[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[S. 599 Enrolled Bill (ENR)]
S.599
One Hundred Fourteenth Congress
of the
United States of America
AT THE FIRST SESSION
Begun and held at the City of Washington on Tuesday,
the sixth day of January, two thousand and fifteen
An Act
To extend and expand the Medicaid emergency psychiatric demonstration
project.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Improving Access to Emergency
Psychiatric Care Act''.
SEC. 2. EXTENSION AND EXPANSION OF MEDICAID EMERGENCY PSYCHIATRIC
DEMONSTRATION PROJECT.
(a) In General.--Subsection (d) of section 2707 of Public Law 111-
148 (42 U.S.C. 1396a note) is amended to read as follows:
``(d) Length of Demonstration Project.--
``(1) In general.--Except as provided in paragraphs (2) and
(3), the demonstration project established under this section shall
be conducted for a period of 3 consecutive years.
``(2) Temporary extension of participation eligibility for
selected states.--
``(A) In general.--Subject to subparagraph (B) and
paragraph (4), a State selected as an eligible State to
participate in the demonstration project on or prior to March
13, 2012, shall, upon the request of the State, be permitted to
continue to participate in the demonstration project through
September 30, 2016, if--
``(i) the Secretary determines that the continued
participation of the State in the demonstration project is
projected not to increase net program spending under title
XIX of the Social Security Act; and
``(ii) the Chief Actuary of the Centers for Medicare &
Medicaid Services certifies that such extension for that
State is projected not to increase net program spending
under title XIX of the Social Security Act.
``(B) Notice of projections.--The Secretary shall provide
each State selected to participate in the demonstration project
on or prior to March 13, 2012, with notice of the determination
and certification made under subparagraph (A) for the State.
``(3) Extension and expansion of demonstration project.--
``(A) Additional extension.--Taking into account the
recommendations submitted to Congress under subsection (f)(3),
the Secretary may permit an eligible State participating in the
demonstration project as of the date such recommendations are
submitted to continue to participate in the project through
December 31, 2019, if, with respect to the State--
``(i) the Secretary determines that the continued
participation of the State in the demonstration project is
projected not to increase net program spending under title
XIX of the Social Security Act; and
``(ii) the Chief Actuary of the Centers for Medicare &
Medicaid Services certifies that the continued
participation of the State in the demonstration project is
projected not to increase net program spending under title
XIX of the Social Security Act.
``(B) Option for expansion to additional states.--Taking
into account the recommendations submitted to Congress pursuant
to subsection (f)(3), the Secretary may expand the number of
eligible States participating in the demonstration project
through December 31, 2019, if, with respect to any new eligible
State--
``(i) the Secretary determines that the participation
of the State in the demonstration project is projected not
to increase net program spending under title XIX of the
Social Security Act; and
``(ii) the Chief Actuary of the Centers for Medicare &
Medicaid Services certifies that the participation of the
State in the demonstration project is projected not to
increase net program spending under title XIX of the Social
Security Act.
``(C) Notice of projections.--The Secretary shall provide
each State participating in the demonstration project as of the
date the Secretary submits recommendations to Congress under
subsection (f)(3), and any additional State that applies to be
added to the demonstration project, with notice of the
determination and certification made for the State under
subparagraphs (A) and (B), respectively, and the standards used
to make such determination and certification--
``(i) in the case of a State participating in the
demonstration project as of the date the Secretary submits
recommendations to Congress under subsection (f)(3), not
later than August 31, 2016; and
``(ii) in the case of an additional State that applies
to be added to the demonstration project, prior to the
State making a final election to participate in the
project.
``(4) Authority to ensure budget neutrality.--The Secretary
annually shall review each participating State's demonstration
project expenditures to ensure compliance with the requirements of
paragraphs (2)(A)(i), (2)(A)(ii), (3)(A)(i), (3)(A)(ii), (3)(B)(i),
and (3)(B)(ii) (as applicable). If the Secretary determines with
respect to a State's participation in the demonstration project
that the State's net program spending under title XIX of the Social
Security Act has increased as a result of the State's participation
in the project, the Secretary shall treat the demonstration project
excess expenditures of the State as an overpayment under title XIX
of the Social Security Act.''.
(b) Funding.--Subsection (e) of section 2707 of such Act (42 U.S.C.
1396a note) is amended--
(1) in the subsection heading, by striking ``Limitations on
Federal'';
(2) in paragraph (2)--
(A) in the paragraph heading, by striking ``5-year''; and
(B) by striking ``through December 31, 2015'' and inserting
``until expended'';
(3) by striking paragraph (3);
(4) by redesignating paragraphs (4) and (5) as paragraphs (3)
and (4), respectively;
(5) in paragraph (3) (as so redesignated), by striking ``and
the availability of funds'' and inserting ``(other than States
deemed to be eligible States through the application of subsection
(c)(4))''; and
(6) in paragraph (4) (as so redesignated)--
(A) in the first sentence--
(i) by inserting ``(other than a State deemed to be an
eligible State through the application of subsection
(c)(4))'' after ``eligible State''; and
(ii) by striking ``paragraph (4)'' and inserting
``paragraph (3)''; and
(B) by inserting after the first sentence the following:
``In addition to any payments made to an eligible State under
the preceding sentence, the Secretary shall, during any period
in effect under paragraph (2) or (3) of subsection (d), or
during any period in which a law described in subsection
(f)(4)(C) is in effect, pay each eligible State (including any
State deemed to be an eligible State through the application of
subsection (c)(4)), an amount each quarter equal to the Federal
medical assistance percentage of expenditures in the quarter
during such period for medical assistance described in
subsection (a). Payments made to a State for emergency
psychiatric demonstration services under this section during
the extension period shall be treated as medical assistance
under the State plan for purposes of section 1903(a)(1) of the
Social Security Act (42 U.S.C. 1396b(a)(1)).''.
(c) Recommendations to Congress.--Subsection (f) of section 2707 of
such Act (42 U.S.C. 1396a note) is amended by adding at the end the
following:
``(3) Recommendation to congress regarding extension and
expansion of project.--Not later than September 30, 2016, the
Secretary shall submit to Congress and make available to the public
recommendations based on an evaluation of the demonstration
project, including the use of appropriate quality measures,
regarding--
``(A) whether the demonstration project should be continued
after September 30, 2016; and
``(B) whether the demonstration project should be expanded
to additional States.
``(4) Recommendation to congress regarding permanent extension
and nationwide expansion.--
``(A) In general.--Not later than April 1, 2019, the
Secretary shall submit to Congress and make available to the
public recommendations based on an evaluation of the
demonstration project, including the use of appropriate quality
measures, regarding--
``(i) whether the demonstration project should be
permanently continued after December 31, 2019, in 1 or more
States; and
``(ii) whether the demonstration project should be
expanded (including on a nationwide basis).
``(B) Requirements.--Any recommendation submitted under
subparagraph (A) to permanently continue the project in a
State, or to expand the project to 1 or more other States
(including on a nationwide basis) shall include a certification
from the Chief Actuary of the Centers for Medicare & Medicaid
Services that permanently continuing the project in a
particular State, or expanding the project to a particular
State (or all States) is projected not to increase net program
spending under title XIX of the Social Security Act.
``(C) Congressional approval required.--The Secretary shall
not permanently continue the demonstration project in any State
after December 31, 2019, or expand the demonstration project to
any additional State after December 31, 2019, unless Congress
enacts a law approving either or both such actions and the law
includes provisions that--
``(i) ensure that each State's participation in the
project complies with budget neutrality requirements; and
``(ii) require the Secretary to treat any expenditures
of a State participating in the demonstration project that
are excess of the expenditures projected under the budget
neutrality standard for the State as an overpayment under
title XIX of the Social Security Act.
``(5) Funding.--Of the unobligated balances of amounts
available in the Centers for Medicare & Medicaid Services Program
Management account, $100,000 shall be available to carry out this
subsection and shall remain available until expended.''.
(d) Conforming Amendments.--Section 2707 of such Act (42 U.S.C.
1396a note) is amended--
(1) in subsection (a), in the matter before paragraph (1), by
inserting ``publicly or'' after ``institution for mental diseases
that is'';
(2) in subsection (c)--
(A) in paragraph (1), by striking ``An eligible State'' and
inserting ``Except as otherwise provided in paragraph (4), an
eligible State'';
(B) in paragraph (3), by striking ``A State shall'' and
inserting ``Except as otherwise provided in paragraph (4), a
State shall''; and
(C) by adding at the end the following:
``(4) Nationwide availability.--In the event that the Secretary
makes a recommendation pursuant to subsection (f)(4) that the
demonstration project be expanded on a national basis, any State
that has submitted or submits an application pursuant to paragraph
(2) shall be deemed to have been selected to be an eligible State
to participate in the demonstration project.''; and
(3) in the heading for subsection (f), by striking ``and
Report'' and inserting ``, Report, and Recommendations''.
(e) Effective Date.--The amendments made by this section shall take
effect on the date of the enactment of this Act.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.