Sec. 2. FMAP adjustment for affected jurisdictions equivalent to compact migrant expenditures
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For calendar quarters beginning on or after January 1 of the first year beginning after the date of the enactment of this Act, the Secretary of Health and Human Services shall increase the FMAP for each affected jurisdiction (without regard for any limitation otherwise specified in section 1905(b) of such Act ( 42 U.S.C. 1396d(b) )) by the number of percentage points estimated under subsection
(d). For purposes of subsection
(a), not later than 90 days before the beginning of the calendar quarter involved, the chief executive official of the affected jurisdiction shall submit to the Secretary of the Interior an estimation of the amount of compact migrant expenditures that will be made by such jurisdiction for such quarter. Not later than 60 days before the beginning of the calendar quarter involved, the Secretary of the Interior shall review the estimation submitted by the chief executive official under subsection
(b), make any appropriate adjustments, and submit to the Secretary of Health and Human Services a final estimated amount of compact migrant expenditures for such quarter. The Secretary of Health and Human Services shall estimate the number of percentage points that the FMAP for each affected jurisdiction would need to be increased for a calendar quarter to result in an increase in the amount of total Federal payments to the affected jurisdiction under title XIX of the Social Security Act for such quarter that is equivalent to the final estimated amount of compact migrant expenditures submitted under subsection
(c)for such quarter. In no case may the increase in the FMAP estimated by the Secretary of Health and Human Services under paragraph
(1)result in the payments to an affected jurisdiction under title XIX of the Social Security Act that exceed the limitations under subsections
(f)and
(g)of section 1108 of such Act ( 42 U.S.C. 1308 ). Not later than 30 days before the beginning of the calendar quarter involved, the Secretary of Health and Human Services shall notify each such chief executive official of the increase in the FMAP estimated by the Secretary under this subsection for the affected jurisdiction involved. For each calendar quarter in which an increase in the FMAP is made for an affected jurisdiction under subsection (d), the chief executive official for the jurisdiction shall submit to the Secretary of the Interior an accounting of the total amount of compact migrant expenditures made by such jurisdiction for such quarter. Such accounting shall be submitted in such form and manner as the Secretary, in consultation with the Secretary of Health and Human Services, shall specify. The Secretary of the Interior shall review each accounting submitted under paragraph
(1)for accuracy, make any appropriate adjustments, and submit a final accounting of the amount of compact migrant expenditures for such quarter for each affected jurisdiction involved to the Secretary of Health and Human Services. The Secretary of Health and Human Services shall— review whether the increase in the FMAP for each affected jurisdiction under subsection
(a)for a calendar quarter involved resulted in an increase in Federal payments to the affected jurisdiction under title XIX of the Social Security Act for such quarter in an amount that is equivalent to the final accounting of the amount of compact migrant expenditures submitted under paragraph
(2)for such jurisdiction; and subject to the limitations under subsection
(f)and
(g)of section 1108 of such Act ( 42 U.S.C. 1308 ), shall make appropriate adjustments to the FMAP for the affected jurisdiction for future quarters to account for any overpayment or underpayment occurring as a result of the increase in such FMAP under this section for the quarter involved for that jurisdiction. In no case shall an increase in the FMAP applicable to an affected jurisdiction under this section result in an FMAP for that jurisdiction that exceeds 100 percent. This section shall not be construed as treating compact migrant expenditures as medical assistance under title XIX of the Social Security Act. In this section: The term affected jurisdiction has the meaning given such term in section 104(e)(2) of the Compact of Free Association Amendments Act of 2003 ( 48 U.S.C. 1921c(e)(2) ). The term compact migrant expenditures means, for a calendar quarter with respect to an affected jurisdiction, the amount of non-Federal funds expended by such jurisdiction for items and services described in section 1905(a) of the Social Security Act ( 42 U.S.C. 1396d(a) ) for qualified nonimmigrants (as defined in section 104(e)(2) of the Compact of Free Association Amendments Act of 2003 ( 48 U.S.C. 1921c(e)(2) )) and related administrative costs. Such term includes payments made by an affected jurisdiction to health care providers for health care items and services provided to qualified nonimmigrants described in subparagraph (A), if such payment is not made under a State plan under title XIX of the Social Security Act, and such payment is not made from any other source of Federal funds. The term FMAP means the Federal medical assistance percentage, as defined in section 1905(b) of the Social Security Act ( 42 U.S.C. 1396d(b) ), as determined without regard to this section. Section 1905(b) of the Social Security Act ( 42 U.S.C. 1396d(b) ) is amended by inserting subject to section 2 of the after Compact Impact Relief Act of 2016 , 83 per centum,
(2).
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Sec. 2
FMAP adjustment for affected jurisdictions equivalent to compact migrant expenditures
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