,,ii #aad? ,,congress #a/ ,session ,s4 #bjig ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,septemb] #bi1 #bjae ,ms4 ,baldw9 introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,f9ance ,a ,,bill ,to am5d title ,,xix ( ! ,social ,security ,act to provide = paym5t = ,m$icaid s]vices furni%$ by ,ryan ,:ite "p ,c grantees "u a co/-bas$ prospective paym5t sy/em4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,,hiv ,cl9ical ,s]vices ,improvem5t ,act4 #b4 ,m$icaid paym5t = s]vices furni%$ by ,ryan ,:ite "p ,c grantees on a co/-bas$ prospective paym5t sy/em 7a7 ,9 g5]al ,section #aijb ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7 is am5d$-- 7#a7 9 subsection 7a77#ae71 by ins]t+ be=e ! semicolon at ! end ! foll[+3 & provide = paym5t = s]vices describ$ 9 section #aije7;a7 provid$ by a recipi5t ( a grant "u "p ,c ( title ,,xxvi ( ! ,public ,heal? ,s]vice ,act 9 accordance ) subsection 7ll72 & 7#b7 by add+ at ! end ! foll[+ new subsection3 7ll7 ,paym5t = s]vices provid$ by ,ryan ,:ite "p ,c grantees 7#a7 ,9 g5]al ,beg9n+ ) fiscal ye> #bjaf ) respect to s]vices furni%$ on or aft] ,janu>y #a1 #bjaf1 & ea* succe$+ fiscal ye>1 ! ,/ate plan %all provide = paym5t = s]vices describ$ 9 section #aije7;a7 79 ?is subsection ref]r$ to z ,m$icaid cov]$ s]vices7 furni%$ by a recipi5t ( a grant "u "p ,c ( title ,,xxvi ( ! ,public ,heal? ,s]vice ,act 79 ?is subsection ref]r$ to z a grantee7 9 accordance ) ! provisions ( ?is subsection4 7#b7 ,fiscal ye> #bjaf ,subject to p>agraph 7#d71 = s]vices furni%$ on & aft] ,janu>y #a1 #bjaf1 dur+ fiscal ye> #bjaf1 ! ,/ate plan %all provide = paym5t = su* s]vices 9 an am\nt 7calculat$ on a p] visit or simil> basis z specifi$ by ! ,secret>y7 t is equal to #ajj p]c5t ( ! av]age ( ! co/s ( ! grantee ( furni%+ su* s]vices dur+ fiscal ye>s #bjad & #bjae :i* are reasonable & relat$ to ! co/ ( furni%+ su* s]vices1 or bas$ on su* o!r te/s ( reasonabl5ess z ! ,secret>y prescribes 9 regulations "u section #ahcc7;a77#c71 or1 9 ! case ( s]vices to :i* su* regulations d n apply1 ! same me?odology us$ "u section #ahcc7;a77#c71 adju/$ to take into acc\nt any increase or decrease 9 ! scope ( su* s]vices furni%$ by ! grantee dur+ fiscal ye> #bjaf4 7#c7 ,fiscal ye> #bjag & succe$+ fiscal ye>s ,subject to p>agraph 7#d71 = s]vices furni%$ dur+ fiscal ye> #bjag or a succe$+ fiscal ye>1 ! ,/ate plan %all provide = paym5t = su* s]vices 9 an am\nt 7calculat$ on a p] visit or simil> basis7 t is equal to ! am\nt calculat$ = su* s]vices "u ?is subsection = ! prec$+ fiscal ye>-- 7,a7 increas$ by ! p]c5tage increase 9 ! ,,mei 7z def9$ 9 section #ahdb7;i77#c77 applicable to prim>y c>e s]vices 7z def9$ 9 section #ahdb7;i77#d77 = t fiscal ye>2 & 7,b7 adju/$ to take into acc\nt any increase or decrease 9 ! scope ( su* s]vices furni%$ by ! grantee dur+ t fiscal ye>4 7#d7 ,e/abli%m5t ( initial ye> paym5t am\nt = new grantees ,9 any case 9 :i* an entity fir/ becomes a grantee aft] fiscal ye> #bjae1 ! ,/ate plan %all provide = paym5t = ,m$icaid cov]$ s]vices furni%$ by ! entity 9 ! fir/ fiscal ye> 9 :i* ! entity s qualifies 9 an am\nt 7calculat$ on a p] visit or simil> basis7 t is equal to #ajj p]c5t ( ! co/s ( furni%+ su* s]vices dur+ su* fiscal ye> bas$ on ! rates e/abli%$ "u ?is subsection = ! fiscal ye> = o!r su* grantees locat$ 9 ! same or adjac5t area ) a simil> case load or1 9 ! abs5ce ( su* a grantee1 9 accordance ) ! regulations & me?odology ref]r$ to 9 p>agraph 7#b7 or bas$ on su* o!r te/s ( reasonabl5ess z ! ,secret>y may specify4 ,= ea* fiscal ye> foll[+ ! fiscal ye> 9 :i* ! entity fir/ qualifies1 ! ,/ate plan %all provide = ! paym5t am\nt to be calculat$ 9 accordance ) p>agraph 7#c74 7#e7 ,adm9i/ration 9 ! case ( manag$ c>e 7,a7 ,9 g5]al ,9 ! case ( s]vices furni%$ by a grantee pursuant to a contract betwe5 ! grantee & a manag$ c>e entity 7z def9$ 9 section #aicb7;a77#a77;,b771 ! ,/ate plan %all provide = paym5t to ! grantee by ! ,/ate ( a supplem5tal paym5t equal to ! am\nt 7if any7 by :i* ! am\nt det]m9$ "u p>agraphs 7#b71 7#c71 & 7#d7 exce$s ! am\nt ( ! paym5ts provid$ "u ! contract4 7,b7 ,paym5t s*$ule ,! supplem5tal paym5t requir$ "u subp>agraph 7,a7 %all be made pursuant to a paym5t s*$ule agre$ to by ! ,/ate & ! grantee1 b 9 no case less frequ5tly ?an e #d mon?s4 7#f7 ,alt]native paym5t me?odologies ,not)/&+ any o!r provision ( ?is section1 ! ,/ate plan may provide = paym5t 9 any fiscal ye> to a grantee = ,m$icaid cov]$ s]vices 9 an am\nt :i* is det]m9$ "u an alt]native paym5t me?odology t-- 7,a7 is agre$ to by ! ,/ate & ! grantee2 & 7,b7 results 9 paym5t to ! grantee ( an am\nt :i* is at lea/ equal to ! am\nt o!rwise requir$ to be paid to ! grantee "u ?is subsection4 7#g7 ,quality managem5t & report+ requirem5ts ,! ,secret>y %all require t1 z appropriate1 a grantee %all be subject to quality managem5t & report+ requirem5ts comp>able to ^? impos$ on f$]ally qualifi$ heal? c5t]s1 includ+ report+ ( enc\nt] data1 cl9ical outcomes data1 quality data1 & su* o!r data z ! ,secret>y %all require1 z a condition ( su* grantee receiv+ paym5t = ,m$icaid cov]$ s]vices "u ?is subsection4 4 7b7 ,effective date 7#a7 ,except z provid$ 9 p>agraph 7#b71 ! am5dm5ts made by subsection 7a7 %all apply to s]vices furni%$ on or aft] ,janu>y #a1 #bjaf1 )\t reg>d to :e!r or n f9al regulations to c>ry out su* am5dm5t h be5 promulgat$ by su* date4 7#b7 ,9 ! case ( a ,/ate plan = m$ical assi/ance "u title ,,xix ( ! ,social ,security ,act :i* ! ,secret>y ( ,heal? & ,human ,s]vices det]m9es requires ,/ate legislation 7o!r ?an legislation appropriat+ funds7 9 ord] = ! plan to meet ! additional requirem5t impos$ by ! am5dm5ts made by subsection 7a71 ! ,/ate plan %all n be reg>d$ z fail+ to comply ) ! requirem5ts ( su* title solely on ! basis ( its failure to meet ?is 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> ( su* session %all be deem$ to be a sep>ate regul> session ( ! ,/ate legislature4