In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.

Input: Consider Input: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Opioid Use Disorder Treatment 
Expansion and Modernization Act''.

SEC. 2. FINDING.

    The Congress finds that opioid use disorder has become a public 
health epidemic that must be addressed by increasing awareness and 
access to all treatment options for opioid use disorder, overdose 
reversal, and relapse prevention.

SEC. 3. OPIOID USE DISORDER TREATMENT MODERNIZATION.

    (a) In General.--Section 303(g)(2) of the Controlled Substances Act 
(21 U.S.C. 823(g)(2)) is amended--
            (1) in subparagraph (B), by striking clauses (i), (ii), and 
        (iii) and inserting the following:
            ``(i) The practitioner is a qualifying practitioner (as 
        defined in subparagraph (G)).
            ``(ii) With respect to patients to whom the practitioner 
        will provide such drugs or combinations of drugs, the 
        practitioner has the capacity to provide directly, by referral, 
        or in such other manner as determined by the Secretary--
                    ``(I) all schedule III, IV, and V drugs, as well as 
                unscheduled medications approved by the Food and Drug 
                Administration, for the treatment of opioid use 
                disorder, including such drugs and medications for 
                maintenance, detoxification, overdose reversal, and 
                relapse prevention, as available; and
                    ``(II) appropriate counseling and other appropriate 
                ancillary services.
            ``(iii)(I) The total number of such patients of the 
        practitioner at any one time will not exceed the applicable 
        number. Except as provided in subclause (II), the applicable 
        number is 30.
            ``(II) The applicable number is 100 if, not sooner than 1 
        year after the date on which the practitioner submitted the 
        initial notification, the practitioner submits a second 
        notification to the Secretary of the need and intent of the 
        practitioner to treat up to 100 patients.
            ``(III) The Secretary may by regulation change such total 
        number.
            ``(IV) The Secretary may exclude from the applicable number 
        patients to whom such drugs or combinations of drugs are 
        directly administered by the qualifying practitioner in the 
        office setting.
            ``(iv) If the Secretary by regulation increases the total 
        number of patients which a qualifying practitioner is permitted 
        to treat pursuant to clause (iii)(II), the Secretary shall 
        require such a practitioner to obtain a written agreement from 
        each patient, including the patient's signature, that the 
        patient--
                    ``(I) will receive an initial assessment and 
                treatment plan and periodic assessments and treatment 
                plans thereafter;
                    ``(II) will be subject to medication adherence and 
                substance use monitoring;
                    ``(III) understands available treatment options, 
                including all drugs approved by the Food and Drug 
                Administration for the treatment of opioid use 
                disorder, including their potential risks and benefits; 
                and
                    ``(IV) understands that receiving regular 
                counseling services is critical to recovery.
            ``(v) The practitioner will comply with the reporting 
        requirements of subparagraph (D)(i)(IV).'';
            (2) in subparagraph (D)--
                    (A) in clause (i), by adding at the end the 
                following:
            ``(IV) The practitioner reports to the Secretary, at such 
        times and in such manner as specified by the Secretary, such 
        information and assurances as the Secretary determines 
        necessary to assess whether the practitioner continues to meet 
        the requirements for a waiver under this paragraph.'';
                    (B) in clause (ii), by striking ``Upon receiving a 
                notification under subparagraph (B)'' and inserting 
                ``Upon receiving a determination from the Secretary 
                under clause (iii) finding that a practitioner meets 
                all requirements for a waiver under subparagraph (B)''; 
                and
                    (C) in clause (iii)--
                            (i) by inserting ``and shall forward such 
                        determination to the Attorney General'' before 
                        the period at the end of the first sentence; 
                        and
                            (ii) by striking ``physician'' and 
                        inserting ``practitioner'';
            (3) in subparagraph (G)--
                    (A) by amending clause (ii)(IV) to read as follows:
                    ``(IV) The physician has, with respect to the 
                treatment and management of opiate-dependent patients, 
                completed not less than 8 hours of training (through 
                classroom situations, seminars at professional society 
                meetings, electronic communications, or otherwise) that 
                is provided by the American Society of Addiction 
                Medicine, the American Academy of Addiction Psychiatry, 
                the American Medical Association, the American 
                Osteopathic Association, the American Psychiatric 
                Association, or any other organization that the 
                Secretary determines is appropriate for purposes of 
                this subclause. Such training shall address--
                            ``(aa) opioid maintenance and 
                        detoxification;
                            ``(bb) appropriate clinical use of all 
                        drugs approved by the Food and Drug 
                        Administration for the treatment of opioid use 
                        disorder;
                            ``(cc) initial and periodic patient 
                        assessments (including substance use 
                        monitoring);
                            ``(dd) individualized treatment planning; 
                        overdose reversal; relapse prevention;
                            ``(ee) counseling and recovery support 
                        services;
                            ``(ff) staffing roles and considerations;
                            ``(gg) diversion control; and
                            ``(hh) other best practices, as identified 
                        by the Secretary.''; and
                    (B) by adding at the end the following:
            ``(iii) The term `qualifying practitioner' means--
                    ``(I) a qualifying physician, as defined in clause 
                (ii); or
                    ``(II) during the period beginning on the date of 
                the enactment of the Opioid Use Disorder Treatment 
                Expansion and Modernization Act and ending on the date 
                that is 3 years after such date of enactment, a 
                qualifying other practitioner, as defined in clause 
                (iv).
            ``(iv) The term `qualifying other practitioner' means a 
        nurse practitioner or physician assistant who satisfies each of 
        the following:
                    ``(I) The nurse practitioner or physician assistant 
                is licensed under State law to prescribe schedule III, 
                IV, or V medications for the treatment of pain.
                    ``(II) The nurse practitioner or physician 
                assistant satisfies one or more of the following:
                            ``(aa) Has completed not fewer than 24 
                        hours of initial training addressing each of 
                        the topics listed in clause (ii)(IV) (through 
                        classroom situations, seminars at professional 
                        society meetings, electronic communications, or 
                        otherwise) provided by the American Society of 
                        Addiction Medicine, the American Academy of 
                        Addiction Psychiatry, the American Medical 
                        Association, the American Osteopathic 
                        Association, the American Nurses Credentialing 
                        Center, the American Psychiatric Association, 
                        the American Association of Nurse 
                        Practitioners, the American Academy of 
                        Physician Assistants, or any other organization 
                        that the Secretary determines is appropriate 
                        for purposes of this subclause.
                            ``(bb) Has such other training or 
                        experience as the Secretary determines will 
                        demonstrate the ability of the nurse 
                        practitioner or physician assistant to treat 
                        and manage opiate-dependent patients.
                    ``(III) The nurse practitioner or physician 
                assistant is supervised by or works in collaboration 
                with a qualifying physician, if the nurse practitioner 
                or physician assistant is required by State law to 
                prescribe medications for the treatment of opioid use 
                disorder in collaboration with or under the supervision 
                of a physician.
        The Secretary may review and update the requirements for being 
        a qualifying other practitioner under this clause.''; and
            (4) in subparagraph (H)--
                    (A) in clause (i), by inserting after subclause 
                (II) the following:
            ``(III) Such other elements of the requirements under this 
        paragraph as the Secretary determines necessary for purposes of 
        implementing such requirements.''; and
                    (B) by amending clause (ii) to read as follows:
    ``(ii) Not later than 1 year after the date of enactment of the 
Opioid Use Disorder Treatment Expansion and Modernization Act, the 
Secretary shall update the treatment improvement protocol containing 
best practice guidelines for the treatment of opioid-dependent patients 
in office-based settings. The Secretary shall update such protocol in 
consultation with experts in opioid use disorder research and 
treatment.''.
    (b) Recommendation of Revocation or Suspension of Registration in 
Case of Substantial Noncompliance.--The Secretary of Health and Human 
Services may recommend to the Attorney General that the registration of 
a practitioner be revoked or suspended if the Secretary determines, 
according to such criteria as the Secretary establishes by regulation, 
that a practitioner who is registered under section 303(g)(2) of the 
Controlled Substances Act (21 U.S.C. 823(g)(2)) is not in substantial 
compliance with the requirements of such section, as amended by this 
Act.
    (c) Opioid Defined.--Section 102(18) of the Controlled Substances 
Act (21 U.S.C. 802(18)) is amended by inserting ``or `opioid''' after 
``The term `opiate'''.
    (d) Reports to Congress.--
            (1) In general.--Not later than 2 years after the date of 
        enactment of this Act and not less than over every 5 years 
        thereafter, the Secretary of Health and Human Services, in 
        consultation with the Drug Enforcement Administration and 
        experts in opioid use disorder research and treatment, shall--
                    (A) perform a thorough review of the provision of 
                opioid use disorder treatment services in the United 
                States, including services provided in opioid treatment 
                programs and other specialty and nonspecialty settings; 
                and
                    (B) submit a report to the Congress on the findings 
                and conclusions of such review.
            (2) Contents.--Each report under paragraph (1) shall 
        include an assessment of--
                    (A) compliance with the requirements of section 
                303(g)(2) of the Controlled Substances Act (21 U.S.C. 
                823(g)(2)), as amended by this Act;
                    (B) the measures taken by the Secretary of Health 
                and Human Services to ensure such compliance;
                    (C) whether there is further need to increase or 
                decrease the number of patients a waivered practitioner 
                is permitted to treat, as provided for by the amendment 
                made by subsection (a)(1);
                    (D) the extent to which, and proportions with 
                which, the full range of Food and Drug Administration-
                approved treatments for opioid use disorder are used in 
                routine health care settings and specialty substance 
                use disorder treatment settings;
                    (E) access to, and use of, counseling and recovery 
                support services, including the percentage of patients 
                receiving such services;
                    (F) changes in State or local policies and 
                legislation relating to opioid use disorder treatment;
                    (G) the use of prescription drug monitoring 
                programs by practitioners who are permitted to dispense 
                narcotic drugs to individuals pursuant to a waiver 
                under section 303(g)(2) of the Controlled Substances 
                Act (21 U.S.C. 823(g)(2));
                    (H) the findings resulting from inspections by the 
                Drug Enforcement Administration of practitioners 
                described in subparagraph (G); and
                    (I) the effectiveness of cross-agency collaboration 
                between Department of Health and Human Services and the 
                Drug Enforcement Administration for expanding effective 
                opioid use disorder treatment.

SEC. 4. SENSE OF CONGRESS.

    It is the Sense of Congress that, with respect to the total number 
of patients that a qualifying physician (as defined in subparagraph 
(G)(iii) of section 303(g)(2) of the Controlled Substances Act (21 
U.S.C. 823(g)(2)) can treat at any one time pursuant to such section, 
the Secretary of Health and Human Services should consider raising such 
total number to 250 patients following a third notification to the 
Secretary of the need and intent of the physician to treat up to 250 
patients that is submitted to the Secretary not sooner than 1 year 
after the date on which the physician submitted to the Secretary a 
second notification to treat up to 100 patients.

SEC. 5. PARTIAL FILLS OF SCHEDULE II CONTROLLED SUBSTANCES.

    (a) In General.--Section 309 of the Controlled Substances Act (21 
U.S.C. 829) is amended by adding at the end the following:
    ``(f) Partial Fills of Schedule II Controlled Substances.--
            ``(1) Partial fills.--
                    ``(A) In general.--A prescription for a controlled 
                substance in schedule II may be partially filled if--
                            ``(i) it is not prohibited by State law;
                            ``(ii) the prescription is written and 
                        filled in accordance with the Controlled 
                        Substances Act (21 U.S.C. 801 et seq.), 
                        regulations prescribed by the Attorney General, 
                        and State law;
                            ``(iii) the partial fill is requested by 
                        the patient or the practitioner that wrote the 
                        prescription; and
                            ``(iv) the total quantity dispensed in all 
                        partial fillings does not exceed the total 
                        quantity prescribed.
                    ``(B) Other circumstances.--A prescription for a 
                controlled substance in schedule II may be partially 
                filled in accordance with section 1306.13 of title 21, 
                Code of Federal Regulations (as in effect on the date 
                of enactment of the Reducing Unused Medications Act of 
                2016).
            ``(2) Remaining portions.--
                    ``(A) In general.--Except as provided in 
                subparagraph (B), remaining portions of a partially 
                filled prescription for a controlled substance in 
                schedule II--
                            ``(i) may be filled; and
                            ``(ii) shall be filled not later than 30 
                        days after the date on which the prescription 
                        is written.
                    ``(B) Emergency situations.--In emergency 
                situations, as described in subsection (a), the 
                remaining portions of a partially filled prescription 
                for a controlled substance in schedule II--
                            ``(i) may be filled; and
                            ``(ii) shall be filled not later than 72 
                        hours after the prescription is issued.''.
    (b) Rule of Construction.--Nothing in this section shall be 
construed to affect the authority of the Attorney General to allow a 
prescription for a controlled substance in schedule III, IV, or V of 
section 202(c) of the Controlled Substances Act (21 U.S.C. 812(c)) to 
be partially filled.

            Passed the House of Representatives May 11, 2016.

            Attest:

                                                 KAREN L. HAAS,

                                                                 Clerk.

Output: Opioid Use Disorder Treatment Expansion and Modernization Act (Sec. 3) This bill amends the Controlled Substances Act to revise the requirements for a practitioner to administer, dispense, or prescribe narcotic drugs for maintenance or detoxification treatment in an office-based opioid treatment program. Currently, a practitioner must notify the Department of Health and Human Services (HHS) and certify that he or she is a qualifying physician (i.e., a state-licensed physician with certain expertise), has the capacity to refer patients for appropriate counseling and ancillary services, and will comply with a patient limit. The patient limit is how many patients the practitioner can treat under the office-based treatment program at one time. This legislation expands qualifying practitioners to include nurse practitioners and physician assistants who are licensed in a state, have expertise (such as relevant training or expertise), and prescribe medications for opioid use disorder in collaboration with or under the supervision of a qualifying physician if state law requires physician oversight of prescribing authority. Additionally, it requires a qualifying practitioner to also certify that he or she will comply with reporting requirements and has the capacity to provide directly or by referral, or in another manner prescribed by HHS, all drugs approved by the Food and Drug Administration to treat opioid use disorder. HHS may issue regulations to change the maximum patient limit for a qualifying practitioner. If HHS increases the limit, then a qualifying practitioner must additionally certify that he or she will obtain written consent from each patient regarding available treatment options. HHS must update the treatment improvement protocol containing best practice guidelines for the treatment of opioid-dependent patients in office-based settings. HHS may recommend revoking or suspending the registration of a practitioner who fails to comply with the requirements of this Act. (Sec. 4) The bill expresses the sense of Congress that HHS should consider raising from 100 to 250 the maximum patient limit for a qualifying physician. (Sec. 5) It amends the Controlled Substances Act to allow a pharmacist to partially fill a prescription for a schedule II controlled substance (such as a prescription opioid painkiller) if: (1) it is not prohibited by state law, (2) it is prescribed in accordance with existing laws and regulations, (3) it is requested by the patient or prescribing practitioner, and (4) the total quantity dispensed in partial fillings does not exceed the total quantity prescribed. Additionally, a pharmacist may partially fill a prescription for a schedule II controlled substance in other circumstances in accordance with existing Drug Enforcement Administration (DEA) regulations. (Current DEA regulations permit partial fills when a pharmacist cannot supply a full quantity, a patient resides in a long-term care facility, or a patient is terminally ill.) The remaining of a partially filled prescription may be filled within 30 days or, in the case of an emergency situation, within 72 hours.


Input: Consider Input: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Immigration Services and 
Infrastructure Improvements Act of 2000''.

SEC. 2. CONGRESSIONAL FINDINGS AND PURPOSES.

    (a) Findings.--Congress makes the following findings:
            (1) Applications for naturalization have increased 
        dramatically in recent years, outpacing the Immigration and 
        Naturalization Service's ability to process them.
            (2) The dramatic increase in applications for 
        naturalization and the inability of the Immigration and 
        Naturalization Service to deal with them adequately has 
        resulted in an unacceptably large backlog in naturalization 
        adjudications.
            (3) The processing times in the Immigration and 
        Naturalization Service's other immigration benefits have been 
        unacceptably long. Applicants for family- and employment-based 
        visas are waiting as long as 3 to 4 years to obtain a visa or 
        an adjustment to lawful permanent resident status.
            (4) In California, the delays in processing adjustment of 
        status applications have averaged 52 months. In Texas, the 
        delays have averaged 69 months. Residents of New York have had 
        to wait up to 28 months; in Florida, 26 months; in Illinois, 37 
        months; in Oregon, 31 months; and in Arizona, 49 months. Most 
        other States have experienced unacceptably long processing and 
        adjudication delays.
            (5) Applicants pay fees to have their applications 
        adjudicated in a timely manner. These fees have increased 
        dramatically in recent years without a commensurate increase in 
        the capability of that Immigration and Naturalization Service 
        to process and adjudicate these cases in an efficient manner.
            (6) Processing these applications in a timely fashion is 
        critical. Each 12-month delay in adjudicating an adjustment of 
        status application requires the alien to file applications to 
        extend employment authorization to work and advance parole 
        documents to travel.
            (7) The enormous delays in processing applications for 
        families and businesses have had a negative impact on the 
        reunification of spouses and minor children and the ability of 
        law-abiding and contributing members of our communities to 
        participate fully in the civic life of the United States.
            (8) United States employers have also experienced 
        debilitating delays in hiring employees who contribute to the 
        economic growth of the United States. These delays have forced 
        employers to send highly skilled and valued employees out of 
        the United States because their immigrant petitions were not 
        approved in a timely fashion. Such disruptions seriously 
        threaten the competitive edge of the United States in the 
        global marketplace.
    (b) Purpose.--The purpose of this Act is to--
            (1) provide the Immigration and Naturalization Service with 
        the mechanisms it needs to eliminate the current backlog in the 
        processing of immigration benefit applications within 1 year 
        after enactment of this Act and to maintain the elimination of 
        the backlog in future years; and
            (2) provide for regular congressional oversight of the 
        performance of the Immigration and Naturalization Service in 
        eliminating the backlog and processing delays in immigration 
        benefits adjudications.
    (c) Policy.--It is the sense of Congress that the processing of an 
immigration benefit application should be completed not later than 180 
days after the initial filing of the application, except that a 
petition for a nonimmigrant visa under section 214(c) of the 
Immigration and Nationality Act should be processed not later than 30 
days after the filing of the petition.

SEC. 3. DEFINITIONS.

    In this Act:
            (1) Backlog.--The term ``backlog'' means, with respect to 
        an immigration benefit application, the period of time in 
        excess of 180 days that such application has been pending 
        before the Immigration and Naturalization Service.
            (2) Immigration benefit application.--The term 
        ``immigration benefit application'' means any application or 
        petition to confer, certify, change, adjust, or extend any 
        status granted under the Immigration and Nationality Act.

SEC. 4. IMMIGRATION SERVICES AND INFRASTRUCTURE IMPROVEMENT ACCOUNT.

    (a) Authority of the Attorney General.--The Attorney General shall 
take such measures as may be necessary to--
            (1) reduce the backlog in the processing of immigration 
        benefit applications, with the objective of the total 
        elimination of the backlog not later than one year after the 
        date of enactment of this Act;
            (2) make such other improvements in the processing of 
        immigration benefit applications as may be necessary to ensure 
        that a backlog does not develop after such date; and
            (3) make such improvements in infrastructure as may be 
        necessary to effectively provide immigration services.
    (b) Authorization of Appropriations.--
            (1) In general.--There is authorized to be appropriated to 
        the Department of Justice from time to time such sums as may be 
        necessary for the Attorney General to carry out subsection (a).
            (2) Designation of account in treasury.--Amounts 
        appropriated pursuant to paragraph (1) may be referred to as 
        the ``Immigration Services and Infrastructure Improvements 
        Account''.
            (3) Availability of funds.--Amounts appropriated pursuant 
        to paragraph (1) are authorized to remain available until 
        expended.
            (4) Limitation on expenditures.--None of the funds 
        appropriated pursuant to paragraph (1) may be expended until 
        the report described in section 5(a) has been submitted to 
        Congress.

SEC. 5. REPORTS TO CONGRESS.

    (a) Backlog Elimination Plan.--
            (1) Report required.--Not later than 90 days after the date 
        of enactment of this Act, the Attorney General shall submit a 
        report to the Committees on the Judiciary and Appropriations of 
        the Senate and the House of Representatives concerning--
                    (A) the backlogs in immigration benefit 
                applications in existence as of the date of enactment 
                of this Act; and
                    (B) the Attorney General's plan for eliminating 
                such backlogs.
            (2) Report elements.--The report shall include--
                    (A) an assessment of the data systems used in 
                adjudicating and reporting on the status of immigration 
                benefit applications, including--
                            (i) a description of the adequacy of 
                        existing computer hardware, computer software, 
                        and other mechanisms to comply with the 
                        adjudications and reporting requirements of 
                        this Act; and
                            (ii) a plan for implementing improvements 
                        to existing data systems to accomplish the 
                        purpose of this Act, as described in section 
                        2(b);
                    (B) a description of the quality controls to be put 
                into force to ensure timely, fair, accurate, and 
                complete processing and adjudication of such 
                applications;
                    (C) the elements specified in subsection (b)(2);
                    (D) an estimate of the amount of appropriated funds 
                that would be necessary in order to eliminate the 
                backlogs in each category of immigration benefit 
                applications described in subsection (b)(2); and
                    (E) a detailed plan on how the Attorney General 
                will use any funds in the Immigration Services and 
                Infrastructure Improvements Account to comply with the 
                purposes of this Act.
    (b) Annual Reports.--
            (1) In general.--Beginning 90 days after the end of the 
        first fiscal year for which any appropriation authorized by 
        section 4(b) is made, and 90 days after the end of each fiscal 
        year thereafter, the Attorney General shall submit a report to 
        the Committees on the Judiciary and Appropriations of the 
        Senate and the House of Representatives concerning the status 
        of--
                    (A) the Immigration Services and Infrastructure 
                Improvements Account including any unobligated balances 
                of appropriations in the Account; and
                    (B) the Attorney General's efforts to eliminate 
                backlogs in any immigration benefit application 
                described in paragraph (2).
            (2) Report elements.--The report shall include--
                    (A) State-by-State data on--
                            (i) the number of naturalization cases 
                        adjudicated in each quarter of each fiscal 
                        year;
                            (ii) the average processing time for 
                        naturalization applications;
                            (iii) the number of naturalization 
                        applications pending for up to 6 months, 12 
                        months, 18 months, 24 months, 36 months, and 48 
                        months or more;
                            (iv) estimated processing times 
                        adjudicating newly submitted naturalization 
                        applications;
                            (v) an analysis of the appropriate 
                        processing times for naturalization 
                        applications; and
                            (vi) the additional resources and process 
                        changes needed to eliminate the backlog for 
                        naturalization adjudications;
                    (B) the status of applications or, where 
                applicable, petitions described in subparagraph (C), by 
                Immigration and Naturalization Service district, 
                including--
                            (i) the number of cases adjudicated in each 
                        quarter of each fiscal year;
                            (ii) the average processing time for such 
                        applications or petitions;
                            (iii) the number of applications or 
                        petitions pending for up to 6 months, 12 
                        months, 18 months, 24 months, 36 months, and 48 
                        months or more;
                            (iv) the estimated processing times 
                        adjudicating newly submitted applications or 
                        petitions;
                            (v) an analysis of the appropriate 
                        processing times for applications or petitions; 
                        and
                            (vi) a description of the additional 
                        resources and process changes needed to 
                        eliminate the backlog for such processing and 
                        adjudications; and
                    (C) a status report on--
                            (i) applications for adjustments of status 
                        to that of an alien lawfully admitted for 
                        permanent residence;
                            (ii) petitions for nonimmigrant visas under 
                        section 214 of the Immigration and Nationality 
                        Act;
                            (iii) petitions filed under section 204 of 
                        such Act to classify aliens as immediate 
                        relatives or preference immigrants under 
                        section 203 of such Act;
                            (iv) applications for asylum under section 
                        208 of such Act;
                            (v) registrations for Temporary Protected 
                        Status under section 244 of such Act; and
                            (vi) a description of the additional 
                        resources and process changes needed to 
                        eliminate the backlog for such processing and 
                        adjudications.
            (3) Absence of appropriated funds.--In the event that no 
        funds are appropriated subject to section 4(b) in the fiscal 
        year in which this Act is enacted, the Attorney General shall 
        submit a report to Congress not later than 90 days after the 
        end of such fiscal year, and each fiscal year thereafter, 
        containing the elements described in paragraph (2).

Output: Authorizes appropriations which shall be designated in the Treasury as the Immigration Services and Infrastructure Improvements Account.
Directs the Attorney General to make specified backlog elimination reports.


Input: Consider Input: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicaid Act of 2004''.

SEC. 2. EXTENSION OF MEDICAID STATE FISCAL RELIEF.

    (a) Extension of Temporary Freeze of Medicaid FMAP for Certain 
States.--Section 401(a) of the Jobs and Growth Tax Relief 
Reconciliation Act of 2003 (42 U.S.C. 1396d note) is amended--
            (1) in the subsection heading, by striking 
        ``$10,000,000,000 for a'';
            (2) in paragraph (2)--
                    (A) in the paragraph heading, by striking ``first 3 
                quarters of''; and
                    (B) by striking ``the first, second, and third 
                calendar quarters'' and inserting ``each calendar 
                quarter'';
            (3) by redesignating paragraphs (3) through (9) as 
        paragraphs (4) through (10), respectively; and
            (4) by inserting after paragraph (2), the following:
            ``(3) Permitting maintenance of fiscal year 2004 fmap for 
        fiscal year 2005.--Subject to paragraph (6), if the FMAP 
        determined without regard to this subsection for a State for 
        fiscal year 2005 is less than the FMAP as so determined for 
        fiscal year 2004, the FMAP for the State for fiscal year 2004 
        shall be substituted for the State's FMAP for each calendar 
        quarter of fiscal year 2005, before the application of this 
        subsection.''.
    (b) Temporary Increase in Medicaid FMAP for All States.--Section 
401(a) of the Jobs and Growth Tax Relief Reconciliation Act of 2003 (42 
U.S.C. 1396d note), as amended by subsection (a), is amended by 
striking paragraphs (4) and (5) (as redesignated by subsection (a)(3)) 
and inserting the following:
            ``(4) Temporary increase in medicaid fmap.--
                    ``(A) General 2.95 percentage points increase for 
                last 2 calendar quarters of fiscal year 2003 and first 
                3 calendar quarters of fiscal year 2004.--Subject to 
                paragraphs (6), (7), and (8), for each State for the 
                third and fourth calendar quarters of fiscal year 2003 
                and for the first, second, and third calendar quarters 
                of fiscal year 2004, the FMAP (taking into account the 
                application of paragraphs (1), (2), and (3)) shall be 
                increased by 2.95 percentage points.
                    ``(B) General 1.60 percentage points increase for 
                last calendar quarter of fiscal year 2004 and each 
                calendar quarter of fiscal year 2005.--Subject to 
                paragraphs (6), (7), and (8), for each State for the 
                fourth calendar quarter of fiscal year 2004 and each 
                calendar quarter of fiscal year 2005, the FMAP (taking 
                into account the application of paragraphs (1), (2), 
                and (3) but without regard to the application of 
                subparagraph (A)) shall be increased by 1.60 percentage 
                points.
            ``(5) Increase in cap on medicaid payments to 
        territories.--
                    ``(A) Last 2 calendar quarters of fiscal year 2003 
                and first 3 calendar quarters of fiscal year 2004.--
                Subject to paragraphs (7) and (8), with respect to the 
                third and fourth calendar quarters of fiscal year 2003 
                and the first, second, and third calendar quarters of 
                fiscal year 2004, the amounts otherwise determined for 
                Puerto Rico, the Virgin Islands, Guam, the Northern 
                Mariana Islands, and American Samoa under subsections 
                (f) and (g) of section 1108 of the Social Security Act 
                (42 U.S.C. 1308) shall each be increased by an amount 
                equal to 5.90 percent of such amounts.
                    ``(B) Last calendar quarter of fiscal year 2004 and 
                each calendar quarter of fiscal year 2005.--Subject to 
                paragraphs (7) and (8), with respect to the fourth 
                calendar quarter of fiscal year 2004 and each calendar 
                quarter of fiscal year 2005, the amounts otherwise 
                determined for Puerto Rico, the Virgin Islands, Guam, 
                the Northern Mariana Islands, and American Samoa under 
                subsections (f) and (g) of section 1108 of the Social 
                Security Act (42 U.S.C. 1308) shall each be increased 
                by an amount equal to 2.52 percent of such amounts.''.
    (c) Conforming Amendments.--Section 401(a) of the Jobs and Growth 
Tax Relief Reconciliation Act of 2003 (42 U.S.C. 1396d note), as 
amended by subsections (a) and (b), is amended--
            (1) in paragraph (1), by striking ``paragraph (5)'' and 
        inserting ``paragraph (6)'';
            (2) in paragraph (2), by striking ``paragraph (5)'' and 
        inserting ``paragraph (6)'';
            (3) in paragraph (7) (as redesignated by subsection 
        (a)(3))--
                    (A) by striking ``paragraph (4)'' each place it 
                appears and inserting ``paragraph (5)''; and
                    (B) by striking ``paragraph (3)'' each place it 
                appears and inserting ``paragraph (4)'';
            (4) in paragraph (8) (as so redesignated), by striking 
        ``the first, second and third calendar quarters of fiscal year 
        2004'' and inserting ``each calendar quarter of fiscal year 
        2004 and fiscal year 2005''; and
            (5) in paragraph (10) (as so redesignated), by striking 
        ``October 1, 2004'' and inserting ``January 1, 2005''.


Output: Medicaid Act of 2004 - Amends the Jobs and Growth Tax Relief Reconciliation Act of 2003 to extend the temporary freeze of the Federal medical assistance percentage (FMAP) under title XIX (Medicaid) of the Social Security Act (SSA) for certain States (continuing the FY 2003 FMAP through each calendar quarter of FY 2004, and the FY 2004 FMAP for each calendar quarter of FY 2005 if the FY 2005 FMAP would otherwise be less than the FY 2004 FMAP).

Amends the Jobs and Growth Tax Relief Reconciliation Act of 2003 to increase the FMAP: (1) by 2.95 percentage points for the last two calendar quarters of FY 2003 and the first three calendar quarters of FY 2004; and (2) by 1.60 percentage points for the last calendar quarter of FY 2004 and each calendar quarter of FY 2005.

Increases by 5.9 percent the ceiling on Medicaid payments to specified territories for the last two calendar quarters of FY 2003 and the first three calendar quarters of FY 2004. Increases such ceiling by 2.52 percent for the last calendar quarter of FY 2004 and each calendar quarter of FY 2005.

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