Sec. 10201. AMENDMENTS TO THE SOCIAL SECURITY ACT AND TITLE II OF THIS ACT
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## SEC. 10201 AMENDMENTS TO THE SOCIAL SECURITY ACT AND TITLE II OF THIS ACT ###
(a)####
(1)* * * ####
(2)Section 1902(a)(10) of the Social Security Act (42 U.S.C. 1396a(a)(10), as amended by section 2001(a)(5)(A), is amended in the matter following subparagraph (G), by striking “and (XV)” and inserting “(XV)”, and by inserting “and
(XVI)if an individual is described in subclause
(IX)of subparagraph (A)(i) and is also described in subclause
(VIII)of that subparagraph, the medical assistance shall be made available to the individual through subclause
(IX)instead of through subclause (VIII)” before the semicolon. * * * * * * * ###
(c)Section 1905 of the Social Security Act (42 U.S.C. 1396d), as amended by sections 2001(a)(3), 2001(a)(5)(C), 2006, and 4107(a)(2), is amended— ####
(1)in subsection (a), in the matter preceding paragraph (1), by inserting in clause (xiv), “or 1902(a)(10)(A)(i)(IX)” before the comma; ####
(2)in subsection (b), in the first sentence, by inserting “, (z),” before “and (aa)”; ####
(3)in subsection (y)— #####
(A)in paragraph (1)(B)(ii)(II), in the first sentence, by inserting “includes inpatient hospital services,” after “100 percent of the poverty line, that”; and #####
(B)####
(4)by inserting after subsection
(y)the following: > > ### “(z) Equitable Support for Certain States > > > #### “(1) > > > #####
(A)> > During the period that begins on January 1, 2014, and ends on December 31, 2015, notwithstanding subsection (b), the Federal medical assistance percentage otherwise determined under subsection
(b)with respect to a fiscal year occurring during that period shall be increased by 2.2 percentage points for any State described in subparagraph
(B)for amounts expended for medical assistance for individuals who are not newly eligible (as defined in subsection (y)(2)) individuals described in subclause
(VIII)of section 1902(a)(10)(A)(i). > > > ##### “(B) > > For purposes of subparagraph (A), a State described in this subparagraph is a State that— > > > ###### “(i) > > is an expansion State described in paragraph (3); > > > ###### “(ii) > > the Secretary determines will not receive any payments under this title on the basis of an increased Federal medical assistance percentage under subsection
(y)for expenditures for medical assistance for newly eligible individuals (as so defined); and > > > ###### “(iii) > > has not been approved by the Secretary to divert a portion of the DSH allotment for a State to the costs of providing medical assistance or other health benefits coverage under a waiver that is in effect on July 2009. > > > #### “(2) > > > #####
(A)> > For calendar quarters in 2014 and each year thereafter, the Federal medical assistance percentage otherwise determined under subsection
(b)for an expansion State described in paragraph
(3)with respect to medical assistance for individuals described in section 1902(a)(10)(A)(i)(VIII) who are nonpregnant childless adults with respect to whom the State may require enrollment in benchmark coverage under section 1937 shall be equal to the percent specified in subparagraph (B)(i) for such year. > > > ##### “(B) > > > ######
(i)> > The percent specified in this subparagraph for a State for a year is equal to the Federal medical assistance percentage (as defined in the first sentence of subsection (b)) for the State increased by a number of percentage points equal to the transition percentage (specified in clause
(ii)for the year) of the number of percentage points by which— > > > ###### “(I) > > such Federal medical assistance percentage for the State, is less than > > > ###### “(II) > > the percent specified in subsection (y)(1) for the year. > > > ###### “(ii) > > The transition percentage specified in this clause for— > > > ###### “(I) > > 2014 is 50 percent; > > > ###### “(II) > > 2015 is 60 percent; > > > ###### “(III) > > 2016 is 70 percent; > > > ###### “(IV) > > 2017 is 80 percent; > > > ###### “(V) > > 2018 is 90 percent; and > > > ###### “(VI) > > 2019 and each subsequent year is 100 percent. > > > #### “(3) > > A State is an expansion State if, on the date of the enactment of the Patient Protection and Affordable Care Act, the State offers health benefits coverage statewide to parents and nonpregnant, childless adults whose income is at least 100 percent of the poverty line, includes inpatient hospital services, that is not dependent on access to employer coverage, employer contribution, or employment and is not limited to premium assistance, hospital-only benefits, a high deductible health plan, or alternative benefits under a demonstration program authorized under section 1938. A State that offers health benefits coverage to only parents or only nonpregnant childless adults described in the preceding sentence shall not be considered to be an expansion State.” > ; * * * * * * * ####
(6)by adding after subsection (bb), the following: > > ### “(cc) Requirement for Certain States > > Notwithstanding subsections (y), (z), and (aa), in the case of a State that requires political subdivisions within the State to contribute toward the non-Federal share of expenditures required under the State plan under section 1902(a)(2), the State shall not be eligible for an increase in its Federal medical assistance percentage under such subsections if it requires that political subdivisions pay a greater percentage of the non-Federal share of such expenditures, or a greater percentage of the non-Federal share of payments under section 1923, than the respective percentages that would have been required by the State under the State plan under this title, State law, or both, as in effect on December 31, 2009, and without regard to any such increase. Voluntary contributions by a political subdivision to the non-Federal share of expenditures under the State plan under this title or to the non-Federal share of payments under section 1923, shall not be considered to be required contributions for purposes of this subsection. The treatment of voluntary contributions, and the treatment of contributions required by a State under the State plan under this title, or State law, as provided by this subsection, shall also apply to the increases in the Federal medical assistance percentage under section 5001 of the American Recovery and Reinvestment Act of 2009.” > . * * * * * * * ###
(e)####
(1)Section 1923(f) of the Social Security Act (42 U.S.C. 1396r–4(f)), as amended by section 2551, is amended— #####
(A)in paragraph (6)— ######
(i)by striking the paragraph heading and inserting the following: “Allotment adjustments”; and ######
(ii)in subparagraph (B), by adding at the end the following: > > ###### “(iii) Allotment for 2d, 3rd, and 4th quarter of fiscal year 2012, fiscal year 2013, and succeeding fiscal years > > Notwithstanding the table set forth in paragraph
(2)or paragraph (7): > > > ###### “(I) 2d, 3rd, and 4th quarter of fiscal year 2012 > > The DSH allotment for Hawaii for the 2d, 3rd, and 4th quarters of fiscal year 2012 shall be $7,500,000. > > > ###### “(II) Treatment as a low-DSH state for fiscal year 2013 and succeeding fiscal years > > With respect to fiscal year 2013, and each fiscal year thereafter, the DSH allotment for Hawaii shall be increased in the same manner as allotments for low DSH States are increased for such fiscal year under clause
(iii)of paragraph (5)(B). > > > ###### “(III) Certain hospital payments > > The Secretary may not impose a limitation on the total amount of payments made to hospitals under the QUEST section 1115 Demonstration Project except to the extent that such limitation is necessary to ensure that a hospital does not receive payments in excess of the amounts described in subsection (g), or as necessary to ensure that such payments under the waiver and such payments pursuant to the allotment provided in this clause do not, in the aggregate in any year, exceed the amount that the Secretary determines is equal to the Federal medical assistance percentage component attributable to disproportionate share hospital payment adjustments for such year that is reflected in the budget neutrality provision of the QUEST Demonstration Project.” > ; and #####
(B)in paragraph (7)— ######
(i)in subparagraph (A), in the matter preceding clause (i), by striking “subparagraph (E)” and inserting “subparagraphs
(E)and (G)”; ######
(ii)in subparagraph (B)— ######
(I)in clause (i), by striking subclauses
(I)and (II), and inserting the following: > > ###### “(I) > > if the State is a low DSH State described in paragraph (5)(B) and has spent not more than 99.90 percent of the DSH allotments for the State on average for the period of fiscal years 2004 through 2008, as of September 30, 2009, the applicable percentage is equal to 25 percent; > > > ###### “(II) > > if the State is a low DSH State described in paragraph (5)(B) and has spent more than 99.90 percent of the DSH allotments for the State on average for the period of fiscal years 2004 through 2008, as of September 30, 2009, the applicable percentage is equal to 17.5 percent; > > > ###### “(III) > > if the State is not a low DSH State described in paragraph (5)(B) and has spent not more than 99.90 percent of the DSH allotments for the State on average for the period of fiscal years 2004 through 2008, as of September 30, 2009, the applicable percentage is equal to 50 percent; and > > > ###### “(IV) > > if the State is not a low DSH State described in paragraph (5)(B) and has spent more than 99.90 percent of the DSH allotments for the State on average for the period of fiscal years 2004 through 2008, as of September 30, 2009, the applicable percentage is equal to 35 percent.” > ; ######
(II)in clause (ii), by striking subclauses
(I)and (II), and inserting the following: > > ###### “(I) > > if the State is a low DSH State described in paragraph (5)(B) and has spent not more than 99.90 percent of the DSH allotments for the State on average for the period of fiscal years 2004 through 2008, as of September 30, 2009, the applicable percentage is equal to the product of the percentage reduction in uncovered individuals for the fiscal year from the preceding fiscal year and 27.5 percent; > > > ###### “(II) > > if the State is a low DSH State described in paragraph (5)(B) and has spent more than 99.90 percent of the DSH allotments for the State on average for the period of fiscal years 2004 through 2008, as of September 30, 2009, the applicable percentage is equal to the product of the percentage reduction in uncovered individuals for the fiscal year from the preceding fiscal year and 20 percent; > > > ###### “(III) > > if the State is not a low DSH State described in paragraph (5)(B) and has spent not more than 99.90 percent of the DSH allotments for the State on average for the period of fiscal years 2004 through 2008, as of September 30, 2009, the applicable percentage is equal to the product of the percentage reduction in uncovered individuals for the fiscal year from the preceding fiscal year and 55 percent; and > > > ###### “(IV) > > if the State is not a low DSH State described in paragraph (5)(B) and has spent more than 99.90 percent of the DSH allotments for the State on average for the period of fiscal years 2004 through 2008, as of September 30, 2009, the applicable percentage is equal to the product of the percentage reduction in uncovered individuals for the fiscal year from the preceding fiscal year and 40 percent.” > ; ######
(III)in subparagraph (E), by striking “35 percent” and inserting “50 percent”; and ######
(IV)by adding at the end the following: > > ##### “(G) Nonapplication > > The preceding provisions of this paragraph shall not apply to the DSH allotment determined for the State of Hawaii for a fiscal year under paragraph (6).” > . * * * * * * * ######
(i)Section 1115 of the Social Security Act (42 U.S.C. 1315) is amended by inserting after subsection
(c)the following: > > ### “(d) > > > ####
(1)> > An application or renewal of any experimental, pilot, or demonstration project undertaken under subsection
(a)to promote the objectives of title XIX or XXI in a State that would result in an impact on eligibility, enrollment, benefits, cost-sharing, or financing with respect to a State program under title XIX or XXI (in this subsection referred to as a ‘demonstration project’) shall be considered by the Secretary in accordance with the regulations required to be promulgated under paragraph (2). > > > #### “(2) > > Not later than 180 days after the date of enactment of this subsection, the Secretary shall promulgate regulations relating to applications for, and renewals of, a demonstration project that provide for— > > > ##### “(A) > > a process for public notice and comment at the State level, including public hearings, sufficient to ensure a meaningful level of public input; > > > ##### “(B) > > requirements relating to— > > > ###### “(i) > > the goals of the program to be implemented or renewed under the demonstration project; > > > ###### “(ii) > > the expected State and Federal costs and coverage projections of the demonstration project; and > > > ###### “(iii) > > the specific plans of the State to ensure that the demonstration project will be in compliance with title XIX or XXI; > > > ##### “(C) > > a process for providing public notice and comment after the application is received by the Secretary, that is sufficient to ensure a meaningful level of public input; > > > ##### “(D) > > a process for the submission to the Secretary of periodic reports by the State concerning the implementation of the demonstration project; and > > > ##### “(E) > > a process for the periodic evaluation by the Secretary of the demonstration project. > > > #### “(3) > > The Secretary shall annually report to Congress concerning actions taken by the Secretary with respect to applications for demonstration projects under this section.” > . * * * * * * *
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- 42 USC 1396r–4(f)
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Sec. 10201
AMENDMENTS TO THE SOCIAL SECURITY ACT AND TITLE II OF THIS ACT
Cite42 USC 1396r–4(f)
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