I 
113TH CONGRESS 
1ST SESSION H. R. 1703 
To amend title XIX of the Social Security Act to permit States to reduce 
the amount of home equity that is exempted for purposes of determining 
eligibility for long-term care assistance under Medicaid and to eliminate 
the State Medicaid maintenance of effort requirement established under 
Public Law 111–148 with respect to eligibility standards to obtain Med-
icaid assistance for long-term care services. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 24, 2013 
Mr. BOUSTANY (for himself, Mrs. BLACKBURN, Mr. GINGREY of Georgia, and 
Mr. TIBERI) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce 
A BILL 
To amend title XIX of the Social Security Act to permit 
States to reduce the amount of home equity that is 
exempted for purposes of determining eligibility for long- 
term care assistance under Medicaid and to eliminate 
the State Medicaid maintenance of effort requirement 
established under Public Law 111–148 with respect to 
eligibility standards to obtain Medicaid assistance for 
long-term care services. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicaid Program In-
tegrity Act of 2013’’. 
SEC. 2. STATE OPTION TO REDUCE MEDICAID HOME EQ-
UITY EXEMPTION AMOUNT. 
(a) IN GENERAL.—Section 1917(f)(1) of the Social 
Security Act (42 U.S.C. 1396p(f)(1)) is amended— 
(1) 
in 
subparagraph 
(B), 
by 
striking 
‘‘ ‘$500,000’, an amount that exceeds such amount, 
but does not exceed $750,000’’ and by inserting the 
following: ‘‘$500,000— 
‘‘(i) an amount that exceeds such 
amount, but does not exceed $750,000; or 
‘‘(ii) an amount that is less than such 
amount, but is not less than $50,000.’’; 
and 
(2) in subparagraph (C)— 
(A) by inserting ‘‘(or beginning in 2014 in 
the case of subparagraph (B)(ii))’’ after ‘‘begin-
ning with 2011’’; and 
(B) by inserting ‘‘(or nearest $100 in the 
case of subparagraph (B)(ii))’’ after ‘‘nearest 
$1,000’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply to individuals who are deter-
mined eligible for medical assistance with respect to nurs-
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ing facility services or other long-term care services based 
on an application filed on or after the date of the enact-
ment of this Act. 
SEC. 3. ELIMINATION OF ACA MAINTENANCE OF EFFORT 
REQUIREMENTS WITH RESPECT TO MED-
ICAID ELIGIBILITY FOR LONG-TERM CARE 
SERVICES. 
(a) IN GENERAL.—Section 1902(gg) of the Social Se-
curity Act (42 U.S.C. 1396a(gg)) is amended by adding 
at the end the following new paragraph: 
‘‘(5) NONAPPLICATION IN CASE OF ELIGIBILITY 
FOR MEDICAL ASSISTANCE FOR LONG-TERM CARE 
SERVICES.—The requirement under paragraph (1) 
shall not apply to changes in standards (such as 
counting the value of life estates as a resource, 
counting the value of savings bonds in the year of 
their purchase, and not excluding the unpaid balance 
of an annuity as a resource) established for eligi-
bility for medical assistance for long-term care serv-
ices described in section 1917(c)(1)(C) so long as 
such changes would have been permitted under the 
law as in effect before the date of the enactment of 
Public Law 111–148.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply to standards for eligibility deter-
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