I 
115TH CONGRESS 
1ST SESSION H. R. 4541 
To extend funding for certain public health programs, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 4, 2017 
Mrs. MURPHY of Florida (for herself, Mr. NEAL, and Mr. PALLONE) intro-
duced the following bill; which was referred to the Committee on Energy 
and Commerce, and in addition to the Committee on Ways and Means, 
for a period to be subsequently determined by the Speaker, in each case 
for consideration of such provisions as fall within the jurisdiction of the 
committee concerned 
A BILL 
To extend funding for certain public health programs, 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 ‘‘Continuing Community 
Health and Medical Professional Programs to Improve 
Our Nation and Keep Insurance Delivery Stable Act of 
2017’’ or the ‘‘CHAMPION KIDS Act of 2017’’. 
SEC. 2. TABLE OF CONTENTS. 
The table of contents of this Act is as follows: 
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Sec. 1. Short title. 
Sec. 2. Table of contents. 
TITLE I—MEDICAID AND PUBLIC HEALTH EXTENDERS 
Sec. 101. Extension for community health centers and the National Health 
Service Corps. 
Sec. 102. Extension for special diabetes programs. 
Sec. 103. Reauthorization of program of payments to teaching health centers 
that operate graduate medical education programs. 
Sec. 104. Extension for family-to-family health information centers. 
Sec. 105. Youth empowerment program; personal responsibility education. 
Sec. 106. Decreasing reduction in Medicaid DSH allotments. 
Sec. 107. Increase in territorial cap for Medicaid payments. 
Sec. 108. Puerto Rico and United States Virgin Island Disaster Relief Med-
icaid. 
Sec. 109. Delay of Bipartisan Budget Act of 2013 third-party liability provi-
sions. 
TITLE II—CHIP 
Sec. 201. Five-year funding extension of the Children’s Health Insurance Pro-
gram. 
Sec. 202. Extension of certain programs and demonstration projects. 
Sec. 203. Extension of outreach and enrollment program. 
Sec. 204. Extension of additional Federal financial participation for CHIP. 
TITLE III—OFFSET 
Sec. 301. Implementation of Office of Inspector General recommendation to 
delay certain Medicare plan prepayments. 
TITLE I—MEDICAID AND PUBLIC 
HEALTH EXTENDERS 
SEC. 101. EXTENSION FOR COMMUNITY HEALTH CENTERS 
AND 
THE 
NATIONAL 
HEALTH 
SERVICE 
CORPS. 
(a) COMMUNITY HEALTH CENTERS FUNDING.—Sec-
tion 10503(b)(1)(E) of the Patient Protection and Afford-
able Care Act (42 U.S.C. 254b–2(b)(1)(E)) is amended 
by striking ‘‘2017’’ and inserting ‘‘2019’’. 
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(b) OTHER COMMUNITY HEALTH CENTERS PROVI-
SIONS.—Section 330 of the Public Health Service Act (42 
U.S.C. 254b) is amended— 
(1) in subsection (b)(1)(A)(ii), by striking 
‘‘abuse’’ and inserting ‘‘use disorder’’; 
(2) in subsection (b)(2)(A), by striking ‘‘abuse’’ 
and inserting ‘‘use disorder’’; 
(3) in subsection (c)— 
(A) in paragraph (1), by striking subpara-
graphs (B) through (D); 
(B) by striking ‘‘(1) IN GENERAL’’ and all 
that follows through ‘‘The Secretary’’ and in-
serting the following: 
‘‘(1) CENTERS.—The Secretary’’; and 
(C) in paragraph (1), as amended, by re-
designating clauses (i) through (v) as subpara-
graphs (A) through (E) and moving the margin 
of each of such redesignated subparagraph 2 
ems to the left; 
(4) by striking subsection (d) and inserting the 
following: 
‘‘(d) IMPROVING QUALITY OF CARE.— 
‘‘(1) SUPPLEMENTAL AWARDS.—The Secretary 
may award supplemental grant funds to health cen-
ters funded under this section to implement evi-
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dence-based models for increasing access to high- 
quality primary care services, which may include 
models related to— 
‘‘(A) improving the delivery of care for in-
dividuals with multiple chronic conditions; 
‘‘(B) workforce configuration; 
‘‘(C) reducing the cost of care; 
‘‘(D) enhancing care coordination; 
‘‘(E) expanding the use of telehealth and 
technology-enabled collaborative learning and 
capacity building models; 
‘‘(F) care integration, including integration 
of behavioral health, mental health, or sub-
stance use disorder services; and 
‘‘(G) addressing emerging public health or 
substance use disorder issues to meet the health 
needs of the population served by the health 
center. 
‘‘(2) 
SUSTAINABILITY.—In 
making 
supple-
mental awards under this subsection, the Secretary 
may consider whether the health center involved has 
submitted a plan for continuing the activities funded 
under this subsection after supplemental funding is 
expended. 
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‘‘(3) SPECIAL CONSIDERATION.—The Secretary 
may give special consideration to applications for 
supplemental funding under this subsection that 
seek to address significant barriers to access to care 
in areas with a greater shortage of health care pro-
viders and health services relative to the national av-
erage.’’; 
(5) in subsection (e)(1)— 
(A) in subparagraph (B)— 
(i) by striking ‘‘2 years’’ and inserting 
‘‘1 year’’; and 
(ii) by adding at the end the fol-
lowing: ‘‘The Secretary shall not make a 
grant under this paragraph unless the ap-
plicant provides assurances to the Sec-
retary that within 120 days of receiving 
grant funding for the operation of the 
health center, the applicant will submit, for 
approval by the Secretary, an implementa-
tion plan to meet the requirements of sub-
section (l)(3). The Secretary may extend 
such 120-day period for achieving compli-
ance upon a demonstration of good cause 
by the health center.’’; and 
(B) in subparagraph (C)— 
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(i) in the subparagraph heading, by 
striking ‘‘AND PLANS’’; 
(ii) by striking ‘‘or plan (as described 
in subparagraphs (B) and (C) of sub-
section (c)(1))’’; 
(iii) by striking ‘‘or plan, including 
the purchase’’ and inserting the following: 
‘‘including— 
‘‘(i) the purchase’’; 
(iv) by inserting ‘‘, which may include 
data and information systems’’ after ‘‘of 
equipment’’; 
(v) by striking the period at the end 
and inserting a semicolon; and 
(vi) by adding at the end the fol-
lowing: 
‘‘(ii) the provision of training and 
technical assistance; and 
‘‘(iii) other activities that— 
‘‘(I) reduce costs associated with 
the provision of health services; 
‘‘(II) improve access to, and 
availability of, health services provided 
to individuals served by the centers; 
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‘‘(III) enhance the quality and 
coordination of health services; or 
‘‘(IV) improve the health status 
of communities.’’; 
(6) in subsection (e)(5)(B)— 
(A) in the heading of subparagraph (B), by 
striking ‘‘AND PLANS’’; and 
(B) by striking ‘‘and subparagraphs (B) 
and (C) of subsection (c)(1) to a health center 
or to a network or plan’’ and inserting ‘‘to a 
health center or to a network’’; 
(7) by striking subsection (s); 
(8) by redesignating subsections (g) through (r) 
as subsections (h) through (s), respectively; 
(9) by inserting after subsection (f), the fol-
lowing: 
‘‘(g) NEW ACCESS POINTS AND EXPANDED SERV-
ICES.— 
‘‘(1) APPROVAL OF NEW ACCESS POINTS.— 
‘‘(A) IN
GENERAL.—The Secretary may 
approve applications for grants under subpara-
graph (A) or (B) of subsection (e)(1) to estab-
lish new delivery sites. 
‘‘(B) SPECIAL
CONSIDERATION.—In car-
rying out subparagraph (A), the Secretary may 
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give special consideration to applicants that 
have demonstrated the new delivery site will be 
located within a sparsely populated area, or an 
area which has a level of unmet need that is 
higher relative to other applicants. 
‘‘(C) CONSIDERATION OF APPLICATIONS.— 
In carrying out subparagraph (A), the Sec-
retary shall approve applications for grants 
under subparagraphs (A) and (B) of subsection 
(e)(1) in such a manner that the ratio of the 
medically underserved populations in rural 
areas which may be expected to use the services 
provided by the applicants involved to the medi-
cally underserved populations in urban areas 
which may be expected to use the services pro-
vided by the applicants is not less than two to 
three or greater than three to two. 
‘‘(D) SERVICE AREA OVERLAP.—If in car-
rying out subparagraph (A) the applicant pro-
poses to serve an area that is currently served 
by another health center funded under this sec-
tion, the Secretary may consider whether the 
award of funding to an additional health center 
in the area can be justified based on the unmet 
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need 
for 
additional 
services 
within 
the 
catchment area. 
‘‘(2) APPROVAL OF EXPANDED SERVICE APPLI-
CATIONS.— 
‘‘(A) IN
GENERAL.—The Secretary may 
approve applications for grants under subpara-
graph (A) or (B) of subsection (e)(1) to expand 
the capacity of the applicant to provide required 
primary health services described in subsection 
(b)(1) or additional health services described in 
subsection (b)(2). 
‘‘(B) PRIORITY EXPANSION PROJECTS.—In 
carrying out subparagraph (A), the Secretary 
may give special consideration to expanded 
service applications that seek to address emerg-
ing public health or behavioral health, mental 
health, or substance abuse issues through in-
creasing the availability of additional health 
services described in subsection (b)(2) in an 
area in which there are significant barriers to 
accessing care. 
‘‘(C) CONSIDERATION OF APPLICATIONS.— 
In carrying out subparagraph (A), the Sec-
retary shall approve applications for applicants 
in such a manner that the ratio of the medically 
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underserved populations in rural areas which 
may be expected to use the services provided by 
the applicants involved to the medically under-
served populations in urban areas which may be 
expected to use the services provided by such 
applicants is not less than two to three or 
greater than three to two.’’; 
(10) in subsection (i) (as so redesignated)— 
(A) in paragraph (1), by striking ‘‘and 
children and youth at risk of homelessness’’ and 
inserting ‘‘, children and youth at risk of home-
lessness, homeless veterans, and veterans at 
risk of homelessness’’; and 
(B) in paragraph (5)— 
(i) by striking subparagraph (B); 
(ii) by redesignating subparagraph 
(C) as subparagraph (B); and 
(iii) in subparagraph (B) (as so redes-
ignated)— 
(I) in the subparagraph heading, 
by striking ‘‘ABUSE’’ and inserting 
‘‘USE DISORDER’’; and 
(II) by striking ‘‘abuse’’ and in-
serting ‘‘use disorder’’; 
(11) in subsection (l) (as so redesignated)— 
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(A) in paragraph (2)— 
(i) in the paragraph heading, by in-
serting ‘‘UNMET’’ before ‘‘NEED’’; 
(ii) in the matter preceding subpara-
graph (A), by inserting ‘‘and an applica-
tion for a grant under subsection (g)’’ 
after ‘‘subsection (e)(1)’’; 
(iii) in subparagraph (A), by inserting 
‘‘unmet’’ before ‘‘need for health services’’; 
(iv) in subparagraph (B), by striking 
‘‘and’’ at the end; 
(v) in subparagraph (C), by striking 
the period at the end and inserting ‘‘; 
and’’; and 
(vi) by adding after subparagraph (C) 
the following: 
‘‘(D) in the case of an application for a 
grant pursuant to subsection (g)(1), a dem-
onstration that the applicant has consulted with 
appropriate State and local government agen-
cies, and health care providers regarding the 
need for the health services to be provided at 
the proposed delivery site.’’; 
(B) in paragraph (3)— 
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(i) in the matter preceding subpara-
graph (A), by inserting ‘‘or subsection (g)’’ 
after ‘‘subsection (e)(1)(B)’’; 
(ii) in subparagraph (B), by striking 
‘‘in the catchment area of the center’’ and 
inserting ‘‘, including other health care 
providers that provide care within the 
catchment area, local hospitals, and spe-
cialty providers in the catchment area of 
the center, to provide access to services not 
available through the health center and to 
reduce the non-urgent use of hospital 
emergency departments’’; 
(iii) in subparagraph (H)(ii), by in-
serting ‘‘who shall be directly employed by 
the center’’ after ‘‘approves the selection of 
a director for the center’’; 
(iv) in subparagraph (L), by striking 
‘‘and’’ at the end; 
(v) in subparagraph (M), by striking 
the period and inserting ‘‘; and’’; and 
(vi) by inserting after subparagraph 
(M), the following: 
‘‘(N) the center has written policies and 
procedures in place to ensure the appropriate 
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use of Federal funds in compliance with appli-
cable Federal statutes, regulations, and the 
terms and conditions of the Federal award.’’; 
and 
(C) by striking paragraph (4); 
(12) in subsection (m) (as so redesignated), by 
adding at the end the following: ‘‘Funds expended to 
carry out activities under this subsection and oper-
ational support activities under subsection (n) shall 
not exceed 3 percent of the amount appropriated for 
this section for the fiscal year involved.’’; 
(13) in subsection (q) (as so redesignated), by 
striking ‘‘grants for new health centers under sub-
sections (c) and (e)’’ and inserting ‘‘operating grants 
under subsection (e), applications for new access 
points and expanded service pursuant to subsection 
(g)’’; 
(14) in subsection (r)(4) (as so redesignated), 
by adding at the end the following: ‘‘A waiver pro-
vided by the Secretary under this paragraph may 
not remain in effect for more than 1 year and may 
not be extended after such period. An entity may not 
receive more than one waiver under this paragraph 
in consecutive years.’’; 
(15) in subsection (s)(3) (as so redesignated)— 
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(A) by striking ‘‘appropriate committees of 
Congress a report concerning the distribution of 
funds under this section’’ and inserting the fol-
lowing: ‘‘Committee on Health, Education, 
Labor, and Pensions of the Senate, and the 
Committee on Energy and Commerce of the 
House of Representatives, a report including, at 
a minimum— 
‘‘(A) the distribution of funds for carrying 
out this section’’; 
(B) by striking ‘‘populations. Such report 
shall include an assessment’’ and inserting the 
following: ‘‘populations; 
‘‘(B) an assessment’’; 
(C) by striking ‘‘and the rationale for any 
substantial changes in the distribution of 
funds.’’ and inserting a semicolon; and 
(D) by adding at the end the following: 
‘‘(C) the distribution of awards and fund-
ing for new or expanded services in each of 
rural areas and urban areas; 
‘‘(D) the distribution of awards and fund-
ing for establishing new access points, and the 
number of new access points created; 
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‘‘(E) the amount of unexpended funding 
for loan guarantees and loan guarantee author-
ity under title XVI; 
‘‘(F) the rationale for any substantial 
changes in the distribution of funds; 
‘‘(G) the rate of closures for health centers 
and access points; 
‘‘(H) the number and reason for any 
grants 
awarded 
pursuant 
to 
subsection 
(e)(1)(B); and 
‘‘(I) the number and reason for any waiv-
ers provided pursuant to subsection (r)(4).’’; 
and 
(16) in subsection (s) (as so redesignated) by 
adding at the end the following new paragraph: 
‘‘(5) FUNDING FOR PARTICIPATION OF HEALTH 
CENTERS IN ALL OF US RESEARCH PROGRAM.—In 
addition to any amounts made available pursuant to 
paragraph (1) of this subsection, section 402A of 
this Act, or section 10503 of the Patient Protection 
and Affordable Care Act, there is authorized to be 
appropriated, and there is appropriated, out of any 
monies in the Treasury not otherwise appropriated, 
to the Secretary $25,000,000 for fiscal year 2018 to 
support the participation of health centers in the All 
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of Us Research Program under the Precision Medi-
cine Initiative under section 498E of this Act.’’. 
(c) NATIONAL HEALTH SERVICE CORPS.—Section 
10503(b)(2)(E) of the Patient Protection and Affordable 
Care Act (42 U.S.C. 254b–2(b)(2)(E)) is amended by 
striking ‘‘2017’’ and inserting ‘‘2019’’. 
(d) CONFORMING AMENDMENT.—Section 3014(h)(1) 
of title 18, United States Code, is amended by striking 
‘‘, as amended by section 221 of the Medicare Access and 
CHIP Reauthorization Act of 2015,’’. 
SEC. 102. EXTENSION FOR SPECIAL DIABETES PROGRAMS. 
(a) SPECIAL DIABETES PROGRAM FOR TYPE I DIA-
BETES.—Section 330B(b)(2)(C) of the Public Health 
Service Act (42 U.S.C. 254c–2(b)(2)(C)) is amended by 
striking ‘‘2017’’ and inserting ‘‘2019’’. 
(b) SPECIAL DIABETES PROGRAM FOR INDIANS.— 
Section 330C(c)(2) of the Public Health Service Act (42 
U.S.C. 254c–3(c)(2)) is amended— 
(1) in subparagraph (C), by striking ‘‘and’’ at 
the end; 
(2) in subparagraph (D), by striking the period 
at the end and inserting ‘‘and $112,500,000 for the 
period consisting of the second, third, and fourth 
quarters of fiscal year 2018; and’’; and 
(3) by adding at the end the following: 
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‘‘(E) $150,000,000 for fiscal year 2019.’’. 
SEC. 103. REAUTHORIZATION OF PROGRAM OF PAYMENTS 
TO TEACHING HEALTH CENTERS THAT OPER-
ATE GRADUATE MEDICAL EDUCATION PRO-
GRAMS. 
(a) PAYMENTS.—Subsection (a) of section 340H of 
the Public Health Service Act (42 U.S.C. 256h) is amend-
ed to read as follows: 
‘‘(a) PAYMENTS.— 
‘‘(1) IN
GENERAL.—Subject to subsection 
(h)(2), the Secretary shall make payments under 
this section for direct expenses and indirect expenses 
to qualified teaching health centers that are listed as 
sponsoring institutions by the relevant accrediting 
body for— 
‘‘(A) maintenance of existing approved 
graduate medical residency training programs; 
‘‘(B) expansion of existing approved grad-
uate medical residency training programs; and 
‘‘(C) establishment of new approved grad-
uate medical residency training programs, as 
appropriate. 
‘‘(2) PRIORITY.—In making payments pursuant 
to paragraph (1)(C), the Secretary shall give priority 
to qualified teaching health centers that— 
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‘‘(A) serve a health professional shortage 
area with a designation in effect under section 
332 or a medically underserved community (as 
defined in section 799B); or 
‘‘(B) are located in a rural area (as de-
fined in section 1886(d)(2)(D) of the Social Se-
curity Act).’’. 
(b) FUNDING.—Subsection (g) of section 340H of the 
Public Health Service Act (42 U.S.C. 256h) is amended— 
(1) by striking ‘‘To carry out’’ and inserting 
the following: 
‘‘(1) IN GENERAL.—To carry out’’; 
(2) by striking ‘‘and $15,000,000 for the first 
quarter of fiscal year 2018’’ and inserting ‘‘, 
$15,000,000 for the first quarter of fiscal year 
2018, $111,500,000 for the period consisting of the 
second, third, and fourth quarters of fiscal year 
2018, and $126,500,000 for fiscal year 2019, to re-
main available until expended’’; and 
(3) by adding at the end the following: 
‘‘(2) 
ADMINISTRATIVE
EXPENSES.—Of 
the 
amount made available to carry out this section for 
any fiscal year, the Secretary may not use more 
than 5 percent of such amount for the expenses of 
administering this section.’’. 
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(c) ANNUAL REPORTING.—Subsection (h)(1) of sec-
tion 340H of the Public Health Service Act (42 U.S.C. 
256h) is amended— 
(1) by redesignating subparagraph (D) as sub-
paragraph (H); and 
(2) by inserting after subparagraph (C) the fol-
lowing: 
‘‘(D) The number of patients treated by 
residents described in paragraph (4). 
‘‘(E) The number of visits by patients 
treated by residents described in paragraph (4). 
‘‘(F) Of the number of residents described 
in paragraph (4) who completed their residency 
training at the end of such residency academic 
year, the number and percentage of such resi-
dents entering primary care practice (meaning 
any of the areas of practice listed in the defini-
tion of a primary care residency program in 
section 749A). 
‘‘(G) Of the number of residents described 
in paragraph (4) who completed their residency 
training at the end of such residency academic 
year, the number and percentage of such resi-
dents who entered practice at a health care fa-
cility— 
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‘‘(i) primarily serving a health profes-
sional shortage area with a designation in 
effect under section 332 or a medically un-
derserved community (as defined in section 
799B); or 
‘‘(ii) located in a rural area (as de-
fined in section 1886(d)(2)(D) of the So-
cial Security Act).’’. 
(d) REPORT ON TRAINING COSTS.—Not later than 
March 31, 2019, the Secretary of Health and Human 
Services shall submit to the Congress a report on the di-
rect graduate expenses of approved graduate medical resi-
dency training programs, and the indirect expenses associ-
ated with the additional costs of teaching residents, of 
qualified teaching health centers (as such terms are used 
or defined in section 340H of the Public Health Service 
Act (42 U.S.C. 256h)). 
(e) DEFINITION.—Subsection (j) of section 340H of 
the Public Health Service Act (42 U.S.C. 256h) is amend-
ed— 
(1) by redesignating paragraphs (2) and (3) as 
paragraphs (3) and (4), respectively; and 
(2) by inserting after paragraph (1) the fol-
lowing: 
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‘‘(2) NEW
APPROVED
GRADUATE
MEDICAL 
RESIDENCY
TRAINING
PROGRAM.—The term ‘new 
approved graduate medical residency training pro-
gram’ means an approved graduate medical resi-
dency training program for which the sponsoring 
qualified teaching health center has not received a 
payment under this section for a previous fiscal year 
(other than pursuant to subsection (a)(1)(C)).’’. 
(f) TECHNICAL CORRECTION.—Subsection (f) of sec-
tion 340H (42 U.S.C. 256h) is amended by striking ‘‘hos-
pital’’ each place it appears and inserting ‘‘teaching health 
center’’. 
(g) PAYMENTS FOR PREVIOUS FISCAL YEARS.—The 
provisions of section 340H of the Public Health Service 
Act (42 U.S.C. 256h), as in effect on the day before the 
date of enactment of this Act, shall continue to apply with 
respect to payments under such section for fiscal years 
before fiscal year 2018. 
SEC. 104. EXTENSION FOR FAMILY-TO-FAMILY HEALTH IN-
FORMATION CENTERS. 
Section 501(c) of the Social Security Act (42 U.S.C. 
701(c)) is amended— 
(1) in paragraph (1)(A)— 
(A) in clause (v), by striking ‘‘and’’ at the 
end; 
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(B) in clause (vi), by striking the period at 
the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
clause: 
‘‘(vii) $6,000,000 for each of fiscal years 2018 
and 2019.’’; 
(2) in paragraph (3)(C), by inserting before the 
period the following: ‘‘, and with respect to fiscal 
years 2018 and 2019, such centers shall also be de-
veloped in all territories and at least one such center 
shall be developed for Indian tribes’’; and 
(3) by amending paragraph (5) to read as fol-
lows: 
‘‘(5) For purposes of this subsection— 
‘‘(A) the term ‘Indian tribe’ has the meaning 
given such term in section 4 of the Indian Health 
Care Improvement Act (25 U.S.C. 1603); 
‘‘(B) the term ‘State’ means each of the 50 
States and the District of Columbia; and 
‘‘(C) the term ‘territory’ means Puerto Rico, 
Guam, American Samoa, the Virgin Islands, and the 
Northern Mariana Islands.’’. 
SEC. 105. YOUTH EMPOWERMENT PROGRAM; PERSONAL 
RESPONSIBILITY EDUCATION. 
(a) YOUTH EMPOWERMENT PROGRAM.— 
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(1) IN GENERAL.—Section 510 of the Social 
Security Act (42 U.S.C. 710) is amended to read as 
follows: 
‘‘SEC. 510. YOUTH EMPOWERMENT PROGRAM. 
‘‘(a) IN GENERAL.— 
‘‘(1) ALLOTMENTS TO STATES.—For the pur-
pose described in subsection (b), the Secretary shall, 
for each of fiscal years 2018 and 2019, allot to each 
State which has transmitted an application for the 
fiscal year under section 505(a) an amount equal to 
the product of— 
‘‘(A) the amount appropriated pursuant to 
subsection (e)(1) for the fiscal year, minus the 
amount reserved under subsection (e)(2) for the 
fiscal year; and 
‘‘(B) the proportion that the number of 
low-income children in the State bears to the 
total of such numbers of children for all the 
States. 
‘‘(2) OTHER ALLOTMENTS.— 
‘‘(A) OTHER ENTITIES.—For the purpose 
described in subsection (b), the Secretary shall, 
for each of fiscal years 2018 and 2019, for any 
State which has not transmitted an application 
for the fiscal year under section 505(a), allot to 
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one or more entities in the State the amount 
that would have been allotted to the State 
under paragraph (1) if the State had submitted 
such an application. 
‘‘(B) PROCESS.—The Secretary shall select 
the recipients of allotments under subparagraph 
(A) by means of a competitive grant process 
under which— 
‘‘(i) not later than 30 days after the 
deadline for the State involved to submit 
an application for the fiscal year under 
section 505(a), the Secretary publishes a 
notice soliciting grant applications; and 
‘‘(ii) not later than 120 days after 
such deadline, all such applications must 
be submitted. 
‘‘(b) PURPOSE.— 
‘‘(1) IN GENERAL.—Except for research under 
paragraph (5) and information collection and report-
ing under paragraph (6), the purpose of an allot-
ment under subsection (a) to a State (or to another 
entity in the State pursuant to subsection (a)(2)) is 
to enable the State or other entity to implement edu-
cation exclusively on sexual risk avoidance (meaning 
voluntarily refraining from sexual activity). 
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‘‘(2) REQUIRED COMPONENTS.—Education on 
sexual risk avoidance pursuant to an allotment 
under this section shall— 
‘‘(A) ensure that the unambiguous and pri-
mary emphasis and context for each topic de-
scribed in paragraph (3) is a message to youth 
that normalizes the optimal health behavior of 
avoiding nonmarital sexual activity; 
‘‘(B) be medically accurate and complete; 
‘‘(C) be age-appropriate; and 
‘‘(D) be based on adolescent learning and 
developmental theories for the age group receiv-
ing the education. 
‘‘(3) TOPICS.—Education on sexual risk avoid-
ance pursuant to an allotment under this section 
shall address each of the following topics: 
‘‘(A) The holistic individual and societal 
benefits associated with personal responsibility, 
self-regulation, goal setting, healthy decision-
making, and a focus on the future. 
‘‘(B) The advantage of refraining from 
nonmarital sexual activity in order to improve 
the future prospects and physical and emotional 
health of youth. 
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‘‘(C) The increased likelihood of avoiding 
poverty when youth attain self-sufficiency and 
emotional maturity before engaging in sexual 
activity. 
‘‘(D) The foundational components of 
healthy relationships and their impact on the 
formation of healthy marriages and safe and 
stable families. 
‘‘(E) How other youth risk behaviors, such 
as drug and alcohol usage, increase the risk for 
teen sex. 
‘‘(F) How to resist and avoid, and receive 
help regarding, sexual coercion and dating vio-
lence, recognizing that even with consent teen 
sex remains a youth risk behavior. 
‘‘(4) CONTRACEPTION.—Education on sexual 
risk avoidance pursuant to an allotment under this 
section shall ensure that— 
‘‘(A) any information provided on contra-
ception is medically accurate and ensures that 
students understand that contraception offers 
physical risk reduction, but not risk elimination; 
and 
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‘‘(B) the education does not include dem-
onstrations, simulations, or distribution of con-
traceptive devices. 
‘‘(5) RESEARCH.— 
‘‘(A) IN GENERAL.—A State or other enti-
ty receiving an allotment pursuant to subsection 
(a) may use up to 20 percent of such allotment 
to build the evidence base for sexual risk avoid-
ance education by conducting or supporting re-
search. 
‘‘(B) REQUIREMENTS.—Any research con-
ducted or supported pursuant to subparagraph 
(A) shall be— 
‘‘(i) rigorous; 
‘‘(ii) evidence-based; and 
‘‘(iii) designed and conducted by inde-
pendent researchers who have experience 
in conducting and publishing research in 
peer-reviewed outlets. 
‘‘(6) INFORMATION COLLECTION AND REPORT-
ING.—A State or other entity receiving an allotment 
pursuant to subsection (a) shall, as specified by the 
Secretary— 
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‘‘(A) collect information on the programs 
and activities funded through the allotment; 
and 
‘‘(B) submit reports to the Secretary on 
the data from such programs and activities. 
‘‘(c) NATIONAL EVALUATION.— 
‘‘(1) IN GENERAL.—The Secretary shall— 
‘‘(A) in consultation with appropriate State 
and local agencies, conduct one or more rig-
orous evaluations of the education funded 
through this section and associated data; and 
‘‘(B) submit a report to the Congress on 
the results of such evaluations, together with a 
summary of the information collected pursuant 
to subsection (b)(6). 
‘‘(2) CONSULTATION.—In conducting the eval-
uations required by paragraph (1), including the es-
tablishment of evaluation methodologies, the Sec-
retary shall consult with relevant stakeholders. 
‘‘(d) APPLICABILITY OF CERTAIN PROVISIONS.— 
‘‘(1) Sections 503, 507, and 508 apply to allot-
ments under subsection (a) to the same extent and 
in the same manner as such sections apply to allot-
ments under section 502(c). 
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‘‘(2) Sections 505 and 506 apply to allotments 
under subsection (a) to the extent determined by the 
Secretary to be appropriate. 
‘‘(e) FUNDING.— 
‘‘(1) IN GENERAL.—To carry out this section, 
there is appropriated, out of any money in the 
Treasury not otherwise appropriated, $75,000,000 
for each of fiscal years 2018 and 2019. 
‘‘(2) RESERVATION.—The Secretary shall re-
serve, for each of fiscal years 2018 and 2019, not 
more than 20 percent of the amount appropriated 
pursuant to paragraph (1) for administering the 
program under this section, including the conducting 
of national evaluations and the provision of technical 
assistance to the recipients of allotments.’’. 
(2) EFFECTIVE DATE.—The amendment made 
by this section takes effect on October 1, 2017. 
(b) PERSONAL RESPONSIBILITY EDUCATION.— 
(1) IN GENERAL.—Section 513 of the Social 
Security Act (42 U.S.C. 713) is amended— 
(A) in subsection (a)(1)(A), by striking 
‘‘2017’’ and inserting ‘‘2019’’; 
(B) in subsection (a)(4)— 
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(i) in subparagraph (A), by striking 
‘‘2017’’ each place it appears and inserting 
‘‘2019’’; and 
(ii) in subparagraph (B)— 
(I) in the subparagraph heading, 
by striking ‘‘3-YEAR GRANTS’’ and in-
serting 
‘‘COMPETITIVE
PREP 
GRANTS’’; and 
(II) in clause (i), by striking ‘‘so-
licit applications to award 3-year 
grants in each of fiscal years 2012 
through 2017’’ and inserting ‘‘con-
tinue through fiscal year 2019 grants 
awarded for any of fiscal years 2015 
through 2017’’; 
(C) in subsection (c)(1), by inserting after 
‘‘youth with HIV/AIDS,’’ the following: ‘‘vic-
tims of human trafficking,’’; and 
(D) in subsection (f), by striking ‘‘2017’’ 
and inserting ‘‘2019’’. 
(2) EFFECTIVE DATE.—The amendments made 
by this subsection take effect on October 1, 2017. 
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SEC. 106. DECREASING REDUCTION IN MEDICAID DSH AL-
LOTMENTS. 
Section 1923(f)(7)(A) of the Social Security Act (42 
U.S.C. 1396r–4(f)(7)(A)) is amended— 
(1) in clause (i), in the matter preceding sub-
clause (I), by striking ‘‘2018’’ and inserting ‘‘2023’’; 
and 
(2) in clause (ii), by striking subclauses (I) 
through (VIII) and inserting the following: 
‘‘(I) $5,000,000,000 for fiscal 
year 2023; 
‘‘(II) $5,500,000,000 for fiscal 
year 2024; and 
‘‘(III) $6,000,000,000 for fiscal 
year 2025.’’. 
SEC. 107. INCREASE IN TERRITORIAL CAP FOR MEDICAID 
PAYMENTS. 
Section 1108(g)(5) of the Social Security Act (42 
U.S.C. 1308(g)(5)) is amended— 
(1) in subparagraph (A)— 
(A) by striking ‘‘subparagraph (B)’’ and 
inserting ‘‘subparagraphs (B), (C), and (D)’’; 
and 
(B) by striking ‘‘2019’’ and inserting 
‘‘2022’’; and 
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(2) by adding at the end the following new sub-
paragraphs: 
‘‘(C) The amount of the increase otherwise pro-
vided under subparagraph (A) for— 
‘‘(i) Puerto Rico shall, after application of 
subparagraph (B), be further increased by 
$1,600,000,000 for each of fiscal years 2018 
through 2022; and 
‘‘(ii) the Virgin Islands shall be further in-
creased by $55,000,000 for each of fiscal years 
2018 through 2022. 
‘‘(D) The amount of the increase otherwise pro-
vided under subparagraph (A) for Guam, the North-
ern Mariana Islands, and America Samoa, respec-
tively, shall be further increased by such amounts 
that the total amount of increases under this sub-
paragraph is equal to $150,000,000. In applying the 
previous sentence, the Secretary shall increase 
amounts for such territories in such a proportion as 
would be applied under subparagraph (A) if such 
territories were the only territories to which such 
subparagraph applied.’’. 
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SEC. 108. PUERTO RICO AND UNITED STATES VIRGIN IS-
LAND DISASTER RELIEF MEDICAID. 
(a) SIMPLIFIED ELIGIBILITY DETERMINATIONS AND 
REDETERMINATIONS.— 
(1) IN GENERAL.—Notwithstanding any provi-
sion of title XIX of the Social Security Act (42 
U.S.C. 1396 et seq.), a State shall, as a condition 
of participation in the Medicaid program under such 
title and without submitting an amendment to the 
State Medicaid plan— 
(A) use streamlined procedures described 
in paragraph (2) in processing applications and 
determining and redetermining eligibility for 
medical assistance under the State Medicaid 
plan for DRM-eligible Maria Survivors during 
the DRM coverage period; and 
(B) provide, in the case of such a Survivor, 
for medical assistance under the State Medicaid 
plan to such Survivor during such period based 
on the family income level eligibility require-
ments established under the State Medicaid 
plan or, if higher, under the State Medicaid 
plan of the State in which such Survivor resided 
as of September 17, 2017. 
(2) STREAMLINED PROCEDURES.—The stream-
lined procedures described in this paragraph, with 
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respect to a State and an applicant for medical as-
sistance under the State Medicaid plan, are the fol-
lowing: 
(A) COMMON APPLICATION FORM.—Use of 
a common 1-page application form developed by 
the Secretary of Health and Human Services, 
in consultation with the National Association of 
State Medicaid Directors. Such form shall— 
(i) require an applicant to provide an 
expected address for the duration of the 
DRM coverage period and to agree to up-
date that information if it changes during 
such period; 
(ii) include notice regarding the pen-
alties for making a fraudulent application; 
(iii) require the applicant to assign to 
the State any rights of the applicant (or 
any other person who is a DRM-eligible 
Maria Survivor and on whose behalf the 
applicant has the legal authority to execute 
an assignment of such rights) under any 
group health plan or other third-party cov-
erage for health care; and 
(iv) require the applicant to list any 
health insurance coverage which the appli-
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cant was enrolled in immediately prior to 
submitting such application. 
(B) SELF-ATTESTATION.—Self-attestation 
by the applicant for medical assistance under 
the State Medicaid plan that the applicant is a 
DRM-eligible Maria Survivor, including with re-
spect to citizenship, identity, immigration sta-
tus, and income requirements. 
(C) NO
DOCUMENTATION.—No require-
ment for documentation evidencing the basis on 
which the applicant qualifies to be a DRM-eligi-
ble Maria Survivor. 
(D) ISSUANCE
OF
ELIGIBILITY
CARD.— 
Issuance of a DRM assistance eligibility card to 
an applicant who completes such application, 
including the self-attestation required under 
subparagraph (B). Such card shall be valid as 
long as the DRM coverage period is in effect 
and shall be accompanied by notice of the ter-
mination date for the DRM coverage period 
and, if applicable, notice that such termination 
date may be extended. If the President extends 
the DRM coverage period, the State shall notify 
DRM-eligible Maria Survivors enrolled in the 
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State Medicaid plan of the new termination 
date for the DRM coverage period. 
(E) DEEMED
ELIGIBILITY.—If an appli-
cant completes the application and presents it 
to a provider or facility participating in the 
State Medicaid plan that is qualified to make 
presumptive eligibility determinations under 
such plan (which at a minimum shall consist of 
facilities identified in section 1902(a)(55) of the 
Social Security Act (42 U.S.C. 1396a(a)(55)) 
and it appears to the provider that the appli-
cant is a DRM-eligible Maria Survivor based on 
the information in the application, the applicant 
will be deemed to be a DRM-eligible Maria Sur-
vivor eligible for medical assistance under the 
State Medicaid plan. 
(F) CONTINUOUS
ELIGIBILITY.—Contin-
uous eligibility, without the need for any rede-
termination of eligibility, for the duration of the 
DRM coverage period. 
(b) NO CONTINUATION OF DRM ASSISTANCE.— 
(1) IN GENERAL.—Except as provided in para-
graphs (2) and (3), no DRM assistance shall be pro-
vided after the end of the DRM coverage period. 
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(2) PRESUMPTIVE ELIGIBILITY.—In the case of 
any DRM-eligible Maria Survivor who is receiving 
DRM assistance from a State in accordance with 
this section and who, as of the end of the DRM cov-
erage period, has an application pending for medical 
assistance under the State Medicaid plan for periods 
beginning after the end of such period, the State 
shall provide such Survivor with a period of pre-
sumptive eligibility for medical assistance under the 
State Medicaid plan (not to exceed 60 days) until a 
determination with respect to the Survivor’s applica-
tion has been made. 
(3) PREGNANT
WOMEN.—In the case of a 
DRM-eligible Maria Survivor who is receiving DRM 
assistance from a State in accordance with this sec-
tion and whose pregnancy ended during the 60-day 
period prior to the end of the DRM coverage period, 
or who is pregnant as of the end of such period, 
such Survivor shall continue to be eligible for DRM 
assistance after the end of the DRM coverage pe-
riod, including (but not limited to) all pregnancy-re-
lated and postpartum medical assistance available 
under the State Medicaid plan, through the end of 
the month in which the 60-day period (beginning on 
the last day of her pregnancy) ends. 
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(c) TREATMENT OF MARIA SURVIVORS PROVIDED 
ASSISTANCE PRIOR
TO DATE
OF ENACTMENT.—Any 
Maria Survivor who is provided medical assistance under 
a State Medicaid plan in accordance with guidance from 
the Secretary during the period that begins on September 
17, 2017, and ends on the date of enactment of this Act 
shall be treated as a DRM-eligible Maria Survivor, without 
the need to file an additional application, for purposes of 
eligibility for medical assistance under this section. 
(d) SCOPE OF COVERAGE.— 
(1) IN GENERAL.—A State providing medical 
assistance under a State Medicaid plan to a DRM- 
eligible Maria Survivor pursuant to this section shall 
provide medical assistance that is either— 
(A) equal in amount and scope to the med-
ical assistance that would otherwise be made 
available to such Survivor if the Survivor were 
a State resident enrolled in the State Medicaid 
plan; or 
(B) if greater in amount and scope, equal 
in amount and scope to the medical assistance 
that would have been made available to such 
Survivor under the State Medicaid plan of the 
State in which such Survivor resided as of Sep-
tember 17, 2017. 
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Coverage for such medical assistance for DRM-eligi-
ble Maria Survivors shall be retroactive to items and 
services furnished on or after September 17, 2017 
(or in the case of applications for DRM assistance 
submitted after January 1, 2018, the first day of 
the 5th month preceding the date on which such ap-
plication is submitted). 
(2) CHILDREN BORN TO PREGNANT WOMEN.— 
In the case of a child born to a DRM-eligible Maria 
Survivor who is provided DRM assistance during the 
DRM coverage period, such child shall be treated as 
having been born to a pregnant woman eligible for 
medical assistance under the State Medicaid plan 
and shall be eligible for medical assistance under 
such plan in accordance with section 1902(e)(4) of 
the Social Security Act (42 U.S.C. 1396a(e)(4)). 
The Federal medical assistance percentage applica-
ble to the State Medicaid plan shall apply to medical 
assistance provided to a child under such plan in ac-
cordance with the preceding sentence and Federal 
payments for such assistance shall not be considered 
to be payments under this section. 
(e) 100 PERCENT
FEDERAL
MATCHING
PAY-
MENTS.— 
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(1) IN
GENERAL.—Notwithstanding section 
1905(b) of the Social Security Act (42 U.S.C. 
1396d(b)), subject to paragraph (2), the Federal 
medical assistance percentage or the Federal match-
ing rate otherwise applied under section 1903(a) of 
such Act (42 U.S.C. 1396b(a)) shall be 100 percent 
for— 
(A) providing DRM assistance to DRM-eli-
gible Maria Survivors during the DRM coverage 
period in accordance with this section; 
(B) costs directly attributable to adminis-
trative activities related to the provision of such 
DRM assistance; and 
(C) DRM assistance provided in accord-
ance with paragraph (2) or (3) of subsection 
(b) after the end of the DRM coverage period. 
(2) LIMITATION.— 
(A) TERRITORIES.—Payments provided to 
a State that is a territory (as defined in section 
1108(c)(1) of the Social Security Act (42 
U.S.C. 1308(c)(1))) in accordance with this 
subsection shall be subject to subsections (f) 
and (g) of section 1108 of the Social Security 
Act (42 U.S.C. 1308). 
(B) OTHER STATES.— 
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(i) IN
GENERAL.—In the case of 
States not described in subparagraph (A), 
the difference between— 
(I) the total amount of payments 
made to such States in accordance 
with this subsection, by reason of the 
Federal medical assistance percentage 
or the Federal matching rate applied 
under paragraph (1); and 
(II) the total amount of pay-
ments that would otherwise be made 
to such States if the Federal medical 
assistance percentage and the Federal 
matching rate under section 1905(b) 
of the Social Security Act and 
1903(a) of such Act were applied, 
may not exceed the amount appropriated 
under clause (ii). 
(ii) APPROPRIATIONS.—There are ap-
propriated, out of any amounts in the 
Treasury 
not 
otherwise 
appropriated, 
$1,000,000,000 for the DRM coverage pe-
riod for purposes of making payments in 
accordance with this subsection to States 
not described in subparagraph (A). 
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(3) EXEMPTION
FROM
ERROR
RATE
PEN-
ALTIES.—All payments attributable to providing 
DRM assistance in accordance with this section shall 
be disregarded for purposes of section 1903(u) of 
the Social Security Act (42 U.S.C. 1396b(u)). 
(f) VERIFICATION
OF STATUS
AS
A MARIA SUR-
VIVOR.— 
(1) IN GENERAL.—A State shall make a good 
faith effort to verify the status of an individual who 
is enrolled in the State Medicaid plan as a DRM-eli-
gible Maria Survivor under the provisions of this 
section. Such effort shall not delay the determina-
tion of the eligibility of the Survivor for DRM assist-
ance under this section. 
(2) EVIDENCE OF VERIFICATION.—A State may 
satisfy the verification requirement under paragraph 
(1) with respect to an individual by showing that the 
State obtained information from the Social Security 
Administration, the Internal Revenue Service, or the 
State Medicaid Agency for the State from which the 
individual is from (if the individual was not a resi-
dent of such State on any day during the week pre-
ceding September 17, 2017). 
(g) PROVIDER PAYMENT RATES.—In the case of any 
DRM assistance provided in accordance with this section 
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to a DRM-eligible Maria Survivor that is covered under 
the State Medicaid plan (as applied without regard to this 
section) the State shall pay a provider of such assistance 
the same payment rate as the State would otherwise pay 
for the assistance if the assistance were provided under 
the State Medicaid plan (or, if no such payment rate ap-
plies under the State Medicaid plan, the usual and cus-
tomary prevailing rate for the item or service for the com-
munity in which it is provided). 
(h) APPLICATION TO INDIVIDUALS ELIGIBLE FOR 
MEDICAL ASSISTANCE.—Nothing in this section shall be 
construed as affecting any rights accorded to an individual 
who is a recipient of medical assistance under a State 
Medicaid plan who is determined to be a DRM-eligible 
Maria Survivor but the provision of DRM assistance to 
such individual shall be limited to the provision of such 
assistance in accordance with this section. 
(i) DEFINITIONS.—In this section: 
(1) DRM ASSISTANCE.—The term ‘‘DRM as-
sistance’’ means medical assistance under a State 
Medicaid plan for a DRM-eligible Maria Survivor 
during the DRM coverage period. 
(2) DRM COVERAGE PERIOD.— 
(A) IN GENERAL.—The term ‘‘DRM cov-
erage period’’ means the period beginning on 
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September 17, 2017, and, subject to subpara-
graph (B), ending on the date that is 24 
months after the date of enactment of this Act. 
(B) SECRETARY AUTHORITY TO EXTEND 
DRM COVERAGE PERIOD.—The Secretary may 
extend the DRM coverage period for an addi-
tional 12 months. Any reference to the term 
‘‘DRM coverage period’’ in this section shall in-
clude any extension under this subparagraph. 
(3) DRM-ELIGIBLE
MARIA
SURVIVOR
DE-
FINED.— 
(A) IN GENERAL.—The term ‘‘DRM-eligi-
ble Maria Survivor’’ means a Maria Survivor 
whose family income does not exceed the income 
eligibility standard which would apply to the 
Survivor under the State Medicaid plan of the 
State in which the Survivor applies for medical 
assistance. 
(B) NO RESOURCES, RESIDENCY, OR CAT-
EGORICAL ELIGIBILITY REQUIREMENTS.—Eligi-
bility under subparagraph (A) shall be deter-
mined without application of any resources test, 
State residency, or categorical eligibility re-
quirements. 
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(C) DEFINITION OF CHILD.—For purposes 
of subparagraph (A), a DRM-eligible Maria 
Survivor shall be determined to be a ‘‘child’’ in 
accordance with the definition of ‘‘child’’ under 
the State Medicaid plan. 
(4) MARIA SURVIVOR.— 
(A) IN GENERAL.—The term ‘‘Maria Sur-
vivor’’ means an individual who, on any day 
during the week preceding September 17, 2017, 
had a primary residence in Puerto Rico or the 
Virgin Islands. 
(B) TREATMENT OF CURRENT MEDICAID 
BENEFICIARIES.—Nothing in this section shall 
be construed as preventing an individual who is 
otherwise entitled to medical assistance under a 
State Medicaid plan from being treated as a 
Maria Survivor under this section. 
(C) TREATMENT
OF
HOMELESS
PER-
SONS.—For purposes of this section, in the case 
of an individual who was homeless on any day 
during the week described in subparagraph (A), 
the individual’s ‘‘residence’’ shall be deemed to 
be the place of residence as otherwise deter-
mined for such an individual under title XIX of 
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the Social Security Act (42 U.S.C. 1396 et 
seq.). 
(5) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
(6) STATE.—The term ‘‘State’’ has the mean-
ing given that term for purposes of title XIX of the 
Social Security Act (42 U.S.C. 1396 et seq.). 
(7) STATE MEDICAID PLAN.—The term ‘‘State 
Medicaid plan’’ means a State plan under title XIX 
of the Social Security Act (42 U.S.C. 1396 et seq.) 
(or a waiver of such plan). 
SEC. 109. DELAY OF BIPARTISAN BUDGET ACT OF 2013 
THIRD-PARTY LIABILITY PROVISIONS. 
(a) IN GENERAL.—Section 202(c) of the Bipartisan 
Budget Act of 2013 (Public Law 113–67; 127 Stat. 1177; 
42 U.S.C. 1396a note), as amended by section 211 of the 
Protecting Access to Medicare Act of 2014 (Public Law 
113–93; 128 Stat. 1047; 42 U.S.C. 1396a note) and sec-
tion 220 of the Medicare Access and CHIP Reauthoriza-
tion Act of 2015 (Public Law 114–10), is amended by 
striking ‘‘2017’’ and inserting ‘‘2019’’. 
(b) EFFECTIVE DATE; TREATMENT.—The amend-
ment made by subparagraph (A) shall take effect on Sep-
tember 30, 2017, and shall apply with respect to claims 
pending, generated, or filed after such date. 
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TITLE II—CHIP 
SEC. 201. FIVE-YEAR FUNDING EXTENSION OF THE CHIL-
DREN’S HEALTH INSURANCE PROGRAM. 
(a) APPROPRIATION; TOTAL ALLOTMENT.—Section 
2104(a) of the Social Security Act (42 U.S.C. 1397dd(a)) 
is amended— 
(1) in paragraph (19), by striking ‘‘and’’; 
(2) in paragraph (20), by striking the period at 
the end and inserting a semicolon; and 
(3) by adding at the end the following new 
paragraphs: 
‘‘(21) for fiscal year 2018, $21,500,000,000; 
‘‘(22) for fiscal year 2019, $22,600,000,000; 
‘‘(23) for fiscal year 2020, $23,700,000,000; 
‘‘(24) for fiscal year 2021, $24,800,000,000; 
and 
‘‘(25) for fiscal year 2022, for purposes of mak-
ing 2 semi-annual allotments— 
‘‘(A) $2,850,000,000 for the period begin-
ning on October 1, 2021, and ending on March 
31, 2022; and 
‘‘(B) $2,850,000,000 for the period begin-
ning on April 1, 2022, and ending on Sep-
tember 30, 2022.’’. 
(b) ALLOTMENTS.— 
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(1) IN GENERAL.—Section 2104(m) of the So-
cial Security Act (42 U.S.C. 1397dd(m)) is amend-
ed— 
(A) in paragraph (2)— 
(i) 
in 
the 
heading, 
by 
striking 
‘‘THROUGH
2016’’ 
and 
inserting 
‘‘THROUGH 2022’’; and 
(ii) in subparagraph (B)— 
(I) in the matter preceding clause 
(i), by striking ‘‘(19)’’ and inserting 
‘‘(24)’’; 
(II) in clause (ii), in the matter 
preceding subclause (I), by inserting 
‘‘(other than fiscal year 2022)’’ after 
‘‘even-numbered fiscal year’’; and 
(III) in clause (ii)(I), by inserting 
‘‘(or, in the case of fiscal year 2018, 
under paragraph (4))’’ after ‘‘clause 
(i)’’; 
(B) in paragraph (5)— 
(i) by striking ‘‘or (4)’’ and inserting 
‘‘(4), or (10)’’; and 
(ii) by striking ‘‘or 2017’’ and insert-
ing ‘‘, 2017, or 2022’’; 
(C) in paragraph (7)— 
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(i) in subparagraph (A), by striking 
‘‘2017’’ and inserting ‘‘2022’’; 
(ii) in subparagraph (B), in the mat-
ter preceding clause (i), by inserting ‘‘(or, 
in the case of fiscal year 2018, by not later 
than the date that is 60 days after the 
date of the enactment of the CHAMPION 
KIDS Act of 2017)’’ after ‘‘before the Au-
gust 31 preceding the beginning of the fis-
cal year’’; and 
(iii) in the matter following subpara-
graph (B), by striking ‘‘or fiscal year 
2016’’ and inserting ‘‘fiscal year 2016, fis-
cal year 2018, fiscal year 2020, or fiscal 
year 2022’’; 
(D) in paragraph (9)— 
(i) in the heading, by striking ‘‘FISCAL 
YEARS 2015 AND 2017’’ and inserting 
‘‘CERTAIN FISCAL YEARS’’; 
(ii) by striking ‘‘or (4)’’ and inserting 
‘‘, (4), or (10)’’; and 
(iii) by striking ‘‘or fiscal year 2017’’ 
and inserting ‘‘, 2017, or 2022’’; and 
(E) by adding at the end the following new 
paragraph: 
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‘‘(10) FOR FISCAL YEAR 2022.— 
‘‘(A) FIRST HALF.—Subject to paragraphs 
(5) and (7), from the amount made available 
under subparagraph (A) of paragraph (25) of 
subsection (a) for the semi-annual period de-
scribed in such subparagraph, increased by the 
amount of the appropriation for such period 
under section 201(b)(3) of the CHAMPION 
KIDS Act of 2017, the Secretary shall compute 
a State allotment for each State (including the 
District of Columbia and each commonwealth 
and territory) for such semi-annual period in an 
amount equal to the first half ratio (described 
in subparagraph (D)) of the amount described 
in subparagraph (C). 
‘‘(B) SECOND
HALF.—Subject to para-
graphs (5) and (7), from the amount made 
available under subparagraph (B) of paragraph 
(25) of subsection (a) for the semi-annual pe-
riod described in such subparagraph, the Sec-
retary shall compute a State allotment for each 
State (including the District of Columbia and 
each commonwealth and territory) for such 
semi-annual period in an amount equal to the 
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amount made available under such subpara-
graph, multiplied by the ratio of— 
‘‘(i) the amount of the allotment to 
such State under subparagraph (A), to 
‘‘(ii) the total of the amount of all of 
the allotments made available under such 
subparagraph. 
‘‘(C) FULL
YEAR
AMOUNT
BASED
ON 
GROWTH
FACTOR
UPDATED
AMOUNT.—The 
amount described in this subparagraph for a 
State is equal to the sum of— 
‘‘(i) the amount of the State allotment 
for fiscal year 2021 determined under 
paragraph (2)(B)(i); and 
‘‘(ii) the amount of any payments 
made to the State under subsection (n) for 
fiscal year 2021, 
multiplied by the allotment increase factor 
under paragraph (6) for fiscal year 2022. 
‘‘(D) FIRST HALF RATIO.—The first half 
ratio described in this subparagraph is the ratio 
of— 
‘‘(i) the sum of— 
‘‘(I) the amount made available 
under subsection (a)(25)(A); and 
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‘‘(II) the amount of the appro-
priation for such period under section 
201(b)(3) of the CHAMPION KIDS 
Act of 2017, to 
‘‘(ii) the sum of— 
‘‘(I) the amount described in 
clause (i); and 
‘‘(II) the amount made available 
under subsection (a)(25)(B).’’. 
(2) 
TECHNICAL
AMENDMENT.—Section 
2104(m)(2)(A) 
of 
such 
Act 
(42 
U.S.C. 
1397dd(m)(2)(A)) is amended by striking ‘‘the allot-
ment increase factor under paragraph (5)’’ each 
place it appears and inserting ‘‘the allotment in-
crease factor under paragraph (6)’’. 
(3) ONE-TIME
APPROPRIATION
FOR
FISCAL 
YEAR 2022.—There is appropriated to the Secretary 
of Health and Human Services, out of any money in 
the 
Treasury 
not 
otherwise 
appropriated, 
$20,200,000,000 to accompany the allotment made 
for the period beginning on October 1, 2021, and 
ending on March 31, 2022, under paragraph 
(25)(A) of section 2104(a) of the Social Security Act 
(42 U.S.C. 1397dd(a)) (as added by subsection 
(a)(3)), to remain available until expended. Such 
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amount shall be used to provide allotments to States 
under paragraph (10) of section 2104(m) of such 
Act (as added by subsection (b)(1)(E)) for the first 
6 months of fiscal year 2022 in the same manner as 
allotments are provided under subsection (a)(25)(A) 
of such section 2104 and subject to the same terms 
and conditions as apply to the allotments provided 
from such subsection (a)(25)(A). 
(c) EXTENSION OF THE CHILD ENROLLMENT CON-
TINGENCY FUND.—Section 2104(n) of the Social Security 
Act (42 U.S.C. 1397dd(n)) is amended— 
(1) in paragraph (2)— 
(A) in subparagraph (A)(ii)— 
(i) by striking ‘‘2010, 2011, 2012, 
2013, 2014, and 2016’’ and inserting 
‘‘2010 through 2014, 2016, and 2018 
through 2021’’; and 
(ii) by striking ‘‘fiscal year 2015 and 
fiscal year 2017’’ and inserting ‘‘fiscal 
years 2015, 2017, and 2022’’; and 
(B) in subparagraph (B)— 
(i) by striking ‘‘2010, 2011, 2012, 
2013, 2014, and 2016’’ and inserting 
‘‘2010 through 2014, 2016, and 2018 
through 2021’’; and 
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(ii) by striking ‘‘fiscal year 2015 and 
fiscal year 2017’’ and inserting ‘‘fiscal year 
2015, 2017, and 2022’’; and 
(2) in paragraph (3)(A), in the matter pre-
ceding clause (i), by striking ‘‘or a semi-annual allot-
ment period for fiscal year 2015 or 2017’’ and in-
serting ‘‘or in any of fiscal years 2018 through 2021 
(or a semi-annual allotment period for fiscal year 
2015, 2017, or 2022)’’. 
(d) EXTENSION OF QUALIFYING STATES OPTION.— 
Section 2105(g)(4) of the Social Security Act (42 U.S.C. 
1397ee(g)(4)) is amended— 
(1) in the heading, by striking ‘‘THROUGH 
2017’’ and inserting ‘‘THROUGH 2022’’; and 
(2) in subparagraph (A), by striking ‘‘2017’’ 
and inserting ‘‘2022’’. 
(e) EXTENSION OF EXPRESS LANE ELIGIBILITY OP-
TION.—Section 1902(e)(13)(I) of the Social Security Act 
(42 U.S.C. 1396a(e)(13)(I)) is amended by striking 
‘‘2017’’ and inserting ‘‘2022’’. 
(f) ASSURANCE OF AFFORDABILITY STANDARD FOR 
CHILDREN AND FAMILIES.— 
(1) IN GENERAL.—Section 2105(d)(3) of the 
Social Security Act (42 U.S.C. 1397ee(d)(3)) is 
amended— 
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(A) in the paragraph heading, by striking 
‘‘UNTIL
OCTOBER
1, 2019’’ and inserting 
‘‘THROUGH SEPTEMBER 30, 2022’’; and 
(B) in subparagraph (A), in the matter 
preceding clause (i)— 
(i) by striking ‘‘2019’’ and inserting 
‘‘2022’’; and 
(ii) by striking ‘‘The preceding sen-
tence shall not be construed as preventing 
a State during such period’’ and inserting 
‘‘During the period that begins on October 
1, 2019, and ends on September 30, 2022, 
the preceding sentence shall only apply 
with respect to children in families whose 
income does not exceed 300 percent of the 
poverty 
line 
(as 
defined 
in 
section 
2110(c)(5)) applicable to a family of the 
size involved. The preceding sentences shall 
not be construed as preventing a State 
during any such periods’’. 
(2) 
CONFORMING
AMENDMENTS.—Section 
1902(gg)(2) of the Social Security Act (42 U.S.C. 
1396a(gg)(2)) is amended— 
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(A) in the paragraph heading, by striking 
‘‘UNTIL
OCTOBER
1, 2019’’ and inserting 
‘‘THROUGH SEPTEMBER 30, 2022’’; and 
(B) by striking ‘‘September 30, 2019,’’ 
and inserting ‘‘September 30, 2022 (but during 
the period that begins on October 1, 2019, and 
ends on September 30, 2022, only with respect 
to children in families whose income does not 
exceed 300 percent of the poverty line (as de-
fined in section 2110(c)(5)) applicable to a fam-
ily of the size involved)’’. 
SEC. 202. EXTENSION OF CERTAIN PROGRAMS AND DEM-
ONSTRATION PROJECTS. 
(a) 
CHILDHOOD
OBESITY
DEMONSTRATION 
PROJECT.—Section 1139A(e)(8) of the Social Security 
Act (42 U.S.C. 1320b–9a(e)(8)) is amended— 
(1) by striking ‘‘and $10,000,000’’ and insert-
ing ‘‘, $10,000,000’’; and 
(2) by inserting after ‘‘2017’’ the following: ‘‘, 
and $25,000,000 for the period of fiscal years 2018 
through 2022’’. 
(b) PEDIATRIC QUALITY MEASURES PROGRAM.— 
Section 1139A(i) of the Social Security Act (42 U.S.C. 
1320b–9a(i)) is amended— 
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(1) by striking ‘‘Out of any’’ and inserting the 
following: 
‘‘(1) IN GENERAL.—Out of any’’; 
(2) by striking ‘‘there is appropriated for each’’ 
and inserting ‘‘there is appropriated— 
‘‘(A) for each’’; 
(3) by striking ‘‘, and there is appropriated for 
the period’’ and inserting ‘‘; 
‘‘(B) for the period’’; 
(4) by striking ‘‘. Funds appropriated under 
this subsection shall remain available until ex-
pended’’ and inserting ‘‘; and’’; and 
(5) by adding at the end the following: 
‘‘(C) for the period of fiscal years 2018 
through 2022, $75,000,000 for the purpose of 
carrying out this section (other than sub-
sections (e), (f), and (g)). 
‘‘(2) 
AVAILABILITY.—Funds 
appropriated 
under this subsection shall remain available until ex-
pended.’’. 
SEC. 203. EXTENSION OF OUTREACH AND ENROLLMENT 
PROGRAM. 
(a) EXTENSION
AND REAUTHORIZATION.—Section 
2113 of the Social Security Act (42 U.S.C. 1397mm) is 
amended— 
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(1) in subsection (a)(1), by striking ‘‘2017’’ and 
inserting ‘‘2022’’; and 
(2) in subsection (g)— 
(A) by striking ‘‘and $40,000,000’’ and in-
serting ‘‘, $40,000,000’’; and 
(B) by inserting after ‘‘2017’’ the fol-
lowing: ‘‘, and $100,000,000 for the period of 
fiscal years 2018 through 2022’’. 
(b) MAKING ORGANIZATIONS THAT USE PARENT 
MENTORS
ELIGIBLE
TO
RECEIVE
GRANTS.—Section 
2113(f) of the Social Security Act (42 U.S.C. 1397mm(f)) 
is amended— 
(1) in paragraph (1)(E), by striking ‘‘or com-
munity-based doula programs’’ and inserting ‘‘, com-
munity-based doula programs, or parent mentors’’; 
and 
(2) by adding at the end the following new 
paragraph: 
‘‘(5) PARENT
MENTOR.—The term ‘parent 
mentor’ means an individual who— 
‘‘(A) is a parent or guardian of at least 
one child who is an eligible child under this title 
or title XIX; and 
‘‘(B) is trained to assist families with chil-
dren who have no health insurance coverage 
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with respect to improving the social deter-
minants of the health of such children, includ-
ing by providing— 
‘‘(i) education about health insurance 
coverage, including, with respect to obtain-
ing such coverage, eligibility criteria and 
application and renewal processes; 
‘‘(ii) assistance with completing and 
submitting applications for health insur-
ance coverage and renewal; 
‘‘(iii) a liaison between families and 
representatives of State plans under title 
XIX or State child health plans under this 
title; 
‘‘(iv) guidance on identifying medical 
and dental homes and community phar-
macies for children; and 
‘‘(v) assistance and referrals to suc-
cessfully address social determinants of 
children’s health, including poverty, food 
insufficiency, housing, and environmental 
hazards.’’. 
(c) EXCLUSION FROM MODIFIED ADJUSTED GROSS 
INCOME.—Section 1902 of the Social Security Act (42 
U.S.C. 1396a) is amended— 
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(1) in subsection (a)(17), by striking ‘‘(e)(14), 
(e)(14)’’ and inserting ‘‘(e)(14), (e)(15)’’; 
(2) in subsection (e), in the first paragraph 
(14), relating to income determined using modified 
adjusted gross income, by adding at the end the fol-
lowing new subparagraph: 
‘‘(J) EXCLUSION
OF
PARENT
MENTOR 
COMPENSATION
FROM
INCOME
DETERMINA-
TION.—Any nominal amount received by an in-
dividual as compensation, including a stipend, 
for participation as a parent mentor (as defined 
in paragraph (5) of section 2113(f)) in an activ-
ity or program funded through a grant under 
such section shall be disregarded for purposes 
of determining the income eligibility of such in-
dividual for medical assistance under the State 
plan or any waiver of such plan.’’; and 
(3) in subsection (e), by striking ‘‘(14) EXCLU-
SION’’ and inserting ‘‘(15) EXCLUSION’’. 
SEC. 204. EXTENSION OF ADDITIONAL FEDERAL FINANCIAL 
PARTICIPATION FOR CHIP. 
Section 2105(b) of the Social Security Act (42 U.S.C. 
1397ee(b)) is amended in the second sentence by inserting 
‘‘and during the period that begins on October 1, 2019, 
and ends on September 30, 2020, the enhanced FMAP 
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determined for a State for a fiscal year (or for any portion 
of a fiscal year occurring during such period) shall be in-
creased by 11.5 percentage points’’ after ‘‘23 percentage 
points,’’. 
TITLE III—OFFSET 
SEC. 301. IMPLEMENTATION OF OFFICE OF INSPECTOR 
GENERAL RECOMMENDATION TO DELAY CER-
TAIN MEDICARE PLAN PREPAYMENTS. 
(a) MEDICARE
ADVANTAGE
PAYMENTS.—Section 
1853(a)(1) of the Social Security Act (42 U.S.C. 1395w– 
23(a)(1)) is amended— 
(1) in subparagraph (A), in the matter pre-
ceding clause (i)— 
(A) by striking ‘‘subsections (e), (g), (i), 
and (l)’’ and inserting ‘‘subparagraph (J), sub-
sections (e), (g), (i), and (l),’’; and 
(B) by inserting ‘‘(or, for months begin-
ning with January 2019, on the date specified 
in subparagraph (J))’’ after ‘‘in advance’’; and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(J) TIMING OF PAYMENTS.— 
‘‘(i) IN
GENERAL.—With respect to 
monthly payments under this section for 
months in a year (beginning with 2019), 
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the date specified in this subparagraph 
with respect to a payment for a month is 
the first business day occurring on or after 
the applicable date defined in clause (ii). 
‘‘(ii) APPLICABLE
DATE.—For pur-
poses of clause (i), with respect to a year 
(beginning with 2019), the term ‘applicable 
date’ means, with respect to a payment 
for— 
‘‘(I) January of such year, Janu-
ary 2nd; 
‘‘(II) February of such year, 
February 5th; 
‘‘(III) March of such year, March 
10th; 
‘‘(IV) April of such year, April 
15th; 
‘‘(V) May of such year, May 
20th; 
‘‘(VI) June of such year, June 
25th; 
‘‘(VII) July and each succeeding 
month (other than December) of such 
year, the first day of the next month; 
and 
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‘‘(VIII) December of such year, 
December 24th.’’. 
(b) CONFORMING AMENDMENT TO PART D.—Section 
1860D–15(d)(1) of the Social Security Act (42 U.S.C. 
1395w–115(d)(1)) is amended by inserting ‘‘and shall be 
made consistent with the timing of monthly payments to 
MA organizations under section 1853(a)(1)(J)’’ after ‘‘as 
the Secretary determines’’. 
Æ 
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