[Congressional Record Volume 165, Number 51 (Monday, March 25, 2019)]
[House]
[Pages H2773-H2780]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
MEDICAID SERVICES INVESTMENT AND ACCOUNTABILITY ACT OF 2019
Mr. RUIZ. Mr. Speaker, I move to suspend the rules and pass the bill
(H.R. 1839) to amend title XIX to extend protection for Medicaid
recipients of home and community-based services against spousal
impoverishment, establish a State Medicaid option to provide
coordinated care to children with complex medical conditions through
health homes, prevent the misclassification of drugs for purposes of
the Medicaid drug rebate program, and for other purposes, as amended.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 1839
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 ``Medicaid Services Investment
and Accountability Act of 2019''.
SEC. 2. EXTENSION OF PROTECTION FOR MEDICAID RECIPIENTS OF
HOME AND COMMUNITY-BASED SERVICES AGAINST
SPOUSAL IMPOVERISHMENT.
(a) In General.--Section 2404 of Public Law 111-148 (42
U.S.C. 1396r-5 note), as amended by section 3(a) of the
Medicaid Extenders Act of 2019 (Public Law 116-3), is amended
by striking ``March 31, 2019'' and inserting ``September 30,
2019''.
(b) Rule of Construction.--
(1) Protecting state spousal income and asset disregard
flexibility under waivers and plan amendments.--Nothing in
section 2404 of Public Law 111-148 (42 U.S.C. 1396r-5 note)
or section 1924 of the Social Security Act (42 U.S.C. 1396r-
5) 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.
(2) State waiver or plan amendment described.--A State
waiver or plan amendment described in this paragraph is any
of the following:
(A) 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 (42 U.S.C. 1396n) or
under section 1115 of such Act (42 U.S.C. 1315).
(B) 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 (42 U.S.C. 1396a(a)(10)(C)) or by reason of section
1902(f) of such Act (42 U.S.C. 1396a(f)) 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 (42 U.S.C. 1396r-5).
(C) A plan amendment to provide medical assistance for home
and community-based attendant services and supports under
section 1915(k) of such Act (42 U.S.C. 1396n(k)).
SEC. 3. STATE OPTION TO PROVIDE COORDINATED CARE THROUGH A
HEALTH HOME FOR CHILDREN WITH MEDICALLY COMPLEX
CONDITIONS.
Title XIX of the Social Security Act (42 U.S.C. 1396 et
seq.) is amended by inserting after section 1945 the
following new section:
``SEC. 1945A. STATE OPTION TO PROVIDE COORDINATED CARE
THROUGH A HEALTH HOME FOR CHILDREN WITH
MEDICALLY COMPLEX CONDITIONS.
``(a) In General.--Notwithstanding section 1902(a)(1)
(relating to statewideness) and section 1902(a)(10)(B)
(relating to comparability), beginning October 1, 2022, a
State, at its option as a State plan amendment, may provide
for medical assistance under this title to children with
medically complex conditions who choose to enroll in a health
home under this section by selecting a designated provider, a
team of health care professionals operating with such a
provider, or a health team as the child's health home for
purposes of providing the child with health home services.
``(b) Health Home Qualification Standards.--The Secretary
shall establish standards for qualification as a health home
for purposes of this section. Such standards shall include
requiring designated providers, teams of health care
professionals operating with such providers, and health teams
to demonstrate to the State the ability to do the following:
``(1) Coordinate prompt care for children with medically
complex conditions, including access to pediatric emergency
services at all times.
``(2) Develop an individualized comprehensive pediatric
family-centered care plan for children with medically complex
conditions that accommodates patient preferences.
``(3) Work in a culturally and linguistically appropriate
manner with the family of a child with medically complex
conditions to develop and incorporate into such child's care
plan, in a manner consistent with the needs of the child and
the choices of the child's family, ongoing home care,
community-based pediatric primary care, pediatric inpatient
care, social support services, and local hospital pediatric
emergency care.
``(4) Coordinate access to--
``(A) subspecialized pediatric services and programs for
children with medically complex conditions, including the
most intensive diagnostic, treatment, and critical care
levels as medically necessary; and
``(B) palliative services if the State provides such
services under the State plan (or a waiver of such plan).
``(5) Coordinate care for children with medically complex
conditions with out-of-State providers furnishing care to
such children to the maximum extent practicable for the
families of such children and where medically necessary, in
accordance with guidance issued under subsection (e)(1) and
section 431.52 of title 42, Code of Federal Regulations.
``(6) Collect and report information under subsection
(g)(1).
``(c) Payments.--
``(1) In general.--A State shall provide a designated
provider, a team of health care professionals operating with
such a provider,
[[Page H2774]]
or a health team with payments for the provision of health
home services to each child with medically complex conditions
that selects such provider, team of health care
professionals, or health team as the child's health home.
Payments made to a designated provider, a team of health care
professionals operating with such a provider, or a health
team for such services shall be treated as medical assistance
for purposes of section 1903(a), except that, during the
first 2 fiscal year quarters that the State plan amendment is
in effect, the Federal medical assistance percentage
applicable to such payments shall be increased by 15
percentage points, but in no case may exceed 90 percent.
``(2) Methodology.--
``(A) In general.--The State shall specify in the State
plan amendment the methodology the State will use for
determining payment for the provision of health home
services. Such methodology for determining payment--
``(i) may be tiered to reflect, with respect to each child
with medically complex conditions provided such services by a
designated provider, a team of health care professionals
operating with such a provider, or a health team, the
severity or number of each such child's chronic conditions,
life-threatening illnesses, disabilities, or rare diseases,
or the specific capabilities of the provider, team of health
care professionals, or health team; and
``(ii) shall be established consistent with section
1902(a)(30)(A).
``(B) Alternate models of payment.--The methodology for
determining payment for provision of health home services
under this section shall not be limited to a per-member per-
month basis and may provide (as proposed by the State and
subject to approval by the Secretary) for alternate models of
payment.
``(3) Planning grants.--
``(A) In general.--Beginning October 1, 2022, the Secretary
may award planning grants to States for purposes of
developing a State plan amendment under this section. A
planning grant awarded to a State under this paragraph shall
remain available until expended.
``(B) State contribution.--A State awarded a planning grant
shall contribute an amount equal to the State percentage
determined under section 1905(b) (without regard to section
5001 of Public Law 111-5) for each fiscal year for which the
grant is awarded.
``(C) Limitation.--The total amount of payments made to
States under this paragraph shall not exceed $5,000,000.
``(d) Coordinating Care.--
``(1) Hospital notification.--A State with a State plan
amendment approved under this section shall require each
hospital that is a participating provider under the State
plan (or a waiver of such plan) to establish procedures for,
in the case of a child with medically complex conditions who
is enrolled in a health home pursuant to this section and
seeks treatment in the emergency department of such hospital,
notifying the health home of such child of such treatment.
``(2) Education with respect to availability of health home
services.--In order for a State plan amendment to be approved
under this section, a State shall include in the State plan
amendment a description of the State's process for educating
providers participating in the State plan (or a waiver of
such plan) on the availability of health home services for
children with medically complex conditions, including the
process by which such providers can refer such children to a
designated provider, team of health care professionals
operating such a provider, or health team for the purpose of
establishing a health home through which such children may
receive such services.
``(3) Family education.--In order for a State plan
amendment to be approved under this section, a State shall
include in the State plan amendment a description of the
State's process for educating families with children eligible
to receive health home services pursuant to this section of
the availability of such services. Such process shall include
the participation of family-to-family entities or other
public or private organizations or entities who provide
outreach and information on the availability of health care
items and services to families of individuals eligible to
receive medical assistance under the State plan (or a waiver
of such plan).
``(4) Mental health coordination.--A State with a State
plan amendment approved under this section shall consult and
coordinate, as appropriate, with the Secretary in addressing
issues regarding the prevention and treatment of mental
illness and substance use among children with medically
complex conditions receiving health home services under this
section.
``(e) Guidance on Coordinating Care From Out-of-State
Providers.--
``(1) In general.--Not later than October 1, 2020, the
Secretary shall issue (and update as the Secretary determines
necessary) guidance to State Medicaid directors on--
``(A) best practices for using out-of-State providers to
provide care to children with medically complex conditions;
``(B) coordinating care for such children provided by such
out-of-State providers (including when provided in emergency
and non-emergency situations);
``(C) reducing barriers for such children receiving care
from such providers in a timely fashion; and
``(D) processes for screening and enrolling such providers
in the respective State plan (or a waiver of such plan),
including efforts to streamline such processes or reduce the
burden of such processes on such providers.
``(2) Stakeholder input.--In carrying out paragraph (1),
the Secretary shall issue a request for information to seek
input from children with medically complex conditions and
their families, States, providers (including children's
hospitals, hospitals, pediatricians, and other providers),
managed care plans, children's health groups, family and
beneficiary advocates, and other stakeholders with respect to
coordinating the care for such children provided by out-of-
State providers.
``(f) Monitoring.--A State shall include in the State plan
amendment--
``(1) a methodology for tracking reductions in inpatient
days and reductions in the total cost of care resulting from
improved care coordination and management under this section;
``(2) a proposal for use of health information technology
in providing health home services under this section and
improving service delivery and coordination across the care
continuum (including the use of wireless patient technology
to improve coordination and management of care and patient
adherence to recommendations made by their provider); and
``(3) a methodology for tracking prompt and timely access
to medically necessary care for children with medically
complex conditions from out-of-State providers.
``(g) Data Collection.--
``(1) Provider reporting requirements.--In order to receive
payments from a State under subsection (c), a designated
provider, a team of health care professionals operating with
such a provider, or a health team shall report to the State,
at such time and in such form and manner as may be required
by the State, the following information:
``(A) With respect to each such provider, team of health
care professionals, or health team, the name, National
Provider Identification number, address, and specific health
care services offered to be provided to children with
medically complex conditions who have selected such provider,
team of health care professionals, or health team as the
health home of such children.
``(B) Information on all applicable measures for
determining the quality of health home services provided by
such provider, team of health care professionals, or health
team, including, to the extent applicable, child health
quality measures and measures for centers of excellence for
children with complex needs developed under this title, title
XXI, and section 1139A.
``(C) Such other information as the Secretary shall specify
in guidance.
When appropriate and feasible, such provider, team of health
care professionals, or health team, as the case may be, shall
use health information technology in providing the State with
such information.
``(2) State reporting requirements.--
``(A) Comprehensive report.--A State with a State plan
amendment approved under this section shall report to the
Secretary (and, upon request, to the Medicaid and CHIP
Payment and Access Commission), at such time and in such form
and manner determined by the Secretary to be reasonable and
minimally burdensome, the following information:
``(i) Information reported under paragraph (1).
``(ii) The number of children with medically complex
conditions who have selected a health home pursuant to this
section.
``(iii) The nature, number, and prevalence of chronic
conditions, life-threatening illnesses, disabilities, or rare
diseases that such children have.
``(iv) The type of delivery systems and payment models used
to provide services to such children under this section.
``(v) The number and characteristics of designated
providers, teams of health care professionals operating with
such providers, and health teams selected as health homes
pursuant to this section, including the number and
characteristics of out-of-State providers, teams of health
care professionals operating with such providers, and health
teams who have provided health care items and services to
such children.
``(vi) The extent to which such children receive health
care items and services under the State plan.
``(vii) Quality measures developed specifically with
respect to health care items and services provided to
children with medically complex conditions.
``(B) Report on best practices.--Not later than 90 days
after a State has a State plan amendment approved under this
section, such State shall submit to the Secretary, and make
publicly available on the appropriate State website, a report
on how the State is implementing guidance issued under
subsection (e)(1), including through any best practices
adopted by the State.
``(h) Rule of Construction.--Nothing in this section may be
construed--
``(1) to require a child with medically complex conditions
to enroll in a health home under this section;
``(2) to limit the choice of a child with medically complex
conditions in selecting a designated provider, team of health
care professionals operating with such a provider, or health
team that meets the health home qualification standards
established under subsection (b) as the child's health home;
or
[[Page H2775]]
``(3) to reduce or otherwise modify--
``(A) the entitlement of children with medically complex
conditions to early and periodic screening, diagnostic, and
treatment services (as defined in section 1905(r)); or
``(B) the informing, providing, arranging, and reporting
requirements of a State under section 1902(a)(43).
``(i) Definitions.--In this section:
``(1) Child with medically complex conditions.--
``(A) In general.--Subject to subparagraph (B), the term
`child with medically complex conditions' means an individual
under 21 years of age who--
``(i) is eligible for medical assistance under the State
plan (or under a waiver of such plan); and
``(ii) has at least--
``(I) one or more chronic conditions that cumulatively
affect three or more organ systems and severely reduces
cognitive or physical functioning (such as the ability to
eat, drink, or breathe independently) and that also requires
the use of medication, durable medical equipment, therapy,
surgery, or other treatments; or
``(II) one life-limiting illness or rare pediatric disease
(as defined in section 529(a)(3) of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 360ff(a)(3))).
``(B) Rule of construction.--Nothing in this paragraph
shall prevent the Secretary from establishing higher levels
as to the number or severity of chronic, life threatening
illnesses, disabilities, rare diseases or mental health
conditions for purposes of determining eligibility for
receipt of health home services under this section.
``(2) Chronic condition.--The term `chronic condition'
means a serious, long-term physical, mental, or developmental
disability or disease, including the following:
``(A) Cerebral palsy.
``(B) Cystic fibrosis.
``(C) HIV/AIDS.
``(D) Blood diseases, such as anemia or sickle cell
disease.
``(E) Muscular dystrophy.
``(F) Spina bifida.
``(G) Epilepsy.
``(H) Severe autism spectrum disorder.
``(I) Serious emotional disturbance or serious mental
health illness.
``(3) Health home.--The term `health home' means a
designated provider (including a provider that operates in
coordination with a team of health care professionals) or a
health team selected by a child with medically complex
conditions (or the family of such child) to provide health
home services.
``(4) Health home services.--
``(A) In general.--The term `health home services' means
comprehensive and timely high-quality services described in
subparagraph (B) that are provided by a designated provider,
a team of health care professionals operating with such a
provider, or a health team.
``(B) Services described.--The services described in this
subparagraph shall include--
``(i) comprehensive care management;
``(ii) care coordination, health promotion, and providing
access to the full range of pediatric specialty and
subspecialty medical services, including services from out-
of-State providers, as medically necessary;
``(iii) comprehensive transitional care, including
appropriate follow-up, from inpatient to other settings;
``(iv) patient and family support (including authorized
representatives);
``(v) referrals to community and social support services,
if relevant; and
``(vi) use of health information technology to link
services, as feasible and appropriate.
``(5) Designated provider.--The term `designated provider'
means a physician (including a pediatrician or a pediatric
specialty or subspecialty provider), children's hospital,
clinical practice or clinical group practice, prepaid
inpatient health plan or prepaid ambulatory health plan (as
defined by the Secretary), rural clinic, community health
center, community mental health center, home health agency,
or any other entity or provider that is determined by the
State and approved by the Secretary to be qualified to be a
health home for children with medically complex conditions on
the basis of documentation evidencing that the entity has the
systems, expertise, and infrastructure in place to provide
health home services. Such term may include providers who are
employed by, or affiliated with, a children's hospital.
``(6) Team of health care professionals.--The term `team of
health care professionals' means a team of health care
professionals (as described in the State plan amendment under
this section) that may--
``(A) include--
``(i) physicians and other professionals, such as
pediatricians or pediatric specialty or subspecialty
providers, nurse care coordinators, dietitians,
nutritionists, social workers, behavioral health
professionals, physical therapists, occupational therapists,
speech pathologists, nurses, individuals with experience in
medical supportive technologies, or any professionals
determined to be appropriate by the State and approved by the
Secretary;
``(ii) an entity or individual who is designated to
coordinate such a team; and
``(iii) community health workers, translators, and other
individuals with culturally-appropriate expertise; and
``(B) be freestanding, virtual, or based at a children's
hospital, hospital, community health center, community mental
health center, rural clinic, clinical practice or clinical
group practice, academic health center, or any entity
determined to be appropriate by the State and approved by the
Secretary.
``(7) Health team.--The term `health team' has the meaning
given such term for purposes of section 3502 of Public Law
111-148.''.
SEC. 4. EXTENSION OF THE COMMUNITY MENTAL HEALTH SERVICES
DEMONSTRATION PROGRAM.
Section 223(d)(3) of the Protecting Access to Medicare Act
of 2014 (42 U.S.C. 1396a note) is amended by striking ``for
2-year demonstration programs under this subsection'' and
inserting ``to conduct demonstration programs under this
subsection for 2 years or through June 30, 2019, whichever is
longer''.
SEC. 5. ADDITIONAL FUNDING FOR THE MONEY FOLLOWS THE PERSON
REBALANCING DEMONSTRATION.
Section 6071(h)(1)(F) of the Deficit Reduction Act of 2005
(42 U.S.C. 1396a note) is amended by striking
``$112,000,000'' and inserting ``132,000,000''.
SEC. 6. PREVENTING THE MISCLASSIFICATION OF DRUGS UNDER THE
MEDICAID DRUG REBATE PROGRAM.
(a) Application of Civil Money Penalty for
Misclassification of Covered Outpatient Drugs.--
(1) In general.--Section 1927(b)(3) of the Social Security
Act (42 U.S.C. 1396r-8(b)(3)) is amended--
(A) in the paragraph heading, by inserting ``and drug
product'' after ``price'';
(B) in subparagraph (A)--
(i) in clause (ii), by striking ``; and'' at the end and
inserting a semicolon;
(ii) in clause (iii), by striking the period at the end and
inserting a semicolon;
(iii) in clause (iv), by striking the semicolon at the end
and inserting ``; and''; and
(iv) by inserting after clause (iv) the following new
clause:
``(v) not later than 30 days after the last day of each
month of a rebate period under the agreement, such drug
product information as the Secretary shall require for each
of the manufacturer's covered outpatient drugs.''; and
(C) in subparagraph (C)--
(i) in clause (ii), by inserting ``, including information
related to drug pricing, drug product information, and data
related to drug pricing or drug product information,'' after
``provides false information'';
(ii) by adding at the end the following new clauses:
``(iii) Misclassified drug product or misreported
information.--
``(I) In general.--Any manufacturer with an agreement under
this section that knowingly (as defined in section 1003.110
of title 42, Code of Federal Regulations (or any successor
regulation)) misclassifies a covered outpatient drug, such as
by knowingly submitting incorrect drug product information,
is subject to a civil money penalty for each covered
outpatient drug that is misclassified in an amount not to
exceed 2 times the amount of the difference between--
``(aa) the total amount of rebates that the manufacturer
paid with respect to the drug to all States for all rebate
periods during which the drug was misclassified; and
``(bb) the total amount of rebates that the manufacturer
would have been required to pay, as determined by the
Secretary using drug product information provided by the
manufacturer, with respect to the drug to all States for all
rebate periods during which the drug was misclassified if the
drug had been correctly classified.
``(II) Other penalties and recovery of underpaid rebates.--
The civil money penalties described in subclause (I) are in
addition to other penalties as may be prescribed by law and
any other recovery of the underlying underpayment for rebates
due under this section or the terms of the rebate agreement
as determined by the Secretary.
``(iv) Increasing oversight and enforcement.--Each year the
Secretary shall retain, in addition to any amount retained by
the Secretary to recoup investigation and litigation costs
related to the enforcement of the civil money penalties under
this subparagraph and subsection (c)(4)(B)(ii)(III), an
amount equal to 25 percent of the total amount of civil money
penalties collected under this subparagraph and subsection
(c)(4)(B)(ii)(III) for the year, and such retained amount
shall be available to the Secretary, without further
appropriation and until expended, for activities related to
the oversight and enforcement of this section and agreements
under this section, including--
``(I) improving drug data reporting systems;
``(II) evaluating and ensuring manufacturer compliance with
rebate obligations; and
``(III) oversight and enforcement related to ensuring that
manufacturers accurately and fully report drug information,
including data related to drug classification.''; and
(iii) in subparagraph (D)--
(I) in clause (iv), by striking ``, and'' and inserting a
comma;
(II) in clause (v), by striking the period and inserting
``, and''; and
(III) by inserting after clause (v) the following new
clause:
``(vi) in the case of categories of drug product or
classification information that were not considered
confidential by the Secretary on the day before the date of
the enactment of this clause.''.
(2) Technical amendments.--
[[Page H2776]]
(A) Section 1903(i)(10) of the Social Security Act (42
U.S.C. 1396b(i)(10)) is amended--
(i) in subparagraph (C)--
(I) by adjusting the left margin so as to align with the
left margin of subparagraph (B); and
(II) by striking ``, and'' and inserting a semicolon;
(ii) in subparagraph (D), by striking ``; or'' and
inserting ``; and''; and
(iii) by adding at the end the following new subparagraph:
``(E) with respect to any amount expended for a covered
outpatient drug for which a suspension under section
1927(c)(4)(B)(ii)(II) is in effect; or''.
(B) Section 1927(b)(3)(C)(ii) of the Social Security Act
(42 U.S.C. 1396r-8(b)(3)(C)(ii)) is amended by striking
``subsections (a) and (b)'' and inserting ``subsections (a),
(b), (f)(3), and (f)(4)''.
(b) Recovery of Unpaid Rebate Amounts Due to
Misclassification of Covered Outpatient Drugs.--
(1) In general.--Section 1927(c) of the Social Security Act
(42 U.S.C. 1396r-8(c)) is amended by adding at the end the
following new paragraph:
``(4) Recovery of unpaid rebate amounts due to
misclassification of covered outpatient drugs.--
``(A) In general.--If the Secretary determines that a
manufacturer with an agreement under this section paid a
lower per-unit rebate amount to a State for a rebate period
as a result of the misclassification by the manufacturer of a
covered outpatient drug (without regard to whether the
manufacturer knowingly made the misclassification or should
have known that the misclassification would be made) than the
per-unit rebate amount that the manufacturer would have paid
to the State if the drug had been correctly classified, the
manufacturer shall pay to the State an amount equal to the
product of--
``(i) the difference between--
``(I) the per-unit rebate amount paid to the State for the
period; and
``(II) the per-unit rebate amount that the manufacturer
would have paid to the State for the period, as determined by
the Secretary, if the drug had been correctly classified; and
``(ii) the total units of the drug paid for under the State
plan in the period.
``(B) Authority to correct misclassifications.--
``(i) In general.--If the Secretary determines that a
manufacturer with an agreement under this section has
misclassified a covered outpatient drug (without regard to
whether the manufacturer knowingly made the misclassification
or should have known that the misclassification would be
made), the Secretary shall notify the manufacturer of the
misclassification and require the manufacturer to correct the
misclassification in a timely manner.
``(ii) Enforcement.--If, after receiving notice of a
misclassification from the Secretary under clause (i), a
manufacturer fails to correct the misclassification by such
time as the Secretary shall require, until the manufacturer
makes such correction, the Secretary may do any or all of the
following:
``(I) Correct the misclassification, using drug product
information provided by the manufacturer, on behalf of the
manufacturer.
``(II) Suspend the misclassified drug and the drug's status
as a covered outpatient drug under the manufacturer's
national rebate agreement, and exclude the misclassified drug
from Federal financial participation in accordance with
section 1903(i)(10)(E).
``(III) Impose a civil money penalty (which shall be in
addition to any other recovery or penalty which may be
available under this section or any other provision of law)
for each rebate period during which the drug is misclassified
not to exceed an amount equal to the product of--
``(aa) the total number of units of each dosage form and
strength of such misclassified drug paid for under any State
plan during such a rebate period; and
``(bb) 23.1 percent of the average manufacturer price for
the dosage form and strength of such misclassified drug.
``(C) Reporting and transparency.--
``(i) In general.--The Secretary shall submit a report to
Congress on at least an annual basis that includes
information on the covered outpatient drugs that have been
identified as misclassified, any steps taken to reclassify
such drugs, the actions the Secretary has taken to ensure the
payment of any rebate amounts which were unpaid as a result
of such misclassification, and a disclosure of expenditures
from the fund created in subsection (b)(3)(C)(iv), including
an accounting of how such funds have been allocated and spent
in accordance with such subsection.
``(ii) Public access.--The Secretary shall make the
information contained in the report required under clause (i)
available to the public on a timely basis.
``(D) Other penalties and actions.--Actions taken and
penalties imposed under this clause shall be in addition to
other remedies available to the Secretary including
terminating the manufacturer's rebate agreement for
noncompliance with the terms of such agreement and shall not
exempt a manufacturer from, or preclude the Secretary from
pursuing, any civil money penalty under this title or title
XI, or any other penalty or action as may be prescribed by
law.''.
(2) Offset of recovered amounts against medical
assistance.--Section 1927(b)(1)(B) of the Social Security Act
(42 U.S.C. 1396r-8(b)(1)(B)) is amended by inserting ``,
including amounts received by a State under subsection
(c)(4),'' after ``in any quarter''.
(c) Clarifying Definitions.--Section 1927(k) of the Social
Security Act (42 U.S.C. 1396r-8(k)) is amended--
(1) in paragraph (2)(A), by striking ``paragraph (5)'' and
inserting ``paragraph (4)''; and
(2) in paragraph (7)(A)--
(A) by striking ``an original new drug application'' and
inserting ``a new drug application'' each place it appears;
(B) in clause (i), by striking ``(not including any drug
described in paragraph (5))'' and inserting ``, including a
drug product approved for marketing as a non-prescription
drug that is regarded as a covered outpatient drug under
paragraph (4),'';
(C) in clause (ii)--
(i) by striking ``was originally marketed'' and inserting
``is marketed''; and
(ii) by inserting ``, unless the Secretary determines that
a narrow exception applies (as described in section 447.502
of title 42, Code of Federal Regulations (or any successor
regulation))'' before the period; and
(D) in clause (iv)--
(i) by inserting ``, including a drug product approved for
marketing as a non-prescription drug that is regarded as a
covered outpatient drug under paragraph (4),'' after
``covered outpatient drug'';
(ii) by inserting ``unless the Secretary determines that a
narrow exception applies (as described in section 447.502 of
title 42, Code of Federal Regulations (or any successor
regulation))'' after ``under the new drug application''; and
(iii) by adding at the end the following new sentence:
``Such term also includes a covered outpatient drug that is a
biological product licensed, produced, or distributed under a
biologics license application approved by the Food and Drug
Administration.''.
(d) Exclusion of Manufacturers for Knowing
Misclassification of Covered Outpatient Drugs.--Section
1128(b) of the Social Security Act (42 U.S.C. 1320a-7(b)) is
amended by adding at the end the following new paragraph:
``(17) Knowingly misclassifying covered outpatient drugs.--
Any manufacturer or officer, director, agent, or managing
employee of such manufacturer that knowingly misclassifies a
covered outpatient drug under an agreement under section
1927, knowingly fails to correct such misclassification, or
knowingly provides false information related to drug pricing,
drug product information, or data related to drug pricing or
drug product information.''.
(e) Effective Date.--The amendments made by this section
shall take effect on the date of the enactment of this Act,
and shall apply to covered outpatient drugs supplied by
manufacturers under agreements under section 1927 of the
Social Security Act (42 U.S.C. 1396r-8) on or after such
date.
SEC. 7. EXTENSION OF THIRD-PARTY LIABILITY PERIOD FOR CHILD
SUPPORT SERVICES.
(a) In General.--Section 202(a)(2) of the Bipartisan Budget
Act of 2013 (Public Law 113-67) is amended by striking ``90
days'' and inserting ``100 days''.
(b) Effective Date.--The amendment made by this section
shall take effect on the date of the enactment of this Act.
SEC. 8. DENIAL OF FFP FOR CERTAIN EXPENDITURES RELATING TO
VACUUM ERECTION SYSTEMS AND PENILE PROSTHETIC
IMPLANTS.
(a) In General.--Section 1903(i) of the Social Security Act
(42 U.S.C. 1396b(i)) is amended by inserting after paragraph
(11) the following:
``(12) with respect to any amounts expended for--
``(A) a vacuum erection system that is not medically
necessary; or
``(B) the insertion, repair, or removal and replacement of
a penile prosthetic implant (unless such insertion, repair,
or removal and replacement is medically necessary); or''.
(b) Effective Date.--The amendment made by subsection (a)
shall apply with respect to items and services furnished on
or after January 1, 2020.
SEC. 9. DETERMINATION OF BUDGETARY EFFECTS.
The budgetary effects of this Act, for the purpose of
complying with the Statutory Pay-As-You-Go Act of 2010, shall
be determined by reference to the latest statement titled
``Budgetary Effects of PAYGO Legislation'' for this Act,
submitted for printing in the Congressional Record by the
Chairman of the House Budget Committee, provided that such
statement has been submitted prior to the vote on passage.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
California (Mr. Ruiz) and the gentleman from Texas (Mr. Burgess) each
will control 20 minutes.
The Chair recognizes the gentleman from California.
General Leave
Mr. RUIZ. Mr. Speaker, I ask unanimous consent that all Members have
5 legislative days to revise and extend their remarks and include
extraneous material on H.R. 1839.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from California?
[[Page H2777]]
There was no objection.
Mr. RUIZ. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I am humbled to rise in support of H.R. 1839, the
Medicaid Services Investment and Accountability Act, a bill that will
strengthen our healthcare system by putting patients first.
I am an emergency physician, and as a doctor I have treated patients
who, because they couldn't afford the care they needed, slipped through
the cracks, worsening their quality of life, harming themselves and
their families, and sometimes ending up in the emergency department for
lifesaving care.
This bill makes five essential reforms to Medicaid that put patients
first, helping children and individuals with mental health issues
access the care that they need.
The bill's first reform reflects the hard work and tireless efforts
of my friend, Representative Dingell, who has led the fight to extend
Medicaid spousal impoverishment protections. Thanks to Representative
Dingell's advocacy, patients will be able to afford treatment and
services without bankrupting their spouses.
Without this important protection, families would face a terrible
choice between either unnecessary institutionalization or impoverishing
themselves to ensure that their loved one receives the care that they
need.
I would also like to thank Congressman Upton for championing this
important policy.
Second, my bill would provide additional funds to the successful
Money Follows the Person demonstration. This funding will help more
individuals transition from institutions to the communities they call
home. I wanted to thank Representatives Dingell and Guthrie for their
advocacy on behalf of the patients and families who continue to benefit
from this successful program.
Third, this bill includes the Advancing Care for Exceptional Kids
Act, bipartisan legislation that gives States the flexibility to
coordinate the most effective care for children with medically complex
needs. The ACE Kids Act would not be possible without the sustained
advocacy and hard work of Congresswoman Castor.
Representative Castor is an incredible advocate for some of our most
vulnerable children and their families and has spent years championing
this bill. I also want to thank my friend, Representative Bilirakis,
for continuing to fight to ensure that our sickest kids have access to
health homes.
Fourth, this bill contains important program integrity improvements
to Medicaid, fixes that will save money and make Medicaid run more
efficiently and effectively without sacrificing quality of care for
patients.
That includes legislation championed by Representatives Schrader and
Welch to crack down on drug companies cheating the Medicaid program by
not paying proper rebates on their drugs. The bill also gives the
Department of Health and Human Services the tools it needs to hold ill-
intentioned pharmaceutical companies accountable, while ensuring that
patients who depend on these drugs continue to have access to them.
Fifth, and finally, this bill extends funding for the Excellence in
Mental Health Act, so that people who are struggling with mental health
and substance use disorders can continue receiving the treatment they
need. The extension will help Congress find a longer-term solution so
that this program can continue providing care to the people who need
it.
I would like to thank Representative Matsui for her continued hard
work to support this demonstration. In brief, this bipartisan bill
strengthens Medicaid by putting patients first. It was the approach I
took as a doctor in the emergency department, and one I am continuing
to take in Congress.
I know this bill will make our healthcare system stronger and more
equitable, and I am proud to lead this critical effort.
I urge my colleagues to support the passage of H.R. 1839, the
Medicaid Services Investment and Accountability Act of 2019, and I
reserve the balance of my time.
Mr. BURGESS. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I want to speak today in support of H.R. 1839, the
Medicaid Services Investment and Accountability Act of 2019.
This is a bipartisan Medicaid extenders package that moves forward
House priorities with responsible offsets. In fact, this package
actually saves the Federal Government $1 million.
H.R. 1839 includes a new program to improve access to healthcare from
medically complex children and reauthorizes important and effective
programs that benefit Americans each and every day.
{time} 1730
Money Follows the Person is an important program for the State of
Texas. This Medicaid demonstration, which was established in 2005, has
enabled eligible individuals in States across our Nation to receive
long-term care services in their homes or other community settings,
rather than an institution such as a nursing home.
While I am disappointed that H.R. 1839 includes only $20 million to
extend this critical program through September instead of through the
end of calendar year 2019, I am pleased that the funding for Money
Follows the Person was ultimately included in this package.
This bill also includes an extension through September of the
protection for Medicaid recipients of home and community-based services
against spousal impoverishment program. This program specifically
protects married individuals requiring Medicaid-covered and long-term
services and supports to ensure that they do not have to deplete their
financial resources or bankrupt themselves in order to become or remain
Medicaid-eligible to receive such services. Our seniors are among our
most vulnerable citizens, and it is programs such as this that will
help protect them from financial ruin.
According to the National Institute of Mental Health, nearly one in
five United States adults lives with a mental illness. Programs
established to help individuals who are struggling with mental health
issues, including the Excellence in Mental Health program, enable
States to implement community behavioral health centers to address the
needs of their populations. H.R. 1839 extends the Excellence in Mental
Health program funding for Oregon and Oklahoma so that they will be on
the same financial cycle as other States that are participating in the
program.
The ACE Kids Act, which will improve care for children with complex
medical needs, is also included in this package. The goal of this
legislation is to improve comprehensive care for medically complex
children through a State option to create a Medicaid health home
specific to children. Health homes have proven effective in improving
care coordination in the adult Medicaid population and hold promise for
complex pediatric patients.
However, I want to clarify that this legislation is not intended to
limit families or their physicians from selecting the provider of
choice for medical services. There is nothing in this legislation that
restricts the child's family or their physician from deciding who is
best qualified as a Medicare provider. The Centers for Medicare and
Medicaid Services has provided assurances that current freedom of
choice rules will apply to new care coordination activity.
As a physician, I know that many children with chronic illnesses have
a strong relationship with their physician and with other providers. I
want to make certain that this new law will help families coordinate
their care without affecting the relationship that families have with
their current doctor or other medical care provider or other providers
in their communities from whom they may wish to receive care.
This package contains must-pass provisions that will improve access
for Medicaid beneficiaries, which is a laudable and important goal. Not
only are these provisions imperative, but they are responsibly offset.
In fact, this package saves money.
I would particularly like to thank the Energy and Commerce Committee
staff, in particular J.P. Paluskiewicz and Caleb Graff, who have spent
a significant amount of their lives negotiating this package to get it
to the floor.
I support this legislation, and I urge other Members to continue to
support this and get the other body to take it up and pass it as well.
[[Page H2778]]
Mr. Speaker, I reserve the balance of my time.
Mr. RUIZ. Mr. Speaker, I yield 3 minutes to the gentlewoman from
California (Ms. Matsui).
Ms. MATSUI. Mr. Speaker, I rise in support of the Medicaid Services
Investment and Accountability Act of 2019 and the important provisions
within this legislation to address mental health and addiction.
Every one of us knows someone who has struggled, is struggling, or
will struggle with mental health issues. Whether it is a friend, a
neighbor, or a family member, mental illness impacts all of us in some
way.
Several years ago, we took a huge step forward to expand access to
mental health services in communities across the Nation. The Excellence
in Mental Health Act of 2014 was the culmination of years of hard work.
At the same time, it was the largest Federal investment toward
improving community-based mental healthcare.
That legislation allowed States to establish certified community
behavioral health centers to ensure everyone who needs mental health
services can receive them. These clinics have expanded mental health
and substance use treatments dramatically, increasing access to 24-hour
care, and they have been extremely successful in showing us how we can
achieve real results in our communities.
Patients can receive medication-assisted treatment at almost every
clinic. For many patients and providers, this is the first time that
such services have been available in their communities, which are very
often in medically underserved areas. Over half of these clinics now
offer same-day access to care, which is so critical to those suffering
from an acute mental health crisis.
I recently heard from a clinic in Oregon that will lose funding at
the end of this week if Congress doesn't act now. This clinic has
doubled the amount of time their doctors are able to spend with
patients, has been able to hire more staff, and goes to meet patients
in the community to better serve the unique needs of this population.
We cannot afford to let this progress expire.
For far too long, those with mental illness have been left in the
shadows, and mental health prevention and treatment have been left out
of our health systems.
The mental health crisis in this country is very personal to me, and
I have been fighting for patients and their loved ones for many years.
I believe there is a lot we can do better to stop or slow down the hurt
and pain patients and families feel when mental health is left
unaddressed.
The bill before us today will extend this critical program in two
States, Oregon and Oklahoma, until June and is a first step toward
funding and expanding the program later this year.
There is a lot more we must do, and I look forward to continuing to
work with my colleague, Representative Markwayne Mullin, to preserve
this vital program.
Mr. BURGESS. Mr. Speaker, I yield such time as he may consume to the
gentleman from Oregon (Mr. Walden), who is the Republican leader of the
Energy and Commerce Committee.
Mr. WALDEN. Mr. Speaker, to my colleagues on both sides of the aisle,
this is really important legislation we are working on today. H.R.
1839, the Medicaid Services Investment and Accountability Act of 2019,
includes short-term extensions of several key Medicaid programs that
have previously passed the House on a bipartisan basis.
I know our staffs on both sides of the aisle put a lot of time and
effort into this, and I thank them all. I especially want to draw
attention to Caleb Graff, who brought his own audience with him today
in the gallery, his parents and brother. He has worked very hard on
this, and we appreciate it.
I thank my chair and colleague, Frank Pallone of the Energy and
Commerce Committee, for the partnership on this extenders package.
Personally, I know a lot of us would have liked to have had these
extended programs go out further to give beneficiaries and providers
more certainty and more stability, and we will continue to put forth
offers in good faith to work across the aisle to fund these critical
parts of America's safety net.
However, we are here today up against a deadline, and I am pleased we
were able to get at least through June and September, respectively,
with these programs.
I am particularly pleased to see this package includes a short-term
extension of the Excellence in Mental Health demonstration for my home
State of Oregon. Both Oregon and Oklahoma were set to run out of
funding at the end of this month, so this money will at least line them
up with the other participating States whose funding expires at the end
of June.
These eight State demonstration projects have shown promise as a way
for community providers to expand access to treatment for mental and
behavioral health, including addiction. As we continue our bipartisan
work on the opioid crisis, which took more than 70,000 American lives
in 2017 alone, Mr. Speaker, our behavioral health centers have the
potential to provide real help. I have been encouraged to hear from
providers in rural parts of my district, like Wallowa and Klamath
Falls, about their success implementing this very program. I look
forward to working on a longer term extension in the coming months.
The other Medicaid policies included in this bill are also very
important.
The Money Follows the Person program is a demonstration program that
helps transition individuals with chronic conditions and disabilities
from institutions back into their local communities. That is where they
can get the best care.
The so-called spousal impoverishment program protects seniors against
the high costs of home and community-based services.
Finally, we are, once again, passing the ACE Kids Act here in the
House, which was championed by our former colleague and chairman of the
committee, Representative Joe Barton of Texas. It would improve the
delivery of care for children with really complex medical conditions.
Mr. Speaker, I urge all our colleagues on both sides of the aisle to
support this bipartisan package of healthcare bills.
The SPEAKER pro tempore. Members are reminded to avoid referencing
occupants of the gallery.
Mr. RUIZ. Mr. Speaker, I yield 2 minutes to the gentlewoman from
Florida (Ms. Castor).
Ms. CASTOR of Florida. Mr. Speaker, I thank my colleague and friend,
Dr. Ruiz, for yielding the time.
Mr. Speaker, on behalf of families of children with complex medical
needs--and there are many families like this all across America--I rise
to urge approval of H.R. 1839, which includes a bill I have been
working on for a number of years with my colleagues, including former
Representative Joe Barton. It is called the ACE Kids Act.
We drafted the Advancing Care for Exceptional Kids Act a few years
ago with a simple but important goal of putting children and their
families first. The bill authorizes the creation of cost-saving and
time-saving health homes where specialized care is coordinated in a
high-quality setting.
Mr. Speaker, the children with complex medical conditions and their
families are heroic, like Caroline West in my hometown of Tampa. She
has a rare genetic condition, cerebral palsy, and a seizure disorder.
She can't walk, and it is very difficult for her to speak, but she
attends school part time and enjoys the life of a typical teenager, in
many respects.
Lucy Ferlita is the only living person in the United States with
early onset myopathy with areflexia, respiratory distress, and
dysphagia. Very little is known about this disease, but we know that it
is very difficult for her to eat. She has to have a feeding tube, a
ventilator to breathe, and nursing care 24 hours a day.
Jaden Velasquez has a congenital heart defect.
Lakota Lockhart has a central nervous system disorder that causes him
to not be able to breathe while he sleeps.
I met all of these kids back home in Tampa at St. Joseph's Children's
Hospital. St. Joe's has a world-renown Chronic-Complex Clinic that was
started 16 years ago by a compassionate pediatrician, Dr. Daniel
Plasencia. This ACE Kids Act is modeled upon their work and the other
good work being done at children's hospitals across this country.
The bill provides an incentive for States to establish health homes
to
[[Page H2779]]
better coordinate care for kids with medical complexities. It also
directs HHS to provide guidance to States on best practices.
Mr. Speaker, I urge my colleagues to adopt this bill with the ACE
Kids Act included.
Mr. Speaker, I include in the Record a letter from a whole host of
organizations thanking us for our leadership and for introducing this
bipartisan legislation to improve care for children with complex
medical conditions.
March 25, 2019.
Hon. Chuck Grassley,
Washington, DC.
Hon. Michael Bennet,
Washington, DC.
Hon. Kathy Castor,
Washington, DC.
Hon. Gus Bilirakis,
Washington, DC.
Hon. Anna Eshoo,
Washington, DC.
Hon. Jaime Herrera Beutler,
Washington, DC.
Dear Sens. Grassley and Bennet, and Reps. Castor,
Bilirakis, Eshoo, and Herrera Beutler: As national
organizations committed to children's health, we write in
strong support of the ``Advancing Care for Exceptional Kids
Act of 2019'' (ACE Kids Act, S. 317/H.R. 1226), which has
been incorporated into the Medicaid Services Investment and
Accountability Act of 2019 (H.R. 1839). We thank you for your
leadership in introducing this bipartisan legislation to
improve care for children with complex medical conditions in
the Medicaid program.
Children with complex medical conditions have chronic life-
limiting illnesses and disabilities, and often see six or
more specialists and a dozen or more physicians. Under the
current Medicaid system, parents of children with multiple,
life-threatening disabilities struggle to coordinate the
complex care of their kids, which often requires travelling
to out-of-state providers. The ACE Kids Act works to create a
patient-centered, pediatric-focused delivery system for this
unique population of children. It is an important step in
fixing the current fragmented system for children with
complex medical conditions, ensuring ready access to care and
reducing the burden on their families.
Under the ACE Kids Act, specially-designed health homes
created for children with complex medical conditions will
employ national quality standards and coordinate care--both
essential to improving overall quality of care. These health
homes will include the full range of acute, post-acute and
primary care providers, and will focus on outpatient care to
ensure children get the care that they need in the most
appropriate setting closest to home while reducing
unnecessary hospitalizations and emergency room visits. The
ACE Kids Act--which is voluntary for states, families and
providers--will also help families access the array of
outpatient and community services and supports needed by
these children.
Providing children with complex medical conditions enrolled
in Medicaid the best possible care is a national challenge,
and the ACE Kids Act will bring us closer to ensuring these
vulnerable children receive the care they need. We are proud
to support the ACE Kids Act, and we look forward to working
with you to advance this critical legislation this year.
Sincerely,
American Academy of Pediatrics; American Association for
Psychoanalysis in Clinical Social Work; American Association
of Child and Adolescent Psychiatry; The American Board of
Pediatrics; American College of Cardiology; American College
of Surgeons; American Heart Association; American Physical
Therapy Association; American Psychological Association;
American Society of Echocardiography; American Thoracic
Society; America's Essential Hospitals; Association of
American Medical Colleges; Association of Medical School
Pediatric Department Chairs; Autism Society of America;
Autism Speaks.
Children's Cause for Cancer Advocacy; Children's Hospital
Association; ChildServe; Epilepsy Foundation; Family Voices;
March of Dimes; Maxim Healthcare Services; Mended Little
Hearts; Moms Rising; National Association for Children's
Behavioral Health; National Association of Pediatric Nurse
Practitioners; National Board for Certified Counselors;
National Down Syndrome Society; Pediatric Congenital Heart
Association; Tricare for Kids Coalition; Vizient.
Mr. BURGESS. Mr. Speaker, I yield 3 minutes to the gentleman from
Michigan (Mr. Upton), who is the former chairman of the Energy and
Commerce Committee and the author of the Cures for the 21st Century
bill.
Mr. UPTON. Mr. Speaker, I rise in strong support of this bipartisan
legislation.
I just want to remark briefly to my colleague from Florida (Ms.
Castor) that the ACE Kids bill was a very important bill that we worked
on actually for three Congresses. Joe Barton and the gentlewoman did a
marvelous job. We didn't quite get it done. We passed it in this House
with more than 400 votes in the last Congress. At the end, the Senate
just didn't take it up.
It is very important that it is included as part of this bipartisan
package, which we hope is early enough that we can get the Senate to
act and pass it, because it really does impact families that are in
much need.
I also am happy that we are moving this comprehensive bill today
because it does contain a variety of important extensions. All of them
had hearings and a lot of bipartisan support from the very first. This
includes protections against spousal impoverishment for those seniors
who have a spouse who is receiving home-based long-term care under
Medicaid.
Back in 2010, we temporarily mandated these protections for home
care, but that mandate was set to expire at the end of this very week,
so it has to be extended.
Last year, my good friend and colleague, Mrs. Dingell, and I
introduced a bill to make the spousal impoverishment protections
permanent, and we worked hard to get that done and passed here in this
House. But at the end, even though we worked tirelessly on this, we got
only a temporary extension. That is why it expires the end of this
week.
This bill doesn't permanently extend it like we had hoped last year,
but it does give a reprieve by extending the protection until the end
of this year, so, in essence, a 9-month extension. It is my hope that
we can use the time to actually pass a permanent extension.
I particularly commend the work of my colleague, Mrs. Dingell from
the great State of Michigan, for her passion on this, to make sure that
we can get it done. I applaud the Speaker for getting it scheduled on
the House floor early so that we can get it done, hopefully, this week,
and the Senate can concur. Then let's use the time to really make it
permanent, to help these families that otherwise will have funds taken
out, as this really does rely on Medicaid, to a large degree.
{time} 1745
Mr. RUIZ. Mr. Speaker, I yield 2 minutes to the gentlewoman from
Michigan (Mrs. Dingell).
Mrs. DINGELL. Mr. Speaker, I thank my colleague from California for
his leadership on this issue and for yielding me time.
Mr. Speaker, I rise to speak in support of H.R. 1839, the Medicaid
Services Investment and Accountability Act.
This bill includes two provisions that are very important to seniors
and the disabled. It makes improvements, but, as you have heard my
other colleagues talk about, not enough and not for long enough.
First of all, it has a provision that I worked on with my colleague,
Mr. Upton, that extends the spousal impoverishment protections for
seniors in Medicaid through the end of the fiscal year. These critical
protections ensure that individuals are not forced to spend down almost
all of their resources and potentially go bankrupt to get the care that
they need. No American should be forced into poverty just to receive
adequate healthcare.
In addition, this bill contains a provision that I worked on with my
colleague, Mr. Guthrie, to extend the highly successful Money Follows
the Person program, again, just through the end of the fiscal year.
This program provides grants to States to help individuals voluntarily
transition from an institutional setting to a community care setting,
their own home. All Americans, regardless of income, deserve to receive
long-term care in a setting that they prefer.
While I am pleased that these programs will be extended through the
end of September and not allowed to lapse--and that is critical--this
is only a partial victory. Both the Money Follows the Person program
and spousal impoverishment protections need to be extended for the long
term, not a few months at a time. We keep doing that. It was 3 months
ago that we just extended it for 3 months.
Seniors and individuals with disabilities need to have security. They
need to know and have peace of mind that these important provisions are
going to be there for the long term. And States need stability and
certainty in order to fully implement these efforts.
Mr. BURGESS. Mr. Speaker, I yield 2 minutes to the gentleman from
Kentucky (Mr. Guthrie), a valuable member of the Energy and Commerce
Committee and the Republican leader of the Oversight and Investigations
Subcommittee.
[[Page H2780]]
Mr. GUTHRIE. Mr. Speaker, I rise today in support of H.R. 1839, which
extends the important Medicaid Money Follows the Person program until
September.
The Medicaid Money Follows the Person program allows certain Medicaid
beneficiaries, such as the elderly or individuals with disabilities, to
transition from a healthcare facility to receiving care in their own
homes. It does not force patients to leave a facility if they don't
want to.
Since the Money Follows the Person program was created over a decade
ago, it has successfully helped over 88,000 individuals receive care in
their own homes.
I have worked with Congresswoman Debbie Dingell on the bipartisan
EMPOWER Care Act, which extends the Medicaid Money Follows the Person
program for 5 years.
I urge my colleagues to support H.R. 1839 to extend the program until
September, and I will continue to work with Congresswoman Dingell to
get the EMPOWER Act across the finish line.
Mr. RUIZ. Mr. Speaker, I am ready to close.
Mr. Speaker, I urge my colleagues to support this bipartisan bill,
H.R. 1839. I really thank all the Members who put their heart and soul
into their pieces of legislation. I thank the staff of the Energy and
Commerce Committee, both Democratic and Republican, who have come
together to work to plug a hole, to fill in the cracks, and to make
sure that services continue, that value is given, and that healthcare
puts our patients first, our kids first, so that we can give them the
appropriate care that they deserve, no matter where they are from or
whether or not they can afford it.
This is why I am so humbled to carry the water on this bill. On
behalf of myself, my staff, and my office, I thank everybody involved
in this bill.
Mr. Speaker, I urge support for this bipartisan bill, H.R. 1839, and
I yield back the balance of my time.
Mr. BURGESS. Mr. Speaker, this is an important bill, and I urge all
Members to support it.
Once again, I want to single out and thank J.P. Paluskiewicz and
Caleb Graff for really moving heaven and earth to get this to the floor
so that these valuable programs do not lapse.
Mr. Speaker, I yield back the balance of my time.
Ms. JOHNSON of Texas. Mr. Speaker, I rise today to voice my support
for H.R. 1839, the Medicaid Services Investment and Accountability Act
of 2019.
This bill would extend programs that help seniors and people with
disabilities live in the community, rather than institutions. It would
extend the authorization of the Excellence in Mental Health
demonstration so that none of the participating states run out of
critical funds. It would authorize additional program integrity
measures in the Medicaid Drug Rebate Program and in other areas of the
Medicaid program. Finally, it would provide states with the option to
provide coordinated care for children with medically complex
conditions.
As representatives of Americans from all corners of our country, we
have a responsibility to protect and enhance Medicaid, a vital safety
net program that finances the delivery of care to 69 million people in
this country. Without this program, the quality and access of
healthcare for our most vulnerable populations will be at risk. We must
ensure that future generations are able to receive the necessary health
benefits to live full and prosperous lives.
On behalf of the over four and a half million Medicaid beneficiaries
in my home state of Texas, I am proud to support the Medicaid Services
Investment and Accountability Act of 2019.
I urge my colleagues to support this bill.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from California (Mr. Ruiz) that the House suspend the rules
and pass the bill, H.R. 1839, as amended.
The question was taken.
The SPEAKER pro tempore. In the opinion of the Chair, two-thirds
being in the affirmative, the ayes have it.
Mr. BURGESS. Mr. Speaker, I object to the vote on the ground that a
quorum is not present and make the point of order that a quorum is not
present.
The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further
proceedings on this question will be postponed.
The point of no quorum is considered withdrawn.
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