In the Senate of the United States, 

July 25, 2019. 

Resolved, That the bill from the House of Representatives (H.R. 3253) entitled ‘‘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.’’, do 

pass with the following 

AMENDMENT: 

Strike all after the enacting clause and insert the 

following: 

1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Sustaining Excellence 

3 in Medicaid Act of 2019’’. 

4 SEC. 2. EXTENSION OF THE COMMUNITY MENTAL HEALTH 

5 SERVICES DEMONSTRATION PROGRAM. 

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

7 Act of 2014 (42 U.S.C. 1396a note), as amended by Public 

8 Law 116–29, is amended by striking ‘‘July 14, 2019’’ and 

9 inserting ‘‘September 13, 2019’’. 
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1 SEC. 3. EXTENSION OF PROTECTION FOR MEDICAID RECIPI2 ENTS OF HOME AND COMMUNITY-BASED 

3 SERVICES AGAINST SPOUSAL IMPOVERISH4 MENT. 

5 (a) IN GENERAL.—Section 2404 of Public Law 111– 

6 148 (42 U.S.C. 1396r–5 note) is amended by striking ‘‘Sep7 tember 30, 2019’’ and inserting ‘‘December 31, 2019’’. 

8 (b) RULE OF CONSTRUCTION.—Nothing in section 

9 2404 of Public Law 111–148 (42 U.S.C. 1396r–5 note) or 

10 section 1902(a)(17) or 1924 of the Social Security Act (42 

11 U.S.C. 1396a(a)(17), 1396r–5) shall be construed as prohib12 iting a State from applying an income or resource dis13 regard under a methodology authorized under section 

14 1902(r)(2) of such Act (42 U.S.C. 1396a(r)(2))— 

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

16 described in section 1902(a)(10)(A)(ii)(VI) of such 

17 Act (42 U.S.C. 1396a(a)(10)(A)(ii)(VI)) (including a 

18 disregard of the income or resources of such individ19 ual’s spouse); or 

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

21 and community-based services authorized under sub22 section (c), (d), (i), or (k) of section 1915 of such Act 

23 (42 U.S.C. 1396n) or under section 1115 of such Act 

24 (42 U.S.C. 1315). 
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1 SEC. 4. EXTENSION OF MONEY FOLLOWS THE PERSON RE2 BALANCING DEMONSTRATION. 

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

4 2005 (42 U.S.C. 1396a note) is amended by striking 

5 ‘‘$132,000,000’’ and inserting ‘‘$254,500,000’’. 

6 SEC. 5. EXTENSION FOR FAMILY-TO-FAMILY HEALTH INFOR7 MATION CENTERS. 

8 Section 501(c) of the Social Security Act (42 U.S.C. 

9 701(c)) is amended— 

10 (1) in paragraph (1)(A)(vii), by striking ‘‘and 

11 2019’’ and inserting ‘‘through 2024’’; and 

12 (2) in paragraph (3)(C), by striking ‘‘fiscal 

13 years 2018 and 2019’’ and inserting ‘‘fiscal year 2018 

14 and each fiscal year thereafter’’. 

15 SEC. 6. REDUCED WHOLESALE ACQUISITION COST (WAC)- 

16 BASED PAYMENTS FOR NEW DRUGS AND 

17 BIOLOGICALS. 

18 Section 1847A(c)(4) of the Social Security Act (42 

19 U.S.C. 1395w–3a(c)(4)) is amended by striking ‘‘payable 

20 under this section for the drug or biological based on—’’ 

21 and all that follows through the period at the end and in22 serting the following: ‘‘payable under this section— 

23 ‘‘(A) in the case of a drug or biological fur24 nished prior to January 1, 2019, based on— 

25 ‘‘(i) the wholesale acquisition cost; or 
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1 ‘‘(ii) the methodologies in effect under 

2 this part on November 1, 2003, to determine 

3 payment amounts for drugs or biologicals; 

4 and 

5 ‘‘(B) in the case of a drug or biological fur6 nished on or after January 1, 2019— 

7 ‘‘(i) at an amount not to exceed 103 

8 percent of the wholesale acquisition cost; or 

9 ‘‘(ii) based on the methodologies in ef10 fect under this part on November 1, 2003, 

11 to determine payment amounts for drugs or 

12 biologicals.’’. 

Attest: 

Secretary. 

116TH CONGRESS 

1ST SESSION H.R. 3253 

AMENDMENT