To provide further additional continuing appropriations for fiscal year 2019, and for other purposes.

To provide further additional continuing appropriations for fiscal year 2019, and for other purposes. A Further Additional Continuing Appropriations Act, 2019 101. The Continuing Appropriations Act, 2019 (division C of Public Law 115–245 (1) by striking the date specified in section 105(3) and inserting February 8, 2019 (2) by adding after section 136 the following: 137. Notwithstanding section 251(a)(1) of the Balanced Budget and Emergency Deficit Control Act of 1985 and the timetable in section 254(a) of such Act, the final sequestration report for fiscal year 2019 pursuant to section 254(f)(1) of such Act and any order for fiscal year 2019 pursuant to section 254(f)(5) of such Act shall be issued, for the Congressional Budget Office, 10 days after the date specified in section 105(3), and for the Office of Management and Budget, 15 days after the date specified in section 105(3). 138. The authority provided under title XXI of the Homeland Security Act of 2002 ( 6 U.S.C. 621 Public Law 113–254 139. Section 319L(e)(1)(A) of the Public Health Service Act (42 U.S.C. 247d–7e(e)(1)(A)) shall continue in effect through the date specified in section 105(3) of this Act. 140. Section 405(a) of the Pandemic and All Hazards Preparedness Act (42 U.S.C. 247d–6a note) shall continue in effect through the date specified in section 105(3) of this Act. . This division may be cited as the Further Additional Continuing Appropriations Act, 2019 B Medicaid Extenders 101. Extension of Money Follows the Person Rebalancing demonstration (a) General Funding Section 6071(h) of the Deficit Reduction Act of 2005 ( 42 U.S.C. 1396a (1) in paragraph (1)— (A) in subparagraph (D), by striking and (B) in subparagraph (E), by striking the period at the end and inserting ; and (C) by adding at the end the following: (F) subject to paragraph (3), $112,000,000 for fiscal year 2019. ; (2) in paragraph (2)— (A) by striking Amounts made Subject to paragraph (3), amounts made (B) by striking September 30, 2016 September 30, 2021 (3) by adding at the end the following new paragraph: (3) Special rule for FY 2019 Funds appropriated under paragraph (1)(F) shall be made available for grants to States only if such States have an approved MFP demonstration project under this section as of December 31, 2018. . (b) Funding for quality assurance and improvement; technical assistance; oversight Section 6071(f) of the Deficit Reduction Act of 2005 ( 42 U.S.C. 1396a (2) Funding From the amounts appropriated under subsection (h)(1)(F) for fiscal year 2019, $500,000 shall be available to the Secretary for such fiscal year to carry out this subsection. . (c) Technical amendment Section 6071(b) of the Deficit Reduction Act of 2005 ( 42 U.S.C. 1396a (10) Secretary The term Secretary . 102. 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 the 5-year period that begins on January 1, 2014, the period beginning on January 1, 2014, and ending on March 31, 2019, (b) Rule of construction (1) Protecting State spousal income and asset disregard flexibility under waivers and plan amendments Nothing in section 2404 of Public Law 111–148 42 U.S.C. 1396r–5 42 U.S.C. 1396r–5 (2) State waiver or plan amendment described A State waiver or plan amendment described in this paragraph is any of the following: (A) A waiver or plan amendment to provide medical assistance for home and community-based services under a waiver or plan amendment under subsection (c), (d), or (i) of section 1915 of the Social Security Act ( 42 U.S.C. 1396n 42 U.S.C. 1315 (B) A plan amendment to provide medical assistance for home and community-based services for individuals by reason of being determined eligible under section 1902(a)(10)(C) of such Act ( 42 U.S.C. 1396a(a)(10)(C) 42 U.S.C. 1396a(f) 42 U.S.C. 1396r–5 (C) A plan amendment to provide medical assistance for home and community-based attendant services and supports under section 1915(k) of such Act ( 42 U.S.C. 1396n(k) 103. Reduction in FMAP after 2020 Section 1940 of the Social Security Act ( 42 U.S.C. 1396w (k) Reduction in FMAP after 2020 (1) In general With respect to a calendar quarter beginning on or after January 1, 2021, the Federal medical assistance percentage otherwise determined under section 1905(b) for a non-compliant State shall be reduced— (A) for calendar quarters in 2021 and 2022, by 0.12 percentage points; (B) for calendar quarters in 2023, by 0.25 percentage points; (C) for calendar quarters in 2024, by 0.35 percentage points; and (D) for calendar quarters in 2025 and each year thereafter, by 0.5 percentage points. (2) Non-compliant State defined For purposes of this subsection, the term non-compliant State (A) that is one of the 50 States or the District of Columbia; (B) with respect to which the Secretary has not approved a State plan amendment submitted under subsection (a)(2); and (C) that is not operating, on an ongoing basis, an asset verification program in accordance with this section. . 104. Medicaid Improvement Fund Section 1941(b)(1) of the Social Security Act ( 42 U.S.C. 1396w–1(b)(1) $31,000,000 $6,000,000 105. Budgetary Effects (a) Statutory PAYGO scorecards The budgetary effects of this division shall not be entered on either PAYGO scorecard maintained pursuant to section 4(d) of the Statutory Pay-As-You-Go Act of 2010 ( 2 U.S.C. 933(d) (b) Senate PAYGO scorecards The budgetary effects of this division shall not be entered on any PAYGO scorecard maintained for purposes of section 4106 of H. Con. Res. 71 (115th Congress). (c) Classification of budgetary effects Notwithstanding Rule 3 of the Budget Scorekeeping Guidelines set forth in the joint explanatory statement of the committee of conference accompanying Conference Report 105–217 and section 250(c)(8) of the Balanced Budget and Emergency Deficit Control Act of 1985, the budgetary effects of this division shall not be estimated— (1) for purposes of section 251 of such Act; and (2) for purposes of paragraph (4)(C) of section 3 of the Statutory Pay-As-You-Go Act of 2010 as being included in an appropriation Act. (d) PAYGO annual report For the purposes of the annual report issued pursuant to section 5 of the Statutory Pay-As-You-Go Act of 2010 ( 2 U.S.C. 934

Summary: DIVISION A--FURTHER ADDITIONAL CONTINUING APPROPRIATIONS ACT, 2019 Further Additional Continuing Appropriations Act, 2019 (Sec. 101) This division amends the Continuing Appropriations Act, 2019 to provide continuing FY2019 appropriations to several federal agencies through the earlier of February 8, 2019 (December 21, 2018, under current law), or the enactment of the applicable appropriations legislation. It is known as a continuing resolution (CR) and ends the partial government shutdown that began when the existing CR expired because seven of the remaining FY2019 appropriations bills have not been enacted. (Five of the FY2019 appropriations bills were enacted earlier this year, including: the Department of Defense Appropriations Act, 2019; the Energy and Water Development and Related Agencies Appropriations Act, 2019; the Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019; the Legislative Branch Appropriations Act, 2019; and the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2019.) The CR extends through February 8, 2019: the Department of Homeland Security Chemical Facility Anti-Terrorism Standards Program; the authority for the Department of Health and Human Services Biomedical Advanced Research and Development Authority to withhold from public disclosure certain technical data or scientific information that reveals vulnerabilities of existing medical or public health defenses against biological, chemical, nuclear, or radiological threats; and an exemption from antitrust laws for meetings and consultations to discuss the development of certain vaccines and drugs related to public health threats such as bioterrorism, pandemics, or epidemics. Additionally, the CR has the effect of extending through February 8, 2019, several authorities and programs that were extended in prior CRs, including: the National Flood Insurance Program, the Violence Against Women Act, the authority for the Environmental Protection Agency to collect and spend certain fees related to pesticides, the Temporary Assistance for Needy Families (TANF) program, and several authorities related to immigration. The CR also delays the release of required Congressional Budget Office and Office of Management and Budget sequestration reports. DIVISION B--MEDICAID EXTENDERS (Sec. 101) The division amends the Deficit Reduction Act of 2005 to make appropriations for FY2019, and otherwise revise, the Money Follows the Person Rebalancing Demonstration Program (Under this program, the Centers for Medicare & Medicaid Services must award grants to state Medicaid programs to assist states in increasing the use of home and community care for long-term care and decreasing the use of institutional care.) (Sec. 102) Additionally, the division temporarily extends the applicability of Medicaid eligibility criteria that protect against spousal impoverishment for recipients of home and community-based services. (Sec. 103) The division also reduces the federal medical assistance percentage (i.e., federal matching rate) for states that have not implemented asset-verification programs for determining Medicaid eligibility. (Sec. 104) The division reduces funding available to the Medicaid Improvement Fund beginning in FY2021. (Sec. 105) This section exempts the budgetary effects of this division from: (1) the Pay-As-You-Go (PAYGO) rules established by the Statutory Pay-As-You-Go Act of 2010 and the FY2018 congressional budget resolution, and (2) certain budget scorekeeping guidelines. It also requires any debits on the statutory PAYGO scorecard for 2019 to be transferred to the 2020 scorecard. (The Statutory Pay-As-You-Go Act of 2010 prohibits certain legislation from increasing the budget deficit. PAYGO scorecards are used to enforce the requirements and determine whether a sequestration order implementing spending cuts is necessary.)