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 enroll-
ment of certain immigrants in State plans under Med-
icaid, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Verify Eligibility Cov-
erage Act’’. 
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SEC. 2. PROMOTING PROGRAM INTEGRITY IN ENROLLING 
CERTAIN IMMIGRANTS UNDER MEDICAID. 
(a) IN GENERAL.—Section 1137(f) of the Social Se-
curity Act (42 U.S.C. 1320b–7(f)) is amended— 
(1) by striking ‘‘Subsections (a)(1) and (d)’’ 
and inserting ‘‘(1) Subsections (a)(1) and (d)’’; and 
(2) by adding at the end the following new 
paragraph: 
‘‘(2)(A) Subparagraphs (A) and (B)(ii) of sub-
section (d)(4) shall not apply in the case of an initial 
determination made on or after the date that is 6 
months after the date of the enactment of this para-
graph with respect to the eligibility of an alien de-
scribed in subparagraph (B) for benefits under the 
program listed in subsection (b)(2). 
‘‘(B) An alien described in this subparagraph is 
an individual declaring to be a citizen or national of 
the United States with respect to whom a State, in 
accordance with section 1902(a)(46)(B), requires— 
‘‘(i) pursuant to section 1902(ee), the sub-
mission of a social security number; or 
‘‘(ii) pursuant to section 1903(x), the pres-
entation of satisfactory documentary evidence of 
citizenship or nationality.’’. 
(b) NO PAYMENTS FOR MEDICAL ASSISTANCE PRO-
VIDED BEFORE PRESENTATION OF EVIDENCE.—Section 
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1903(i)(22) of the Social Security Act (42 U.S.C. 
1396b(i)(22)) is amended— 
(1) by striking ‘‘with respect to amounts ex-
pended’’ and inserting ‘‘(A) with respect to amounts 
expended’’; 
(2) by inserting ‘‘and’’ at the end; and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(B) in the case of a State that elects to pro-
vide a reasonable period to present satisfactory doc-
umentary evidence of such citizenship or nationality 
pursuant to paragraph (2)(C) of section 1902(ee) or 
paragraph (4) of subsection (x) of this section, for 
amounts expended for medical assistance for such an 
individual (other than an individual described in 
paragraph (2) of such subsection (x)) during such 
period;’’. 
(c) 
CONFORMING
AMENDMENTS.—Section 
1137(d)(4) of the Social Security Act (42 U.S.C. 1320b– 
7(d)(4)) is amended— 
(1) in subparagraph (A), in the matter pre-
ceding clause (i), by inserting ‘‘subject to subsection 
(f)(2),’’ before ‘‘the State’’; and 
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(2) in subparagraph (B)(ii), by inserting ‘‘sub-
ject to subsection (f)(2),’’ before ‘‘pending such 
verification’’. 
SEC. 3. MEDICAID IMPROVEMENT FUND. 
Section 1941 of the Social Security Act (42 U.S.C. 
1396w–1(b)) is amended to read as follows: 
‘‘SEC. 1941. MEDICAID IMPROVEMENT FUND. 
‘‘(a) IN GENERAL.—The Secretary shall establish, 
and administer, under this title a Medicaid Improvement 
Fund (in this section referred to as the ‘Fund’) which 
shall be available to the Secretary for the following pur-
poses: 
‘‘(1) To improve the management of the Med-
icaid program by the Centers for Medicare & Med-
icaid Services, including oversight of contracts and 
contractors 
and 
evaluation 
of 
demonstration 
projects. 
‘‘(2) To improve access to care for the most 
vulnerable individuals eligible to receive medical as-
sistance under the State plan under this title (or a 
waiver of such plan), including by carrying out sec-
tion 4 of the Verify Eligibility Coverage Act (relating 
to reducing waiting lists for medical assistance for 
home and community-based services under a State 
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plan waiver under subsection (c), (d), or (i) of sec-
tion 1915 or section 1115). 
‘‘(b) SUPPLEMENT, NOT
SUPPLANT.—Payments 
made for activities under this section shall be in addition 
to payments that would otherwise be made for activities 
described in subsection (a). 
‘‘(c) FUNDING.— 
‘‘(1) IN GENERAL.— 
‘‘(A) 
MANAGEMENT
IMPROVEMENTS.— 
There shall be available to the Fund, for the 
purposes described in subsection (a)(1), for ex-
penditures from the Fund for fiscal year 2021 
and thereafter, $5,000,000. 
‘‘(B) INCREASING ACCESS.—There shall be 
available to the Fund, for the purposes de-
scribed in subsection (a)(2), for expenditures 
from the Fund for fiscal year 2020 and there-
after, $1,095,000,000. 
‘‘(2) FUNDING LIMITATION.—Amounts in the 
Fund shall be available in advance of appropriations 
but only if the total amount obligated from the 
Fund does not exceed the amount available to the 
Fund under subparagraphs (A) and (B) of para-
graph (1). The Secretary may obligate funds from 
the Fund only if the Secretary determines (and the 
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Chief Actuary of the Centers for Medicare & Med-
icaid Services and the appropriate budget officer cer-
tify) that there are available in the Fund sufficient 
amounts to cover all such obligations incurred con-
sistent with the previous sentence.’’. 
SEC. 4. PROVIDING CARE FOR THE MOST VULNERABLE PA-
TIENTS ON WAITING LISTS. 
(a) IN GENERAL.—Subject to subsection (d), the Sec-
retary of Health and Human Services shall provide, for 
each of fiscal years 2020 through 2028, payment to eligi-
ble States selected under subsection (c) to provide for 
medical assistance for home and community-based services 
under a State plan waiver under subsection (c), (d), or 
(i) of section 1915 of the Social Security Act (42 U.S.C. 
1396n) or section 1115 of the Social Security Act (42 
U.S.C. 1315) to individuals who are eligible but, as of 
January 1, 2019, are on a waiting list for such services 
through such waiver. 
(b) STATE ELIGIBILITY.—A State is eligible for a 
payment under this section if the State submits an appli-
cation to the Secretary at such time, in such form and 
manner, and containing such information, provisions, and 
assurances, as specified by the Secretary. 
(c) SELECTION.—Subject to subsection (d), the Sec-
retary shall, for each of fiscal years 2020 through 2028, 
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select, on a competitive basis, from among eligible States, 
the States that will receive payment under this section. 
In making such selections, the Secretary shall give priority 
to— 
(1) States with the highest number of individ-
uals on a waiting list described in subsection (a); 
(2) States with the highest average or highest 
median periods individuals have been on such a list; 
and 
(3) States with individuals on such a list who 
have the lowest income levels, as compared to the in-
come of individuals on such a list of other eligible 
States. 
(d) FUNDING.— 
(1) FUNDS
ALLOCATED
TO
STATES.—Of the 
funds available for purposes of carrying out this sec-
tion under section 1941(c) of the Social Security Act 
(42 U.S.C. 1396w–1(c)), the Secretary shall allocate 
such funds to States selected under subsection (c) 
on the basis of criteria, including a State’s applica-
tion submitted under subsection (b), the availability 
of funds under such section 1941(c), and criteria 
specified under subsection (c), as determined by the 
Secretary. 
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(2) PAYMENTS TO STATES.—For each calendar 
quarter beginning on or after October 1, 2019, the 
Secretary shall pay to each State selected under sub-
section (c), from the allocation made to the State 
under paragraph (1), an amount equal to 90 percent 
of the Federal medical assistance percentage of the 
amount expended during such quarter for the med-
ical assistance described in subsection (a). 
(e) DEFINITIONS.—In this section: 
(1) FEDERAL MEDICAL ASSISTANCE PERCENT-
AGE.—The term ‘‘Federal medical assistance per-
centage’’ has the meaning given such term in section 
1905(b) of the Social Security Act (42 U.S.C. 
1396d(b)). 
(2) MEDICAL ASSISTANCE.—The term ‘‘medical 
assistance’’ has the meaning given such term in sec-
tion 1905(a) of the Social Security Act (42 U.S.C. 
1396d(a)). 
(3) STATE.—The term ‘‘State’’ has the mean-
ing given such term for purposes of title XIX of the 
Social Security Act (42 U.S.C. 1396 et seq.). 
Æ 
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