[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2119 Introduced in House (IH)]

114th CONGRESS
  1st Session
                                H. R. 2119

  To amend title XI of the Social Security Act to require that State 
   applications for State plan waivers under the Medicaid program be 
 approved only if such applications are budget neutral, and for other 
                               purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 29, 2015

 Mr. Shimkus introduced the following bill; which was referred to the 
                    Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
  To amend title XI of the Social Security Act to require that State 
   applications for State plan waivers under the Medicaid program be 
 approved only if such applications are budget neutral, and for other 
                               purposes.

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

SECTION 1. BUDGET NEUTRALITY REQUIRED FOR STATE PLAN WAIVERS UNDER 
              MEDICAID.

    (a) In General.--Section 1115(d) of the Social Security Act (42 
U.S.C. 1315(d)) is amended--
            (1) by redesignating paragraph (3) as paragraph (4); and
            (2) by inserting after paragraph (2) the following new 
        paragraph:
            ``(3)(A) Beginning with fiscal year 2016, the Secretary 
        shall require, as a condition on the approval of a 
        demonstration project in a State under this section, that the 
        project be budget neutral, as determined by the Secretary in 
        accordance with subparagraph (B) and subject to subparagraph 
        (C).
            ``(B) A determination by the Secretary under this paragraph 
        on whether a demonstration project is budget neutral shall be 
        based on--
                    ``(i) the historical Federal and State expenditures 
                made under the State plan under title XIX, including 
                any adjustments to such expenditures (other than 
                adjustments to account for improper or otherwise 
                unallowable payments) supported by data or other 
                documentation;
                    ``(ii) the State's historical spending growth rates 
                and population growth rates, including any adjustments 
                supported by data or documentation; and
                    ``(iii) any other criteria determined appropriate 
                by the Secretary.
            ``(C) The Secretary may not determine that a demonstration 
        project is budget neutral under this paragraph unless the Chief 
        Actuary of the Centers for Medicare & Medicaid Services 
        certifies to the Secretary that the project is budget neutral.
            ``(D) For purposes of this paragraph, the term `budget 
        neutral' means, with respect to a demonstration project, that 
        the Federal expenditures under the project in the State do not 
        exceed the Federal expenditures that would otherwise have been 
        made if the State had in effect a plan approved under title 
        XIX.''; and
            (3) in paragraph (4) (as redesignated by paragraph (1))--
                    (A) by striking ``Congress concerning actions'' and 
                inserting ``Congress on, and make available to the 
                public information on, any actions''; and
                    (B) by inserting ``, including any data or other 
                information relating to determinations of the Secretary 
                under paragraph (3) that such demonstration projects 
                are budget neutral'' before the period at the end.
    (b) Regulations.--Not later than 90 days after the date of the 
enactment of this Act, the Secretary of Health and Human Services shall 
issue regulations to carry out the amendments made by subsection (a), 
including regulations specifying the criteria to be used in making 
determinations under paragraph (3) of section 1115(d) of the Social 
Security Act (42 U.S.C. 1315(d)), as inserted by subsection (a).
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