I 

116TH CONGRESS 

1ST SESSION H. R. 3695 

To amend titles XI and XIX of the Social Security Act to promote program 

integrity with respect to the enrollment of certain immigrants in State 

plans under Medicaid, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 11, 2019 

Mr. FLORES (for himself, Mr. GUTHRIE, and Mr. MULLIN) introduced the 

following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend titles XI and XIX of the Social Security Act 

to promote program integrity with respect to the enrollment of certain immigrants in State plans under Medicaid, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Verify Eligibility Cov5 erage Act’’. 


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1 SEC. 2. PROMOTING PROGRAM INTEGRITY IN ENROLLING 

2 CERTAIN IMMIGRANTS UNDER MEDICAID. 

3 (a) IN GENERAL.—Section 1137(f) of the Social Se4 curity Act (42 U.S.C. 1320b–7(f)) is amended— 

5 (1) by striking ‘‘Subsections (a)(1) and (d)’’ 

6 and inserting ‘‘(1) Subsections (a)(1) and (d)’’; and 

7 (2) by adding at the end the following new 

8 paragraph: 

9 ‘‘(2)(A) Subparagraphs (A) and (B)(ii) of sub10 section (d)(4) shall not apply in the case of an initial 

11 determination made on or after the date that is 6 

12 months after the date of the enactment of this para13 graph with respect to the eligibility of an alien de14 scribed in subparagraph (B) for benefits under the 

15 program listed in subsection (b)(2). 

16 ‘‘(B) An alien described in this subparagraph is 

17 an individual declaring to be a citizen or national of 

18 the United States with respect to whom a State, in 

19 accordance with section 1902(a)(46)(B), requires— 

20 ‘‘(i) pursuant to section 1902(ee), the sub21 mission of a social security number; or 

22 ‘‘(ii) pursuant to section 1903(x), the pres23 entation of satisfactory documentary evidence of 

24 citizenship or nationality.’’. 

25 (b) NO PAYMENTS FOR MEDICAL ASSISTANCE PRO26 VIDED BEFORE PRESENTATION OF EVIDENCE.—Section 


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1 1903(i)(22) of the Social Security Act (42 U.S.C. 

2 1396b(i)(22)) is amended— 

3 (1) by striking ‘‘with respect to amounts ex4 pended’’ and inserting ‘‘(A) with respect to amounts 

5 expended’’; 

6 (2) by inserting ‘‘and’’ at the end; and 

7 (3) by adding at the end the following new sub8 paragraph: 

9 ‘‘(B) in the case of a State that elects to pro10 vide a reasonable period to present satisfactory doc11 umentary evidence of such citizenship or nationality 

12 pursuant to paragraph (2)(C) of section 1902(ee) or 

13 paragraph (4) of subsection (x) of this section, for 

14 amounts expended for medical assistance for such an 

15 individual (other than an individual described in 

16 paragraph (2) of such subsection (x)) during such 

17 period;’’. 

18 (c) CONFORMING AMENDMENTS.—Section 

19 1137(d)(4) of the Social Security Act (42 U.S.C. 1320b– 

20 7(d)(4)) is amended— 

21 (1) in subparagraph (A), in the matter pre22 ceding clause (i), by inserting ‘‘subject to subsection 

23 (f)(2),’’ before ‘‘the State’’; and 


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1 (2) in subparagraph (B)(ii), by inserting ‘‘sub2 ject to subsection (f)(2),’’ before ‘‘pending such 

3 verification’’. 

4 SEC. 3. MEDICAID IMPROVEMENT FUND. 

5 Section 1941 of the Social Security Act (42 U.S.C. 

6 1396w–1(b)) is amended to read as follows: 

7 ‘‘SEC. 1941. MEDICAID IMPROVEMENT FUND. 

8 ‘‘(a) IN GENERAL.—The Secretary shall establish, 

9 and administer, under this title a Medicaid Improvement 

10 Fund (in this section referred to as the ‘Fund’) which 

11 shall be available to the Secretary for the following pur12 poses: 

13 ‘‘(1) To improve the management of the Med14 icaid program by the Centers for Medicare & Med15 icaid Services, including oversight of contracts and 

16 contractors and evaluation of demonstration 

17 projects. 

18 ‘‘(2) To improve access to care for the most 

19 vulnerable individuals eligible to receive medical as20 sistance under the State plan under this title (or a 

21 waiver of such plan), including by carrying out sec22 tion 4 of the Verify Eligibility Coverage Act (relating 

23 to reducing waiting lists for medical assistance for 

24 home and community-based services under a State 


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1 plan waiver under subsection (c), (d), or (i) of sec2 tion 1915 or section 1115). 

3 ‘‘(b) SUPPLEMENT, NOT SUPPLANT.—Payments 

4 made for activities under this section shall be in addition 

5 to payments that would otherwise be made for activities 

6 described in subsection (a). 

7 ‘‘(c) FUNDING.— 

8 ‘‘(1) IN GENERAL.— 

9 ‘‘(A) MANAGEMENT IMPROVEMENTS.— 

10 There shall be available to the Fund, for the 

11 purposes described in subsection (a)(1), for ex12 penditures from the Fund for fiscal year 2021 

13 and thereafter, $5,000,000. 

14 ‘‘(B) INCREASING ACCESS.—There shall be 

15 available to the Fund, for the purposes de16 scribed in subsection (a)(2), for expenditures 

17 from the Fund for fiscal year 2020 and there18 after, $1,095,000,000. 

19 ‘‘(2) FUNDING LIMITATION.—Amounts in the 

20 Fund shall be available in advance of appropriations 

21 but only if the total amount obligated from the 

22 Fund does not exceed the amount available to the 

23 Fund under subparagraphs (A) and (B) of para24 graph (1). The Secretary may obligate funds from 

25 the Fund only if the Secretary determines (and the 


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1 Chief Actuary of the Centers for Medicare & Med2 icaid Services and the appropriate budget officer cer3 tify) that there are available in the Fund sufficient 

4 amounts to cover all such obligations incurred con5 sistent with the previous sentence.’’. 

6 SEC. 4. PROVIDING CARE FOR THE MOST VULNERABLE PA7 TIENTS ON WAITING LISTS. 

8 (a) IN GENERAL.—Subject to subsection (d), the Sec9 retary of Health and Human Services shall provide, for 

10 each of fiscal years 2020 through 2028, payment to eligi11 ble States selected under subsection (c) to provide for 

12 medical assistance for home and community-based services 

13 under a State plan waiver under subsection (c), (d), or 

14 (i) of section 1915 of the Social Security Act (42 U.S.C. 

15 1396n) or section 1115 of the Social Security Act (42 

16 U.S.C. 1315) to individuals who are eligible but, as of 

17 January 1, 2019, are on a waiting list for such services 

18 through such waiver. 

19 (b) STATE ELIGIBILITY.—A State is eligible for a 

20 payment under this section if the State submits an appli21 cation to the Secretary at such time, in such form and 

22 manner, and containing such information, provisions, and 

23 assurances, as specified by the Secretary. 

24 (c) SELECTION.—Subject to subsection (d), the Sec25 retary shall, for each of fiscal years 2020 through 2028, 


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1 select, on a competitive basis, from among eligible States, 

2 the States that will receive payment under this section. 

3 In making such selections, the Secretary shall give priority 

4 to— 

5 (1) States with the highest number of individ6 uals on a waiting list described in subsection (a); 

7 (2) States with the highest average or highest 

8 median periods individuals have been on such a list; 

9 and 

10 (3) States with individuals on such a list who 

11 have the lowest income levels, as compared to the in12 come of individuals on such a list of other eligible 

13 States. 

14 (d) FUNDING.— 

15 (1) FUNDS ALLOCATED TO STATES.—Of the 

16 funds available for purposes of carrying out this sec17 tion under section 1941(c) of the Social Security Act 

18 (42 U.S.C. 1396w–1(c)), the Secretary shall allocate 

19 such funds to States selected under subsection (c) 

20 on the basis of criteria, including a State’s applica21 tion submitted under subsection (b), the availability 

22 of funds under such section 1941(c), and criteria 

23 specified under subsection (c), as determined by the 

24 Secretary. 


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1 (2) PAYMENTS TO STATES.—For each calendar 

2 quarter beginning on or after October 1, 2019, the 

3 Secretary shall pay to each State selected under sub4 section (c), from the allocation made to the State 

5 under paragraph (1), an amount equal to 90 percent 

6 of the Federal medical assistance percentage of the 

7 amount expended during such quarter for the med8 ical assistance described in subsection (a). 

9 (e) DEFINITIONS.—In this section: 

10 (1) FEDERAL MEDICAL ASSISTANCE PERCENT11 AGE.—The term ‘‘Federal medical assistance per12 centage’’ has the meaning given such term in section 

13 1905(b) of the Social Security Act (42 U.S.C. 

14 1396d(b)). 

15 (2) MEDICAL ASSISTANCE.—The term ‘‘medical 

16 assistance’’ has the meaning given such term in sec17 tion 1905(a) of the Social Security Act (42 U.S.C. 

18 1396d(a)). 

19 (3) STATE.—The term ‘‘State’’ has the mean20 ing given such term for purposes of title XIX of the 

21 Social Security Act (42 U.S.C. 1396 et seq.). 

Æ 


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