I 

114TH CONGRESS 

2D SESSION H. R. 4368 

To amend title XIX of the Social Security Act to clarify the treatment 

of lottery winnings and other lump sum income for purposes of income 

eligibility under the Medicaid program, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 12, 2016 

Mr. PITTS (for himself and Mr. GUTHRIE) introduced the following bill; which 

was referred to the Committee on Energy and Commerce 

A BILL 

To amend title XIX of the Social Security Act to clarify 

the treatment of lottery winnings and other lump sum 

income for purposes of income eligibility under the Medicaid program, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. TREATMENT OF LOTTERY WINNINGS AND 

4 OTHER LUMP-SUM INCOME FOR PURPOSES 

5 OF INCOME ELIGIBILITY UNDER MEDICAID. 

6 (a) IN GENERAL.—Section 1902 of the Social Secu7 rity Act (42 U.S.C. 1396a) is amended— 


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1 (1) in subsection (a)(17), by striking ‘‘(e)(14), 

2 (e)(14)’’ and inserting ‘‘(e)(14), (e)(15)’’; and 

3 (2) in subsection (e)— 

4 (A) in paragraph (14) (relating to modified 

5 adjusted gross income), by adding at the end 

6 the following new subparagraph: 

7 ‘‘(J) TREATMENT OF CERTAIN LOTTERY

8 WINNINGS AND INCOME RECEIVED AS A LUMP

9 SUM.— 

10 ‘‘(i) IN GENERAL.—In the case of an 

11 individual who is the recipient of qualified 

12 lottery winnings (pursuant to lotteries oc13 curring on or after January 1, 2018) or 

14 qualified lump sum income (received on or 

15 after such date) and whose eligibility for 

16 medical assistance is determined based on 

17 the application of modified adjusted gross 

18 income under subparagraph (A), a State 

19 shall, in determining such eligibility, in20 clude such winnings or income (as applica21 ble) as income received— 

22 ‘‘(I) in the month in which such 

23 winnings or income (as applicable) is 

24 received if the amount of such 


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1 winnings or income is less than 

2 $60,000; 

3 ‘‘(II) over a period of two months 

4 if the amount of such winnings or in5 come (as applicable) is greater than or 

6 equal to $60,000 but less than 

7 $70,000; 

8 ‘‘(III) over a period of three 

9 months if the amount of such 

10 winnings or income (as applicable) is 

11 greater than or equal to $70,000 but 

12 less than $80,000; and 

13 ‘‘(IV) over an additional one14 month period for each increment of 

15 $10,000 of such winnings or income 

16 (as applicable) received, not to exceed 

17 120 months (for winnings or income 

18 of $1,240,000 or more), if the amount 

19 of such winnings or income is greater 

20 than or equal to $80,000. 

21 ‘‘(ii) COUNTING IN EQUAL INSTALL22 MENTS.—For purposes of clause (i), 

23 winnings or income to which such clause 

24 applies shall be counted in equal monthly 


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1 installments over the applicable period of 

2 months specified in such clause. 

3 ‘‘(iii) QUALIFIED LOTTERY WINNINGS

4 DEFINED.—In this subparagraph, the term 

5 ‘qualified lottery winnings’ means winnings 

6 from a sweepstakes, lottery, or pool de7 scribed in paragraph (3) of section 4402 of 

8 the Internal Revenue Code of 1986 or a 

9 lottery operated by a multistate or multi10 jurisdictional lottery association, including 

11 amounts awarded as a lump sum payment. 

12 ‘‘(iv) QUALIFIED LUMP SUM INCOME

13 DEFINED.—In this subparagraph, the term 

14 ‘qualified lump sum income’ means income 

15 that is received as a lump sum from one 

16 of the following sources: 

17 ‘‘(I) Monetary winnings from 

18 gambling (as defined by the Secretary 

19 and including gambling activities de20 scribed in section 1955(b)(4) of title 

21 18, United States Code). 

22 ‘‘(II) Damages received, whether 

23 by suit or agreement and whether as 

24 lump sums or as periodic payments 

25 (other than monthly payments), on 


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1 account of causes of action other than 

2 causes of action arising from personal 

3 physical injuries or physical sickness. 

4 ‘‘(III) Income received as liquid 

5 assets from the estate (as defined in 

6 section 1917(b)(4)) of a deceased in7 dividual.’’; and 

8 (B) by striking ‘‘(14) EXCLUSION’’ and in9 serting ‘‘(15) EXCLUSION’’. 

10 (b) RULE OF CONSTRUCTION.—Nothing in the 

11 amendment made by subsection (a)(2)(A) shall be con12 strued as preventing a State from intercepting the State 

13 lottery winnings awarded to an individual in the State to 

14 recover amounts paid by the State under the State Med15 icaid plan under title XIX of the Social Security Act for 

16 medical assistance furnished to the individual. 

Æ 


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