(i) IN
GENERAL.—For purposes of 
subparagraph (A), with respect to the com-
putation of the state unemployment in-
crease percentage (as described under sec-
tion 5001(c)(4) of ARRA) for the last 2 
fiscal quarters of the ARRA transitional 
assistance period, the most recent previous 
3-consecutive-month period (as described 
under section 5001(c)(4)(A)(i) of ARRA) 
shall be the 3-consecutive-month period be-
ginning with December 2012, or, if it re-
sults in a higher applicable percent under 
section 5001(c)(3) of ARRA, the 3-con-
secutive-month period beginning with Jan-
uary 2013. 
(ii) REPEAL OF SPECIAL RULE UNDER 
ARRA FOR LAST 2 CALENDAR QUARTERS 
OF
THE
RECESSION
ADJUSTMENT
PE-
RIOD.—Section 5001(c)(4) of ARRA is 
amended by striking subparagraph (C) and 
inserting the following: 
‘‘(C) SPECIAL RULE.—With respect to the 
first 2 calendar quarters of the recession ad-
justment period, the most recent previous 3- 
consecutive-month period described in subpara-
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graph (A)(i) shall be the 3-consecutive-month 
period beginning with October 2008.’’. 
(b) SCOPE OF APPLICATION.—The adjustments in 
the FMAP for a State under this section shall apply for 
purposes of title XIX of the Social Security Act and shall 
not apply with respect to— 
(1) disproportionate share hospital payments 
described in section 1923 of such Act (42 U.S.C. 
1396r–4); 
(2) payments under title IV of such Act (42 
U.S.C. 601 et seq.) (except that the increases under 
paragraphs (1) and (2) of subsection (a) shall apply 
to payments under part E of title IV of such Act (42 
U.S.C. 670 et seq.) and, for purposes of the applica-
tion of this section to the District of Columbia, pay-
ments under such part shall be deemed to be made 
on the basis of the FMAP applied with respect to 
such District for purposes of title XIX and as in-
creased under subsection (a)(2)); 
(3) any payments under title XXI of such Act 
(42 U.S.C. 1397aa et seq.); 
(4) any payments under title XIX of such Act 
that are based on the enhanced FMAP described in 
section 2105(b) of such Act (42 U.S.C. 1397ee(b)); 
or 
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(5) any payments under title XIX of such Act 
that are attributable to expenditures for medical as-
sistance provided to individuals made eligible under 
a State plan under title XIX of the Social Security 
Act (including under any waiver under such title or 
under section 1115 of such Act (42 U.S.C. 1315)) 
because of income standards (expressed as a per-
centage of the poverty line) for eligibility for medical 
assistance that are higher than the income stand-
ards (as so expressed) for such eligibility as in effect 
on July 1, 2008, (including as such standards were 
proposed to be in effect under a State law enacted 
but not effective as of such date or a State plan 
amendment or waiver request under title XIX of 
such Act that was pending approval on such date). 
(c) STATE INELIGIBILITY; LIMITATION; SPECIAL 
RULES.— 
(1) MAINTENANCE
OF
ELIGIBILITY
REQUIRE-
MENTS.— 
(A) IN
GENERAL.—Subject to subpara-
graph (B) and (C), a State is not eligible for 
an increase in its FMAP under subsection (a) 
if eligibility standards, methodologies, or proce-
dures under its State plan under title XIX of 
the Social Security Act (including any waiver 
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smartinez on DSKB9S0YB1PROD with BILLS
under such title or under section 1115 of such 
Act (42 U.S.C. 1315)) are more restrictive than 
the eligibility standards, methodologies, or pro-
cedures, respectively, under such plan (or waiv-
er) as in effect on July 1, 2008. 
(B) STATE
REINSTATEMENT
OF
ELIGI-
BILITY PERMITTED.—Subject to subparagraph 
(C), a State that has restricted eligibility stand-
ards, methodologies, or procedures under its 
State plan under title XIX of the Social Secu-
rity Act (including any waiver under such title 
or under section 1115 of such Act (42 U.S.C. 
1315)) after July 1, 2008, is no longer ineli-
gible under subparagraph (A) beginning with 
the first calendar quarter in which the State 
has reinstated eligibility standards, methodolo-
gies, or procedures that are no more restrictive 
than the eligibility standards, methodologies, or 
procedures, respectively, under such plan (or 
waiver) as in effect on July 1, 2008. 
(C) SPECIAL RULES.—A State shall not be 
ineligible under subparagraph (A)— 
(i) for the fiscal quarters before Octo-
ber 1, 2011, on the basis of a restriction 
that was applied after July 1, 2008, and 
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before the date of the enactment of this 
Act, if the State prior to October 1, 2011, 
has reinstated eligibility standards, meth-
odologies, or procedures that are no more 
restrictive than the eligibility standards, 
methodologies, or procedures, respectively, 
under such plan (or waiver) as in effect on 
July 1, 2008; or 
(ii) on the basis of a restriction that 
was directed to be made under State law 
as in effect on July 1, 2008, and would 
have been in effect as of such date, but for 
a delay in the effective date of a waiver 
under section 1115 of such Act with re-
spect to such restriction. 
(2) COMPLIANCE WITH PROMPT PAY REQUIRE-
MENTS.— 
(A) APPLICATION TO PRACTITIONERS.— 
(i) IN GENERAL.—Subject to the suc-
ceeding provisions of this subparagraph, no 
State shall be eligible for an increased 
FMAP rate as provided under this section 
for any claim received by a State from a 
practitioner subject to the terms of section 
1902(a)(37)(A) of the Social Security Act 
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(42 U.S.C. 1396a(a)(37)(A)) for such days 
during any period in which that State has 
failed to pay claims in accordance with 
such section as applied under title XIX of 
such Act. 
(ii) 
REPORTING
REQUIREMENT.— 
Each State shall report to the Secretary, 
on a quarterly basis, its compliance with 
the requirements of clause (i) as such re-
quirements pertain to claims made for cov-
ered services during each month of the 
preceding quarter. 
(iii) WAIVER AUTHORITY.—The Sec-
retary may waive the application of clause 
(i) to a State, or the reporting requirement 
imposed under clause (ii), during any pe-
riod in which there are exigent cir-
cumstances, including natural disasters, 
that prevent the timely processing of 
claims or the submission of such a report. 
(iv) 
APPLICATION
TO
CLAIMS.— 
Clauses (i) and (ii) shall only apply to 
claims made for covered services after the 
date of enactment of this Act. 
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(B) APPLICATION TO NURSING FACILITIES 
AND HOSPITALS.—The provisions of subpara-
graph (A) shall apply with respect to a nursing 
facility or hospital, insofar as it is paid under 
title XIX of the Social Security Act on the basis 
of submission of claims, in the same or similar 
manner (but within the same timeframe) as 
such provisions apply to practitioners described 
in such subparagraph. 
(3) STATE’S APPLICATION TOWARD RAINY DAY 
FUND.—A State is not eligible for an increase in its 
FMAP under paragraphs (2) or (3) of subsection (a) 
if any amounts attributable (directly or indirectly) to 
such increase are deposited or credited into any re-
serve or rainy day fund of the State. 
(4) NO WAIVER AUTHORITY.—Except as pro-
vided in paragraph (2)(A)(iii), the Secretary may 
not waive the application of this subsection or sub-
section (d) under section 1115 of the Social Security 
Act or otherwise. 
(5) LIMITATION OF FMAP TO 100 PERCENT.—In 
no case shall an increase in FMAP under this sec-
tion result in an FMAP that exceeds 100 percent. 
(d) REQUIREMENTS.— 
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(1) STATE REPORTS.—Each State that is paid 
additional Federal funds as a result of this section 
shall, not later than September 30, 2014, submit a 
report to the Secretary, in such form and such man-
ner as the Secretary shall determine, regarding how 
the additional Federal funds were expended. 
(2) ADDITIONAL REQUIREMENT FOR CERTAIN 
STATES.—In the case of a State that requires polit-
ical subdivisions within the State to contribute to-
ward the non-Federal share of expenditures under 
the State Medicaid plan required under section 
1902(a)(2) of the Social Security Act (42 U.S.C. 
1396a(a)(2)), the State is not eligible for an in-
crease in its FMAP under paragraphs (2) or (3) of 
subsection (a) if it requires that such political sub-
divisions pay for quarters during the ARRA transi-
tional assistance period a greater percentage of the 
non-Federal share of such expenditures, or a greater 
percentage of the non-Federal share of payments 
under section 1923, than the respective percentage 
that would have been required by the State under 
such plan on September 30, 2008, prior to applica-
tion of this section. 
(e) DEFINITIONS.—In this Act, except as otherwise 
provided: 
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(1) ARRA.—The term ‘‘ARRA’’ means the 
American Recovery and Reinvestment Act of 2009 
(Public Law 111–5; 123 Stat. 140). 
(2) FMAP.—The term ‘‘FMAP’ ’’ means the 
Federal medical assistance percentage, as defined in 
section 1905(b) of the Social Security Act (42 
U.S.C. 1396d(b)), as determined without regard to 
this section except as otherwise specified. 
(3) POVERTY LINE.—The term ‘‘poverty line’’ 
has the meaning given such term in section 673(2) 
of the Community Services Block Grant Act (42 
U.S.C. 9902(2)), including any revision required by 
such section. 
(4) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
(5) STATE.—The term ‘‘State’’ has the mean-
ing given such term in section 1101(a)(1) of the So-
cial Security Act (42 U.S.C. 1301(a)(1)) for pur-
poses of title XIX of the Social Security Act (42 
U.S.C. 1396 et seq.). 
(f) SUNSET.—This section shall not apply to items 
and services furnished after the end of the ARRA transi-
tional assistance period. 
Æ 
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