180
not have any legal effect on payments under grants for 
which amounts appropriated under subsection (c) were obli-
gated prior to such date. 
(c) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of making grants under subsection (a), there are 
authorized to be appropriated $40,000,000 for the period 
of fiscal years 2007 through 2012. 
SEC. 403. CHANGE IN THRESHOLD FOR MEDICAID INDIRECT 
HOLD 
HARMLESS 
PROVISION 
OF 
BROAD-
BASED HEALTH CARE TAXES. 
Section 1903(w)(4)(C) of the Social Security Act (42 
U.S.C. 1396b(w)(4)(C)) is amended—
(1) by inserting ‘‘(i)’’ after ‘‘(C)’’; and 
(2) by adding at the end the following: 
‘‘(ii) For purposes of clause (i), a determination 
of the existence of an indirect guarantee shall be made 
under paragraph (3)(i) of section 433.68(f) of title 42, 
Code of Federal Regulations, as in effect on November 
1, 2006, except that for portions of fiscal years begin-
ning on or after January 1, 2008, and before October 
1, 2011, ‘5.5 percent’ shall be substituted for ‘6 per-
cent’ each place it appears.’’.
181
SEC. 404. DSH ALLOTMENTS FOR FISCAL YEAR 2007 FOR 
TENNESSEE AND HAWAII. 
Section 1923(f)(6) of the Social Security Act (42 
U.S.C. 1396r–4(f)(6)) is amended to read as follows: 
‘‘(6) ALLOTMENT
ADJUSTMENTS
FOR
FISCAL 
YEAR 2007.—
‘‘(A) TENNESSEE.—
‘‘(i) IN GENERAL.—Only with respect 
to fiscal year 2007, the DSH allotment for 
Tennessee for such fiscal year, notwith-
standing the table set forth in paragraph 
(2) or the terms of the TennCare Dem-
onstration Project in effect for the State, 
shall be the greater of—
‘‘(I) the amount that the Sec-
retary determines is equal to the Fed-
eral 
medical 
assistance 
percentage 
component attributable to dispropor-
tionate share hospital payment adjust-
ments for the demonstration year end-
ing in 2006 that is reflected in the 
budget neutrality provision of the 
TennCare Demonstration Project; and 
‘‘(II) $280,000,000. 
‘‘(ii) LIMITATION ON AMOUNT OF PAY-
MENT
ADJUSTMENTS
ELIGIBLE
FOR
FED-
182
ERAL FINANCIAL PARTICIPATION.—Payment 
under section 1903(a) shall not be made to 
Tennessee with respect to the aggregate 
amount of any payment adjustments made 
under this section for hospitals in the State 
for fiscal year 2007 that is in excess of 30 
percent of the DSH allotment for the State 
for such fiscal year determined pursuant to 
clause (i). 
‘‘(iii) STATE PLAN AMENDMENT.—The 
Secretary shall permit Tennessee to submit 
an amendment to its State plan under this 
title that describes the methodology to be 
used by the State to identify and make pay-
ments to disproportionate share hospitals, 
including children’s hospitals and institu-
tions for mental diseases or other mental 
health facilities. The Secretary may not ap-
prove such plan amendment unless the 
methodology described in the amendment is 
consistent with the requirements under this 
section for making payment adjustments to 
disproportionate share hospitals. For pur-
poses of demonstrating budget neutrality 
under the TennCare Demonstration Project,
183
payment adjustments made pursuant to a 
State plan amendment approved in accord-
ance with this subparagraph shall be con-
sidered expenditures under such project. 
‘‘(iv) OFFSET OF FEDERAL SHARE OF 
PAYMENT ADJUSTMENTS FOR FISCAL YEAR 
2007 AGAINST ESSENTIAL ACCESS HOSPITAL 
SUPPLEMENTAL
POOL
PAYMENTS
UNDER 
THE
TENNCARE
DEMONSTRATION 
PROJECT.—
‘‘(I) The total amount of Essential 
Access Hospital supplemental pool 
payments that may be made under the 
TennCare Demonstration Project for 
fiscal year 2007 shall be reduced on a 
dollar for dollar basis by the amount of 
any payments made under section 
1903(a) to Tennessee with respect to 
payment adjustments made under this 
section for hospitals in the State for 
such fiscal year. 
‘‘(II) The sum of the total amount 
of 
payments 
made 
under 
section 
1903(a) to Tennessee with respect to 
payment adjustments made under this
184
section for hospitals in the State for 
fiscal year 2007 and the total amount 
of Essential Access Hospital supple-
mental pool payments made under the 
TennCare Demonstration Project for 
such fiscal year shall not exceed the 
State’s DSH allotment for such fiscal 
year established under clause (i). 
‘‘(B) HAWAII.—
‘‘(i) IN GENERAL.—Only with respect 
to fiscal year 2007, the DSH allotment for 
Hawaii for such fiscal year, notwith-
standing the table set forth in paragraph 
(2), shall be $10,000,000. 
‘‘(ii) STATE PLAN AMENDMENT.—The 
Secretary shall permit Hawaii to submit an 
amendment to its State plan under this 
title that describes the methodology to be 
used by the State to identify and make pay-
ments to disproportionate share hospitals, 
including children’s hospitals and institu-
tions for mental diseases or other mental 
health facilities. The Secretary may not ap-
prove such plan amendment unless the 
methodology described in the amendment is
185
consistent with the requirements under this 
section for making payment adjustments to 
disproportionate share hospitals.’’. 
SEC. 405. CERTAIN MEDICAID DRA TECHNICAL CORREC-
TIONS. 
(a) TECHNICAL CORRECTIONS RELATING TO STATE 
OPTION FOR ALTERNATIVE PREMIUMS AND COST SHARING 
(SECTIONS 6041 THROUGH 6043).—
(1) CLARIFICATION OF CONTINUED APPLICATION 
OF REGULAR COST SHARING RULES FOR INDIVIDUALS 
WITH FAMILY INCOME NOT EXCEEDING 100 PERCENT 
OF THE POVERTY LINE.—Section 1916A of the Social 
Security Act, as inserted by section 6041(a) of the 
Deficit Reduction Act of 2005 and amended by sec-
tions 6042 and 6043 of such Act, is amended—
(A) in subsection (a)(1)—
(i) by inserting ‘‘but subject to para-
graph (2),’’ after ‘‘1902(a)(10)(B),’’; and 
(ii) by inserting ‘‘and non-emergency 
services furnished in a hospital emergency 
department for which cost sharing may be 
imposed under subsection (e)’’ after ‘‘(c)’’; 
(B) by redesignating paragraph (2) of sub-
section (a) as paragraph (3);
186
(C) in subsection (a), by inserting after 
paragraph (1) the following: 
‘‘(2) EXEMPTION FOR INDIVIDUALS WITH FAMILY 
INCOME NOT EXCEEDING 100 PERCENT OF THE POV-
ERTY LINE.—
‘‘(A) IN
GENERAL.—Paragraph (1) and 
subsection (d) shall not apply, and sections 1916 
and 1902(a)(10)(B) shall continue to apply, in 
the case of an individual whose family income 
does not exceed 100 percent of the poverty line 
applicable to a family of the size involved. 
‘‘(B) LIMIT
ON
AGGREGATE
COST
SHAR-
ING.—To the extent cost sharing under sub-
section (c) and (e) or under section 1916 is im-
posed against individuals described in subpara-
graph (A), the limitation under subsection 
(b)(1)(B)(ii) on the total aggregate amount of 
cost sharing shall apply to such cost sharing for 
all individuals in a family described in subpara-
graph (A) in the same manner as such limita-
tions apply to cost sharing and families de-
scribed in subsection (b)(1)(B)(ii).’’; 
(D) in subsections (c)(2)(C) and (e)(2)(C), 
by inserting ‘‘under subsection (a)(2)(B) or’’ 
after ‘‘cap on cost sharing applied’’; and
187
(E) in subsection (e)(2)(A), by inserting 
‘‘who is not described in subparagraph (B)’’ 
after ‘‘subsection (b)(1)’’. 
(2) CLARIFICATION OF TREATMENT OF NON-PRE-
FERRED
DRUG
AND
NON-EMERGENCY
COST-SHAR-
ING.—Such section is further amended—
(A) in subsections (b)(1) and (b)(2), by 
striking ‘‘, subject to subsections (c)(2) and 
(e)(2)(A)’’; 
(B) in subsection (c)(1), in the matter pre-
ceding subparagraph (A), by striking ‘‘least (or 
less) costly effective’’ and inserting ‘‘most (or 
more) cost effective’’; 
(C) in subsection (c)(1)(B), by striking 
‘‘otherwise be imposed under’’ and inserting ‘‘be 
imposed under subsection (a) due to the applica-
tion of’’; 
(D) in subsection (c)(2)(B), by striking 
‘‘otherwise not subject to cost sharing due to the 
application of subsection (b)(3)(B)’’ and insert-
ing ‘‘not subject to cost sharing under subsection 
(a) due to the application of paragraph (1)(B)’’; 
(E) in subsection (e)(2)(A)—
(i) by amending the heading to read as 
follows: ‘‘INDIVIDUALS
WITH
FAMILY
IN-
188
COME BETWEEN 100 AND 150 PERCENT OF 
THE POVERTY LINE.—’’; and 
(ii) by striking ‘‘under subsection 
(b)(1)’’ and inserting ‘‘under subsection 
(b)(1)(B)(ii)’’; 
(F) in subsection (e)(2)(B), by striking 
‘‘who is otherwise not subject to cost sharing 
under subsection (b)(3)’’ and inserting ‘‘described 
in subsection (a)(2)(A) or who is not subject to 
cost sharing under subsection (b)(3)(B) with re-
spect to non-emergency services described in 
paragraph (1)’’ and 
(G) in subsection (e)(2)(C), by inserting ‘‘or 
section 1916’’ after ‘‘subsection (a)’’. 
(3) CLARIFICATION OF COST SHARING RULES AP-
PLICABLE TO DISABLED CHILDREN PROVIDED MED-
ICAL ASSISTANCE UNDER THE ELIGIBILITY CATEGORY 
ADDED BY THE FAMILY OPPORTUNITY ACT.—Such sec-
tion is further amended—
(A) in subsection (a)(1), in the second sen-
tence, by striking ‘‘section 1916(g)’’ and insert-
ing ‘‘subsection (g) or (i) of section 1916’’; and 
(B) in subsection (b)(3)—
(i) in subparagraph (A), by adding at 
the end the following:
189
‘‘(vi) Disabled children who are receiv-
ing medical assistance by virtue of the ap-
plication 
of 
sections 
1902(a)(10)(A)(ii)(XIX) 
and 
1902(cc).’’; 
and 
(ii) in subparagraph (B), by adding at 
the end the following: 
‘‘(ix) Services furnished to disabled 
children who are receiving medical assist-
ance by virtue of the application of sections 
1902(a)(10)(A)(ii)(XIX) and 1902(cc).’’. 
(4) CORRECTION OF IV–B REFERENCES.—Such 
section is further amended in subsection (b)(3)—
(A) in subparagraph (A)(i), by striking 
‘‘aid or assistance is made available under part 
B of title IV to children in foster care’’ and in-
serting ‘‘child welfare services are made available 
under part B of title IV on the basis of being a 
child in foster care’’; and 
(B) in subparagraph (B)(i), by striking 
‘‘aid or assistance is made available under part 
B of title IV to children in foster care’’ and in-
serting ‘‘child welfare services are made available 
under part B of title IV on the basis of being a 
child in foster care or’’.
190
(5) 
NON-EMERGENCY
SERVICES.—Section 
1916A(e)(4)(A) of the Social Security Act, as added 
by section 6043(a) of the Deficit Reduction Act of 
2005, is amended by striking ‘‘the physician deter-
mines’’. 
(6) EFFECTIVE DATE.—The amendments made 
by this subsection shall take effect as if included in 
the amendments made by sections 6041(a) of the Def-
icit Reduction Act of 2005, except that insofar as such 
amendments are to, or relate to, subsection (c) or (e) 
of section 1916A of the Social Security Act, such 
amendments shall take effect as if included in the 
amendments made by section 6042 or 6043, respec-
tively, of the Deficit Reduction Act of 2005. 
(b) CLARIFYING TREATMENT OF CERTAIN ANNUITIES 
(SECTION 6012).—
(1) IN
GENERAL.—Section 1917(c)(1)(F)(i) of 
the Social Security Act (42 U.S.C. 1396p(c)(1)(F)(i)), 
as added by section 6012(b) of the Deficit Reduction 
Act of 2005, is amended by striking ‘‘annuitant’’ and 
inserting ‘‘institutionalized individual’’. 
(2) EFFECTIVE DATE.—The amendment made by 
paragraph (1) shall be effective as if included in the 
enactment of section 6012 of the Deficit Reduction 
Act of 2005.
191
(c) ADDITIONAL MISCELLANEOUS TECHNICAL COR-
RECTIONS.—
(1) DOCUMENTATION (SECTION 6036).—
(A) IN GENERAL.—Effective as if included 
in the amendment made by section 6036(a)(2) of 
the Deficit Reduction Act of 2005, section 
1903(x) of the Social Security Act (42 U.S.C. 
1396b(x)), as inserted by such section 6036(a)(2), 
is amended—
(i) in paragraph (1), by striking 
‘‘(i)(23)’’ and inserting ‘‘(i)(22)’’; 
(ii) in paragraph (2)—
(I) in the matter preceding sub-
paragraph (A), by striking ‘‘alien’’ 
and inserting ‘‘individual declaring to 
be a citizen or national of the United 
States’’; 
(II) by striking subparagraph (B) 
and inserting the following: 
‘‘(B) and is receiving—
‘‘(i) disability insurance benefits under 
section 223 or monthly insurance benefits 
under section 202 based on such individ-
ual’s disability (as defined in section 
223(d)); or
192
‘‘(ii) supplemental security income 
benefits under title XVI;’’; 
(III) in subparagraph (C)—
(aa) by striking ‘‘other’’; and 
(bb) by striking ‘‘had’’ and 
inserting ‘‘has’’; 
(IV) by redesignating subpara-
graph (C) as subparagraph (D); and 
(V) by inserting after subpara-
graph (B) the following new subpara-
graph: 
‘‘(C) and with respect to whom—
‘‘(i) child welfare services are made 
available under part B of title IV on the 
basis of being a child in foster care; or 
‘‘(ii) adoption or foster care assistance 
is made available under part E of title IV; 
or’’; and 
(iii) in paragraph (3)(C)(iii), by strik-
ing ‘‘I–97’’ and inserting ‘‘I–197’’. 
(B) ASSURANCE
OF
STATE
FOSTER
CARE 
AGENCY
VERIFICATION
OF
CITIZENSHIP
OR 
LEGAL STATUS.—
193
(i) STATE PLAN AMENDMENT.—Section 
471(a) of the Social Security Act (42 U.S.C. 
671(a)) is amended—
(I) in paragraph (25), by striking 
‘‘and’’ at the end; 
(II) in paragraph (26)(C), by 
striking the period at the end and in-
serting ‘‘; and’’; and 
(III) by adding at the end the fol-
lowing: 
‘‘(27) provides that, with respect to any child in 
foster care under the responsibility of the State under 
this part or part B and without regard to whether 
foster care maintenance payments are made under 
section 472 on behalf of the child, the State has in ef-
fect procedures for verifying the citizenship or immi-
gration status of the child.’’. 
(ii) INCLUSION IN REVIEWS OF CHILD 
AND FAMILY SERVICES PROGRAMS.—Section 
1123A(b)(2) of the Social Security Act (42 
U.S.C. 1320a-2a(b)(2)) is amended by in-
serting ‘‘(which shall include determining 
whether the State program is in conformity 
with the requirement of section 471(a)(27))’’ 
after ‘‘review’’.
194
(iii) EFFECTIVE
DATE.—The amend-
ments made by this subparagraph shall take 
effect on the date that is 6 months after the 
date of the enactment of this Act. 
(2) 
MISCELLANEOUS
TECHNICAL
CORREC-
TIONS.—
(A) Effective as if included in the enact-
ment of the Deficit Reduction Act of 2005 (Pub-
lic Law 109–171), the following sections of such 
Act are amended as follows: 
(i) Section 5114(a)(2) is amended by 
striking ‘‘section 1842(b)(6)(F) of such Act 
(42 U.S.C. 1395u(b)(6)(F))’’ and inserting 
‘‘section 1842(b)(6) of such Act (42 U.S.C. 
1395u(b)(6))’’. 
(ii) Section 6003(b)(2) is amended, by 
striking ‘‘subsection (k)’’ and inserting 
‘‘subsection (k)(1)’’. 
(iii) Sections 6031(b), 6032(b), and 
6035(c) are each amended by striking ‘‘sec-
tion 
6035(e)’’ 
and 
inserting 
‘‘section 
6034(e)’’. 
(iv) Section 6034(b) is amended by 
striking ‘‘section 6033(a)’’ and inserting 
‘‘section 6032(a)’’.
195
(v) Section 6036 is amended—
(I) in subsection (b), by striking 
‘‘section 1903(z)’’ and inserting ‘‘sec-
tion 1903(x)’’; and 
(II) in subsection (c), by striking 
‘‘(i)(23)’’ and inserting ‘‘(i)(22)’’. 
(B) Effective as if included in the amend-
ment made by section 6015(a)(1) of the Deficit 
Reduction 
Act 
of 
2005, 
section 
1919(c)(5)(A)(i)(II) of the Social Security Act 
(42 U.S.C. 1396r(c)(5)(A)(i)(II)) is amended by 
striking ‘‘clause (v)’’ and inserting ‘‘subpara-
graph (B)(v)’’. 
DIVISION C—OTHER 
PROVISIONS 
TITLE I—GULF OF MEXICO 
ENERGY SECURITY 
SEC. 101. SHORT TITLE. 
This title may be cited as the ‘‘Gulf of Mexico Energy 
Security Act of 2006’’. 
SEC. 102. DEFINITIONS. 
In this title: 
(1) 181 AREA.—The term ‘‘181 Area’’ means the 
area identified in map 15, page 58, of the Proposed 
Final Outer Continental Shelf Oil and Gas Leasing
196
Program for 1997–2002, dated August 1996, of the 
Minerals Management Service, available in the Office 
of the Director of the Minerals Management Service, 
excluding the area offered in OCS Lease Sale 181, 
held on December 5, 2001. 
(2) 181 SOUTH AREA.—The term ‘‘181 South 
Area’’ means any area—
(A) located—
(i) south of the 181 Area; 
(ii) west of the Military Mission Line; 
and 
(iii) in the Central Planning Area; 
(B) excluded from the Proposed Final Outer 
Continental Shelf Oil and Gas Leasing Program 
for 1997–2002, dated August 1996, of the Min-
erals Management Service; and 
(C) included in the areas considered for oil 
and gas leasing, as identified in map 8, page 37 
of the document entitled ‘‘Draft Proposed Pro-
gram Outer Continental Shelf Oil and Gas Leas-
ing Program 2007–2012’’, dated February 2006. 
(3) BONUS
OR
ROYALTY
CREDIT.—The term 
‘‘bonus or royalty credit’’ means a legal instrument 
or other written documentation, or an entry in an ac-