TASK DEFINITION: In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.
PROBLEM: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Orphan Works Act of 2006''.

SEC. 2. LIMITATION ON REMEDIES IN CASES INVOLVING ORPHAN WORKS.

    (a) Limitation on Remedies.--Chapter 5 of title 17, United States 
Code, is amended by adding at the end the following new section:
``Sec. 514. Limitation on remedies in cases involving orphan works
    ``(a) Limitation on Remedies.--
            ``(1) Conditions.--Notwithstanding sections 502 through 
        505, in an action brought under this title for infringement of 
        copyright in a work, the remedies for infringement shall be 
        limited under subsection (b) if the infringer sustains the 
        burden of proving, and the court finds, that--
                    ``(A) before the infringing use of the work began, 
                the infringer, a person acting on behalf of the 
                infringer, or any person jointly and severally liable 
                with the infringer for the infringement of the work--
                            ``(i) performed and documented a reasonably 
                        diligent search in good faith to locate the 
                        owner of the infringed copyright; but
                            ``(ii) was unable to locate the owner; and
                    ``(B) the infringing use of the work provided 
                attribution, in a manner reasonable under the 
                circumstances, to the author and owner of the 
                copyright, if known with a reasonable degree of 
                certainty based on information obtained in performing 
                the reasonably diligent search.
            ``(2) Definitions; requirements for searches.--
                    ``(A) Owner of infringed copyright.--For purposes 
                of paragraph (1), the `owner' of an infringed copyright 
                in a work is the legal or beneficial owner of, or any 
                party with authority to grant or license, an exclusive 
                right under section 106 applicable to the infringement.
                    ``(B) Requirements for reasonably diligent 
                search.--(i) For purposes of paragraph (1), a search to 
                locate the owner of an infringed copyright in a work--
                            ``(I) is `reasonably diligent' only if it 
                        includes steps that are reasonable under the 
                        circumstances to locate that owner in order to 
                        obtain permission for the use of the work; and
                            ``(II) is not `reasonably diligent' solely 
                        by reference to the lack of identifying 
                        information with respect to the copyright on 
                        the copy or phonorecord of the work.
                    ``(ii) The steps referred to in clause (i)(I) shall 
                ordinarily include, at a minimum, review of the 
                information maintained by the Register of Copyrights 
                under subparagraph (C).
                    ``(iii) A reasonably diligent search includes the 
                use of reasonably available expert assistance and 
                reasonably available technology, which may include, if 
                reasonable under the circumstances, resources for which 
                a charge or subscription fee is imposed.
                    ``(C) Information to guide searches.--The Register 
                of Copyrights shall receive, maintain, and make 
                available to the public, including through the 
                Internet, information from authoritative sources, such 
                as industry guidelines, statements of best practices, 
                and other relevant documents, that is designed to 
                assist users in conducting and documenting a reasonably 
                diligent search under this subsection. Such information 
                may include--
                            ``(i) the records of the Copyright Office 
                        that are relevant to identifying and locating 
                        copyright owners;
                            ``(ii) other sources of copyright ownership 
                        information reasonably available to users;
                            ``(iii) methods to identify copyright 
                        ownership information associated with a work;
                            ``(iv) sources of reasonably available 
                        technology tools and reasonably available 
                        expert assistance; and
                            ``(v) best practices for documenting a 
                        reasonably diligent search.
    ``(b) Limitations on Remedies.--The limitations on remedies in a 
case to which subsection (a) applies are the following:
            ``(1) Monetary relief.--
                    ``(A) General rule.--Subject to subparagraph (B), 
                an award for monetary relief (including actual damages, 
                statutory damages, costs, and attorney's fees) may not 
                be made, other than an order requiring the infringer to 
                pay reasonable compensation for the use of the 
                infringed work.
                    ``(B) Exceptions.--(i) An order requiring the 
                infringer to pay reasonable compensation for the use of 
                the infringed work may not be made under subparagraph 
                (A) if--
                            ``(I) the infringement is performed without 
                        any purpose of direct or indirect commercial 
                        advantage and primarily for a charitable, 
                        religious, scholarly, or educational purpose, 
                        and
                            ``(II) the infringer ceases the 
                        infringement expeditiously after receiving 
                        notice of the claim for infringement,
                unless the copyright owner proves, and the court finds, 
                that the infringer has earned proceeds directly 
                attributable to the infringement.
                    ``(ii) If the infringer fails to negotiate in good 
                faith with the owner of the infringed work regarding 
                the amount of reasonable compensation for the use of 
                the infringed work, the court may award full costs, 
                including a reasonable attorney's fee, against the 
                infringer under section 505, subject to section 412.
            ``(2) Injunctive relief.--
                    ``(A) General rule.--Subject to subparagraph (B), 
                the court may impose injunctive relief to prevent or 
                restrain the infringing use, except that, if the 
                infringer has met the requirements of subsection (a), 
                the relief shall, to the extent practicable, account 
                for any harm that the relief would cause the infringer 
                due to its reliance on having performed a reasonably 
                diligent search under subsection (a).
                    ``(B) Special rule for new works.--In a case in 
                which the infringer recasts, transforms, adapts, or 
                integrates the infringed work with the infringer's 
                original expression in a new work of authorship, the 
                court may not, in granting injunctive relief, restrain 
                the infringer's continued preparation or use of that 
                new work, if the infringer--
                            ``(i) pays reasonable compensation to the 
                        owner of the infringed copyright for the use of 
                        the infringed work; and
                            ``(ii) provides attribution to the owner of 
                        the infringed copyright in a manner that the 
                        court determines is reasonable under the 
                        circumstances.
                    ``(C) Treatment of parties not subject to suit.--
                The limitations on remedies under this paragraph shall 
                not be available to an infringer that asserts in an 
                action under section 501(b) that neither it nor its 
                representative acting in an official capacity is 
                subject to suit in Federal court for an award of 
                damages to the copyright owner under section 504, 
                unless the court finds that such infringer has-- 
                            ``(i) complied with the requirements of 
                        subsection (a) of this section;
                            ``(ii) made a good faith offer of 
                        compensation that was rejected by the copyright 
                        owner; and
                            ``(iii) affirmed in writing its willingness 
                        to pay such compensation to the copyright owner 
                        upon the determination by the court that such 
                        compensation was reasonable under paragraph (3) 
                        of this subsection.
                    ``(D) Construction.--Nothing in subparagraph (C) 
                shall be deemed to authorize or require, and no action 
                taken pursuant to subparagraph (C) shall be deemed to 
                constitute, an award of damages by the court against 
                the infringer.
                    ``(E) Rights and privileges not waived.--No action 
                taken by an infringer pursuant to subparagraph (C) 
                shall be deemed to waive any right or privilege that, 
                as a matter of law, protects such infringer from being 
                subject to suit in Federal court for an award of 
                damages to the copyright owner under section 504.
            ``(3) Reasonable compensation.--In establishing reasonable 
        compensation under paragraph (1) or (2), the owner of the 
        infringed copyright has the burden of establishing the amount 
        on which a reasonable willing buyer and a reasonable willing 
        seller in the positions of the owner and the infringer would 
        have agreed with respect to the infringing use of the work 
        immediately before the infringement began.
    ``(c) Preservation of Other Rights, Limitations, and Defense.--This 
section does not affect any right, limitation, or defense to copyright 
infringement, including fair use, under this title. If another 
provision of this title provides for a statutory license when the 
copyright owner cannot be located, that provision applies in lieu of 
this section.
    ``(d) Copyright for Derivative Works.--Notwithstanding section 
103(a), the infringing use of a work in accordance with this section 
shall not limit or affect the copyright protection for a work that uses 
the infringed work.''.
    (b) Conforming Amendment.--The table of sections for chapter 5 of 
title 17, United States Code, is amended by adding at the end the 
following new item:

``514. Limitation on remedies in cases involving orphan works''.
    (c) Effective Date.--The amendments made by this section shall 
apply only to infringing uses that commence on or after June 1, 2008.

SEC. 3. REPORT TO CONGRESS ON AMENDMENTS.

    The Register of Copyrights shall, not later than December 12, 2014, 
report to the Committee on the Judiciary of the House of 
Representatives and the Committee on the Judiciary of the Senate on the 
implementation and effects of the amendments made by section 2, 
including any recommendations for legislative changes that the Register 
considers appropriate.

SEC. 4. INQUIRY ON REMEDIES FOR SMALL COPYRIGHT CLAIMS.

    (a) In General.--The Register of Copyrights shall conduct an 
inquiry with respect to remedies for copyright infringement claims 
seeking limited amounts of monetary relief, including consideration of 
alternatives to disputes currently heard in the United States district 
courts. The inquiry shall cover infringement claims to which section 
514 of title 17, United States Code (as added by section 2 of this 
Act), apply, and other infringement claims under title 17, United 
States Code.
    (b) Procedures.--The Register of Copyrights shall publish notice of 
the inquiry under subsection (a), providing a period during which 
interested persons may submit comments on the inquiry, and an 
opportunity for interested persons to participate in public roundtables 
on the inquiry. The Register shall hold the public roundtables at such 
times as the Register considers appropriate.
    (c) Report to Congress.--The Register of Copyrights shall, not 
later than 1 year after the date of the enactment of this Act, prepare 
and submit to the Committee on the Judiciary of the House of 
Representatives and the Committee on the Judiciary of the Senate a 
report on the inquiry conducted under this section, including such 
recommendations that the Register considers appropriate.

SOLUTION: Orphan Works Act of 2006 - Limits the remedies available in a copyright infringement action if the infringer proves that: (1) the infringer performed and documented a reasonably diligent search in good faith to locate the copyright owner before using the work, but was unable to locate the owner; and (2) the infringing use of the work provided attribution to the author and owner of the copyright, if known.

Requires the Register of Copyrights to make information available from authoritative sources to assist users in conducting and documenting a reasonably diligent search.

Permits an award of reasonable compensation for the use of the infringed work, except if: (1) the infringement is performed without any commercial advantage and for primarily a charitable, religious, scholarly, or educational purpose; and (2) the infringer ceases the infringement expeditiously after receiving notice of the claim for infringement.

Allows the court to impose injunctive relief to prevent or restrain the infringing use, but such relief shall account for harm caused to the infringer due to reliance on having performed a reasonably diligent search. Prohibits the court from imposing injunctive relief that restrains the continued preparation or use of a new work that recasts, transforms, adapts, or integrates the infringed work with the infringer's original expression in a new work of authorship if the infringer pays reasonable compensation and provides attribution to the copyright owner.

Requires the Register of Copyrights to conduct an inquiry with respect to remedies for copyright infringement claims seeking limited amounts of monetary relief, including consideration of alternatives to disputes currently heard in the U.S. district courts.

PROBLEM: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Pension Interest Rate Relief Act of 
2002''.

SEC. 2. INTEREST RATE RANGE FOR ADDITIONAL FUNDING REQUIREMENTS.

    (a) Amendments to the Internal Revenue Code of 1986.--
            (1) Special rule.--Clause (i) of section 412(l)(7)(C) of 
        the Internal Revenue Code of 1986 (relating to interest rate) 
        is amended by adding at the end the following new subclause:
                                    ``(III) Special rule for 2001 
                                through 2004.--For a plan year 
                                beginning in 2001, 2002, 2003 or 2004, 
                                notwithstanding subclause (I), in the 
                                case that the rate of interest used 
                                under subsection (b)(5) exceeds the 
                                highest rate permitted under subclause 
                                (I), the rate of interest used to 
                                determine current liability under this 
                                subsection may exceed the rate of 
                                interest otherwise permitted under 
                                subclause (I); except that such rate of 
                                interest shall not exceed 120 percent 
                                of the weighted average referred to in 
                                subsection (b)(5)(B)(ii).''
            (2) Quarterly contributions.--Subsection (m) of section 412 
        of such Code is amended by adding at the end the following new 
        paragraph:
            ``(7) Special rule for 2005.--In any case in which the 
        interest rate used to determine current liability is determined 
        under subsection (l)(7)(C)(i)(III) for purposes of applying 
        paragraphs (1) and (4)(B)(ii) for plan years beginning in 2005, 
        the current liability for the preceding plan year shall be 
        redetermined using 105 percent as the specified percentage 
        determined under subsection (l)(7)(C)(i)(II).''
    (b) Amendments to the Employee Retirement Income Security Act of 
1974.--
            (1) Special rule.--Clause (i) of section 302(d)(7)(C) of 
        the Employee Retirement Income Security Act of 1974 (29 U.S.C. 
        1082(d)(7)(C)) is amended by adding at the end the following 
        new subclause:
                                    ``(III) Special rule for 2001 
                                through 2004.--For a plan year 
                                beginning in 2001, 2002, 2003 or 2004, 
                                notwithstanding subclause (I), in the 
                                case that the rate of interest used 
                                under subsection (b)(5) exceeds the 
                                highest rate permitted under subclause 
                                (I), the rate of interest used to 
                                determine current liability under this 
                                subsection may exceed the rate of 
                                interest otherwise permitted under 
                                subclause (I); except that such rate of 
                                interest shall not exceed 120 percent 
                                of the weighted average referred to in 
                                subsection (b)(5)(B)(ii).''
            (2) Quarterly contributions.--Subsection (e) of section 302 
        of such Act (29 U.S.C. 1082) is amended by adding at the end 
        the following new paragraph:
            ``(7) Special rule for 2005.--In any case in which the 
        interest rate used to determine current liability is determined 
        under subsection (d)(7)(C)(i)(III) for purposes of applying 
        paragraphs (1) and (4)(B)(ii) for plan years beginning in 2005, 
        the current liability for the preceding plan year shall be 
        redetermined using 105 percent as the specified percentage 
        determined under subsection (d)(7)(C)(i)(II).''
    (c) PBGC.--Clause (iii) of section 4006(a)(3)(E) of the Employee 
Retirement Income Security of Act 1974 (29 U.S.C. 1306(a)(3)(E)) is 
amended by adding at the end the following new subclause:
    ``(IV) In the case of plan years beginning after December 31, 2001, 
and before January 1, 2005, subclause (II) shall be applied by 
substituting `100 percent' for `85 percent' and by substituting `115 
percent' for `100 percent'. Subclause (III) shall be applied for such 
years without regard to the preceding sentence. Any reference to this 
clause by any other sections or subsections (other than sections 4010, 
4011 and 4043) shall be treated as a reference to this clause without 
regard to this subclause.''
    (d) Amendments to Retirement Protection Act of 1994.--
            (1) Transition rule made permanent.--Paragraph (1) of 
        section 769(c) of the Retirement Protection Act of 1994 is 
        amended--
                    (A) by striking ``transition'' each place it 
                appears in the heading and the text, and
                    (B) by striking ``for any plan year beginning after 
                1996 and before 2010''.
            (2) Special rules.--Paragraph (2) of section 769(c) of the 
        Retirement Protection Act of 1994 is amended to read as 
        follows:
            ``(2) Special rules.--The rules described in this paragraph 
        are as follows:
                    ``(A) For purposes of section 412(l)(9)(A) of the 
                Internal Revenue Code of 1986 and section 302(d)(9)(A) 
                of the Employee Retirement Income Security Act of 1974, 
                the funded current liability percentage for any plan 
                year shall be treated as not less than 90 percent.
                    ``(B) For purposes of section 412(m) of the 
                Internal Revenue Code of 1986 and section 302(e)(9) of 
                the Employee Retirement Income Security Act of 1974, 
                the funded current liability percentage for any plan 
                year shall be treated as not less than 100 percent.
                    ``(C) For purposes of determining unfunded vested 
                benefits under section 4006(a)(3)(E)(iii) of the 
                Employee Retirement Income Security Act of 1974, the 
                mortality table shall be the mortality table used by 
                the plan.''.
            (3) Effective date.--The amendments made by this subsection 
        shall apply to plan years beginning after December 31, 2001.

SOLUTION: Pension Interest Rate Relief Act of 2002 - Amends the Internal Revenue Code and Employee Retirement Income Security Act of 1974 by increasing, for plan years beginning 2001 through 2004, the permissible interest rate range used to determine additional funding requirements for certain benefit plans which are not multiemployer plans.Sets forth a special rule regarding the interest rate used to determine liability for plan years beginning in 2005.Amends the Retirement Protection Act of 1994 to establish special rules relating to funding liability percentages and the mortality table to be used for purposes of determining unfunded vested benefits.

PROBLEM: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Preventing and Reducing Improper 
Medicare and Medicaid Expenditures to Restore Integrity to Benefits Act 
of 2015''.

SEC. 2. STRENGTHENING MEDICAID PROGRAM INTEGRITY THROUGH FLEXIBILITY.

    Section 1936 of the Social Security Act (42 U.S.C. 1396u-6) is 
amended--
            (1) in subsection (a), by inserting ``, or otherwise,'' 
        after ``entities''; and
            (2) in subsection (e)--
                    (A) in paragraph (1), in the matter preceding 
                subparagraph (A), by inserting ``(including the costs 
                of equipment, salaries and benefits, and travel and 
                training)'' after ``Program under this section''; and
                    (B) in paragraph (3), by striking ``by 100'' and 
                inserting ``by 100, or such number as determined 
                necessary by the Secretary to carry out the Program,''.

SEC. 3. ESTABLISHING MEDICARE ADMINISTRATIVE CONTRACTOR ERROR REDUCTION 
              INCENTIVES.

    (a) In General.--Section 1874A(b)(1)(D) of the Social Security Act 
(42 U.S.C. 1395kk-1(b)(1)(D)) is amended--
            (1) by striking ``quality.--The Secretary'' and inserting 
        ``quality.--
                            ``(i) In general.--Subject to clauses (ii) 
                        and (iii), the Secretary''; and
            (2) by inserting after clause (i), as added by paragraph 
        (1), the following new clauses:
                            ``(ii) Improper payment rate reduction 
                        incentives.--The Secretary shall provide 
                        incentives for medicare administrative 
                        contractors to reduce the improper payment 
                        error rates in their jurisdictions.
                            ``(iii) Incentives.--The incentives 
                        provided for under clause (ii)--
                                    ``(I) may include a sliding scale 
                                of award fee payments and additional 
                                incentives to medicare administrative 
                                contractors that either reduce the 
                                improper payment rates in their 
                                jurisdictions to certain thresholds, as 
                                determined by the Secretary, or 
                                accomplish tasks, as determined by the 
                                Secretary, that further improve payment 
                                accuracy; and
                                    ``(II) may include substantial 
                                reductions in award fee payments under 
                                cost-plus-award-fee contracts, for 
                                medicare administrative contractors 
                                that reach an upper end improper 
                                payment rate threshold or other 
                                threshold as determined by the 
                                Secretary, or fail to accomplish tasks, 
                                as determined by the Secretary, that 
                                further improve payment accuracy.''.
    (b) Effective Date.--
            (1) In general.--The amendments made by subsection (a) 
        shall apply to contracts entered into or renewed on or after 
        the date that is 3 years after the date of enactment of this 
        Act.
            (2) Application to existing contracts.--In the case of 
        contracts in existence on or after the date of the enactment of 
        this Act and that are not subject to the effective date under 
        paragraph (1), the Secretary of Health and Human Services 
        shall, when appropriate and practicable, seek to apply the 
        incentives provided for in the amendments made by subsection 
        (a) through contract modifications.

SEC. 4. STRENGTHENING PENALTIES FOR THE ILLEGAL DISTRIBUTION OF A 
              MEDICARE, MEDICAID, OR CHIP BENEFICIARY IDENTIFICATION OR 
              BILLING PRIVILEGES.

    Section 1128B(b) of the Social Security Act (42 U.S.C. 1320a-7b(b)) 
is amended by adding at the end the following:
            ``(4) Whoever without lawful authority knowingly and 
        willfully purchases, sells or distributes, or arranges for the 
        purchase, sale, or distribution of a beneficiary identification 
        number or unique health identifier for a health care provider 
        under title XVIII, title XIX, or title XXI shall be imprisoned 
        for not more than 10 years or fined not more than $500,000 
        ($1,000,000 in the case of a corporation), or both.''.

SEC. 5. IMPROVING THE SHARING OF DATA BETWEEN THE FEDERAL GOVERNMENT 
              AND STATE MEDICAID PROGRAMS.

    (a) In General.--The Secretary of Health and Human Services (in 
this section referred to as the ``Secretary'') shall establish a plan 
to encourage and facilitate the participation of States in the 
Medicare-Medicaid Data Match Program (commonly referred to as the 
``Medi-Medi Program'') under section 1893(g) of the Social Security Act 
(42 U.S.C. 1395ddd(g)).
    (b) Program Revisions To Improve Medi-Medi Data Match Program 
Participation by States.--Section 1893(g)(1)(A) of the Social Security 
Act (42 U.S.C. 1395ddd(g)(1)(A)) is amended--
            (1) in the matter preceding clause (i), by inserting ``or 
        otherwise'' after ``eligible entities'';
            (2) in clause (i)--
                    (A) by inserting ``to review claims data'' after 
                ``algorithms''; and
                    (B) by striking ``service, time, or patient'' and 
                inserting ``provider, service, time, or patient'';
            (3) in clause (ii)--
                    (A) by inserting ``to investigate and recover 
                amounts with respect to suspect claims'' after 
                ``appropriate actions''; and
                    (B) by striking ``; and'' and inserting a 
                semicolon;
            (4) in clause (iii), by striking the period and inserting 
        ``; and''; and
            (5) by adding at the end the following new clause:
                            ``(iv) furthering the Secretary's design, 
                        development, installation, or enhancement of an 
                        automated data system architecture--
                                    ``(I) to collect, integrate, and 
                                assess data for purposes of program 
                                integrity, program oversight, and 
                                administration, including the Medi-Medi 
                                Program; and
                                    ``(II) that improves the 
                                coordination of requests for data from 
                                States.''.
    (c) Providing States With Data on Improper Payments Made for Items 
or Services Provided to Dual Eligible Individuals.--
            (1) In general.--The Secretary shall develop and implement 
        a plan that allows each State agency responsible for 
        administering a State plan for medical assistance under title 
        XIX of the Social Security Act access to relevant data on 
        improper or fraudulent payments made under the Medicare program 
        under title XVIII of the Social Security Act (42 U.S.C. 1395 et 
        seq.) for health care items or services provided to dual 
        eligible individuals.
            (2) Dual eligible individual defined.--In this section, the 
        term ``dual eligible individual'' means an individual who is 
        entitled to, or enrolled for, benefits under part A of title 
        XVIII of the Social Security Act (42 U.S.C. 1395c et seq.), or 
        enrolled for benefits under part B of title XVIII of such Act 
        (42 U.S.C. 1395j et seq.), and is eligible for medical 
        assistance under a State plan under title XIX of such Act (42 
        U.S.C. 1396 et seq.) or under a waiver of such plan.

SEC. 6. REPORT ON IMPLEMENTATION.

    Not later than 18 months after the date of the enactment of this 
Act, the Secretary of Health and Human Services shall submit to 
Congress a report on the implementation of the provisions of, and the 
amendments made by--
            (1) this Act; and
            (2) sections 506 and 507 of the Medicare Access and CHIP 
        Reauthorization Act of 2015 (Public Law 114-10).

SOLUTION:
Preventing and Reducing Improper Medicare and Medicaid Expenditures to Restore Integrity to Benefits Act of 2015 This bill amends title XIX (Medicaid) of the Social Security Act to make several changes related to the prevention of Medicaid fraud. With respect to the Medicaid Integrity Program (MIP), the bill: (1) specifies that program appropriations&nbsp;may cover costs of equipment, travel, training, and salaries and benefits; and (2) allows the Department of Health and Human Services (HHS) flexibility in determining the number of additional staff necessary to carry out the program. (MIP is a federal program aimed at preventing and reducing provider fraud, waste, and abuse in the Medicaid program.) Under current law, HHS may contract with Medicare administrative contractors (MACs), which are&nbsp;private&nbsp;insurers that process Medicare claims within&nbsp;specified geographic jurisdictions. The bill&nbsp;requires HHS to provide specified incentives for MACs to reduce improper payment error rates within their jurisdictions. The bill establishes criminal penalties of up to 10 years imprisonment and up to $500,000 in fines for illegally purchasing or distributing Medicare, Medicaid, or Children's Health Insurance Program (CHIP) beneficiary identification or billing privileges. The bill increases the scope of the Medicare-Medicaid Data Match Program (Medi-Medi Program), an existing program through which contractors and participating&nbsp;governmental agencies collaboratively analyze&nbsp;Medicare and Medicaid billing trends. HHS must establish a plan to encourage states to participate in the Medi-Medi Program.  HHS shall develop and implement a plan to allow states to access relevant data on improper or fraudulent payments made under the Medicare program on behalf of individuals dually eligible for both Medicare and Medicaid.