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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8106 Introduced in House (IH)]

<DOC>

118th CONGRESS
  2d Session
                                H. R. 8106

To amend title XIX of the Social Security Act to increase transparency 
 and expand coverage options with respect to home and community-based 
                   services under a Medicaid waiver.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                             April 23, 2024

Mrs. Rodgers of Washington (for herself and Mr. Pallone) 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 increase transparency 
 and expand coverage options with respect to home and community-based 
                   services under a Medicaid waiver.

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

SECTION 1. INCREASING TRANSPARENCY AND EXPANDING HCBS COVERAGE OPTIONS.

    Section 1915(c) of the Social Security Act (42 U.S.C. 1396n(c)) is 
amended--
            (1) in paragraph (2)--
                    (A) in subparagraph (E)--
                            (i) by inserting ``, not less frequently 
                        than'' before ``annually''; and
                            (ii) by inserting ``(including, with 
                        respect to such information provided on or 
                        after January 1, 2028, the information 
                        specified in paragraph (12))'' before the 
                        period at the end; and
                    (B) by adding at the end the following flush 
                sentence:
``The Secretary shall make all information provided under subparagraph 
(E) on or after January 1, 2028, publicly available on the website of 
the Centers for Medicare & Medicaid Services.''; and
            (2) by adding at the end the following new paragraphs:
            ``(11)(A) Notwithstanding paragraph (1), the Secretary may 
        approve a waiver under this subsection for a State to include 
        as medical assistance under the State plan of such State 
        payment for part or all of the cost of home or community-based 
        services (other than room and board (as described in such 
        paragraph)) approved by the Secretary which are provided 
        pursuant to a written plan of care to individuals other than 
        individuals described in such paragraph if such State meets the 
        requirements specified in subparagraph (B).
            ``(B) For purposes of paragraph (1), the requirements 
        specified in this paragraph are, with respect to a State, the 
        following:
                    ``(i) As of the date that such State requests a 
                waiver under this subsection to provide home or 
                community-based services to individuals with respect to 
                whom there has not been a determination described in 
                such paragraph made, all other waivers (if any) granted 
                under this subsection with respect to the State plan 
                meet the requirements of this subsection.
                    ``(ii) The State demonstrates to the Secretary that 
                approval of a waiver under this subsection with respect 
                to individuals described in clause (i) will have no 
                material impact on the average amount of time that 
                individuals with respect to whom a determination 
                described in paragraph (1) has been made will need to 
                wait to receive home or community-based services under 
                any waiver granted under this subsection.
                    ``(iii) The State provides to the Secretary--
                            ``(I) an estimate of the number of 
                        individuals described in clause (i) that the 
                        State will make such services available to 
                        under a waiver under this subsection; and
                            ``(II) a description of how the types and 
                        quantities of such services furnished to such 
                        individuals under such a waiver may differ from 
                        the types and quantities of such services 
                        furnished to individuals not described in 
                        clause (i) under such a waiver.
            ``(12) For purposes of paragraph (2)(E), the information 
        specified in this paragraph is the following:
                    ``(A) In the case of a State that limits the number 
                of individuals who may be provided home or community-
                based services under a waiver granted under this 
                subsection--
                            ``(i) a description of how the State 
                        maintains its list of individuals who have 
                        applied to receive such services under such 
                        waiver but who, due to such limit, have not yet 
                        been approved to receive such services;
                            ``(ii) information on whether the State 
                        screens individuals on such list to determine 
                        whether such individuals are eligible to 
                        receive such services under such waiver;
                            ``(iii) information on whether (and, if 
                        applicable, how often) the State periodically 
                        re-screens such individuals to determine 
                        whether such individuals are so eligible; and
                            ``(iv) the average amount of time that 
                        individuals approved to receive such services 
                        were on such list.
                    ``(B) A description of the types of services 
                furnished under waivers under this subsection, 
                including the following:
                            ``(i) The average amount of time from when 
                        such services are initially approved for an 
                        individual to when such individual begins 
                        receiving such services.
                            ``(ii) With respect to the most recent 1-
                        year period ending on the date that such 
                        information is provided to the Secretary for 
                        which data is available (or such other period 
                        as may be specified by the Secretary), the 
                        average percentage of hours of home or 
                        community-based services authorized under 
                        written plans of care for individuals receiving 
                        such services under a waiver granted under this 
                        subsection that are actually furnished to such 
                        individual.
                    ``(C) Information regarding access to homemaker 
                services, home health aide services, and personal care 
                services under waivers under this subsection, including 
                the following:
                            ``(i) With respect to the most recent 1-
                        year period ending on the date that such 
                        information is provided to the Secretary for 
                        which data is available, the average amount of 
                        time from when homemaker services, home health 
                        aide services, or personal care services are 
                        initially approved to be furnished to 
                        individuals under such a waiver to when 
                        services began.
                            ``(ii) With respect to the period described 
                        in clause (i), the average percentage of hours 
                        of homemaker services, home health aide 
                        services, and personal care services authorized 
                        under written plans of care for individuals 
                        receiving such services under a waiver granted 
                        under this subsection that are actually 
                        furnished to such individual.''.

SEC. 2. CMS GUIDANCE TO STATES ON INTERIM COVERAGE UNDER WAIVER.

    Not later than January 1, 2025, the Secretary of Health and Human 
Services shall issue guidance to the States to clarify how a State with 
a waiver in effect under section 1915(c) of the Social Security Act (42 
U.S.C. 1396n(c)) may provide, with respect to an individual who is 
eligible for home and community-based services (as such term is 
described in such section) under such waiver, up to 60 days of coverage 
of such services under an interim care plan for the period beginning on 
the date such eligibility is determined and ending on the date that a 
written plan of care (as such term is described in such section) with 
respect to such individual is finalized.
                                 <all>
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