Sec. 114. Reducing State Medicaid costs
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Section 1902 of the Social Security Act ( 42 U.S.C. 1396a ) is amended— in subsection (a)(17), by striking (e)(14), (e)(14) and inserting (e)(14), (e)(15) ; and in subsection (e)— in paragraph
(14)(relating to modified adjusted gross income), by adding at the end the following new subparagraph : In the case of an individual who is the recipient of qualified lottery winnings (pursuant to lotteries occurring on or after January 1, 2020) or qualified lump sum income (received on or after such date) and whose eligibility for medical assistance is determined based on the application of modified adjusted gross income under subparagraph (A), a State shall, in determining such eligibility, include such winnings or income (as applicable) as income received— in the month in which such winnings or income (as applicable) is received if the amount of such winnings or income is less than $80,000; over a period of 2 months if the amount of such winnings or income (as applicable) is greater than or equal to $80,000 but less than $90,000; over a period of 3 months if the amount of such winnings or income (as applicable) is greater than or equal to $90,000 but less than $100,000; and over a period of 3 months plus 1 additional month for each increment of $10,000 of such winnings or income (as applicable) received, not to exceed a period of 120 months (for winnings or income of $1,260,000 or more), if the amount of such winnings or income is greater than or equal to $100,000. For purposes of subclauses (II), (III), and
(IV)of clause (i), winnings or income to which such subclause applies shall be counted in equal monthly installments over the period of months specified under such subclause. An individual whose income, by application of clause (i), exceeds the applicable eligibility threshold established by the State, may continue to be eligible for medical assistance to the extent that the State determines, under procedures established by the State under the State plan (or in the case of a waiver of the plan under section 1115, incorporated in such waiver), or as otherwise established by such State in accordance with such standards as may be specified by the Secretary, that the denial of eligibility of the individual would cause an undue medical or financial hardship as determined on the basis of criteria established by the Secretary. A State shall, with respect to an individual who loses eligibility for medical assistance under the State plan (or a waiver of such plan) by reason of clause (i), before the date on which the individual loses such eligibility, inform the individual of the date on which the individual would no longer be considered ineligible by reason of such clause to receive medical assistance under the State plan or under any waiver of such plan and the date on which the individual would be eligible to reapply to receive such medical assistance. In this subparagraph, the term qualified lottery winnings means winnings from a sweepstakes, lottery, or pool described in paragraph
(3)of section 4402 of the Internal Revenue Code of 1986 or a lottery operated by a multistate or multijurisdictional lottery association, including amounts awarded as a lump sum payment. In this subparagraph, the term qualified lump sum income means income that is received as a lump sum from one of the following sources: Monetary winnings from gambling (as defined by the Secretary and including monetary winnings from gambling activities described in section 1955(b)(4) of title 18, United States Code). Income received as liquid assets from the estate (as defined in section 1917(b)(4)) of a deceased individual. ; and by striking
(14)and inserting Exclusion
(15). Exclusion Nothing in the amendment made by paragraph (1)(B)(i) shall be construed as preventing a State from intercepting the State lottery winnings awarded to an individual in the State to recover amounts paid by the State under the State Medicaid plan under title XIX of the Social Security Act for medical assistance furnished to the individual. Nothing in the amendment made by paragraph (1)(B)(i) shall be construed, with respect to a determination of household income for purposes of a determination of eligibility for medical assistance under the State plan under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq.) (or a waiver of such plan) made by applying modified adjusted gross income under subparagraph
(A)of section 1902(e)(14) of such Act ( 42 U.S.C. 1396a(e)(14) ), as limiting the eligibility for such medical assistance of any individual that is a member of the household other than the individual (or the individual’s spouse) who received qualified lottery winnings or qualified lump-sum income (as defined in subparagraph
(J)of such section 1902(e)(14), as added by paragraph (1)(B)(i) of this subsection). Section 1902(a)(34) of the Social Security Act ( 42 U.S.C. 1396a(a)(34) ) is amended by striking in or after the third month before the month in which he made application and inserting in or after the month in which the individual made application . Section 1905(a) of the Social Security Act ( 42 U.S.C. 1396d(a) ) is amended by striking in or after the third month before the month in which the recipient makes application for assistance and inserting in or after the month in which the recipient makes application for assistance . The amendments made by paragraph
(1)shall apply to medical assistance with respect to individuals whose eligibility for such assistance is based on an application for such assistance made (or deemed to be made) on or after October 1, 2017. Section 1917(f)(1) of the Social Security Act ( 42 U.S.C. 1396p(f)(1) ) is amended— in subparagraph (A), by striking subparagraphs
(B)and
(C)and inserting subparagraph
(B); by striking subparagraph (B); by redesignating subparagraph
(C)as subparagraph (B); and in subparagraph (B), as so redesignated, by striking dollar amounts specified in this paragraph and inserting dollar amount specified in subparagraph
(A). The amendments made by paragraph
(1)shall apply with respect to eligibility determinations made after the date that is 180 days after the date of the enactment of this section. In the case of a State plan under title XIX of the Social Security Act that the Secretary of Health and Human Services determines requires State legislation in order for the respective plan to meet any requirement imposed by amendments made by this subsection, the respective plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such an additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of the enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session shall be considered to be a separate regular session of the State legislature.
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