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[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4541 Introduced in House (IH)]

<DOC>

115th CONGRESS
  1st Session
                                H. R. 4541

  To extend funding for certain public health programs, and for other 
                               purposes.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                            December 4, 2017

    Mrs. Murphy of Florida (for herself, Mr. Neal, and Mr. Pallone) 
 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 extend funding for certain public health programs, and for other 
                               purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Continuing Community Health and 
Medical Professional Programs to Improve Our Nation and Keep Insurance 
Delivery Stable Act of 2017'' or the ``CHAMPION KIDS Act of 2017''.

SEC. 2. TABLE OF CONTENTS.

    The table of contents of this Act is as follows:

Sec. 1. Short title.
Sec. 2. Table of contents.
             TITLE I--MEDICAID AND PUBLIC HEALTH EXTENDERS

Sec. 101. Extension for community health centers and the National 
                            Health Service Corps.
Sec. 102. Extension for special diabetes programs.
Sec. 103. Reauthorization of program of payments to teaching health 
                            centers that operate graduate medical 
                            education programs.
Sec. 104. Extension for family-to-family health information centers.
Sec. 105. Youth empowerment program; personal responsibility education.
Sec. 106. Decreasing reduction in Medicaid DSH allotments.
Sec. 107. Increase in territorial cap for Medicaid payments.
Sec. 108. Puerto Rico and United States Virgin Island Disaster Relief 
                            Medicaid.
Sec. 109. Delay of Bipartisan Budget Act of 2013 third-party liability 
                            provisions.
                             TITLE II--CHIP

Sec. 201. Five-year funding extension of the Children's Health 
                            Insurance Program.
Sec. 202. Extension of certain programs and demonstration projects.
Sec. 203. Extension of outreach and enrollment program.
Sec. 204. Extension of additional Federal financial participation for 
                            CHIP.
                           TITLE III--OFFSET

Sec. 301. Implementation of Office of Inspector General recommendation 
                            to delay certain Medicare plan prepayments.

             TITLE I--MEDICAID AND PUBLIC HEALTH EXTENDERS

SEC. 101. EXTENSION FOR COMMUNITY HEALTH CENTERS AND THE NATIONAL 
              HEALTH SERVICE CORPS.

    (a) Community Health Centers Funding.--Section 10503(b)(1)(E) of 
the Patient Protection and Affordable Care Act (42 U.S.C. 254b-
2(b)(1)(E)) is amended by striking ``2017'' and inserting ``2019''.
    (b) Other Community Health Centers Provisions.--Section 330 of the 
Public Health Service Act (42 U.S.C. 254b) is amended--
            (1) in subsection (b)(1)(A)(ii), by striking ``abuse'' and 
        inserting ``use disorder'';
            (2) in subsection (b)(2)(A), by striking ``abuse'' and 
        inserting ``use disorder'';
            (3) in subsection (c)--
                    (A) in paragraph (1), by striking subparagraphs (B) 
                through (D);
                    (B) by striking ``(1) In general'' and all that 
                follows through ``The Secretary'' and inserting the 
                following:
            ``(1) Centers.--The Secretary''; and
                    (C) in paragraph (1), as amended, by redesignating 
                clauses (i) through (v) as subparagraphs (A) through 
                (E) and moving the margin of each of such redesignated 
                subparagraph 2 ems to the left;
            (4) by striking subsection (d) and inserting the following:
    ``(d) Improving Quality of Care.--
            ``(1) Supplemental awards.--The Secretary may award 
        supplemental grant funds to health centers funded under this 
        section to implement evidence-based models for increasing 
        access to high-quality primary care services, which may include 
        models related to--
                    ``(A) improving the delivery of care for 
                individuals with multiple chronic conditions;
                    ``(B) workforce configuration;
                    ``(C) reducing the cost of care;
                    ``(D) enhancing care coordination;
                    ``(E) expanding the use of telehealth and 
                technology-enabled collaborative learning and capacity 
                building models;
                    ``(F) care integration, including integration of 
                behavioral health, mental health, or substance use 
                disorder services; and
                    ``(G) addressing emerging public health or 
                substance use disorder issues to meet the health needs 
                of the population served by the health center.
            ``(2) Sustainability.--In making supplemental awards under 
        this subsection, the Secretary may consider whether the health 
        center involved has submitted a plan for continuing the 
        activities funded under this subsection after supplemental 
        funding is expended.
            ``(3) Special consideration.--The Secretary may give 
        special consideration to applications for supplemental funding 
        under this subsection that seek to address significant barriers 
        to access to care in areas with a greater shortage of health 
        care providers and health services relative to the national 
        average.'';
            (5) in subsection (e)(1)--
                    (A) in subparagraph (B)--
                            (i) by striking ``2 years'' and inserting 
                        ``1 year''; and
                            (ii) by adding at the end the following: 
                        ``The Secretary shall not make a grant under 
                        this paragraph unless the applicant provides 
                        assurances to the Secretary that within 120 
                        days of receiving grant funding for the 
                        operation of the health center, the applicant 
                        will submit, for approval by the Secretary, an 
                        implementation plan to meet the requirements of 
                        subsection (l)(3). The Secretary may extend 
                        such 120-day period for achieving compliance 
                        upon a demonstration of good cause by the 
                        health center.''; and
                    (B) in subparagraph (C)--
                            (i) in the subparagraph heading, by 
                        striking ``and plans'';
                            (ii) by striking ``or plan (as described in 
                        subparagraphs (B) and (C) of subsection 
                        (c)(1))'';
                            (iii) by striking ``or plan, including the 
                        purchase'' and inserting the following: 
                        ``including--
                            ``(i) the purchase'';
                            (iv) by inserting ``, which may include 
                        data and information systems'' after ``of 
                        equipment'';
                            (v) by striking the period at the end and 
                        inserting a semicolon; and
                            (vi) by adding at the end the following:
                            ``(ii) the provision of training and 
                        technical assistance; and
                            ``(iii) other activities that--
                                    ``(I) reduce costs associated with 
                                the provision of health services;
                                    ``(II) improve access to, and 
                                availability of, health services 
                                provided to individuals served by the 
                                centers;
                                    ``(III) enhance the quality and 
                                coordination of health services; or
                                    ``(IV) improve the health status of 
                                communities.'';
            (6) in subsection (e)(5)(B)--
                    (A) in the heading of subparagraph (B), by striking 
                ``and plans''; and
                    (B) by striking ``and subparagraphs (B) and (C) of 
                subsection (c)(1) to a health center or to a network or 
                plan'' and inserting ``to a health center or to a 
                network'';
            (7) by striking subsection (s);
            (8) by redesignating subsections (g) through (r) as 
        subsections (h) through (s), respectively;
            (9) by inserting after subsection (f), the following:
    ``(g) New Access Points and Expanded Services.--
            ``(1) Approval of new access points.--
                    ``(A) In general.--The Secretary may approve 
                applications for grants under subparagraph (A) or (B) 
                of subsection (e)(1) to establish new delivery sites.
                    ``(B) Special consideration.--In carrying out 
                subparagraph (A), the Secretary may give special 
                consideration to applicants that have demonstrated the 
                new delivery site will be located within a sparsely 
                populated area, or an area which has a level of unmet 
                need that is higher relative to other applicants.
                    ``(C) Consideration of applications.--In carrying 
                out subparagraph (A), the Secretary shall approve 
                applications for grants under subparagraphs (A) and (B) 
                of subsection (e)(1) in such a manner that the ratio of 
                the medically underserved populations in rural areas 
                which may be expected to use the services provided by 
                the applicants involved to the medically underserved 
                populations in urban areas which may be expected to use 
                the services provided by the applicants is not less 
                than two to three or greater than three to two.
                    ``(D) Service area overlap.--If in carrying out 
                subparagraph (A) the applicant proposes to serve an 
                area that is currently served by another health center 
                funded under this section, the Secretary may consider 
                whether the award of funding to an additional health 
                center in the area can be justified based on the unmet 
                need for additional services within the catchment area.
            ``(2) Approval of expanded service applications.--
                    ``(A) In general.--The Secretary may approve 
                applications for grants under subparagraph (A) or (B) 
                of subsection (e)(1) to expand the capacity of the 
                applicant to provide required primary health services 
                described in subsection (b)(1) or additional health 
                services described in subsection (b)(2).
                    ``(B) Priority expansion projects.--In carrying out 
                subparagraph (A), the Secretary may give special 
                consideration to expanded service applications that 
                seek to address emerging public health or behavioral 
                health, mental health, or substance abuse issues 
                through increasing the availability of additional 
                health services described in subsection (b)(2) in an 
                area in which there are significant barriers to 
                accessing care.
                    ``(C) Consideration of applications.--In carrying 
                out subparagraph (A), the Secretary shall approve 
                applications for applicants in such a manner that the 
                ratio of the medically underserved populations in rural 
                areas which may be expected to use the services 
                provided by the applicants involved to the medically 
                underserved populations in urban areas which may be 
                expected to use the services provided by such 
                applicants is not less than two to three or greater 
                than three to two.'';
            (10) in subsection (i) (as so redesignated)--
                    (A) in paragraph (1), by striking ``and children 
                and youth at risk of homelessness'' and inserting ``, 
                children and youth at risk of homelessness, homeless 
                veterans, and veterans at risk of homelessness''; and
                    (B) in paragraph (5)--
                            (i) by striking subparagraph (B);
                            (ii) by redesignating subparagraph (C) as 
                        subparagraph (B); and
                            (iii) in subparagraph (B) (as so 
                        redesignated)--
                                    (I) in the subparagraph heading, by 
                                striking ``abuse'' and inserting ``use 
                                disorder''; and
                                    (II) by striking ``abuse'' and 
                                inserting ``use disorder'';
            (11) in subsection (l) (as so redesignated)--
                    (A) in paragraph (2)--
                            (i) in the paragraph heading, by inserting 
                        ``unmet'' before ``need'';
                            (ii) in the matter preceding subparagraph 
                        (A), by inserting ``and an application for a 
                        grant under subsection (g)'' after ``subsection 
                        (e)(1)'';
                            (iii) in subparagraph (A), by inserting 
                        ``unmet'' before ``need for health services'';
                            (iv) in subparagraph (B), by striking 
                        ``and'' at the end;
                            (v) in subparagraph (C), by striking the 
                        period at the end and inserting ``; and''; and
                            (vi) by adding after subparagraph (C) the 
                        following:
                    ``(D) in the case of an application for a grant 
                pursuant to subsection (g)(1), a demonstration that the 
                applicant has consulted with appropriate State and 
                local government agencies, and health care providers 
                regarding the need for the health services to be 
                provided at the proposed delivery site.'';
                    (B) in paragraph (3)--
                            (i) in the matter preceding subparagraph 
                        (A), by inserting ``or subsection (g)'' after 
                        ``subsection (e)(1)(B)'';
                            (ii) in subparagraph (B), by striking ``in 
                        the catchment area of the center'' and 
                        inserting ``, including other health care 
                        providers that provide care within the 
                        catchment area, local hospitals, and specialty 
                        providers in the catchment area of the center, 
                        to provide access to services not available 
                        through the health center and to reduce the 
                        non-urgent use of hospital emergency 
                        departments'';
                            (iii) in subparagraph (H)(ii), by inserting 
                        ``who shall be directly employed by the 
                        center'' after ``approves the selection of a 
                        director for the center'';
                            (iv) in subparagraph (L), by striking 
                        ``and'' at the end;
                            (v) in subparagraph (M), by striking the 
                        period and inserting ``; and''; and
                            (vi) by inserting after subparagraph (M), 
                        the following:
                    ``(N) the center has written policies and 
                procedures in place to ensure the appropriate use of 
                Federal funds in compliance with applicable Federal 
                statutes, regulations, and the terms and conditions of 
                the Federal award.''; and
                    (C) by striking paragraph (4);
            (12) in subsection (m) (as so redesignated), by adding at 
        the end the following: ``Funds expended to carry out activities 
        under this subsection and operational support activities under 
        subsection (n) shall not exceed 3 percent of the amount 
        appropriated for this section for the fiscal year involved.'';
            (13) in subsection (q) (as so redesignated), by striking 
        ``grants for new health centers under subsections (c) and (e)'' 
        and inserting ``operating grants under subsection (e), 
        applications for new access points and expanded service 
        pursuant to subsection (g)'';
            (14) in subsection (r)(4) (as so redesignated), by adding 
        at the end the following: ``A waiver provided by the Secretary 
        under this paragraph may not remain in effect for more than 1 
        year and may not be extended after such period. An entity may 
        not receive more than one waiver under this paragraph in 
        consecutive years.'';
            (15) in subsection (s)(3) (as so redesignated)--
                    (A) by striking ``appropriate committees of 
                Congress a report concerning the distribution of funds 
                under this section'' and inserting the following: 
                ``Committee on Health, Education, Labor, and Pensions 
                of the Senate, and the Committee on Energy and Commerce 
                of the House of Representatives, a report including, at 
                a minimum--
                    ``(A) the distribution of funds for carrying out 
                this section'';
                    (B) by striking ``populations. Such report shall 
                include an assessment'' and inserting the following: 
                ``populations;
                    ``(B) an assessment'';
                    (C) by striking ``and the rationale for any 
                substantial changes in the distribution of funds.'' and 
                inserting a semicolon; and
                    (D) by adding at the end the following:
                    ``(C) the distribution of awards and funding for 
                new or expanded services in each of rural areas and 
                urban areas;
                    ``(D) the distribution of awards and funding for 
                establishing new access points, and the number of new 
                access points created;
                    ``(E) the amount of unexpended funding for loan 
                guarantees and loan guarantee authority under title 
                XVI;
                    ``(F) the rationale for any substantial changes in 
                the distribution of funds;
                    ``(G) the rate of closures for health centers and 
                access points;
                    ``(H) the number and reason for any grants awarded 
                pursuant to subsection (e)(1)(B); and
                    ``(I) the number and reason for any waivers 
                provided pursuant to subsection (r)(4).''; and
            (16) in subsection (s) (as so redesignated) by adding at 
        the end the following new paragraph:
            ``(5) Funding for participation of health centers in all of 
        us research program.--In addition to any amounts made available 
        pursuant to paragraph (1) of this subsection, section 402A of 
        this Act, or section 10503 of the Patient Protection and 
        Affordable Care Act, there is authorized to be appropriated, 
        and there is appropriated, out of any monies in the Treasury 
        not otherwise appropriated, to the Secretary $25,000,000 for 
        fiscal year 2018 to support the participation of health centers 
        in the All of Us Research Program under the Precision Medicine 
        Initiative under section 498E of this Act.''.
    (c) National Health Service Corps.--Section 10503(b)(2)(E) of the 
Patient Protection and Affordable Care Act (42 U.S.C. 254b-2(b)(2)(E)) 
is amended by striking ``2017'' and inserting ``2019''.
    (d) Conforming Amendment.--Section 3014(h)(1) of title 18, United 
States Code, is amended by striking ``, as amended by section 221 of 
the Medicare Access and CHIP Reauthorization Act of 2015,''.

SEC. 102. EXTENSION FOR SPECIAL DIABETES PROGRAMS.

    (a) Special Diabetes Program for Type I Diabetes.--Section 
330B(b)(2)(C) of the Public Health Service Act (42 U.S.C. 254c-
2(b)(2)(C)) is amended by striking ``2017'' and inserting ``2019''.
    (b) Special Diabetes Program for Indians.--Section 330C(c)(2) of 
the Public Health Service Act (42 U.S.C. 254c-3(c)(2)) is amended--
            (1) in subparagraph (C), by striking ``and'' at the end;
            (2) in subparagraph (D), by striking the period at the end 
        and inserting ``and $112,500,000 for the period consisting of 
        the second, third, and fourth quarters of fiscal year 2018; 
        and''; and
            (3) by adding at the end the following:
                    ``(E) $150,000,000 for fiscal year 2019.''.

SEC. 103. REAUTHORIZATION OF PROGRAM OF PAYMENTS TO TEACHING HEALTH 
              CENTERS THAT OPERATE GRADUATE MEDICAL EDUCATION PROGRAMS.

    (a) Payments.--Subsection (a) of section 340H of the Public Health 
Service Act (42 U.S.C. 256h) is amended to read as follows:
    ``(a) Payments.--
            ``(1) In general.--Subject to subsection (h)(2), the 
        Secretary shall make payments under this section for direct 
        expenses and indirect expenses to qualified teaching health 
        centers that are listed as sponsoring institutions by the 
        relevant accrediting body for--
                    ``(A) maintenance of existing approved graduate 
                medical residency training programs;
                    ``(B) expansion of existing approved graduate 
                medical residency training programs; and
                    ``(C) establishment of new approved graduate 
                medical residency training programs, as appropriate.
            ``(2) Priority.--In making payments pursuant to paragraph 
        (1)(C), the Secretary shall give priority to qualified teaching 
        health centers that--
                    ``(A) serve a health professional shortage area 
                with a designation in effect under section 332 or a 
                medically underserved community (as defined in section 
                799B); or
                    ``(B) are located in a rural area (as defined in 
                section 1886(d)(2)(D) of the Social Security Act).''.
    (b) Funding.--Subsection (g) of section 340H of the Public Health 
Service Act (42 U.S.C. 256h) is amended--
            (1) by striking ``To carry out'' and inserting the 
        following:
            ``(1) In general.--To carry out'';
            (2) by striking ``and $15,000,000 for the first quarter of 
        fiscal year 2018'' and inserting ``, $15,000,000 for the first 
        quarter of fiscal year 2018, $111,500,000 for the period 
        consisting of the second, third, and fourth quarters of fiscal 
        year 2018, and $126,500,000 for fiscal year 2019, to remain 
        available until expended''; and
            (3) by adding at the end the following:
            ``(2) Administrative expenses.--Of the amount made 
        available to carry out this section for any fiscal year, the 
        Secretary may not use more than 5 percent of such amount for 
        the expenses of administering this section.''.
    (c) Annual Reporting.--Subsection (h)(1) of section 340H of the 
Public Health Service Act (42 U.S.C. 256h) is amended--
            (1) by redesignating subparagraph (D) as subparagraph (H); 
        and
            (2) by inserting after subparagraph (C) the following:
                    ``(D) The number of patients treated by residents 
                described in paragraph (4).
                    ``(E) The number of visits by patients treated by 
                residents described in paragraph (4).
                    ``(F) Of the number of residents described in 
                paragraph (4) who completed their residency training at 
                the end of such residency academic year, the number and 
                percentage of such residents entering primary care 
                practice (meaning any of the areas of practice listed 
                in the definition of a primary care residency program 
                in section 749A).
                    ``(G) Of the number of residents described in 
                paragraph (4) who completed their residency training at 
                the end of such residency academic year, the number and 
                percentage of such residents who entered practice at a 
                health care facility--
                            ``(i) primarily serving a health 
                        professional shortage area with a designation 
                        in effect under section 332 or a medically 
                        underserved community (as defined in section 
                        799B); or
                            ``(ii) located in a rural area (as defined 
                        in section 1886(d)(2)(D) of the Social Security 
                        Act).''.
    (d) Report on Training Costs.--Not later than March 31, 2019, the 
Secretary of Health and Human Services shall submit to the Congress a 
report on the direct graduate expenses of approved graduate medical 
residency training programs, and the indirect expenses associated with 
the additional costs of teaching residents, of qualified teaching 
health centers (as such terms are used or defined in section 340H of 
the Public Health Service Act (42 U.S.C. 256h)).
    (e) Definition.--Subsection (j) of section 340H of the Public 
Health Service Act (42 U.S.C. 256h) is amended--
            (1) by redesignating paragraphs (2) and (3) as paragraphs 
        (3) and (4), respectively; and
            (2) by inserting after paragraph (1) the following:
            ``(2) New approved graduate medical residency training 
        program.--The term `new approved graduate medical residency 
        training program' means an approved graduate medical residency 
        training program for which the sponsoring qualified teaching 
        health center has not received a payment under this section for 
        a previous fiscal year (other than pursuant to subsection 
        (a)(1)(C)).''.
    (f) Technical Correction.--Subsection (f) of section 340H (42 
U.S.C. 256h) is amended by striking ``hospital'' each place it appears 
and inserting ``teaching health center''.
    (g) Payments for Previous Fiscal Years.--The provisions of section 
340H of the Public Health Service Act (42 U.S.C. 256h), as in effect on 
the day before the date of enactment of this Act, shall continue to 
apply with respect to payments under such section for fiscal years 
before fiscal year 2018.

SEC. 104. EXTENSION FOR FAMILY-TO-FAMILY HEALTH INFORMATION CENTERS.

    Section 501(c) of the Social Security Act (42 U.S.C. 701(c)) is 
amended--
            (1) in paragraph (1)(A)--
                    (A) in clause (v), by striking ``and'' at the end;
                    (B) in clause (vi), by striking the period at the 
                end and inserting ``; and''; and
                    (C) by adding at the end the following new clause:
            ``(vii) $6,000,000 for each of fiscal years 2018 and 
        2019.'';
            (2) in paragraph (3)(C), by inserting before the period the 
        following: ``, and with respect to fiscal years 2018 and 2019, 
        such centers shall also be developed in all territories and at 
        least one such center shall be developed for Indian tribes''; 
        and
            (3) by amending paragraph (5) to read as follows:
    ``(5) For purposes of this subsection--
            ``(A) the term `Indian tribe' has the meaning given such 
        term in section 4 of the Indian Health Care Improvement Act (25 
        U.S.C. 1603);
            ``(B) the term `State' means each of the 50 States and the 
        District of Columbia; and
            ``(C) the term `territory' means Puerto Rico, Guam, 
        American Samoa, the Virgin Islands, and the Northern Mariana 
        Islands.''.

SEC. 105. YOUTH EMPOWERMENT PROGRAM; PERSONAL RESPONSIBILITY EDUCATION.

    (a) Youth Empowerment Program.--
            (1) In general.--Section 510 of the Social Security Act (42 
        U.S.C. 710) is amended to read as follows:

``SEC. 510. YOUTH EMPOWERMENT PROGRAM.

    ``(a) In General.--
            ``(1) Allotments to states.--For the purpose described in 
        subsection (b), the Secretary shall, for each of fiscal years 
        2018 and 2019, allot to each State which has transmitted an 
        application for the fiscal year under section 505(a) an amount 
        equal to the product of--
                    ``(A) the amount appropriated pursuant to 
                subsection (e)(1) for the fiscal year, minus the amount 
                reserved under subsection (e)(2) for the fiscal year; 
                and
                    ``(B) the proportion that the number of low-income 
                children in the State bears to the total of such 
                numbers of children for all the States.
            ``(2) Other allotments.--
                    ``(A) Other entities.--For the purpose described in 
                subsection (b), the Secretary shall, for each of fiscal 
                years 2018 and 2019, for any State which has not 
                transmitted an application for the fiscal year under 
                section 505(a), allot to one or more entities in the 
                State the amount that would have been allotted to the 
                State under paragraph (1) if the State had submitted 
                such an application.
                    ``(B) Process.--The Secretary shall select the 
                recipients of allotments under subparagraph (A) by 
                means of a competitive grant process under which--
                            ``(i) not later than 30 days after the 
                        deadline for the State involved to submit an 
                        application for the fiscal year under section 
                        505(a), the Secretary publishes a notice 
                        soliciting grant applications; and
                            ``(ii) not later than 120 days after such 
                        deadline, all such applications must be 
                        submitted.
    ``(b) Purpose.--
            ``(1) In general.--Except for research under paragraph (5) 
        and information collection and reporting under paragraph (6), 
        the purpose of an allotment under subsection (a) to a State (or 
        to another entity in the State pursuant to subsection (a)(2)) 
        is to enable the State or other entity to implement education 
        exclusively on sexual risk avoidance (meaning voluntarily 
        refraining from sexual activity).
            ``(2) Required components.--Education on sexual risk 
        avoidance pursuant to an allotment under this section shall--
                    ``(A) ensure that the unambiguous and primary 
                emphasis and context for each topic described in 
                paragraph (3) is a message to youth that normalizes the 
                optimal health behavior of avoiding nonmarital sexual 
                activity;
                    ``(B) be medically accurate and complete;
                    ``(C) be age-appropriate; and
                    ``(D) be based on adolescent learning and 
                developmental theories for the age group receiving the 
                education.
            ``(3) Topics.--Education on sexual risk avoidance pursuant 
        to an allotment under this section shall address each of the 
        following topics:
                    ``(A) The holistic individual and societal benefits 
                associated with personal responsibility, self-
                regulation, goal setting, healthy decisionmaking, and a 
                focus on the future.
                    ``(B) The advantage of refraining from nonmarital 
                sexual activity in order to improve the future 
                prospects and physical and emotional health of youth.
                    ``(C) The increased likelihood of avoiding poverty 
                when youth attain self-sufficiency and emotional 
                maturity before engaging in sexual activity.
                    ``(D) The foundational components of healthy 
                relationships and their impact on the formation of 
                healthy marriages and safe and stable families.
                    ``(E) How other youth risk behaviors, such as drug 
                and alcohol usage, increase the risk for teen sex.
                    ``(F) How to resist and avoid, and receive help 
                regarding, sexual coercion and dating violence, 
                recognizing that even with consent teen sex remains a 
                youth risk behavior.
            ``(4) Contraception.--Education on sexual risk avoidance 
        pursuant to an allotment under this section shall ensure that--
                    ``(A) any information provided on contraception is 
                medically accurate and ensures that students understand 
                that contraception offers physical risk reduction, but 
                not risk elimination; and
                    ``(B) the education does not include 
                demonstrations, simulations, or distribution of 
                contraceptive devices.
            ``(5) Research.--
                    ``(A) In general.--A State or other entity 
                receiving an allotment pursuant to subsection (a) may 
                use up to 20 percent of such allotment to build the 
                evidence base for sexual risk avoidance education by 
                conducting or supporting research.
                    ``(B) Requirements.--Any research conducted or 
                supported pursuant to subparagraph (A) shall be--
                            ``(i) rigorous;
                            ``(ii) evidence-based; and
                            ``(iii) designed and conducted by 
                        independent researchers who have experience in 
                        conducting and publishing research in peer-
                        reviewed outlets.
            ``(6) Information collection and reporting.--A State or 
        other entity receiving an allotment pursuant to subsection (a) 
        shall, as specified by the Secretary--
                    ``(A) collect information on the programs and 
                activities funded through the allotment; and
                    ``(B) submit reports to the Secretary on the data 
                from such programs and activities.
    ``(c) National Evaluation.--
            ``(1) In general.--The Secretary shall--
                    ``(A) in consultation with appropriate State and 
                local agencies, conduct one or more rigorous 
                evaluations of the education funded through this 
                section and associated data; and
                    ``(B) submit a report to the Congress on the 
                results of such evaluations, together with a summary of 
                the information collected pursuant to subsection 
                (b)(6).
            ``(2) Consultation.--In conducting the evaluations required 
        by paragraph (1), including the establishment of evaluation 
        methodologies, the Secretary shall consult with relevant 
        stakeholders.
    ``(d) Applicability of Certain Provisions.--
            ``(1) Sections 503, 507, and 508 apply to allotments under 
        subsection (a) to the same extent and in the same manner as 
        such sections apply to allotments under section 502(c).
            ``(2) Sections 505 and 506 apply to allotments under 
        subsection (a) to the extent determined by the Secretary to be 
        appropriate.
    ``(e) Funding.--
            ``(1) In general.--To carry out this section, there is 
        appropriated, out of any money in the Treasury not otherwise 
        appropriated, $75,000,000 for each of fiscal years 2018 and 
        2019.
            ``(2) Reservation.--The Secretary shall reserve, for each 
        of fiscal years 2018 and 2019, not more than 20 percent of the 
        amount appropriated pursuant to paragraph (1) for administering 
        the program under this section, including the conducting of 
        national evaluations and the provision of technical assistance 
        to the recipients of allotments.''.
            (2) Effective date.--The amendment made by this section 
        takes effect on October 1, 2017.
    (b) Personal Responsibility Education.--
            (1) In general.--Section 513 of the Social Security Act (42 
        U.S.C. 713) is amended--
                    (A) in subsection (a)(1)(A), by striking ``2017'' 
                and inserting ``2019'';
                    (B) in subsection (a)(4)--
                            (i) in subparagraph (A), by striking 
                        ``2017'' each place it appears and inserting 
                        ``2019''; and
                            (ii) in subparagraph (B)--
                                    (I) in the subparagraph heading, by 
                                striking ``3-year grants'' and 
                                inserting ``Competitive prep grants''; 
                                and
                                    (II) in clause (i), by striking 
                                ``solicit applications to award 3-year 
                                grants in each of fiscal years 2012 
                                through 2017'' and inserting ``continue 
                                through fiscal year 2019 grants awarded 
                                for any of fiscal years 2015 through 
                                2017'';
                    (C) in subsection (c)(1), by inserting after 
                ``youth with HIV/AIDS,'' the following: ``victims of 
                human trafficking,''; and
                    (D) in subsection (f), by striking ``2017'' and 
                inserting ``2019''.
            (2) Effective date.--The amendments made by this subsection 
        take effect on October 1, 2017.

SEC. 106. DECREASING REDUCTION IN MEDICAID DSH ALLOTMENTS.

    Section 1923(f)(7)(A) of the Social Security Act (42 U.S.C. 1396r-
4(f)(7)(A)) is amended--
            (1) in clause (i), in the matter preceding subclause (I), 
        by striking ``2018'' and inserting ``2023''; and
            (2) in clause (ii), by striking subclauses (I) through 
        (VIII) and inserting the following:
                                    ``(I) $5,000,000,000 for fiscal 
                                year 2023;
                                    ``(II) $5,500,000,000 for fiscal 
                                year 2024; and
                                    ``(III) $6,000,000,000 for fiscal 
                                year 2025.''.

SEC. 107. INCREASE IN TERRITORIAL CAP FOR MEDICAID PAYMENTS.

    Section 1108(g)(5) of the Social Security Act (42 U.S.C. 
1308(g)(5)) is amended--
            (1) in subparagraph (A)--
                    (A) by striking ``subparagraph (B)'' and inserting 
                ``subparagraphs (B), (C), and (D)''; and
                    (B) by striking ``2019'' and inserting ``2022''; 
                and
            (2) by adding at the end the following new subparagraphs:
            ``(C) The amount of the increase otherwise provided under 
        subparagraph (A) for--
                    ``(i) Puerto Rico shall, after application of 
                subparagraph (B), be further increased by 
                $1,600,000,000 for each of fiscal years 2018 through 
                2022; and
                    ``(ii) the Virgin Islands shall be further 
                increased by $55,000,000 for each of fiscal years 2018 
                through 2022.
            ``(D) The amount of the increase otherwise provided under 
        subparagraph (A) for Guam, the Northern Mariana Islands, and 
        America Samoa, respectively, shall be further increased by such 
        amounts that the total amount of increases under this 
        subparagraph is equal to $150,000,000. In applying the previous 
        sentence, the Secretary shall increase amounts for such 
        territories in such a proportion as would be applied under 
        subparagraph (A) if such territories were the only territories 
        to which such subparagraph applied.''.

SEC. 108. PUERTO RICO AND UNITED STATES VIRGIN ISLAND DISASTER RELIEF 
              MEDICAID.

    (a) Simplified Eligibility Determinations and Redeterminations.--
            (1) In general.--Notwithstanding any provision of title XIX 
        of the Social Security Act (42 U.S.C. 1396 et seq.), a State 
        shall, as a condition of participation in the Medicaid program 
        under such title and without submitting an amendment to the 
        State Medicaid plan--
                    (A) use streamlined procedures described in 
                paragraph (2) in processing applications and 
                determining and redetermining eligibility for medical 
                assistance under the State Medicaid plan for DRM-
                eligible Maria Survivors during the DRM coverage 
                period; and
                    (B) provide, in the case of such a Survivor, for 
                medical assistance under the State Medicaid plan to 
                such Survivor during such period based on the family 
                income level eligibility requirements established under 
                the State Medicaid plan or, if higher, under the State 
                Medicaid plan of the State in which such Survivor 
                resided as of September 17, 2017.
            (2) Streamlined procedures.--The streamlined procedures 
        described in this paragraph, with respect to a State and an 
        applicant for medical assistance under the State Medicaid plan, 
        are the following:
                    (A) Common application form.--Use of a common 1-
                page application form developed by the Secretary of 
                Health and Human Services, in consultation with the 
                National Association of State Medicaid Directors. Such 
                form shall--
                            (i) require an applicant to provide an 
                        expected address for the duration of the DRM 
                        coverage period and to agree to update that 
                        information if it changes during such period;
                            (ii) include notice regarding the penalties 
                        for making a fraudulent application;
                            (iii) require the applicant to assign to 
                        the State any rights of the applicant (or any 
                        other person who is a DRM-eligible Maria 
                        Survivor and on whose behalf the applicant has 
                        the legal authority to execute an assignment of 
                        such rights) under any group health plan or 
                        other third-party coverage for health care; and
                            (iv) require the applicant to list any 
                        health insurance coverage which the applicant 
                        was enrolled in immediately prior to submitting 
                        such application.
                    (B) Self-attestation.--Self-attestation by the 
                applicant for medical assistance under the State 
                Medicaid plan that the applicant is a DRM-eligible 
                Maria Survivor, including with respect to citizenship, 
                identity, immigration status, and income requirements.
                    (C) No documentation.--No requirement for 
                documentation evidencing the basis on which the 
                applicant qualifies to be a DRM-eligible Maria 
                Survivor.
                    (D) Issuance of eligibility card.--Issuance of a 
                DRM assistance eligibility card to an applicant who 
                completes such application, including the self-
                attestation required under subparagraph (B). Such card 
                shall be valid as long as the DRM coverage period is in 
                effect and shall be accompanied by notice of the 
                termination date for the DRM coverage period and, if 
                applicable, notice that such termination date may be 
                extended. If the President extends the DRM coverage 
                period, the State shall notify DRM-eligible Maria 
                Survivors enrolled in the State Medicaid plan of the 
                new termination date for the DRM coverage period.
                    (E) Deemed eligibility.--If an applicant completes 
                the application and presents it to a provider or 
                facility participating in the State Medicaid plan that 
                is qualified to make presumptive eligibility 
                determinations under such plan (which at a minimum 
                shall consist of facilities identified in section 
                1902(a)(55) of the Social Security Act (42 U.S.C. 
                1396a(a)(55)) and it appears to the provider that the 
                applicant is a DRM-eligible Maria Survivor based on the 
                information in the application, the applicant will be 
                deemed to be a DRM-eligible Maria Survivor eligible for 
                medical assistance under the State Medicaid plan.
                    (F) Continuous eligibility.--Continuous 
                eligibility, without the need for any redetermination 
                of eligibility, for the duration of the DRM coverage 
                period.
    (b) No Continuation of DRM Assistance.--
            (1) In general.--Except as provided in paragraphs (2) and 
        (3), no DRM assistance shall be provided after the end of the 
        DRM coverage period.
            (2) Presumptive eligibility.--In the case of any DRM-
        eligible Maria Survivor who is receiving DRM assistance from a 
        State in accordance with this section and who, as of the end of 
        the DRM coverage period, has an application pending for medical 
        assistance under the State Medicaid plan for periods beginning 
        after the end of such period, the State shall provide such 
        Survivor with a period of presumptive eligibility for medical 
        assistance under the State Medicaid plan (not to exceed 60 
        days) until a determination with respect to the Survivor's 
        application has been made.
            (3) Pregnant women.--In the case of a DRM-eligible Maria 
        Survivor who is receiving DRM assistance from a State in 
        accordance with this section and whose pregnancy ended during 
        the 60-day period prior to the end of the DRM coverage period, 
        or who is pregnant as of the end of such period, such Survivor 
        shall continue to be eligible for DRM assistance after the end 
        of the DRM coverage period, including (but not limited to) all 
        pregnancy-related and postpartum medical assistance available 
        under the State Medicaid plan, through the end of the month in 
        which the 60-day period (beginning on the last day of her 
        pregnancy) ends.
    (c) Treatment of Maria Survivors Provided Assistance Prior to Date 
of Enactment.--Any Maria Survivor who is provided medical assistance 
under a State Medicaid plan in accordance with guidance from the 
Secretary during the period that begins on September 17, 2017, and ends 
on the date of enactment of this Act shall be treated as a DRM-eligible 
Maria Survivor, without the need to file an additional application, for 
purposes of eligibility for medical assistance under this section.
    (d) Scope of Coverage.--
            (1) In general.--A State providing medical assistance under 
        a State Medicaid plan to a DRM-eligible Maria Survivor pursuant 
        to this section shall provide medical assistance that is 
        either--
                    (A) equal in amount and scope to the medical 
                assistance that would otherwise be made available to 
                such Survivor if the Survivor were a State resident 
                enrolled in the State Medicaid plan; or
                    (B) if greater in amount and scope, equal in amount 
                and scope to the medical assistance that would have 
                been made available to such Survivor under the State 
                Medicaid plan of the State in which such Survivor 
                resided as of September 17, 2017.
        Coverage for such medical assistance for DRM-eligible Maria 
        Survivors shall be retroactive to items and services furnished 
        on or after September 17, 2017 (or in the case of applications 
        for DRM assistance submitted after January 1, 2018, the first 
        day of the 5th month preceding the date on which such 
        application is submitted).
            (2) Children born to pregnant women.--In the case of a 
        child born to a DRM-eligible Maria Survivor who is provided DRM 
        assistance during the DRM coverage period, such child shall be 
        treated as having been born to a pregnant woman eligible for 
        medical assistance under the State Medicaid plan and shall be 
        eligible for medical assistance under such plan in accordance 
        with section 1902(e)(4) of the Social Security Act (42 U.S.C. 
        1396a(e)(4)). The Federal medical assistance percentage 
        applicable to the State Medicaid plan shall apply to medical 
        assistance provided to a child under such plan in accordance 
        with the preceding sentence and Federal payments for such 
        assistance shall not be considered to be payments under this 
        section.
    (e) 100 Percent Federal Matching Payments.--
            (1) In general.--Notwithstanding section 1905(b) of the 
        Social Security Act (42 U.S.C. 1396d(b)), subject to paragraph 
        (2), the Federal medical assistance percentage or the Federal 
        matching rate otherwise applied under section 1903(a) of such 
        Act (42 U.S.C. 1396b(a)) shall be 100 percent for--
                    (A) providing DRM assistance to DRM-eligible Maria 
                Survivors during the DRM coverage period in accordance 
                with this section;
                    (B) costs directly attributable to administrative 
                activities related to the provision of such DRM 
                assistance; and
                    (C) DRM assistance provided in accordance with 
                paragraph (2) or (3) of subsection (b) after the end of 
                the DRM coverage period.
            (2) Limitation.--
                    (A) Territories.--Payments provided to a State that 
                is a territory (as defined in section 1108(c)(1) of the 
                Social Security Act (42 U.S.C. 1308(c)(1))) in 
                accordance with this subsection shall be subject to 
                subsections (f) and (g) of section 1108 of the Social 
                Security Act (42 U.S.C. 1308).
                    (B) Other states.--
                            (i) In general.--In the case of States not 
                        described in subparagraph (A), the difference 
                        between--
                                    (I) the total amount of payments 
                                made to such States in accordance with 
                                this subsection, by reason of the 
                                Federal medical assistance percentage 
                                or the Federal matching rate applied 
                                under paragraph (1); and
                                    (II) the total amount of payments 
                                that would otherwise be made to such 
                                States if the Federal medical 
                                assistance percentage and the Federal 
                                matching rate under section 1905(b) of 
                                the Social Security Act and 1903(a) of 
                                such Act were applied,
                        may not exceed the amount appropriated under 
                        clause (ii).
                            (ii) Appropriations.--There are 
                        appropriated, out of any amounts in the 
                        Treasury not otherwise appropriated, 
                        $1,000,000,000 for the DRM coverage period for 
                        purposes of making payments in accordance with 
                        this subsection to States not described in 
                        subparagraph (A).
            (3) Exemption from error rate penalties.--All payments 
        attributable to providing DRM assistance in accordance with 
        this section shall be disregarded for purposes of section 
        1903(u) of the Social Security Act (42 U.S.C. 1396b(u)).
    (f) Verification of Status as a Maria Survivor.--
            (1) In general.--A State shall make a good faith effort to 
        verify the status of an individual who is enrolled in the State 
        Medicaid plan as a DRM-eligible Maria Survivor under the 
        provisions of this section. Such effort shall not delay the 
        determination of the eligibility of the Survivor for DRM 
        assistance under this section.
            (2) Evidence of verification.--A State may satisfy the 
        verification requirement under paragraph (1) with respect to an 
        individual by showing that the State obtained information from 
        the Social Security Administration, the Internal Revenue 
        Service, or the State Medicaid Agency for the State from which 
        the individual is from (if the individual was not a resident of 
        such State on any day during the week preceding September 17, 
        2017).
    (g) Provider Payment Rates.--In the case of any DRM assistance 
provided in accordance with this section to a DRM-eligible Maria 
Survivor that is covered under the State Medicaid plan (as applied 
without regard to this section) the State shall pay a provider of such 
assistance the same payment rate as the State would otherwise pay for 
the assistance if the assistance were provided under the State Medicaid 
plan (or, if no such payment rate applies under the State Medicaid 
plan, the usual and customary prevailing rate for the item or service 
for the community in which it is provided).
    (h) Application to Individuals Eligible for Medical Assistance.--
Nothing in this section shall be construed as affecting any rights 
accorded to an individual who is a recipient of medical assistance 
under a State Medicaid plan who is determined to be a DRM-eligible 
Maria Survivor but the provision of DRM assistance to such individual 
shall be limited to the provision of such assistance in accordance with 
this section.
    (i) Definitions.--In this section:
            (1) DRM assistance.--The term ``DRM assistance'' means 
        medical assistance under a State Medicaid plan for a DRM-
        eligible Maria Survivor during the DRM coverage period.
            (2) DRM coverage period.--
                    (A) In general.--The term ``DRM coverage period'' 
                means the period beginning on September 17, 2017, and, 
                subject to subparagraph (B), ending on the date that is 
                24 months after the date of enactment of this Act.
                    (B) Secretary authority to extend drm coverage 
                period.--The Secretary may extend the DRM coverage 
                period for an additional 12 months. Any reference to 
                the term ``DRM coverage period'' in this section shall 
                include any extension under this subparagraph.
            (3) DRM-eligible maria survivor defined.--
                    (A) In general.--The term ``DRM-eligible Maria 
                Survivor'' means a Maria Survivor whose family income 
                does not exceed the income eligibility standard which 
                would apply to the Survivor under the State Medicaid 
                plan of the State in which the Survivor applies for 
                medical assistance.
                    (B) No resources, residency, or categorical 
                eligibility requirements.--Eligibility under 
                subparagraph (A) shall be determined without 
                application of any resources test, State residency, or 
                categorical eligibility requirements.
                    (C) Definition of child.--For purposes of 
                subparagraph (A), a DRM-eligible Maria Survivor shall 
                be determined to be a ``child'' in accordance with the 
                definition of ``child'' under the State Medicaid plan.
            (4) Maria survivor.--
                    (A) In general.--The term ``Maria Survivor'' means 
                an individual who, on any day during the week preceding 
                September 17, 2017, had a primary residence in Puerto 
                Rico or the Virgin Islands.
                    (B) Treatment of current medicaid beneficiaries.--
                Nothing in this section shall be construed as 
                preventing an individual who is otherwise entitled to 
                medical assistance under a State Medicaid plan from 
                being treated as a Maria Survivor under this section.
                    (C) Treatment of homeless persons.--For purposes of 
                this section, in the case of an individual who was 
                homeless on any day during the week described in 
                subparagraph (A), the individual's ``residence'' shall 
                be deemed to be the place of residence as otherwise 
                determined for such an individual under title XIX of 
                the Social Security Act (42 U.S.C. 1396 et seq.).
            (5) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (6) State.--The term ``State'' has the meaning given that 
        term for purposes of title XIX of the Social Security Act (42 
        U.S.C. 1396 et seq.).
            (7) State medicaid plan.--The term ``State Medicaid plan'' 
        means a State plan under title XIX of the Social Security Act 
        (42 U.S.C. 1396 et seq.) (or a waiver of such plan).

SEC. 109. DELAY OF BIPARTISAN BUDGET ACT OF 2013 THIRD-PARTY LIABILITY 
              PROVISIONS.

    (a) In General.--Section 202(c) of the Bipartisan Budget Act of 
2013 (Public Law 113-67; 127 Stat. 1177; 42 U.S.C. 1396a note), as 
amended by section 211 of the Protecting Access to Medicare Act of 2014 
(Public Law 113-93; 128 Stat. 1047; 42 U.S.C. 1396a note) and section 
220 of the Medicare Access and CHIP Reauthorization Act of 2015 (Public 
Law 114-10), is amended by striking ``2017'' and inserting ``2019''.
    (b) Effective Date; Treatment.--The amendment made by subparagraph 
(A) shall take effect on September 30, 2017, and shall apply with 
respect to claims pending, generated, or filed after such date.

                             TITLE II--CHIP

SEC. 201. FIVE-YEAR FUNDING EXTENSION OF THE CHILDREN'S HEALTH 
              INSURANCE PROGRAM.

    (a) Appropriation; Total Allotment.--Section 2104(a) of the Social 
Security Act (42 U.S.C. 1397dd(a)) is amended--
            (1) in paragraph (19), by striking ``and'';
            (2) in paragraph (20), by striking the period at the end 
        and inserting a semicolon; and
            (3) by adding at the end the following new paragraphs:
            ``(21) for fiscal year 2018, $21,500,000,000;
            ``(22) for fiscal year 2019, $22,600,000,000;
            ``(23) for fiscal year 2020, $23,700,000,000;
            ``(24) for fiscal year 2021, $24,800,000,000; and
            ``(25) for fiscal year 2022, for purposes of making 2 semi-
        annual allotments--
                    ``(A) $2,850,000,000 for the period beginning on 
                October 1, 2021, and ending on March 31, 2022; and
                    ``(B) $2,850,000,000 for the period beginning on 
                April 1, 2022, and ending on September 30, 2022.''.
    (b) Allotments.--
            (1) In general.--Section 2104(m) of the Social Security Act 
        (42 U.S.C. 1397dd(m)) is amended--
                    (A) in paragraph (2)--
                            (i) in the heading, by striking ``through 
                        2016'' and inserting ``through 2022''; and
                            (ii) in subparagraph (B)--
                                    (I) in the matter preceding clause 
                                (i), by striking ``(19)'' and inserting 
                                ``(24)'';
                                    (II) in clause (ii), in the matter 
                                preceding subclause (I), by inserting 
                                ``(other than fiscal year 2022)'' after 
                                ``even-numbered fiscal year''; and
                                    (III) in clause (ii)(I), by 
                                inserting ``(or, in the case of fiscal 
                                year 2018, under paragraph (4))'' after 
                                ``clause (i)'';
                    (B) in paragraph (5)--
                            (i) by striking ``or (4)'' and inserting 
                        ``(4), or (10)''; and
                            (ii) by striking ``or 2017'' and inserting 
                        ``, 2017, or 2022'';
                    (C) in paragraph (7)--
                            (i) in subparagraph (A), by striking 
                        ``2017'' and inserting ``2022'';
                            (ii) in subparagraph (B), in the matter 
                        preceding clause (i), by inserting ``(or, in 
                        the case of fiscal year 2018, by not later than 
                        the date that is 60 days after the date of the 
                        enactment of the CHAMPION KIDS Act of 2017)'' 
                        after ``before the August 31 preceding the 
                        beginning of the fiscal year''; and
                            (iii) in the matter following subparagraph 
                        (B), by striking ``or fiscal year 2016'' and 
                        inserting ``fiscal year 2016, fiscal year 2018, 
                        fiscal year 2020, or fiscal year 2022'';
                    (D) in paragraph (9)--
                            (i) in the heading, by striking ``fiscal 
                        years 2015 and 2017'' and inserting ``certain 
                        fiscal years'';
                            (ii) by striking ``or (4)'' and inserting 
                        ``, (4), or (10)''; and
                            (iii) by striking ``or fiscal year 2017'' 
                        and inserting ``, 2017, or 2022''; and
                    (E) by adding at the end the following new 
                paragraph:
            ``(10) For fiscal year 2022.--
                    ``(A) First half.--Subject to paragraphs (5) and 
                (7), from the amount made available under subparagraph 
                (A) of paragraph (25) of subsection (a) for the semi-
                annual period described in such subparagraph, increased 
                by the amount of the appropriation for such period 
                under section 201(b)(3) of the CHAMPION KIDS Act of 
                2017, the Secretary shall compute a State allotment for 
                each State (including the District of Columbia and each 
                commonwealth and territory) for such semi-annual period 
                in an amount equal to the first half ratio (described 
                in subparagraph (D)) of the amount described in 
                subparagraph (C).
                    ``(B) Second half.--Subject to paragraphs (5) and 
                (7), from the amount made available under subparagraph 
                (B) of paragraph (25) of subsection (a) for the semi-
                annual period described in such subparagraph, the 
                Secretary shall compute a State allotment for each 
                State (including the District of Columbia and each 
                commonwealth and territory) for such semi-annual period 
                in an amount equal to the amount made available under 
                such subparagraph, multiplied by the ratio of--
                            ``(i) the amount of the allotment to such 
                        State under subparagraph (A), to
                            ``(ii) the total of the amount of all of 
                        the allotments made available under such 
                        subparagraph.
                    ``(C) Full year amount based on growth factor 
                updated amount.--The amount described in this 
                subparagraph for a State is equal to the sum of--
                            ``(i) the amount of the State allotment for 
                        fiscal year 2021 determined under paragraph 
                        (2)(B)(i); and
                            ``(ii) the amount of any payments made to 
                        the State under subsection (n) for fiscal year 
                        2021,
                multiplied by the allotment increase factor under 
                paragraph (6) for fiscal year 2022.
                    ``(D) First half ratio.--The first half ratio 
                described in this subparagraph is the ratio of--
                            ``(i) the sum of--
                                    ``(I) the amount made available 
                                under subsection (a)(25)(A); and
                                    ``(II) the amount of the 
                                appropriation for such period under 
                                section 201(b)(3) of the CHAMPION KIDS 
                                Act of 2017, to
                            ``(ii) the sum of--
                                    ``(I) the amount described in 
                                clause (i); and
                                    ``(II) the amount made available 
                                under subsection (a)(25)(B).''.
            (2) Technical amendment.--Section 2104(m)(2)(A) of such Act 
        (42 U.S.C. 1397dd(m)(2)(A)) is amended by striking ``the 
        allotment increase factor under paragraph (5)'' each place it 
        appears and inserting ``the allotment increase factor under 
        paragraph (6)''.
            (3) One-time appropriation for fiscal year 2022.--There is 
        appropriated to the Secretary of Health and Human Services, out 
        of any money in the Treasury not otherwise appropriated, 
        $20,200,000,000 to accompany the allotment made for the period 
        beginning on October 1, 2021, and ending on March 31, 2022, 
        under paragraph (25)(A) of section 2104(a) of the Social 
        Security Act (42 U.S.C. 1397dd(a)) (as added by subsection 
        (a)(3)), to remain available until expended. Such amount shall 
        be used to provide allotments to States under paragraph (10) of 
        section 2104(m) of such Act (as added by subsection (b)(1)(E)) 
        for the first 6 months of fiscal year 2022 in the same manner 
        as allotments are provided under subsection (a)(25)(A) of such 
        section 2104 and subject to the same terms and conditions as 
        apply to the allotments provided from such subsection 
        (a)(25)(A).
    (c) Extension of the Child Enrollment Contingency Fund.--Section 
2104(n) of the Social Security Act (42 U.S.C. 1397dd(n)) is amended--
            (1) in paragraph (2)--
                    (A) in subparagraph (A)(ii)--
                            (i) by striking ``2010, 2011, 2012, 2013, 
                        2014, and 2016'' and inserting ``2010 through 
                        2014, 2016, and 2018 through 2021''; and
                            (ii) by striking ``fiscal year 2015 and 
                        fiscal year 2017'' and inserting ``fiscal years 
                        2015, 2017, and 2022''; and
                    (B) in subparagraph (B)--
                            (i) by striking ``2010, 2011, 2012, 2013, 
                        2014, and 2016'' and inserting ``2010 through 
                        2014, 2016, and 2018 through 2021''; and
                            (ii) by striking ``fiscal year 2015 and 
                        fiscal year 2017'' and inserting ``fiscal year 
                        2015, 2017, and 2022''; and
            (2) in paragraph (3)(A), in the matter preceding clause 
        (i), by striking ``or a semi-annual allotment period for fiscal 
        year 2015 or 2017'' and inserting ``or in any of fiscal years 
        2018 through 2021 (or a semi-annual allotment period for fiscal 
        year 2015, 2017, or 2022)''.
    (d) Extension of Qualifying States Option.--Section 2105(g)(4) of 
the Social Security Act (42 U.S.C. 1397ee(g)(4)) is amended--
            (1) in the heading, by striking ``through 2017'' and 
        inserting ``through 2022''; and
            (2) in subparagraph (A), by striking ``2017'' and inserting 
        ``2022''.
    (e) Extension of Express Lane Eligibility Option.--Section 
1902(e)(13)(I) of the Social Security Act (42 U.S.C. 1396a(e)(13)(I)) 
is amended by striking ``2017'' and inserting ``2022''.
    (f) Assurance of Affordability Standard for Children and 
Families.--
            (1) In general.--Section 2105(d)(3) of the Social Security 
        Act (42 U.S.C. 1397ee(d)(3)) is amended--
                    (A) in the paragraph heading, by striking ``until 
                october 1, 2019'' and inserting ``through september 30, 
                2022''; and
                    (B) in subparagraph (A), in the matter preceding 
                clause (i)--
                            (i) by striking ``2019'' and inserting 
                        ``2022''; and
                            (ii) by striking ``The preceding sentence 
                        shall not be construed as preventing a State 
                        during such period'' and inserting ``During the 
                        period that begins on October 1, 2019, and ends 
                        on September 30, 2022, the preceding sentence 
                        shall only apply with respect to children in 
                        families whose income does not exceed 300 
                        percent of the poverty line (as defined in 
                        section 2110(c)(5)) applicable to a family of 
                        the size involved. The preceding sentences 
                        shall not be construed as preventing a State 
                        during any such periods''.
            (2) Conforming amendments.--Section 1902(gg)(2) of the 
        Social Security Act (42 U.S.C. 1396a(gg)(2)) is amended--
                    (A) in the paragraph heading, by striking ``until 
                october 1, 2019'' and inserting ``through september 30, 
                2022''; and
                    (B) by striking ``September 30, 2019,'' and 
                inserting ``September 30, 2022 (but during the period 
                that begins on October 1, 2019, and ends on September 
                30, 2022, only with respect to children in families 
                whose income does not exceed 300 percent of the poverty 
                line (as defined in section 2110(c)(5)) applicable to a 
                family of the size involved)''.

SEC. 202. EXTENSION OF CERTAIN PROGRAMS AND DEMONSTRATION PROJECTS.

    (a) Childhood Obesity Demonstration Project.--Section 1139A(e)(8) 
of the Social Security Act (42 U.S.C. 1320b-9a(e)(8)) is amended--
            (1) by striking ``and $10,000,000'' and inserting ``, 
        $10,000,000''; and
            (2) by inserting after ``2017'' the following: ``, and 
        $25,000,000 for the period of fiscal years 2018 through 2022''.
    (b) Pediatric Quality Measures Program.--Section 1139A(i) of the 
Social Security Act (42 U.S.C. 1320b-9a(i)) is amended--
            (1) by striking ``Out of any'' and inserting the following:
            ``(1) In general.--Out of any'';
            (2) by striking ``there is appropriated for each'' and 
        inserting ``there is appropriated--
                    ``(A) for each'';
            (3) by striking ``, and there is appropriated for the 
        period'' and inserting ``;
                    ``(B) for the period'';
            (4) by striking ``. Funds appropriated under this 
        subsection shall remain available until expended'' and 
        inserting ``; and''; and
            (5) by adding at the end the following:
                    ``(C) for the period of fiscal years 2018 through 
                2022, $75,000,000 for the purpose of carrying out this 
                section (other than subsections (e), (f), and (g)).
            ``(2) Availability.--Funds appropriated under this 
        subsection shall remain available until expended.''.

SEC. 203. EXTENSION OF OUTREACH AND ENROLLMENT PROGRAM.

    (a) Extension and Reauthorization.--Section 2113 of the Social 
Security Act (42 U.S.C. 1397mm) is amended--
            (1) in subsection (a)(1), by striking ``2017'' and 
        inserting ``2022''; and
            (2) in subsection (g)--
                    (A) by striking ``and $40,000,000'' and inserting 
                ``, $40,000,000''; and
                    (B) by inserting after ``2017'' the following: ``, 
                and $100,000,000 for the period of fiscal years 2018 
                through 2022''.
    (b) Making Organizations That Use Parent Mentors Eligible To 
Receive Grants.--Section 2113(f) of the Social Security Act (42 U.S.C. 
1397mm(f)) is amended--
            (1) in paragraph (1)(E), by striking ``or community-based 
        doula programs'' and inserting ``, community-based doula 
        programs, or parent mentors''; and
            (2) by adding at the end the following new paragraph:
            ``(5) Parent mentor.--The term `parent mentor' means an 
        individual who--
                    ``(A) is a parent or guardian of at least one child 
                who is an eligible child under this title or title XIX; 
                and
                    ``(B) is trained to assist families with children 
                who have no health insurance coverage with respect to 
                improving the social determinants of the health of such 
                children, including by providing--
                            ``(i) education about health insurance 
                        coverage, including, with respect to obtaining 
                        such coverage, eligibility criteria and 
                        application and renewal processes;
                            ``(ii) assistance with completing and 
                        submitting applications for health insurance 
                        coverage and renewal;
                            ``(iii) a liaison between families and 
                        representatives of State plans under title XIX 
                        or State child health plans under this title;
                            ``(iv) guidance on identifying medical and 
                        dental homes and community pharmacies for 
                        children; and
                            ``(v) assistance and referrals to 
                        successfully address social determinants of 
                        children's health, including poverty, food 
                        insufficiency, housing, and environmental 
                        hazards.''.
    (c) Exclusion From Modified Adjusted Gross Income.--Section 1902 of 
the Social Security Act (42 U.S.C. 1396a) is amended--
            (1) in subsection (a)(17), by striking ``(e)(14), (e)(14)'' 
        and inserting ``(e)(14), (e)(15)'';
            (2) in subsection (e), in the first paragraph (14), 
        relating to income determined using modified adjusted gross 
        income, by adding at the end the following new subparagraph:
                    ``(J) Exclusion of parent mentor compensation from 
                income determination.--Any nominal amount received by 
                an individual as compensation, including a stipend, for 
                participation as a parent mentor (as defined in 
                paragraph (5) of section 2113(f)) in an activity or 
                program funded through a grant under such section shall 
                be disregarded for purposes of determining the income 
                eligibility of such individual for medical assistance 
                under the State plan or any waiver of such plan.''; and
            (3) in subsection (e), by striking ``(14) Exclusion'' and 
        inserting ``(15) Exclusion''.

SEC. 204. EXTENSION OF ADDITIONAL FEDERAL FINANCIAL PARTICIPATION FOR 
              CHIP.

    Section 2105(b) of the Social Security Act (42 U.S.C. 1397ee(b)) is 
amended in the second sentence by inserting ``and during the period 
that begins on October 1, 2019, and ends on September 30, 2020, the 
enhanced FMAP determined for a State for a fiscal year (or for any 
portion of a fiscal year occurring during such period) shall be 
increased by 11.5 percentage points'' after ``23 percentage points,''.

                           TITLE III--OFFSET

SEC. 301. IMPLEMENTATION OF OFFICE OF INSPECTOR GENERAL RECOMMENDATION 
              TO DELAY CERTAIN MEDICARE PLAN PREPAYMENTS.

    (a) Medicare Advantage Payments.--Section 1853(a)(1) of the Social 
Security Act (42 U.S.C. 1395w-23(a)(1)) is amended--
            (1) in subparagraph (A), in the matter preceding clause 
        (i)--
                    (A) by striking ``subsections (e), (g), (i), and 
                (l)'' and inserting ``subparagraph (J), subsections 
                (e), (g), (i), and (l),''; and
                    (B) by inserting ``(or, for months beginning with 
                January 2019, on the date specified in subparagraph 
                (J))'' after ``in advance''; and
            (2) by adding at the end the following new subparagraph:
                    ``(J) Timing of payments.--
                            ``(i) In general.--With respect to monthly 
                        payments under this section for months in a 
                        year (beginning with 2019), the date specified 
                        in this subparagraph with respect to a payment 
                        for a month is the first business day occurring 
                        on or after the applicable date defined in 
                        clause (ii).
                            ``(ii) Applicable date.--For purposes of 
                        clause (i), with respect to a year (beginning 
                        with 2019), the term `applicable date' means, 
                        with respect to a payment for--
                                    ``(I) January of such year, January 
                                2nd;
                                    ``(II) February of such year, 
                                February 5th;
                                    ``(III) March of such year, March 
                                10th;
                                    ``(IV) April of such year, April 
                                15th;
                                    ``(V) May of such year, May 20th;
                                    ``(VI) June of such year, June 
                                25th;
                                    ``(VII) July and each succeeding 
                                month (other than December) of such 
                                year, the first day of the next month; 
                                and
                                    ``(VIII) December of such year, 
                                December 24th.''.
    (b) Conforming Amendment to Part D.--Section 1860D-15(d)(1) of the 
Social Security Act (42 U.S.C. 1395w-115(d)(1)) is amended by inserting 
``and shall be made consistent with the timing of monthly payments to 
MA organizations under section 1853(a)(1)(J)'' after ``as the Secretary 
determines''.
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