I 
115TH CONGRESS 
1ST SESSION H. R. 3932 
To amend title XI of the Social Security Act to provide for increased Puerto 
Rico Medicaid payments, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 3, 2017 
Mr. LANCE (for himself and Miss GONZA´LEZ-COLO´N of Puerto Rico) intro-
duced the following bill; which was referred to the Committee on Energy 
and Commerce 
A BILL 
To amend title XI of the Social Security Act to provide 
for increased Puerto Rico Medicaid payments, 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 ‘‘Healthcare Expendi-
tures for Low-income Populations in Puerto Rico Act’’ or 
the ‘‘HELP Puerto Rico Act’’. 
SEC. 2. PUERTO RICO MEDICAID PAYMENTS. 
(a) INCREASED CAP.—Section 1108(g) of the Social 
Security Act (42 U.S.C. 1308(g)) is amended— 
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(1) in paragraph (2)(A), by inserting ‘‘(or, with 
respect to fiscal years 2018 and 2019, increased by 
such percentage increase plus one percentage point)’’ 
after ‘‘beginning of the fiscal year’’; and 
(2) in paragraph (5)— 
(A) in subparagraph (A), by striking ‘‘sub-
paragraph (B)’’ and inserting ‘‘subparagraphs 
(B), (C), (D), and (E)’’; and 
(B) by adding at the end the following new 
subparagraphs: 
‘‘(C) The amount of the increase otherwise 
provided under subparagraph (A) for Puerto 
Rico 
shall 
be 
further 
increased 
by 
$880,000,000. 
‘‘(D)(i) For the period beginning October 
1, 2017, and ending December 31, 2019, the 
amount of the increase otherwise provided 
under subparagraph (A) for Puerto Rico shall 
be further increased by $120,000,000 if the Fi-
nancial Oversight and Management Board for 
Puerto Rico established under section 101 of 
the Puerto Rico Oversight, Management, and 
Economic Stability Act (48 U.S.C. 2121) cer-
tifies by a majority vote that Puerto Rico has 
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taken reasonable and appropriate steps during 
such period to— 
‘‘(I) reduce fraud, waste, and abuse 
under the program under title XIX; 
‘‘(II) implement strategies to reduce 
unnecessary, 
inefficient, 
or 
excessive 
spending under title XIX; 
‘‘(III) improve the use and availability 
of Medicaid data for program operation 
and oversight; and 
‘‘(IV) improve the quality of care and 
patient experience for individuals enrolled 
under the program under title XIX. 
‘‘(ii) As a condition of any additional in-
crease pursuant to clause (i), not later than Oc-
tober 1, 2018, Puerto Rico shall submit to the 
Financial Oversight and Management Board for 
Puerto Rico a report regarding steps taken to 
achieve each of the goals described in sub-
clauses (I) through (IV) of clause (i). 
‘‘(E) Payments under section 1903(a)(8) 
for a quarter of a fiscal year shall not be taken 
into account in applying subsection (f) (as in-
creased in accordance with this paragraph and 
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paragraphs (1), (2), (3), and (4)) to Puerto 
Rico for such fiscal year.’’. 
(b) FEDERAL MATCH
FOR MEDICAL PERSONNEL 
AND FRAUD REDUCTION.—Section 1903(a) of the Social 
Security Act (42 U.S.C. 1396b(a)) is amended— 
(1) in paragraph (2)(A), by inserting ‘‘subject 
to paragraph (8),’’ before ‘‘an amount’’; 
(2) in paragraph (6)— 
(A) in subparagraph (B), by inserting 
‘‘subject to paragraph (8),’’ before ‘‘75 per cen-
tum’’; and 
(B) by striking at the end ‘‘plus’’; 
(3) in paragraph (7), by striking at the end the 
period and inserting ‘‘; plus’’; and 
(4) by adding at the end the following new 
paragraph: 
‘‘(8) for quarters during the period beginning 
January 1, 2018, and ending December 31, 2019, 
paragraphs (2)(A) and (6) shall apply with respect 
to Puerto Rico as if— 
‘‘(A) the reference to ‘75 per centum’ in 
paragraph (2)(A) were a reference to ‘90 per 
centum’; and 
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‘‘(B) the reference to ‘75 per centum’ in 
paragraph (6)(B) were a reference to ‘90 per 
centum’.’’. 
Æ 
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