270 
‘‘(E) Section 1902(ff) (relating to disregard 
of certain property for purposes of making eligi-
bility determinations).’’. 
(c) CONTINUATION OF CURRENT LAW PROTECTIONS OF 
CERTAIN INDIAN PROPERTY FROM MEDICAID ESTATE RE-
COVERY.—Section 1917(b)(3) of the Social Security Act (42 
U.S.C. 1396p(b)(3)) is amended— 
(1) by inserting ‘‘(A)’’ after ‘‘(3)’’; and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(B) The standards specified by the Sec-
retary under subparagraph (A) shall require that 
the procedures established by the State agency 
under subparagraph (A) exempt income, re-
sources, and property that are exempt from the 
application of this subsection as of April 1, 
2003, under manual instructions issued to carry 
out this subsection (as in effect on such date) be-
cause of the Federal responsibility for Indian 
Tribes and Alaska Native Villages. Nothing in 
this subparagraph shall be construed as pre-
venting the Secretary from providing additional 
estate recovery exemptions under this title for In-
dians.’’. 
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271 
SEC. 5006. CONSULTATION ON MEDICAID AND CHIP. 
(a) IN GENERAL.—Section 1139 of the Social Security 
Act (42 U.S.C. 1320b–9) is amended to read as follows: 
‘‘CONSULTATION WITH TRIBAL TECHNICAL ADVISORY 
GROUP (TTAG) 
‘‘SEC. 1139. 
‘‘The Secretary shall maintain within the Centers for 
Medicaid & Medicare Services (CMS) a Tribal Technical 
Advisory Group, which was first established in accordance 
with requirements of the charter dated September 30, 2003, 
and the Secretary shall include in such Group a representa-
tive of the Urban Indian Organizations and the Service. 
The representative of the Urban Indian Organization shall 
be deemed to be an elected officer of a tribal government 
for purposes of applying section 204(b) of the Unfunded 
Mandates Reform Act of 1995 (2 U.S.C. 1534(b)).’’. 
(b) SOLICITATION OF ADVICE UNDER MEDICAID AND 
CHIP.— 
(1) MEDICAID STATE PLAN AMENDMENT.—Sec-
tion 1902(a) of the Social Security Act (42 U.S.C. 
1396a(a)) is amended— 
(A) in paragraph (70), by striking ‘‘and’’ 
at the end; 
(B) in paragraph (71), by striking the pe-
riod at the end and inserting ‘‘; and’’; and 
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272 
(C) by inserting after paragraph (71), the 
following new paragraph: 
‘‘(72) in the case of any State in which 1 or 
more Indian Health Programs or Urban Indian Or-
ganizations furnishes health care services, provide for 
a process under which the State seeks advice on a reg-
ular, ongoing basis from designees of such Indian 
Health Programs and Urban Indian Organizations 
on matters relating to the application of this title 
that are likely to have a direct effect on such Indian 
Health Programs and Urban Indian Organizations 
and that— 
‘‘(A) shall include solicitation of advice 
prior to submission of any plan amendments, 
waiver requests, and proposals for demonstration 
projects likely to have a direct effect on Indians, 
Indian Health Programs, or Urban Indian Or-
ganizations; and 
‘‘(B) may include appointment of an advi-
sory committee and of a designee of such Indian 
Health Programs and Urban Indian Organiza-
tions to the medical care advisory committee ad-
vising the State on its State plan under this 
title.’’. 
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273 
(2) APPLICATION TO CHIP.—Section 2107(e)(1) 
of such Act (42 U.S.C. 1397gg(e)(1)), as amended by 
section 5005(b), is amended by adding at the end the 
following new subparagraph: 
‘‘(F) Section 1902(a)(72) (relating to re-
quiring certain States to seek advice from des-
ignees of Indian Health Programs and Urban 
Indian Organizations).’’. 
(c) RULE OF CONSTRUCTION.—Nothing in the amend-
ments made by this section shall be construed as super-
seding existing advisory committees, working groups, guid-
ance, or other advisory procedures established by the Sec-
retary of Health and Human Services or by any State with 
respect to the provision of health care to Indians. 
SEC. 5007. TEMPORARY INCREASE IN DSH ALLOTMENTS 
DURING RECESSION. 
Section 1923(f)(3) of the Social Security Act (42 
U.S.C. 1396r–4(f)(3)) is amended— 
(1) in subparagraph (A), by striking ‘‘paragraph 
(6)’’ and inserting ‘‘paragraph (6) and subparagraph 
(E)’’; and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(E) TEMPORARY
INCREASE
IN
ALLOT-
MENTS DURING RECESSION.— 
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274 
‘‘(i) IN
GENERAL.—Subject to clause 
(ii), the DSH allotment for any State— 
‘‘(I) for fiscal year 2009 is equal 
to 102.5 percent of the DSH allotment 
that would be determined under this 
paragraph for the State for fiscal year 
2009 without application of this sub-
paragraph, notwithstanding subpara-
graph (B); 
‘‘(II) for fiscal year 2010 is equal 
to 102.5 percent of the the DSH allot-
ment for the State for fiscal year 2009, 
as determined under subclause (I); and 
‘‘(III) for each succeeding fiscal 
year is equal to the DSH allotment for 
the State under this paragraph deter-
mined without applying subclauses (I) 
and (II). 
‘‘(ii) APPLICATION.—Clause (i) shall 
not apply to a State for a year in the case 
that the DSH allotment for such State for 
such year under this paragraph determined 
without applying clause (i) would grow 
higher than the DSH allotment specified 
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275 
under clause (i) for the State for such 
year.’’. 
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Union Calendar No. 3 
111TH CONGRESS 
1ST SESSION 
H. R. 629 
[Report No. 111–7, Part I] 
A BILL 
To provide energy and commerce provisions of the 
American Recovery and Reinvestment Act of 2009. 
JANUARY 27, 2009 
The Committees on Ways and Means, Education and 
Labor, and Science and Technology discharged; com-
mitted to the Committee of the Whole House on the 
State of the Union and ordered to be printed 
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