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‘‘(A) incorporate a widely accepted, non- 
proprietary, searchable, computer-readable for-
mat, such as the eXtensible Markup Language; 
‘‘(B) contain interoperable standards devel-
oped and maintained by intergovernmental 
partnerships, such as the National Information 
Exchange Model; 
‘‘(C) incorporate interoperable standards 
developed and maintained by Federal entities 
with authority over contracting and financial 
assistance; 
‘‘(D) be consistent with and implement ap-
plicable accounting principles; 
‘‘(E) be implemented in a manner that is 
cost-effective and improves program efficiency 
and effectiveness; and 
‘‘(F) be capable of being continually up-
graded as necessary. 
‘‘(3) RULE
OF
CONSTRUCTION.—Nothing in 
this subsection shall be construed to require a 
change to existing data exchange standards found to 
be effective and efficient.’’. 
(b) EFFECTIVE DATE.—Not later than the date that 
is 24 months after the date of the enactment of this sec-
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tion, the Secretary of Health and Human Services shall 
issue a proposed rule that— 
(1) identifies federally required data exchanges, 
include specification and timing of exchanges to be 
standardized, and address the factors used in deter-
mining whether and when to standardize data ex-
changes; and 
(2) specifies State implementation options and 
describes future milestones. 
UNEMPLOYMENT INSURANCE TECHNICAL CORRECTIONS 
SEC. 206. Section 306(a) of the Social Security Act 
(42 U.S.C. 506(a)) is amended— 
(1) by striking ‘‘individuals’’ and inserting 
‘‘claimants of regular compensation, including claim-
ants’’; and 
(2) by inserting a comma after ‘‘section 
303(j)’’. 
TITLE III 
MEDICAID EXTENDERS 
EXTENSION OF MONEY FOLLOWS THE PERSON 
REBALANCING DEMONSTRATION 
SEC. 301. (a) GENERAL FUNDING.—Section 6071(h) 
of the Deficit Reduction Act of 2005 (42 U.S.C. 1396a 
note) is amended— 
(1) in paragraph (1)— 
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(A) in subparagraph (D), by striking 
‘‘and’’ after the semicolon; 
(B) in subparagraph (E), by striking the 
period at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(F) 
subject 
to 
paragraph 
(3), 
$112,000,000 for fiscal year 2019.’’; 
(2) in paragraph (2)— 
(A) by striking ‘‘Amounts made’’ and in-
serting ‘‘Subject to paragraph (3), amounts 
made’’; and 
(B) by striking ‘‘September 30, 2016’’ and 
inserting ‘‘September 30, 2021’’; and 
(3) by adding at the end the following new 
paragraph: 
‘‘(3) SPECIAL RULE FOR FY 2019.—Funds ap-
propriated under paragraph (1)(F) shall be made 
available for grants to States only if such States 
have an approved MFP demonstration project under 
this section as of December 31, 2018.’’. 
(b) FUNDING FOR QUALITY ASSURANCE AND IM-
PROVEMENT; TECHNICAL
ASSISTANCE; OVERSIGHT.— 
Section 6071(f) of the Deficit Reduction Act of 2005 (42 
U.S.C. 1396a note) is amended by striking paragraph (2) 
and inserting the following: 
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‘‘(2) FUNDING.—From the amounts appro-
priated under subsection (h)(1)(F) for fiscal year 
2019, $500,000 shall be available to the Secretary 
for such fiscal year to carry out this subsection.’’. 
(c) TECHNICAL AMENDMENT.—Section 6071(b) of 
the Deficit Reduction Act of 2005 (42 U.S.C. 1396a note) 
is amended by adding at the end the following: 
‘‘(10) 
SECRETARY.—The 
term 
‘Secretary’ 
means the Secretary of Health and Human Serv-
ices.’’. 
EXTENSION OF PROTECTION FOR MEDICAID RECIPIENTS 
OF
HOME
AND
COMMUNITY-BASED
SERVICES 
AGAINST SPOUSAL IMPOVERISHMENT 
SEC. 302. (a) IN GENERAL.—Section 2404 of Public 
Law 111–148 (42 U.S.C. 1396r–5 note) is amended by 
striking ‘‘the 5-year period that begins on January 1, 
2014,’’ and inserting ‘‘the period beginning on January 
1, 2014, and ending on March 31, 2019,’’. 
(b) RULE OF CONSTRUCTION.— 
(1) PROTECTING STATE SPOUSAL INCOME AND 
ASSET
DISREGARD
FLEXIBILITY
UNDER
WAIVERS 
AND PLAN AMENDMENTS.—Nothing in section 2404 
of Public Law 111–148 (42 U.S.C. 1396r–5 note) or 
section 1924 of the Social Security Act (42 U.S.C. 
1396r–5) shall be construed as prohibiting a State 
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from disregarding an individual’s spousal income 
and assets under a State waiver or plan amendment 
described in paragraph (2) for purposes of making 
determinations of eligibility for home and commu-
nity-based services or home and community-based 
attendant services and supports under such waiver 
or plan amendment. 
(2) STATE WAIVER OR PLAN AMENDMENT DE-
SCRIBED.—A State waiver or plan amendment de-
scribed in this paragraph is any of the following: 
(A) A waiver or plan amendment to pro-
vide medical assistance for home and commu-
nity-based services under a waiver or plan 
amendment under subsection (c), (d), or (i) of 
section 1915 of the Social Security Act (42 
U.S.C. 1396n) or under section 1115 of such 
Act (42 U.S.C. 1315). 
(B) A plan amendment to provide medical 
assistance for home and community-based serv-
ices for individuals by reason of being deter-
mined eligible under section 1902(a)(10)(C) of 
such Act (42 U.S.C. 1396a(a)(10)(C)) or by 
reason of section 1902(f) of such Act (42 
U.S.C. 1396a(f)) or otherwise on the basis of a 
reduction of income based on costs incurred for 
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medical or other remedial care under which the 
State disregarded the income and assets of the 
individual’s spouse in determining the initial 
and ongoing financial eligibility of an individual 
for such services in place of the spousal impov-
erishment provisions applied under section 1924 
of such Act (42 U.S.C. 1396r–5). 
(C) A plan amendment to provide medical 
assistance for home and community-based at-
tendant services and supports under section 
1915(k) of such Act (42 U.S.C. 1396n(k)). 
REDUCTION IN FMAP AFTER 2020 FOR STATES WITHOUT 
ASSET VERIFICATION PROGRAM 
SEC. 303. Section 1940 of the Social Security Act 
(42 U.S.C. 1396w) is amended by adding at the end the 
following new subsection: 
‘‘(k) REDUCTION IN FMAP AFTER 2020 FOR NON- 
COMPLIANT STATES.— 
‘‘(1) IN GENERAL.—With respect to a calendar 
quarter beginning on or after January 1, 2021, the 
Federal medical assistance percentage otherwise de-
termined under section 1905(b) for a non-compliant 
State shall be reduced— 
‘‘(A) for calendar quarters in 2021 and 
2022, by 0.12 percentage points; 
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‘‘(B) for calendar quarters in 2023, by 
0.25 percentage points; 
‘‘(C) for calendar quarters in 2024, by 
0.35 percentage points; and 
‘‘(D) for calendar quarters in 2025 and 
each year thereafter, by 0.5 percentage points. 
‘‘(2) NON-COMPLIANT
STATE
DEFINED.—For 
purposes of this subsection, the term ‘non-compliant 
State’ means a State— 
‘‘(A) that is one of the 50 States or the 
District of Columbia; 
‘‘(B) with respect to which the Secretary 
has not approved a State plan amendment sub-
mitted under subsection (a)(2); and 
‘‘(C) that is not operating, on an ongoing 
basis, an asset verification program in accord-
ance with this section.’’. 
MEDICAID IMPROVEMENT FUND 
SEC. 304. Section 1941(b)(1) of the Social Security 
Act (42 U.S.C. 1396w–1(b)(1)) is amended by striking 
‘‘$31,000,000’’ and inserting ‘‘$6,000,000’’. 
BUDGETARY EFFECTS 
SEC. 305. (a) STATUTORY PAYGO SCORECARDS.— 
The budgetary effects of this division shall not be entered 
on either PAYGO scorecard maintained pursuant to sec-
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tion 4(d) of the Statutory Pay-As-You-Go Act of 2010 (2 
U.S.C. 933(d)). 
(b) SENATE PAYGO SCORECARDS.—The budgetary 
effects of this division shall not be entered on any PAYGO 
scorecard maintained for purposes of section 4106 of H. 
Con. Res. 71 (115th Congress). 
(c) CLASSIFICATION
OF BUDGETARY EFFECTS.— 
Notwithstanding Rule 3 of the Budget Scorekeeping 
Guidelines set forth in the joint explanatory statement of 
the committee of conference accompanying Conference Re-
port 105–217 and section 250(c)(8) of the Balanced 
Budget and Emergency Deficit Control Act of 1985, the 
budgetary effects of this division shall not be estimated— 
(1) for purposes of section 251 of such Act; and 
(2) for purposes of paragraph (4)(C) of section 
3 of the Statutory Pay-As-You-Go Act of 2010 as 
being included in an appropriation Act. 
TITLE IV 
BUDGETARY EFFECTS 
SEC. 401. Effective on the date of enactment of this 
Act, the balances on the PAYGO scorecards established 
pursuant to paragraphs (4) and (5) of section 4(d) of the 
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Statutory Pay-As-You-Go Act of 2010 (2 U.S.C. 933(d)) 
shall be zero. 
Passed the House of Representatives January 23, 
2019. 
Attest: 
KAREN L. HAAS, 
Clerk. 
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Calendar No. 16 
116TH CONGRESS 
1ST SESSION 
H. R. 648 
AN ACT 
Making appropriations for the fiscal year ending 
September 30, 2019, and for other purposes. 
JANUARY 28, 2019 
Read the second time and placed on the calendar 
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