To provide the same temporary increase in the FMAP for all States and to permit States to choose the period through June 2011 for receiving the increase.

SA 297. Mr. GRASSLEY 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:

[[Page S1588]]

Beginning on page 714, strike line 1 and all that follows
through page 725, line 14, and insert the following:

SEC. 5001. TEMPORARY INCREASE OF MEDICAID FMAP.

(a) Permitting Maintenance of Fmap.--Subject to subsections
(d), (e), (f), and (g) if the FMAP determined without regard
to this section for a State for--
(1) fiscal year 2009 is less than the FMAP as so determined
for fiscal year 2008, the FMAP for the State for fiscal year
2008 shall be substituted for the State's FMAP for fiscal
year 2009, before the application of this section;
(2) fiscal year 2010 is less than the FMAP as so determined
for fiscal year 2008 or fiscal year 2009 (after the
application of paragraph (1)), the greater of such FMAP for
the State for fiscal year 2008 or fiscal year 2009 shall be
substituted for the State's FMAP for fiscal year 2010, before
the application of this section; and
(3) fiscal year 2011 is less than the FMAP as so determined
for fiscal year 2008, fiscal year 2009 (after the application
of paragraph (1)), or fiscal year 2010 (after the application
of paragraph (2)), the greatest of such FMAP for the State
for fiscal year 2008, fiscal year 2009, or fiscal year 2010
shall be substituted for the State's FMAP for fiscal year
2011, before the application of this section, but only for
the first, second, and third calendar quarters in fiscal year
2011.
(b) General 9.5 Percentage Point Increase.--Subject to
subsections (d), (e), (f), and (g), for each State for
calendar quarters during the recession adjustment period (as
defined in subsection (h)(2)), the FMAP (after the
application of subsection (a)) shall be increased (without
regard to any limitation otherwise specified in section
1905(b) of the Social Security Act) by 9.5 percentage points.
(c) Increase in Cap on Medicaid Payments to Territories.--
Subject to subsections (e), (f), and (g), with respect to
entire fiscal years occurring during the recession adjustment
period and with respect to fiscal years only a portion of
which occurs during such period (and in proportion to the
portion of the fiscal year that occurs during such period),
the amounts otherwise determined for Puerto Rico, the Virgin
Islands, Guam, the Northern Mariana Islands, and American
Samoa under subsections (f) and (g) of section 1108 of the
Social Security Act (42 6 U.S.C. 1308) shall each be
increased by 9.5 percent.
(d) Scope of Application.--The increases in the FMAP for a
State under this section shall apply for purposes of title
XIX of the Social Security Act and shall not apply with
respect to--
(1) disproportionate share hospital payments described in
section 1923 of such Act (42 U.S.C. 1396r-4);
(2) payments under title IV of such Act (42 U.S.C. 601 et
seq.) (except that the increases under subsections (a) and
(b) shall apply to payments under part E of title IV of such
Act (42 U.S.C. 670 et seq.));
(3) payments under title XXI of such Act (42 U.S.C. 1397aa
et seq.);
(4) any payments under title XIX of such Act that are based
on the enhanced FMAP described in section 2105(b) of such Act
(42 U.S.C. 1397ee(b)); or
(5) any payments under title XIX of such Act that are
attributable to expenditures for medical assistance provided
to individuals made eligible under a State plan under title
XIX of the Social Security Act (including under any waiver
under such title or under section 1115 of such Act (42 U.S.C.
1315)) because of income standards (expressed as a percentage
of the poverty line) for eligibility for medical assistance
that are higher than the income standards (as so expressed)
for such eligibility as in effect on July 1, 2008.
(e) State Ineligibility.--
(1) Maintenance of eligibility requirements.--
(A) In general.--Subject to subparagraphs (B) and (C), a
State is not eligible for an increase in its FMAP under
subsection (a) or (b), or an increase in a cap amount under
subsection (c), if eligibility standards, methodologies, or
procedures under its State plan under title XIX of the Social
Security Act (including any waiver under such title or under
section 1115 of such Act (42 U.S.C. 1315)) are more
restrictive than the eligibility standards, methodologies, or
procedures, respectively, under such plan (or waiver) as in
effect on July 1, 2008.
(B) State reinstatement of eligibility permitted.--Subject
to subparagraph (C), a State that has restricted eligibility
standards, methodologies, or procedures under its State plan
under title XIX of the Social Security Act (including any
waiver under such title or under section 1115 of such Act (42
U.S.C. 1315)) after July 1, 2008, is no longer ineligible
under subparagraph (A) beginning with the first calendar
quarter in which the State has reinstated eligibility
standards, methodologies, or procedures that are no more
restrictive than the eligibility standards, methodologies, or
procedures, respectively, under such plan (or waiver) as in
effect on July 1, 2008.
(C) Special rules.--A State shall not be ineligible under
subparagraph (A)--
(i) for the calendar quarters before July 1, 2009, on the
basis of a restriction that was applied after July 1, 2008,
and before the date of the enactment of this Act, if the
State prior to July 1, 2009, has reinstated eligibility
standards, methodologies, or procedures that are no more
restrictive than the eligibility standards, methodologies, or
procedures, respectively, under such plan (or waiver) as in
effect on July 1, 2008; or
(ii) on the basis of a restriction that was directed to be
made under State law as of July 1, 2008, and would have been
in effect as of such date, but for a delay in the request
for, and approval of, a waiver under section 1115 of such Act
with respect to such restriction.
(2) Compliance with prompt pay requirements.--No State
shall be eligible for an increased FMAP rate as provided
under this section for any claim submitted by a provider
subject to the terms of section 1902(a)(37)(A) of the Social
Security Act (42 U.S.C. 1396a(a)(37)(A)) during any period in
which that State has failed to pay claims in accordance with
section 1902(a)(37)(A) of such Act. Each State shall report
to the Secretary, no later than 30 days following the 1st day
of the month, its compliance with the requirements of section
1902(a)(37)(A) of the Social Security Act as they pertain to
claims made for covered services during the preceding month.
(3) No waiver authority.--The Secretary may not waive the
application of this subsection or subsection (f) under
section 1115 of the Social Security Act or otherwise.
(f) Requirements.--
(1) In general.--A State may not deposit or credit the
additional Federal funds paid to the State as a result of
this section to any reserve or rainy day fund maintained by
the State.
(2) State reports.--Each State that is paid additional
Federal funds as a result of this section shall, not later
than September 30, 2011, submit a report to the Secretary, in
such form and such manner as the Secretary shall determine,
regarding how the additional Federal funds were expended.
(3) Additional requirement for certain states.--In the case
of a State that requires political subdivisions within the
State to contribute toward the non-Federal share of
expenditures under the State Medicaid plan required under
section 1902(a)(2) of the Social Security Act (42 U.S.C.
1396a(a)(2)), the State is not eligible for an increase in
its FMAP under subsection (b), or an increase in a cap amount
under subsection (c), if it requires that such political
subdivisions pay for quarters during the recession adjustment
period 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
percentage that would have been required by the State under
such plan on September 30, 2008, prior to application of this
section.
(g) State Selection of Recession Adjustment Relief
Period.--The increase in a State's FMAP under subsection (a)
or (b), or an increase in a State's cap amount under
subsection (c), shall only apply to the State for 9
consecutive calendar quarters during the recession adjustment
period. Each State shall notify the Secretary of the 9-
calendar quarter period for which the State elects to receive
such increase.
(h) Definitions.--In this section, except as otherwise
provided:
(1) FMAP.--The term ``FMAP'' means the Federal medical
assistance percentage, as defined in section 1905(b) of the
Social Security Act (42 U.S.C. 1396d(b)), as determined
without regard to this section except as otherwise specified.
(2) Poverty line.--The term ``poverty line'' has the
meaning given such term in section 673(2) of the Community
Services Block Grant Act (42 U.S.C. 9902(2)), including any
revision required by such section.
(3) Recession adjustment period.--The term ``recession
adjustment period'' means the period beginning on October 1,
2008, and ending on June 20, 2011.
(4) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(5) State.--The term ``State'' has the meaning given such
term for purposes of title XIX of the Social Security Act (42
U.S.C. 1396 et seq.).
(i) Sunset.--This section shall not apply to items and
services furnished after the end of the recession adjustment
period.
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