< Back to H.R. 4250 (104th Congress, 1995–1996)

Text of the To amend title XIX of the Social Security Act to permit a State the option of covering community-based attendant services ...

...community-based attendant services under the Medicaid program.

This bill was introduced on September 27, 1996, in a previous session of Congress, but was not enacted. The text of the bill below is as of Sep 27, 1996 (Introduced).

Source: GPO

HR 4250 IH

104th CONGRESS

2d Session

H. R. 4250

To amend title XIX of the Social Security Act to permit a State the option of covering community-based attendant services under the Medicaid program.

IN THE HOUSE OF REPRESENTATIVES

September 27, 1996

Mr. GUNDERSON (for himself and Mr. GINGRICH) 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 a State the option of covering community-based attendant services under the Medicaid program.

    Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. OPTIONAL COVERAGE OF COMMUNITY-BASED ATTENDANT SERVICES UNDER THE MEDICAID PROGRAM.

    (a) COVERAGE-

      (1) IN GENERAL- Section 1905 of the Social Security Act (42 U.S.C. 1396d) is amended--

        (A) in subsection (a)--

          (i) by striking ‘and’ at the end of paragraph (24),

          (ii) by redesignating paragraph (25) as paragraph (26), and

          (iii) by inserting after paragraph (24) the following new paragraph:

      ‘(25) subject to subsection (t)(3), qualified community-based attendant services (as defined in subsection (t)(1)); and’; and

        (B) by adding at the end the following new subsection:

    ‘(t)(1) The term ‘qualified community-based attendant services’ means community-based attendant services furnished to individuals under a plan of care if all the following conditions are met:

      ‘(A) The individuals to whom the services are furnished select, manage, and control the attendant services to be provided.

      ‘(B) Attendant services would be covered only if they are home or community-based and are not provided in a nursing facility or other institutional facility.

      ‘(C) Eligibility for such coverage would be limited to those who required such services based on functional need.

      ‘(D) Such services would be available in home and in other locations, including school, work, recreation and church.

      ‘(E) Such services would be available on an as-needed basis.

      ‘(F) Backup and emergency attendant services would be available.

      ‘(G) Notwithstanding section 1916, a State may impose copayments and cost-sharing for individuals for attendant services based on the income of individuals involved and in a manner so as not to be a disincentive for employment.

      ‘(H) Coverage of services could be effected through any appropriate means, which may include through provision of vouchers to eligible individuals, through direct cash payment, through an individual provider model, or through a consumer-directed agency model.

      ‘(I) Voluntary training should be available to recipients on how to select, manage, and dismiss attendants.

      ‘(J) The particular attendant services to be covered for an eligible individual would be based on a service delivery plan that is agreed upon by the individual and the attendants.

      ‘(K) Health-related tasks included within such services could be delegated to (or performed by) unlicensed personal attendants.

      ‘(L) The State provides for the periodic submission to the Secretary of reports on the coverage of such services under this subsection.

    ‘(2) Medical assistance for qualified community-based attendant services need not be made available in all geographic areas of a State or to all beneficiaries, notwithstanding anything to the contrary in section 1902(a)(1) or section 1902(a)(10)(B).

    ‘(3) Medical assistance for qualified community-based attendant services may not be made available by a State under section 1905(a)(25) unless the State establishes that the provision of medical assistance with respect to such services will not increase the Federal payments made under this title above the level of such payments if such medical assistance under such section had not been provided.’.

      (2) CONFORMING AMENDMENTS- (A) Section 1902(j) (42 U.S.C. 1396a(j)) is amended by striking ‘(25)’ and inserting ‘26)’.

      (B) Section 1902(a)(10)(C)(iv) (42 U.S.C. 1396a(a)(10)(C)(iv)) is amended by striking ‘(24)’ and inserting ‘(25)’.

    (b) EFFECTIVE DATE- The amendments made by subsection (a) shall apply to services furnished on or after the date of the enactment of this Act.

    (c) REPORTS TO CONGRESS- The Secretary of Secretary of Health and Human Services shall submit to Congress periodic reports on the impact of the amendments made by this section on medicaid beneficiaries, States, and the Federal Government.