[Congressional Record Volume 161, Number 140 (Monday, September 28, 2015)]
[Senate]
[Pages S6979-S6980]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
IMPROVING ACCESS TO EMERGENCY PSYCHIATRIC CARE ACT
Mr. DAINES. Mr. President, I ask unanimous consent that the Senate
proceed to the immediate consideration of Calendar No. 180, S. 599.
The PRESIDING OFFICER. The clerk will report the bill by title.
The legislative clerk read as follows:
A bill (S. 599) to extend and expand the Medicaid emergency
psychiatric demonstration project.
There being no objection, the Senate proceeded to consider the bill,
which had been reported from the Committee on Finance, with an
amendment to strike all after the enacting clause and insert in lieu
thereof the following:
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).
[[Page S6980]]
``(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.--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 (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.
Mr. DAINES. Mr. President, I ask unanimous consent that the
committee-reported substitute be agreed to; the bill, as amended, be
read a third time and passed, and the motion to reconsider be
considered made and laid upon the table with no intervening action or
debate.
The PRESIDING OFFICER. Without objection, it is so ordered.
The committee amendment in the nature of a substitute was agreed to.
The bill (S. 599), as amended, was ordered to be engrossed for a
third reading, was read the third time, and passed.
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