SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Managing Our Medi-
care and Medicaid Services and Protecting Our Parents 
Act’’ . 
SEC. 2. LOAN REPAYMENT PROGRAM FOR NURSE PRACTI-
TIONERS AND PHYSICIANS ASSISTANTS SERV-
ING IN UNDERSERVED NURSING HOMES. 
Title IV of the Public Health Service Act (42 U.S.C. 
281 et seq.) is amended—
(1) by redesignating the second section 487F as 
section 487G; and 
(2) by inserting after section 487G (as so re-
designated) the following: 
‘‘SEC. 487H. LOAN REPAYMENT PROGRAM FOR NURSE 
PRACTITIONERS AND PHYSICIAN ASSISTANTS 
SERVING 
IN 
UNDERSERVED 
NURSING 
HOMES. 
‘‘(a) ESTABLISHMENT.—To the extent and in the 
amounts provided in advance in appropriations Acts, the 
Secretary, acting through the Administrator of the Health 
Resources and Services Administration, shall establish a 
program to enter into contracts with individuals under 
which the individual involved agrees to serve for a period 
of not less than 3 years as a nurse practitioner or a physi-
cian assistant at an underserved nursing home, in consid-
eration of the Federal Government agreeing to make pay-
ments, for not more than 5 years of such service, on the 
principal and interest of the educational loans of the indi-
vidual. 
‘‘(b) AMOUNT OF PAYMENTS.—The amount of a pay-
ment by the Secretary under this section for a year of 
service by an individual as a nurse practitioner or physi-
cian assistant at an underserved nursing home shall not 
exceed the lesser of the remaining outstanding obligation 
on the individual’s educational loans or—
‘‘(1) $2,000 at the completion of the first year 
of such service; 
‘‘(2) $2,500 at the completion of the second 
year of such service; 
‘‘(3) $3,500 at the completion of the third year 
of such service; 
‘‘(4) $4,500 at the completion of the fourth 
year of such service; and 
‘‘(5) $5,000 at the completion of the fifth year 
of such service. 
‘‘(c) APPLICATION OF PROVISIONS.—Except as in-
consistent with this section, the provisions of sections 
338B, 338C, and 338E shall apply to the program estab-
lished under this section to the same extent and in the 
same manner as such provisions apply to the National
Health Service Corps Loan Repayment Program estab-
lished in subpart III of part D of title III. 
‘‘(d) DEFINITIONS.—For purposes of this section: 
‘‘(1) The term ‘medicaid recipient’ means, with 
respect to a resident of a nursing home, a resident 
of the home who is provided medical assistance 
under title XIX of the Social Security Act for nurs-
ing home services. 
‘‘(2) The term ‘medicare recipient’ means, with 
respect to a resident of a skilled nursing home, a 
resident who is being provided benefits under part A 
of title XVIII of the Social Security Act with respect 
to extended care services in the home. 
‘‘(3) The term ‘nursing home’ means any insti-
tution or facility defined as such for licensing pur-
poses under State law, or, if State law does not em-
ploy the term nursing home, the equivalent term or 
terms as determined by the Secretary, but does not 
include a religious nonmedical health care institution 
(as defined in section 1861(ss)(1) of the Social Se-
curity Act). 
‘‘(4) The term ‘underserved nursing home’ 
means a nursing home in which at least 85 percent 
of the number of residents of the home are medicaid 
recipients, not more than 8 percent of such residents
are medicare recipients, and not more than 10 per-
cent of such residents are neither medicaid nor 
medicare recipients. 
‘‘(e) FUNDING.—
‘‘(1) AUTHORIZATION
OF
APPROPRIATIONS.—
For the purpose of carrying out this section, there 
are authorized to be appropriated such sums as may 
be necessary for each fiscal year. 
‘‘(2) AVAILABILITY.—Amounts appropriated for 
carrying out this section shall remain available until 
the expiration of the second fiscal year beginning 
after the fiscal year for which the amounts were 
made available.’’. 
SEC. 3. TRAINING PROGRAM FOR NURSING HOME ADMINIS-
TRATORS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Director of the Cen-
ters for Medicare & Medicaid Services, shall provide grants 
to States to implement nursing home administrator men-
tor programs described in subsection (b). 
(b) MENTOR PROGRAM DESCRIBED.—A mentor pro-
gram described in this subsection is a program to improve 
the training of nursing home administrators and to 
strengthen their commitment to serve as leaders in their 
States. Such a program shall provide for the following:
(1) Identification of individuals who are nursing 
home administrators and have exceptional potential 
to serve as mentors to other nursing home adminis-
trators. 
(2) Training of such individuals to serve as 
mentors for other nursing home administrators who 
are employed in underserved nursing homes (as de-
fined in section 487H(e)(3) of the Public Health 
Service Act). 
(c) APPLICATIONS.—A State seeking a grant under 
this section shall submit an application to the Secretary 
at such time, in such manner, and containing such infor-
mation as the Secretary may require. 
(d) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated $25,000,000 to carry 
out this section. 
(e) DEFINITIONS.—For purposes of this section: 
(1) NURSING
HOME.—The term ‘‘nursing 
home’’ means any institution or facility defined as 
such for licensing purposes under State law, or, if 
State law does not employ the term nursing home, 
the equivalent term or terms as determined by the 
Secretary, but does not include a religious nonmed-
ical health care institution (as defined in section
1861(ss)(1) of the Social Security Act (42 U.S.C. 
1395x(ss)(1)). 
(2) NURSING
HOME
ADMINISTRATOR.—The 
term ‘‘nursing home administrator’’means any indi-
vidual who is charged with the general administra-
tion of a nursing home whether or not such indi-
vidual has an ownership interest in such home and 
whether or not the individual’s functions and duties 
are shared with one or more other individuals. 
(3) STATE.—The term ‘‘State’’ has the mean-
ing given such term for purposes of title XIX of the 
Social Security Act. 
SEC. 4. HIGH FAMILY INVOLVEMENT IN NURSING HOMES. 
The Director of the Centers for Medicare & Medicaid 
Services shall provide, in implementing the Nursing Home 
Quality Initiative, the degree of family involvement (as de-
fined by the Director) among the quality indicators for 
the evaluation of the quality of nursing homes, . 
SEC. 5. REINSTITUTION OF BOREN AMENDMENT MEDICAID 
PAYMENT METHODOLOGY. 
(a) IN GENERAL.—Section 1902(a)(13) of the Social 
Security Act (42 U.S.C. 1396a(a)(13)) is amended to read 
as follows: 
‘‘(13) provide for payment of services through 
the use of rates determined pursuant to the criteria
under this paragraph as in effect on August 1, 
1997;’’. 
(b) ESTABLISHMENT OF SAFE HARBOR RATES.—
Section 1902 of such Act (42 U.S.C. 1396a) is amended 
by adding at the end the following: ‘‘The Secretary may, 
by regulation, promulgate standards or methodologies for 
determining rates that comply with paragraph (13), and 
a State that pays rates that meet such standards or meth-
odologies is deemed to be in compliance with paragraph 
(13).’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to services furnished on or after 
the date that is one year after the date of the enactment 
of this Act. 
SEC. 6. INCREASE OF MEDICAID FMAP. 
Section 1905(b) of the Social Security Act (42 U.S.C. 
1396d(b)) is amended by adding at the end the following: 
‘‘Notwithstanding the first sentence of this subsection, 
only for purposes of this title (and not with respect to the 
determination of the enhanced FMAP) and with respect 
to calendar quarters beginning after October 1, 2004, in 
the case of a State in which the Federal medical assistance 
percentage otherwise determined under the first sentence 
is less than 60 percent, such percentage shall be increased 
by 2 percentage points, and in the case of a State in which
such percentage is otherwise so determined to be 60 per-
cent or greater, such percentage shall be increased by 1 
percentage point.’’.
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