IB 

Union Calendar No. 373 

110TH CONGRESS 

2D SESSION H. R. 5613 

[Report No. 110–600] 

To extend certain moratoria and impose additional moratoria on certain 

Medicaid regulations through April 1, 2009. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 13, 2008 

Mr. DINGELL (for himself and Mr. TIM MURPHY of Pennsylvania) introduced 

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

Commerce 

APRIL 22, 2008 

Additional sponsors: Mr. PALLONE, Mr. ALLEN, Ms. SCHAKOWSKY, Mr. 

ENGEL, Mr. KING of New York, Mr. WAXMAN, Mr. TOWNS, Mr. BOUCHER, Mr. ROSS, Ms. ESHOO, Mr. GORDON of Tennessee, Mrs. MALONEY

of New York, Mr. HARE, Ms. SUTTON, Mr. MCDERMOTT, Mr. BOSWELL, 

Mr. MARKEY, Mr. GOODE, Mr. HOLT, Mr. HOEKSTRA, Ms. BERKLEY, 

Mr. MCNULTY, Mr. BRALEY of Iowa, Mr. FARR, Mrs. CAPPS, Mr. GENE

GREEN of Texas, Mr. REYES, Mr. RUPPERSBERGER, Mr. SARBANES, Mr. 

INSLEE, Ms. HARMAN, Mr. FERGUSON, Mr. CAPUANO, Mr. WELCH of 

Vermont, Mr. DOYLE, Mr. CUMMINGS, Ms. MATSUI, Mr. WU, Mr. STARK, 

Ms. DEGETTE, Mr. MARSHALL, Ms. SOLIS, Ms. CASTOR, Mr. 

RODRIGUEZ, Mr. JOHNSON of Georgia, Mr. VAN HOLLEN, Mr. FRANK

of Massachusetts, Mr. ABERCROMBIE, Mr. KILDEE, Mr. DELAHUNT, Mr. 

ALTMIRE, Mr. KAGEN, Mr. STUPAK, Mr. TIERNEY, Mr. CARDOZA, Mr. 

WYNN, Mr. NEAL of Massachusetts, Ms. ROYBAL-ALLARD, Ms. BALDWIN, Ms. MCCOLLUM of Minnesota, Ms. CLARKE, Ms. EDDIE BERNICE

JOHNSON of Texas, Mr. OLVER, Mr. MCGOVERN, Mr. SPRATT, Mr. 

DAVIS of Alabama, Mr. MCCOTTER, Mr. PRICE of North Carolina, Mr. 

ISRAEL, Mr. MILLER of North Carolina, Mr. FATTAH, Ms. MOORE of 

Wisconsin, Mr. PASCRELL, Ms. KAPTUR, Mr. SAM JOHNSON of Texas, 

Mr. MEEKS of New York, Mrs. WILSON of New Mexico, Ms. WOOLSEY, 

Ms. DELAURO, Mrs. MCCARTHY of New York, Mr. SCOTT of Virginia, 

Ms. RICHARDSON, Mr. HALL of New York, Mr. BISHOP of Georgia, Mr. 

WEXLER, Mr. LANGEVIN, Mr. PASTOR, Mr. MORAN of Kansas, Mr. 


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HONDA, Mr. LEWIS of Georgia, Mr. GEORGE MILLER of California, Mr. 

RANGEL, Mr. GONZALEZ, Mr. PERLMUTTER, Mr. GRIJALVA, Mr. BECERRA, Ms. LEE, Mr. UDALL of New Mexico, Mr. WALSH of New York, Mr. 

WALZ of Minnesota, Mr. LYNCH, Mr. LOEBSACK, Ms. VELA ́ZQUEZ, Ms. 

LINDA T. SA ́NCHEZ of California, Mr. HINCHEY, Mr. ELLISON, Mr. 

CLAY, Mr. THOMPSON of California, Mr. KENNEDY, Mr. NADLER, Mr. 

FILNER, Mrs. LOWEY, Mr. ACKERMAN, Mr. PLATTS, Mr. OBERSTAR, Ms. 

NORTON, Mr. CROWLEY, Mrs. GILLIBRAND, Mr. MICHAUD, Ms. HOOLEY, 

Mr. HIGGINS, Mr. SERRANO, Mr. BERMAN, Mrs. DAVIS of California, Mr. 

HAYES, Mr. GERLACH, Mrs. TAUSCHER, Mr. RAMSTAD, Ms. GIFFORDS, 

Mr. DENT, Mr. AL GREEN of Texas, Mr. RAHALL, Mr. MCHUGH, Mr. 

MATHESON, Mr. SCOTT of Georgia, Ms. TSONGAS, Mr. ARCURI, Mr. 

KUHL of New York, Mr. SKELTON, Ms. SLAUGHTER, Mr. MCNERNEY, 

Mr. THOMPSON of Mississippi, Mr. YARMUTH, Mr. DAVIS of Illinois, Ms. 

ZOE LOFGREN of California, Mr. SHERMAN, Mr. BISHOP of New York, 

Mrs. NAPOLITANO, Mr. CHANDLER, Ms. SCHWARTZ, Ms. PRYCE of Ohio, 

Mr. PAYNE, Mr. ENGLISH of Pennsylvania, Mr. YOUNG of Alaska, Mr. 

BARROW, Mr. HODES, Mr. DOGGETT, Mr. MURPHY of Connecticut, Mr. 

MORAN of Virginia, Mrs. DRAKE, Mr. LATOURETTE, Mr. SHAYS, Ms. 

WATERS, Mr. GUTIERREZ, Mr. BILIRAKIS, Mr. SESTAK, Mr. WEINER, 

Mr. UDALL of Colorado, Mr. ALEXANDER, Mr. SIRES, Mr. REYNOLDS, 

Mr. DICKS, Mr. TIBERI, Ms. WASSERMAN SCHULTZ, Mr. SNYDER, Mr. 

FOSSELLA, Mr. BUTTERFIELD, Mr. EDWARDS, Mr. TERRY, Ms. LORETTA SANCHEZ of California, Mr. LOBIONDO, Mr. BRADY of Pennsylvania, 

Mr. KLEIN of Florida, Mr. LINCOLN DIAZ-BALART of Florida, Mr. 

MELANCON, Mr. RUSH, Mr. COHEN, Mr. BACA, Mr. HINOJOSA, Mr. 

COURTNEY, Mr. RYAN of Ohio, Mr. KUCINICH, Mr. LIPINSKI, Mr. 

LARSON of Connecticut, Mr. RENZI, Mr. CARNEY, Mrs. BONO MACK, Mr. 

COSTELLO, Mr. COSTA, Mr. ORTIZ, Mr. SCHIFF, Ms. WATSON, Mrs. 

EMERSON, and Mr. HOBSON

APRIL 22, 2008 

Reported with amendments, committed to the Committee of the Whole House 

on the State of the Union, and ordered to be printed 

[Strike out all after the enacting clause and insert the part printed in italic] 

[For text of the introduced bill, see bill as introduced on March 13, 2008] 

A BILL 

To extend certain moratoria and impose additional moratoria 

on certain Medicaid regulations through April 1, 2009. 

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


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Protecting the Medicaid 

3 Safety Net Act of 2008’’. 

4 SEC. 2. MORATORIA ON CERTAIN MEDICAID REGULATIONS. 

5 (a) EXTENSION OF CERTAIN MORATORIA IN PUBLIC

6 LAW 110–28.—Section 7002(a)(1) of the U.S. Troop Readi7 ness, Veterans’ Care, Katrina Recovery, and Iraq Account8 ability Appropriations Act, 2007 (Public Law 110–28) is 

9 amended— 

10 (1) by striking ‘‘prior to the date that is 1 year 

11 after the date of enactment of this Act’’ and inserting 

12 ‘‘prior to April 1, 2009’’; 

13 (2) in subparagraph (A), by inserting after 

14 ‘‘Federal Regulations)’’ the following: ‘‘or in the final 

15 regulation, relating to such parts, published on May 

16 29, 2007 (72 Federal Register 29748)’’; and 

17 (3) in subparagraph (C), by inserting before the 

18 period at the end the following: ‘‘, including the pro19 posed regulation published on May 23, 2007 (72 Fed20 eral Register 28930)’’. 

21 (b) EXTENSION OF CERTAIN MORATORIA IN PUBLIC

22 LAW 110–173.—Section 206 of the Medicare, Medicaid, and 

23 SCHIP Extension Act of 2007 (Public Law 110–173) is 

24 amended— 

25 (1) by striking ‘‘June 30, 2008’’ and inserting 

26 ‘‘April 1, 2009’’; 


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1 (2) by inserting ‘‘, including the proposed regu2 lation published on August 13, 2007 (72 Federal Reg3 ister 45201),’’ after ‘‘rehabilitation services’’; and 

4 (3) by inserting ‘‘, including the final regulation 

5 published on December 28, 2007 (72 Federal Register 

6 73635),’’ after ‘‘school-based transportation’’. 

7 (c) ADDITIONAL MORATORIA.— 

8 (1) IN GENERAL.—Notwithstanding any other 

9 provision of law, the Secretary of Health and Human 

10 Services shall not, prior to April 1, 2009, take any 

11 action (through promulgation of regulation, issuance 

12 of regulatory guidance, use of Federal payment audit 

13 procedures, or other administrative action, policy, or 

14 practice, including a Medical Assistance Manual 

15 transmittal or letter to State Medicaid directors) to 

16 impose any restrictions relating to a provision de17 scribed in subparagraph (A), (B), or (C) of para18 graph (2) if such restrictions are more restrictive in 

19 any aspect than those applied to the respective provi20 sion as of the date specified in paragraph (3) for such 

21 provision. 

22 (2) PROVISIONS DESCRIBED.— 

23 (A) PORTION OF INTERIM FINAL REGULA24 TION RELATING TO MEDICAID TREATMENT OF OP25 TIONAL CASE MANAGEMENT SERVICES.— 


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1 (i) IN GENERAL.—Subject to clause 

2 (ii), the provision described in this subpara3 graph is the interim final regulation relat4 ing to optional State plan case management 

5 services under the Medicaid program pub6 lished on December 4, 2007 (72 Federal 

7 Register 68077) in its entirety. 

8 (ii) EXCEPTION.—The provision de9 scribed in this subparagraph does not in10 clude the portion of such regulation as re11 lates directly to implementing section 

12 1915(g)(2)(A)(ii) of the Social Security Act, 

13 as amended by section 6052 of the Deficit 

14 Reduction Act of 2005 (Public Law 109– 

15 171), through the definition of case manage16 ment services and targeted case manage17 ment services contained in proposed section 

18 440.169 of title 42, Code of Federal Regula19 tions, but only to the extent that such por20 tion is not more restrictive than the policies 

21 set forth in the Dear State Medicaid Direc22 tor letter on case management issued on 

23 January 19, 2001 (SMDL #01–013), and 

24 with respect to community transition case 

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1 rector letter issued on July 25, 2000 

2 (Olmstead Update 3). 

3 (B) PROPOSED REGULATION RELATING TO

4 REDEFINITION OF MEDICAID OUTPATIENT HOS5 PITAL SERVICES.—The provision described in 

6 this subparagraph is the proposed regulation re7 lating to clarification of outpatient clinic and 

8 hospital facility services definition and upper 

9 payment limit under the Medicaid program pub10 lished on September 28, 2007 (72 Federal Reg11 ister 55158) in its entirety. 

12 (C) PORTION OF PROPOSED REGULATION

13 RELATING TO MEDICAID ALLOWABLE PROVIDER

14 TAXES.— 

15 (i) IN GENERAL.—Subject to clause 

16 (ii), the provision described in this subpara17 graph is the final regulation relating to 

18 health-care-related taxes under the Medicaid 

19 program published on February 22, 2008 

20 (73 Federal Register 9685) in its entirety. 

21 (ii) EXCEPTION.—The provision de22 scribed in this subparagraph does not in23 clude the portions of such regulation as re24 late to the following: 


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1 (I) REDUCTION IN THRESHOLD.— 

2 The reduction from 6 percent to 5.5 

3 percent in the threshold applied under 

4 section 433.68(f)(3)(i) of title 42, Code 

5 of Federal Regulations, for determining 

6 whether or not there is an indirect 

7 guarantee to hold a taxpayer harmless, 

8 as required to carry out section 

9 1903(w)(4)(C)(ii) of the Social Secu10 rity Act, as added by section 403 of the 

11 Medicare Improvement and Extension 

12 Act of 2006 (division B of Public Law 

13 109–432). 

14 (II) CHANGE IN DEFINITION OF

15 MANAGED CARE.—The change in the 

16 definition of managed care as proposed 

17 in the revision of section 433.56(a)(8) 

18 of title 42, Code of Federal Regula19 tions, as required to carry out section 

20 1903(w)(7)(A)(viii) of the Social Secu21 rity Act, as amended by section 6051 

22 of the Deficit Reduction Act of 2005 

23 (Public Law 109–171). 

24 (3) DATE SPECIFIED.—The date specified in this 

25 paragraph for the provision described in— 


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1 (A) subparagraph (A) of paragraph (2) is 

2 December 3, 2007; 

3 (B) subparagraph (B) of such paragraph is 

4 September 27, 2007; or 

5 (C) subparagraph (C) of such paragraph is 

6 February 21, 2008. 

7 SEC. 3. FUNDS TO REDUCE MEDICAID FRAUD AND ABUSE. 

8 (a) IN GENERAL.—For purposes of reducing fraud and 

9 abuse in the Medicaid program under title XIX of the So10 cial Security Act, there is appropriated to the Secretary 

11 of Health and Human Services, out of any money in the 

12 Treasury not otherwise appropriated, $25,000,000, for each 

13 fiscal year (beginning with fiscal year 2009). Amounts ap14 propriated under this section shall remain available for ex15 penditure until expended and shall be in addition to any 

16 other amounts appropriated or made available to the Sec17 retary for such purposes with respect to the Medicaid pro18 gram. 

19 (b) ANNUAL REPORT.—Not later than September 30 

20 of 2009 and of each subsequent year, the Secretary of Health 

21 and Human Services shall submit to the Committee on En22 ergy and Commerce of the House of Representatives and 

23 the Committee on Finance of the Senate a report on the 

24 activities (and the results of such activities) funded under 

25 subsection (a) to reduce waste, fraud, and abuse in the MedVerDate Aug 31 2005 04:55 Apr 23, 2008 Jkt 069200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6203 E:\BILLS\H5613.RH H5613

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1 icaid program under title XIX of the Social Security Act 

2 during the previous 12 month period, including the amount 

3 of funds appropriated under such subsection (a) for each 

4 such activity and an estimate of the savings to the Medicaid 

5 program resulting from each such activity. 

6 SEC. 4. STUDY AND REPORTS TO CONGRESS. 

7 (a) SECRETARIAL REPORT IDENTIFYING PROBLEMS.— 

8 Not later than July 1, 2008, the Secretary of Health and 

9 Human Services shall submit to the Committee on Energy 

10 and Commerce of the House of Representatives and the 

11 Committee on Finance of the Senate a report that— 

12 (1) outlines the specific problems the Medicaid 

13 regulations referred to in the amendments made by 

14 subsections (a) and (b) of section 2 and in the provi15 sions described in subsection (c)(2) of such section 

16 were intended to address; 

17 (2) detailing how these regulations were designed 

18 to address these specific problems; and 

19 (3) cites the legal authority for such regulations. 

20 (b) INDEPENDENT COMPREHENSIVE STUDY AND RE21 PORT.— 

22 (1) IN GENERAL.—Not later than July 1, 2008, 

23 the Secretary of Health and Human Services shall 

24 enter into a contract with an independent organiza25 tion for the purpose of— 


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1 (A) producing a comprehensive report on 

2 the prevalence of the problems outlined in the re3 port submitted under subsection (a); 

4 (B) identifying strategies in existence to ad5 dress these problems; and 

6 (C) assessing the impact of each regulation 

7 referred to in such subsection on each State and 

8 the District of Columbia. 

9 (2) ADDITIONAL MATTER.—The report under 

10 paragraph (1) shall also include— 

11 (A) an identification of which claims for 

12 items and services (including administrative ac13 tivities) under title XIX of the Social Security 

14 Act are not processed through systems described 

15 in section 1903(r) of such Act; 

16 (B) an examination of the reasons why 

17 these claims for such items and services are not 

18 processed through such systems; and 

19 (C) recommendations on actions by the Fed20 eral government and the States that can make 

21 claims for such items and services more accurate 

22 and complete consistent with such title. 

23 (3) DEADLINE.—The report under paragraph (1) 

24 shall be submitted to the Committee on Energy and 

25 Commerce of the House of Representatives and the 


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1 Committee on Finance of the Senate not later than 

2 March 1, 2009. 

3 (4) COOPERATION OF STATES.—If the Secretary 

4 of Health and Human Services determines that a 

5 State or the District of Columbia has not cooperated 

6 with the independent organization for purposes of the 

7 report under this subsection, the Secretary shall re8 duce the amount paid to the State or District under 

9 section 1903(a) of the Social Security Act (42 U.S.C. 

10 1396b(a)) by $25,000 for each day on which the Sec11 retary determines such State or District has not so 

12 cooperated. Such reduction shall be made through a 

13 process that permits the State or District to challenge 

14 the Secretary’s determination. 

15 (c) FUNDING.— 

16 (1) IN GENERAL.—Out of any money in the 

17 Treasury of the United States not otherwise appro18 priated, there are appropriated to the Secretary with19 out further appropriation, $5,000,000 to carry out 

20 this section. 

21 (2) AVAILABILITY; AMOUNTS IN ADDITION TO

22 OTHER AMOUNTS APPROPRIATED FOR SUCH ACTIVI23 TIES.—Amounts appropriated pursuant to paragraph 

24 (1) shall— 

25 (A) remain available until expended; and 


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1 (B) be in addition to any other amounts 

2 appropriated or made available to the Secretary 

3 of Health and Human Services with respect to 

4 the Medicaid program. 

5 SEC. 5. ASSET VERIFICATION THROUGH ACCESS TO INFOR6 MATION HELD BY FINANCIAL INSTITUTIONS. 

7 (a) ADDITION OF AUTHORITY.—Title XIX of the Social 

8 Security Act is amended by inserting after section 1939 the 

9 following new section: 

10 ‘‘ASSET VERIFICATION THROUGH ACCESS TO INFORMATION

11 HELD BY FINANCIAL INSTITUTIONS

12 ‘‘SEC. 1940. (a) IMPLEMENTATION.— 

13 ‘‘(1) IN GENERAL.—Subject to the provisions of 

14 this section, each State shall implement an asset 

15 verification program described in subsection (b), for 

16 purposes of determining or redetermining the eligi17 bility of an individual for medical assistance under 

18 the State plan under this title. 

19 ‘‘(2) PLAN SUBMITTAL.—In order to meet the re20 quirement of paragraph (1), each State shall— 

21 ‘‘(A) submit not later than a deadline speci22 fied by the Secretary consistent with paragraph 

23 (3), a State plan amendment under this title 

24 that describes how the State intends to imple25 ment the asset verification program; and 


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1 ‘‘(B) provide for implementation of such 

2 program for eligibility determinations and rede3 terminations made on or after 6 months after the 

4 deadline established for submittal of such plan 

5 amendment. 

6 ‘‘(3) PHASE-IN.— 

7 ‘‘(A) IN GENERAL.— 

8 ‘‘(i) IMPLEMENTATION IN CURRENT

9 ASSET VERIFICATION DEMO STATES.—The 

10 Secretary shall require those States specified 

11 in subparagraph (C) (to which an asset 

12 verification program has been applied be13 fore the date of the enactment of this sec14 tion) to implement an asset verification 

15 program under this subsection by the end of 

16 fiscal year 2009. 

17 ‘‘(ii) IMPLEMENTATION IN OTHER

18 STATES.—The Secretary shall require other 

19 States to submit and implement an asset 

20 verification program under this subsection 

21 in such manner as is designed to result in 

22 the application of such programs, in the ag23 gregate for all such other States, to enroll24 ment of approximately, but not less than, 

25 the following percentage of enrollees, in the 


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1 aggregate for all such other States, by the 

2 end of the fiscal year involved: 

3 ‘‘(I) 12.5 percent by the end of fis4 cal year 2009. 

5 ‘‘(II) 25 percent by the end of fis6 cal year 2010. 

7 ‘‘(III) 50 percent by the end of fis8 cal year 2011. 

9 ‘‘(IV) 75 percent by the end of fis10 cal year 2012. 

11 ‘‘(V) 100 percent by the end of fis12 cal year 2013. 

13 ‘‘(B) CONSIDERATION.—In selecting States 

14 under subparagraph (A)(ii), the Secretary shall 

15 consult with the States involved and take into 

16 account the feasibility of implementing asset 

17 verification programs in each such State. 

18 ‘‘(C) STATES SPECIFIED.—The States speci19 fied in this subparagraph are California, New 

20 York, and New Jersey. 

21 ‘‘(D) CONSTRUCTION.—Nothing in subpara22 graph (A)(ii) shall be construed as preventing a 

23 State from requesting, and the Secretary approv24 ing, the implementation of an asset verification 


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1 program in advance of the deadline otherwise es2 tablished under such subparagraph. 

3 ‘‘(4) EXEMPTION OF TERRITORIES.—This section 

4 shall only apply to the 50 States and the District of 

5 Columbia. 

6 ‘‘(b) ASSET VERIFICATION PROGRAM.— 

7 ‘‘(1) IN GENERAL.—For purposes of this section, 

8 an asset verification program means a program de9 scribed in paragraph (2) under which a State— 

10 ‘‘(A) requires each applicant for, or recipi11 ent of, medical assistance under the State plan 

12 under this title on the basis of being aged, blind, 

13 or disabled to provide authorization by such ap14 plicant or recipient (and any other person whose 

15 resources are material to the determination of 

16 the eligibility of the applicant or recipient for 

17 such assistance) for the State to obtain (subject 

18 to the cost reimbursement requirements of section 

19 1115(a) of the Right to Financial Privacy Act 

20 but at no cost to the applicant or recipient) from 

21 any financial institution (within the meaning of 

22 section 1101(1) of such Act) any financial record 

23 (within the meaning of section 1101(2) of such 

24 Act) held by the institution with respect to the 

25 applicant or recipient (and such other person, as 


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1 applicable), whenever the State determines the 

2 record is needed in connection with a determina3 tion with respect to such eligibility for (or the 

4 amount or extent of) such medical assistance; 

5 and 

6 ‘‘(B) uses the authorization provided under 

7 subparagraph (A) to verify the financial re8 sources of such applicant or recipient (and such 

9 other person, as applicable), in order to deter10 mine or redetermine the eligibility of such appli11 cant or recipient for medical assistance under 

12 the State plan. 

13 ‘‘(2) PROGRAM DESCRIBED.—A program de14 scribed in this paragraph is a program for verifying 

15 individual assets in a manner consistent with the ap16 proach used by the Commissioner of Social Security 

17 under section 1631(e)(1)(B)(ii). 

18 ‘‘(c) DURATION OF AUTHORIZATION.—Notwith19 standing section 1104(a)(1) of the Right to Financial Pri20 vacy Act, an authorization provided to a State under sub21 section (b)(1) shall remain effective until the earliest of— 

22 ‘‘(1) the rendering of a final adverse decision on 

23 the applicant’s application for medical assistance 

24 under the State’s plan under this title; 


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1 ‘‘(2) the cessation of the recipient’s eligibility for 

2 such medical assistance; or 

3 ‘‘(3) the express revocation by the applicant or 

4 recipient (or such other person described in subsection 

5 (b)(1), as applicable) of the authorization, in a writ6 ten notification to the State. 

7 ‘‘(d) TREATMENT OF RIGHT TO FINANCIAL PRIVACY

8 ACT REQUIREMENTS.— 

9 ‘‘(1) An authorization obtained by the State 

10 under subsection (b)(1) shall be considered to meet the 

11 requirements of the Right to Financial Privacy Act 

12 for purposes of section 1103(a) of such Act, and need 

13 not be furnished to the financial institution, notwith14 standing section 1104(a) of such Act. 

15 ‘‘(2) The certification requirements of section 

16 1103(b) of the Right to Financial Privacy Act shall 

17 not apply to requests by the State pursuant to an au18 thorization provided under subsection (b)(1). 

19 ‘‘(3) A request by the State pursuant to an au20 thorization provided under subsection (b)(1) is 

21 deemed to meet the requirements of section 1104(a)(3) 

22 of the Right to Financial Privacy Act and of section 

23 1102 of such Act, relating to a reasonable description 

24 of financial records. 


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1 ‘‘(e) REQUIRED DISCLOSURE.—The State shall inform 

2 any person who provides authorization pursuant to sub3 section (b)(1)(A) of the duration and scope of the authoriza4 tion. 

5 ‘‘(f) REFUSAL OR REVOCATION OF AUTHORIZATION.— 

6 If an applicant for, or recipient of, medical assistance 

7 under the State plan under this title (or such other person 

8 described in subsection (b)(1), as applicable) refuses to pro9 vide, or revokes, any authorization made by the applicant 

10 or recipient (or such other person, as applicable) under sub11 section (b)(1)(A) for the State to obtain from any financial 

12 institution any financial record, the State may, on that 

13 basis, determine that the applicant or recipient is ineligible 

14 for medical assistance. 

15 ‘‘(g) USE OF CONTRACTOR.—For purposes of imple16 menting an asset verification program under this section, 

17 a State may select and enter into a contract with a public 

18 or private entity meeting such criteria and qualifications 

19 as the State determines appropriate, consistent with re20 quirements in regulations relating to general contracting 

21 provisions and with section 1903(i)(2). In carrying out ac22 tivities under such contract, such an entity shall be subject 

23 to the same requirements and limitations on use and disclo24 sure of information as would apply if the State were to 

25 carry out such activities directly. 


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1 ‘‘(h) TECHNICAL ASSISTANCE.—The Secretary shall 

2 provide States with technical assistance to aid in imple3 mentation of an asset verification program under this sec4 tion. 

5 ‘‘(i) REPORTS.—A State implementing an asset 

6 verification program under this section shall furnish to the 

7 Secretary such reports concerning the program, at such 

8 times, in such format, and containing such information as 

9 the Secretary determines appropriate. 

10 ‘‘(j) TREATMENT OF PROGRAM EXPENSES.—Notwith11 standing any other provision of law, reasonable expenses 

12 of States in carrying out the program under this section 

13 shall be treated, for purposes of section 1903(a), in the same 

14 manner as State expenditures specified in paragraph (7) 

15 of such section.’’. 

16 (b) STATE PLAN REQUIREMENTS.—Section 1902(a) of 

17 such Act (42 U.S.C. 1396a(a)) is amended— 

18 (1) in paragraph (69) by striking ‘‘and’’ at the 

19 end; 

20 (2) in paragraph (70) by striking the period at 

21 the end and inserting ‘‘; and’’; and 

22 (3) by inserting after paragraph (70), as so 

23 amended, the following new paragraph: 


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1 ‘‘(71) provide that the State will implement an 

2 asset verification program as required under section 

3 1940.’’. 

4 (c) WITHHOLDING OF FEDERAL MATCHING PAYMENTS

5 FOR NONCOMPLIANT STATES.—Section 1903(i) of such Act 

6 (42 U.S.C. 1396b(i)) is amended— 

7 (1) in paragraph (22) by striking ‘‘or’’ at the 

8 end; 

9 (2) in paragraph (23) by striking the period at 

10 the end and inserting ‘‘; or’’; and 

11 (3) by adding after paragraph (23) the following 

12 new paragraph: 

13 ‘‘(24) if a State is required to implement an 

14 asset verification program under section 1940 and 

15 fails to implement such program in accordance with 

16 such section, with respect to amounts expended by 

17 such State for medical assistance for individuals sub18 ject to asset verification under such section, unless— 

19 ‘‘(A) the State demonstrates to the Sec20 retary’s satisfaction that the State made a good 

21 faith effort to comply; 

22 ‘‘(B) not later than 60 days after the date 

23 of a finding that the State is in noncompliance, 

24 the State submits to the Secretary (and the SecVerDate Aug 31 2005 04:55 Apr 23, 2008 Jkt 069200 PO 00000 Frm 00020 Fmt 6652 Sfmt 6203 E:\BILLS\H5613.RH H5613

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1 retary approves) a corrective action plan to rem2 edy such noncompliance; and 

3 ‘‘(C) not later than 12 months after the date 

4 of such submission (and approval), the State ful5 fills the terms of such corrective action plan.’’. 

6 (d) REPEAL.—Section 4 of Public Law 110–90 is re7 pealed. 

8 SEC. 6. ADJUSTMENT TO PAQI FUND. 

9 Section 1848(l)(2) of the Social Security Act (42 

10 U.S.C. 1395w–4(l)(2)), as amended by section 101(a)(2) of 

11 the Medicare, Medicaid, and SCHIP Extension Act of 2007 

12 (Public Law 110–173), is amended— 

13 (1) in subparagraph (A)(i)— 

14 (A) in subclause (III), by striking 

15 ‘‘$4,960,000,000’’ and inserting 

16 ‘‘$3,790,000,000’’; and 

17 (B) by adding at the end the following new 

18 subclause: 

19 ‘‘(IV) For expenditures during 

20 2014, an amount equal to 

21 $3,690,000,000.’’; 

22 (2) in subparagraph (A)(ii), by adding at the 

23 end the following new subclause: 

24 ‘‘(IV) 2014.—The amount avail25 able for expenditures during 2014 shall 


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22 

•HR 5613 RH

1 only be available for an adjustment to 

2 the update of the conversion factor 

3 under subsection (d) for that year.’’; 

4 and 

5 (3) in subparagraph (B)— 

6 (A) in clause (ii), by striking ‘‘and’’ at the 

7 end; 

8 (B) in clause (iii), by striking the period at 

9 the end and inserting ‘‘; and’’; and 

10 (C) by adding at the end the following new 

11 clause: 

12 ‘‘(iv) 2014 for payment with respect to 

13 physicians’ services furnished during 

14 2014.’’. 

Amend the title so as to read: ‘‘A bill to extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009, and for 

other purposes.’’. 


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Union Calendar No. 373 

110TH CONGRESS 

2D SESSION H. R. 5613 

[Report No. 110

–600] 

A BILL 

To extend certain moratoria and impose additional 

through April 1, 2009. moratoria on certain Medicaid regulations 

APRIL 22, 2008 

Reported with amendments, committed to the Committee 

dered to be printed of the Whole House on the State of the Union, and orVerDate Aug 31 2005 04:55 Apr 23, 2008 Jkt 069200 PO 00000 Frm 00024 Fmt 6651 Sfmt 6651 E:\BILLS\H5613.RH H5613

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