,i  #aad? ,,congress  #b;d ,session  ,h4
 ,r4 #eijb  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,july #ad1 #bjaf,mr4  
,tonko 7= himself1 ,mr4 ,/iv]s1 ,mr4    
,langev91 & ,mr4 ,h>p]7 introduc$ !     
foll[+ bill2 :i* 0 ref]r$ to !          
,committee on ,en]gy & ,comm]ce  ,a     
,,bill  ,to am5d title ,,xix ( ! ,social
 ,security ,act to provide a tempor>y   
high] ,f$]al m$ical assi/ance p]c5tage =
 ,f$]al exp5ditures "u ! ,m$icaid       
program t are associat$ ) ! co/ (       
compliance ) c]ta9 ,f$]al regulations ) 
respect to s]vices furni%$ 9 c]ta9      
int]m$iate c>e facilities or home &     
community-bas$ s]vices furni%$ to       
individuals ) intellectual &            
developm5tal disabilities4  #a4 ,%ort   
title ,?is ,act may be cit$ z !         
,disability ,community ,act ( #bjaf4    
#b4 ,high] ,,fmap = c]ta9 ,m$icaid      
exp5ditures associat$ ) c]ta9 regulation
 compliance  7a7 ,9 g5]al ,section      
#aijc7;a77#e7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acif;b7a77#e77 is      

am5d$--  7#a7 by /rik+ an am\nt equal to
 & ins]t+ 7,a7 an am\nt equal to2  7#b7 
by /rik+ supplies2 & ins]t+ supplies2 &2
 &  7#c7 by add+ at ! end ! foll[+3     
7,b7 an am\nt equal to #ij p]c5t ( ! sum
 ( ! am\nts exp5d$ dur+ a qu>t] 9 #bjag1
 #bjah1 or #bjai1 = items & s]vices     
furni%$ 9 an int]m$iate c>e facility = !
 m5tally ret>d$ or = home &             
community-bas$ s]vices furni%$ to       
individuals ) intellectual &            
developm5tal disabilities1 z ! ,secret>y
 det]m9es are attributable to compliance
 ) any ( ! regulations specifi$ 9--  7i7
 "p #eia ( title #bi1 ,code ( ,f$]al    
,regulations2  7ii7 "p #eeb ( title #bi1
 ,code ( ,f$]al ,regulations2 or  7iii7 
"p #dcj1 #dca1 #dce1 #dcf1 #ddj1 #dda1  
or #ddg ( title #db1 ,code ( ,f$]al     
,regulations2  4  7b7 ,con=m+ t]m9ology 
= int]m$iate c>e facilities ,title ,,xix
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #acif et seq47 is am5d$--     
7#a7 by /rik+ int]m$iate c>e facility = 
! m5tally ret>d$ ea* "t su* t]m appe>s  

7includ+ 9 head+s7 & ins]t+ int]m$iate  
c>e facility = individuals )            
intellectual & developm5tal             
disabilities2  7#b7 by /rik+ int]m$iate 
c>e facilities = ! m5tally ret>d$ ea* "t
 su* t]m appe>s 7includ+ 9 head+s7 &    
ins]t+ int]m$iate c>e facilities =      
individuals ) intellectual &            
developm5tal disabilities2  7#c7 by     
/rik+ ,/ate m5tal ret>dation or         
developm5tal disability au?ority ea* "t 
su* t]m appe>s & ins]t+ ,/ate           
intellectual or developm5tal disability 
au?ority2  7#d7 9 section #aije7;d7--   
7,a7 9 ! matt] be=e p>agraph 7#a71 by   
/rik+ !re(7 = ! m5tally ret>d$ or p]sons
 & ins]t+ !re(7 = individuals )         
intellectual or developm5tal            
disabilities or2  7,b7 9 p>agraph 7#a71 
by /rik+ m5tally ret>d$ individuals &   
ins]t+ individuals ) intellectual or    
developm5tal disabilities2 &  7,c7 9    
p>agraph 7#b71 by /rik+ ! m5tally ret>d$
 individual & ins]t+ ! individual ) an  
intellectual or developm5tal disability2

  7#e7 9 section #aiae7;c77#g77;,c71 by 
/rik+ m5tal ret>dation & ins]t+         
intellectual or developm5tal            
disabilities2  7#f7 9 section           
#aiai7;b7-- 7,a7 9 p>agraph 7#c7--  7i7 
9 subp>agraph 7,e71 by /rik+ m5tally    
ret>d$ & ins]t+ has intellectual or     
developm5tal disabilities2 &  7ii7 9    
subp>agraph 7,f7--  7,i7 9 ! head+1 by  
/rik+ & m5tally ret>d$ individuals &    
ins]t+ individuals & individuals )      
intellectual or developm5tal            
disabilities2 &  7,,ii7 9 clause 7ii7-- 
7aa7 by /rik+ is m5tally ret>d$ & ins]t+
 has an intellectual or developm5tal    
disability2 &  7bb7 by /rik+ = m5tal    
ret>dation & ins]t+ = intellectual or   
developm5tal disabilities2  7,b7 9      
p>agraph 7#d7-- 7i7 9 subp>agraph       
7,a77vii71 by /rik+ m5tally ill &       
m5tally ret>d$ resid5ts & ins]t+        
resid5ts :o are m5tally ill or :o h     
intellectual or developm5tal            
disabilities2 &  7ii7 9 subp>agraph     
7,c77ii77,,iv71 by /rik+ ! m5tally      

ret>d$ & ins]t+ individuals )           
intellectual or developm5tal            
disabilities2 &  7#g7 9 section         
#aiai7;e7--  7,a7 9 p>agraph 7#g7-- 7i7 
9 subp>agraph 7,a77i71 by /rik+ m5tally 
ill & m5tally ret>d$ individuals &      
ins]t+ individuals :o are m5tally ill or
 :o h intellectual or developm5tal      
disabilities2  7ii7 9 subp>agraph 7,b7--
 7,i7 by /rik+ m5tal ret>dation ea*     
place su* t]m appe>s & ins]t+           
intellectual or developm5tal disability2
  7,,ii7 9 clause 7ii7-- 7aa7 9 ! head+1
 by /rik+ m5tally ret>d$ resid5ts &     
ins]t+ resid5ts ) intellectual or       
developm5tal disabilities2 &  7bb7 9 !  
matt] prec$+ subclause 7,i71 by /rik+ is
 m5tally ret>d$ & ins]t+ has an         
intellectual or developm5tal disability2
 &  7,,iii7 9 clause 7iii71 by /rik+    
m5tally ill or m5tally ret>d$ resid5t & 
ins]t+ resid5t :o is m5tally ill or :o  
has an intellectual or developm5tal     
disability2  7iii7 9 subp>agraph 7,c71  
by /rik+ m5tal ret>dation ea* place su* 

t]m appe>s & ins]t+ intellectual or     
developm5tal disability2  7iv7 9        
subp>agraph 7,e7--  7,i7 by /rik+ are   
m5tally ret>d$ or & ins]t+ h            
intellectual or developm5tal            
disabilities or are2 &  7,,ii7 by /rik+ 
m5tal ret>dation & ins]t+ intellectual  
or developm5tal disability2 &  7v7 9    
subp>agraph 7,g77ii7-- 7,i7 by /rik+ be 
m5tally ret>d$ & ins]t+ h an            
intellectual or developm5tal disability2
 &  7,,ii7 by /rik+ is m5tally ret>d$ or
 a p]son ) & ins]t+ has an intellectual 
or developm5tal disability or4  #c4     
,electronic visit v]ification sy/em     
requir$ = p]sonal c>e s]vices & home    
heal? c>e s]vices "u m$icaid  7a7 ,9    
g5]al ,section #aijc ( ! ,social        
,security ,act 7#db ,u4,s4,c4 #acif;b7  
is am5d$ by ins]t+ aft] subsection 7k7 !
 foll[+ new subsection3  7l7  7#a7      
,subject to p>agraphs 7#c7 & 7#d71 )    
respect to any am\nt exp5d$ = p]sonal   
c>e s]vices or home heal? c>e s]vices   
requir+ an 9-home visit by a provid] t  

are provid$ "u a ,/ate plan "u ?is title
 7or "u a waiv] ( ! plan7 & furni%$ 9 a 
cal5d> qu>t] beg9n+ on or aft] ,janu>y  
#a1 #bjai 7or1 9 ! case ( home heal? c>e
 s]vices1 on or aft] ,janu>y #a1 #bjbc71
 unless a ,/ate requires ! use ( an     
electronic visit v]ification sy/em = su*
 s]vices furni%$ 9 su* qu>t] "u ! plan  
or su* waiv]1 ! ,f$]al m$ical assi/ance 
p]c5tage %all be r$uc$--  7,a7 9 ! case 
( p]sonal c>e s]vices-- 7i7 = cal5d>    
qu>t]s 9 #bjai & #bjbj1 by 4#be p]c5tage
 po9ts2  7ii7 = cal5d> qu>t]s 9 #bjba1  
by 4#e p]c5tage po9ts2  7iii7 = cal5d>  
qu>t]s 9 #bjbb1 by 4#ge p]c5tage po9ts2 
&  7iv7 = cal5d> qu>t]s 9 #bjbc & ea*   
ye> !reaft]1 by #a p]c5tage po9t2 &     
7,b7 9 ! case ( home heal? c>e s]vices--
  7i7 = cal5d> qu>t]s 9 #bjbc & #bjbd1  
by 4#be p]c5tage po9ts2  7ii7 = cal5d>  
qu>t]s 9 #bjbe1 by 4#e p]c5tage po9ts2  
7iii7 = cal5d> qu>t]s 9 #bjbf1 by 4#ge  
p]c5tage po9ts2 &  7iv7 = cal5d> qu>t]s 
9 #bjbg & ea* ye> !reaft]1 by #a        
p]c5tage po9t4  7#b7 ,subject to        

p>agraphs 7#c7 & 7#d71 9 implem5t+ !    
requirem5t = ! use ( an electronic visit
 v]ification sy/em "u p>agraph 7#a71 a  
,/ate %all--  7,a7 consult ) ag5cies &  
entities t provide p]sonal c>e s]vices1 
home heal? c>e s]vices1 or bo? "u !     
,/ate plan 7or "u a waiv] ( ! plan7 to  
ensure t su* sy/em--  7i7 is m9imally   
burd5some2  7ii7 takes into acc\nt exi/+
 be/ practices & electronic visit       
v]ification sy/ems 9 use 9 ! ,/ate2 &   
7iii7 is conduct$ 9 accordance ) !      
requirem5ts ( ,,hipaa privacy & security
 law 7z def9$ 9 section #cjji ( !       
,public ,heal? ,s]vice ,act72  7,b7 take
 into acc\nt a /akehold] process t      
includes input f b5efici>ies1 family    
c>egiv]s1 p]sonal c>e or home heal? c>e 
s]vices work]s1 & o!r /akehold]s1 z     
det]m9$ by ! ,/ate 9 accordance )       
guidance f ! ,secret>y2 &  7,c7 ensure t
 individuals :o furni% p]sonal c>e      
s]vices1 home heal? c>e s]vices1 or bo? 
"u ! ,/ate plan 7or "u a waiv] ( ! plan7
 are provid$ ! opportunity = tra9+ on ! 

use ( su* sy/em4  7#c7 ,p>agraphs 7#a7 &
 7#b7 %all n apply 9 ! case ( a ,/ate t1
 z ( ! date ( ! enactm5t ( ?is          
subsection1 requires ! use ( any sy/em =
 ! electronic v]ification ( visits      
conduct$ z "p ( bo? p]sonal c>e s]vices 
& home heal? c>e s]vices4  7#d7  7,a7 ,9
 ! case ( a ,/ate describ$ 9 subp>agraph
 7,b71 ! r$uction "u p>agraph 7#a7 %all 
n apply--  7i7 9 ! case ( p]sonal c>e   
s]vices1 = cal5d> qu>t]s 9 #bjai2 &     
7ii7 9 ! case ( home heal? c>e s]vices1 
= cal5d> qu>t]s 9 #bjbc4  7,b7 ,=       
purposes ( subp>agraph 7,a71 a ,/ate    
describ$ 9 ?is subp>agraph is a ,/ate t 
demon/rates to ! ,secret>y t ! ,/ate--  
7i7 has made a good fai? ef=t to comply 
) ! requirem5ts ( p>agraphs 7#a7 & 7#b7 
7includ+ by tak+ /eps to adopt !        
te*nology us$ = an electronic visit     
v]ification sy/em72 or  7ii7 9 implem5t+
 su* a sy/em1 has enc\nt]$ unavoidable  
sy/em delays4  7#e7 ,9 ?is subsection3  
7,a7 ,! t]m electronic visit v]ification
 sy/em means1 ) respect to p]sonal c>e  

s]vices or home heal? c>e s]vices1 a    
sy/em "u :i* visits conduct$ z "p ( su* 
s]vices are electronically v]ifi$ )     
respect to--  7i7 ! type ( s]vice p]=m$2
  7ii7 ! individual receiv+ ! s]vice2   
7iii7 ! date ( ! s]vice2  7iv7 !        
location ( s]vice deliv]y2  7v7 !       
individual provid+ ! s]vice2 &  7vi7 !  
"t ! s]vice beg9s & ends4  7,b7 ,! t]m  
home heal? c>e s]vices means s]vices    
describ$ 9 section #aije7;a77#g7 provid$
 "u a ,/ate plan "u ?is title 7or "u a  
waiv] ( ! plan74  7,c7 ,! t]m p]sonal   
c>e s]vices means p]sonal c>e s]vices   
provid$ "u a ,/ate plan "u ?is title 7or
 "u a waiv] ( ! plan71 includ+ s]vices  
provid$ "u section #aije7;a77#bd71      
#aiae7;c71 #aiae7;i71 #aiae7;j71 or     
#aiae7k7 or "u a wavi] "u section #aaae4
  7#f7  7,a7 ,9 ! case 9 :i* a ,/ate    
requires p]sonal c>e s]vice & home heal?
 c>e s]vice provid]s to utilize an      
electronic visit v]ification sy/em      
op]at$ by ! ,/ate or a contractor on    
behalf ( ! ,/ate1 ! ,secret>y %all pay  

to ! ,/ate1 = ea* qu>t]1 an am\nt equal 
to #ij p] c5tum ( s mu* ( ! sums exp5d$ 
dur+ su* qu>t] z are attributable to !  
design1 developm5t1 or in/allation ( su*
 sy/em1 & #ge p] c5tum ( s mu* ( ! sums 
= ! op]ation & ma9t5ance ( su* sy/em4   
7,b7 ,subp>agraph 7,a7 %all n apply 9 ! 
case 9 :i* a ,/ate requires p]sonal c>e 
s]vice & home heal? c>e s]vice provid]s 
to utilize an electronic visit          
v]ification sy/em t is n op]at$ by !    
,/ate or a contractor on behalf ( !     
,/ate4  4  7b7 ,collection &            
dissem9ation ( be/ practices ,n lat] ?an
 ,janu>y #a1 #bjah1 ! ,secret>y ( ,heal?
 & ,human ,s]vices %all1 ) respect to   
electronic visit v]ification sy/ems 7z  
def9$ 9 subsection 7l77#e7 ( section    
#aijc ( ! ,social ,security ,act 7#db   
,u4,s4,c4 #acif;b71 z ins]t$ by         
subsection 7a771 collect & dissem9ate   
be/ practices to ,/ate ,m$icaid         
,directors ) respect to--  7#a7 tra9+   
individuals :o furni% p]sonal c>e       
s]vices1 home heal? c>e s]vices1 or bo? 

"u ! ,/ate plan "u title ,,xix ( su*    
,act 7or "u a waiv] ( ! plan7 on su*    
sy/ems & ! op]ation ( su* sy/ems & !    
prev5tion ( fraud ) respect to !        
provision ( p]sonal c>e s]vices or home 
heal? c>e s]vices 7z def9$ 9 su*        
subsection 7l77#e772 &  7#b7 ! provision
 ( notice & educational mat]ials to     
family c>egiv]s & b5efici>ies ) respect 
to ! use ( su* electronic visit         
v]ification sy/ems & o!r means to prev5t
 su* fraud4  7c7 ,rules ( con/ruction   
7#a7 ,no employ]-employee relation%ip   
e/abli%$ ,no?+ 9 ! am5dm5t made by ?is  
section may be con/ru$ z e/abli%+ an    
employ]-employee relation%ip betwe5 !   
ag5cy or entity t provides = p]sonal c>e
 s]vices or home heal? c>e s]vices & !  
individuals :o1 "u a contract ) su* an  
ag5cy or entity1 furni% su* s]vices =   
purposes ( "p #eeb ( title #bi1 ,code ( 
,f$]al ,regulations 7or any successor   
regulations74  7#b7 ,no p>ticul> or     
uni=m electronic visit v]ification sy/em
 requir$ ,no?+ 9 ! am5dm5t made by ?is  

section %all be con/ru$ to require ! use
 ( a p>ticul> or uni=m electronic visit 
v]ification sy/em 7z def9$ 9 subsection 
7l77#e7 ( section #aijc ( ! ,social     
,security ,act1 z ins]t$ by subsection  
7a77 by all ag5cies or entities t       
provide p]sonal c>e s]vices or home     
heal? c>e "u a ,/ate plan "u title ,,xix
 ( ! ,social ,security ,act 7or "u a    
waiv] ( ! plan7 7#db ,u4,s4,c4 #acif et 
seq474  7#c7 ,no limits on provision (  
c>e ,no?+ 9 ! am5dm5t made by ?is       
section may be con/ru$ to limit1 )      
respect to p]sonal c>e s]vices or home  
heal? c>e s]vices provid$ "u a ,/ate    
plan "u title ,,xix ( ! ,social         
,security ,act 7or "u a waiv] ( ! plan7 
7#db ,u4,s4,c4 #acif et seq471 provid]  
selection1 con/ra9 b5efici>ies'         
selection ( a c>egiv]1 or imp$e ! mann] 
9 :i* c>e is deliv]$4  7#d7 ,no         
prohibition on /ate quality measures    
requirem5ts ,no?+ 9 ! am5dm5t made by   
?is section %all be con/ru$ z prohibit+ 
a ,/ate1 9 implem5t+ an electronic visit

 v]ification sy/em 7z def9$ 9 subsection
 7l77#e7 ( section #aijc ( ! ,social    
,security ,act1 z ins]t$ by subsection  
7a771 f e/abli%+ requirem5ts relat$ to  
quality measures = su* sy/em4