under this title which are attributable to recoveries
described in subparagraph (B) which are not recouped or
offset because of such subparagraph shall be deposited by
the Secretary into a separate fund in the Treasury which
shall be used and available to the Secretary, without fur-
ther appropriation, to carry out Federal grant-in-aid pro-
grams to reduce tobacco use among minors.’’.
(b) EFFECTIVE DATE.—The amendments made by
subsection (a) apply to amounts recovered or paid to a
State before, on, or after the date of enactment of this
Act.
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