,,ii #aac? ,,congress #b;d ,session ,s4 #aihj ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,febru>y #c1 #bjad,mr4 ,rockefell] introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,f9ance ,a ,,bill ,to am5d titles ,,xix & ,,xxi ( ! ,social ,security ,act to provide = #ab-mon? cont9u\s enrollm5t "u ! ,m$icaid program & ,*ildr5's ,heal? ,insurance ,program & to promote quality c>e4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,m$icaid & ,,*ip ,cont9u\s ,quality ,act ( #bjad4 #b4 ,f9d+s ,congress f9ds ! foll[+3 7#a7 ,e ye> millions ( p are enroll$ 9 ,m$icaid & ! ,*ildr5's ,heal? ,insurance ,program 79 ?is section ref]r$ to z ,,*ip71 b subsequ5tly lose _! cov]age1 despite /ill be+ eligible1 because ( ineffici5t & cumb]some pap]work & logi/ical requirem5ts4 7#b7 ,data %[ t ! typical enrollee receives ,m$icaid cov]age = ab\t ?ree-qu>t]s ( ! ye>4 ,cov]age p]iods are l[] = non-eld]ly1 non-disabl$ adults ?an = ^? ) disabilities1 s5iors1 & *ildr54 7#c7 ,m$icaid enrollees ) cov]age disruption are m likely to be hospitaliz$ = illnesses l a/hma1 diabetes1 or c>diovascul> disease t c be effectively manag$ ?r\gh ongo+ prim>y m$ical c>e & m$ication1 are less likely to be scre5$ = brea/ canc]1 & may h poor] canc] outcomes4 7#d7 ,*ildr5 enroll$ 9 ,,*ip also exp]i5ce disruptions 9 heal? cov]age & c>e4 ,= example1 dur+ j a "o-ye> p]iod1 ov] "o-?ird ( ,,*ip enrollees 7 also enroll$ 9 a ,/ate's ,m$icaid program4 ,transitions betwe5 ,m$icaid & ,,*ip c cause disruptions 9 c>e because ! heal? c>e cov]age & p>ticipat+ provid]s v>y betwe5 ! two programs4 7#e7 ,int]ruptions 9 cov]age c impair ! receipt ( effective prim>y c>e & lead to exp5sive hospitalizations or em]g5cy room visits4 7#f7 ,unnecess>y enrollm5t1 dis5rollm5t & re5rollm5t 9 ,m$icaid & ,,*ip result 9 high] adm9i/rative exp5ses = re5rollm5t & result 9 m p un9sur$ at any giv5 "t4 7#g7 ,/able cov]age "u ,m$icaid & ,,*ip l[]s av]age mon?ly m$ical co/s4 ,cont9u\s enrollm5t also p]mits bett] prev5tion & disease managem5t1 lead+ to few] s]i\s illnesses & hospitalizations4 7#h7 ,*ildr5 ) /able cov]age are less likely to h unmet m$ical ne$s1 all[+ *ildr5 to receive ! prev5tive c>e t is necess>y to help !m gr[ into heal?y adults4 7#i7 ,= ! majority ( ,m$icaid enrollees :o are s]v$ by ,prim>y ,c>e ,case ,managem5t 7,,pccm7 or fee-=-s]vice arrangem5ts1 !re are no ,f$]al requirem5ts = comp>able quality monitor+ or improvem5t4 ,no /ructur$ ov]sight exi/s = ,m$icaid enrollees :5 !y move betwe5 fee-=-s]vice & capitat$ manag$ c>e plans4 ,?us1 !re curr5tly is no ability to make fair assessm5ts across all modes ( c>e = ,m$icaid enrollees4 #c4 #ab-mon? cont9u\s enrollm5t 7a7 ,requirem5t ( #ab-,mon? cont9u\s enrollm5t "u ,m$icaid 7#a7 ,9 g5]al ,section #aijb7;e77#ab7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7e771 is am5d$ to read z foll[s3 7#ab7 #ab-mon? cont9u\s enrollm5t 7,a7 ,9 g5]al ,not)/&+ any o!r provision ( ?is title1 a ,/ate plan approv$ "u ?is title 7or "u any waiv] ( su* plan approv$ pursuant to section #aaae or section #aiae71 %all provide t an individual :o is det]m9$ to be eligible = b5efits "u su* plan 7or waiv]7 %all rema9 eligible & enroll$ = su* b5efits ?r\gh ! end ( ! mon? 9 :i* ! #ab-mon? p]iod 7beg9n+ on ! date ( det]m9ation ( eligibility7 ends4 7,b7 ,promot+ ret5tion ( eligible & enroll$ p]sons beyond #ab mon?s ,! ,secret>y %all-- 7i7 id5tify me?ods t promote ! ret5tion ( individuals :o are enroll$ "u ! ,/ate plan & :o rema9 eligible = m$ical assi/ance beyond ! #ab-mon? p]iod describ$ 9 subp>agraph 7,a72 & 7ii7 actively promote ! adoption ( su* enrollm5t ret5tion me?ods by ,/ates1 :i* %\ld include b n be limit$ to issu+ guidance & develop+ res\rces on ,/ate be/ practices4 7,c7 ,enrollm5t & ret5tion report+ 7i7 ,9 g5]al ,n lat] ?an ,septemb] #cj1 #bjad1 ! ,secret>y %all publi% ! proc$ures t ,/ates are expect$ to use to provide annual enrollm5t & ret5tion reports beg9n+ ,septemb] #cj1 #bjae4 7ii7 ,/ate report+ requirem5ts ,at a m9imum1 su* report+ proc$ures %all include a description ( ,/ate eligibility crit]ia & enrollm5t proc$ures "u ?is title1 & data reg>d+ enrollm5t & ret5tion us+ /&>diz$ report+ =mats det]m9$ by ! ,secret>y4 7iii7 ,secret>y report & publication ,! ,secret>y %all annually publi% enrollm5t & ret5tion p]=mance results = all ,/ates beg9n+ n lat] ?an ,june #cj1 #bjaf4 7iv7 ,ea* su* annual report %all include e/imates ( ,m$icaid enrollm5t cont9uity ratios = ea* ,/ate4 ,9 ?is clause1 ! t]m enrollm5t cont9uity ratio means1 = a giv5 gr\p1 ! ratio ( ! av]age mon?ly enrollm5t ( t gr\p 9 ! fiscal ye> divid$ by ! total unduplicat$ enrollm5t = t gr\p 9 ! fiscal ye>1 express$ z a p]c5tage4 7v7 ,= purposes ( su* reports1 ! ,secret>y %all develop bo? ov]all ratios = all enrollees & sep>ate ratios = ! foll[+ categories3 7,i7 ,*ildr54 7,,ii7 ,individuals ^: eligibility category is relat$ to be+ equal to or ov] ! age ( #fe4 7,,iii7 ,individuals ^: eligibility category is relat$ to disability or bl9dness4 7,,iv7 ,individuals ^: eligibility category is relat$ to _! /atus z p>5ts & c>etak] relatives ( *ildr5 "u #ai or :o are o!rwise n eld]ly1 bl9d or disabl$ adults4 4 7b7 ,requirem5t ( #ab-,mon? cont9u\s enrollm5t "u ,,*ip 7#a7 ,9 g5]al ,section #bajb7;b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;bb7b77 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#f7 ,requirem5t = #ab-mon? cont9u\s enrollm5t ,not)/&+ any o!r provision ( ?is title1 a ,/ate *ild heal? plan t provides *ild heal? assi/ance "u ?is title ?r\gh a means o!r ?an describ$ 9 section #baja7;a77#b71 %all provide t an individual :o is det]m9$ to be eligible = b5efits "u su* plan %all rema9 eligible & enroll$ = su* b5efits ?r\gh ! end ( ! mon? 9 :i* ! #ab-mon? p]iod 7beg9n+ on ! date ( det]m9ation ( eligibility7 ends4 4 7#b7 ,con=m+ am5dm5t ,section #baje7;a77#d77;,a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;ee7a77#d77;,a77 is am5d$-- 7,a7 by /rik+ has elect$ ! option ( & ins]t+ is 9 compliance ) ! requirem5t =2 & 7,b7 by /rik+ apply+ su* policy "u its ,/ate *ild heal? plan "u ?is title & ins]t+ 9 compliance ) section #bajb7;b74 7c7 ,effective date 7#a7 ,9 g5]al ,except z provid$ 9 p>agraph 7#b7 or 7#c71 ! am5dm5ts made by subsections 7a7 & 7b7 %all apply to det]m9ations 7& r$et]m9ations7 ( eligibility made on or aft] ! date t is #ah mon?s aft] ! date ( ! enactm5t ( ?is ,act4 7#b7 ,ext5sion ( effective date = /ate law am5dm5t ,9 ! case ( a ,/ate plan "u title ,,xix or ,/ate *ild heal? plan "u title ,,xxi ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq41 #db ,u4,s4,c4 #acig;aa et seq47 :i* ! ,secret>y ( ,heal? & ,human ,s]vices det]m9es requires ,/ate legislation 7o!r ?an legislation appropriat+ funds7 9 ord] = ! respective plan to meet ! additional requirem5t impos$ by ! am5dm5t made by subsection 7a7 or 7b71 respectively1 ! respective plan %all n be reg>d$ z fail+ to comply ) ! requirem5ts ( su* title solely on ! basis ( its failure to meet su* applicable additional requirem5t be=e ! fir/ day ( ! fir/ cal5d> qu>t] beg9n+ aft] ! close ( ! fir/ regul> session ( ! ,/ate legislature t beg9s aft] ! date ( enactm5t ( ?is ,act4 ,= purposes ( ! previ\s s5t5ce1 9 ! case ( a ,/ate t has a #b-ye> legislative session1 ea* ye> ( ! session is consid]$ to be a sep>ate regul> session ( ! ,/ate legislature4 7#c7 ,option to implem5t #ab-mon? cont9u\s eligibility prior to effective date ,a ,/ate may elect ?r\gh a ,/ate plan am5dm5t "u title ,,xix or ,,xxi ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq41 #db ,u4,s4,c4 #acig;aa et seq47 to apply ! am5dm5t made by subsection 7a7 or 7b71 respectively1 on any date prior to ! #ah-mon? date specifi$ 9 p>agraph 7#a71 b n soon] ?an ! date ( ! enactm5t ( ?is ,act4 #d4 ,prev5t+ ! application "u ,,*ip ( cov]age wait+ p]iods 7a7 ,9 g5]al ,section #bajb7;b77#a77;,b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;bb7b77#a77;,b77 is am5d$-- 7#a7 9 clause 7iii7-- 7,a7 by /rik+ 9 ! case ( & ins]t+ 9 ! case ( a t>get$ l[-income *ild 7includ+ a *ild provid$ d5tal-only supplem5tal cov]age "u section #baaj7;b77#e77 or 9 ! case (2 & 7,b7 by add+ & aft] ! semicolon2 7#b7 by /rik+ clause 7iv72 & 7#c7 by r$esignat+ clause 7v7 z clause 7iv74 7b7 ,con=m+ am5dm5ts ,section #baje7;c77#aj7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;ee7c77#aj77 is am5d$ by /rik+ subp>agraph 7,f7 & r$esignat+ subp>agraphs 7,g7 ?r\gh 7,m7 z subp>agraphs 7,f7 ?r\gh 7,l71 respectively4 7c7 ,effective date ,! am5dm5ts made by ?is section %all take effect on ! date ( enactm5t ( ?is ,act4 #e4 ,p]=mance bonuses = enrollm5t & ret5tion improvem5ts = c]ta9 individuals 7a7 ,m$icaid ,section #aijc ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7 is am5d$ by add+ at ! end ! foll[+ new subsection3 7aa7 ,p]=mance bonuses = enrollm5t & ret5tion ( l[-,income individuals 7#a7 ,9 g5]al ,9 addition to p]=mance bonuses = enrollm5t & ret5tion describ$ 9 section #baje7;a7 7relat$ to *ildr571 a ,/ate may qualify = #a or m p]=mance bonuses relat$ to ! enrollm5t & ret5tion ( individuals describ$ 9 section #aijb7;e77#ab77;,c77iii77,,iii74 ,= purposes ( ?is p>agraph1 a ,/ate meets ! condition ( ?is p>agraph = su* individuals if1 = ea* category ( individuals specifi$ 9 section #aijb7;e77#ab77;,c77iii77,,iii7 & select$ by ! ,/ate = additional enrollm5t & ret5tion provisions1 ! ,/ate is implem5t+ at lea/ #c ( ! foll[+ enrollm5t & ret5tion provisions 7treat+ ea* subp>agraph z a sep>ate enrollm5t & ret5tion provision7 ?r\gh\t ! entire fiscal ye>3 7,a7 ,align+ treatm5t ( income "u m$icaid ) t ( o!r insurance af=dability programs ,! ,/ate implem5ts policies1 includ+ prorat+ income ov] annual p]iods1 s z to align its treatm5t ( income = purposes ( a det]m9ation ( eligibility = m$ical assi/ance ) t ( o!r af=dability insurance programs ) ! goal ( elim9at+ inconsi/5t det]m9ations among ^! programs4 7,b7 ,ma9ta9+ cov]age = individuals dur+ p]iods ( transition 7i7 ,9 g5]al ,^u det]m9ation t an individual is no long] eligible = m$ical assi/ance1 ! ,/ate implem5ts policies to ma9ta9 eligibility = m$ical assi/ance1 includ+ enrollm5t 9 ! manag$ c>e organization 9 :i* ! individual 0 enroll$ at ! "t ( ! det]m9ation ( ineligibility1 dur+ ! p]iod ( "t 9 :i*-- 7,i7 eligibility-relat$ in=mation is transmitt$ to ! o!r insurance af=dability programs2 7,,ii7 a det]m9ation is made z to = :i* o!r insurance af=dability program ! individual is eligible2 & 7,,iii7 cov]age 9 su* program & any relat$ manag$ c>e organization becomes effective4 7ii7 ,manag$ c>e organization cont9uity ,! ,/ate %all also implem5t policies to enroll ! individual 9 ! manag$ c>e organization 9 :i* ! individual 0 a memb] prior to ! loss ( m$ical assi/ance eligibility1 if su* manag$ c>e organization p>ticipates 9 ! o!r insurance af=dability program1 unless ! individual volunt>ily selects a sep>ate manag$ c>e organization4 7,c7 ,enhanc$ data-%>+ betwe5 ag5cies ,! ,/ate utilizes f9d+s f an ,am]ican ,heal? ,b5efit ,ex*ange1 an ,express ,lane ,ag5cy 7z id5tifi$ by ! ,/ate & z describ$ 9 section #aijb7;e77#ac77;,f77 or ! ,social ,security ,adm9i/ration or o!r ag5cies adm9i/]+ employm5t1 educational1 or social s]vices programs z id5tifi$ by ! ,/ate1 to docum5t income1 assets1 resid5cy1 age or o!r relevant in=mation 9 det]m9+ or r5ew+ eligibility4 7,d7 ,eligibility bas$ on p5d+ /atus ,! ,/ate ma9ta9s eligibility = enrollees ^: r5ewal /atus has n yet be5 det]m9$ & = :om eligibility bas$ on alt]native eligibility crit]ia has n yet be5 rul$ out4 7,e7 ,default re5rollm5t 9 manag$ c>e organization ,9 ! case ( individuals :o are det]m9$ to be eligible = m$ical assi/ance "u ?is title aft] ! loss ( eligibility = few] ?an #f mon?s1 & :o previ\sly _h be5 memb]s ( a manag$ c>e organization1 ! ,/ate re-enrolls ! individual 9 ! manag$ c>e organization 9 :i* ! individual 0 a memb] prior to ! loss ( eligibility1 unless ! individual volunt>ily selects a sep>ate manag$ c>e organization4 7#b7 ,p]=mance bonus paym5t to (fset co/s result+ f #ab-mon? cont9u\s enrollm5t = m$icaid enrollees 7,a7 ,au?ority to make bonus paym5ts 7i7 ,9 g5]al ,9 addition to ! paym5ts provid$ "u section #baje7;a7 ( ! ,social ,security ,act1 subject to subp>agraph 7,c7 ! ,secret>y %all make paym5ts to a ,/ate 7beg9n+ ) fiscal ye> #bjaf7 t satisfies ! requirem5ts ( subp>agraph 7,b74 7ii7 ,regulations ,paym5ts to ,/ates %all be allocat$ annually among ,/ates 9 accordance ) regulations promulgat$ by ! ,secret>y n lat] ?an ,july #a1 #bjae4 7iii7 ,tim+ ,! paym5t "u ?is p>agraph %all be made1 to a ,/ate = a fiscal ye>1 z a s+le paym5t n lat] ?an ! la/ day ( ! fir/ cal5d> qu>t] ( ! foll[+ fiscal ye> to :i* ! p]=mance paym5t applies4 7,b7 ,/ate eligibility = bonus paym5ts ,a ,/ate %all be eligible = bonus paym5ts "u ?is subsection if-- 7i7 ! ,/ate has adopt$ at lea/ #c ( ! #e policies describ$ 9 subp>agraphs 7,a7 ?r\gh 7,e7 ( p>agraph 7#a72 & 7ii7 ! ,/ate is able to demon/rate improvem5t 9 ! cont9uity ( enrollm5t by ag$1 bl9d1 & disabl$ & adult populations1 comp>$ to its basel9e p]=mance 9 fiscal ye> #bjac4 7,c7 ,am\nts available = paym5ts 7i7 ,9 g5]al ,! total am\nt ( paym5ts "u p>agraphs 7#a7 & 7#b7 ( ?is section %all be equal to #ejj1jjj1jjj = fiscal ye> #bjaf = mak+ paym5ts "u ?is p>agraph1 to be available until exp5d$4 7ii7 ,budget au?ority ,?is subsection con/itutes budget au?ority 9 advance ( appropriations ,acts & repres5ts ! obligation ( ! ,secret>y to provide = ! paym5t ( am\nts provid$ "u ?is subsection4 7,d7 ,uses ( enrollm5t & ret5tion p]=mance bonuses ,no?+ 9 ?is section %all prohibit a ,/ate f e/abli%+ crit]ia :i* w\ld p]mit ! ,/ate to di/ribute a portion ( ! proce$s ( any p]=mance bonuses receiv$ pursuant to ?is section to f9ancially support provid]s :o h contribut$ to improv$ enrollm5t & ret5tion activities4 ,= purposes ( allocation ( ,enrollm5t & ,ret5tion ,p]=mance ,bonuses ! def9ition ( provid] %all h ! mean+ giv5 to x 9 a ,/ate ,plan4 4 7b7 ,ext5sion ( ,,*ip ,p]=mance ,bonus ,to align ) reau?orization ( ,/ate allotm5ts ,section #baje7;a77#c7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;ee7a77#c77 is am5d$-- 7#a7 9 subp>agraph 7,a71 by /rik+ #bjac & ins]t+ #bjae2 7#b7 9 subp>agraph 7,e77ii7-- 7,a7 9 ! head+ = subclause 7,i77aa71 by /rik+ #bjab & ins]t+ #bjad2 7,b7 9 subclause 7,i77aa7-- 7i7 by /rik+ #bjab & ins]t+ #bjad2 7ii7 by /rik+ subsection 7a7 & ins]t+ section #bajd7;a72 & 7iii7 by /rik+ subsection 7m7 & ins]t+ section #bajd7m72 7,c7 9 ! head+ = subclause 7,i77bb71 by /rik+ #bjac & ins]t+ #bjae2 7,d7 9 subclause 7,i77bb7-- 7i7 by /rik+ fiscal ye> #bjac & ins]t+ fiscal ye> #bjae2 7ii7 by /rik+ subsection 7a77#af77;,a7 & ins]t+ section #bajd7;a77#ah77;,a72 7iii7 by /rik+ ,octob] #a1 #bjab1 & end+ on ,m>* #ca1 #bjac & ins]t+ ,octob] #a1 #bjad1 & end+ on ,m>* #ca1 #bjae2 7iv7 by /rik+ subsection 7m7 & ins]t+ section #bajd7m72 & 7v7 by /rik+ or set aside "u subsection 7b77#b7 ( section #baaa = su* fiscal ye>2 7,e7 9 ! head+ = subclause 7,i77cc71 by /rik+ #bjac & ins]t+ #bjae2 7,f7 9 subclause 7,i77cc7-- 7i7 by /rik+ #bjac ea* place x appe>s & ins]t+ #bjae2 7ii7 by /rik+ subsection 7a77#af77;,b7 & ins]t+ section #bajd7;a77#ah77;,b72 7iii7 by /rik+ subsection 7m7 & ins]t+ section #bajd7m72 & 7iv7 by /rik+ or set aside "u subsection 7b77#b7 ( section #baaa = su* fiscal ye>2 7,g7 9 subclause 7,,ii71 by /rik+ #bjac & ins]t+ #bjae2 & 7,h7 9 subclause 7,,iii71 by /rik+ #bjac & ins]t+ #bjae2 & 7#c7 9 subp>agraph 7,f77iii71 by /rik+ #bjac & ins]t+ #bjae4 #f4 ,measur+ & report+ on comp>able heal? c>e quality measures = all p]sons enroll$ 9 ,m$icaid 7a7 ,quality assurance /&>ds ,section #aicb7;c77#a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acifu-#b7;c77#a77 is am5d$ 9 subp>agraph 7,a71 by ins]t+ aft] #aijc7m7 ! foll[+3 or comp>able prim>y c>e case managem5t s]vices provid]s describ$ 9 section #aije7t7 z well z heal? c>e s]vices furni%$ 9 fee-=-s]vice sett+s4 7b7 ,adult heal? quality measures ,title ,,xi ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acja et seq471 z am5d$ by section #bgja ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7,public ,law #aaa-adh71 is am5d$ at section #aaci;,b 7#db ,u4,s4,c4 #acbj;b-#i;b7-- 7#a7 by add+ aft] 7b77#c7 ! foll[+3 7#d7 ,quality report+ = m$icaid eligible adults ,beg9n+ ,janu>y #a1 #bjaf1 ! ,secret>y %all require ,/ates to use ! measures & approa*es id5tifi$ 9 p>agraph 7#c7 ( ?is subsection to report on ! initial core set ( quality measures = ,m$icaid eligible adults id5tifi$ 9 p>agraph 7#b71 subject to revisions made by 7#e77;,b7 ( ?is subsection4 2 7#b7 by r$esignat+ subsection 7b77#d7 z 7b77#e7 & 7b77#e7 z 7b77#f72 7#c7 9 subsection 7d77#a77;,b7 ins]t+ aft] ,section #aicg ( ?is title ! foll[+3 or comp>able prim>y c>e case managem5t s]vices provid]s describ$ 9 section #aije7t7 z well z heal? c>e s]vices furni%$ 9 fee-=-s]vice sett+s2 & 7#d7 9 subsection 7d77#b7 by ins]t+ aft] 7#a7 ! foll[+3 includ+ analysis ( comp>able quality measures = ,m$icaid eligible adults :o receive _! heal? s]vices ?r\gh manag$ c>e1 prim>y c>e case managem5t1 & fee-=-s]vice sett+s4 7c7 ,p$iatric heal? c>e measures 7#a7 ,9 g5]al ,title ,,xi ( ! ,social ,security ,act1 is am5d$ at section #aaci;,a7a7 7#db ,u4,s4,c4 #acbj;b-#i;a7a77 by-- 7,a7 ins]t+ aft] p>agraph 7#d7 z if x 7 includ$ ^u enactm5t3 7#e7 ,report+ ( p$iatric heal? c>e measures ,n lat] ?an five ye>s aft] ! date ( enactm5t ( ! ,m$icaid ,cont9u\s ,quality ,act ( #bjab1 ,/ates %all use ! proc$ures & approa*es id5tifi$ 9 p>agraph 7#d7 to report in=mation on ! initial core measurem5t set reg>d+ ! quality ( p$iatric heal? c>e "u titles ,,xix & ,,xxi4 2 7,b7 r$esignat+ p>agraphs 7#e71 7#f71 7#g7 & 7#h7 z 7#f71 7#g71 7#h7 & 7#i71 respectively2 & 7,c7 9 subsection 7c77#a77;,b71 ins]t+ aft] section #bajc ( su* ,act ! foll[+3 or comp>able prim>y c>e case managem5t s]vices provid]s describ$ 9 section #aije7t7 z well z heal? c>e s]vices furni%$ 9 fee-=-s]vice sett+s4 #g4 ,p]=mance bonuses = significant a*ievem5t 9 ,m$icaid quality p]=mance ,section #aicb7;c77#a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acifu-#b7;c77#a77 is am5d$ by add+ at ! end ! foll[+ new subp>agraph3 7,f7 ,p]=mance bonus = quality p]=mance a*ievem5t 7i7 ,9 g5]al ,! ,secret>y %all e/abli% a ,m$icaid ,quality ,p]=mance ,bonus fund = aw>d+ p]=mance bonuses to ,/ates = high atta9m5t & improvem5t on a core set ( quality measures relat$ to ! goals & purposes ( ! ,m$icaid program4 7ii7 ,quality p]=mance bonus me?odology ,n lat] ?an ?ree ye>s aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y %all e/abli% a me?odology = aw>d+ ,m$icaid ,quality ,p]=mance bonuses to ,/ates n less ?an annually :i* w be bas$ on ! annual ,/ate reports requir$ "u section #aach;,b ( title ,,xi ( ! ,social ,security ,act1 9 accordance ) regulations promulgat$ by ! ,secret>y4 7iii7 ,quality p]=mance measurem5t bonuses ,m$icaid ,quality ,p]=mance ,bonus funds w be aw>d$ to up to #aj ,/ates t meet ?re%olds e/abli%$ by ! ,secret>y =-- 7,i7 ! top five ,/ates a*iev+ ! designation ( sup]ior quality p]=m+ ,/ate2 or 7,,ii7 five ,/ates demon/rat+ ! greate/ relative level ( annual improvem5t 9 quality p]=mance4 7iv7 ,initial appropriation ,! total am\nt ( paym5ts "u ?is subp>agraph %all be equal to #ejj1jjj1jjj = mak+ paym5ts "u ?is subp>agraph1 to be available until exp5d$4 ,?is subp>agraph con/itutes budget au?ority 9 advance ( appropriations ,acts & repres5ts ! obligation ( ! ,secret>y to provide = ! paym5t ( am\nts provid$ "u ?is subp>agraph4 7v7 ,uses ( quality p]=mance bonus funds 7,i7 ,designation = quality improvem5t activities ,z a condition ( receiv+ a bonus fund aw>d "u clause 7iii71 a ,/ate %all agree to designate at lea/ #ge p]c5t ( ! p]=mance bonus funds = ! developm5t & op]ation ( quality-relat$ initiatives t w directly b5efit provid]s1 includ+-- 7aa7 provid] pay-=-p]=mance programs2 7bb7 provid] collaboration initiatives t h be5 demon/rat$ to improve p]=mance on quality2 7cc7 provid] quality improvem5t initiatives1 includ+ ^? aim$ at improv+ c>e = special & h>d-to-rea* populations2 & 7dd7 ,secret>y-approv$ activities & initiatives t a ,/ate may pursue to enc\rage quality improvem5t & pati5t-focus$ high value c>e4 ,no?+ 9 ?is subp>agraph %all prohibit a ,/ate f e/abli%+ crit]ia = ! ,/ate provid] p]=mance program t limits ! aw>d to a p>ticul> provid] type7s71 t limits application to a specific geographic area1 or t directs inc5tive programs = quality-relat$ activities = specific populations1 includ+ individuals eligible "u ?is title & title ,,xviii ( ! ,social ,security ,act1 h>d-to-rea* populations4 7,,ii7 ,rema9+ bonus funds ,/ates may designate up to #be p]c5t ( ! quality p]=mance bonus aw>d = activities relat$ to ! goals & purposes ( ! program4 7vi7 ,def9ition ( provid]s ,= purposes ( allocation ( ,m$icaid ,quality ,p]=mance ,bonuses ! def9ition ( provid] %all h ! mean+ giv5 to x 9 a ,/ate ,plan4 ,no?+ 9 ?is section %all prohibit a ,/ate f inve/+ bonus funds into quality improvem5t activities = manag$ c>e entities4 4