S.Amdt. 210

SA 210. Mr. CORNYN (for himself, Mr. Grassley, Mr. Coburn, and Mr.
Martinez) submitted an amendment intended to be proposed to amendment
SA 98 proposed by Mr. Inouye (for himself and Mr. Baucus) to the bill
H.R. 1, making supplemental appropriations for job preservation and
creation, infrastructure investment, energy efficiency and science,
assistance to the unemployed, and State and local fiscal stabilization,
for fiscal year ending September 30, 2009, and for other purposes;
which was ordered to lie on the table; as follows:

On page 723, between lines 7 and 8, insert the following:
(3) Anti-fraud implementation plan; gao reports.--
(A) Requirement to submit plan for approval.--
(i) In general.--A State is not eligible for an increase in
its FMAP under subsection (a), (b), or (c), or an increase in
a cap amount under subsection (d), for any fiscal year
quarter occurring during the recessionary adjustment period
that begins on or after October 1, 2009, unless, not later
than 6 months after the first date on which the State
receives additional Federal funds under this section, the
State submits a report to the Secretary that contains a plan
for implementation of at least 4 of the anti-fraud measures
described in subparagraph (B) with respect to the State
Medicaid program under title XIX of the Social Security Act.
(ii) Approval and implementation.--The Secretary shall
approve or disapprove a plan submitted by a State under
clause (i) not later than 30 days after the date on which the
Secretary receives the plan. A State shall implement an
approved plan not later than 180 days after the date on which
the plan is approved.
(B) Anti-fraud measures described.--The anti-fraud measures
described in this subparagraph are the following:
(i) Implementation, in consultation with the Secretary and
in coordination and consistent with activities carried out
under contracts entered into under section 1893(h) of the
Social Security Act (42 U.S.C. 1395ddd), of a recovery audit
program under Medicaid.
(ii) Implementation of a Medicare-Medicaid data match
program under section 1893(g) of the Social Security Act (42
U.S.C. 1395ddd).
(iii) Implementation of enhanced third party liability
identification programs under section 1902(a)(25) of the
Social Security Act to carry out the amendments made by
section 6035 of the Deficit Reduction Act of 2005.
(iv) An increase in the amount of State expenditures
attributable to the operation of the State medicaid fraud
control unit described in section 1903(q) of the Social
Security Act (42 U.S.C. 1396b(q)) by at least 50 percent more
than the amount of such expenditures for the most recent
fiscal year.
(v) Operation, beginning on October 1, 2009, of an
eligibility determination system which provides for data
matching through the Public Assistance Reporting Information
System (PARIS), in accordance with the requirements of
section 1903(r)(3) of the Social Security Act (42 U.S.C.
1396b(r)(3)).
(vi) Full implementation of the requirements of section
1923(j) of the Social Security Act (42 U.S.C. 1396r-4(j)),
including the requirement for an annual, independent
certified audit of DSH payment adjustments made to hospitals.
(vii) Full implementation, beginning on October 1, 2009, of
an asset verification program that satisfies the requirements
of section 1940 of the Social Security Act (42 U.S.C. 1396w).
(viii) Online, public access, posting of all Medicaid
claims and patient encounter data (with such data patient de-
identified and otherwise made available in a manner that
protects the privacy of patients).
(ix) Electronic eligibility verification of Medicaid
beneficiaries to confirm client identification, eligibility,
and to reduce administrative costs.
(x) Any other policy proposed by a State that the Secretary
certifies is likely to reduce fraud in the State's Medicaid
program.
(C) GAO reports.--The Comptroller General of the United
States shall submit the following reports to Congress on the
plans submitted by States under subparagraph (A)(i):
(i) Initial report.--Not later than March 31, 2010, a
report specifying the details of the plans submitted by
States under subparagraph (A).
(ii) Update and implementation.--Not later than December
31, 2010, a report specifying the details of any updates made
to such plans and of the implementation of such plans.
______