§ 1396k. Assignment, enforcement, and collection of rights of payments for medical care; establishment of procedures pursuant to State plan; amounts retained by State

Legislative history

Reconstructed from this section’s Code source credit and amendment notes, resolved against the local Statutes at Large. Editorial notes are evidence, not the law that made the change.

1. 1935

   Medicare-Medicaid Anti-Fraud and Abuse Amendments

   Pub. L. 95–142 § 11(b) · 91 Stat. 1175

   Enacted · 42 U.S.C. § 1396k

   Aug. 14, 1935, ch. 531, title XIX, § 1912, as added Pub. L. 95–142, § 11(b), Oct. 25, 1977, 91 Stat. 1196

   Source evidence

   Code source credit
   Aug. 14, 1935, ch. 531, title XIX, § 1912, as added Pub. L. 95–142, § 11(b), Oct. 25, 1977, 91 Stat. 1196

   Enacted provision · exact public law section
   (b) Title XIX of the Social Security Act is amended by adding at the end thereof the following new section: “Sec. 1912. “assignment of rights of payment (a) For the purpose of assisting in the collection of medical support payments and other payments for medical care owed to recipients of medical assistance under the State plan approved under this title, a State plan for medical assistance may— “(1) provide that, as a condition of eligibility for medical assistance under the State plan to an individual who has the legal capacity to execute an assignment for himself, the individual is required— “(A) to assign the State any rights, of the individual or of any other person who is eligible for medical assistance under this title and on whose behalf the individual has the legal authority to execute an assignment of such rights, to support (specified as support for the purpose of medical care by a court or administrative order) and to payment for medical care from any third party; and “(B) to cooperate with the State (i) in establishing the paternity of such person (referred to in subparagraph (A)) if the person is a child born out of wedlock, and (ii) in obtaining support and payments (described in subparagraph (A)) for himself and for such person, unless (in either case) the individual is found to have good cause for refusing to cooperate as determined by the State agency in accordance with standards prescribed by the Secretary, which standards shall take into consideration the best interests of the individuals involved: and “(2) provide for entering into cooperative arrangements Cooperative arrangements with State agencies. (including financial arrangements), with any appropriate agency of any State (including, with respect to the enforcement and collection of rights of payment for medical care by or through a parent, with a State’s agency established or designated under section 454(3)) and with appropriate courts and law enforcement 42 USC 654. officials, to assist the agency or agencies administering the State plan with respect to (A) the enforcement and collection of rights to support or payment assigned under this section and (B) any other matters of common concern. “(b) Such part of any amount collected by the State under an Retainages. assignment made under the provisions of this section shall be retained by the State as is necessary to reimburse it for medical assistance payments made on behalf of an individual with respect to whom such assignment was executed (with appropriate reimbursement of the Federal Government to the extent of its participation in the financing of such medical assistance), and the remainder of such amount collected shall be paid to such individual.”.

2. 1984

   Spending Reduction Act of 1984

   Pub. L. 98–369 div. B title III § 2367(b) · 98 Stat. 494

   Substituted · 42 U.S.C. § 1396k(a)

   Pub. L. 98–369 substituted “State plan for medical assistance shall” for “State plan for medical assistance may”

   Source evidence

   Code amendment note
   Subsec. (a). Pub. L. 98–369 substituted “State plan for medical assistance shall” for “State plan for medical assistance may”.

   Enacted provision · exact public law section
   (b) Section 1912(a) of such Act is amended by striking out “State 42 USC 1396k. plan for medical assistance may” and inserting in lieu thereof “State plan for medical assistance shall”.

3. 1986

   Medicare and Medicaid Budget Reconciliation Amendments of 1985

   Pub. L. 99–272 title IX § 9503(e) · 100 Stat. 82

   Added · 42 U.S.C. § 1396k(a)(1)(C)

   Pub. L. 99–272 added subpar. (C)

   Source evidence

   Code amendment note
   Subsec. (a)(1)(C). Pub. L. 99–272 added subpar. (C).

   Enacted provision · exact public law section
   (e) Condition of Eligibility.— Section 1912(a)(1) of the Social Security Act (42 U.S.C. 1396k(a)(1)) is amended by striking out “and” at the end of subparagraph (A), and by adding at the end thereof the following new subparagraph: “(C) to cooperate with the State in identifying, and providing information to assist the State in pursuing, any third party who may be liable to pay for care and services available under the plan, unless such individual has good cause for refusing to cooperate as determined by the State agency in accordance with standards prescribed by the Secretary, which standards shall take into consideration the best interests of the individuals involved; and”.

4. 1990

   Omnibus Budget Reconciliation Act of 1990

   Pub. L. 101–508 title IV § 4606(a) · 104 Stat. 1388

   Inserted · 42 U.S.C. § 1396k(a)(1)(B)

   Pub. L. 101–508 inserted “the individual is described in section 1396a(l)(1)(A) of this title or” after “unless (in either case)”

   Source evidence

   Code amendment note
   Subsec. (a)(1)(B). Pub. L. 101–508 inserted “the individual is described in section 1396a(l)(1)(A) of this title or” after “unless (in either case)”.

   Enacted provision · exact public law section
   (a) In General.— Section 1912(a)(l)(B) (42 U.S.C. 1396k(a)(l)(B)) is amended by inserting “the individual is described in section 1902(1)(1)(A) or” after “unless (in either case)”.

5. 2013

   Bipartisan Budget Act of 2013

   Pub. L. 113–67 § 202(b)(2) · 127 Stat. 1165

   Repealed · 42 U.S.C. § 1396k(a)(1)(A)

   Pub. L. 113–67, § 202(b)(2), which directed substitution of “any payment from a third party that has a legal liability to pay for care and services available under the plan” for “payment for medical care from any third party”, was repealed by Pub. L. 115–123, § 53102(b)(1)

   Source evidence

   Code amendment note
   Subsec. (a)(1)(A). Pub. L. 113–67, § 202(b)(2), which directed substitution of “any payment from a third party that has a legal liability to pay for care and services available under the plan” for “payment for medical care from any third party”, was repealed by Pub. L. 115–123, § 53102(b)(1).

   Enacted provision · exact public law section
   (2) Assignment of rights of payment.— Section 1912(a)(1)(A) of such Act (42 U.S.C. 1396k(a)(1)(A)) is amended by striking “payment for medical care from any third party” and inserting “any payment from a third party that has a legal liability to pay for care and services available under the plan”.

   Effective date note
   Pub. L. 115–123, div. E, title XII, § 53102(b)(1), Feb. 9, 2018, 132 Stat. 298, provided that the repeal of section 202(b) of Pub. L. 113–67 is effective Sept. 30, 2017, and the provisions amended by section 202(b) shall be applied and administered as if such amendments had never been enacted. In addition, such repeal by section 53102(b)(1) of Pub. L. 115–123 applicable with respect to any open claims, including claims pending, generated, or filed, after Sept. 30, 2017, see section 53102(b)(3) of Pub. L. 115–123, set out as a note under section 1396a of this title.

6. 2018

   Advancing Chronic Care, Extenders, and Social Services (ACCESS) Act

   Pub. L. 115–123 § 53102(b)(1) · 132 Stat. 64

   Repealed · 42 U.S.C. § 1396k(a)(1)(A)

   Pub. L. 115–123, § 53102(b)(1), repealed Pub. L. 113–67, § 202(b)(2), and provided that the provisions amended by section 202(b) shall be applied and administered as if such amendment had never been enacted. See 2013 Amendment note below

   Source evidence

   Code amendment note
   Subsec. (a)(1)(A). Pub. L. 115–123, § 53102(b)(1), repealed Pub. L. 113–67, § 202(b)(2), and provided that the provisions amended by section 202(b) shall be applied and administered as if such amendment had never been enacted. See 2013 Amendment note below.

   Enacted provision · exact public law section
   (1) Repeal.— Effective as of September 30, 2017, subsection (b) of section 202 of the Bipartisan Budget Act of 2013 (Public Law 113–67; 127 Stat. 1177; 42 U.S.C. 1396a note) (including any amendments made by such subsection) 42 USC 1396a and note, 1396k, 1396p. is repealed and the provisions amended by such subsection shall be applied and administered as if such amendments had never been enacted.

   Effective date note
   Pub. L. 115–123, div. E, title XII, § 53102(b)(1), Feb. 9, 2018, 132 Stat. 298, provided that the repeal of section 202(b) of Pub. L. 113–67 is effective Sept. 30, 2017, and the provisions amended by section 202(b) shall be applied and administered as if such amendments had never been enacted. In addition, such repeal by section 53102(b)(1) of Pub. L. 115–123 applicable with respect to any open claims, including claims pending, generated, or filed, after Sept. 30, 2017, see section 53102(b)(3) of Pub. L. 115–123, set out as a note under section 1396a of this title.

6 of 6 references resolved to an enrolled provision