H. R. 2617—1470 
‘‘(4) TERMINATION.—The Secretary may terminate a hos-
pital from participation in such initiative (and the waivers 
and flexibilities applicable to such hospital) if the Secretary 
determines that the hospital no longer meets the criteria 
described in paragraph (3). 
‘‘(b) STUDY AND REPORT.— 
‘‘(1) IN
GENERAL.—The Secretary shall conduct a study 
to— 
‘‘(A) analyze, to the extent practicable, the criteria 
established by hospitals under the Acute Hospital Care 
at Home initiative of the Secretary to determine which 
individuals may be furnished services under such initiative; 
and 
‘‘(B) analyze and compare, to the extent practicable— 
‘‘(i) quality of care furnished to individuals with 
similar conditions and characteristics in the inpatient 
setting and through the Acute Hospital Care at Home 
initiative, including health outcomes, hospital readmis-
sion rates, hospital mortality rates, length of stay, 
infection rates, and patient experience of care; 
‘‘(ii) clinical conditions treated and diagnosis- 
related groups of discharges from the inpatient setting 
and under the Acute Hospital Care at Home initiative; 
‘‘(iii) costs incurred by furnishing care in the 
inpatient setting and through the Acute Hospital Care 
at Home initiative; 
‘‘(iv) the quantity, mix and intensity of such serv-
ices (such as in-person visits and virtual contacts with 
patients) furnished in the Acute Hospital Care at Home 
initiative and furnished in the inpatient setting; and 
‘‘(v) socioeconomic information on beneficiaries 
treated under the initiative, including racial and ethnic 
data, income, and whether such beneficiaries are dually 
eligible for benefits under this title and title XIX. 
‘‘(2) REPORT.—Not later than September 30, 2024, the Sec-
retary of Health and Human Services shall post on a website 
of the Centers for Medicare & Medicaid Services a report on 
the study conducted under paragraph (1). 
‘‘(3) FUNDING.—In addition to amounts otherwise available, 
there is appropriated to the Centers for Medicare & Medicaid 
Services Program Management Account for fiscal year 2023, 
out of any amounts in the Treasury not otherwise appropriated, 
$5,000,000, to remain available until expended, for purposes 
of carrying out this subsection. 
‘‘(c) IMPLEMENTATION.—Notwithstanding any other provision of 
law, the Secretary may implement this section by program instruc-
tion or otherwise. 
‘‘(d) PUBLICLY AVAILABLE INFORMATION.—The Secretary shall, 
as feasible, make the information collected under subsections 
(a)(3)(E) and (b)(1) available on the Medicare.gov internet website 
(or a successor website).’’. 
SEC. 4141. EXTENSION OF PASS-THROUGH STATUS UNDER THE MEDI-
CARE PROGRAM FOR CERTAIN DEVICES IMPACTED BY 
COVID–19. 
(a) IN GENERAL.—Section 1833(t)(6) of the Social Security Act 
(42 U.S.C. 1395l(t)(6)) is amended—
H. R. 2617—1471 
(1) in subparagraph (B)(iii), in the matter preceding sub-
clause (I), by striking ‘‘A category’’ and inserting ‘‘Subject to 
subparagraph (K), a category’’; and 
(2) by adding at the end the following new subparagraph: 
‘‘(K) PASS-THROUGH EXTENSION FOR CERTAIN DEVICES.— 
‘‘(i) IN GENERAL.—In the case of a device whose 
period of pass-through status under this paragraph 
will end on December 31, 2022, such pass-through 
status shall be extended for a 1–year period beginning 
on January 1, 2023. 
‘‘(ii) NO ADJUSTMENT FOR PACKAGED COSTS.—For 
purposes of the 1–year period described in clause (i), 
the Secretary shall not remove the packaged costs of 
such device (as determined by the Secretary) from 
the payment amount under this subsection for a cov-
ered OPD service (or group of services) with which 
it is packaged. 
‘‘(iii) NO
APPLICATION
OF
AGGREGATE
LIMIT
OR 
BUDGET
NEUTRALITY.—Notwithstanding 
any 
other 
provision of this subsection, this subparagraph shall 
not be taken into account— 
‘‘(I) in applying the limit on annual aggregate 
adjustments under subparagraph (E) for 2023; or 
‘‘(II) in making any budget neutrality adjust-
ments under this subsection for 2023.’’. 
(b) IMPLEMENTATION.—Notwithstanding any other provision of 
law, the Secretary of Health and Human Service may implement 
the amendments made by subsection (a) by program instruction 
or otherwise. 
SEC. 4142. INCREASING TRANSPARENCY FOR HOME HEALTH PAY-
MENTS UNDER THE MEDICARE PROGRAM. 
(a) TRANSPARENCY.—In notice and comment rulemaking used 
to implement section 1895(b)(3)(D) of the Social Security Act (42 
U.S.C. 1395fff(b)(3)(D), the Secretary of Health and Human Services 
(referred to in this section as the ‘‘Secretary’’) shall, on the date 
of the notice of proposed rulemaking, make available through the 
internet website of the Centers for Medicare & Medicaid Services 
the following: 
(1) Electronic data files showing the Centers for Medicare 
& Medicaid Services simulation of 60-day episodes under the 
home health prospective payment system in effect prior to 
the Patient Driven Groupings Model using data from 30-day 
periods paid under such Model, if such data are used in deter-
mining payment adjustments under clauses (ii) or (iii) of such 
section 1895(b)(3)(D). 
(2) To the extent practicable, a description of actual 
behavior changes, as described in clause (i) of such section 
1895(b)(3)(D), including behavior changes as a result of the 
implementation of sections 1895(b)(2)(B) and 1895(b)(4)(B) of 
the Social Security Act (42 U.S.C. 1395fff(b)(2)(B) and 
1395(b)(4)(B)) that occurred in calendar years 2020 through 
2026. 
(b) ENGAGEMENT WITH STAKEHOLDERS.— 
(1) IN GENERAL.—Not later than 90 days after the date 
of enactment of this section, the Secretary shall use an open 
door forum, a town hall meeting, a web-based forum, or other
H. R. 2617—1472 
appropriate mechanism to receive input from home health 
stakeholders and interested parties on Medicare home health 
payment rate development, including the items described in 
paragraphs (1) and (2) of subsection (a) with respect to the 
home health prospective payment system rate for calendar 
year 2023. 
(2) REQUIREMENT.—At least 30 days before the forum, 
meeting, or other mechanism referred to in paragraph (1), 
the Secretary shall make available through the internet website 
of the Centers for Medicare & Medicaid Services the items 
described in paragraphs (1) and (2) of subsection (a) with 
respect to the home health prospective payment system rate 
for calendar year 2023 as finalized in the final rule entitled 
‘‘Medicare Program; Calendar Year 2023 Home Health Prospec-
tive Payment System Rate Update; Home Health Quality 
Reporting Program Requirements; Home Health Value-Based 
Purchasing Expanded Model Requirements; and Home Infusion 
Therapy Services Requirements’’ published in the Federal Reg-
ister on November 4, 2022 (87 Fed. Reg. 66790). 
(c) CONSTRUCTION.—Nothing in this section shall be construed 
to require any change in the methodology used by the Secretary 
to implement such section 1895(b)(3)(D), to restrict the Secretary’s 
discretion in establishing the methodology to implement such sec-
tion, or to suggest that the Secretary’s promulgation of the method-
ology implementing such Calendar Year 2023 home health final 
rule was inadequate under Chapter 5 of title 5, United States 
Code (commonly known as the ‘‘Administrative Procedures Act’’) 
or any other provision of law. 
SEC. 4143. WAIVER OF CAP ON ANNUAL PAYMENTS FOR NURSING AND 
ALLIED HEALTH EDUCATION PAYMENTS. 
(a) IN GENERAL.—Section 1886(l)(2)(B) of the Social Security 
Act (42 U.S.C. 1395ww(l)(2)(B)) is amended— 
(1) by striking ‘‘PAYMENTS.—Such ratio’’ and inserting ‘‘PAY-
MENTS.— 
‘‘(i) IN GENERAL.—Subject to clause (ii), such ratio’’; 
and 
(2) by adding at the end the following new clause: 
‘‘(ii) EXCEPTION TO ANNUAL LIMITATION FOR EACH 
OF 2010 THROUGH 2019.—For each of 2010 through 2019, 
the limitation under clause (i) on the total amount 
of additional payments for nursing and allied health 
education to be distributed to hospitals under this sub-
section for portions of cost reporting periods occurring 
in the year shall not apply to such payments made 
in such year to those hospitals that, as of the date 
of the enactment of this clause, are operating a school 
of nursing, a school of allied health, or a school of 
nursing and allied health.’’. 
(b) NO AFFECT ON PAYMENTS FOR DIRECT GRADUATE MEDICAL 
EDUCATION.—Section 1886(h)(3)(D)(iii) of the Social Security Act 
(42 U.S.C. 1395ww(h)(3)(D)(iii)) is amended by adding at the end 
the following sentence: ‘‘In applying the preceding sentence for 
each of 2010 through 2019, the Secretary shall not take into account 
any increase in the total amount of such additional payment 
amounts for such nursing and allied health education for portions
H. R. 2617—1473 
of cost reporting periods occurring in the year pursuant to the 
application of paragraph (2)(B)(ii) of such subsection.’’. 
(c) RETROACTIVE APPLICATION.—The amendments made by this 
section shall apply to payments made for portions of cost reporting 
periods occurring in 2010 through 2019. 
(d) FUNDING.—In addition to amounts otherwise available, 
there is appropriated to the Centers for Medicare & Medicaid Serv-
ices Program Management Account for fiscal year 2023, out of 
any amounts in the Treasury not otherwise appropriated, 
$3,000,000, to remain available until expended, for purposes of 
carrying out the amendments made by this section. 
Subtitle E—Health Care Tax Provisions 
SEC. 4151. EXTENSION OF SAFE HARBOR FOR ABSENCE OF DEDUCT-
IBLE FOR TELEHEALTH. 
(a) IN GENERAL.—Section 223(c)(2)(E) of the Internal Revenue 
Code of 1986 is amended by striking ‘‘In the case of plan years’’ 
and all that follows through ‘‘a plan’’ and inserting ‘‘In the case 
of— 
‘‘(i) months beginning after March 31, 2022, and 
before January 1, 2023, and 
‘‘(ii) plan years beginning on or before December 
31, 2021, or after December 31, 2022, and before 
January 1, 2025, 
a plan’’. 
(b) CERTAIN COVERAGE DISREGARDED.—Section 223(c)(1)(B)(ii) 
of the Internal Revenue Code of 1986 is amended by striking 
‘‘(in the case of plan years beginning on or before December 31, 
2021, or in the case of months beginning after March 31, 2022, 
and before January 1, 2023)’’ and inserting ‘‘(in the case of months 
or plan years to which paragraph (2)(E) applies)’’. 
(c) EFFECTIVE DATE.—The amendments made by this section 
shall apply to plan years beginning after December 31, 2022. 
Subtitle F—Offsets 
SEC. 4161. REDUCTION OF MEDICARE IMPROVEMENT FUND. 
Section 1898(b)(1) of the Social Security Act (42 U.S.C. 
1395iii(b)(1)) is amended by striking ‘‘$7,278,000,000’’ and inserting 
‘‘$180,000,000’’. 
SEC. 4162. EXTENSION OF ADJUSTMENT TO CALCULATION OF HOSPICE 
CAP AMOUNT UNDER MEDICARE. 
Section 1814(i)(2)(B) of the Social Security Act (42 U.S.C. 
1395f(i)(2)(B)) is amended— 
(1) in clause (ii), by striking ‘‘2031’’ and inserting ‘‘2032’’; 
and 
(2) in clause (iii), by striking ‘‘2031’’ and inserting ‘‘2032’’. 
SEC. 4163. MEDICARE DIRECT SPENDING REDUCTIONS. 
Section 251A(6) of the Balanced Budget and Emergency Deficit 
Control Act of 1985 (2 U.S.C. 901a(6)) is amended— 
(1) in subparagraph (B), in the matter preceding clause 
(i)—
H. R. 2617—1474 
(A) by striking ‘‘On the dates OMB issues its sequestra-
tion preview reports’’ and inserting ‘‘On the date on which 
the President submits the budget under section 1105 of 
title 31, United States Code,’’; and 
(B) by striking ‘‘pursuant to section 254(c),’’; 
(2) in subparagraph (C), by moving the margin 2 ems 
to the left; 
(3) by striking subparagraphs (D) and (E); and 
(4) by adding at the end the following: 
‘‘(D) On the date on which the President submits the budget 
under section 1105 of title 31, United States Code, for fiscal 
year 2032, the President shall order a sequestration of pay-
ments for the Medicare programs specified in section 256(d), 
effective upon issuance, such that, notwithstanding the 2 per-
cent limit specified in subparagraph (A) for such payments— 
‘‘(i) with respect to the first 6 months in which such 
order is effective for such fiscal year, the payment reduction 
shall be 2.0 percent; and 
‘‘(ii) with respect to the second 6 months in which 
such order is effective for such fiscal year, the payment 
reduction shall be 0 percent.’’. 
TITLE V—MEDICAID AND CHIP 
PROVISIONS 
Subtitle A—Territories 
SEC. 5101. MEDICAID ADJUSTMENTS FOR THE TERRITORIES. 
(a) REVISING ALLOTMENTS FOR PUERTO RICO.—Section 1108(g) 
of the Social Security Act (42 U.S.C. 1308(g)) is amended— 
(1) in paragraph (2)— 
(A) in subparagraph (A)— 
(i) in clause (i)— 
(I) by striking ‘‘clause (ii)’’ and inserting 
‘‘clause (ii) or (iii)’’; and 
(II) by striking ‘‘and’’ at the end; 
(ii) in clause (ii), by striking the semicolon and 
inserting ‘‘; and’’; and 
(iii) by adding at the end the following new clause: 
‘‘(iii) for fiscal year 2023 and each subsequent fiscal 
year, the amount specified in paragraph (11) for such 
fiscal year;’’; and 
(B) in the matter following subparagraph (E), by 
striking ‘‘each fiscal year after fiscal year 2021’’ and 
inserting ‘‘fiscal year 2022 (and, in the case of a territory 
other than Puerto Rico, for each subsequent fiscal year)’’; 
and 
(2) by adding at the end the following new paragraphs: 
‘‘(11) ALLOTMENT AMOUNTS FOR PUERTO RICO FOR FISCAL 
YEAR 2023 AND SUBSEQUENT FISCAL YEARS.—For purposes of 
paragraph (2)(A)(iii), subject to paragraphs (12) and (13), the 
amounts specified in this paragraph are the following: 
‘‘(A) For fiscal year 2023, $3,275,000,000. 
‘‘(B) For fiscal year 2024, $3,325,000,000. 
‘‘(C) For fiscal year 2025, $3,475,000,000.
H. R. 2617—1478 
(1) in subparagraph (A), by inserting ‘‘and for fiscal year 
2023 and each subsequent fiscal year (or, in the case of Puerto 
Rico, and for fiscal year 2023 and each subsequent fiscal year 
before fiscal year 2028)’’ after ‘‘fiscal year 2021)’’; and 
(2) in subparagraph (B)(i), by inserting ‘‘or by reason of 
the amendments made by section 5101 of the Health Extenders, 
Improving Access to Medicare, Medicaid, and CHIP, and 
Strengthening Public Health Act of 2022’’ before the period 
at the end. 
(e) PUERTO RICO PROGRAM INTEGRITY.—Section 1108(g)(7)(A) 
of the Social Security Act (42 U.S.C. 1308(g)(7)(A)) is amended— 
(1) in clause (iii), in the header, by inserting ‘‘REPORTING’’ 
after ‘‘REFORM’’; and 
(2) by adding at the end the following new clause: 
‘‘(v) CONTRACTING AND PROCUREMENT OVERSIGHT 
LEAD REQUIREMENT.— 
‘‘(I) IN
GENERAL.—Not later than 6 months 
after the date of the enactment of this clause, 
the agency responsible for the administration of 
Puerto Rico’s Medicaid program under title XIX 
shall designate an officer (other than the director 
of such agency) to serve as the Contracting and 
Procurement Oversight Lead to carry out the 
duties specified in subclause (II). 
‘‘(II) DUTIES.—Not later than 60 days after 
the end of each fiscal quarter (beginning with the 
first fiscal quarter beginning on or after the date 
that is 1 year after the date of the enactment 
of this clause), the officer designated pursuant to 
subclause (I) shall, with respect to each contract 
described in clause (iii) with an annual value 
exceeding $150,000 entered into during such 
quarter, certify to the Secretary either— 
‘‘(aa) that such contract has met the 
procurement standards identified under any 
of sections 75.327, 75.328, and 75.329 of title 
45, Code of Federal Regulations (or successor 
regulations); or 
‘‘(bb) 
that 
extenuating 
circumstances 
(including a lack of multiple entities competing 
for such contract) prevented the compliance 
of such contract with such standards. 
‘‘(III) PUBLICATION.—The officer designated 
pursuant to subclause (I) shall make public each 
certification containing extenuating circumstances 
described in subclause (II)(bb) not later than 30 
days after such certification is made, including 
a description of, and justification of, such extenu-
ating circumstances. 
‘‘(IV) REVIEW OF COMPLIANCE.—Not later than 
2 years after the date of the enactment of this 
clause, the Inspector General of the Department 
of Health and Human Services shall submit to 
Congress a report on the compliance of Puerto 
Rico with the provisions of this clause.’’.
H. R. 2617—1479 
(f) MEDICAID DATA SYSTEMS IMPROVEMENT PAYMENTS.—Section 
1108 of the Social Security Act (42 U.S.C. 1308) is amended by 
adding at the end the following new subsection: 
‘‘(i) DATA SYSTEMS IMPROVEMENT PAYMENTS.— 
‘‘(1) IN GENERAL.—Subject to paragraphs (2) and (3), the 
Secretary shall pay to each eligible territory an amount equal 
to 100 percent of the qualifying data system improvement 
expenditures incurred by such territory on or after October 
1, 2023. 
‘‘(2) TREATMENT AS MEDICAID PAYMENTS.— 
‘‘(A) IN
GENERAL.—Payments to eligible territories 
made under this paragraph shall be considered to have 
been made under, and are subject to the requirements 
of, section 1903. 
‘‘(B) NONDUPLICATION.—No payment shall be made 
under title XIX (other than as provided under paragraph 
(1)), title XXI, or any other provision of law with respect 
to an expenditure for which payment is made under such 
paragraph. 
‘‘(3) ALLOTMENTS.—The Secretary shall specify an allotment 
for each eligible territory for payments made under paragraph 
(1) in a manner such that— 
‘‘(A) the total amount of payments made under such 
paragraph for all eligible territories does not exceed 
$20,000,000; and 
‘‘(B) each eligible territory receives an equitable allot-
ment of such payments. 
‘‘(4) NO EFFECT ON TERRITORIAL CAPS.—A payment to an 
eligible territory under this subsection shall not be taken into 
account for purposes of applying the payment limits under 
subsections (f) and (g). 
‘‘(5) DEFINITIONS.—In this subsection: 
‘‘(A) ELIGIBLE TERRITORY.—The term ‘eligible territory’ 
means American Samoa, Guam, the Northern Mariana 
Islands, and the Virgin Islands. 
‘‘(B) QUALIFYING DATA SYSTEM IMPROVEMENT EXPENDI-
TURE.—The term ‘qualifying data system improvement 
expenditure’ means an expenditure by an eligible territory 
to improve, update, or enhance a data system that is used 
by the territory to carry out an administrative activity 
for which Federal financial participation is available under 
section 1903(a).’’. 
(g) STRATEGIC PLAN AND EVALUATION.— 
(1) IN GENERAL.—Each territory described in paragraph 
(2) shall— 
(A) not later than September 30, 2023, submit to the 
Secretary of Health and Human Services a 4-year strategic 
plan that outlines the territory’s goals relating to workforce 
development, financing, systems implementation and oper-
ation, and program integrity with respect to the territory’s 
Medicaid program under title XIX of the Social Security 
Act (42 U.S.C. 1396 et seq.); and 
(B) not later than September 30, 2027, submit to the 
Secretary of Health and Human Services an analysis of 
the extent to which the territory has achieved, or is making 
progress toward achieving, the goals described in such stra-
tegic plan, and any policy changes relating to such goals
H. R. 2617—1480 
that were adopted by the territory after the submission 
of the plan. 
(2) TERRITORIES DESCRIBED.—The territories described in 
this paragraph are American Samoa, Guam, the Northern Mar-
iana Islands, and the Virgin Islands. 
Subtitle B—Medicaid and CHIP Coverage 
SEC. 5111. FUNDING EXTENSION OF THE CHILDREN’S HEALTH INSUR-
ANCE PROGRAM AND RELATED PROVISIONS. 
(a) IN GENERAL.—Section 2104(a) of the Social Security Act 
(42 U.S.C. 1397dd(a)) is amended— 
(1) in paragraph (27), by striking ‘‘through 2026’’ and 
inserting ‘‘through 2028’’; and 
(2) in paragraph (28)— 
(A) in the matter preceding subparagraph (A), by 
striking ‘‘for fiscal year 2027’’ and inserting ‘‘for fiscal year 
2029’’; 
(B) in subparagraph (A), by striking ‘‘beginning on 
October 1, 2026, and ending on March 31, 2027’’ and 
inserting ‘‘beginning on October 1, 2028, and ending on 
March 31, 2029’’; and 
(C) in subparagraph (B), by striking ‘‘beginning on 
April 1, 2027, and ending on September 30, 2027’’ and 
inserting ‘‘beginning on April 1, 2029, and ending on Sep-
tember 30, 2029’’. 
(b) CHIP ALLOTMENTS.— 
(1) IN GENERAL.—Section 2104(m) of the Social Security 
Act (42 U.S.C. 1397dd(m)) is amended— 
(A) in paragraph (2)(B)(i), by striking ‘‘, 2023, and 
2027’’ and inserting ‘‘2023, and 2029’’; 
(B) in paragraph (5), by striking ‘‘or 2027’’ and inserting 
‘‘or 2029’’; 
(C) in paragraph (7)— 
(i) in subparagraph (A), by striking ‘‘fiscal year 
2027,’’ and inserting ‘‘fiscal year 2029’’; and 
(ii) in the flush left matter at the end, by striking 
‘‘or fiscal year 2026.’’ and inserting ‘‘fiscal year 2026, 
or fiscal year 2028.’’; 
(D) in paragraph (9), by striking ‘‘or 2027’’ and 
inserting ‘‘or 2029’’; and 
(E) in paragraph (11)— 
(i) in the paragraph header, by striking ‘‘FISCAL 
YEAR 2027’’ and inserting ‘‘FISCAL YEAR 2029’’; and 
(ii) in subparagraph (C)— 
(I) by striking ‘‘fiscal year 2026’’ each place 
it appears and inserting ‘‘fiscal year 2028’’; and 
(II) by striking ‘‘fiscal year 2027’’ and inserting 
‘‘fiscal year 2029’’. 
(2) CONFORMING AMENDMENTS.—Section 50101(b)(2) of the 
Bipartisan Budget Act of 2018 (Public Law 115–123) is 
amended— 
(A) in the paragraph header, by striking ‘‘FISCAL YEAR 
2027’’ and inserting ‘‘FISCAL YEAR 2029’’; 
(B) by striking ‘‘fiscal year 2027’’ each place it appears 
and inserting ‘‘fiscal year 2029’’; and
H. R. 2617—1481 
(C) by striking ‘‘beginning on October 1, 2026, and 
ending on March 31, 2027’’ and inserting ‘‘beginning on 
October 1, 2028, and ending on March 31, 2029’’. 
(c) OTHER RELATED CHIP POLICIES.— 
(1) 
PEDIATRIC
QUALITY
MEASURES
PROGRAM.—Section 
1139A(i)(1) of the Social Security Act (42 U.S.C. 1320b–9a(i)(1)) 
is amended— 
(A) in subparagraph (C), by striking at the end ‘‘and’’; 
(B) in subparagraph (D), by striking the period at 
the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following new subpara-
graph: 
‘‘(E) for each of fiscal years 2028 and 2029, $15,000,000 
for the purpose of carrying out this section (other than 
subsections (e), (f), and (g)).’’. 
(2) ASSURANCE OF ELIGIBILITY STANDARDS FOR CHILDREN.— 
Section 2105(d)(3) of the Social Security Act (42 U.S.C. 
1397ee(d)(3)) is amended— 
(A) in the paragraph heading, by striking ‘‘THROUGH 
SEPTEMBER 30, 2027’’ and inserting ‘‘THROUGH SEPTEMBER 
30, 2029’’; and 
(B) in subparagraph (A) by striking ‘‘September 30, 
2027’’ each place it appears and inserting ‘‘September 30, 
2029’’. 
(3) QUALIFYING STATES OPTION.—Section 2105(g)(4) of the 
Social Security Act (42 U.S.C. 1397ee(g)(4)) is amended— 
(A) in the paragraph heading, by striking ‘‘THROUGH 
2027’’ and inserting ‘‘THROUGH 2029’’; and 
(B) in subparagraph (A), by striking ‘‘through 2027’’ 
and inserting ‘‘through 2029’’. 
(4) OUTREACH AND ENROLLMENT PROGRAM.—Section 2113 
of the Social Security Act (42 U.S.C. 1397mm) is amended— 
(A) in subsection (a)— 
(i) in paragraph (1), by striking ‘‘through 2027’’ 
and inserting ‘‘through 2029’’; and 
(ii) in paragraph (3), by striking ‘‘through 2027’’ 
and inserting ‘‘through 2029’’; and 
(B) in subsection (g)— 
(i) by striking ‘‘2017,,’’ and inserting ‘‘2017,’’; 
(ii) by striking ‘‘and $48,000,000’’ and inserting 
‘‘$48,000,000’’; and 
(iii) by inserting after ‘‘through 2027’’ the following: 
‘‘, and $40,000,000 for the period of fiscal years 2028 
and 2029’’. 
(5) CHILD
ENROLLMENT
CONTINGENCY
FUND.—Section 
2104(n) of the Social Security Act (42 U.S.C. 1397dd(n)) is 
amended— 
(A) by striking ‘‘2024 through 2026’’ each place it 
appears and inserting ‘‘2024 through 2028’’; and 
(B) by striking ‘‘2023, and 2027’’ each place it appears 
and inserting ‘‘2023, and 2029’’. 
(d) EXTENSION OF CERTAIN PROVISIONS.— 
(1) 
EXPRESS
LANE
ELIGIBILITY
OPTION.—Section 
1902(e)(13)(I) 
of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1396a(e)(13)(I)) is amended by striking ‘‘2027’’ and inserting 
‘‘2029’’.
H. R. 2617—1482 
(2) CONFORMING AMENDMENTS FOR ASSURANCE OF AFFORD-
ABILITY
STANDARD
FOR
CHILDREN
AND
FAMILIES.—Section 
1902(gg)(2) of the Social Security Act (42 U.S.C. 1396a(gg)(2)) 
is amended— 
(A) in the paragraph heading, by striking ‘‘THROUGH 
SEPTEMBER 30, 2027’’ and inserting ‘‘THROUGH SEPTEMBER 
30, 2029’’; and 
(B) by striking ‘‘2027’’ each place it appears and 
inserting ‘‘2029,’’. 
SEC. 5112. CONTINUOUS ELIGIBILITY FOR CHILDREN UNDER MED-
ICAID AND CHIP. 
(a) UNDER THE MEDICAID PROGRAM.—Section 1902(e) of the 
Social Security Act (42 U.S.C. 1396a(e)) is amended by striking 
paragraph (12) and inserting the following new paragraph: 
‘‘(12) 1 YEAR OF CONTINUOUS ELIGIBILITY FOR CHILDREN.— 
The State plan (or waiver of such State plan) shall provide 
that an individual who is under the age of 19 and who is 
determined to be eligible for benefits under a State plan (or 
waiver of such plan) approved under this title under subsection 
(a)(10)(A) shall remain eligible for such benefits until the earlier 
of— 
‘‘(A) the end of the 12-month period beginning on the 
date of such determination; 
‘‘(B) the time that such individual attains the age 
of 19; or 
‘‘(C) the date that such individual ceases to be a resi-
dent of such State.’’. 
(b) UNDER THE CHILDREN’S HEALTH INSURANCE PROGRAM.— 
Section 2107(e)(1) of the Social Security Act (42 U.S.C. 1397gg(e)(1)) 
is amended— 
(1) by redesignating subparagraphs (K) through (T) as sub-
paragraphs (L) through (U), respectively; and 
(2) by inserting after subparagraph (J) the following new 
subparagraph: 
‘‘(K) Section 1902(e)(12) (relating to 1 year of contin-
uous eligibility for children), except that a targeted low- 
income child enrolled under the State child health plan 
or waiver may be transferred to the Medicaid program 
under title XIX for the remaining duration of the 12-month 
continuous eligibility period, if the child becomes eligible 
for full benefits under title XIX during such period.’’. 
(c) EFFECTIVE DATE.—The amendments made by this section 
shall take effect on the first day of the first fiscal quarter that 
begins on or after the date that is 1 year after the date of enactment 
of this Act. 
SEC. 5113. MODIFICATIONS TO POSTPARTUM COVERAGE UNDER MED-
ICAID AND CHIP. 
Effective as if included in the enactment of sections 9812 and 
9822 of the American Rescue Plan Act of 2021 (Public Law 117– 
2), subsection (b) of each such section is amended by striking 
‘‘during the 5-year period’’. 
SEC. 5114. EXTENSION OF MONEY FOLLOWS THE PERSON REBAL-
ANCING DEMONSTRATION. 
(a) IN GENERAL.—Subsection (h) of section 6071 of the Deficit 
Reduction Act of 2005 (42 U.S.C. 1396a note) is amended—
H. R. 2617—1483 
(1) in paragraph (1)— 
(A) in each of subparagraphs (F), (H), and (J), by 
striking ‘‘and’’ after the semicolon; 
(B) in subparagraph (K), by striking the period and 
inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(L) $450,000,000 for each of fiscal years 2024 through 
2027.’’; 
(2) in paragraph (2), by striking ‘‘September 30, 2023’’ 
and inserting ‘‘September 30 of the subsequent fiscal year’’; 
and 
(3) by adding at the end the following new paragraph: 
‘‘(3) TECHNICAL ASSISTANCE.—In addition to amounts other-
wise available, there is appropriated to the Secretary, out of 
any money in the Treasury not otherwise appropriated for 
fiscal 2023 and for each subsequent 3-year period through 
fiscal year 2029, $5,000,000, to remain available until expended, 
for carrying out subsections (f) and (g).’’. 
(b) REDISTRIBUTION
OF UNEXPENDED GRANT AWARDS.—Sub-
section (e)(2) of section 6071 of the Deficit Reduction Act of 2005 
(42 U.S.C. 1396a note) is amended by adding at the end the fol-
lowing new sentence: ‘‘Any portion of a State grant award for 
a fiscal year under this section that is unexpended by the State 
at the end of the fourth succeeding fiscal year shall be rescinded 
by the Secretary and added to the appropriation for the fifth suc-
ceeding fiscal year.’’. 
SEC. 5115. EXTENSION OF MEDICAID PROTECTIONS AGAINST SPOUSAL 
IMPOVERISHMENT FOR RECIPIENTS OF HOME AND 
COMMUNITY-BASED SERVICES. 
Section 2404 of the Patient Protection and Affordable Care 
Act (42 U.S.C. 1396r–5 note) is amended by striking ‘‘September 
30, 2023’’ and inserting ‘‘September 30, 2027’’. 
Subtitle C—Medicaid and CHIP Mental 
Health 
SEC. 5121. MEDICAID AND CHIP REQUIREMENTS FOR HEALTH 
SCREENINGS, 
REFERRALS, 
AND 
CASE 
MANAGEMENT 
SERVICES FOR ELIGIBLE JUVENILES IN PUBLIC INSTITU-
TIONS. 
(a) MEDICAID STATE PLAN REQUIREMENT.—Section 1902 of the 
Social Security Act (42 U.S.C. 1396a) is amended— 
(1) in subsection (a)(84)— 
(A) in subparagraph (A), by inserting ‘‘, subject to 
subparagraph (D),’’ after ‘‘but’’; 
(B) in subparagraph (B), by striking ‘‘and’’ at the end; 
(C) in subparagraph (C), by adding ‘‘and’’ at the end; 
and 
(D) by adding at the end the following new subpara-
graph: 
‘‘(D) in the case of an individual who is an eligible 
juvenile described in subsection (nn)(2) and is within 30 
days of the date on which such eligible juvenile is scheduled
H. R. 2617—1484 
to be released from a public institution following adjudica-
tion, the State shall have in place a plan, and in accordance 
with such plan, provide for— 
‘‘(i) in the 30 days prior to the release of such 
eligible juvenile from such public institution (or not 
later than one week, or as soon as practicable, after 
release from the public institution), and in coordination 
with such institution, any screening or diagnostic 
service which meets reasonable standards of medical 
and dental practice, as determined by the State, or 
as indicated as medically necessary, in accordance with 
paragraphs (1)(A) and (5) of section 1905(r), including 
a behavioral health screening or diagnostic service; 
and 
‘‘(ii) in the 30 days prior to the release of such 
eligible juvenile from such public institution, and for 
at least 30 days following the release of such eligible 
juvenile from such institution, targeted case manage-
ment services, including referrals for such eligible juve-
nile to the appropriate care and services available in 
the geographic region of the home or residence of such 
eligible juvenile (where feasible) under the State plan 
(or waiver of such plan);’’; and 
(2) in subsection (nn)(3), by striking ‘‘(30)’’ and inserting 
‘‘(31)’’. 
(b) AUTHORIZATION OF FEDERAL FINANCIAL PARTICIPATION.— 
The subdivision (A) of section 1905(a) of the Social Security Act 
(42 U.S.C. 1396d(a)) following paragraph (31) of such section is 
amended by inserting ‘‘, or in the case of an eligible juvenile 
described in section 1902(a)(84)(D) with respect to the screenings, 
diagnostic services, referrals, and targeted case management serv-
ices required under such section’’ after ‘‘(except as a patient in 
a medical institution’’. 
(c) CHIP CONFORMING AMENDMENTS.— 
(1) Section 2102 of the Social Security Act (42 U.S.C. 
1397bb) is amended by adding at the end the following new 
subsection: 
‘‘(d) TREATMENT OF CHILDREN WHO ARE INMATES OF A PUBLIC 
INSTITUTION.— 
‘‘(1) IN GENERAL.—The State child health plan shall provide 
that— 
‘‘(A) the State shall not terminate eligibility for child 
health assistance under the State child health plan for 
a targeted low-income child because the child is an inmate 
of a public institution, but may suspend coverage during 
the period the child is such an inmate; 
‘‘(B) in the case of a targeted low-income child who 
was determined eligible for child health assistance under 
the State child health plan (or waiver of such plan) imme-
diately before becoming an inmate of a public institution, 
the State shall, prior to the child’s release from such public 
institution, conduct a redetermination of eligibility for such 
child with respect to such child health assistance (without 
requiring a new application from the child) and, if the 
State determines pursuant to such redetermination that 
the child continues to meet the eligibility requirements 
for such child health assistance, the State shall restore
H. R. 2617—1485 
coverage for such child health assistance to such child 
upon the child’s release from such public institution; and 
‘‘(C) in the case of a targeted low-income child who 
is determined eligible for child health assistance while 
an inmate of a public institution (subject to the exception 
to the exclusion of children who are inmates of a public 
institution described in section 2110(b)(7)), the State shall 
process any application for child health assistance sub-
mitted by, or on behalf of, the child such that the State 
makes a determination of eligibility for the child with 
respect to child health assistance upon release of the child 
from the public institution. 
‘‘(2) REQUIRED COVERAGE OF SCREENINGS, DIAGNOSTIC SERV-
ICES, REFERRALS, AND CASE MANAGEMENT FOR CERTAIN INMATES 
PRE-RELEASE.—A State child health plan shall provide that, 
in the case of a targeted low-income child who is within 30 
days of the date on which such child is scheduled to be released 
from a public institution following adjudication, the State shall 
have in place a plan for providing, and shall provide in accord-
ance with such plan, screenings, diagnostic services, referrals, 
and case management services otherwise covered under the 
State child health plan (or waiver of such plan) in the same 
manner as described in section 1902(a)(84)(D).’’. 
(2) Section 2110(b) of the Social Security Act (42 U.S.C. 
1397jj(b)) is amended— 
(A) in paragraph (2)(A), by inserting ‘‘except as pro-
vided in paragraph (7),’’ before ‘‘a child who is an inmate 
of a public institution’’; and 
(B) by adding at the end the following new paragraph: 
‘‘(7) EXCEPTION
TO
EXCLUSION
OF
CHILDREN
WHO
ARE 
INMATES
OF
A
PUBLIC
INSTITUTION.—In the case of a child 
who is an inmate of a public institution, during the 30 days 
prior to the release of the child from such institution the 
child shall not be considered to be described in paragraph 
(2)(A) with respect to the screenings, diagnostic services, refer-
rals, and case management services otherwise covered under 
the State child health plan (or waiver of such plan) that the 
State is required to provide under section 2102(d)(2).’’. 
(d) EFFECTIVE DATE.—The amendments made by this section 
shall apply beginning on the first day of the first calendar quarter 
that begins on or after the date that is 24 months after the date 
of enactment of this Act. 
SEC. 5122. REMOVAL OF LIMITATIONS ON FEDERAL FINANCIAL 
PARTICIPATION FOR INMATES WHO ARE ELIGIBLE JUVE-
NILES PENDING DISPOSITION OF CHARGES. 
(a) MEDICAID.— 
(1) IN GENERAL.—The subdivision (A) of section 1905(a) 
of the Social Security Act (42 U.S.C. 1396d(a)) following para-
graph (31) of such section, as amended by section 5121(b), 
is further amended by inserting ‘‘, or, at the option of the 
State, for an individual who is an eligible juvenile (as defined 
in section 1902(nn)(2)), while such individual is an inmate 
of a public institution (as defined in section 1902(nn)(3)) 
pending disposition of charges’’ after ‘‘or in the case of an 
eligible juvenile described in section 1902(a)(84)(D) with respect
H. R. 2617—1486 
to the screenings, diagnostic services, referrals, and case 
management required under such section’’. 
(2) CONFORMING
AMENDMENT.—Section 1902(a)(84)(A) of 
the Social Security Act (42 U.S.C. 1396a(a)(84)(A)) is amended 
by inserting ‘‘(or in the case of a State electing the option 
described in the subdivision (A) following paragraph (31) of 
section 1905(a), during such period beginning after the disposi-
tion of charges with respect to such individual)’’ after ‘‘is such 
an inmate’’. 
(b) CHIP.—Section 2110(b)(7) of the Social Security Act (42 
U.S.C. 13977jj(b)(7)), as added by section 5121(c)(2)(B), is 
amended— 
(1) in the heading, by striking ‘‘EXCEPTION’’ and inserting 
‘‘EXCEPTIONS’’; and 
(2) by adding at the end the following new sentence: ‘‘At 
the option of the State, a child who is an inmate of a public 
institution shall not be considered to be described in paragraph 
(2)(A) during the period that the child is an inmate of such 
institution pending disposition of charges.’’. 
(c) EFFECTIVE DATE.—The amendments made by this section 
shall take effect on the first day of the first calendar quarter 
that begins after the date that is 24 months after the date of 
enactment of this Act and shall apply to items and services fur-
nished for periods beginning on or after such date. 
SEC. 5123. REQUIRING ACCURATE, UPDATED, AND SEARCHABLE PRO-
VIDER DIRECTORIES. 
(a) APPLICATION TO MANAGED CARE.—Section 1932(a)(5) of the 
Social Security Act (42 U.S.C. 1396u–2(a)(5)) is amended— 
(1) in subparagraph (B)(i), by inserting ‘‘, including as 
required by subparagraph (E)’’ before the period at the end; 
and 
(2) by adding at the end the following new subparagraph: 
‘‘(E) PROVIDER DIRECTORIES.— 
‘‘(i) IN GENERAL.—Each managed care organiza-
tion, prepaid inpatient health plan (as defined by the 
Secretary), prepaid ambulatory health plan (as defined 
by the Secretary), and, when appropriate, primary care 
case management entity (as defined by the Secretary) 
with a contract with a State to enroll individuals who 
are eligible for medical assistance under the State 
plan under this title or under a waiver of such plan, 
shall publish (and update on at least a quarterly basis 
or more frequently as required by the Secretary) on 
a public website, a searchable directory of network 
providers, which shall include physicians, hospitals, 
pharmacies, providers of mental health services, pro-
viders of substance use disorder services, providers 
of long term services and supports as appropriate, and 
such other providers as required by the Secretary, 
and that includes with respect to each such provider— 
‘‘(I) the name of the provider; 
‘‘(II) the specialty of the provider; 
‘‘(III) the address at which the provider pro-
vides services; 
‘‘(IV) the telephone number of the provider; 
and