S.Amdt. 252

SA 252. Mr. COBURN (for himself, Mr. Grassley, and Mr. Cornyn)
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) Plan to establish a medical home program to coordinate
care for eligible medicaid beneficiaries.--
(A) In general.--
(i) Submission.--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, and before the date
(not later than 6 months after the date of enactment of this
Act) on which the State submits to the Secretary a plan to
establish a medical home program to coordinate care for
eligible Medicaid beneficiaries.
(ii) Implementation.--Each State that is paid additional
Federal funds as a result of this section shall, not later
than 18 months after such date of enactment, implement such a
plan that has been approved by the Secretary.
(B) Details.--Such plan shall include the following:
(i) Subject to clause (ii), provide primary care physicians
and other participating providers of services a management
fee that reflects the amount of time spent with an eligible
Medicaid beneficiary, and the family of such eligible
Medicaid beneficiary, providing primary care services,
chronic care disease management services, and other services
for purposes of coordinating care of the eligible Medicaid
beneficiary.
(ii) Such management fee shall not be provided to a primary
care physician with respect to an eligible Medicaid
beneficiary unless such eligible Medicaid beneficiary has
designated the primary care physician (under procedures
established by the State) as the health home of the eligible
Medicaid beneficiary.
(C) Definition of eligible medicaid beneficiary.--In this
paragraph, the term ``eligible Medicaid beneficiary'' means
an individual who--
(i) is enrolled in the State Medicaid plan under title XIX
of the Social Security Act; and
(ii) is determined to have 1 or more chronic diseases.
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