    [United States Statutes at Large, Volume 133, 116th Congress, 1st Session]
    [From the U.S. Government Publishing Office, www.gpo.gov]

    Public Law 116-3
    116th Congress

    An Act

    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. <>

    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 Extenders Act of 2019''.
    SEC. 2. EXTENSION OF MONEY FOLLOWS THE PERSON REBALANCING
    DEMONSTRATION.

    (a) General Funding.--Section 6071(h) of the Deficit Reduction Act
    of 2005 (42 U.S.C. 1396a note) is amended--
    (1) in paragraph (1)--
    (A) in subparagraph (D), by striking ``and'' after
    the semicolon;
    (B) in subparagraph (E), by striking the period at
    the end and inserting ``; and''; and
    (C) by adding at the end the following:
    ``(F) subject to paragraph (3), $112,000,000 for
    fiscal year 2019.'';
    (2) in paragraph (2)--
    (A) by striking ``Amounts made'' and inserting
    ``Subject to paragraph (3), amounts made''; and
    (B) by striking ``September 30, 2016'' and inserting
    ``September 30, 2021''; and
    (3) by adding at the end the following new paragraph:
    ``(3) <>  Special rule for fy 2019.--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.''.

    (b) Funding for Quality Assurance and Improvement; Technical
    Assistance; Oversight.--Section 6071(f) of the Deficit Reduction Act of
    2005 (42 U.S.C. 1396a note) is amended by striking paragraph (2) and
    inserting the following:
    ``(2) Funding.--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.''.

    (c) Technical Amendment.--Section 6071(b) of the Deficit Reduction
    Act of 2005 (42 U.S.C. 1396a note) is amended by adding at the end the
    following:
    ``(10) <>  Secretary.--The term
    `Secretary' means the Secretary of Health and Human Services.''.

    [[Page 7]]

    SEC. 3. 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) is amended by striking ``the 5-year
    period that begins on January 1, 2014,'' and inserting ``the period
    beginning on January 1, 2014, and ending on March 31, 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. 4. REDUCTION IN FMAP AFTER 2020 FOR STATES WITHOUT ASSET
    VERIFICATION PROGRAM.

    Section 1940 of the Social Security Act (42 U.S.C. 1396w) is amended
    by adding at the end the following new subsection:
    ``(k) Reduction in FMAP After 2020 for Non-Compliant States.--
    ``(1) <>  In general.--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--
    ``(A) for calendar quarters in 2021 and 2022, by
    0.12 percentage points;

    [[Page 8]]

    ``(B) for calendar quarters in 2023, by 0.25
    percentage points;
    ``(C) for calendar quarters in 2024, by 0.35
    percentage points; and
    ``(D) for calendar quarters in 2025 and each year
    thereafter, by 0.5 percentage points.
    ``(2) Non-compliant state defined.--For purposes of this
    subsection, the term `non-compliant State' means a State--
    ``(A) that is one of the 50 States or the District
    of Columbia;
    ``(B) with respect to which the Secretary has not
    approved a State plan amendment submitted under
    subsection (a)(2); and
    ``(C) that is not operating, on an ongoing basis, an
    asset verification program in accordance with this
    section.''.
    SEC. 5. MEDICAID IMPROVEMENT FUND.

    Section 1941(b)(1) of the Social Security Act (42 U.S.C. 1396w-
    1(b)(1)) is amended by striking ``$31,000,000'' and inserting
    ``$6,000,000''.

    Approved January 24, 2019.

    LEGISLATIVE HISTORY--H.R. 259:
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    CONGRESSIONAL RECORD, Vol. 165 (2019):
    Jan. 8, considered and passed House.
    Jan. 17, considered and passed Senate.