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[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 259 Enrolled Bill (ENR)]

        H.R.259

                     One Hundred Sixteenth Congress

                                 of the

                        United States of America

                          AT THE FIRST SESSION

          Begun and held at the City of Washington on Thursday,
           the third day of January, two thousand and nineteen

                                 An Act

 
      To extend the Medicaid Money Follows the Person Rebalancing 
demonstration, to extend protection for Medicaid recipients of home and 
 community-based services against spousal impoverishment, 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 ``Medicaid Extenders Act of 2019''.
SEC. 2. EXTENSION OF MONEY FOLLOWS THE PERSON REBALANCING 
DEMONSTRATION.
    (a) General Funding.--Section 6071(h) of the Deficit Reduction Act 
of 2005 (42 U.S.C. 1396a note) is amended--
        (1) in paragraph (1)--
            (A) in subparagraph (D), by striking ``and'' after the 
        semicolon;
            (B) in subparagraph (E), by striking the period at the end 
        and inserting ``; and''; and
            (C) by adding at the end the following:
            ``(F) subject to paragraph (3), $112,000,000 for fiscal 
        year 2019.'';
        (2) in paragraph (2)--
            (A) by striking ``Amounts made'' and inserting ``Subject to 
        paragraph (3), amounts made''; and
            (B) by striking ``September 30, 2016'' and inserting 
        ``September 30, 2021''; and
        (3) by adding at the end the following new paragraph:
        ``(3) Special rule for fy 2019.--Funds appropriated under 
    paragraph (1)(F) shall be made available for grants to States only 
    if such States have an approved MFP demonstration project under 
    this section as of December 31, 2018.''.
    (b) Funding for Quality Assurance and Improvement; Technical 
Assistance; Oversight.--Section 6071(f) of the Deficit Reduction Act of 
2005 (42 U.S.C. 1396a note) is amended by striking paragraph (2) and 
inserting the following:
        ``(2) Funding.--From the amounts appropriated under subsection 
    (h)(1)(F) for fiscal year 2019, $500,000 shall be available to the 
    Secretary for such fiscal year to carry out this subsection.''.
    (c) Technical Amendment.--Section 6071(b) of the Deficit Reduction 
Act of 2005 (42 U.S.C. 1396a note) is amended by adding at the end the 
following:
        ``(10) Secretary.--The term `Secretary' means the Secretary of 
    Health and Human Services.''.
SEC. 3. EXTENSION OF PROTECTION FOR MEDICAID RECIPIENTS OF HOME AND 
COMMUNITY-BASED SERVICES AGAINST SPOUSAL IMPOVERISHMENT.
    (a) In General.--Section 2404 of Public Law 111-148 (42 U.S.C. 
1396r-5 note) is amended by striking ``the 5-year period that begins on 
January 1, 2014,'' and inserting ``the period beginning on January 1, 
2014, and ending on March 31, 2019,''.
    (b) Rule of Construction.--
        (1) Protecting state spousal income and asset disregard 
    flexibility under waivers and plan amendments.--Nothing in section 
    2404 of Public Law 111-148 (42 U.S.C. 1396r-5 note) or section 1924 
    of the Social Security Act (42 U.S.C. 1396r-5) shall be construed 
    as prohibiting a State from disregarding an individual's spousal 
    income and assets under a State waiver or plan amendment described 
    in paragraph (2) for purposes of making determinations of 
    eligibility for home and community-based services or home and 
    community-based attendant services and supports under such waiver 
    or plan amendment.
        (2) State waiver or plan amendment described.--A State waiver 
    or plan amendment described in this paragraph is any of the 
    following:
            (A) A waiver or plan amendment to provide medical 
        assistance for home and community-based services under a waiver 
        or plan amendment under subsection (c), (d), or (i) of section 
        1915 of the Social Security Act (42 U.S.C. 1396n) or under 
        section 1115 of such Act (42 U.S.C. 1315).
            (B) A plan amendment to provide medical assistance for home 
        and community-based services for individuals by reason of being 
        determined eligible under section 1902(a)(10)(C) of such Act 
        (42 U.S.C. 1396a(a)(10)(C)) or by reason of section 1902(f) of 
        such Act (42 U.S.C. 1396a(f)) or otherwise on the basis of a 
        reduction of income based on costs incurred for medical or 
        other remedial care under which the State disregarded the 
        income and assets of the individual's spouse in determining the 
        initial and ongoing financial eligibility of an individual for 
        such services in place of the spousal impoverishment provisions 
        applied under section 1924 of such Act (42 U.S.C. 1396r-5).
            (C) A plan amendment to provide medical assistance for home 
        and community-based attendant services and supports under 
        section 1915(k) of such Act (42 U.S.C. 1396n(k)).
SEC. 4. REDUCTION IN FMAP AFTER 2020 FOR STATES WITHOUT ASSET 
VERIFICATION PROGRAM.
    Section 1940 of the Social Security Act (42 U.S.C. 1396w) is 
amended by adding at the end the following new subsection:
    ``(k) Reduction in FMAP After 2020 for Non-Compliant States.--
        ``(1) In general.--With respect to a calendar quarter beginning 
    on or after January 1, 2021, the Federal medical assistance 
    percentage otherwise determined under section 1905(b) for a non-
    compliant State shall be reduced--
            ``(A) for calendar quarters in 2021 and 2022, by 0.12 
        percentage points;
            ``(B) for calendar quarters in 2023, by 0.25 percentage 
        points;
            ``(C) for calendar quarters in 2024, by 0.35 percentage 
        points; and
            ``(D) for calendar quarters in 2025 and each year 
        thereafter, by 0.5 percentage points.
        ``(2) Non-compliant state defined.--For purposes of this 
    subsection, the term `non-compliant State' means a State--
            ``(A) that is one of the 50 States or the District of 
        Columbia;
            ``(B) with respect to which the Secretary has not approved 
        a State plan amendment submitted under subsection (a)(2); and
            ``(C) that is not operating, on an ongoing basis, an asset 
        verification program in accordance with this section.''.
SEC. 5. MEDICAID IMPROVEMENT FUND.
    Section 1941(b)(1) of the Social Security Act (42 U.S.C. 1396w-
1(b)(1)) is amended by striking ``$31,000,000'' and inserting 
``$6,000,000''.

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.
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