Title: Verify Eligibility Coverage Act
Policy area: Health

Summary:
Verify Eligibility Coverage Act
This bill allows a state to delay or deny an individual's initial eligibility for Medicaid benefits without providing a reasonable opportunity to submit evidence of a satisfactory immigration status or pending official verification of such status. A state that elects to provide a reasonable period for an individual to provide such evidence may not receive payment for amounts expended on the individual's medical assistance during that period.
In FY2020-FY2028, the Centers for Medicare & Medicaid Services, using the Medicaid Improvement Fund, shall pay a 90% Federal Medical Assistance Percentage (i.e., federal matching rate) to eligible states for home- and community-based services furnished under a state Medicaid waiver to patients who had been on a waiting list for such services.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3695 Introduced in House (IH)]

<DOC>






116th CONGRESS
  1st Session
                                H. R. 3695

   To amend titles XI and XIX of the Social Security Act to promote 
program integrity with respect to the enrollment of certain immigrants 
         in State plans under Medicaid, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 11, 2019

 Mr. Flores (for himself, Mr. Guthrie, and Mr. Mullin) introduced the 
   following bill; which was referred to the Committee on Energy and 
                                Commerce

_______________________________________________________________________

                                 A BILL


 
   To amend titles XI and XIX of the Social Security Act to promote 
program integrity with respect to the enrollment of certain immigrants 
         in State plans under Medicaid, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Verify Eligibility Coverage Act''.

SEC. 2. PROMOTING PROGRAM INTEGRITY IN ENROLLING CERTAIN IMMIGRANTS 
              UNDER MEDICAID.

    (a) In General.--Section 1137(f) of the Social Security Act (42 
U.S.C. 1320b-7(f)) is amended--
            (1) by striking ``Subsections (a)(1) and (d)'' and 
        inserting ``(1) Subsections (a)(1) and (d)''; and
            (2) by adding at the end the following new paragraph:
            ``(2)(A) Subparagraphs (A) and (B)(ii) of subsection (d)(4) 
        shall not apply in the case of an initial determination made on 
        or after the date that is 6 months after the date of the 
        enactment of this paragraph with respect to the eligibility of 
        an alien described in subparagraph (B) for benefits under the 
        program listed in subsection (b)(2).
            ``(B) An alien described in this subparagraph is an 
        individual declaring to be a citizen or national of the United 
        States with respect to whom a State, in accordance with section 
        1902(a)(46)(B), requires--
                    ``(i) pursuant to section 1902(ee), the submission 
                of a social security number; or
                    ``(ii) pursuant to section 1903(x), the 
                presentation of satisfactory documentary evidence of 
                citizenship or nationality.''.
    (b) No Payments for Medical Assistance Provided Before Presentation 
of Evidence.--Section 1903(i)(22) of the Social Security Act (42 U.S.C. 
1396b(i)(22)) is amended--
            (1) by striking ``with respect to amounts expended'' and 
        inserting ``(A) with respect to amounts expended'';
            (2) by inserting ``and'' at the end; and
            (3) by adding at the end the following new subparagraph:
            ``(B) in the case of a State that elects to provide a 
        reasonable period to present satisfactory documentary evidence 
        of such citizenship or nationality pursuant to paragraph (2)(C) 
        of section 1902(ee) or paragraph (4) of subsection (x) of this 
        section, for amounts expended for medical assistance for such 
        an individual (other than an individual described in paragraph 
        (2) of such subsection (x)) during such period;''.
    (c) Conforming Amendments.--Section 1137(d)(4) of the Social 
Security Act (42 U.S.C. 1320b-7(d)(4)) is amended--
            (1) in subparagraph (A), in the matter preceding clause 
        (i), by inserting ``subject to subsection (f)(2),'' before 
        ``the State''; and
            (2) in subparagraph (B)(ii), by inserting ``subject to 
        subsection (f)(2),'' before ``pending such verification''.

SEC. 3. MEDICAID IMPROVEMENT FUND.

    Section 1941 of the Social Security Act (42 U.S.C. 1396w-1(b)) is 
amended to read as follows:

``SEC. 1941. MEDICAID IMPROVEMENT FUND.

    ``(a) In General.--The Secretary shall establish, and administer, 
under this title a Medicaid Improvement Fund (in this section referred 
to as the `Fund') which shall be available to the Secretary for the 
following purposes:
            ``(1) To improve the management of the Medicaid program by 
        the Centers for Medicare & Medicaid Services, including 
        oversight of contracts and contractors and evaluation of 
        demonstration projects.
            ``(2) To improve access to care for the most vulnerable 
        individuals eligible to receive medical assistance under the 
        State plan under this title (or a waiver of such plan), 
        including by carrying out section 4 of the Verify Eligibility 
        Coverage Act (relating to reducing waiting lists for medical 
        assistance for home and community-based services under a State 
        plan waiver under subsection (c), (d), or (i) of section 1915 
        or section 1115). 
    ``(b) Supplement, Not Supplant.--Payments made for activities under 
this section shall be in addition to payments that would otherwise be 
made for activities described in subsection (a).
    ``(c) Funding.--
            ``(1) In general.--
                    ``(A) Management improvements.--There shall be 
                available to the Fund, for the purposes described in 
                subsection (a)(1), for expenditures from the Fund for 
                fiscal year 2021 and thereafter, $5,000,000.
                    ``(B) Increasing access.--There shall be available 
                to the Fund, for the purposes described in subsection 
                (a)(2), for expenditures from the Fund for fiscal year 
                2020 and thereafter, $1,095,000,000.
            ``(2) Funding limitation.--Amounts in the Fund shall be 
        available in advance of appropriations but only if the total 
        amount obligated from the Fund does not exceed the amount 
        available to the Fund under subparagraphs (A) and (B) of 
        paragraph (1). The Secretary may obligate funds from the Fund 
        only if the Secretary determines (and the Chief Actuary of the 
        Centers for Medicare & Medicaid Services and the appropriate 
        budget officer certify) that there are available in the Fund 
        sufficient amounts to cover all such obligations incurred 
        consistent with the previous sentence.''.

SEC. 4. PROVIDING CARE FOR THE MOST VULNERABLE PATIENTS ON WAITING 
              LISTS.

    (a) In General.--Subject to subsection (d), the Secretary of Health 
and Human Services shall provide, for each of fiscal years 2020 through 
2028, payment to eligible States selected under subsection (c) to 
provide for medical assistance for home and community-based services 
under a State plan waiver under subsection (c), (d), or (i) of section 
1915 of the Social Security Act (42 U.S.C. 1396n) or section 1115 of 
the Social Security Act (42 U.S.C. 1315) to individuals who are 
eligible but, as of January 1, 2019, are on a waiting list for such 
services through such waiver.
    (b) State Eligibility.--A State is eligible for a payment under 
this section if the State submits an application to the Secretary at 
such time, in such form and manner, and containing such information, 
provisions, and assurances, as specified by the Secretary.
    (c) Selection.--Subject to subsection (d), the Secretary shall, for 
each of fiscal years 2020 through 2028, select, on a competitive basis, 
from among eligible States, the States that will receive payment under 
this section. In making such selections, the Secretary shall give 
priority to--
            (1) States with the highest number of individuals on a 
        waiting list described in subsection (a);
            (2) States with the highest average or highest median 
        periods individuals have been on such a list; and
            (3) States with individuals on such a list who have the 
        lowest income levels, as compared to the income of individuals 
        on such a list of other eligible States.
    (d) Funding.--
            (1) Funds allocated to states.--Of the funds available for 
        purposes of carrying out this section under section 1941(c) of 
        the Social Security Act (42 U.S.C. 1396w-1(c)), the Secretary 
        shall allocate such funds to States selected under subsection 
        (c) on the basis of criteria, including a State's application 
        submitted under subsection (b), the availability of funds under 
        such section 1941(c), and criteria specified under subsection 
        (c), as determined by the Secretary.
            (2) Payments to states.--For each calendar quarter 
        beginning on or after October 1, 2019, the Secretary shall pay 
        to each State selected under subsection (c), from the 
        allocation made to the State under paragraph (1), an amount 
        equal to 90 percent of the Federal medical assistance 
        percentage of the amount expended during such quarter for the 
        medical assistance described in subsection (a).
    (e) Definitions.--In this section:
            (1) Federal medical assistance percentage.--The term 
        ``Federal medical assistance percentage'' has the meaning given 
        such term in section 1905(b) of the Social Security Act (42 
        U.S.C. 1396d(b)).
            (2) Medical assistance.--The term ``medical assistance'' 
        has the meaning given such term in section 1905(a) of the 
        Social Security Act (42 U.S.C. 1396d(a)).
            (3) State.--The term ``State'' has the meaning given such 
        term for purposes of title XIX of the Social Security Act (42 
        U.S.C. 1396 et seq.).
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