Fairness in Medicaid Funding Act of 1994 - Amends title XIX (Medicaid) of the Social Security Act to change the Federal medical assistance percentage used under the Medicaid program. Bases payments to the States for administration costs on the Federal medical assistance percentage.
[Congressional Bills 103th Congress]
[From the U.S. Government Printing Office]
[H.R. 4047 Introduced in House (IH)]
103d CONGRESS
2d Session
H. R. 4047
To amend title XIX of the Social Security Act to improve the Federal
medical assistance percentage used under the medicaid program, and for
other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 16, 1994
Mrs. Thurman (for herself, Ms. Brown of Florida, Mr. Bacchus of
Florida, Mr. Bilirakis, Mr. Canady, Mr. Deutsch, Mrs. Fowler, Mr.
Gibbons, Mr. Goss, Mr. Hastings, Mr. Hutto, Mr. Johnston of Florida,
Mr. Lewis of Florida, Mr. McCollum, Mr. Diaz-Balart, Mrs. Meek, Mr.
Mica, Mr. Miller of Florida, Mr. Peterson of Florida, Ms. Ros-Lehtinen,
Mr. Shaw, Mr. Stearns, and Mr. Young of Florida) introduced the
following bill; which was referred to the Committee on Energy and
Commerce
_______________________________________________________________________
A BILL
To amend title XIX of the Social Security Act to improve the Federal
medical assistance percentage used under the medicaid program, 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 ``Fairness in Medicaid Funding Act of
1994''.
SEC. 2. CHANGE IN FEDERAL MEDICAL ASSISTANCE PERCENTAGE.
(a) In General.--Subsection (b) of section 1905 of the Social
Security Act (42 U.S.C. 1396d(b)) is amended to read as follows:
``(b)(1)(A) Except as provided in paragraph (3), the term `Federal
medical assistance percentage' means, for each of the 50 States and the
District of Columbia, 100 percent reduced by the product of the
applicable percentage (as defined in subparagraph (B)) and the ratio
of--
``(i)(I) for each of the 50 States, the total taxable
resources ratio (as defined in subparagraph (C)) of the State,
or
``(II) for the District of Columbia, the per capita income
ratio (as defined in subparagraph (D)), to--
``(ii) the population in poverty ratio (as defined in
subparagraph (E)) of the State or District.
``(B)(i) For purposes of this subsection, the term `applicable
percentage' means a percentage estimated by the Secretary with the
advice of the General Accounting Office that, when applied under
subparagraph (A), would result in an amount of aggregate payments under
section 1903(a) for calendar years 1994 through 1998 equal to the
amount of aggregate payments that would have been made under such
section for quarters in such years if this subsection were applied as
in effect on the day before the date of the enactment of the Medicaid
Fairness in Funding Act of 1993.
``(ii) The applicable percentage estimated by the Secretary under
clause (i) shall continue to apply with respect to quarters beginning
after calendar year 1998.
``(C) For purposes of this subsection, the term `total taxable
resources ratio' means--
``(i) an amount equal to the most recent 3-year average of
the total taxable resources of the State, as determined by the
Secretary of the Treasury, divided by
``(ii) an amount equal to the sum of the 3-year averages
determined under clause (i) for each of the 50 States.
``(D) For purposes of this subsection, the term `per capita income
ratio' means--
``(i) an amount equal to the most recent 3-year average of
the total personal income of the District of Columbia, as
determined in accordance with the provisions of section
1101(a)(8)(B), divided by
``(ii) an amount equal to the total personal income of the
continental United States (including Alaska) and Hawaii, as
determined under section 1101(a)(8)(B).
``(E) For purposes of this subsection, the term `population in
poverty ratio' means--
``(i) an amount equal to the 3-year-average of the number
of individuals in the State (or the District of Columbia) whose
family income is below the income official poverty line (as
defined by the Office of Management and Budget and revised
annually in accordance with section 673(2) of the Omnibus
Budget Reconciliation Act of 1981), divided by
``(ii) an amount equal to the sum of the averages
determined under clause (i) for the 50 States.
``(2) The Federal medical assistance percentage for Puerto Rico,
the Virgin Islands, Guam, the Northern Mariana Islands, and American
Samoa shall be 50 percent.
``(3)(A) Except as provided in subparagraph (B), the Federal
medical assistance percentage shall in no case be less than 40 percent
or greater than 83 percent.
``(B) The Federal medical assistance percentage shall be 100
percent with respect to amounts expended as medical assistance for
services which are received through an Indian Health Service facility
whether operated by the Indian Health Service or by an Indian tribe or
tribal organization (as defined in section 4 of the Indian Health Care
Improvement Act).
``(4) For purposes of any provision of law other than a provision
of this title, unless otherwise specifically provided, any reference to
the `Federal medical assistance percentage' as defined in this section
shall be considered a reference to such term as defined under this
subsection as in effect on the day before the date of the enactment of
the Medicaid Fairness in Funding Act of 1993.''.
(b) Conforming Amendment.--Section 1118 of the Social Security Act
(42 U.S.C. 1318) is amended by striking ``(as defined in section
1905)'' and inserting ``(as defined in section 1905(b), as in effect on
the day before the date of the enactment of the Medicaid Fairness in
Funding Act of 1993)''.
(c) Effective Date.--The amendments made by this section shall
apply to payments made to States with respect to calendar quarters
beginning on or after January 1, 1994.
SEC. 3. ADMINISTRATION EXPENDITURES.
(a) In General.--Section 1903(a) of the Social Security Act (42
U.S.C. 1396b(a)) is amended--
(1) in paragraph (2)--
(A) in subparagraph (A), by striking ``75 per
centum'' and inserting ``the Federal medical assistance
percentage'';
(B) by striking subparagraph (B) and inserting the
following new subparagraph:
``(B) with respect to amounts expended for nursing aide
training and competency evaluation programs, and competency
evaluation programs described in section 1919(e)(1) (including
the costs for nurses aides to complete such competency
evaluation programs) regardless of whether the programs are
provided in or outside nursing facilities or the skill of the
personnel involved in such programs, an amount equal to the
Federal medical assistance percentage of so much of the sums
expended during such quarter (as found necessary by the
Secretary for the proper and efficient administration of the
State plan) as are attributable to such programs; plus'';
(C) in subparagraph (C), by striking ``75 percent''
and inserting ``the Federal medical assistance
percentage''; and
(D) by striking subparagraph (D) and inserting the
following new subparagraph:
``(D) an amount equal to the Federal medical assistance
percentage of so much of the sums expended (as found necessary
by the Secretary for the proper and efficient administration of
the State plan) as are attributable to State activities under
section 1919(g); plus'';
(2) in paragraph (3)--
(A) in subparagraph (A)--
(i) by striking ``(A)(i)'' and inserting
``(A)'';
(ii) by striking ``90 per centum'' and
inserting ``the Federal medical assistance
percentage'';
(iii) by striking ``under this title, and''
and inserting ``under this title; plus''; and
(iv) by striking clause (ii);
(B) in subparagraph (B), by striking ``75 per
centum'' and inserting ``the Federal medical assistance
percentage'';
(C) in subparagraph (C), by striking ``75 per
centum'' and inserting ``the Federal medical assistance
percentage''; and
(D) in subparagraph (D), by striking ``75 percent''
and inserting ``the Federal medical assistance
percentage'';
(3) in paragraph (4), by striking ``100 percent'' and
inserting ``the Federal medical assistance percentage'';
(4) in paragraph (5), by striking ``90 per centum'' and
inserting ``the Federal medical assistance percentage'';
(5) by striking paragraph (6) and inserting the following
new paragraph:
``(6) subject to subsection (b)(3), an amount equal to the
Federal medical assistance percentage of the sums expended with
respect to costs incurred during such quarter (as found
necessary by the Secretary for the elimination of fraud in the
provision and administration of medical assistance provided
under the State plan) which are attributable to the
establishment and operation of (including the training of
personnel employed by) a State medicaid fraud control unit
(described in subsection (q)); plus''; and
(6) in paragraph (7), by striking ``subject to section
1919(g)(3)(B), an amount equal to 50 per centum'' and inserting
``subject to section 1919(g)(3)(C), an amount equal to the
Federal medical assistance percentage''.
(b) Effective Date.--The amendments made by this section shall
apply to payments made to States with respect to calendar quarters
beginning on or after January 1, 1994.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
Referred to the Subcommittee on Health and the Environment.
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