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.).
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
Referred to the Subcommittee on Health.
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