115 HR 3921 RH: Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act of 2017
U.S. House of Representatives
2017-10-03
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
1.This Act may be cited as the Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act of 2017
or the HEALTHY KIDS Act
.
2.The table of contents for this Act is as follows: Sec. 1. Short title. Sec. 2. Table of contents. Title I—CHIP Extension and Other Medicaid and CHIP Provisions Sec. 101. Five-year funding extension of the Children’s Health Insurance Program. Sec. 102. Extension of certain programs and demonstration projects. Sec. 103. Extension of outreach and enrollment program. Sec. 104. Extension and reduction of additional Federal financial participation for CHIP. Sec. 105. Modifying reduction in Medicaid DSH allotments. Sec. 106. Puerto Rico and the Virgin Islands Medicaid payments. Title II—Offsets Sec. 201. Medicaid third party liability provisions. Sec. 202. Treatment of lottery winnings and other lump-sum income for purposes of income eligibility under Medicaid. Sec. 203. Adjustments to Medicare part B and part D premium subsidies for higher income individuals. <enum>I</enum><header>CHIP Extension and Other Medicaid and CHIP Provisions</header> <section commented="no" id="H45E9DB361E154A70A845B8961FBF1B20"><enum>101.</enum><header>Five-year funding extension of the Children’s Health Insurance Program</header> <subsection commented="no" id="H75BDE6D7DF044B70BCF3FDAB9A7082F7"><enum>(a)</enum><header>Appropriation; total allotment</header><text>Section 2104(a) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397dd">42 U.S.C. 1397dd(a)</external-xref>) is amended—</text>
<paragraph commented="no" id="HFD4E8EB278F748768C91F4750FA0924A"><enum>(1)</enum><text>in paragraph (19), by striking <quote>and</quote>;</text> </paragraph><paragraph commented="no" id="H1752E00187C94EDAB031688D99B640FA"><enum>(2)</enum><text>in paragraph (20), by striking the period at the end and inserting a semicolon; and</text>
</paragraph><paragraph commented="no" id="HA64D2722C8614568AB0E97F262D15D3D"><enum>(3)</enum><text>by adding at the end the following new paragraphs:</text> <quoted-block changed="added" committee-id="HIF00" id="H86125AAC4CBA4B15BB63A7DC133EEE25" reported-display-style="italic" style="OLC"> <paragraph commented="no" id="H4B81B237C0414462B93F02F3FB72DF4B"><enum>(21)</enum><text>for fiscal year 2018, $21,500,000,000;</text>
</paragraph><paragraph commented="no" id="HB8A8E12A56444B45BE9407E5B23E1956"><enum>(22)</enum><text display-inline="yes-display-inline">for fiscal year 2019, $22,600,000,000;</text> </paragraph><paragraph commented="no" id="HE72AA351A910451ABFB9151B173D2503"><enum>(23)</enum><text display-inline="yes-display-inline">for fiscal year 2020, $23,700,000,000;</text>
</paragraph><paragraph commented="no" id="H75B606ECD8844ED4B12B4114219F774B"><enum>(24)</enum><text display-inline="yes-display-inline">for fiscal year 2021, $24,800,000,000; and</text> </paragraph><paragraph commented="no" id="HDB48EDF23FA44535B5A08B688DD9538C"><enum>(25)</enum><text display-inline="yes-display-inline">for fiscal year 2022, for purposes of making 2 semi-annual allotments—</text>
<subparagraph id="HC05DF1F112544E6DA5F59DC51F8A3A4A"><enum>(A)</enum><text display-inline="yes-display-inline">$2,850,000,000 for the period beginning on October 1, 2021, and ending on March 31, 2022; and</text> </subparagraph><subparagraph id="H29B9852A6ED842CB84ED42DBB9835A6A"><enum>(B)</enum><text display-inline="yes-display-inline">$2,850,000,000 for the period beginning on April 1, 2022, and ending on September 30, 2022.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" id="H2FA59EEA875647E198BBA4213F44B04C"><enum>(b)</enum><header>Allotments</header>
<paragraph commented="no" id="HFEC606AAE0494BEB8BD134977528D468"><enum>(1)</enum><header>In general</header><text>Section 2104(m) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397dd">42 U.S.C. 1397dd(m)</external-xref>) is amended—</text> <subparagraph commented="no" id="H468A32F2725D44F4ACB6A3E27E1E3990"><enum>(A)</enum><text>in paragraph (2)—</text>
<clause commented="no" id="H8B86941B05284C2A8415B02794F114AF"><enum>(i)</enum><text>in the heading, by striking <quote><header-in-text level="paragraph" style="OLC">through <enum-in-header>2016</enum-in-header></header-in-text></quote> and inserting <quote><header-in-text level="paragraph" style="OLC">through <enum-in-header>2022</enum-in-header></header-in-text></quote>; and</text> </clause><clause commented="no" id="HF1901D83326548FBA68B9005A72B09FF"><enum>(ii)</enum><text>in subparagraph (B)—</text>
<subclause id="HA5611A1D80A74CDE8D2D37131ED7EF2A"><enum>(I)</enum><text>in the matter preceding clause (i), by striking <quote>(19)</quote> and inserting <quote>(24)</quote>;</text> </subclause><subclause id="H837C13B0E50946A496605C374213F327"><enum>(II)</enum><text>in clause (ii), in the matter preceding subclause (I), by inserting <quote>(other than fiscal year 2022)</quote> after <quote>even-numbered fiscal year</quote>; and</text>
</subclause><subclause id="H44CFC94E55E94B53A07DCDC3DC82C81D"><enum>(III)</enum><text>in clause (ii)(I), by inserting <quote>(or, in the case of fiscal year 2018, under paragraph (4))</quote> after <quote>clause (i)</quote>;</text> </subclause></clause></subparagraph><subparagraph commented="no" id="H2DD02A47C77A44168608F57E6EE88000"><enum>(B)</enum><text>in paragraph (5)—</text>
<clause commented="no" id="H8A714AB26D814CE899260C9433023005"><enum>(i)</enum><text>by striking <quote>or (4)</quote> and inserting <quote>(4), or (10)</quote>; and</text> </clause><clause commented="no" id="H9D2C8D01007B44F6BE2D006E8C590EBB"><enum>(ii)</enum><text>by striking <quote>or 2017</quote> and inserting <quote>, 2017, or 2022</quote>;</text>
</clause></subparagraph><subparagraph id="HAE2DA68ECCD7468BA737AEA8FDB25EDE"><enum>(C)</enum><text>in paragraph (7)—</text> <clause commented="no" id="H3747778CE0C44E17AC5DDE87CD3BFF4C"><enum>(i)</enum><text>in subparagraph (A), by striking <quote>2017</quote> and inserting <quote>2022</quote>;</text>
</clause><clause commented="no" id="H7801A3F583434DD0979F0F73E5A4E6BE"><enum>(ii)</enum><text>in subparagraph (B), in the matter preceding clause (i), by inserting <quote>(or, in the case of fiscal year 2018, by not later than the date that is 60 days after the date of the enactment of the HEALTHY KIDS Act of 2017)</quote> after <quote>before the August 31 preceding the beginning of the fiscal year</quote>; and</text>
</clause><clause id="H00EE3DC8E1604B19844077C234415D5F"><enum>(iii)</enum><text>in the matter following subparagraph (B), by striking <quote>or fiscal year 2016</quote> and inserting <quote>fiscal year 2016, fiscal year 2018, fiscal year 2020, or fiscal year 2022</quote>;</text> </clause></subparagraph><subparagraph id="H6B00BA73757F4F9D8C45134A77147CD7"><enum>(D)</enum><text>in paragraph (9)—</text>
<clause id="H2DC01ED43B4043D88B5225719118AB77"><enum>(i)</enum><text>in the heading, by striking <quote><header-in-text level="paragraph" style="OLC">fiscal years <enum-in-header>2015</enum-in-header> and <enum-in-header>2017</enum-in-header></header-in-text></quote> and inserting <quote><header-in-text level="paragraph" style="OLC">certain fiscal years</header-in-text></quote>;</text> </clause><clause id="HA2BFDADCD24349B98AA37ED233208E9A"><enum>(ii)</enum><text>by striking <quote>or (4)</quote> and inserting <quote>, (4), or (10)</quote>; and</text>
</clause><clause id="HADAF3B7C96AF4E44AF86953203032CA1"><enum>(iii)</enum><text>by striking <quote>or fiscal year 2017</quote> and inserting <quote>, 2017, or 2022</quote>; and</text> </clause></subparagraph><subparagraph id="H35710A639CAE40F093A86321F3943C03"><enum>(E)</enum><text>by adding at the end the following new paragraph:</text>
<quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="H974A0A27CFF04926B59749E76B082CE9" reported-display-style="italic" style="OLC">
<paragraph commented="no" id="H98621E04D0B94F3AB1FC5BBF9A0EA6B6"><enum>(10)</enum><header>For fiscal year <enum-in-header>2022</enum-in-header></header>
<subparagraph commented="no" id="HA914770CCA9E4BBE90411FA394A9EA60"><enum>(A)</enum><header>First half</header><text display-inline="yes-display-inline">Subject to paragraphs (5) and (7), from the amount made available under subparagraph (A) of paragraph (25) of subsection (a) for the semi-annual period described in such subparagraph, increased by the amount of the appropriation for such period under section 101(b)(3) of the HEALTHY KIDS Act, the Secretary shall compute a State allotment for each State (including the District of Columbia and each commonwealth and territory) for such semi-annual period in an amount equal to the first half ratio (described in subparagraph (D)) of the amount described in subparagraph (C).</text>
</subparagraph><subparagraph commented="no" id="H76A9C1D581F14D6EB8AB0B67D50CEBCF"><enum>(B)</enum><header>Second half</header><text display-inline="yes-display-inline">Subject to paragraphs (5) and (7), from the amount made available under subparagraph (B) of paragraph (25) of subsection (a) for the semi-annual period described in such subparagraph, the Secretary shall compute a State allotment for each State (including the District of Columbia and each commonwealth and territory) for such semi-annual period in an amount equal to the amount made available under such subparagraph, multiplied by the ratio of—</text>
<clause commented="no" id="H2400FD42E0E14E5791A25BAA461DD6BB"><enum>(i)</enum><text display-inline="yes-display-inline">the amount of the allotment to such State under subparagraph (A); to</text> </clause><clause commented="no" id="H379AE2551C62468F811FDEC84A35C3FA"><enum>(ii)</enum><text display-inline="yes-display-inline">the total of the amount of all of the allotments made available under such subparagraph.</text>
</clause></subparagraph><subparagraph commented="no" id="H253FC98A775A45D18D8A5F48B9CAD354"><enum>(C)</enum><header>Full year amount based on growth factor updated amount</header><text display-inline="yes-display-inline">The amount described in this subparagraph for a State is equal to the sum of—</text> <clause id="H71F1300F1A0B4AB6A3D89492F2AABAD2"><enum>(i)</enum><text>the amount of the State allotment for fiscal year 2021 determined under paragraph (2)(B)(i); and</text>
</clause><clause id="H25F2FE4CF07E4B7581F07B7D7333B302"><enum>(ii)</enum><text>the amount of any payments made to the State under subsection (n) for fiscal year 2021,</text> </clause><continuation-text continuation-text-level="subparagraph">multiplied by the allotment increase factor under paragraph (6) for fiscal year 2022.</continuation-text></subparagraph><subparagraph commented="no" id="HAEE9600A1CA943B59FC18E582548F13B"><enum>(D)</enum><header>First half ratio</header><text display-inline="yes-display-inline">The first half ratio described in this subparagraph is the ratio of—</text>
<clause commented="no" id="H2AF7D9AE00934993AAD8E6DE3B1160C5"><enum>(i)</enum><text display-inline="yes-display-inline">the sum of—</text> <subclause commented="no" id="HF3666450F6354A4B89BD63ABA0170968"><enum>(I)</enum><text display-inline="yes-display-inline">the amount made available under subsection (a)(25)(A); and</text>
</subclause><subclause commented="no" id="HF180B318369E400CBF8C36F26F577629"><enum>(II)</enum><text display-inline="yes-display-inline">the amount of the appropriation for such period under section 101(b)(3) of the HEALTHY KIDS Act; to</text> </subclause></clause><clause commented="no" id="H9F0F0AE7D5D74FB4A7953B0C442908A0"><enum>(ii)</enum><text display-inline="yes-display-inline">the sum of—</text>
<subclause commented="no" id="H7DD8D7AA90A84B0E8D2DC103989E54E3"><enum>(I)</enum><text display-inline="yes-display-inline">the amount described in clause (i); and</text> </subclause><subclause commented="no" id="HE472339645A9450086981390879C6583"><enum>(II)</enum><text display-inline="yes-display-inline">the amount made available under subsection (a)(25)(B).</text></subclause></clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph commented="no" id="HA6F7218968E24BE488396FC4C0FDDEA7"><enum>(2)</enum><header>Technical amendment</header><text display-inline="yes-display-inline">Section 2104(m)(2)(A) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397dd">42 U.S.C. 1397dd(m)(2)(A)</external-xref>) is amended by striking <quote>the allotment increase factor under paragraph (5)</quote> each place it appears and inserting <quote>the allotment increase factor under paragraph (6)</quote>.</text> </paragraph><paragraph commented="no" id="HF7D2D3D9B14F4ABD91919D19D3D40578"><enum>(3)</enum><header>One-time appropriation for fiscal year 2022</header><text display-inline="yes-display-inline">There is appropriated to the Secretary of Health and Human Services, out of any money in the Treasury not otherwise appropriated, $20,200,000,000 to accompany the allotment made for the period beginning on October 1, 2021, and ending on March 31, 2022, under paragraph (25)(A) of section 2104(a) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397dd">42 U.S.C. 1397dd(a)</external-xref>) (as added by subsection (a)(3)), to remain available until expended. Such amount shall be used to provide allotments to States under paragraph (10) of section 2104(m) of such Act (as added by subsection (b)(1)(E)) for the first 6 months of fiscal year 2022 in the same manner as allotments are provided under subsection (a)(25)(A) of such section 2104 and subject to the same terms and conditions as apply to the allotments provided from such subsection (a)(25)(A).</text>
</paragraph></subsection><subsection commented="no" id="H120DF90A6B4349E1B96BC47E3AFC3414"><enum>(c)</enum><header>Extension of the Child Enrollment Contingency Fund</header><text display-inline="yes-display-inline">Section 2104(n) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397dd">42 U.S.C. 1397dd(n)</external-xref>) is amended—</text> <paragraph commented="no" id="H6025082DD3BF4B8382F3BC15D9E03C44"><enum>(1)</enum><text>in paragraph (2)—</text>
<subparagraph commented="no" id="HAC5CBBADE5084558957DB4A173A42BD2"><enum>(A)</enum><text display-inline="yes-display-inline">in subparagraph (A)(ii)—</text> <clause commented="no" id="HD10AAC1E4EDB4418A9EB5CF0F605B2D4"><enum>(i)</enum><text>by striking <quote>2010, 2011, 2012, 2013, 2014, and 2016</quote> and inserting <quote>2010 through 2014, 2016, and 2018 through 2021</quote>; and</text>
</clause><clause commented="no" id="H897BDD09E1784D9FB115E57FC74A1BFA"><enum>(ii)</enum><text>by striking <quote>fiscal year 2015 and fiscal year 2017</quote> and inserting <quote>fiscal years 2015, 2017, and 2022</quote>; and</text> </clause></subparagraph><subparagraph commented="no" id="HB543C5293E674A24BC2BF6017DC0980A"><enum>(B)</enum><text display-inline="yes-display-inline">in subparagraph (B)—</text>
<clause commented="no" id="H1B5937B8976C4945A6D85AEE9BF84527"><enum>(i)</enum><text>by striking <quote>2010, 2011, 2012, 2013, 2014, and 2016</quote> and inserting <quote>2010 through 2014, 2016, and 2018 through 2021</quote>; and</text> </clause><clause commented="no" id="H0AAB1C09315E4BC0A8C85B2A8AB00AA0"><enum>(ii)</enum><text>by striking <quote>fiscal year 2015 and fiscal year 2017</quote> and inserting <quote>fiscal years 2015, 2017, and 2022</quote>; and</text>
</clause></subparagraph></paragraph><paragraph commented="no" id="H33389FFED84F407EBFDC9C0C07500005"><enum>(2)</enum><text>in paragraph (3)(A), in the matter preceding clause (i), by striking <quote>or a semi-annual allotment period for fiscal year 2015 or 2017</quote> and inserting <quote>or in any of fiscal years 2018 through 2021 (or a semi-annual allotment period for fiscal year 2015, 2017, or 2022)</quote>.</text>
</paragraph></subsection><subsection commented="no" id="H5D0D909DD73A4BABBED49C60A9115D88"><enum>(d)</enum><header>Extension of qualifying states option</header><text>Section 2105(g)(4) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397ee">42 U.S.C. 1397ee(g)(4)</external-xref>) is amended—</text> <paragraph commented="no" id="H718A8534CAE04DCA94EF911B93BE617C"><enum>(1)</enum><text>in the heading, by striking <quote><header-in-text level="paragraph" style="OLC">through <enum-in-header>2017</enum-in-header></header-in-text></quote> and inserting <quote><header-in-text level="paragraph" style="OLC">through <enum-in-header>2022</enum-in-header></header-in-text></quote>; and</text>
</paragraph><paragraph commented="no" id="HD4BB6D8C2CDD4D72BACDDBD08D263341"><enum>(2)</enum><text>in subparagraph (A), by striking <quote>2017</quote> and inserting <quote>2022</quote>.</text> </paragraph></subsection><subsection commented="no" id="H72E270E973BE4C55AEE7FDD0794DE9C7"><enum>(e)</enum><header>Extension of express lane eligibility option</header><text>Section 1902(e)(13)(I) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a(e)(13)(I)</external-xref>) is amended by striking <quote>2017</quote> and inserting <quote>2022</quote>.</text>
</subsection><subsection commented="no" id="H3162DD93AA2B4CAD8101DAE197F94958"><enum>(f)</enum><header>Assurance of affordability standard for children and families</header>
<paragraph commented="no" id="HAA8B6A15B5A4470EA651F52BD6FE7767"><enum>(1)</enum><header>In general</header><text>Section 2105(d)(3) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397ee">42 U.S.C. 1397ee(d)(3)</external-xref>) is amended—</text> <subparagraph commented="no" id="H23F1219121114A0B97CFBAA9C6BA8783"><enum>(A)</enum><text>in the paragraph heading, by striking <quote><header-in-text level="paragraph" style="OLC">until October <enum-in-header>1</enum-in-header>, <enum-in-header>2019</enum-in-header></header-in-text></quote> and inserting <quote><header-in-text level="paragraph" style="OLC">through September <enum-in-header>30</enum-in-header>, <enum-in-header>2022</enum-in-header></header-in-text></quote>; and</text>
</subparagraph><subparagraph commented="no" id="HE89642CC723947D4A42ACC2C25023FE8"><enum>(B)</enum><text>in subparagraph (A), in the matter preceding clause (i)—</text> <clause commented="no" id="H781D87989F954296812ED01DAB814E16"><enum>(i)</enum><text>by striking <quote>2019</quote> and inserting <quote>2022</quote>; and</text>
</clause><clause commented="no" id="H5220F1F3EF8B49CEBA98195859CC20D2"><enum>(ii)</enum><text>by striking <quote>The preceding sentence shall not be construed as preventing a State during such period</quote> and inserting <quote>During the period that begins on October 1, 2019, and ends on September 30, 2022, the preceding sentence shall only apply with respect to children in families whose income does not exceed 300 percent of the poverty line (as defined in section 2110(c)(5)) applicable to a family of the size involved. The preceding sentences shall not be construed as preventing a State during any such periods</quote>.</text>
</clause></subparagraph></paragraph><paragraph commented="no" id="HD4233AEA54BE440CB2FFB2F01CE0DC47"><enum>(2)</enum><header>Conforming amendments</header><text>Section 1902(gg)(2) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a(gg)(2)</external-xref>) is amended—</text> <subparagraph commented="no" id="H301204A6EABC4E5B8C5C8748995F22E2"><enum>(A)</enum><text>in the paragraph heading, by striking <quote><header-in-text level="paragraph" style="OLC">until October <enum-in-header>1</enum-in-header>, <enum-in-header>2019</enum-in-header></header-in-text></quote> and inserting <quote><header-in-text level="paragraph" style="OLC">through September <enum-in-header>30</enum-in-header>, <enum-in-header>2022</enum-in-header></header-in-text></quote>; and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H0B92DF0AD31E4DF5AC68912EED76A111"><enum>(B)</enum><text>by striking <quote>September 30, 2019,</quote> and inserting <quote>September 30, 2022 (but during the period that begins on October 1, 2019, and ends on September 30, 2022, only with respect to children in families whose income does not exceed 300 percent of the poverty line (as defined in section 2110(c)(5)) applicable to a family of the size involved)</quote>.</text>
</subparagraph></paragraph></subsection><subsection id="HA1029A19C27A49E2968519C73FA714F9"><enum>(g)</enum><header>CHIP look-Alike plans</header>
<paragraph id="H163E8EFBEEE74D3081E0AF8C43D7C04C"><enum>(1)</enum><header>Blending risk pools</header><text>Section 2107 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397gg">42 U.S.C. 1397gg</external-xref>) is amended by adding at the end the following:</text>
<quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="H2DAD134FD5ED420FA51E31DAA625372C" reported-display-style="italic" style="OLC">
<subsection id="H0B6A898DA4DB422BB8DA5F7E55A64211"><enum>(g)</enum><header>Use of blended risk pools</header>
<paragraph id="H916A8F12641743F6B3562B91CCEF8BB6"><enum>(1)</enum><header>In general</header><text>Nothing in this title (or any other provision of Federal law) shall be construed as preventing a State from considering children enrolled in a qualified CHIP look-alike program and children enrolled in a State child health plan under this title (or a waiver of such plan) as members of a single risk pool.</text>
</paragraph><paragraph commented="no" id="H92FE6ACA5CD243BFAD55698253E3C653"><enum>(2)</enum><header>Qualified CHIP look-alike program</header><text display-inline="yes-display-inline">In this subsection, the term <term>qualified CHIP look-alike program</term> means a State program—</text> <subparagraph commented="no" id="HF82540737EAB4C8B84CDF8DCA9A0C707"><enum>(A)</enum><text display-inline="yes-display-inline">under which children who are under the age of 19 and are not eligible to receive medical assistance under title XIX or child health assistance under this title may purchase coverage through the State that provides benefits that are at least identical to the benefits provided under the State child health plan under this title (or a waiver of such plan); and</text>
</subparagraph><subparagraph commented="no" id="H32F746353ABE449BAE30F3220FA595BA"><enum>(B)</enum><text display-inline="yes-display-inline">that is funded exclusively through non-Federal funds, including funds received by the State in the form of premiums for the purchase of such coverage.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph commented="no" id="H230C650EACAF4E83957EAE2B064E3463"><enum>(2)</enum><header>Coverage rule</header>
<subparagraph commented="no" id="H82A9DD868A2641C1B2FBBA95E3E0E62E"><enum>(A)</enum><header>In general</header><text><external-xref legal-doc="usc" parsable-cite="usc/26/5000A">Section 5000A(f)(1)</external-xref> of the Internal Revenue Code of 1986 is amended in subparagraph (A)(iii), by inserting <quote>or under a qualified CHIP look-alike program (as defined in section 2107(g) of the Social Security Act)</quote> before the comma at the end.</text>
</subparagraph><subparagraph commented="no" id="HB1B683C814DC424FB56964E2D07EAEA0"><enum>(B)</enum><header>Effective date</header><text>The amendment made by subparagraph (A) shall apply with respect to taxable years beginning after December 31, 2017.</text>
</subparagraph></paragraph></subsection></section><section commented="no" id="H4CF94DCB6FB047CF8DD76C3AB11342A4"><enum>102.</enum><header>Extension of certain programs and demonstration projects</header>
<subsection commented="no" id="H301765E82A674D73A701DF7B0A61E74A"><enum>(a)</enum><header>Childhood obesity demonstration project</header><text>Section 1139A(e)(8) of the Social Security Act (42 U.S.C. 1320b–9a(e)(8)) is amended—</text> <paragraph commented="no" id="H1ADB92FC293741B7912191F3F5AB440E"><enum>(1)</enum><text>by striking <quote>and $10,000,000</quote> and inserting <quote>, $10,000,000</quote>; and</text>
</paragraph><paragraph commented="no" id="H5E5D99B0E89E427CB7846984BB2BBE74"><enum>(2)</enum><text>by inserting after <quote>2017</quote> the following: <quote>, and $25,000,000 for the period of fiscal years 2018 through 2022</quote>.</text> </paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HD599E36DCDE6464483EFA43E3D0D0913"><enum>(b)</enum><header display-inline="yes-display-inline">Pediatric quality measures program</header><text display-inline="yes-display-inline">Section 1139A(i) of the Social Security Act (42 U.S.C. 1320b–9a(i)) is amended—</text>
<paragraph commented="no" display-inline="no-display-inline" id="H440BF74AE4E84A22A7D5EE4F0F4116E6"><enum>(1)</enum><text display-inline="yes-display-inline">by striking <quote>Out of any</quote> and inserting the following:</text> <quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="HF944ECE7C14740EEB1B13ED8067BB542" reported-display-style="italic" style="OLC"> <paragraph commented="no" display-inline="no-display-inline" id="H5AF32370A60B44EABAAB272D973B669D"><enum>(1)</enum><header>In general</header><text>Out of any</text></paragraph><after-quoted-block>;</after-quoted-block></quoted-block>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H922CBCCCE2F242DBAFDBAB3B3AF887C4"><enum>(2)</enum><text>by striking <quote>there is appropriated for each</quote> and inserting “there is appropriated—</text> <quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="H6AC829D816B34366A5AC0DAF260D16FB" reported-display-style="italic" style="OLC"> <subparagraph commented="no" display-inline="no-display-inline" id="H6E1C8CD4818A4D7DB8FE36119AC06B26"><enum>(A)</enum><text>for each</text></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H89AC3D4CE1E542FD8623007DD536A8BA"><enum>(3)</enum><text>by striking <quote>, and there is appropriated for the period</quote> and inserting “;</text> <quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="HF1A1C6F78FF849DBAB5B7B1F59A24213" reported-display-style="italic" style="OLC"> <subparagraph commented="no" display-inline="no-display-inline" id="HF3CA30ADE4774D46A76CFF0C4DA685A1"><enum>(B)</enum><text>for the period</text></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H33FBE149D7C1450F8CDE99A9E8E5343E"><enum>(4)</enum><text>by striking <quote>. Funds appropriated under this subsection shall remain available until expended.</quote> and inserting <quote>; and</quote>; and</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="H09B40D6FC757457D9940D56D37D43CDB"><enum>(5)</enum><text>by adding at the end the following:</text>
<quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="HADC7A921DA0B4337B1E40176DAFCCB9B" reported-display-style="italic" style="OLC">
<subparagraph commented="no" display-inline="no-display-inline" id="H250B7741BE6044C9A4857C4A36AFA199"><enum>(C)</enum><text>for the period of fiscal years 2018 through 2022, $75,000,000 for the purpose of carrying out this section (other than subsections (e), (f), and (g)).</text>
</subparagraph><paragraph commented="no" display-inline="no-display-inline" id="H861D1587EB774C1BB0EEA94236C76AAD"><enum>(2)</enum><header>Availability</header><text>Funds appropriated under this subsection shall remain available until expended.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block> </paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="H97EDE57B05E94C65A1A73CEEC0162B6D" section-type="subsequent-section"><enum>103.</enum><header display-inline="yes-display-inline">Extension of outreach and enrollment program</header> <subsection id="H40E11859E72743ABA95262DD3BD459DE"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 2113 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397mm">42 U.S.C. 1397mm</external-xref>) is amended—</text>
<paragraph commented="no" id="HF96D98D2DCF3483FB1EA9A7D68EAD108"><enum>(1)</enum><text>in subsection (a)(1), by striking <quote>2017</quote> and inserting <quote>2022</quote>; and</text> </paragraph><paragraph commented="no" id="H56B32A48E7DB40EBA7810135B8E293D0"><enum>(2)</enum><text>in subsection (g)—</text>
<subparagraph commented="no" id="H37814F9416F040F7A2F16A4AA29830DF"><enum>(A)</enum><text>by striking <quote>and $40,000,000</quote> and inserting <quote>, $40,000,000</quote>; and</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H7415D2171A3142BAA7AC204FEE83F69A"><enum>(B)</enum><text>by inserting after <quote>2017</quote> the following: <quote>, and $100,000,000 for the period of fiscal years 2018 through 2022</quote>.</text>
</subparagraph></paragraph></subsection><subsection id="H408362C103304AFCA2C9688AF32A74A7"><enum>(b)</enum><header>Making parent mentors eligible to receive grants</header><text display-inline="yes-display-inline">Section 2113(f) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397mm">42 U.S.C. 1397mm(f)</external-xref>) is amended—</text> <paragraph id="HC1E3AC7AC5594DE8B1FB2CB50526ADD0"><enum>(1)</enum><text>in paragraph (1), by adding at the end the following new subparagraph:</text>
<quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="H574186BA7D5F4830AEA3CC524588E2E9" reported-display-style="italic" style="OLC">
<subparagraph id="H53A5370E8C264D86AB9A0846EF8F0584"><enum>(H)</enum><text display-inline="yes-display-inline">Parent mentors.</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block> </paragraph><paragraph id="HA2CD1E07E4064C018EA9235AD667850F"><enum>(2)</enum><text>by adding at the end the following new paragraph:</text>
<quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="HA2426C53EF8440F6AD2F9E66922EEDB1" reported-display-style="italic" style="OLC">
<paragraph id="H4905325C55554C33B48B99B6B376D4E5"><enum>(5)</enum><header>Parent mentor</header><text display-inline="yes-display-inline">The term <quote>parent mentor</quote> means an individual who—</text> <subparagraph id="H846C28D2650A40FC9D26338121837CBB"><enum>(A)</enum><text>is a parent or guardian of at least one child who is an eligible child under this title or title XIX; and</text>
</subparagraph><subparagraph id="H1ED654BC3F09436BBF27B94373743054"><enum>(B)</enum><text>is trained to assist families with children who have no health insurance coverage with respect to improving the social determinants of the health of such children, including by providing—</text>
<clause id="H615639AFFE084782BBD8CB46BC43D2DB"><enum>(i)</enum><text>education about health insurance coverage, including, with respect to obtaining such coverage, eligibility criteria and application and renewal processes;</text>
</clause><clause id="HDE445D4AE2094006ABEA69CC5E0956C9"><enum>(ii)</enum><text>assistance with completing and submitting applications for health insurance coverage;</text> </clause><clause id="H2CA7F72652D049FC8673635FDE66D5B9"><enum>(iii)</enum><text>a liaison between families and representatives of State plans under title XIX or State child health plans under this title;</text>
</clause><clause id="HD65E6B0F6F6C45188C3EDF85D6BB7478"><enum>(iv)</enum><text>guidance on identifying medical and dental homes and community pharmacies for children; and</text> </clause><clause id="H9DECA8D3F0564E2F85873B8DD0AF41ED"><enum>(v)</enum><text>assistance and referrals to successfully address social determinants of children’s health, including poverty, food insufficiency, and housing.</text></clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="H41CB13DA57934AAE8A490656A020F613"><enum>104.</enum><header>Extension and reduction of additional Federal financial participation for CHIP</header><text display-inline="no-display-inline">Section 2105(b) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397ee">42 U.S.C. 1397ee(b)</external-xref>) is amended in the second sentence by inserting <quote>and during the period that begins on October 1, 2019, and ends on September 30, 2020, the enhanced FMAP determined for a State for a fiscal year (or for any portion of a fiscal year occurring during such period) shall be increased by 11.5 percentage points</quote> after <quote>23 percentage points,</quote>.</text>
</section><section id="H1E57DBD82F954131B7CAD14B517E8684" section-type="subsequent-section"><enum>105.</enum><header>Modifying reduction in Medicaid DSH allotments</header><text display-inline="no-display-inline">Section 1923(f)(7)(A)(ii) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396r-4">42 U.S.C. 1396r–4(f)(7)(A)(ii)</external-xref>) is amended—</text> <paragraph id="H31E2CC64C16E4FB8A4ECF723AE22FBC7"><enum>(1)</enum><text>by striking subclause (I) and redesignating subclauses (II) through (VIII) as subclauses (I) through (VII), respectively;</text>
</paragraph><paragraph id="H33BFAD402FA64CF8991F57FE35FF4FC8"><enum>(2)</enum><text>in subclause (VI), as redesignated by paragraph (1), by striking at the end <quote>and</quote>;</text> </paragraph><paragraph id="H2C6E980AFC034BD3AB2D401575876BD5"><enum>(3)</enum><text>in subclause (VII), as redesignated by paragraph (1), by striking at the end the period and inserting a semicolon; and</text>
</paragraph><paragraph id="H0E5171B62AE74320BE585C9898670B66"><enum>(4)</enum><text>by adding at the end the following new subclauses:</text> <quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="HC2EFC7AC39374717A1ABE9E5F4B233E9" reported-display-style="italic" style="OLC"> <subclause id="HC5A18260E88149ACB9CB2A7D791355EF"><enum>(VIII)</enum><text>$8,000,000,000 for fiscal year 2026; and</text>
</subclause><subclause id="H3D6FA27057C24C8EB55574861CBE11D4"><enum>(IX)</enum><text display-inline="yes-display-inline">$8,000,000,000 for fiscal year 2027.</text></subclause><after-quoted-block>.</after-quoted-block></quoted-block> </paragraph></section><section id="H44D30F111505403CB22086699D085421" section-type="subsequent-section"><enum>106.</enum><header>Puerto Rico and the Virgin Islands Medicaid payments</header> <subsection id="HDE5659F51BDA4CC0A4EC7ECB3FEF8003"><enum>(a)</enum><header>Increased cap</header><text display-inline="yes-display-inline">Section 1108(g) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1308">42 U.S.C. 1308(g)</external-xref>) is amended—</text>
<paragraph id="H1DF82AF4152242C79B6CAAAE2EFE4BD2"><enum>(1)</enum><text>in paragraph (2)—</text> <subparagraph id="HCD09A9CFEFB64CEABCEEAC99CB3AB6AA"><enum>(A)</enum><text>in subparagraph (A), by inserting <quote>(or, with respect to fiscal years 2018 and 2019, increased by such percentage increase plus one percentage point)</quote> after <quote>beginning of the fiscal year</quote>; and</text>
</subparagraph><subparagraph id="H087710B6287C460E9CF365D21DDBD5C0"><enum>(B)</enum><text>in subparagraph (B), by inserting <quote>(or, with respect to fiscal years 2018 and 2019, increased by such percentage increase plus one percentage point)</quote> after <quote>percentage increase referred to in subparagraph (A)</quote>;</text>
</subparagraph></paragraph><paragraph id="H83B461FA5B11487AA23DFC9744687E19"><enum>(2)</enum><text>in paragraph (5)—</text> <subparagraph id="H9F044415B7F74B06A9F376D460B0FDC4"><enum>(A)</enum><text>in subparagraph (A), by striking <quote>subparagraph (B)</quote> and inserting <quote>subparagraphs (B), (C), (D), (E), and (F)</quote>; and</text>
</subparagraph><subparagraph id="H550C23BF530A45F3A5DBF1FE381E333C"><enum>(B)</enum><text>by adding at the end the following new subparagraphs:</text> <quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="HAA9751369C204D44B6E00ABD59F3E31D" reported-display-style="italic" style="OLC"> <subparagraph id="H2AF0AB072DE941FF90F15B37901BDAC0" indent="up1"><enum>(C)</enum><text display-inline="yes-display-inline">The amount of the increase otherwise provided under subparagraph (A) for Puerto Rico shall be further increased by $880,000,000.</text>
</subparagraph><subparagraph id="H4E287EC653F543CC9D9D32A989C9EF16" indent="up1"><enum>(D)</enum>
<clause commented="no" display-inline="yes-display-inline" id="HCE4F83F56F6943BDB3BCA618C3507163"><enum>(i)</enum><text display-inline="yes-display-inline">For the period beginning October 1, 2017, and ending December 31, 2019, the amount of the increase otherwise provided under subparagraph (A) for Puerto Rico shall be further increased by $120,000,000 if the Financial Oversight and Management Board for Puerto Rico established under section 101 of the Puerto Rico Oversight, Management, and Economic Stability Act (<external-xref legal-doc="usc" parsable-cite="usc/48/2121">48 U.S.C. 2121</external-xref>) certifies by a majority vote that Puerto Rico has taken reasonable and appropriate steps during such period to—</text>
<subclause changed="added" committee-id="HIF00" id="HE9E14846BE8649E09B93003574D4BF90" indent="up1" reported-display-style="italic"><enum>(I)</enum><text>reduce fraud, waste, and abuse under the program under title XIX;</text> </subclause><subclause changed="added" committee-id="HIF00" id="HB8A448EDC954470AA8F8A397A374CB14" indent="up1" reported-display-style="italic"><enum>(II)</enum><text>implement strategies to reduce unnecessary, inefficient, or excessive spending under title XIX;</text>
</subclause><subclause changed="added" committee-id="HIF00" id="HDF058B7853F3452FA84762D650D2C9B9" indent="up1" reported-display-style="italic"><enum>(III)</enum><text>improve the use and availability of Medicaid data for program operation and oversight; and</text> </subclause><subclause changed="added" committee-id="HIF00" id="HDF7C85B84367425FB19547EFC4B0C8EB" indent="up1" reported-display-style="italic"><enum>(IV)</enum><text>improve the quality of care and patient experience for individuals enrolled under the program under title XIX.</text>
</subclause></clause><clause changed="added" committee-id="HIF00" id="HA28185E832DC4E6D953A75049C097A50" indent="up1" reported-display-style="italic"><enum>(ii)</enum><text display-inline="yes-display-inline">As a condition of any additional increase pursuant to clause (i), not later than October 1, 2018, Puerto Rico shall submit to the Financial Oversight and Management Board for Puerto Rico a report regarding steps taken to achieve each of the goals described in subclauses (I) through (IV) of clause (i).</text>
</clause></subparagraph><subparagraph commented="no" id="HBB3732356D7A4226886A0ED1A98C3D16" indent="up1"><enum>(E)</enum><text>Payments under section 1903(a)(8) for a quarter of a fiscal year shall not be taken into account in applying subsection (f) (as increased in accordance with this paragraph and paragraphs (1), (2), (3), and (4)) to Puerto Rico or the Virgin Islands for such fiscal year.</text>
</subparagraph><subparagraph commented="no" id="HC794D894D51E4CA9B53159C0206C089E" indent="up1"><enum>(F)</enum>
<clause commented="no" display-inline="yes-display-inline" id="H396AEE2B507A47658523AAFACF41381A"><enum>(i)</enum><text display-inline="yes-display-inline">For the period beginning October 1, 2017, and ending December 31, 2019, the amount of the increase otherwise provided under subparagraph (A) for the Virgin Islands shall be further increased by an amount equal to the per capita equivalent of the total amount of the increase provided for Puerto Rico under subparagraphs (C) and (D) for such period.</text>
</clause><clause changed="added" commented="no" committee-id="HIF00" id="H11E757C27C7D44BBB2A24D5C049A62A0" indent="up1" reported-display-style="italic"><enum>(ii)</enum><text display-inline="yes-display-inline">For purposes of clause (i), the term <quote>per capita equivalent</quote> means the ratio of—</text> <subclause commented="no" id="HB6A6507E18024BC2A4D76F0137E84425"><enum>(I)</enum><text>the population of the Virgin Islands, as determined by the most recent census estimate released by the Bureau of the Census before September 4, 2017; to</text>
</subclause><subclause commented="no" id="H964480E5DDD6436C8A389A4354D79047"><enum>(II)</enum><text>the population of Puerto Rico, as so determined.</text></subclause></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block> </subparagraph></paragraph></subsection><subsection id="H805276BADFD84B8B8EAE18018CF70724"><enum>(b)</enum><header>Federal match for medical personnel and fraud reduction</header><text>Section 1903(a) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396b">42 U.S.C. 1396b(a)</external-xref>) is amended—</text>
<paragraph id="HBBD82081EC404F6592B1F4FF43D1C2C4"><enum>(1)</enum><text>in paragraph (2)(A), by inserting <quote>subject to paragraph (8),</quote> before <quote>an amount</quote>;</text> </paragraph><paragraph id="H63FB1B62D1754C608145C14A70A66C71"><enum>(2)</enum><text>in paragraph (6)—</text>
<subparagraph id="H198D1FB5E03E41C08A3F04CE282ED197"><enum>(A)</enum><text>in subparagraph (B), by inserting <quote>subject to paragraph (8),</quote> before <quote>75 per centum</quote>; and</text> </subparagraph><subparagraph id="H301A342D47B94908A123F0469BA46DCA"><enum>(B)</enum><text>by striking at the end <quote>plus</quote>;</text>
</subparagraph></paragraph><paragraph id="H76D1B5D55F784EECB57118172DDCA86A"><enum>(3)</enum><text>in paragraph (7), by striking at the end the period and inserting <quote>; plus</quote> ; and</text> </paragraph><paragraph id="HF655F770747C4351A85087EE5CA8DB20"><enum>(4)</enum><text>by adding at the end the following new paragraph:</text>
<quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="H80E1EA6B877D414FBEC9F582F227EA84" reported-display-style="italic" style="OLC">
<paragraph id="HEBBEB28BAE264924AD3F78D3531B94D3"><enum>(8)</enum><text display-inline="yes-display-inline">for quarters during the period beginning January 1, 2018, and ending December 31, 2019, paragraphs (2)(A) and (6) shall apply with respect to Puerto Rico and the Virgin Islands as if—</text>
<subparagraph id="H070BCAE596C44D95A2559A5FB2713F6F"><enum>(A)</enum><text>the reference to <quote>75 per centum</quote> in paragraph (2)(A) were a reference to <quote>90 per centum</quote>; and</text> </subparagraph><subparagraph id="H5A8AB3210CF3499DB36455D9F33AE51B"><enum>(B)</enum><text>the reference to <quote>75 per centum</quote> in paragraph (6)(B) were a reference to <quote>90 per centum</quote>.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section><enum>II</enum><header>Offsets</header>
<section id="HBC18BCA42D7343F19993A73F70151C7F"><enum>201.</enum><header>Medicaid third party liability provisions</header>
<subsection id="H533A011D4B5F4B4A9DCC8D1B48AA0BAA"><enum>(a)</enum><header>Medicaid third party liability</header>
<paragraph id="HBCB9CBA85E73432DA66736EC2D526838"><enum>(1)</enum><header>Delay of Bipartisan Budget Act of 2013 third party liability provisions</header>
<subparagraph id="H05045D126F774489A5210A674BB014B2"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">Section 202(c) of the Bipartisan Budget Act of 2013 (<external-xref legal-doc="public-law" parsable-cite="pl/113/67">Public Law 113–67</external-xref>; 127 Stat. 1177; <external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a</external-xref> note), as amended by section 211 of the Protecting Access to Medicare Act of 2014 (<external-xref legal-doc="public-law" parsable-cite="pl/113/93">Public Law 113–93</external-xref>; 128 Stat. 1047; <external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a</external-xref> note) and section 220 of the Medicare Access and CHIP Reauthorization Act of 2015 (<external-xref legal-doc="public-law" parsable-cite="pl/114/10">Public Law 114–10</external-xref>), is amended by striking <quote>2017</quote> and inserting <quote>2019</quote>.</text>
</subparagraph><subparagraph id="HB693D5FD0B3C44649883002FB7A131B4"><enum>(B)</enum><header>Effective date; treatment</header><text>The amendment made by subparagraph (A) shall take effect on September 30, 2017, and shall apply with respect to claims generated or filed after such date.</text>
</subparagraph></paragraph><paragraph id="H7A575426871D47E3B8272F3537BCD006"><enum>(2)</enum><header>Clarification of definitions applicable to third party liability</header>
<subparagraph id="H0396E62840BD402DBD0DF5D0C13365AC"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1902 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a</external-xref>) is amended by adding at the end the following new subsection:</text>
<quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="HC9B7B53844C8430AB8A4AE9DE877C152" reported-display-style="italic" style="OLC">
<subsection id="H04386FF0C3484C82B407EBE764106AB6"><enum>(nn)</enum><header>Responsible Third Party and Health Insurer Definitions</header><text display-inline="yes-display-inline">For purposes of subsection (a)(25) and section 1903(d)(2)(B):</text> <paragraph id="H416B3C6AAC3845D0910D35267EF8145E"><enum>(1)</enum><header>Responsible third party</header><text>The term <quote>responsible third party</quote> means a health insurer, an accountable care organization, or any other party that is, by statute, contract, or agreement, legally responsible for payment of a claim for a health care item or service. Such term does not include a party if payment by such party has been made or can reasonably be expected to be made under a workmen’s compensation law or plan of the United States or a State, or under an automobile or liability insurance policy or plan (including a self-insured plan), or under no fault insurance.</text>
</paragraph><paragraph id="HFD238C160E5347D7B65CE3CCF0C39C11"><enum>(2)</enum><header>Health insurer</header><text display-inline="yes-display-inline">The term <quote>health insurer</quote> means a group health plan, as defined in section 607(1) of the Employee Retirement Income Security Act of 1974, a self-insured plan, a fully-insured plan<italic></italic>, a service benefit plan, a medicaid managed care plan under section 1903(m) or 1932, a pharmacy benefit manager, and any other health plan determined appropriate by the Secretary.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph><subparagraph commented="no" id="HC77B091FC7B744EFA83A4F99302192BD"><enum>(B)</enum><header>Conforming amendments</header><text display-inline="yes-display-inline">Section 1902(a)(25) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a(a)(25)</external-xref>) is amended—</text> <clause commented="no" id="H77902B4652DE47019B0D814023409D96"><enum>(i)</enum><text>in subparagraph (A), in the matter preceding clause (i), by striking <quote>third parties</quote> and all that follows through <quote>item or service)</quote> and inserting <quote>responsible third parties</quote>;</text>
</clause><clause commented="no" id="H0904D2C393024DBAABF60F5E9A53C947"><enum>(ii)</enum><text display-inline="yes-display-inline">in subparagraph (G), by striking <quote>health insurer</quote> and all that follows through <quote>item or service)</quote> and inserting <quote>responsible third party</quote>;</text> </clause><clause commented="no" id="H985DAC6D2E6049229EACF2A806D89216"><enum>(iii)</enum><text>in subparagraph (I), in the matter preceding clause (i), by striking <quote>health insurers</quote> and all that follows through <quote>item or service</quote> and inserting <quote>responsible third parties</quote>; and</text>
</clause><clause commented="no" id="HF3A0EA59E7D7449F80755043748D99EB"><enum>(iv)</enum><text display-inline="yes-display-inline">by inserting <quote>responsible</quote> before <quote>third</quote> each place it appears in subparagraphs (A)(i), (A)(ii), (C), (D), and (H).</text> </clause></subparagraph></paragraph><paragraph id="H57F9EFCF9BC842538D9B08DDB44F294D"><enum>(3)</enum><header>Removal of special treatment of certain types of care and payments under Medicaid third party liability rules</header><text display-inline="yes-display-inline">Section 1902(a)(25) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a(a)(25)</external-xref>), as amended by section 202(c) of the Bipartisan Budget Act of 2013 (after application of paragraph (1)), is amended by striking subparagraphs (E) and (F).</text>
</paragraph><paragraph id="H41625EC2F4D74C3BB6D1645BFA8CC8AB"><enum>(4)</enum><header>Clarification of role of health insurers with respect to third party liability</header>
<subparagraph id="H4369813324B94235996F9CDEED9A68EB"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1902(a)(25) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a(a)(25)</external-xref>), as amended by paragraph (3), is further amended by inserting after subparagraph (D) the following new subparagraphs:</text>
<quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="HBD0EACC92F504D56BD697D3EC9E6B565" reported-display-style="italic" style="traditional">
<subparagraph id="H845BB24BE7404B279DB73C1C67D02AF1"><enum>(E)</enum><text display-inline="yes-display-inline">that, in the case of a State that provides medical assistance under this title through a contract with a health insurer, such contract shall specify whether the State is—</text>
<clause id="HAB9E40F19C264C08A1B58CC355382742"><enum>(i)</enum><text display-inline="yes-display-inline">delegating to such insurer all or some of its right of recovery from a responsible third party for an item or service for which payment has been made under the State plan (or under a waiver of the plan); and</text>
</clause><clause id="HC72F9CC3C202423484F4102EBFF8DBF3"><enum>(ii)</enum><text display-inline="yes-display-inline">transferring to such insurer all or some of the assignment to the State of any right of an individual or other entity to payment from a responsible third party for an item or service for which payment has been made under the State plan (or under a waiver of the plan);</text>
</clause></subparagraph><subparagraph id="HA2194B5781DE4E8F80BE1BBF22699930"><enum>(F)</enum><text display-inline="yes-display-inline">that, in the case of a State that elects an option described in clause (i) or (ii) of subparagraph (E) with respect to a health insurer, the State shall provide assurances to the Secretary that the State laws referred to in subparagraph (I) confer to the health insurer the authority of the State with respect to the requirements specified in clauses (i) through (iv) of such subparagraph;</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="H55BAB7C5308B4972865C5E8EB16B13CE"><enum>(B)</enum><header>Treatment of collected amounts</header><text display-inline="yes-display-inline">Section 1903(d)(2)(B) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396b">42 U.S.C. 1396b(d)(2)(B)</external-xref>) is amended by adding at the end the following: <quote>For purposes of this subparagraph, reimbursements made by a responsible third party to health insurers pursuant to section 1902(a)(25)(E) shall be treated in the same manner as reimbursements made to a State under the previous sentence.</quote>.</text>
</subparagraph></paragraph><paragraph id="H89A851EB5F97415DAC67DC9C9B9BEDE4"><enum>(5)</enum><header>Increasing State flexibility with respect to third party liability</header><text>Section 1902(a)(25)(I) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a(a)(25)(I)</external-xref>) is amended—</text> <subparagraph id="H3B3B6C6D0EC94497B5B7DCD6E829E1AC"><enum>(A)</enum><text display-inline="yes-display-inline">in clause (i), by striking <quote>medical assistance under the State plan</quote> and inserting <quote>medical assistance under a State plan (or under a waiver of the plan)</quote>;</text>
</subparagraph><subparagraph id="HCF4E2B7A4D0B42378D464F1D39D59EDE"><enum>(B)</enum><text>by striking clause (ii) and inserting the following new clause:</text> <quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="HEF216D6956474A339C047D8C28E7E067" reported-display-style="italic" style="traditional"> <clause id="H52C24D466C5A434CA3B3F6F20F72B87E"><enum>(ii)</enum><text>accept—</text>
<subclause id="HD7557E487A1B40B894CB504697A35B75"><enum>(I)</enum><text display-inline="yes-display-inline">any State’s right of recovery and the assignment to any State of any right of an individual or other entity to payment from the party for an item or service for which payment has been made under the respective State’s plan (or under a waiver of the plan); and</text>
</subclause><subclause id="H2F0D8A1BF77E4B47B18B3EC65F6C1DEF"><enum>(II)</enum><text display-inline="yes-display-inline">as a valid authorization of the responsible third party for the furnishing of an item or service to an individual eligible to receive medical assistance under this title, an authorization made on behalf of such individual under the State plan (or under a waiver of such plan) for the furnishing of such item or service to such individual;</text></subclause></clause><after-quoted-block>; </after-quoted-block></quoted-block>
</subparagraph><subparagraph id="HB767C27A14E94E8A823CEB275B3DAAD1"><enum>(C)</enum><text>in clause (iii)—</text> <clause id="H70AFA371D52649548D18E299F9A363A4"><enum>(i)</enum><text>by striking <quote>respond to</quote> and inserting <quote>not later than 60 days after receiving</quote>; and</text>
</clause><clause id="H36B89B259E0F4ACC84B78CE0049D5CFD"><enum>(ii)</enum><text>by striking <quote>; and</quote> at the end and inserting <quote>, respond to such inquiry; and</quote>; and</text> </clause></subparagraph><subparagraph id="H97C0CF5BC0AE4F57B0648C4C443069C0"><enum>(D)</enum><text>in clause (iv), by inserting <quote>a failure to obtain a prior authorization,</quote> after <quote>claim form,</quote>.</text>
</subparagraph></paragraph><paragraph id="H81BD41A4DE254FCB8E1F847EF54ED30D"><enum>(6)</enum><header>State incentive to pursue third party liability for newly eligibles</header><text>Section 1903(d)(2)(B) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396b">42 U.S.C. 1396b(d)(2)(B)</external-xref>), as amended by paragraph (4)(B), is further amended by adding at the end the following: <quote>In the case of expenditures for medical assistance provided during 2017 and subsequent years for individuals described in subclause (VIII) of section 1902(a)(10)(A)(i), in determining the amount, if any, of overpayment under this subparagraph with respect to such medical assistance, the Secretary shall apply the Federal medical assistance percentage for the State under section 1905(b), notwithstanding the application of section 1905(y).</quote>.</text>
</paragraph></subsection><subsection id="HA5B2BC1661EE416CA0090D747742E0AF"><enum>(b)</enum><header>Compliance with third party insurance reporting</header><text>Section 1903 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396b">42 U.S.C. 1396b</external-xref>) is amended by inserting after subsection (m) the following new subsection:</text>
<quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="HB0E5F7DE544E43048AC4398E273F1F35" reported-display-style="italic" style="traditional">
<subsection id="H77CF66330A194B7683CFD25A048A322E"><enum>(n)</enum>
<paragraph commented="no" display-inline="yes-display-inline" id="H41A52981F6F24416B212FDFD1984653F"><enum>(1)</enum><text>For any year beginning after 2020 (or a sooner year as provided in paragraph (2)), if a State fails to comply with the requirements of section 1902(a)(25) with respect to each calendar quarter in such year, the Secretary may reduce the Federal medical assistance percentage by 0.1 percentage point for calendar quarters in each subsequent year in which the State fails to so comply (and cumulatively for a failure to so comply for a period of consecutive years).</text>
</paragraph><paragraph changed="added" committee-id="HIF00" id="H0E8B65106EBD4421A2DD5762301B2C60" indent="up1" reported-display-style="italic"><enum>(2)</enum><text>The Secretary may apply paragraph (1)—</text> <subparagraph id="H177A49727F99416EBC7F31C5A9101D80"><enum>(A)</enum><text display-inline="yes-display-inline">for any year beginning after 2018, if a State fails to comply with the requirements of section 1902(a)(25) with respect to payment for items and services furnished to individuals described in subclause (VIII) of section 1902(a)(10)(A)(i) or non-expansion individuals; and</text>
</subparagraph><subparagraph id="H1B2B59B31C8947939934875CA04F9BC5"><enum>(B)</enum><text display-inline="yes-display-inline">for any year beginning after 2019, if a State fails to comply with the requirements of section 1902(a)(25) with respect to payment for items and services furnished to individuals described in subdivision (i), (iii), or (iv) of section 1905(a).</text>
</subparagraph></paragraph><paragraph changed="added" committee-id="HIF00" id="H9334E0B6580E445B9BA4CECF22FB27CF" indent="up1" reported-display-style="italic"><enum>(3)</enum><text display-inline="yes-display-inline">For purposes of this subsection, the term <quote>non-expansion individual</quote> means, with respect to a State for a month, an individual who is—</text> <subparagraph id="H0DAB0E0DC64C4772A1F17ED8B395C4D7"><enum>(A)</enum><text>eligible for medical assistance for items or services under this title and enrolled under the State plan (or a waiver of such plan) under this title for the month;</text>
</subparagraph><subparagraph id="HD49C96D552D14177A66AAC8492FF54CE"><enum>(B)</enum><text display-inline="yes-display-inline">not under 19 years of age;</text> </subparagraph><subparagraph id="H8E138611F0CE447EBBC9C750FFFFF0BB"><enum>(C)</enum><text>not 65 years of age or older; and</text>
</subparagraph><subparagraph id="HEE9049F3817947D7B4F3747EF8FED1C4"><enum>(D)</enum><text display-inline="yes-display-inline">not eligible for medical assistance under this title on the basis of being blind or disabled.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block> </subsection><subsection id="HCFCD7FAF6DB9405FBBBBDB10EBE455A0"><enum>(c)</enum><header>Application to CHIP</header> <paragraph id="HE5B9F3EBE3764D77884A9A38F8AF4DE7"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Section 2107(e)(1) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397gg">42 U.S.C. 1397gg(e)(1)</external-xref>) is amended—</text>
<subparagraph id="H1F614C2F4EDF4F2898BB1F36CE8D806A"><enum>(A)</enum><text>by redesignating subparagraphs (B) through (R) as subparagraphs (C) through (S), respectively; and</text> </subparagraph><subparagraph id="H3985E07DD0044F3FB77E282E341EC063"><enum>(B)</enum><text>by inserting after subparagraph (A) the following new subparagraph:</text>
<quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="HCB36ED7871514A96A856C85649FDEA04" reported-display-style="italic" style="OLC">
<subparagraph id="H8B797B27340F42E4A7168AFCC5A58320"><enum>(B)</enum><text display-inline="yes-display-inline">Section 1902(a)(25) (relating to third party liability).</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block> </subparagraph></paragraph><paragraph id="HED69A948CC8F4D2B94DE32054B0238D2"><enum>(2)</enum><header>Mandatory reporting</header><text>Section 1902(a)(25)(I)(i) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a(a)(25)(I)(i)</external-xref>), as amended by subsection (a)(5), is further amended—</text>
<subparagraph id="HCE2753A3D2E040F5BF208E6F57314E6C"><enum>(A)</enum><text>by striking <quote>(and, at State option, child</quote> and inserting <quote>and child</quote>; and</text> </subparagraph><subparagraph id="HF18CE90321994B2198AC7758C25347B4"><enum>(B)</enum><text>by striking <quote>title XXI)</quote> and inserting <quote>title XXI</quote>.</text>
</subparagraph></paragraph></subsection><subsection id="H851B7C5DAC6E4060902643E5DCCCB764"><enum>(d)</enum><header>Training on third party liability</header><text>Section 1936 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396u-6">42 U.S.C. 1396u–6</external-xref>) is amended—</text> <paragraph id="H555BEAA0168A48C58DEC04CF45B69DE6"><enum>(1)</enum><text>in subsection (b)(4), by striking <quote>and quality of care</quote> and inserting <quote>, quality of care, and the liability of responsible third parties (as defined in section 1902(nn))</quote>; and</text>
</paragraph><paragraph id="H9E80A5B6A5B741DEA101939C9838499F"><enum>(2)</enum><text>by adding at the end the following new subsection:</text> <quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="HE73B3800F8DF4E9C892EE3BC515E5E73" reported-display-style="italic" style="OLC"> <subsection id="H21B8DF2FDC294262B7D68DA948088E40"><enum>(f)</enum><header>Third party liability training</header><text display-inline="yes-display-inline">With respect to education or training activities carried out pursuant to subsection (b)(4) with respect to the liability of responsible third parties (as defined in section 1902(nn) for payment for items and services furnished under State plans (or under waivers of such plans)) under this title, the Secretary shall—</text>
<paragraph id="H3D0B8EFB85CE4D6CB6A429C0A866A71E"><enum>(1)</enum><text>publish (and update on an annual basis) on the public Internet website of the Centers for Medicare & Medicaid Services a dedicated Internet page containing best practices to be used in assessing such liability;</text>
</paragraph><paragraph id="HE57EF3FE746C4514A12EFF5B3FE82882"><enum>(2)</enum><text>monitor efforts to assess such liability and analyze the challenges posed by that assessment;</text> </paragraph><paragraph id="H9ECB64BF54E540718592A4E6E364ECE9"><enum>(3)</enum><text>distribute to State agencies administering the State plan under this title information related to such efforts and challenges; and</text>
</paragraph><paragraph id="H28FAA5949842426DA665C3A1E7814DDD"><enum>(4)</enum><text>provide guidance to such State agencies with respect to State oversight of efforts under a medicaid managed care plan under section 1903(m) or 1932 to assess such liability.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="HC2CE87B8CD5746FB8C6DF86A5F26EECA"><enum>(e)</enum><header>Development of model uniform fields for States To report third party information</header><text>Not later than January 1, 2019, the Secretary of Health and Human Services shall, in consultation with the States, develop and make available to the States a model uniform reporting field that States may use for purposes of reporting to the Secretary through the Transformed Medicaid Statistical Information System (T–MSIS) (or a successor system), or within CMS Form 64 (or any successor form), information identifying responsible third parties (as defined in subsection (nn) of section 1902 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a</external-xref>), as added by subsection (a)(2)(A)) and other relevant information for ascertaining the legal responsibility of such third parties to pay for care and services available under the State plan (or under a waiver of the plan) under title XIX of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396</external-xref> et seq.).</text>
</subsection><subsection id="HEF37C0B26AA0407AB7080C642C45B05F"><enum>(f)</enum><header>Effective date</header>
<paragraph id="H512D92F989B643C7B506533D5C72FA7B"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Except as provided in paragraph (2), this section and the amendments made by this section (other than as specified in the preceding provisions of this section) shall take effect on October 1, 2019, and shall apply to medical assistance or child health assistance provided on or after such date.</text>
</paragraph><paragraph id="H14A26D21964C477AA5148507864DC43E"><enum>(2)</enum><header>Exception if State legislation required</header><text display-inline="yes-display-inline">In the case of a State plan for medical assistance under title XIX of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396</external-xref> et seq.), or a State child health plan for child health assistance under title XXI of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397aa">42 U.S.C. 1397aa</external-xref> et seq.), that the Secretary of Health and Human Services determines requires State legislation (other than legislation appropriating funds) in order for the plan to meet the additional requirement imposed by the amendments made under this section, such plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet this additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of the enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of such session shall be deemed to be a separate regular session of the State legislature.</text>
</paragraph></subsection></section><section id="HDF34497CCD2549D29ACBCD6705369E01"><enum>202.</enum><header>Treatment of lottery winnings and other lump-sum income for purposes of income eligibility under
Medicaid</header>
<subsection id="H52E0E7F8776E479D879B20BCE4937BBB"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1902 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a</external-xref>) is amended—</text> <paragraph id="H72B0A6C16B0F4F62B35478105AB845B1"><enum>(1)</enum><text>in subsection (a)(17), by striking <quote>(e)(14), (e)(14)</quote> and inserting <quote>(e)(14), (e)(15)</quote>; and</text>
</paragraph><paragraph id="HF0E08332F6534F429E04C656FA56D011"><enum>(2)</enum><text>in subsection (e)—</text> <subparagraph id="H22974D3340F34B37ABBE2FEE6F06B686"><enum>(A)</enum><text>in paragraph (14) (relating to modified adjusted gross income), by adding at the end the following new subparagraph<italic></italic>:</text>
<quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="HAC592EEDA84C4A25BA40684F86F34E06" reported-display-style="italic" style="OLC">
<subparagraph id="HA465CE9CFCFB4983959A7A533792BAB5"><enum>(J)</enum><header>Treatment of certain lottery winnings and income received as a lump sum</header>
<clause id="H592AEA5305134E7897A5257F16F4F08B"><enum>(i)</enum><header>In general</header><text display-inline="yes-display-inline">In the case of an individual who is the recipient of qualified lottery winnings (pursuant to lotteries occurring on or after January 1, 2018) or qualified lump sum income (received on or after such date) and whose eligibility for medical assistance is determined based on the application of modified adjusted gross income under subparagraph (A), a State shall, in determining such eligibility, include such winnings or income (as applicable) as income received—</text>
<subclause id="HCE1DE7144AB945189A170362CCD27A0A"><enum>(I)</enum><text display-inline="yes-display-inline">in the month in which such winnings or income (as applicable) is received if the amount of such winnings or income is less than $80,000;</text>
</subclause><subclause id="H2BC854DC762B4D2793D7C3AB80CBDD94"><enum>(II)</enum><text display-inline="yes-display-inline">over a period of 2 months if the amount of such winnings or income (as applicable) is greater than or equal to $80,000 but less than $90,000;</text>
</subclause><subclause id="HEA1475BE9BC34AEC97FD3A9FAB2DE8D6"><enum>(III)</enum><text display-inline="yes-display-inline">over a period of 3 months if the amount of such winnings or income (as applicable) is greater than or equal to $90,000 but less than $100,000; and</text>
</subclause><subclause id="H12E8C9992D0844B19A55DD26F7AFE27C"><enum>(IV)</enum><text display-inline="yes-display-inline">over a period of 3 months plus 1 additional month for each increment of $10,000 of such winnings or income (as applicable) received, not to exceed a period of 120 months (for winnings or income of $1,260,000 or more), if the amount of such winnings or income is greater than or equal to $100,000.</text>
</subclause></clause><clause id="H38E189BA5AC64EEDA2BB8A913826B37A"><enum>(ii)</enum><header>Counting in equal installments</header><text>For purposes of subclauses (II), (III), and (IV) of clause (i), winnings or income to which such subclause applies shall be counted in equal monthly installments over the period of months specified under such subclause.</text>
</clause><clause commented="no" id="H70B19ED0B07C4DD2AC64AB1EE5FC5773"><enum>(iii)</enum><header>Hardship exemption</header><text display-inline="yes-display-inline">An individual whose income, by application of clause (i), exceeds the applicable eligibility threshold established by the State, shall continue to be eligible for medical assistance to the extent that the State determines, under procedures established by the State (in accordance with standards specified by the Secretary), that the denial of eligibility of the individual would cause an undue medical or financial hardship as determined on the basis of criteria established by the Secretary.</text>
</clause><clause commented="no" id="HEDE3E7BDB8F9406A8185FD85E8A32768"><enum>(iv)</enum><header>Notifications and assistance required in case of loss of eligibility</header><text>A State shall, with respect to an individual who loses eligibility for medical assistance under the State plan (or a waiver of such plan) by reason of clause (i)—</text>
<subclause commented="no" id="HE773B15CBDFB4B3F952C3743F170F5B6"><enum>(I)</enum><text>before the date on which the individual loses such eligibility, inform the individual—</text> <item commented="no" id="H5088FAEAA28F4B018F5B5E9048ECCFB5"><enum>(aa)</enum><text>of the individual’s opportunity to enroll in a qualified health plan offered through an Exchange established under title I of the Patient Protection and Affordable Care Act during the special enrollment period specified in <external-xref legal-doc="usc" parsable-cite="usc/26/9801">section 9801(f)(3)</external-xref> of the Internal Revenue Code of 1986 (relating to loss of Medicaid or CHIP coverage); and</text>
</item><item commented="no" id="HB2645DA7E747453FA63384D7E3D3C803"><enum>(bb)</enum><text display-inline="yes-display-inline">of the date on which the individual would no longer be considered ineligible by reason of clause (i) to receive medical assistance under the State plan or under any waiver of such plan and be eligible to reapply to receive such medical assistance; and</text>
</item></subclause><subclause commented="no" id="H05E4C9DE136045699BFD3D6B2EC8971A"><enum>(II)</enum><text>provide technical assistance to the individual seeking to enroll in such a qualified health plan.</text> </subclause></clause><clause id="H283EFFDC4F9B437786BDB60886C54B6B"><enum>(v)</enum><header>Qualified lottery winnings defined</header><text>In this subparagraph, the term <term>qualified lottery winnings</term> means winnings from a sweepstakes, lottery, or pool described in paragraph (3) of <external-xref legal-doc="usc" parsable-cite="usc/26/4402">section 4402</external-xref> of the Internal Revenue Code of 1986 or a lottery operated by a multistate or multijurisdictional lottery association, including amounts awarded as a lump sum payment.</text>
</clause><clause id="HFBDD791B6A7B459988770F897D7126A6"><enum>(vi)</enum><header>Qualified lump sum income defined</header><text display-inline="yes-display-inline">In this subparagraph, the term <term>qualified lump sum income</term> means income that is received as a lump sum<italic></italic> from one of the following sources:</text> <subclause id="HA713823EF6134A9AA9D51C4438AA05D0"><enum>(I)</enum><text display-inline="yes-display-inline">Monetary winnings from gambling (as defined by the Secretary and including gambling activities described in section 1955(b)(4) of title 18, United States Code).</text>
</subclause><subclause id="H02C5DDD5733C459A8A1AFD8DFE12CC16"><enum>(II)</enum><text display-inline="yes-display-inline">Damages received, whether by suit or agreement and whether as lump sums or as periodic payments (other than monthly payments), on account of causes of action other than causes of action arising from personal physical injuries or physical sickness.</text>
</subclause><subclause id="HA3EB0DA090A44A58BCE9E05EA36A1DD8"><enum>(III)</enum><text>Income received as liquid assets from the estate (as defined in section 1917(b)(4)) of a deceased individual.</text></subclause></clause></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="H9A0A89CFB1CA431DA7888C30977F8A5F"><enum>(B)</enum><text>by striking <quote>(14) <header-in-text level="paragraph" style="OLC">Exclusion</header-in-text></quote> and inserting <quote>(15) <header-in-text level="paragraph" style="OLC">Exclusion</header-in-text></quote>.</text> </subparagraph></paragraph></subsection><subsection id="H5B5833564EF34BFDAC1596396B1F4C02"><enum>(b)</enum><header>Rules of construction</header> <paragraph id="HF0D9668A511D413FA92C7DCAC52DD290"><enum>(1)</enum><header>Interception of lottery winnings allowed</header><text>Nothing in the amendment made by subsection (a)(2)(A) shall be construed as preventing a State from intercepting the State lottery winnings awarded to an individual in the State to recover amounts paid by the State under the State Medicaid plan under title XIX of the Social Security Act for medical assistance furnished to the individual.</text>
</paragraph><paragraph commented="no" id="H91DB34F0D62F4492AA89B207A1C564C5"><enum>(2)</enum><header>Applicability limited to eligibility of recipient of lottery winnings or lump sum income</header><text display-inline="yes-display-inline">Nothing in the amendment made by subsection (a)(2)(A) shall be construed, with respect to a determination of household income for purposes of a determination of eligibility for medical assistance under the State plan under title XIX of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396</external-xref> et seq.) (or a waiver of such plan) made by applying modified adjusted gross income under subparagraph (A) of section 1902(e)(14) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a(e)(14)</external-xref>), as limiting the eligibility for such medical assistance of any individual that is a member of the household other than the individual who received qualified lottery winnings or qualified lump-sum income (as defined in subparagraph (J) of such section 1902(e)(14), as added by subsection (a)(2)(A) of this section).</text>
</paragraph></subsection></section><section id="HFCB5044127CF4754B2FF00620703DB15" section-type="subsequent-section"><enum>203.</enum><header>Adjustments to Medicare part B and part D premium subsidies for higher income individuals</header>
<subsection id="H5D6A9AE6592847859B62BB0D080F7730"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1839(i)(3)(C)(i)(II) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395r">42 U.S.C. 1395r(i)(3)(C)(i)(II)</external-xref>) is amended, in the table, by striking the last row and inserting the following new rows:</text>
<quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="H7700D00B32A345B9A22E805969166C4E" reported-display-style="italic" style="OLC">
<table align-to-level="section" blank-lines-before="1" colsep="0" frame="none" line-rules="no-gen" rowsep="0" rule-weights="0.0.0.0.0.0" table-template-name="Generic: 2 text, 1st longer" table-type="">
<tgroup cols="2" grid-typeface="1.1" no-carding="1" rowsep="0" thead-tbody-ldg-size="10.10.12"><colspec coldef="txt" colname="column1" colwidth="243.00pt" min-data-value="200"></colspec><colspec coldef="fig" colname="column2" colwidth="117.57pt" min-data-value="18"></colspec>
<tbody>
<row><entry colname="column1" leader-modify="force-ldr-bottom" stub-definition="txt-ldr" stub-hierarchy="1">More than $160,000 but less than $500,000</entry><entry align="right" colname="column2" leader-modify="clr-ldr">80 percent</entry></row>
<row><entry align="left" colname="column1" leader-modify="force-ldr" stub-definition="txt-ldr" stub-hierarchy="1"> At least $500,000</entry><entry align="right" colname="column2" leader-modify="clr-ldr">100 percent.</entry></row></tbody></tgroup></table><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HFEC1199A3F9940FC96C8BB51330981EE"><enum>(b)</enum><header>Joint returns</header><text display-inline="yes-display-inline">Section 1839(i)(3)(C)(ii) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395r">42 U.S.C. 1395r(i)(3)(C)(ii)</external-xref>) is amended by inserting before the period the following: <quote>except, with respect to the dollar amounts applied in the last row of the table under subclause (II) of such clause (and the second dollar amount specified in the second to last row of such table), clause (i) shall be applied by substituting dollar amounts which are 175 percent of such dollar amounts for the calendar year</quote>.</text>
</subsection><subsection id="HF6DCFFA34A16423C8EBE1315BB5F5759"><enum>(c)</enum><header>Inflation adjustment</header><text>Section 1839(i) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395r">42 U.S.C. 1395r(i)</external-xref>) is amended—</text> <paragraph id="H1186C1208F4C4382A3E162179278B32F"><enum>(1)</enum><text>in paragraph (5)—</text>
<subparagraph id="H524A819E76014906B9F6405BB969B6FC"><enum>(A)</enum><text>in subparagraph (A), by striking <quote>In the case</quote> and inserting <quote>Subject to subparagraph (C), in the case</quote>;</text> </subparagraph><subparagraph id="H59ECDD78BE814625B8736F0A61129CE0"><enum>(B)</enum><text>in subparagraph (B), by striking <quote>subparagraph (A)</quote> and inserting <quote>subparagraph (A) or (C)</quote>; and</text>
</subparagraph><subparagraph id="H49E356EB886D4C10B970B8C91C80DB81"><enum>(C)</enum><text>by adding at the end the following new subparagraph:</text> <quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="H2956E10EA280499CB95119E87C651A12" reported-display-style="italic" style="OLC"> <subparagraph id="H57320AC2A9934533A9E3B2026F67E242"><enum>(C)</enum><header>Treatment of adjustments for certain higher income individuals</header> <clause id="H93C82E8B3C674175B422FD8606CF7711"><enum>(i)</enum><header>In general</header><text>Subparagraph (A) shall not apply with respect to each dollar amount in paragraph (3) of $500,000.</text>
</clause><clause id="H778C10945CDC47A0808BFDFEA9AC7C16"><enum>(ii)</enum><header>Adjustment beginning 2027</header><text display-inline="yes-display-inline">In the case of any calendar year beginning after 2026, each dollar amount in paragraph (3) of $500,000 shall be increased by an amount equal to—</text>
<subclause id="H79D0669D655D4262930A94136933675B"><enum>(I)</enum><text>such dollar amount, multiplied by</text> </subclause><subclause id="H688DE8505EEE4318997A04C73E7D8A7E"><enum>(II)</enum><text>the percentage (if any) by which the average of the Consumer Price Index for all urban consumers (United States city average) for the 12-month period ending with August of the preceding calendar year exceeds such average for the 12-month period ending with August 2025.</text></subclause></clause></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H42259AC852B14E649DAA62DCA677FDE3"><enum>(2)</enum><text>in paragraph (6)(B), by inserting <quote>(other than $500,000)</quote> after <quote>the dollar amounts</quote>.</text> </paragraph></subsection></section> October 23, 2017 The Committee on Ways and Means discharged; committed to the Committee of the Whole House on the State of the Union and ordered to be printed