,i  #aaeth ,,congress  #ast ,session    
,h4 ,r4 #abgg  ,,in ,,the ,,house ,,of  
,,representatives  ,march #a1 #bjag,mrs4
 ,blackburn introduced the following    
bill2 which was referred to the         
,committee on ,energy and ,commerce  ,a 
,,bill  ,to permit indefinite extensions
 for certain previously extended        
,medicaid managed care waivers4  #a4    
,short title ,this ,act may be cited as 
the ,state ,medicaid ,waiver            
,flexibility ,act of #bjag4  #b4        
,grandfathering certain ,medicaid       
managed care waivers  7a7 ,in general   
,in the case of a ,state with a         
grandfathered managed care waiver1 the  
,state may continue to implement the    
managed care delivery system that is the
 subject of such waiver in perpetuity   
under the ,state plan under title ,,xix 
of the ,social ,security ,act 7or a     
waiver of such plan7 without submitting 
an application to the ,secretary for a  
new waiver to implement such managed    
care delivery system1 so long as the    

terms and conditions of the waiver      
involved are not modified4 ,if the      
,state seeks to modify the terms or     
conditions of such a waiver1 the ,state 
shall submit to the ,secretary an       
application for approval of a new waiver
 under such modified terms and          
conditions4  7b7 ,state with a          
grandfathered managed care waiver       
defined ,in this section1 the term      
,state with a grandfathered managed care
 waiver means a ,state-- 7#a7 with a    
waiver approved by the ,secretary of    
,health and ,human ,services under      
section #aiae7;b7 of the ,social        
,security ,act 7#db ,u4,s4,c4           
#acifu-#b7;b77 with respect to the      
authority of the ,state to implement a  
managed care delivery system under the  
,state plan under title ,,xix of the    
,social ,security ,act 7or under a      
waiver of such plan under section #aaae 
of such ,act7 that is in effect as of   
,january #a1 #bjag2 and  7#b7 the       
renewal of such waiver was approved no  

less than two times4  7c7 ,rule of      
construction ,nothing in this section   
shall be construed1 with respect to a   
waiver approved by the ,secretary of    
,health and ,human ,services under      
section #aaae of the ,social ,security  
,act 7#db ,u4,s4,c4 #acae71 to allow for
 the continued application in perpetuity
 of such waiver with respect to any     
aspect of the implementation of the     
,medicaid program under title ,,xix of  
such ,act in such ,state other than the 
authority of the ,state to implement a  
managed care delivery system in such    
,state4