icaid program under title XIX of the Social Security Act 
during the previous 12 month period, including the amount 
of funds appropriated under such subsection (a) for each 
such activity and an estimate of the savings to the Medicaid 
program resulting from each such activity. 
SEC. 4. STUDY AND REPORTS TO CONGRESS. 
(a) SECRETARIAL REPORT IDENTIFYING PROBLEMS.— 
Not later than July 1, 2008, the Secretary of Health and 
Human Services shall submit to the Committee on Energy 
and Commerce of the House of Representatives and the 
Committee on Finance of the Senate a report that— 
(1) outlines the specific problems the Medicaid 
regulations referred to in the amendments made by 
subsections (a) and (b) of section 2 and in the provi-
sions described in subsection (c)(2) of such section 
were intended to address; 
(2) detailing how these regulations were designed 
to address these specific problems; and 
(3) cites the legal authority for such regulations. 
(b) INDEPENDENT COMPREHENSIVE STUDY AND RE-
PORT.— 
(1) IN GENERAL.—Not later than July 1, 2008, 
the Secretary of Health and Human Services shall 
enter into a contract with an independent organiza-
tion for the purpose of— 
VerDate Aug 31 2005 
04:55 Apr 23, 2008
Jkt 069200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6203
E:\BILLS\H5613.RH
H5613
wwoods2 on PRODPC68 with BILLS
(A) producing a comprehensive report on 
the prevalence of the problems outlined in the re-
port submitted under subsection (a); 
(B) identifying strategies in existence to ad-
dress these problems; and 
(C) assessing the impact of each regulation 
referred to in such subsection on each State and 
the District of Columbia. 
(2) ADDITIONAL
MATTER.—The report under 
paragraph (1) shall also include— 
(A) an identification of which claims for 
items and services (including administrative ac-
tivities) under title XIX of the Social Security 
Act are not processed through systems described 
in section 1903(r) of such Act; 
(B) an examination of the reasons why 
these claims for such items and services are not 
processed through such systems; and 
(C) recommendations on actions by the Fed-
eral government and the States that can make 
claims for such items and services more accurate 
and complete consistent with such title. 
(3) DEADLINE.—The report under paragraph (1) 
shall be submitted to the Committee on Energy and 
Commerce of the House of Representatives and the 
VerDate Aug 31 2005 
04:55 Apr 23, 2008
Jkt 069200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6203
E:\BILLS\H5613.RH
H5613
wwoods2 on PRODPC68 with BILLS
Committee on Finance of the Senate not later than 
March 1, 2009. 
(4) COOPERATION OF STATES.—If the Secretary 
of Health and Human Services determines that a 
State or the District of Columbia has not cooperated 
with the independent organization for purposes of the 
report under this subsection, the Secretary shall re-
duce the amount paid to the State or District under 
section 1903(a) of the Social Security Act (42 U.S.C. 
1396b(a)) by $25,000 for each day on which the Sec-
retary determines such State or District has not so 
cooperated. Such reduction shall be made through a 
process that permits the State or District to challenge 
the Secretary’s determination. 
(c) FUNDING.— 
(1) IN
GENERAL.—Out of any money in the 
Treasury of the United States not otherwise appro-
priated, there are appropriated to the Secretary with-
out further appropriation, $5,000,000 to carry out 
this section. 
(2) AVAILABILITY; AMOUNTS
IN
ADDITION
TO 
OTHER AMOUNTS APPROPRIATED FOR SUCH ACTIVI-
TIES.—Amounts appropriated pursuant to paragraph 
(1) shall— 
(A) remain available until expended; and 
VerDate Aug 31 2005 
04:55 Apr 23, 2008
Jkt 069200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6203
E:\BILLS\H5613.RH
H5613
wwoods2 on PRODPC68 with BILLS
(B) be in addition to any other amounts 
appropriated or made available to the Secretary 
of Health and Human Services with respect to 
the Medicaid program. 
SEC. 5. ASSET VERIFICATION THROUGH ACCESS TO INFOR-
MATION HELD BY FINANCIAL INSTITUTIONS. 
(a) ADDITION OF AUTHORITY.—Title XIX of the Social 
Security Act is amended by inserting after section 1939 the 
following new section: 
‘‘ASSET VERIFICATION THROUGH ACCESS TO INFORMATION 
HELD BY FINANCIAL INSTITUTIONS 
‘‘SEC. 1940. (a) IMPLEMENTATION.— 
‘‘(1) IN GENERAL.—Subject to the provisions of 
this section, each State shall implement an asset 
verification program described in subsection (b), for 
purposes of determining or redetermining the eligi-
bility of an individual for medical assistance under 
the State plan under this title. 
‘‘(2) PLAN SUBMITTAL.—In order to meet the re-
quirement of paragraph (1), each State shall— 
‘‘(A) submit not later than a deadline speci-
fied by the Secretary consistent with paragraph 
(3), a State plan amendment under this title 
that describes how the State intends to imple-
ment the asset verification program; and 
VerDate Aug 31 2005 
04:55 Apr 23, 2008
Jkt 069200
PO 00000
Frm 00012
Fmt 6652
Sfmt 6203
E:\BILLS\H5613.RH
H5613
wwoods2 on PRODPC68 with BILLS
‘‘(B) provide for implementation of such 
program for eligibility determinations and rede-
terminations made on or after 6 months after the 
deadline established for submittal of such plan 
amendment. 
‘‘(3) PHASE-IN.— 
‘‘(A) IN GENERAL.— 
‘‘(i) IMPLEMENTATION
IN
CURRENT 
ASSET
VERIFICATION
DEMO
STATES.—The 
Secretary shall require those States specified 
in subparagraph (C) (to which an asset 
verification program has been applied be-
fore the date of the enactment of this sec-
tion) to implement an asset verification 
program under this subsection by the end of 
fiscal year 2009. 
‘‘(ii) 
IMPLEMENTATION
IN
OTHER 
STATES.—The Secretary shall require other 
States to submit and implement an asset 
verification program under this subsection 
in such manner as is designed to result in 
the application of such programs, in the ag-
gregate for all such other States, to enroll-
ment of approximately, but not less than, 
the following percentage of enrollees, in the 
VerDate Aug 31 2005 
04:55 Apr 23, 2008
Jkt 069200
PO 00000
Frm 00013
Fmt 6652
Sfmt 6203
E:\BILLS\H5613.RH
H5613
wwoods2 on PRODPC68 with BILLS
aggregate for all such other States, by the 
end of the fiscal year involved: 
‘‘(I) 12.5 percent by the end of fis-
cal year 2009. 
‘‘(II) 25 percent by the end of fis-
cal year 2010. 
‘‘(III) 50 percent by the end of fis-
cal year 2011. 
‘‘(IV) 75 percent by the end of fis-
cal year 2012. 
‘‘(V) 100 percent by the end of fis-
cal year 2013. 
‘‘(B) CONSIDERATION.—In selecting States 
under subparagraph (A)(ii), the Secretary shall 
consult with the States involved and take into 
account the feasibility of implementing asset 
verification programs in each such State. 
‘‘(C) STATES SPECIFIED.—The States speci-
fied in this subparagraph are California, New 
York, and New Jersey. 
‘‘(D) CONSTRUCTION.—Nothing in subpara-
graph (A)(ii) shall be construed as preventing a 
State from requesting, and the Secretary approv-
ing, the implementation of an asset verification 
VerDate Aug 31 2005 
04:55 Apr 23, 2008
Jkt 069200
PO 00000
Frm 00014
Fmt 6652
Sfmt 6203
E:\BILLS\H5613.RH
H5613
wwoods2 on PRODPC68 with BILLS
program in advance of the deadline otherwise es-
tablished under such subparagraph. 
‘‘(4) EXEMPTION OF TERRITORIES.—This section 
shall only apply to the 50 States and the District of 
Columbia. 
‘‘(b) ASSET VERIFICATION PROGRAM.— 
‘‘(1) IN GENERAL.—For purposes of this section, 
an asset verification program means a program de-
scribed in paragraph (2) under which a State— 
‘‘(A) requires each applicant for, or recipi-
ent of, medical assistance under the State plan 
under this title on the basis of being aged, blind, 
or disabled to provide authorization by such ap-
plicant or recipient (and any other person whose 
resources are material to the determination of 
the eligibility of the applicant or recipient for 
such assistance) for the State to obtain (subject 
to the cost reimbursement requirements of section 
1115(a) of the Right to Financial Privacy Act 
but at no cost to the applicant or recipient) from 
any financial institution (within the meaning of 
section 1101(1) of such Act) any financial record 
(within the meaning of section 1101(2) of such 
Act) held by the institution with respect to the 
applicant or recipient (and such other person, as 
VerDate Aug 31 2005 
04:55 Apr 23, 2008
Jkt 069200
PO 00000
Frm 00015
Fmt 6652
Sfmt 6203
E:\BILLS\H5613.RH
H5613
wwoods2 on PRODPC68 with BILLS
applicable), whenever the State determines the 
record is needed in connection with a determina-
tion with respect to such eligibility for (or the 
amount or extent of) such medical assistance; 
and 
‘‘(B) uses the authorization provided under 
subparagraph (A) to verify the financial re-
sources of such applicant or recipient (and such 
other person, as applicable), in order to deter-
mine or redetermine the eligibility of such appli-
cant or recipient for medical assistance under 
the State plan. 
‘‘(2) PROGRAM
DESCRIBED.—A program de-
scribed in this paragraph is a program for verifying 
individual assets in a manner consistent with the ap-
proach used by the Commissioner of Social Security 
under section 1631(e)(1)(B)(ii). 
‘‘(c) 
DURATION
OF
AUTHORIZATION.—Notwith-
standing section 1104(a)(1) of the Right to Financial Pri-
vacy Act, an authorization provided to a State under sub-
section (b)(1) shall remain effective until the earliest of— 
‘‘(1) the rendering of a final adverse decision on 
the applicant’s application for medical assistance 
under the State’s plan under this title; 
VerDate Aug 31 2005 
04:55 Apr 23, 2008
Jkt 069200
PO 00000
Frm 00016
Fmt 6652
Sfmt 6203
E:\BILLS\H5613.RH
H5613
wwoods2 on PRODPC68 with BILLS
‘‘(2) the cessation of the recipient’s eligibility for 
such medical assistance; or 
‘‘(3) the express revocation by the applicant or 
recipient (or such other person described in subsection 
(b)(1), as applicable) of the authorization, in a writ-
ten notification to the State. 
‘‘(d) TREATMENT OF RIGHT TO FINANCIAL PRIVACY 
ACT REQUIREMENTS.— 
‘‘(1) An authorization obtained by the State 
under subsection (b)(1) shall be considered to meet the 
requirements of the Right to Financial Privacy Act 
for purposes of section 1103(a) of such Act, and need 
not be furnished to the financial institution, notwith-
standing section 1104(a) of such Act. 
‘‘(2) The certification requirements of section 
1103(b) of the Right to Financial Privacy Act shall 
not apply to requests by the State pursuant to an au-
thorization provided under subsection (b)(1). 
‘‘(3) A request by the State pursuant to an au-
thorization provided under subsection (b)(1) is 
deemed to meet the requirements of section 1104(a)(3) 
of the Right to Financial Privacy Act and of section 
1102 of such Act, relating to a reasonable description 
of financial records. 
VerDate Aug 31 2005 
04:55 Apr 23, 2008
Jkt 069200
PO 00000
Frm 00017
Fmt 6652
Sfmt 6203
E:\BILLS\H5613.RH
H5613
wwoods2 on PRODPC68 with BILLS
‘‘(e) REQUIRED DISCLOSURE.—The State shall inform 
any person who provides authorization pursuant to sub-
section (b)(1)(A) of the duration and scope of the authoriza-
tion. 
‘‘(f) REFUSAL OR REVOCATION OF AUTHORIZATION.— 
If an applicant for, or recipient of, medical assistance 
under the State plan under this title (or such other person 
described in subsection (b)(1), as applicable) refuses to pro-
vide, or revokes, any authorization made by the applicant 
or recipient (or such other person, as applicable) under sub-
section (b)(1)(A) for the State to obtain from any financial 
institution any financial record, the State may, on that 
basis, determine that the applicant or recipient is ineligible 
for medical assistance. 
‘‘(g) USE OF CONTRACTOR.—For purposes of imple-
menting an asset verification program under this section, 
a State may select and enter into a contract with a public 
or private entity meeting such criteria and qualifications 
as the State determines appropriate, consistent with re-
quirements in regulations relating to general contracting 
provisions and with section 1903(i)(2). In carrying out ac-
tivities under such contract, such an entity shall be subject 
to the same requirements and limitations on use and disclo-
sure of information as would apply if the State were to 
carry out such activities directly. 
VerDate Aug 31 2005 
04:55 Apr 23, 2008
Jkt 069200
PO 00000
Frm 00018
Fmt 6652
Sfmt 6203
E:\BILLS\H5613.RH
H5613
wwoods2 on PRODPC68 with BILLS
‘‘(h) TECHNICAL ASSISTANCE.—The Secretary shall 
provide States with technical assistance to aid in imple-
mentation of an asset verification program under this sec-
tion. 
‘‘(i) REPORTS.—A State implementing an asset 
verification program under this section shall furnish to the 
Secretary such reports concerning the program, at such 
times, in such format, and containing such information as 
the Secretary determines appropriate. 
‘‘(j) TREATMENT OF PROGRAM EXPENSES.—Notwith-
standing any other provision of law, reasonable expenses 
of States in carrying out the program under this section 
shall be treated, for purposes of section 1903(a), in the same 
manner as State expenditures specified in paragraph (7) 
of such section.’’. 
(b) STATE PLAN REQUIREMENTS.—Section 1902(a) of 
such Act (42 U.S.C. 1396a(a)) is amended— 
(1) in paragraph (69) by striking ‘‘and’’ at the 
end; 
(2) in paragraph (70) by striking the period at 
the end and inserting ‘‘; and’’; and 
(3) by inserting after paragraph (70), as so 
amended, the following new paragraph: 
VerDate Aug 31 2005 
04:55 Apr 23, 2008
Jkt 069200
PO 00000
Frm 00019
Fmt 6652
Sfmt 6203
E:\BILLS\H5613.RH
H5613
wwoods2 on PRODPC68 with BILLS
‘‘(71) provide that the State will implement an 
asset verification program as required under section 
1940.’’. 
(c) WITHHOLDING OF FEDERAL MATCHING PAYMENTS 
FOR NONCOMPLIANT STATES.—Section 1903(i) of such Act 
(42 U.S.C. 1396b(i)) is amended— 
(1) in paragraph (22) by striking ‘‘or’’ at the 
end; 
(2) in paragraph (23) by striking the period at 
the end and inserting ‘‘; or’’; and 
(3) by adding after paragraph (23) the following 
new paragraph: 
‘‘(24) if a State is required to implement an 
asset verification program under section 1940 and 
fails to implement such program in accordance with 
such section, with respect to amounts expended by 
such State for medical assistance for individuals sub-
ject to asset verification under such section, unless— 
‘‘(A) the State demonstrates to the Sec-
retary’s satisfaction that the State made a good 
faith effort to comply; 
‘‘(B) not later than 60 days after the date 
of a finding that the State is in noncompliance, 
the State submits to the Secretary (and the Sec-
VerDate Aug 31 2005 
04:55 Apr 23, 2008
Jkt 069200
PO 00000
Frm 00020
Fmt 6652
Sfmt 6203
E:\BILLS\H5613.RH
H5613
wwoods2 on PRODPC68 with BILLS
retary approves) a corrective action plan to rem-
edy such noncompliance; and 
‘‘(C) not later than 12 months after the date 
of such submission (and approval), the State ful-
fills the terms of such corrective action plan.’’. 
(d) REPEAL.—Section 4 of Public Law 110–90 is re-
pealed. 
SEC. 6. ADJUSTMENT TO PAQI FUND. 
Section 1848(l)(2) of the Social Security Act (42 
U.S.C. 1395w–4(l)(2)), as amended by section 101(a)(2) of 
the Medicare, Medicaid, and SCHIP Extension Act of 2007 
(Public Law 110–173), is amended— 
(1) in subparagraph (A)(i)— 
(A) 
in 
subclause 
(III), 
by 
striking 
‘‘$4,960,000,000’’ 
and 
inserting 
‘‘$3,790,000,000’’; and 
(B) by adding at the end the following new 
subclause: 
‘‘(IV) For expenditures during 
2014, 
an 
amount 
equal 
to 
$3,690,000,000.’’; 
(2) in subparagraph (A)(ii), by adding at the 
end the following new subclause: 
‘‘(IV) 2014.—The amount avail-
able for expenditures during 2014 shall 
VerDate Aug 31 2005 
04:55 Apr 23, 2008
Jkt 069200
PO 00000
Frm 00021
Fmt 6652
Sfmt 6203
E:\BILLS\H5613.RH
H5613
wwoods2 on PRODPC68 with BILLS
only be available for an adjustment to 
the update of the conversion factor 
under subsection (d) for that year.’’; 
and 
(3) in subparagraph (B)— 
(A) in clause (ii), by striking ‘‘and’’ at the 
end; 
(B) in clause (iii), by striking the period at 
the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
clause: 
‘‘(iv) 2014 for payment with respect to 
physicians’ 
services 
furnished 
during 
2014.’’. 
Amend the title so as to read: ‘‘A bill to extend cer-
tain moratoria and impose additional moratoria on cer-
tain Medicaid regulations through April 1, 2009, and for 
other purposes.’’. 
VerDate Aug 31 2005 
04:55 Apr 23, 2008
Jkt 069200
PO 00000
Frm 00022
Fmt 6652
Sfmt 6201
E:\BILLS\H5613.RH
H5613
wwoods2 on PRODPC68 with BILLS
VerDate Aug 31 2005 
04:55 Apr 23, 2008
Jkt 069200
PO 00000
Frm 00023
Fmt 6652
Sfmt 6201
E:\BILLS\H5613.RH
H5613
wwoods2 on PRODPC68 with BILLS
Union Calendar No. 373 
110TH CONGRESS 
2D SESSION 
H. R. 5613 
[Report No. 110–600] 
A BILL 
To extend certain moratoria and impose additional 
moratoria 
on 
certain 
Medicaid 
regulations 
through April 1, 2009. 
APRIL 22, 2008 
Reported with amendments, committed to the Committee 
of the Whole House on the State of the Union, and or-
dered to be printed 
VerDate Aug 31 2005 
04:55 Apr 23, 2008
Jkt 069200
PO 00000
Frm 00024
Fmt 6651
Sfmt 6651
E:\BILLS\H5613.RH
H5613
wwoods2 on PRODPC68 with BILLS