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<bill bill-stage="Introduced-in-House" bill-type="olc" dms-id="H609D199E73C344D6BB90387F436E8DBB" key="H" public-private="public"><metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
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<dc:title>116 HR 259 IH: Medicaid Extenders Act of 2019</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2019-01-04</dc:date>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>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.</dc:rights>
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<form>
<distribution-code display="yes">I</distribution-code><congress display="yes">116th CONGRESS</congress><session display="yes">1st Session</session><legis-num display="yes">H. R. 259</legis-num><current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber><action display="yes"><action-date date="20190104">January 4, 2019</action-date><action-desc><sponsor name-id="P000034">Mr. Pallone</sponsor> (for himself and <cosponsor name-id="W000791">Mr. Walden</cosponsor>) introduced the following bill; which was referred to the <committee-name committee-id="HIF00">Committee on Energy and Commerce</committee-name>, and in addition to the Committee on <committee-name committee-id="HBU00">the Budget</committee-name>, for a period to be subsequently determined by the Speaker, in each case for consideration of such
			 provisions as fall within the jurisdiction of the committee concerned</action-desc></action><legis-type>A BILL</legis-type><official-title display="yes">To extend the Medicaid Money Follows the Person Rebalancing demonstration, to extend protection for
			 Medicaid recipients of home and community-based services against spousal
			 impoverishment, and for other purposes.</official-title></form>
	<legis-body id="H08F5A5383CCE403CAB9E0A396C50439B" style="OLC">
 <section id="H27763F9985384C018929A303857D2209" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Medicaid Extenders Act of 2019</short-title></quote>.</text> </section><section id="HB355EA85BAE94B69A44735F73FC43441"><enum>2.</enum><header>Extension of Money Follows the Person Rebalancing demonstration</header> <subsection id="H9606EF73E93A4E5FA5AC560E46796E97"><enum>(a)</enum><header>General Funding</header><text display-inline="yes-display-inline">Section 6071(h) of the Deficit Reduction Act of 2005 (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a</external-xref> note) is amended—</text>
 <paragraph id="H62EC7200206D4D06BA3ED679CF920401"><enum>(1)</enum><text>in paragraph (1)—</text> <subparagraph id="HEFDAC674BFAE445B87311910E8C49A9A"><enum>(A)</enum><text>in subparagraph (D), by striking <quote>and</quote> after the semicolon;</text>
 </subparagraph><subparagraph id="H5C038BD7FA774C22967A449752FC8FE1"><enum>(B)</enum><text>in subparagraph (E), by striking the period at the end and inserting <quote>; and</quote>; and</text> </subparagraph><subparagraph id="H03B7DE804ECA488CACDAB79B676F8172"><enum>(C)</enum><text>by adding at the end the following:</text>
						<quoted-block display-inline="no-display-inline" id="H4F5AB732B51148FBBA995AA6A39CD96B" style="OLC">
 <subparagraph id="H5B2BCE2FB0CF4B08A8DD790C01CDDA6B"><enum>(F)</enum><text>subject to paragraph (3), $112,000,000 for fiscal year 2019.</text></subparagraph><after-quoted-block>; </after-quoted-block></quoted-block> </subparagraph></paragraph><paragraph commented="no" id="H751D53896AE046A1A794B600C6700650"><enum>(2)</enum><text>in paragraph (2)—</text>
 <subparagraph commented="no" id="HF7B6C7575A8847EFB7DF6A6AB2CED5EA"><enum>(A)</enum><text>by striking <quote>Amounts made</quote> and inserting <quote>Subject to paragraph (3), amounts made</quote>; and</text> </subparagraph><subparagraph commented="no" id="HC06055671D674555BE9EA048F2BE999E"><enum>(B)</enum><text>by striking <quote>September 30, 2016</quote> and inserting <quote>September 30, 2021</quote>; and</text>
 </subparagraph></paragraph><paragraph id="HF33FA11271FE42FCB0AC99298BCBD6DF"><enum>(3)</enum><text>by adding at the end the following new paragraph:</text> <quoted-block display-inline="no-display-inline" id="HB5ABFC1B4ED746BAAFF8028DD6F48109" style="OLC"> <paragraph id="HDFA15E7877F74D79BBA3978003D69FD2"><enum>(3)</enum><header>Special rule for FY 2019</header><text display-inline="yes-display-inline">Funds appropriated under paragraph (1)(F) shall be made available for grants to States only if such States have an approved MFP demonstration project under this section as of December 31, 2018.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
 </paragraph></subsection><subsection commented="no" id="H99DD43E1D9E6441F9330F6C295F00954"><enum>(b)</enum><header>Funding for quality assurance and improvement; technical assistance; oversight</header><text>Section 6071(f) of the Deficit Reduction Act of 2005 (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a</external-xref> note) is amended by striking paragraph (2) and inserting the following:</text>
				<quoted-block display-inline="no-display-inline" id="H7C0059104B0446F5A81C27FBD07B64A2" style="OLC">
 <paragraph commented="no" id="HBC4CA831D00C47BAAD64C37C88FF48DD"><enum>(2)</enum><header>Funding</header><text>From the amounts appropriated under subsection (h)(1)(F) for fiscal year 2019, $500,000 shall be available to the Secretary for such fiscal year to carry out this subsection.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
 </subsection><subsection id="H40C6908FF85D4309B3D3F195E060E379"><enum>(c)</enum><header>Technical amendment</header><text>Section 6071(b) of the Deficit Reduction Act of 2005 (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a</external-xref> note) is amended by adding at the end the following:</text>
				<quoted-block display-inline="no-display-inline" id="H095673C867124744B8B394ACC867EC33" style="OLC">
 <paragraph id="H541DDEC058F74010861AE9E30E8E259C"><enum>(10)</enum><header>Secretary</header><text>The term <term>Secretary</term> means the Secretary of Health and Human Services.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block> </subsection></section><section id="HB9C1167E0A634B748CADA741A13744BC"><enum>3.</enum><header>Extension of protection for Medicaid recipients of home and community-based services against spousal impoverishment</header> <subsection id="HCA69E05EF6B546A686A3FC06E7B55499"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 2404 of <external-xref legal-doc="public-law" parsable-cite="pl/111/148">Public Law 111–148</external-xref> (<external-xref legal-doc="usc" parsable-cite="usc/42/1396r-5">42 U.S.C. 1396r–5</external-xref> note) is amended by striking <quote>the 5-year period that begins on January 1, 2014,</quote> and inserting <quote>the period beginning on January 1, 2014, and ending on March 31, 2019,</quote>.</text>
			</subsection><subsection commented="no" id="HFABA5BF9D1ED48EBBCC70F08D1BC16E5"><enum>(b)</enum><header>Rule of construction</header>
 <paragraph commented="no" id="H6AEC0F39C035440F8662C5746B06A2C1"><enum>(1)</enum><header>Protecting State spousal income and asset disregard flexibility under waivers and plan amendments</header><text>Nothing in section 2404 of <external-xref legal-doc="public-law" parsable-cite="pl/111/148">Public Law 111–148</external-xref> (<external-xref legal-doc="usc" parsable-cite="usc/42/1396r-5">42 U.S.C. 1396r–5</external-xref> note) or section 1924 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396r-5">42 U.S.C. 1396r–5</external-xref>) shall be construed as prohibiting a State from disregarding an individual’s spousal income and assets under a State waiver or plan amendment described in paragraph (2) for purposes of making determinations of eligibility for home and community-based services or home and community-based attendant services and supports under such waiver or plan amendment.</text>
 </paragraph><paragraph commented="no" id="H1B9C4E5AB72A4E77B670E62A49C734C4"><enum>(2)</enum><header>State waiver or plan amendment described</header><text display-inline="yes-display-inline">A State waiver or plan amendment described in this paragraph is any of the following:</text> <subparagraph commented="no" id="H0A21F99E7B454D5AAC02E2748308C84B"><enum>(A)</enum><text>A waiver or plan amendment to provide medical assistance for home and community-based services under a waiver or plan amendment under subsection (c), (d), or (i) of section 1915 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396n">42 U.S.C. 1396n</external-xref>) or under section 1115 of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1315">42 U.S.C. 1315</external-xref>).</text>
 </subparagraph><subparagraph commented="no" id="H0A2997BA10724919BC99B869EA50CDE7"><enum>(B)</enum><text>A plan amendment to provide medical assistance for home and community-based services for individuals by reason of being determined eligible under section 1902(a)(10)(C) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a(a)(10)(C)</external-xref>) or by reason of section 1902(f) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a(f)</external-xref>) or otherwise on the basis of a reduction of income based on costs incurred for medical or other remedial care under which the State disregarded the income and assets of the individual’s spouse in determining the initial and ongoing financial eligibility of an individual for such services in place of the spousal impoverishment provisions applied under section 1924 of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396r-5">42 U.S.C. 1396r–5</external-xref>).</text>
 </subparagraph><subparagraph commented="no" id="HBB2A6B81703D448288FB15FBF886C105"><enum>(C)</enum><text>A plan amendment to provide medical assistance for home and community-based attendant services and supports under section 1915(k) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396n">42 U.S.C. 1396n(k)</external-xref>).</text>
 </subparagraph></paragraph></subsection></section><section id="H3C65B0C5BE5C420D841707D2FF666886"><enum>4.</enum><header>Reduction in FMAP after 2020 for States without asset verification program</header><text display-inline="no-display-inline">Section 1940 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396w">42 U.S.C. 1396w</external-xref>) is amended by adding at the end the following new subsection:</text>
			<quoted-block display-inline="no-display-inline" id="HA3215C8ABE434806950D25B5FF940692" style="OLC">
				<subsection id="HD21B8DF3E13940B7A6385D3EC114C543"><enum>(k)</enum><header>Reduction in FMAP after 2020 for non-Compliant States</header>
 <paragraph id="H173D65202D864DD99B41C93E8D77D4A7"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">With respect to a calendar quarter beginning on or after January 1, 2021, the Federal medical assistance percentage otherwise determined under section 1905(b) for a non-compliant State shall be reduced—</text>
 <subparagraph id="H75466B9E99EE44DB8CE4FB67C1575119"><enum>(A)</enum><text>for calendar quarters in 2021 and 2022, by 0.12 percentage points;</text> </subparagraph><subparagraph id="HFB8916D61D5E455D91BDC67468339BC3"><enum>(B)</enum><text>for calendar quarters in 2023, by 0.25 percentage points;</text>
 </subparagraph><subparagraph id="H6AA67851C75C45C9ABFD218181C480CA"><enum>(C)</enum><text>for calendar quarters in 2024, by 0.35 percentage points; and</text> </subparagraph><subparagraph id="HBDB4A9DA9141458F9FC256B4DE0C5A5C"><enum>(D)</enum><text>for calendar quarters in 2025 and each year thereafter, by 0.5 percentage points.</text>
 </subparagraph></paragraph><paragraph id="H3B0D0D87E6F34A3FB8B8C9A60C3768A0"><enum>(2)</enum><header>Non-compliant State defined</header><text>For purposes of this subsection, the term <term>non-compliant State</term> means a State—</text> <subparagraph id="H15796F9772F54D0EA45D705C08A1D7AD"><enum>(A)</enum><text>that is one of the 50 States or the District of Columbia;</text>
 </subparagraph><subparagraph id="HF0A5CCB50F0C41D5B9C3CEF055329A4D"><enum>(B)</enum><text>with respect to which the Secretary has not approved a State plan amendment submitted under subsection (a)(2); and</text>
 </subparagraph><subparagraph commented="no" id="HD481F4091D4A4356B5C39DC4DB573118"><enum>(C)</enum><text>that is not operating, on an ongoing basis, an asset verification program in accordance with this section.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
 </section><section commented="no" display-inline="no-display-inline" id="HD2711FA1ACC245638BB3E813F964BCEF" section-type="subsequent-section"><enum>5.</enum><header>Medicaid Improvement Fund</header><text display-inline="no-display-inline">Section 1941(b)(1) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396w-1">42 U.S.C. 1396w–1(b)(1)</external-xref>) is amended by striking <quote>$31,000,000</quote> and inserting <quote>$6,000,000</quote>.</text> </section><section commented="no" display-inline="no-display-inline" id="HDC9C3E93F6564D05B43C7EFA1EFD7068" section-type="subsequent-section"><enum>6.</enum><header>Budgetary Effects</header> <subsection id="HB943643C05EE471F8316D0DF73519A24"><enum>(a)</enum><header>Statutory PAYGO scorecards</header><text display-inline="yes-display-inline">The budgetary effects of this Act shall not be entered on either PAYGO scorecard maintained pursuant to section 4(d) of the Statutory Pay-As-You-Go Act of 2010 (<external-xref legal-doc="usc" parsable-cite="usc/2/933">2 U.S.C. 933(d)</external-xref>).</text>
 </subsection><subsection id="H346D7CEE3CEE4B7AAA5CBD800FEFCDB3"><enum>(b)</enum><header>Senate PAYGO scorecards</header><text>The budgetary effects of this Act shall not be entered on any PAYGO scorecard maintained for purposes of section 4106 of H. Con. Res. 71 (115th Congress).</text>
 </subsection><subsection id="HFEC0C9D890524BE9BC5E166550F2C6DB"><enum>(c)</enum><header>Classification of budgetary effects</header><text>Notwithstanding Rule 3 of the Budget Scorekeeping Guidelines set forth in the joint explanatory statement of the committee of conference accompanying Conference Report 105–217 and section 250(c)(8) of the Balanced Budget and Emergency Deficit Control Act of 1985, the budgetary effects of this Act shall not be estimated—</text>
 <paragraph id="HE1140831C10E40C0B82B03736CFA59E5"><enum>(1)</enum><text display-inline="yes-display-inline">for purposes of section 251 of the Balanced Budget and Emergency Deficit Control Act of 1985; and</text> </paragraph><paragraph id="H0CA9D29A8AEE45BFA37BC1E745BD5236"><enum>(2)</enum><text>for purposes of paragraph (4)(C) of section 3 of the Statutory Pay-As-You-Go Act of 2010 as being included in an appropriation Act.</text>
 </paragraph></subsection><subsection id="H12F3DD7FD2D144CBB95B6A6CF706F4D6"><enum>(d)</enum><header>PAYGO annual report</header><text>For the purposes of the annual report issued pursuant to section 5 of the Statutory Pay-As-You-Go Act of 2010 (<external-xref legal-doc="usc" parsable-cite="usc/2/934">2 U.S.C. 934</external-xref>) after adjournment of the second session of the 115th Congress, and for determining whether a sequestration order is necessary under such section, the debit for the budget year on the 5-year scorecard, if any, and the 10-year scorecard, if any, shall be deducted from such scorecard in 2019 and added to such scorecard in 2020.</text>
			</subsection></section></legis-body></bill>


