I
111th CONGRESS
1st Session
H. R. 2716
IN THE HOUSE OF REPRESENTATIVES
June 4, 2009
Mr. Becerra (for himself and Mr. Doggett) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned
A BILL
To amend title XIX of the Social Security Act to provide financial stability for seniors and people with disabilities through improvements in the Medicare Savings Program.
Short title; table of contents
Short title
This Act may be cited
as the Medicare Savings Program
Improvement Act of 2009
.
Table of contents
The table of contents of this Act is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. Increase in income levels for eligibility.
Sec. 3. Modification of resource standards.
Sec. 4. Eligibility for other programs.
Sec. 5. Effective date of MSP benefits.
Sec. 6. Treatment of qualified Medicare beneficiaries, specified low-income Medicare beneficiaries, and other dual eligibles as medicare beneficiaries.
Sec. 7. Monitoring and enforcement of limitation on beneficiary liability.
Sec. 8. Medicaid treatment of certain Medicare providers.
Sec. 9. State provision of medical assistance to dual eligibles in MA plans.
Sec. 10. Medicare enrollment assistance.
Sec. 11. Medicaid agency consideration of low-income subsidy application and data transmittal.
Sec. 12. QMB buy-in of part A and part B premiums.
Sec. 13. Increasing availability of MSP applications through availability on the Internet and designation of preferred language.
Sec. 14. Medicare savings program applications.
Sec. 15. Repeal of payment limitation.
Increase in income levels for eligibility
Increase to 150 Percent of FPL for Qualified Medicare Beneficiaries
In general
Section 1905(p)(2) of the Social Security Act (42 U.S.C. 1396d(p)(2)) is amended—
in subparagraph
(A), by striking 100 percent
and inserting 150
percent
;
in subparagraph (B)—
by
striking and
at the end of clause (ii);
by
striking the period at the end of clause (iii) and inserting ,
and
; and
by adding at the end the following:
January 1, 2011, is 150 percent.
; and
in subparagraph (C)—
by
striking and
at the end of clause (iii);
by
striking the period at the end of clause (iv) and inserting ,
and
; and
by adding at the end the following:
January 1, 2011, is 150 percent.
.
Application of income test based on family size
Section 1905(p)(2)(A) of such
Act (42 U.S.C. 1396d(p)(2)(A)) is amended by adding at the end the following:
For purposes of this subparagraph, family size means the applicant, the
spouse (if any) of the applicant if living in the same household as the
applicant, and the number of individuals who are related to the applicant (or
applicants), who are living in the same household as the applicant (or
applicants), and who are dependent on the applicant (or the applicant’s spouse)
for at least one-half of their financial support.
.
Not counting in-kind support and maintenance as income
Section 1905(p)(2)(D) of such Act (42 U.S.C. 1396d(p)(2)(D)) is amended by adding at the end the following new clause:
In determining income under this subsection, support and maintenance furnished in kind shall not be counted as income.
.
Expansion of Specified Low-Income Medicare Beneficiary (SLMB) Program
Eligibility of individuals with incomes below 200 percent of FPL
Section 1902(a)(10)(E) of the Social Security Act (42 U.S.C. 1396b(a)(10)(E)) is amended—
by adding
and
at the end of clause (ii);
in clause (iii)—
by
striking and 120 percent in 1995 and years thereafter
and
inserting , or 120 percent in 1995 and any succeeding year before 2011,
or 200 percent in 2011 and years thereafter
; and
by
striking and
at the end; and
by striking clause (iv).
References
Section
1905(p)(1) of such Act (42 U.S.C. 1396d(p)(1)) is amended by adding at and
below subparagraph (C) the following: The term
.specified
low-income medicare beneficiary
means an individual described in
section 1902(a)(13)(iii).
Providing 100 percent federal financing
The third sentence of section 1905(b)
of such Act (42 U.S.C. 1396d(b)) is amended by inserting before the period at
the end the following: and with respect to medical assistance for
Medicare cost-sharing provided under section 1902(a)(10)(E)(iii) and under
section 1902(a)(10)(E)(i) with respect to individuals with income (as
determined in accordance with subsection (p)(1)(B)) is greater than 100 percent
of the official income poverty line applicable to a family of the size
involved and with respect to additional medical
assistance that is attributable to the amendments made by subsections (a) and
(b) of section 3 of the Medicare Financial Stability for Seniors and People
with Disabilities Act of 2009 and with respect
to additional medical assistance that is attributable to qualified medicare
beneficiaries with family income that exceeds 100 percent of such poverty
line
.
Effective date
Except as provided in paragraph (2), the amendments made by this section shall take effect on January 1, 2011, and, with respect to title XIX of the Social Security Act, shall apply to calendar quarters beginning on or after January 1, 2011.
In the case of a State plan for medical assistance under title XIX of the Social Security Act which the Secretary of Health and Human Services determines requires State legislation (other than legislation appropriating funds) in order for the plan to meet the additional requirements imposed by the amendments made by this section, the State plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet these additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of the enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of such session shall be deemed to be a separate regular session of the State legislature.
Modification of resource standards
In general
Section 1905(p) of the Social Security Act (42 U.S.C. 1396d(p)) is amended—
in paragraph (1), by amending subparagraph (C) to read as follows:
whose resources (as determined under section 1613 for purposes of the supplemental income security program, except as provided in paragraph (6)(B)) do not exceed the amount described in paragraph (6)(A).
;
by redesignating paragraph (6) as paragraph (7); and
by inserting after paragraph (5) the following:
The resource level specified in this subparagraph for—
for 2011, is $27,500 (or $55,000 in the case of the combined value of the individual’s assets or resources and the assets or resources of the individual’s spouse); and
for a subsequent year is the applicable resource level specified in this subparagraph for the previous year increased by the annual percentage increase in the consumer price index (all items; U.S. city average) as of September of such previous year.
In determining the resources of an individual (and their eligible spouse, if any) under section 1613 for purposes of paragraph (1)(C) (relating to qualified Medicare beneficiaries) or section 1902(a)(10)(E)(iii) (relating to specified low-income medicare beneficiaries), the following additional exclusions shall apply:
No part of the value of any life insurance policy shall be taken into account.
No balance in, or benefits received under, an employee pension benefit plan (as defined in section 3 of the Employee Retirement Income Security Act of 1974) shall be taken into account
.
Effective date
Except as provided in paragraph (2), the amendments made by this section shall apply to calendar quarters beginning on or after January 1, 2011.
In the case of a State plan for medical assistance under title XIX of the Social Security Act which the Secretary of Health and Human Services determines requires State legislation (other than legislation appropriating funds) in order for the plan to meet the additional requirements imposed by the amendments made by this section, the State plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet these additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of the enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of such session shall be deemed to be a separate regular session of the State legislature.
Eligibility for other programs
In general
Section 1905(p) of the Social Security Act (42 U.S.C. 1396d(p)), as amended by section 2(a), is amended—
by redesignating paragraph (7) as paragraph (8); and
by inserting after paragraph (6) the following new paragraph:
Notwithstanding any other provision of law, any medical assistance for some or all medicare cost-sharing under this title shall not be considered income or resources in determining eligibility for, or the amount of assistance or benefits provided under, any other public benefit provided under Federal law or the law of any State or political subdivision thereof.
.
Effective date
The amendments made by subsection (a) shall apply to eligibility for benefits on or after January 1, 2010.
Effective date of MSP benefits
Providing for 3 Months Retroactive Eligibility
In general
Section 1905(a) of the Social Security Act (42 U.S.C. 1396d(a)) is
amended, in the matter preceding paragraph (1), by striking described in
subsection (p)(1), if provided after the month
and inserting
described in subsection (p)(1) or a specified low-income medicare
beneficiary, if provided in or after the third month before the month in which
the individual expresses an interest in applying to become such a beneficiary,
as determined in the manner provided for assistance under section
1860D-14
. Section 1905(a) of the
Social Security Act (42 U.S.C. 1396d(a)) is amended, in the matter preceding
paragraph (1), by striking assistance or, in the case of medicare
cost-sharing
and all that follows through beneficiary)
and inserting assistance)
.
Conforming amendments
Section 1902(e)(8) of such Act (42 U.S.C. 1396a(e)(8)) is amended—
by striking the first sentence; and
by striking such
determination
.
Section 1848(g)(3) of such Act (42 U.S.C. 1395w–4(g)(3)) is amended by adding at the end the following new subparagraph:
Treatment of retroactive eligibility
In the case of an individual who is determined to be eligible for medical assistance described in subparagraph (A) retroactively, the Secretary shall provide a process whereby claims which are submitted for services furnished during the period of retroactive eligibility and during a month in which the individual otherwise would have been eligible for such assistance and which were not submitted in accordance with such subparagraph are resubmitted and re-processed in accordance with such subparagraph.
.
Effective date
The amendments made by this section shall take effect on January 1, 2010, but shall not result in eligibility for benefits for medicare cost-sharing for months before January 2010.
Treatment of qualified Medicare beneficiaries, specified low-income Medicare beneficiaries, and other dual eligibles as medicare beneficiaries
In General
Section 1862 of the Social Security Act (42 U.S.C. 1395y) is amended by adding at the end the following new subsection:
Treatment of Qualified Medicare Beneficiaries (QMBs), Specified Low-Income Medicare Beneficiaries (SLMBs), and Other Dual Eligibles
Nothing in this title shall be construed as authorizing a provider of services or supplier to discriminate (through a private contractual arrangement or otherwise) against an individual who is otherwise entitled to services under this title on the basis that the individual is a qualified medicare beneficiary (as defined in section 1905(p)(1)), a specified low-income medicare beneficiary, or is otherwise eligible for medical assistance for medicare cost-sharing or other benefits under title XIX.
.
Effective date
The amendment made by subsection (a) shall apply to items and services furnished on or after the date of the enactment of this Act.
Monitoring and enforcement of limitation on beneficiary liability
In general
Section 1902(n) of the Social Security Act (42 U.S.C. 1396b(n)) is amended—
by striking paragraph (2); and
in paragraph (3)—
by striking
In the case in which
and all that follows through the
application of paragraph (2)
and inserting With respect to an
item or service
;
in subparagraph
(A), by striking (if any)
; and
by redesignating such paragraph as paragraph (2).
Conforming amendment
Section 1905(p)(2)
of such Act (42 U.S.C. 1396d(p)(2)) is amended by striking (subject to
section 1902(n))
.
Effective date
The amendments made by this section shall apply to items and services furnished on or after January 1, 2011.
Medicaid treatment of certain Medicare providers
In general
Section 1902(n) of the Social Security Act (42 U.S.C. 1396a(n)) is amended by adding at the end the following new paragraph:
A State plan shall not deny a claim from a provider or supplier with respect to medicare cost-sharing described in subparagraph (B), (C), or (D) of section 1905(p)(3) for an item or service which is eligible for payment under title XVIII on the basis that the provider or supplier does not have a provider agreement in effect under this title or does not otherwise serve all individuals entitled to medical assistance under this title. The State shall create a mechanism through which provider or suppliers that do not otherwise have provider agreements with the State can bill the State for medicare cost-sharing for qualified medicare beneficiaries.
.
Effective date
The amendment made by subsection (a) shall apply to items and services furnished on or after the date of the enactment of this Act.
State provision of medical assistance to dual eligibles in MA plans
In general
Section 1902(n) of the Social Security Act (42 U.S.C. 1396b(n)), as amended by section 8(a), is further amended by adding at the end the following new paragraph:
Each State shall—
identify those individuals who are eligible for medical assistance for medicare cost-sharing and who are enrolled with a Medicare Advantage plan under part C of title XVIII; and
for the individuals so identified, provide for payment of medical assistance for the medicare cost-sharing (including cost-sharing under a Medicare Advantage plan) to which they are entitled.
The Inspector General of the Department of Health and Human Services shall examine whether States are providing for medical assistance for Medicare cost-sharing for individuals enrolled in Medicare Advantage plans in accordance with this title. The Inspector General shall submit to the Secretary, not later than one year after the date of the enactment of this paragraph, a report on such examination and a finding as to whether States are failing to provide such medical assistance.
If a report under clause (i) includes a finding that States are failing to provide such medical assistance, not later than 60 days after the date of receiving such report the Secretary shall submit to Congress a report that includes a plan of action on how to enforce such requirement.
.
Effective date
The amendment made by subsection (a) shall be effective as if included in the enactment of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173).
Medicare enrollment assistance
Additional Funding for State Health Insurance Assistance Programs
Grants
In general
The Secretary of Health and Human Services (in this
section referred to as the Secretary
) shall use amounts made
available under subparagraph (B) to make grants to States for State health
insurance assistance programs receiving assistance under section 4360 of the
Omnibus Budget Reconciliation Act of 1990.
Funding
For purposes of making grants under this subsection, the Secretary shall provide for the transfer, from the Federal Hospital Insurance Trust Fund under section 1817 of the Social Security Act (42 U.S.C. 1395i) and the Federal Supplementary Medical Insurance Trust Fund under section 1841 of such Act (42 U.S.C. 1395t), in the same proportion as the Secretary determines under section 1853(f) of such Act (42 U.S.C. 1395w–23(f)), of $14,000,000 to the Centers for Medicare & Medicaid Services Program Management Account for fiscal year 2011, to remain available until expended.
Amount of grants
The amount of a grant to a State under this subsection from the total amount made available under paragraph (1) shall be equal to the sum of the amount allocated to the State under paragraph (3)(A) and the amount allocated to the State under subparagraph (3)(B).
Allocation to States
Allocation based on percentage of low-income beneficiaries
The amount allocated to a State under this subparagraph from 2/3 of the total amount made available under paragraph (1) shall be based on the number of individuals who meet the requirement under subsection (a)(3)(A)(ii) of section 1860D–14 of the Social Security Act (42 U.S.C. 1395w–114) but who have not enrolled to receive a subsidy under such section 1860D–14 relative to the total number of individuals who meet the requirement under such subsection (a)(3)(A)(ii) in each State, as estimated by the Secretary.
Allocation based on percentage of rural beneficiaries
The amount allocated to a State under this subparagraph from 1/3 of the total amount made available under paragraph (1) shall be based on the number of part D eligible individuals (as defined in section 1860D–1(a)(3)(A) of such Act (42 U.S.C. 1395w–101(a)(3)(A))) residing in a rural area relative to the total number of such individuals in each State, as estimated by the Secretary.
Portion of grant based on percentage of low-income beneficiaries to be used to provide outreach to individuals who may be subsidy eligible individuals or eligible for the Medicare Savings Program
Each grant awarded under this subsection with respect to amounts allocated under paragraph (3)(A) shall be used to provide outreach to individuals who may be subsidy eligible individuals (as defined in section 1860D–14(a)(3)(A) of the Social Security Act (42 U.S.C. 1395w–114(a)(3)(A)) or eligible for the Medicare Savings Program (as defined in subsection (f)).
Additional Funding for Area Agencies on Aging
Grants
In general
The Secretary, acting through the Assistant Secretary for Aging, shall make grants to States for area agencies on aging (as defined in section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002)) and Native American programs carried out under the Older Americans Act of 1965 (42 U.S.C. 3001 et seq.).
Funding
For purposes of making grants under this subsection, the Secretary shall provide for the transfer, from the Federal Hospital Insurance Trust Fund under section 1817 of the Social Security Act (42 U.S.C. 1395i) and the Federal Supplementary Medical Insurance Trust Fund under section 1841 of such Act (42 U.S.C. 1395t), in the same proportion as the Secretary determines under section 1853(f) of such Act (42 U.S.C. 1395w–23(f)), of $10,000,000 to the Administration on Aging for fiscal year 2011, to remain available until expended.
Amount of grant and allocation to States based on percentage of low-income and rural beneficiaries
The amount of a grant to a State under this subsection from the total amount made available under paragraph (1) shall be determined in the same manner as the amount of a grant to a State under subsection (a), from the total amount made available under paragraph (1) of such subsection, is determined under paragraph (2) and subparagraphs (A) and (B) of paragraph (3) of such subsection.
Required use of funds
All funds
Subject to subparagraph (B), each grant awarded under this subsection shall be used to provide outreach to eligible Medicare beneficiaries regarding the benefits available under title XVIII of the Social Security Act.
Outreach to individuals who may be subsidy eligible individuals or eligible for the Medicare Savings Program
Subsection (a)(4) shall apply to each grant awarded under this subsection in the same manner as it applies to a grant under subsection (a).
Additional Funding for Aging and Disability Resource Centers
Grants
In general
The Secretary shall make grants to Aging and Disability Resource Centers under the Aging and Disability Resource Center grant program that are established centers under such program on the date of the enactment of this Act.
Funding
For purposes of making grants under this subsection, the Secretary shall provide for the transfer, from the Federal Hospital Insurance Trust Fund under section 1817 of the Social Security Act (42 U.S.C. 1395i) and the Federal Supplementary Medical Insurance Trust Fund under section 1841 of such Act (42 U.S.C. 1395t), in the same proportion as the Secretary determines under section 1853(f) of such Act (42 U.S.C. 1395w–23(f)), of $10,000,000 to the Administration on Aging for fiscal year 2011, to remain available until expended.
Required use of funds
Each grant awarded under this subsection shall be used to provide outreach to individuals regarding the benefits available under the Medicare prescription drug benefit under part D of title XVIII of the Social Security Act and under the Medicare Savings Program.
Coordination of efforts To inform older Americans about benefits available under Federal and State programs
In general
The Secretary, acting through the Assistant Secretary for Aging, in cooperation with related Federal agency partners, shall make a grant to, or enter into a contract with, a qualified, experienced entity under which the entity shall—
maintain and update web-based decision support tools, and integrated, person-centered systems, designed to inform older individuals (as defined in section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002)) about the full range of benefits for which the individuals may be eligible under Federal and State programs;
utilize cost-effective strategies to find older individuals with the greatest economic need (as defined in such section 102) and inform the individuals of the programs;
develop and maintain an information clearinghouse on best practices and the most cost-effective methods for finding older individuals with greatest economic need and informing the individuals of the programs; and
provide, in collaboration with related Federal agency partners administering the Federal programs, training and technical assistance on the most effective outreach, screening, and follow-up strategies for the Federal and State programs.
Funding
For purposes of making a grant or entering into a contract under paragraph (1), the Secretary shall provide for the transfer, from the Federal Hospital Insurance Trust Fund under section 1817 of the Social Security Act (42 U.S.C. 1395i) and the Federal Supplementary Medical Insurance Trust Fund under section 1841 of such Act (42 U.S.C. 1395t), in the same proportion as the Secretary determines under section 1853(f) of such Act (42 U.S.C. 1395w–23(f)), of $10,000,000 to the Administration on Aging for fiscal year 2011, to remain available until expended.
Medicare Savings Program defined
For purposes of this section, the term Medicare Savings Program means the program of medical assistance for payment of the cost of medicare cost-sharing under the Medicaid program pursuant to sections 1902(a)(10)(E) and 1933 of the Social Security Act (42 U.S.C. 1396a(a)(10)(E), 1396u–3).
Medicaid agency consideration of low-income subsidy application and data transmittal
Conforming amendment to section 1144
The first sentence of section 1144(c)(3) of the Social Security Act (42 U.S.C. 1320b–14(c)(3)), as added by section 113(a) of Public Law 110–275, is amended—
by striking
transmittal
; and
by inserting
as specified in section 1935(a)(4)
before the period at the
end.
Clarifying amendment to section 1935
Section 1935(a)(4) of the Social
Security Act (42 U.S.C. 1396u–5(a)(4)), as added by section 113(b) of Public
Law 110–275, is amended by striking the last sentence and inserting the
following: For the purpose of a State’s obligation under section
1902(a)(8) to furnish medical assistance with reasonable promptness, the date
of the electronic transmission of low income subsidy program data, as described
in section 1144(c), from the Commissioner of Social Security to the State
Medicaid Agency, shall constitute the date of filing of such application for
benefits under the Medicare Savings Program. For the purpose of determining
when such medical assistance will be made available, the State shall consider
the date of the individual’s application for the low income subsidy program to
constitute the date of filing of an application for benefits under the Medicare
Savings Program.
.
Effective date
The amendments made by this section are effective as if they had been included in the enactment of section 113(b) of Public Law 110–275.
OIG study
The Inspector General of the Department of Health and Human Services shall examine the extent to which States are complying with the requirement, under amendments made by the Medicare Improvements for Patients and Providers Act of 2008 (Public Law 110–275), that they initiate an application for Medicare Savings Program from data of the Social Security Administration suggesting eligibility.
QMB buy-in of part A and part B premiums
Requirement
Section 1902(a) of the Social Security Act (42 U.S.C. 1396a(a)) is amended—
in
paragraph (72), by striking and
at the end;
in paragraph (73),
by striking the period at the end and inserting ; and
;
and
by inserting after paragraph (73) the following new paragraph:
provide that the State enters into a modification of an agreement under section 1818(g).
.
Effective date
In general
Except as provided in paragraph (2), the amendments made by this section take effect on the first day of the first calendar quarter beginning 6 months after the date of the enactment of this Act.
Extension of effective date for state law amendment
In the case of a State plan under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) which the Secretary of Health and Human Services determines requires State legislation in order for the plan to meet the additional requirements imposed by the amendments made by this section, the State plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet these additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session is considered to be a separate regular session of the State legislature.
Increasing availability of MSP applications through availability on the Internet and designation of preferred language
Requirement for States
In general
Section 1902(a) of the Social Security Act (42 U.S.C. 1396a(a)), as amended by section 12, is amended—
in paragraph (73),
by striking and
at the end;
in paragraph (74),
by striking the period at the end and inserting ; and
;
and
by inserting after paragraph (74) the following new paragraph:
provide—
that the application for medical assistance for Medicare cost-sharing under this title used by the State allows an individual to specify a preferred language for subsequent communication and, in the case in which a language other than English is specified, provide that subsequent communications under this title to the individual shall be in such language; and
that the State makes such application available through an Internet website and provides for such application to be completed on such website.
.
Effective date
The amendments made by this subsection take effect on and after the first day of the first calendar quarter beginning 2 years after the date of the enactment of this Act.
Requirement for the secretary
Section 1905(p)(5) of the Social Security Act (42
U.S.C. 1396d(p)(5)) is amended by adding at the end the following new sentence:
Such form shall allow an individual to specify a preferred language for
subsequent communication.
Medicare savings program applications
In general
Section 1902(a) of the Social Security Act (42 U.S.C. 1396a(a)), as amended by sections 12 and 13, is further amended—
in
paragraph (74), by striking and
at the end;
in paragraph (75),
by striking the period at the end and inserting ; and
;
and
by inserting after paragraph (75) the following new paragraph:
provide that the State coordinates with the State agency that administers benefits under the supplemental nutrition assistance program established under the Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.) to ensure that individuals applying for medical assistance provided under paragraph (10)(E), as described in sections 1905(p) and 1933, have the opportunity to apply for, establish eligibility for, and, if eligible, receive supplemental nutrition assistance program benefits.
.
Effective date
In general
Except as provided in paragraph (2), the amendments made by subsection (a) take effect on the first day of the first calendar quarter beginning 6 months after the date of the enactment of this Act.
Extension of effective date for state law amendment
In the case of a State plan under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) which the Secretary of Health and Human Services determines requires State legislation in order for the plan to meet the additional requirements imposed by the amendments made by subsection (a), the State plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet these additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session is considered to be a separate regular session of the State legislature.
Report to Congress
Not later than 1 year after the date of enactment of this Act, the Secretary of Health and Human Services shall submit to Congress a report on the process each State uses to meet the requirements under section 1902(a)(76) of the Social Security Act, as added by subsection (a).
Repeal of payment limitation
In general
Section 1902(n) of the Social Security Act (42 U.S.C. 1396a(n)) is amended—
by striking paragraphs (2) and (3); and
in paragraph (1)—
by striking
(n)(1)
and inserting (n)
; and
by striking
may provide
and inserting shall provide
.
Conforming amendments
Section 1902(a)(10) of
such Act is amended, in the subclause (VIII) following subparagraph (G), by
striking subsection (n) and
.
Section 1905(p)(2) of such Act (42
U.S.C. 1396d(p)(2)) is amended by striking (subject to section
1902(n))
.
Effective date
The amendments made by this section shall apply to items and services furnished on or after January 1, 2010.