1.This Act may be cited as the
Strengthening Medicaid for America’s
Children Act of 2009
.
2.Enhanced FMAP for
children under Medicaid
(a)Section 1905 of the
Social Security Act (42 U.S.C. 1396d) is amended—
(1)in
subsection (b), by inserting and subsection (y)
after
section 1933(d),
; and
(2)by
adding at the end the following new subsection:
(y)Conditions-based
Enhanced FMAP for children
(1)Subject to paragraph
(4), in the case of a State that meets the requirements of paragraph (2) with
respect to a quarter and that implements at least 3 of the policies described
in paragraph (3)(B) for the quarter under the State plan under this title, the
Federal medical assistance percentage applicable with respect to expenditures
made for medical assistance for children shall be increased by the percentage
(specified in paragraph (3)(A)) of the number of percentage points by
which—
(A)the enhanced FMAP
(as defined in section 2105(b)), exceeds
(B)the Federal
medical assistance percentage otherwise applicable.
(2)Maintenance-of-effort
requirementsThe requirements
of this paragraph with respect to a State for a quarter are that the State must
agree to the following two maintenance-of-effort requirements:
(A)An amount equivalent to the aggregate State
general revenue funds being applied as of July 1, 2008, under this title for
purposes of obtaining Federal financial participation under this title for
medical assistance furnished to children must remain invested in health care
programs and services for children and available to supplement (and not
supplant) program funding, with priority given to increasing reimbursement
rates for providers and coverage expansion.
(B)To maintain
eligibility, methods, standards, procedures, and provider rates applicable to
children under this title at levels not less than the levels in effect as of
July 1, 2008.
(3)Scaling of
increase based on degree of implementation of policies
(A)For purposes of paragraph (1), in the case of a State
that implements—
(i)at
least 6 of the policies described in subparagraph (B) for a calendar quarter,
the percentage under this subparagraph is 100 percent;
(ii)5
of such policies, the percentage under this paragraph is 75 percent; or
(iii)fewer than 4
(but no less than 3) of such policies, the percentage under this paragraph is
50 percent.
(B)The policies described in this subparagraph are as
follows (as more fully specified by the Secretary):
(i)The State has implemented 12-month
continuous coverage for children for medical assistance under this
title.
(ii)Children leaving
foster care on their 18th birthday may maintain eligibility for medical
assistance under this title up to the age of 23 if they are attending college
full- or part-time.
(iii)As a condition
of eligibility for children under section 1902(l), the State does not apply an
asset test or applies a simplified asset verification system.
(iv)The State does
not require a face-to-face interview as a condition of eligibility for children
for medical assistance under this title.
(v)The
State permits renewals of eligibility for children for medical assistance under
this title to be effected administratively or through an ex parte
process.
(vi)The State permits
a joint application for medical assistance under this title and for child
health assistance under title XXI with the same information verification
process to obtain assistance under this title or title XXI.
(vii)The State has
implemented under this title and title XXI presumptive eligibility for children
described in section 1920A.
(viii)The State has
implemented the Express Lane eligibility option under section
1902(e)(13).
(ix)The State provides for coordination of
delivery of care for children for which medical assistance is available under
this title through a medical home or similar model.
(4)This
subsection shall not apply for any calendar quarter for a State for which the
State may be eligible for an increase in FMAP under section 5001 of division B
of the American Recovery and Reinvestment Act (Public Law 111–5).
(5)In this subsection, the term children means
an individual who is under 21 years of
age.
.