#aad? ,,congress  #a/ ,session  ,9 !    
,h\se ( ,repres5tatives1 ,u4 ,s41       
,novemb] #af1 #bjae  ,,am5dm5t3  ,t !   
bill f ! ,s5ate 7,s4 #eii7 entitl$ ,an  
,act to ext5d & exp& ! ,m$icaid em]g5cy 
psy*iatric demon/ration project41 d pass
 ) ! foll[+ ,/rike out all aft] ! enact+
 clause & ins]t3  #a4 ,%ort title ,?is  
,act may be cit$ z ! ,improv+ ,access to
 ,em]g5cy ,psy*iatric ,c>e ,act4  #b4   
,ext5sion & expansion ( m$icaid em]g5cy 
psy*iatric demon/ration project  7a7 ,9 
g5]al ,subsection 7d7 ( section #bgjg ( 
,public ,law #aaa-adh 7#db ,u4,s4,c4    
#acif;a note7 is am5d$ to read z foll[s3
  7d7 ,l5g? ( demon/ration project  7#a7
 ,9 g5]al ,except z provid$ 9 p>agraphs 
7#b7 & 7#c71 ! demon/ration project     
e/abli%$ "u ?is section %all be conduct$
 = a p]iod ( #c consecutive ye>s4  7#b7 
,tempor>y ext5sion ( p>ticipation       
eligibility = select$ ,/ates  7,a7 ,9   
g5]al ,subject to subp>agraph 7,b7 &    
p>agraph 7#d71 a ,/ate select$ z an     
eligible ,/ate to p>ticipate 9 !        

demon/ration project on or prior to ,m>*
 #ac1 #bjab1 %all1 ^u ! reque/ ( !      
,/ate1 be p]mitt$ to cont9ue to         
p>ticipate 9 ! demon/ration project     
?r\gh ,septemb] #cj1 #bjaf1 if--  7i7 ! 
,secret>y det]m9es t ! cont9u$          
p>ticipation ( ! ,/ate 9 ! demon/ration 
project is project$ n to increase net   
program sp5d+ "u title ,,xix ( ! ,social
 ,security ,act2 &  7ii7 ! ,*ief ,actu>y
 ( ! ,c5t]s = ,m$ic>e  ,m$icaid ,s]vices
 c]tifies t su* ext5sion = t ,/ate is   
project$ n to increase net program sp5d+
 "u title ,,xix ( ! ,social ,security   
,act4  7,b7 ,notice ( projections ,!    
,secret>y %all provide ea* ,/ate select$
 to p>ticipate 9 ! demon/ration project 
on or prior to ,m>* #ac1 #bjab1 ) notice
 ( ! det]m9ation & c]tification made "u 
subp>agraph 7,a7 = ! ,/ate4  7#c7       
,ext5sion & expansion ( demon/ration    
project  7,a7 ,additional ext5sion ,tak+
 into acc\nt ! recomm5dations submitt$  
to ,congress "u subsection 7f77#c71 !   
,secret>y may p]mit an eligible ,/ate   

p>ticipat+ 9 ! demon/ration project z ( 
! date su* recomm5dations are submitt$  
to cont9ue to p>ticipate 9 ! project    
?r\gh ,decemb] #ca1 #bjai1 if1 ) respect
 to ! ,/ate--  7i7 ! ,secret>y det]m9es 
t ! cont9u$ p>ticipation ( ! ,/ate 9 !  
demon/ration project is project$ n to   
increase net program sp5d+ "u title     
,,xix ( ! ,social ,security ,act2 &     
7ii7 ! ,*ief ,actu>y ( ! ,c5t]s =       
,m$ic>e  ,m$icaid ,s]vices c]tifies t ! 
cont9u$ p>ticipation ( ! ,/ate 9 !      
demon/ration project is project$ n to   
increase net program sp5d+ "u title     
,,xix ( ! ,social ,security ,act4  7,b7 
,option = expansion to additional ,/ates
 ,tak+ into acc\nt ! recomm5dations     
submitt$ to ,congress pursuant to       
subsection 7f77#c71 ! ,secret>y may exp&
 ! numb] ( eligible ,/ates p>ticipat+ 9 
! demon/ration project ?r\gh ,decemb]   
#ca1 #bjai1 if1 ) respect to any new    
eligible ,/ate-- 7i7 ! ,secret>y        
det]m9es t ! p>ticipation ( ! ,/ate 9 ! 
demon/ration project is project$ n to   

increase net program sp5d+ "u title     
,,xix ( ! ,social ,security ,act2 &     
7ii7 ! ,*ief ,actu>y ( ! ,c5t]s =       
,m$ic>e  ,m$icaid ,s]vices c]tifies t ! 
p>ticipation ( ! ,/ate 9 ! demon/ration 
project is project$ n to increase net   
program sp5d+ "u title ,,xix ( ! ,social
 ,security ,act4  7,c7 ,notice (        
projections ,! ,secret>y %all provide   
ea* ,/ate p>ticipat+ 9 ! demon/ration   
project z ( ! date ! ,secret>y submits  
recomm5dations to ,congress "u          
subsection 7f77#c71 & any additional    
,/ate t applies to be add$ to !         
demon/ration project1 ) notice ( !      
det]m9ation & c]tification made = !     
,/ate "u subp>agraphs 7,a7 & 7,b71      
respectively1 & ! /&>ds us$ to make su* 
det]m9ation & c]tification--  7i7 9 !   
case ( a ,/ate p>ticipat+ 9 !           
demon/ration project z ( ! date !       
,secret>y submits recomm5dations to     
,congress "u subsection 7f77#c71 n lat] 
?an ,augu/ #ca1 #bjaf2 &  7ii7 9 ! case 
( an additional ,/ate t applies to be   

add$ to ! demon/ration project1 prior to
 ! ,/ate mak+ a f9al election to        
p>ticipate 9 ! project4  7#d7 ,au?ority 
to ensure budget neutrality ,! ,secret>y
 annually %all review ea* p>ticipat+    
,/ate's demon/ration project exp5ditures
 to ensure compliance ) ! requirem5ts ( 
p>agraphs 7#b77;,a77i71 7#b77;,a77ii71  
7#c77;,a77i71 7#c77;,a77ii71            
7#c77;,b77i71 & 7#c77;,b77ii7 7z        
applicable74 ,if ! ,secret>y det]m9es ) 
respect to a ,/ate's p>ticipation 9 !   
demon/ration project t ! ,/ate's net    
program sp5d+ "u title ,,xix ( ! ,social
 ,security ,act has increas$ z a result 
( ! ,/ate's p>ticipation 9 ! project1 ! 
,secret>y %all treat ! demon/ration     
project excess exp5ditures ( ! ,/ate z  
an ov]paym5t "u title ,,xix ( ! ,social 
,security ,act4  4  7b7 ,fund+          
,subsection 7e7 ( section #bgjg ( su*   
,act 7#db ,u4,s4,c4 #acif;a note7 is    
am5d$--  7#a7 9 ! subsection head+1 by  
/rik+ ,limitations on ,f$]al2  7#b7 9   
p>agraph 7#b7--  7,a7 9 ! p>agraph      

head+1 by /rik+ #e-ye>2 &  7,b7 by /rik+
 ?r\gh ,decemb] #ca1 #bjae & ins]t+     
until exp5d$2  7#c7 by /rik+ p>agraph   
7#c72  7#d7 by r$esignat+ p>agraphs 7#d7
 & 7#e7 z p>agraphs 7#c7 & 7#d71        
respectively2  7#e7 9 p>agraph 7#c7 7z s
 r$esignat$71 by /rik+ & ! availability 
( funds & ins]t+ 7o!r ?an ,/ates deem$  
to be eligible ,/ates ?r\gh !           
application ( subsection 7c77#d772 &    
7#f7 9 p>agraph 7#d7 7z s r$esignat$7-- 
7,a7 9 ! fir/ s5t5ce-- 7i7 by ins]t+    
7o!r ?an a ,/ate deem$ to be an eligible
 ,/ate ?r\gh ! application ( subsection 
7c77#d77 aft] eligible ,/ate2 &  7ii7 by
 /rik+ p>agraph 7#d7 & ins]t+ p>agraph  
7#c72 &  7,b7 by ins]t+ aft] ! fir/     
s5t5ce ! foll[+3 ,9 addition to any     
paym5ts made to an eligible ,/ate "u !  
prec$+ s5t5ce1 ! ,secret>y %all1 dur+   
any p]iod 9 effect "u p>agraph 7#b7 or  
7#c7 ( subsection 7d71 or dur+ any p]iod
 9 :i* a law describ$ 9 subsection      
7f77#d77;,c7 is 9 effect1 pay ea*       
eligible ,/ate 7includ+ any ,/ate deem$ 

to be an eligible ,/ate ?r\gh !         
application ( subsection 7c77#d771 an   
am\nt ea* qu>t] equal to ! ,f$]al m$ical
 assi/ance p]c5tage ( exp5ditures 9 !   
qu>t] dur+ su* p]iod = m$ical assi/ance 
describ$ 9 subsection 7a74 ,paym5ts made
 to a ,/ate = em]g5cy psy*iatric        
demon/ration s]vices "u ?is section dur+
 ! ext5sion p]iod %all be treat$ z      
m$ical assi/ance "u ! ,/ate plan =      
purposes ( section #aijc7;a77#a7 ( !    
,social ,security ,act 7#db ,u4,s4,c4   
#acif;b7a77#a7744  7c7 ,recomm5dations  
to congress ,subsection 7f7 ( section   
#bgjg ( su* ,act 7#db ,u4,s4,c4 #acif;a 
note7 is am5d$ by add+ at ! end !       
foll[+3  7#c7 ,recomm5dation to congress
 reg>d+ ext5sion & expansion ( project  
,n lat] ?an ,septemb] #cj1 #bjaf1 !     
,secret>y %all submit to ,congress &    
make available to ! public              
recomm5dations bas$ on an evaluation ( !
 demon/ration project1 includ+ ! use (  
appropriate quality measures1 reg>d+--  
7,a7 :e!r ! demon/ration project %\ld be

 cont9u$ aft] ,septemb] #cj1 #bjaf2 &   
7,b7 :e!r ! demon/ration project %\ld be
 exp&$ to additional ,/ates4  7#d7      
,recomm5dation to congress reg>d+       
p]man5t ext5sion & nationwide expansion 
7,a7 ,9 g5]al ,n lat] ?an ,april #a1    
#bjai1 ! ,secret>y %all submit to       
,congress & make available to ! public  
recomm5dations bas$ on an evaluation ( !
 demon/ration project1 includ+ ! use (  
appropriate quality measures1 reg>d+--  
7i7 :e!r ! demon/ration project %\ld be 
p]man5tly cont9u$ aft] ,decemb] #ca1    
#bjai1 9 #a or m ,/ates2 &  7ii7 :e!r ! 
demon/ration project %\ld be exp&$      
7includ+ on a nationwide basis74  7,b7  
,requirem5ts ,any recomm5dation submitt$
 "u subp>agraph 7,a7 to p]man5tly       
cont9ue ! project 9 a ,/ate1 or to exp& 
! project to #a or m o!r ,/ates 7includ+
 on a nationwide basis7 %all include a  
c]tification f ! ,*ief ,actu>y ( !      
,c5t]s = ,m$ic>e  ,m$icaid ,s]vices t   
p]man5tly cont9u+ ! project 9 a p>ticul>
 ,/ate1 or exp&+ ! project to a p>ticul>

 ,/ate 7or all ,/ates7 is project$ n to 
increase net program sp5d+ "u title     
,,xix ( ! ,social ,security ,act4  7,c7 
,congressional approval requir$ ,!      
,secret>y %all n p]man5tly cont9ue !    
demon/ration project 9 any ,/ate aft]   
,decemb] #ca1 #bjai1 or exp& !          
demon/ration project to any additional  
,/ate aft] ,decemb] #ca1 #bjai1 unless  
,congress enacts a law approv+ ei!r or  
bo? su* actions & ! law includes        
provisions t-- 7i7 ensure t ea* ,/ate's 
p>ticipation 9 ! project complies )     
budget neutrality requirem5ts2 &  7ii7  
require ! ,secret>y to treat any        
exp5ditures ( a ,/ate p>ticipat+ 9 !    
demon/ration project t are excess ( !   
exp5ditures project$ "u ! budget        
neutrality /&>d = ! ,/ate z an ov]paym5t
 "u title ,,xix ( ! ,social ,security   
,act4  7#e7 ,fund+ ,( ! unobligat$      
balances ( am\nts available 9 ! ,c5t]s =
 ,m$ic>e  ,m$icaid ,s]vices ,program    
,managem5t acc\nt1 #ajj1jjj %all be     
available to c>ry out ?is subsection &  

%all rema9 available until exp5d$4  4   
7d7 ,con=m+ am5dm5ts ,section #bgjg (   
su* ,act 7#db ,u4,s4,c4 #acif;a note7 is
 am5d$-- 7#a7 9 subsection 7a71 9 !     
matt] be=e p>agraph 7#a71 by ins]t+     
publicly or aft] in/itution = m5tal     
diseases t is2  7#b7 9 subsection 7c7-- 
7,a7 9 p>agraph 7#a71 by /rik+ ,an      
eligible ,/ate & ins]t+ ,except z       
o!rwise provid$ 9 p>agraph 7#d71 an     
eligible ,/ate2  7,b7 9 p>agraph 7#c71  
by /rik+ ,a ,/ate %all & ins]t+ ,except 
z o!rwise provid$ 9 p>agraph 7#d71 a    
,/ate %all2 &  7,c7 by add+ at ! end !  
foll[+3  7#d7 ,nationwide availability  
,9 ! ev5t t ! ,secret>y makes a         
recomm5dation pursuant to subsection    
7f77#d7 t ! demon/ration project be     
exp&$ on a national basis1 any ,/ate t  
has submitt$ or submits an application  
pursuant to p>agraph 7#b7 %all be deem$ 
to h be5 select$ to be an eligible ,/ate
 to p>ticipate 9 ! demon/ration project4
  2 &  7#c7 9 ! head+ = subsection 7f71 
by /rik+ & report & ins]t+ 1 report1 &  

recomm5dations4  7e7 ,effective date ,! 
am5dm5ts made by ?is section %all take  
effect on ! date ( ! enactm5t ( ?is     
,act4  ,cl]k4