Sec. 106. Puerto Rico and the Virgin Islands Medicaid payments
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Section 1108(g) of the Social Security Act ( 42 U.S.C. 1308(g) ) is amended— in paragraph (2)— in subparagraph (A), by inserting (or, with respect to fiscal years 2018 and 2019, increased by such percentage increase plus one percentage point) after beginning of the fiscal year ; and in subparagraph (B), by inserting (or, with respect to fiscal years 2018 and 2019, increased by such percentage increase plus one percentage point) after percentage increase referred to in subparagraph
(A); in paragraph (5)— in subparagraph (A), by striking subparagraph
(B)and inserting subparagraphs (B), (C), (D), (E), and
(F); and by adding at the end the following new subparagraphs: The amount of the increase otherwise provided under subparagraph
(A)for Puerto Rico shall be further increased by $880,000,000. For the period beginning October 1, 2017, and ending December 31, 2019, the amount of the increase otherwise provided under subparagraph
(A)for Puerto Rico shall be further increased by $120,000,000 if the Financial Oversight and Management Board for Puerto Rico established under section 101 of the Puerto Rico Oversight, Management, and Economic Stability Act ( 48 U.S.C. 2121 ) certifies by a majority vote that Puerto Rico has taken reasonable and appropriate steps during such period to— reduce fraud, waste, and abuse under the program under title XIX; implement strategies to reduce unnecessary, inefficient, or excessive spending under title XIX; improve the use and availability of Medicaid data for program operation and oversight; and improve the quality of care and patient experience for individuals enrolled under the program under title XIX. As a condition of any additional increase pursuant to clause (i), not later than October 1, 2018, Puerto Rico shall submit to the Financial Oversight and Management Board for Puerto Rico a report regarding steps taken to achieve each of the goals described in subclauses
(I)through
(IV)of clause (i). Payments under section 1903(a)(8) for a quarter of a fiscal year shall not be taken into account in applying subsection
(f)(as increased in accordance with this paragraph and paragraphs (1), (2), (3), and (4)) to Puerto Rico or the Virgin Islands for such fiscal year. For the period beginning October 1, 2017, and ending December 31, 2019, the amount of the increase otherwise provided under subparagraph
(A)for the Virgin Islands shall be further increased by an amount equal to the per capita equivalent of the total amount of the increase provided for Puerto Rico under subparagraphs
(C)and
(D)for such period. For purposes of clause (i), the term per capita equivalent means the ratio of— the population of the Virgin Islands, as determined by the most recent census estimate released by the Bureau of the Census before September 4, 2017; to the population of Puerto Rico, as so determined. . Section 1903(a) of the Social Security Act ( 42 U.S.C. 1396b(a) ) is amended— in paragraph (2)(A), by inserting subject to paragraph (8), before an amount ; in paragraph (6)— in subparagraph (B), by inserting subject to paragraph (8), before 75 per centum ; and by striking at the end plus ; in paragraph (7), by striking at the end the period and inserting ; plus ; and by adding at the end the following new paragraph: for quarters during the period beginning January 1, 2018, and ending December 31, 2019, paragraphs (2)(A) and
(6)shall apply with respect to Puerto Rico and the Virgin Islands as if— the reference to 75 per centum in paragraph (2)(A) were a reference to 90 per centum ; and the reference to 75 per centum in paragraph (6)(B) were a reference to 90 per centum . .
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