H. R. 3253 

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 provide for certain extensions with respect to the Medicaid program under 

title XIX of the Social Security Act, 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 ‘‘Sustaining Excellence in Medicaid 

Act of 2019’’. 

SEC. 2. EXTENSION OF THE COMMUNITY MENTAL HEALTH SERVICES 

DEMONSTRATION PROGRAM. 

Section 223(d)(3) of the Protecting Access to Medicare Act of 

2014 (42 U.S.C. 1396a note), as amended by Public Law 116– 

29, is amended by striking ‘‘July 14, 2019’’ and inserting ‘‘September 

13, 2019’’. 

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 ‘‘September 30, 2019’’ 

and inserting ‘‘December 31, 2019’’. 

(b) RULE OF CONSTRUCTION.—Nothing in section 2404 of Public 

Law 111–148 (42 U.S.C. 1396r–5 note) or section 1902(a)(17) or 

1924 of the Social Security Act (42 U.S.C. 1396a(a)(17), 1396r– 

5) shall be construed as prohibiting a State from applying an 

income or resource disregard under a methodology authorized under 

section 1902(r)(2) of such Act (42 U.S.C. 1396a(r)(2))— 

(1) to the income or resources of an individual described 

in section 1902(a)(10)(A)(ii)(VI) of such Act (42 U.S.C. 

1396a(a)(10)(A)(ii)(VI)) (including a disregard of the income or 

resources of such individual’s spouse); or 

(2) on the basis of an individual’s need for home and 

community-based services authorized under subsection (c), (d), 

(i), or (k) of section 1915 of such Act (42 U.S.C. 1396n) or 

under section 1115 of such Act (42 U.S.C. 1315). 

SEC. 4. EXTENSION OF MONEY FOLLOWS THE PERSON REBALANCING 

DEMONSTRATION. 

Section 6071(h)(1)(F) of the Deficit Reduction Act of 2005 (42 

U.S.C. 1396a note) is amended by striking ‘‘$132,000,000’’ and 

inserting ‘‘$254,500,000’’. 
H. R. 3253—2 

SEC. 5. 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)(vii), by striking ‘‘and 2019’’ and 

inserting ‘‘through 2024’’; and 

(2) in paragraph (3)(C), by striking ‘‘fiscal years 2018 and 

2019’’ and inserting ‘‘fiscal year 2018 and each fiscal year 

thereafter’’. 

SEC. 6. REDUCED WHOLESALE ACQUISITION COST (WAC)-BASED PAYMENTS FOR NEW DRUGS AND BIOLOGICALS. 

Section 1847A(c)(4) of the Social Security Act (42 U.S.C. 1395w– 

3a(c)(4)) is amended by striking ‘‘payable under this section for 

the drug or biological based on—’’ and all that follows through 

the period at the end and inserting the following: ‘‘payable under 

this section— 

‘‘(A) in the case of a drug or biological furnished prior 

to January 1, 2019, based on— 

‘‘(i) the wholesale acquisition cost; or 

‘‘(ii) the methodologies in effect under this part 

on November 1, 2003, to determine payment amounts 

for drugs or biologicals; and 

‘‘(B) in the case of a drug or biological furnished on 

or after January 1, 2019— 

‘‘(i) at an amount not to exceed 103 percent of 

the wholesale acquisition cost; or 

‘‘(ii) based on the methodologies in effect under 

this part on November 1, 2003, to determine payment 

amounts for drugs or biologicals.’’. 

Speaker of the House of Representatives. 

Vice President of the United States and

President of the Senate.