[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[S. 599 Introduced in Senate (IS)]
114th CONGRESS
1st Session
S. 599
To extend and expand the Medicaid emergency psychiatric demonstration
project.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
February 26, 2015
Mr. Cardin (for himself, Mr. Toomey, and Ms. Collins) introduced the
following bill; which was read twice and referred to the Committee on
Finance
_______________________________________________________________________
A BILL
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 paragraph (3), 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 the date described in
subparagraph (B) if--
``(i) the Secretary determines that the
continued participation of the State in the
demonstration project is not expected to
increase 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 to
reduce (or is projected not to result in any
increase in) net program spending under title
XIX of the Social Security Act.
``(B) Date described.--The date described in this
subparagraph is the earlier of--
``(i) the date on which Secretary submits
the recommendations required under subsection
(f)(3); or
``(ii) September 30, 2016.
``(3) Extension and expansion of demonstration project.--
``(A) Additional extension.--Taking into account
the recommendations submitted to Congress pursuant to
subsection (f)(3), the Secretary may, if the Secretary
determines that extension and expansion of the
demonstration project satisfies the criteria for the
temporary extension under subparagraphs (A) and (B) of
paragraph (2)--
``(i) extend the demonstration project
through December 31, 2019; and
``(ii) permit any eligible State
participating in the demonstration project as
of the date such recommendations are submitted
to continue to participate in the project.
``(B) Option for expansion to additional states.--
Taking into account the recommendations submitted to
Congress pursuant to subsection (f)(3), the Secretary
may expand (including on a nationwide basis) the number
of eligible States participating in the demonstration
project during the extension period established under
subparagraph (A) if, with respect to any new eligible
State--
``(i) the Secretary determines that the
participation of the State in the demonstration
project is not expected to increase 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 to reduce (or is projected
not to result in any increase in) net program
spending under title XIX of the Social Security
Act.
``(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), (2)(B), (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 States under this paragraph shall
be considered to have been made under, and are subject
to, the requirements of section 1903 of the Social
Security Act (42 U.S.C. 1396b).''.
(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 December 31, 2016; and
``(B) whether the demonstration project should be
expanded (including on a nationwide basis).
``(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 to reduce (or is projected
not to result in any increase in) net program spending
under title XIX of the Social Security Act. If the
Secretary determines with respect to a State's
participation in the demonstration project that net
program spending under title XIX of such Act has
increased as a result of 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.
``(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.
``(5) Funding.--Out of any funds in the Treasury not
otherwise appropriated, there is appropriated to the Centers
for Medicare & Medicaid Services Program Management Account to
carry out this subsection, $100,000 for fiscal year 2015, to
remain available until expended.''.
(d) Conforming Amendments.--Section 2707 of such Act (42 U.S.C.
1396a note) is amended--
(1) 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
(2) 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.
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