I 

115TH CONGRESS 

1ST SESSION H. R. 543 

To amend title XIX of the Social Security Act for purposes of prioritizing 

the most vulnerable Medicaid patients. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 13, 2017 

Mr. COLLINS of New York (for himself, Mr. MULLIN, Mr. GUTHRIE, Mrs. 

BLACKBURN, Mr. BUCSHON, and Mr. FLORES) introduced the following 

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

A BILL 

To amend title XIX of the Social Security Act for purposes 

of prioritizing the most vulnerable Medicaid patients. 

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 ‘‘Prioritizing the Most 

5 Vulnerable Americans Act’’. 

6 SEC. 2. PRIORITIZING THE MOST VULNERABLE MEDICAID 

7 PATIENTS. 

8 (a) IN GENERAL.—Section 1115 of the Social Secu9 rity Act (42 U.S.C. 1315) is amended by adding at the 

10 end the following new subsection: 


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1 ‘‘(g) In making a determination using the authority 

2 under paragraph (2)(A) of subsection (a) (relating to 

3 treating costs that would not otherwise be included as ex4 penditures under section 1903 and which are not included 

5 as part of the costs of projects under section 1110 as ex6 penditures under the State plan or plans approved under 

7 title XIX) to approve an application or renewal of any ex8 perimental, pilot, or demonstration project undertaken 

9 under such subsection to promote the objectives of title 

10 XIX (referred to in this subsection as a ‘Medicaid dem11 onstration project’), the Secretary shall— 

12 ‘‘(1) give priority to Medicaid demonstration 

13 projects that have been proven to be effective in im14 proving the medical care and health outcomes of in15 dividuals who are uninsured, individuals eligible to 

16 receive medical assistance under a State plan under 

17 title XIX, or individuals whose household income 

18 does not exceed 150 percent of the poverty line (as 

19 defined in section 2110(c)(5)) applicable to a family 

20 of the size involved; 

21 ‘‘(2) require that the State submitting such ap22 plication or renewal submit to the Secretary, and 

23 make publicly available, any available data or 

24 metrics regarding the health outcomes for the indiVerDate Sep 11 2014 03:09 Jan 27, 2017 Jkt 069200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H543.IH H543

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1 viduals to be served by such Medicaid demonstration 

2 project; 

3 ‘‘(3) ensure that such Medicaid demonstration 

4 project is not duplicative of any Federal program or 

5 funding opportunity; and 

6 ‘‘(4) require that the State submitting such ap7 plication or renewal submit to the Secretary, and 

8 make publicly available, an analysis of the degree to 

9 which such Medicaid demonstration project, if at all, 

10 precludes efforts undertaken by private sector and 

11 charitable sector entities to improve medical care 

12 and health outcomes for the individuals described in 

13 paragraph (1).’’. 

14 (b) EFFECTIVE DATE.—The amendment made by 

15 subsection (a) shall apply with respect to applications or 

16 renewals submitted on or after January 1, 2018. 

Æ 


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