Prioritizing the Most Vulnerable Americans Act

Prioritizing the Most Vulnerable Medicaid Patients

This bill amend title XI (General Provisions) of the Social Security Act to require the Centers for Medicare & Medicaid Services, in approving Medicaid demonstration projects, to:

• prioritize projects that have been proven effective in improving care and outcomes with respect to uninsured, Medicaid-eligible, or low-income individuals;
• require participating states to make publicly available data regarding the health outcomes for individuals to be served;
• ensure that projects are not duplicative of any federal program or funding opportunity; and
• require participating states to make publicly available an analysis of the degree to which such projects preclude private and charitable sector efforts to improve care and outcomes with respect to uninsured, Medicaid-eligible, or low-income individuals. 

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 543 Introduced in House (IH)]

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115th CONGRESS
  1st Session
                                H. R. 543

     To amend title XIX of the Social Security Act for purposes of 
          prioritizing the most vulnerable Medicaid patients.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 13, 2017

  Mr. Collins of New York (for himself, Mr. Mullin, Mr. Guthrie, Mrs. 
Blackburn, Mr. Bucshon, and Mr. Flores) 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 for purposes of 
          prioritizing the most vulnerable Medicaid patients.

    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 ``Prioritizing the Most Vulnerable 
Americans Act''.

SEC. 2. PRIORITIZING THE MOST VULNERABLE MEDICAID PATIENTS.

    (a) In General.--Section 1115 of the Social Security Act (42 U.S.C. 
1315) is amended by adding at the end the following new subsection:
    ``(g) In making a determination using the authority under paragraph 
(2)(A) of subsection (a) (relating to treating costs that would not 
otherwise be included as expenditures under section 1903 and which are 
not included as part of the costs of projects under section 1110 as 
expenditures under the State plan or plans approved under title XIX) to 
approve an application or renewal of any experimental, pilot, or 
demonstration project undertaken under such subsection to promote the 
objectives of title XIX (referred to in this subsection as a `Medicaid 
demonstration project'), the Secretary shall--
            ``(1) give priority to Medicaid demonstration projects that 
        have been proven to be effective in improving the medical care 
        and health outcomes of individuals who are uninsured, 
        individuals eligible to receive medical assistance under a 
        State plan under title XIX, or individuals whose household 
        income does not exceed 150 percent of the poverty line (as 
        defined in section 2110(c)(5)) applicable to a family of the 
        size involved;
            ``(2) require that the State submitting such application or 
        renewal submit to the Secretary, and make publicly available, 
        any available data or metrics regarding the health outcomes for 
        the individuals to be served by such Medicaid demonstration 
        project;
            ``(3) ensure that such Medicaid demonstration project is 
        not duplicative of any Federal program or funding opportunity; 
        and
            ``(4) require that the State submitting such application or 
        renewal submit to the Secretary, and make publicly available, 
        an analysis of the degree to which such Medicaid demonstration 
        project, if at all, precludes efforts undertaken by private 
        sector and charitable sector entities to improve medical care 
        and health outcomes for the individuals described in paragraph 
        (1).''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply with respect to applications or renewals submitted on or after 
January 1, 2018.
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