Sec. 2. Extending the increased Federal medical assistance percentage and cap amounts for territories
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Section 1905(ff) of the Social Security Act ( 42 U.S.C. 1396d(ff) ) is amended— in paragraph (2), by striking 2021 and inserting 2026 ; and in paragraph (3), by striking 2021 and inserting 2029 . Section 1108(g) of the Social Security Act ( 42 U.S.C. 1308(g) ) is amended— in paragraph (7)(B)(i), in the matter preceding subclause (I), by striking 2021 and inserting 2026 ; and in paragraph (8)(B), by striking 2021 and inserting 2026 . Section 1108(g) of the Social Security Act ( 42 U.S.C. 1308(g) ) is amended— in paragraph (2)(A)(ii), by striking 2021 and inserting 2026 ; and in paragraph (6)— in the header, by striking and inserting 2021 ; 2026 in subparagraph (A)— in clause (i), by striking and at the end; and in clause (ii)— by striking fiscal year 2021 and inserting each of fiscal years 2021 and 2022 ; and by striking the period and inserting ; and ; and in subparagraph (B)— in clause (i), by striking 2021 and inserting 2026 ; and in clause (ii)(II), by striking 2021 and inserting 2026 .
Section 1108(g)(6)(A) of the Social Security Act ( 42 U.S.C. 1308(g) ), as amended by subparagraph (A), is further amended by adding at the end the following new clause: for each of fiscal years 2023 through 2026, $2,719,072,000. . Section 1108(g)(2) of the Social Security Act ( 42 U.S.C. 1308(g)(2) ) is amended in each of subparagraphs (B)(iii), (C)(iii), (D)(iii), and (E)(iii), by striking fiscal year 2021 and inserting each of fiscal years 2021 and 2022 . Section 1108(g)(2) of the Social Security Act ( 42 U.S.C. 1308(g)(2) ) is amended— in subparagraph (B)— in clause (i), by striking clause
(ii)and inserting clauses
(ii)through
(iv); in clause (ii), by striking and at the end; in clause (iii), by adding and at the end; and by adding at the end the following new clause: for each of fiscal years 2023 through 2029, $126,000,000; ; in subparagraph (C)— in clause (i), by striking clause
(ii)and inserting clauses
(ii)through
(iv); in clause (ii), by striking and at the end; in clause (iii), by adding and at the end; and by adding at the end the following new clause: for each of fiscal years 2023 through 2029, $127,000,000; ; in subparagraph (D)— in clause (i), by striking clause
(ii)and inserting clauses
(ii)through
(iv); in clause (ii), by striking and at the end; in clause (iii), by adding and at the end; and by adding at the end the following new clause: for each of fiscal years 2023 through 2029, $60,000,000; and ; and in subparagraph (E)— in clause (i), by striking clause
(ii)and inserting clauses
(ii)through
(iv); in clause (ii), by striking and at the end; in clause (iii), by adding and at the end; and by adding at the end the following new clause: for each of fiscal years 2023 through 2029, $84,000,000. . Section 1108(g)(2) of the Social Security Act ( 42 U.S.C. 1308(g)(2) ) is amended, in the matter following subparagraph (E)— by striking fiscal year 2021 and inserting fiscal year 2029 (or, in the case of Puerto Rico, fiscal year 2026) ; by striking through 2021 and inserting through 2029 (or, in the case of Puerto Rico, 2026) ; and by striking each such subparagraph and inserting subparagraph
(A)and any of clauses
(ii)through
(iv)of subparagraphs
(B)through
(E). Section 1940 of the Social Security Act ( 42 U.S.C. 1396w ) is amended— in subsection (a)— in paragraph (3)(A), by adding at the end the following new clause: The Secretary shall require Puerto Rico to implement an asset verification program under this subsection by the end of fiscal year 2024. ; and in paragraph (4)— in the paragraph heading, by striking and inserting Exemption of territories ; and Exemption of certain territories by striking and the District of Columbia and inserting , the District of Columbia, and Puerto Rico ; and in subsection (k)— in paragraph (1)— by redesignating subparagraphs
(A)through
(D)as clauses
(i)through (iv), respectively, and adjusting the margins accordingly; in the matter preceding clause (i), as so redesignated— by striking beginning on or after January 1, 2021 ; and by striking for a non-compliant State shall be reduced— and inserting the following: for— a non-compliant State that is one of the 50 States or the District of Columbia shall be reduced— ; in clause (iv), as so redesignated, by striking the period at the end and inserting ; and ; and by adding at the end the following new subparagraph: a non-compliant State that is Puerto Rico shall be reduced— for calendar quarters in fiscal years 2025 and 2026, by 0.12 percentage points; for calendar quarters in fiscal year 2027, by 0.25 percentage points; for calendar quarters in fiscal year 2028, by 0.35 percentage points; and for calendar quarters in fiscal year 2029 and each fiscal year thereafter, by 0.5 percentage points. ; and in paragraph (2)(A), by striking or the District of Columbia and inserting the District of Columbia, or Puerto Rico . Section 1108(g)(9) of the Social Security Act ( 42 U.S.C. 1308(g)(9) ) is amended— in subparagraph (A), by striking 2021 and inserting 2029 ; and in subparagraph (B)(i), by inserting or by reason of the amendments made by section 2 of the Supporting Medicaid in the U.S. Territories Act of 2021 before the period at the end. Section 1108(g)(7)(A) of the Social Security Act ( 42 U.S.C. 1308(g)(7)(A) ) is amended— in clause (iii), in the header, by inserting after reporting ; and reform by adding at the end the following new clauses: Not later than October 1, 2022, Puerto Rico shall submit to the Chair and Ranking Member of the Committee on Energy and Commerce of the House of Representatives and the Chair and Ranking Member of the Committee on Finance of the Senate a report outlining steps being taken by Puerto Rico to reach compliance with the reporting requirements described in section 1139A(a)(4)(B) and section 1139B(b)(5)(C) and describing what further actions are needed by Puerto Rico in order to comply with such requirements with respect to annual State reports under section 1139A(c) and State reports under section 1139B(d)(1) beginning with fiscal year 2024. Not later than 6 months after the date of the enactment of this clause, the agency responsible for the administration of Puerto Rico’s Medicaid program under title XIX shall designate an officer (other than the director of such agency) to serve as the Contracting and Procurement Oversight Lead to carry out the duties specified in subclause (II). Not later than 60 days after the end of each fiscal quarter (beginning with the first fiscal quarter beginning on or after the date that is 1 year after the date of the enactment of this clause), the officer designated pursuant to subclause
(I)shall, with respect to each contract described in clause
(iii)with an annual value exceeding $150,000 entered into during such quarter, certify to the Secretary either— that such contract has met the procurement standards identified under any of sections 75.327, 75.328, and 75.329 of title 45, Code of Federal Regulations (or successor regulations); or that extenuating circumstances (including a lack of multiple entities competing for such contract) prevented the compliance of such contract with such standards. The officer designated pursuant to subclause
(I)shall make public each certification containing extenuating circumstances described in subclause (II)(bb) not later than 30 days after such certification is made, including a description of, and justification of, such extenuating circumstances. Not later than 2 years after the date of the enactment of this clause, the Inspector General of the Department of Health and Human Services shall submit to Congress a report on the compliance of Puerto Rico with the provisions of this clause. .
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Sec. 2
Extending the increased Federal medical assistance percentage and cap amounts for territories
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