,i #aae? ,,congress #a/ ,session ,h4 ,r4 #ciba ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,octob] #c1 #bjag,mr4 ,burgess introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce1 & 9 addition to ! ,committee on ,ways & ,means1 = a p]iod to be subsequ5tly det]m9$ by ! ,speak]1 9 ea* case = consid]ation ( su* provisions z fall )9 ! jurisdiction ( ! committee conc]n$ ,a ,,bill ,to ext5d fund+ = ! ,*ildr5's ,heal? ,insurance ,program1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,help+ ,ensure ,access = ,little ,ones1 ,toddl]s1 & ,hopeful ,y\? by ,keep+ ,insurance ,deliv]y ,/able ,act ( #bjag or ! ,,heal?y ,,kids ,act4 #b4 ,table ( cont5ts ,! table ( cont5ts = ?is ,act is z foll[s3 ,sec4 #a4 ,%ort title4 ,sec4 #b4 ,table ( cont5ts4 ,title ,i--,,*ip ,ext5sion & ,o!r ,m$icaid & ,,*ip ,provisions ,sec4 #aja4 ,five-ye> fund+ ext5sion ( ! ,*ildr5's ,heal? ,insurance ,program4 ,sec4 #ajb4 ,ext5sion ( c]ta9 programs & demon/ration projects4 ,sec4 #ajc4 ,ext5sion ( outrea* & enrollm5t program4 ,sec4 #ajd4 ,ext5sion & r$uction ( additional ,f$]al f9ancial p>ticipation = ,,*ip4 ,sec4 #aje4 ,modify+ r$uction 9 ,m$icaid ,,d% allotm5ts4 ,sec4 #ajf4 ,pu]to ,rico ,m$icaid paym5ts4 ,title ,,ii--,(fsets ,sec4 #bja4 ,m$icaid ?ird p>ty liability4 ,sec4 #bjb4 ,treatm5t ( lott]y w9n+s & o!r lump-sum income = purposes ( income eligibility "u ,m$icaid4 ,sec4 #bjc4 ,adju/m5ts to ,m$ic>e "p ,b & "p ,d premium subsidies = high] income individuals4 ,i ,,*ip ,ext5sion & ,o!r ,m$icaid & ,,*ip ,provisions #aja4 ,five-ye> fund+ ext5sion ( ! ,*ildr5's ,heal? ,insurance ,program 7a7 ,appropriation2 total allotm5t ,section #bajd7;a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;dd7a77 is am5d$-- 7#a7 9 p>agraph 7#ai71 by /rik+ &2 7#b7 9 p>agraph 7#bj71 by /rik+ ! p]iod at ! end & ins]t+ a semicolon2 & 7#c7 by add+ at ! end ! foll[+ new p>agraphs3 7#ba7 = fiscal ye> #bjah1 #ba1ejj1jjj1jjj2 7#bb7 = fiscal ye> #bjai1 #bb1fjj1jjj1jjj2 7#bc7 = fiscal ye> #bjbj1 #bc1gjj1jjj1jjj2 7#bd7 = fiscal ye> #bjba1 #bd1hjj1jjj1jjj2 & 7#be7 = fiscal ye> #bjbb1 = purposes ( mak+ #b semi-annual allotm5ts-- 7,a7 #b1hej1jjj1jjj = ! p]iod beg9n+ on ,octob] #a1 #bjba1 & end+ on ,m>* #ca1 #bjbb2 & 7,b7 #b1hej1jjj1jjj = ! p]iod beg9n+ on ,april #a1 #bjbb1 & end+ on ,septemb] #cj1 #bjbb4 4 7b7 ,allotm5ts 7#a7 ,9 g5]al ,section #bajd7m7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;dd7m77 is am5d$-- 7,a7 9 p>agraph 7#b7-- 7i7 9 ! head+1 by /rik+ ?r\gh #bjaf & ins]t+ ?r\gh #bjbb2 & 7ii7 9 subp>agraph 7,b7-- 7,i7 9 ! matt] prec$+ clause 7i71 by /rik+ 7#ai7 & ins]t+ 7#bd72 7,,ii7 9 clause 7ii71 9 ! matt] prec$+ subclause 7,i71 by ins]t+ 7o!r ?an fiscal ye> #bjbb7 aft] ev5-numb]$ fiscal ye>2 & 7,,iii7 9 clause 7ii77,i71 by ins]t+ 7or1 9 ! case ( fiscal ye> #bjah1 "u p>agraph 7#d77 aft] clause 7i72 7,b7 9 p>agraph 7#e7-- 7i7 by /rik+ or 7#d7 & ins]t+ 7#d71 or 7#aj72 & 7ii7 by /rik+ or #bjag & ins]t+ 1 #bjag1 or #bjbb2 7,c7 9 p>agraph 7#g7-- 7i7 9 subp>agraph 7,a71 by /rik+ #bjag & ins]t+ #bjbb2 7ii7 9 subp>agraph 7,b71 9 ! matt] prec$+ clause 7i71 by ins]t+ 7or1 9 ! case ( fiscal ye> #bjah1 by n lat] ?an ! date t is #fj days aft] ! date ( ! enactm5t ( ! ,,heal?y ,,kids ,act ( #bjag7 aft] be=e ! ,augu/ #ca prec$+ ! beg9n+ ( ! fiscal ye>2 & 7iii7 9 ! matt] foll[+ subp>agraph 7,b71 by /rik+ or fiscal ye> #bjaf & ins]t+ fiscal ye> #bjaf1 fiscal ye> #bjah1 fiscal ye> #bjbj1 or fiscal ye> #bjbb2 7,d7 9 p>agraph 7#i7-- 7i7 9 ! head+1 by /rik+ fiscal ye>s #bjae & #bjag & ins]t+ c]ta9 fiscal ye>s2 7ii7 by /rik+ or 7#d7 & ins]t+ 1 7#d71 or 7#aj72 & 7iii7 by /rik+ or fiscal ye> #bjag & ins]t+ 1 #bjag1 or #bjbb2 & 7,e7 by add+ at ! end ! foll[+ new p>agraph3 7#aj7 ,= fiscal ye> #bjbb 7,a7 ,fir/ half ,subject to p>agraphs 7#e7 & 7#g71 f ! am\nt made available "u subp>agraph 7,a7 ( p>agraph 7#be7 ( subsection 7a7 = ! semi-annual p]iod describ$ 9 su* subp>agraph1 increas$ by ! am\nt ( ! appropriation = su* p]iod "u section #aja7;b77#c7 ( ! ,,heal?y ,,kids ,act1 ! ,secret>y %all compute a ,/ate allotm5t = ea* ,/ate 7includ+ ! ,di/rict ( ,columbia & ea* commonweal? & t]ritory7 = su* semi-annual p]iod 9 an am\nt equal to ! fir/ half ratio 7describ$ 9 subp>agraph 7,d77 ( ! am\nt describ$ 9 subp>agraph 7,c74 7,b7 ,second half ,subject to p>agraphs 7#e7 & 7#g71 f ! am\nt made available "u subp>agraph 7,b7 ( p>agraph 7#be7 ( subsection 7a7 = ! semi-annual p]iod describ$ 9 su* subp>agraph1 ! ,secret>y %all compute a ,/ate allotm5t = ea* ,/ate 7includ+ ! ,di/rict ( ,columbia & ea* commonweal? & t]ritory7 = su* semi-annual p]iod 9 an am\nt equal to ! am\nt made available "u su* subp>agraph1 multipli$ by ! ratio (-- 7i7 ! am\nt ( ! allotm5t to su* ,/ate "u subp>agraph 7,a72 to 7ii7 ! total ( ! am\nt ( all ( ! allotm5ts made available "u su* subp>agraph4 7,c7 ,full ye> am\nt bas$ on gr[? factor updat$ am\nt ,! am\nt describ$ 9 ?is subp>agraph = a ,/ate is equal to ! sum (-- 7i7 ! am\nt ( ! ,/ate allotm5t = fiscal ye> #bjba det]m9$ "u p>agraph 7#b77;,b77i72 & 7ii7 ! am\nt ( any paym5ts made to ! ,/ate "u subsection 7n7 = fiscal ye> #bjba1 multipli$ by ! allotm5t increase factor "u p>agraph 7#f7 = fiscal ye> #bjbb4 7,d7 ,fir/ half ratio ,! fir/ half ratio describ$ 9 ?is subp>agraph is ! ratio (-- 7i7 ! sum (-- 7,i7 ! am\nt made available "u subsection 7a77#be77;,a72 & 7,,ii7 ! am\nt ( ! appropriation = su* p]iod "u section #aja7;b77#c7 ( ! ,,heal?y ,,kids ,act2 to 7ii7 ! sum (-- 7,i7 ! am\nt describ$ 9 clause 7i72 & 7,,ii7 ! am\nt made available "u subsection 7a77#be77;,b74 4 7#b7 ,te*nical am5dm5t ,section #bajd7m77#b77;,a7 ( su* ,act 7#db ,u4,s4,c4 #acig;dd7m77#b77;,a77 is am5d$ by /rik+ ! allotm5t increase factor "u p>agraph 7#e7 ea* place x appe>s & ins]t+ ! allotm5t increase factor "u p>agraph 7#f74 7#c7 ,"o-"t appropriation = fiscal ye> #bjbb ,!re is appropriat$ to ! ,secret>y ( ,heal? & ,human ,s]vices1 out ( any money 9 ! ,treasury n o!rwise appropriat$1 #bj1bjj1jjj1jjj to accompany ! allotm5t made = ! p]iod beg9n+ on ,octob] #a1 #bjba1 & end+ on ,m>* #ca1 #bjbb1 "u p>agraph 7#be77;,a7 ( section #bajd7;a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;dd7a77 7z add$ by subsection 7a77#c771 to rema9 available until exp5d$4 ,su* am\nt %all be us$ to provide allotm5ts to ,/ates "u p>agraph 7#aj7 ( section #bajd7m7 ( su* ,act 7z add$ by subsection 7b77#a77;,e77 = ! fir/ #f mon?s ( fiscal ye> #bjbb 9 ! same mann] z allotm5ts are provid$ "u subsection 7a77#be77;,a7 ( su* section #bajd & subject to ! same t]ms & conditions z apply to ! allotm5ts provid$ f su* subsection 7a77#be77;,a74 7c7 ,ext5sion ( ! ,*ild ,enrollm5t ,cont+5cy ,fund ,section #bajd7n7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;dd7n77 is am5d$-- 7#a7 9 p>agraph 7#b7-- 7,a7 9 subp>agraph 7,a77ii7-- 7i7 by /rik+ #bjaj1 #bjaa1 #bjab1 #bjac1 #bjad1 & #bjaf & ins]t+ #bjaj ?r\gh #bjad1 #bjaf1 & #bjah ?r\gh #bjba2 & 7ii7 by /rik+ fiscal ye> #bjae & fiscal ye> #bjag & ins]t+ fiscal ye>s #bjae1 #bjag1 & #bjbb2 & 7,b7 9 subp>agraph 7,b7-- 7i7 by /rik+ #bjaj1 #bjaa1 #bjab1 #bjac1 #bjad1 & #bjaf & ins]t+ #bjaj ?r\gh #bjad1 #bjaf1 & #bjah ?r\gh #bjba2 & 7ii7 by /rik+ fiscal ye> #bjae & fiscal ye> #bjag & ins]t+ fiscal ye> #bjae1 #bjag1 & #bjbb2 & 7#b7 9 p>agraph 7#c77;,a71 9 ! matt] prec$+ clause 7i71 by /rik+ or a semi-annual allotm5t p]iod = fiscal ye> #bjae or #bjag & ins]t+ or 9 any ( fiscal ye>s #bjah ?r\gh #bjba 7or a semi-annual allotm5t p]iod = fiscal ye> #bjae1 #bjag1 or #bjbb74 7d7 ,ext5sion ( qualify+ /ates option ,section #baje7;g77#d7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;ee7g77#d77 is am5d$-- 7#a7 9 ! head+1 by /rik+ ?r\gh #bjag & ins]t+ ?r\gh #bjbb2 & 7#b7 9 subp>agraph 7,a71 by /rik+ #bjag & ins]t+ #bjbb4 7e7 ,ext5sion ( express lane eligibility option ,section #aijb7;e77#ac77;,i7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7e77#ac77;,i77 is am5d$ by /rik+ #bjag & ins]t+ #bjbb4 7f7 ,assurance ( af=dability /&>d = *ildr5 & families 7#a7 ,9 g5]al ,section #baje7;d77#c7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;ee7d77#c77 is am5d$-- 7,a7 9 ! p>agraph head+1 by /rik+ until ,octob] #a1 #bjai & ins]t+ ?r\gh ,septemb] #cj1 #bjbb2 & 7,b7 9 subp>agraph 7,a71 9 ! matt] prec$+ clause 7i7-- 7i7 by /rik+ #bjai & ins]t+ #bjbb2 & 7ii7 by /rik+ ,! prec$+ s5t5ce %all n be con/ru$ z prev5t+ a ,/ate dur+ su* p]iod & ins]t+ ,dur+ ! p]iod t beg9s on ,octob] #a1 #bjai1 & ends on ,septemb] #cj1 #bjbb1 ! prec$+ s5t5ce %all only apply ) respect to *ildr5 9 families ^: income does n exce$ #cjj p]c5t ( ! pov]ty l9e 7z def9$ 9 section #baaj7;c77#e77 applicable to a family ( ! size involv$4 ,! prec$+ s5t5ces %all n be con/ru$ z prev5t+ a ,/ate dur+ any su* p]iods4 7#b7 ,con=m+ am5dm5ts ,section #aijb7;gg77#b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7gg77#b77 is am5d$-- 7,a7 9 ! p>agraph head+1 by /rik+ until ,octob] #a1 #bjai & ins]t+ ?r\gh ,septemb] #cj1 #bjbb2 & 7,b7 by /rik+ ,septemb] #cj1 #bjai1 & ins]t+ ,septemb] #cj1 #bjbb 7b dur+ ! p]iod t beg9s on ,octob] #a1 #bjai1 & ends on ,septemb] #cj1 #bjbb1 only ) respect to *ildr5 9 families ^: income does n exce$ #cjj p]c5t ( ! pov]ty l9e 7z def9$ 9 section #baaj7;c77#e77 applicable to a family ( ! size involv$74 7g7 ,,*ip look-,alike plans 7#a7 ,bl5d+ risk pools ,section #bajg ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;gg7 is am5d$ by add+ at ! end ! foll[+3 7g7 ,use ( bl5d$ risk pools 7#a7 ,9 g5]al ,no?+ 9 ?is title 7or any o!r provision ( ,f$]al law7 %all be con/ru$ z prev5t+ a ,/ate f consid]+ *ildr5 enroll$ 9 a qualifi$ ,,*ip look-alike program & *ildr5 enroll$ 9 a ,/ate *ild heal? plan "u ?is title 7or a waiv] ( su* plan7 z memb]s ( a s+le risk pool4 7#b7 ,qualifi$ ,,*ip look-alike program ,9 ?is subsection1 ! t]m qualifi$ ,,*ip look-alike program means a ,/ate program-- 7,a7 "u :i* *ildr5 :o are "u ! age ( #ah & are n eligible to receive m$ical assi/ance "u title ,,xix or *ild heal? assi/ance "u ?is title may pur*ase cov]age ?r\gh ! ,/ate t provides b5efits t are at lea/ id5tical to ! b5efits provid$ "u ! ,/ate *ild heal? plan "u ?is title 7or a waiv] ( su* plan72 & 7,b7 t is fund$ exclusively ?r\gh non-,f$]al funds1 includ+ funds receiv$ by ! ,/ate 9 ! =m ( premiums = ! pur*ase ( su* cov]age4 4 7#b7 ,cov]age rule 7,a7 ,9 g5]al ,section #ejjj;,a7f77#a7 ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ 9 subp>agraph 7,a77iii71 by ins]t+ or "u a qualifi$ ,,*ip look-alike program 7z def9$ 9 section #bajg7;g7 ( ! ,social ,security ,act7 be=e ! comma at ! end4 7,b7 ,effective date ,! am5dm5t made by subp>agraph 7,a7 %all apply ) respect to taxable ye>s beg9n+ aft] ,decemb] #ca1 #bjag4 #ajb4 ,ext5sion ( c]ta9 programs & demon/ration projects 7a7 ,*ildhood obesity demon/ration project ,section #aaci;,a7e77#h7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#i;a7e77#h77 is am5d$-- 7#a7 by /rik+ & #aj1jjj1jjj & ins]t+ 1 #aj1jjj1jjj2 & 7#b7 by ins]t+ aft] #bjag ! foll[+3 1 & #be1jjj1jjj = ! p]iod ( fiscal ye>s #bjah ?r\gh #bjbb4 7b7 ,p$iatric quality measures program ,section #aaci;,a7i7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#i;a7i77 is am5d$-- 7#a7 by /rik+ ,out ( any & ins]t+ ! foll[+3 7#a7 ,9 g5]al ,out ( any 2 7#b7 by /rik+ !re is appropriat$ = ea* & ins]t+ 8!re is appropriat$-- 7,a7 = ea* 2 7#c7 by /rik+ 1 & !re is appropriat$ = ! p]iod & ins]t+ 82 7,b7 = ! p]iod 2 7#d7 by /rik+ 4 ,funds appropriat$ "u ?is subsection %all rema9 available until exp5d$ & ins]t+ 2 &2 & 7#e7 by add+ at ! end ! foll[+3 7,c7 = ! p]iod ( fiscal ye>s #bjah ?r\gh #bjbb1 #ge1jjj1jjj = ! purpose ( c>ry+ out ?is section 7o!r ?an subsections 7e71 7f71 & 7g774 7#b7 ,availability ,funds appropriat$ "u ?is subsection %all rema9 available until exp5d$4 4 #ajc4 ,ext5sion ( outrea* & enrollm5t program ,section #baac ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acigmm7 is am5d$-- 7#a7 9 subsection 7a77#a71 by /rik+ #bjag & ins]t+ #bjbb2 & 7#b7 9 subsection 7g7-- 7,a7 by /rik+ & #dj1jjj1jjj & ins]t+ 1 #dj1jjj1jjj2 & 7,b7 by ins]t+ aft] #bjag ! foll[+3 1 & #ajj1jjj1jjj = ! p]iod ( fiscal ye>s #bjah ?r\gh #bjbb4 #ajd4 ,ext5sion & r$uction ( additional ,f$]al f9ancial p>ticipation = ,,*ip ,section #baje7;b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;ee7b77 is am5d$ 9 ! second s5t5ce by ins]t+ & dur+ ! p]iod t beg9s on ,octob] #a1 #bjai1 & ends on ,septemb] #cj1 #bjbj1 ! enhanc$ ,,fmap det]m9$ = a ,/ate = a fiscal ye> 7or = any portion ( a fiscal ye> occurr+ dur+ su* p]iod7 %all be increas$ by #aa4e p]c5tage po9ts aft] #bc p]c5tage po9ts14 #aje4 ,modify+ r$uction 9 ,m$icaid ,,d% allotm5ts ,section #aibc7;f77#g77;,a77ii7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acifr-#d7;f77#g77;,a77ii77 is am5d$-- 7#a7 by /rik+ subclause 7,i7 & r$esignat+ subclauses 7,,ii7 ?r\gh 7,,viii7 z subclauses 7,i7 ?r\gh 7,,vii71 respectively2 7#b7 9 subclause 7,,vi71 z r$esignat$ by p>agraph 7#a71 by /rik+ at ! end &2 7#c7 9 subclause 7,,vii71 z r$esignat$ by p>agraph 7#a71 by /rik+ at ! end ! p]iod & ins]t+ a semicolon2 & 7#d7 by add+ at ! end ! foll[+ new subclauses3 7,,viii7 #h1jjj1jjj1jjj = fiscal ye> #bjbf2 & 7,,ix7 #h1jjj1jjj1jjj = fiscal ye> #bjbg4 4 #ajf4 ,pu]to ,rico ,m$icaid paym5ts 7a7 ,increas$ cap ,section #aajh7;g7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acjh7;g77 is am5d$-- 7#a7 9 p>agraph 7#b77;,a71 by ins]t+ 7or1 ) respect to fiscal ye>s #bjah & #bjai1 increas$ by su* p]c5tage increase plus "o p]c5tage po9t7 aft] beg9n+ ( ! fiscal ye>2 & 7#b7 9 p>agraph 7#e7-- 7,a7 9 subp>agraph 7,a71 by /rik+ subp>agraph 7,b7 & ins]t+ subp>agraphs 7,b71 7,c71 7,d71 & 7,e72 & 7,b7 by add+ at ! end ! foll[+ new subp>agraphs3 7,c7 ,! am\nt ( ! increase o!rwise provid$ "u subp>agraph 7,a7 = ,pu]to ,rico %all be fur!r increas$ by #hhj1jjj1jjj4 7,d7 7i7 ,= ! p]iod beg9n+ ,octob] #a1 #bjag1 & end+ ,decemb] #ca1 #bjai1 ! am\nt ( ! increase o!rwise provid$ "u subp>agraph 7,a7 = ,pu]to ,rico %all be fur!r increas$ by #abj1jjj1jjj if ! ,f9ancial ,ov]sight & ,managem5t ,bo>d = ,pu]to ,rico e/abli%$ "u section #aja ( ! ,pu]to ,rico ,ov]sight1 ,managem5t1 & ,economic ,/ability ,act 7#dh ,u4,s4,c4 #baba7 c]tifies by a majority vote t ,pu]to ,rico has tak5 reasonable & appropriate /eps dur+ su* p]iod to-- 7,i7 r$uce fraud1 wa/e1 & abuse "u ! program "u title ,,xix2 7,,ii7 implem5t /rategies to r$uce unnecess>y1 ineffici5t1 or excessive sp5d+ "u title ,,xix2 7,,iii7 improve ! use & availability ( ,m$icaid data = program op]ation & ov]sight2 & 7,,iv7 improve ! quality ( c>e & pati5t exp]i5ce = individuals enroll$ "u ! program "u title ,,xix4 7ii7 ,z a condition ( any additional increase pursuant to clause 7i71 n lat] ?an ,octob] #a1 #bjah1 ,pu]to ,rico %all submit to ! ,f9ancial ,ov]sight & ,managem5t ,bo>d = ,pu]to ,rico a report reg>d+ /eps tak5 to a*ieve ea* ( ! goals describ$ 9 subclauses 7,i7 ?r\gh 7,,iv7 ( clause 7i74 7,e7 ,paym5ts "u section #aijc7;a77#h7 = a qu>t] ( a fiscal ye> %all n be tak5 into acc\nt 9 apply+ subsection 7f7 7z increas$ 9 accordance ) ?is p>agraph & p>agraphs 7#a71 7#b71 7#c71 & 7#d77 to ,pu]to ,rico = su* fiscal ye>4 4 7b7 ,f$]al mat* = m$ical p]sonnel & fraud r$uction ,section #aijc7;a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7a77 is am5d$-- 7#a7 9 p>agraph 7#b77;,a71 by ins]t+ subject to p>agraph 7#h71 be=e an am\nt2 7#b7 9 p>agraph 7#f7-- 7,a7 9 subp>agraph 7,b71 by ins]t+ subject to p>agraph 7#h71 be=e #ge p] c5tum2 & 7,b7 by /rik+ at ! end plus2 7#c7 9 p>agraph 7#g71 by /rik+ at ! end ! p]iod & ins]t+ 2 plus2 & 7#d7 by add+ at ! end ! foll[+ new p>agraph3 7#h7 = qu>t]s dur+ ! p]iod beg9n+ ,janu>y #a1 #bjah1 & end+ ,decemb] #ca1 #bjai1 p>agraphs 7#b77;,a7 & 7#f7 %all apply ) respect to ,pu]to ,rico z if-- 7,a7 ! ref]5ce to #ge p] c5tum 9 p>agraph 7#b77;,a7 7 a ref]5ce to #ij p] c5tum2 & 7,b7 ! ref]5ce to #ge p] c5tum 9 p>agraph 7#f77;,b7 7 a ref]5ce to #ij p] c5tum4 4 ,,ii ,(fsets #bja4 ,m$icaid ?ird p>ty liability provisions 7a7 ,m$icaid ?ird p>ty liability 7#a7 ,delay ( ,bip>tisan ,budget ,act ( #bjac ?ird p>ty liability provisions 7,a7 ,9 g5]al ,section #bjb7;c7 ( ! ,bip>tisan ,budget ,act ( #bjac 7,public ,law #aac-fg2 #abg ,/at4 #aagg2 #db ,u4,s4,c4 #acif;a note71 z am5d$ by section #baa ( ! ,protect+ ,access to ,m$ic>e ,act ( #bjad 7,public ,law #aac-ic2 #abh ,/at4 #ajdg2 #db ,u4,s4,c4 #acif;a note7 & section #bbj ( ! ,m$ic>e ,access & ,,*ip ,reau?orization ,act ( #bjae 7,public ,law #aad-aj71 is am5d$ by /rik+ #bjag & ins]t+ #bjai4 7,b7 ,effective date2 treatm5t ,! am5dm5t made by subp>agraph 7,a7 %all take effect on ,septemb] #cj1 #bjag1 & %all apply ) respect to claims g5]at$ or fil$ aft] su* date4 7#b7 ,cl>ification ( def9itions applicable to ?ird p>ty liability 7,a7 ,9 g5]al ,section #aijb ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7 is am5d$ by add+ at ! end ! foll[+ new subsection3 7nn7 ,= purposes ( subsection 7a77#be7 & section #aijc7;d77#b77;,b73 7#a7 ,! t]m responsible ?ird p>ty means a heal? insur]1 an acc\ntable c>e organization1 or any o!r p>ty t is1 by /atute1 contract1 or agreem5t1 legally responsible = paym5t ( a claim = a heal? c>e item or s]vice4 ,su* t]m does n include a p>ty if paym5t by su* p>ty has be5 made or c reasonably be expect$ to be made "u a workm5's comp5sation law or plan ( ! ,unit$ ,/ates or a ,/ate1 or "u an automobile or liability insurance policy or plan 7includ+ a self-insur$ plan71 or "u no fault insurance4 7#b7 ,! t]m heal? insur] means a gr\p heal? plan1 z def9$ 9 section #fjg7a7 ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd1 a self-insur$ plan1 a fully-insur$ plan1 a s]vice b5efit plan1 a m$icaid manag$ c>e plan "u section #aijc7m7 or #aicb1 a ph>macy b5efit manag]1 & any o!r heal? plan det]m9$ appropriate by ! ,secret>y4 4 7,b7 ,con=m+ am5dm5ts ,section #aijb7;a77#be7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#be77 is am5d$-- 7i7 9 subp>agraph 7,a71 9 ! matt] prec$+ clause 7i71 by /rik+ ?ird p>ties & all t foll[s ?r\gh item or s]vice7 & ins]t+ responsible ?ird p>ties2 7ii7 9 subp>agraph 7,g71 by /rik+ heal? insur] & all t foll[s ?r\gh item or s]vice7 & ins]t+ responsible ?ird p>ty2 7iii7 9 subp>agraph 7,i71 9 ! matt] prec$+ clause 7i71 by /rik+ heal? insur]s & all t foll[s ?r\gh item or s]vice & ins]t+ responsible ?ird p>ties2 & 7iv7 by ins]t+ responsible be=e ?ird ea* place x appe>s 9 subp>agraphs 7,a77i71 7,a77ii71 7,c71 7,d71 & 7,h74 7#c7 ,removal ( special treatm5t ( c]ta9 types ( c>e & paym5ts "u ,m$icaid ?ird p>ty liability rules ,section #aijb7;a77#be7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#be771 z am5d$ by section #bjb7;c7 ( ! ,bip>tisan ,budget ,act ( #bjac 7aft] application ( p>agraph 7#a771 is am5d$ by /rik+ subp>agraphs 7,e7 & 7,f74 7#d7 ,cl>ification ( role ( heal? insur]s ) respect to ?ird p>ty liability 7,a7 ,9 g5]al ,section #aijb7;a77#be7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#be771 z am5d$ by p>agraph 7#c71 is fur!r am5d$ by ins]t+ aft] subp>agraph 7,d7 ! foll[+ new subp>agraphs3 7,e7 t1 9 ! case ( a ,/ate t provides m$ical assi/ance "u ?is title ?r\gh a contract ) a heal? insur]1 su* contract %all specify :e!r ! ,/ate is-- 7i7 delegat+ to su* insur] all or "s ( its "r ( recov]y f a responsible ?ird p>ty = an item or s]vice = :i* paym5t has be5 made "u ! ,/ate plan 7or "u a waiv] ( ! plan72 & 7ii7 transf]r+ to su* insur] all or "s ( ! assignm5t to ! ,/ate ( any "r ( an individual or o!r entity to paym5t f a responsible ?ird p>ty = an item or s]vice = :i* paym5t has be5 made "u ! ,/ate plan 7or "u a waiv] ( ! plan72 7,f7 t1 9 ! case ( a ,/ate t elects an option describ$ 9 clause 7i7 or 7ii7 ( subp>agraph 7,e7 ) respect to a heal? insur]1 ! ,/ate %all provide assurances to ! ,secret>y t ! ,/ate laws ref]r$ to 9 subp>agraph 7,i7 conf] to ! heal? insur] ! au?ority ( ! ,/ate ) respect to ! requirem5ts specifi$ 9 clauses 7i7 ?r\gh 7iv7 ( su* subp>agraph2 4 7,b7 ,treatm5t ( collect$ am\nts ,section #aijc7;d77#b77;,b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7d77#b77;,b77 is am5d$ by add+ at ! end ! foll[+3 ,= purposes ( ?is subp>agraph1 reimbursem5ts made by a responsible ?ird p>ty to heal? insur]s pursuant to section #aijb7;a77#be77;,e7 %all be treat$ 9 ! same mann] z reimbursem5ts made to a ,/ate "u ! previ\s s5t5ce44 7#e7 ,increas+ ,/ate flexibility ) respect to ?ird p>ty liability ,section #aijb7;a77#be77;,i7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#be77;,i77 is am5d$-- 7,a7 9 clause 7i71 by /rik+ m$ical assi/ance "u ! ,/ate plan & ins]t+ m$ical assi/ance "u a ,/ate plan 7or "u a waiv] ( ! plan72 7,b7 by /rik+ clause 7ii7 & ins]t+ ! foll[+ new clause3 7ii7 accept-- 7,i7 any ,/ate's "r ( recov]y & ! assignm5t to any ,/ate ( any "r ( an individual or o!r entity to paym5t f ! p>ty = an item or s]vice = :i* paym5t has be5 made "u ! respective ,/ate's plan 7or "u a waiv] ( ! plan72 & 7,,ii7 z a valid au?orization ( ! responsible ?ird p>ty = ! furni%+ ( an item or s]vice to an individual eligible to receive m$ical assi/ance "u ?is title1 an au?orization made on behalf ( su* individual "u ! ,/ate plan 7or "u a waiv] ( su* plan7 = ! furni%+ ( su* item or s]vice to su* individual2 2 7,c7 9 clause 7iii7-- 7i7 by /rik+ respond to & ins]t+ n lat] ?an #fj days aft] receiv+2 & 7ii7 by /rik+ 2 & at ! end & ins]t+ 1 respond to su* inquiry2 &2 & 7,d7 9 clause 7iv71 by ins]t+ a failure to obta9 a prior au?orization1 aft] claim =m14 7#f7 ,/ate inc5tive to pursue ?ird p>ty liability = newly eligibles ,section #aijc7;d77#b77;,b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7d77#b77;,b771 z am5d$ by p>agraph 7#d77;,b71 is fur!r am5d$ by add+ at ! end ! foll[+3 ,9 ! case ( exp5ditures = m$ical assi/ance provid$ dur+ #bjag & subsequ5t ye>s = individuals describ$ 9 subclause 7,,viii7 ( section #aijb7;a77#aj77;,a77i71 9 det]m9+ ! am\nt1 if any1 ( ov]paym5t "u ?is subp>agraph ) respect to su* m$ical assi/ance1 ! ,secret>y %all apply ! ,f$]al m$ical assi/ance p]c5tage = ! ,/ate "u section #aije7;b71 not)/&+ ! application ( section #aije7y744 7b7 ,compliance ) ?ird p>ty insurance report+ ,section #aijc ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7 is am5d$ by ins]t+ aft] subsection 7m7 ! foll[+ new subsection3 7n7 7#a7 ,= any ye> beg9n+ aft] #bjbj 7or a soon] ye> z provid$ 9 p>agraph 7#b771 if a ,/ate fails to comply ) ! requirem5ts ( section #aijb7;a77#be7 ) respect to ea* cal5d> qu>t] 9 su* ye>1 ! ,secret>y may r$uce ! ,f$]al m$ical assi/ance p]c5tage by #j4a p]c5tage po9t = cal5d> qu>t]s 9 ea* subsequ5t ye> 9 :i* ! ,/ate fails to s comply 7& cumulatively = a failure to s comply = a p]iod ( consecutive ye>s74 7#b7 ,! ,secret>y may apply p>agraph 7#a7-- 7,a7 = any ye> beg9n+ aft] #bjah1 if a ,/ate fails to comply ) ! requirem5ts ( section #aijb7;a77#be7 ) respect to paym5t = items & s]vices furni%$ to individuals describ$ 9 subclause 7,,viii7 ( section #aijb7;a77#aj77;,a77i7 or non-expansion individuals2 & 7,b7 = any ye> beg9n+ aft] #bjai1 if a ,/ate fails to comply ) ! requirem5ts ( section #aijb7;a77#be7 ) respect to paym5t = items & s]vices furni%$ to individuals describ$ 9 subdivision 7i71 7iii71 or 7iv7 ( section #aije7;a74 7#c7 ,= purposes ( ?is subsection1 ! t]m non-expansion individual means1 ) respect to a ,/ate = a mon?1 an individual :o is-- 7,a7 eligible = m$ical assi/ance = items or s]vices "u ?is title & enroll$ "u ! ,/ate plan 7or a waiv] ( su* plan7 "u ?is title = ! mon?2 7,b7 n "u #ai ye>s ( age2 7,c7 n #fe ye>s ( age or old]2 & 7,d7 n eligible = m$ical assi/ance "u ?is title on ! basis ( be+ bl9d or disabl$4 4 7c7 ,application to ,,*ip 7#a7 ,9 g5]al ,section #bajg7;e77#a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;gg7e77#a77 is am5d$-- 7,a7 by r$esignat+ subp>agraphs 7,b7 ?r\gh 7,r7 z subp>agraphs 7,c7 ?r\gh 7,s71 respectively2 & 7,b7 by ins]t+ aft] subp>agraph 7,a7 ! foll[+ new subp>agraph3 7,b7 ,section #aijb7;a77#be7 7relat+ to ?ird p>ty liability74 4 7#b7 ,m&atory report+ ,section #aijb7;a77#be77;,i77i7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#be77;,i77i771 z am5d$ by subsection 7a77#e71 is fur!r am5d$-- 7,a7 by /rik+ 7&1 at ,/ate option1 *ild & ins]t+ & *ild2 & 7,b7 by /rik+ title ,,xxi7 & ins]t+ title ,,xxi4 7d7 ,tra9+ on ?ird p>ty liability ,section #aicf ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acifu-#f7 is am5d$-- 7#a7 9 subsection 7b77#d71 by /rik+ & quality ( c>e & ins]t+ 1 quality ( c>e1 & ! liability ( responsible ?ird p>ties 7z def9$ 9 section #aijb7nn772 & 7#b7 by add+ at ! end ! foll[+ new subsection3 7f7 ,?ird p>ty liability tra9+ ,) respect to education or tra9+ activities c>ri$ out pursuant to subsection 7b77#d7 ) respect to ! liability ( responsible ?ird p>ties 7z def9$ 9 section #aijb7nn7 = paym5t = items & s]vices furni%$ "u ,/ate plans 7or "u waiv]s ( su* plans77 "u ?is title1 ! ,secret>y %all-- 7#a7 publi% 7& update on an annual basis7 on ! public ,int]net website ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices a d$icat$ ,int]net page conta9+ be/ practices to be us$ 9 assess+ su* liability2 7#b7 monitor ef=ts to assess su* liability & analyze ! *all5ges pos$ by t assessm5t2 7#c7 di/ribute to ,/ate ag5cies adm9i/]+ ! ,/ate plan "u ?is title in=mation relat$ to su* ef=ts & *all5ges2 & 7#d7 provide guidance to su* ,/ate ag5cies ) respect to ,/ate ov]sight ( ef=ts "u a m$icaid manag$ c>e plan "u section #aijc7m7 or #aicb to assess su* liability4 4 7e7 ,developm5t ( model uni=m fields = ,/ates ,to report ?ird p>ty in=mation ,n lat] ?an ,janu>y #a1 #bjai1 ! ,secret>y ( ,heal? & ,human ,s]vices %all1 9 consultation ) ! ,/ates1 develop & make available to ! ,/ates a model uni=m report+ field t ,/ates may use = purposes ( report+ to ! ,secret>y ?r\gh ! ,trans=m$ ,m$icaid ,/ati/ical ,in=mation ,sy/em 7,t-,,msis7 7or a successor sy/em71 or )9 ,,cms ,=m #fd 7or any successor =m71 in=mation id5tify+ responsible ?ird p>ties 7z def9$ 9 subsection 7nn7 ( section #aijb ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a71 z add$ by subsection 7a77#b77;,a77 & o!r relevant in=mation = asc]ta9+ ! legal responsibility ( su* ?ird p>ties to pay = c>e & s]vices available "u ! ,/ate plan 7or "u a waiv] ( ! plan7 "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq474 7f7 ,effective date 7#a7 ,9 g5]al ,except z provid$ 9 p>agraph 7#b71 ?is section & ! am5dm5ts made by ?is section 7o!r ?an z specifi$ 9 ! prec$+ provisions ( ?is section7 %all take effect on ,octob] #a1 #bjai1 & %all apply to m$ical assi/ance or *ild heal? assi/ance provid$ on or aft] su* date4 7#b7 ,exception if ,/ate legislation requir$ ,9 ! case ( a ,/ate plan = m$ical assi/ance "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq471 or a ,/ate *ild heal? plan = *ild heal? assi/ance "u title ,,xxi ( su* ,act 7#db ,u4,s4,c4 #acig;aa et seq471 t ! ,secret>y ( ,heal? & ,human ,s]vices det]m9es requires ,/ate legislation 7o!r ?an legislation appropriat+ funds7 9 ord] = ! plan to meet ! additional requirem5t impos$ by ! am5dm5ts made "u ?is section1 su* 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 #bjb4 ,treatm5t ( lott]y w9n+s & o!r lump-sum income = purposes ( income eligibility "u ,m$icaid 7a7 ,9 g5]al ,section #aijb ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7 is am5d$-- 7#a7 9 subsection 7a77#ag71 by /rik+ 7e77#ad71 7e77#ad7 & ins]t+ 7e77#ad71 7e77#ae72 & 7#b7 9 subsection 7e7-- 7,a7 9 p>agraph 7#ad7 7relat+ to modifi$ adju/$ gross income71 by add+ at ! end ! foll[+ new subp>agraph3 7,j7 ,treatm5t ( c]ta9 lott]y w9n+s & income receiv$ z a lump sum 7i7 ,9 g5]al ,9 ! case ( an individual :o is ! recipi5t ( qualifi$ lott]y w9n+s 7pursuant to lott]ies occurr+ on or aft] ,janu>y #a1 #bjah7 or qualifi$ lump sum income 7receiv$ on or aft] su* date7 & ^: eligibility = m$ical assi/ance is det]m9$ bas$ on ! application ( modifi$ adju/$ gross income "u subp>agraph 7,a71 a ,/ate %all1 9 det]m9+ su* eligibility1 include su* w9n+s or income 7z applicable7 z income receiv$-- 7,i7 9 ! mon? 9 :i* su* w9n+s or income 7z applicable7 is receiv$ if ! am\nt ( su* w9n+s or income is less ?an #hj1jjj2 7,,ii7 ov] a p]iod ( #b mon?s if ! am\nt ( su* w9n+s or income 7z applicable7 is great] ?an or equal to #hj1jjj b less ?an #ij1jjj2 7,,iii7 ov] a p]iod ( #c mon?s if ! am\nt ( su* w9n+s or income 7z applicable7 is great] ?an or equal to #ij1jjj b less ?an #ajj1jjj2 & 7,,iv7 ov] a p]iod ( #c mon?s plus #a additional mon? = ea* increm5t ( #aj1jjj ( su* w9n+s or income 7z applicable7 receiv$1 n to exce$ a p]iod ( #abj mon?s 7= w9n+s or income ( #a1bfj1jjj or m71 if ! am\nt ( su* w9n+s or income is great] ?an or equal to #ajj1jjj4 7ii7 ,c\nt+ 9 equal in/allm5ts ,= purposes ( subclauses 7,,ii71 7,,iii71 & 7,,iv7 ( clause 7i71 w9n+s or income to :i* su* subclause applies %all be c\nt$ 9 equal mon?ly in/allm5ts ov] ! p]iod ( mon?s specifi$ "u su* subclause4 7iii7 ,h>d%ip exemption ,an individual ^: income1 by application ( clause 7i71 exce$s ! applicable eligibility ?re%old e/abli%$ by ! ,/ate1 %all cont9ue to be eligible = m$ical assi/ance to ! ext5t t ! ,/ate det]m9es1 "u proc$ures e/abli%$ by ! ,/ate 79 accordance ) /&>ds specifi$ by ! ,secret>y71 t ! d5ial ( eligibility ( ! individual w\ld cause an undue m$ical or f9ancial h>d%ip z det]m9$ on ! basis ( crit]ia e/abli%$ by ! ,secret>y4 7iv7 ,notifications & assi/ance requir$ 9 case ( loss ( eligibility ,a ,/ate %all1 ) respect to an individual :o loses eligibility = m$ical assi/ance "u ! ,/ate plan 7or a waiv] ( su* plan7 by reason ( clause 7i7-- 7,i7 be=e ! date on :i* ! individual loses su* eligibility1 in=m ! individual-- 7aa7 ( ! individual's opportunity to enroll 9 a qualifi$ heal? plan (f]$ ?r\gh an ,ex*ange e/abli%$ "u title ,i ( ! ,pati5t ,protection & ,af=dable ,c>e ,act dur+ ! special enrollm5t p]iod specifi$ 9 section #ihja7;f77#c7 ( ! ,int]nal ,rev5ue ,code ( #aihf 7relat+ to loss ( ,m$icaid or ,,*ip cov]age72 & 7bb7 ( ! date on :i* ! individual w\ld no long] be consid]$ ineligible by reason ( clause 7i7 to receive m$ical assi/ance "u ! ,/ate plan or "u any waiv] ( su* plan & be eligible to reapply to receive su* m$ical assi/ance2 & 7,,ii7 provide te*nical assi/ance to ! individual seek+ to enroll 9 su* a qualifi$ heal? plan4 7v7 ,qualifi$ lott]y w9n+s def9$ ,9 ?is subp>agraph1 ! t]m qualifi$ lott]y w9n+s means w9n+s f a sweep/akes1 lott]y1 or pool describ$ 9 p>agraph 7#c7 ( section #ddjb ( ! ,int]nal ,rev5ue ,code ( #aihf or a lott]y op]at$ by a multi/ate or multijurisdictional lott]y association1 includ+ am\nts aw>d$ z a lump sum paym5t4 7vi7 ,qualifi$ lump sum income def9$ ,9 ?is subp>agraph1 ! t]m qualifi$ lump sum income means income t is receiv$ z a lump sum f "o ( ! foll[+ s\rces3 7,i7 ,monet>y w9n+s f gambl+ 7z def9$ by ! ,secret>y & includ+ gambl+ activities describ$ 9 section #aiee7;b77#d7 ( title #ah1 ,unit$ ,/ates ,code74 7,,ii7 ,damages receiv$1 :e!r by suit or agreem5t & :e!r z lump sums or z p]iodic paym5ts 7o!r ?an mon?ly paym5ts71 on acc\nt ( causes ( action o!r ?an causes ( action aris+ f p]sonal physical injuries or physical sickness4 7,,iii7 ,income receiv$ z liquid assets f ! e/ate 7z def9$ 9 section #aiag7;b77#d77 ( a deceas$ individual4 2 & 7,b7 by /rik+ 7#ad7 ,exclusion & ins]t+ 7#ae7 ,exclusion4 7b7 ,rules ( con/ruction 7#a7 ,int]ception ( lott]y w9n+s all[$ ,no?+ 9 ! am5dm5t made by subsection 7a77#b77;,a7 %all be con/ru$ z prev5t+ a ,/ate f int]cept+ ! ,/ate lott]y w9n+s aw>d$ to an individual 9 ! ,/ate to recov] am\nts paid by ! ,/ate "u ! ,/ate ,m$icaid plan "u title ,,xix ( ! ,social ,security ,act = m$ical assi/ance furni%$ to ! individual4 7#b7 ,applicability limit$ to eligibility ( recipi5t ( lott]y w9n+s or lump sum income ,no?+ 9 ! am5dm5t made by subsection 7a77#b77;,a7 %all be con/ru$1 ) respect to a det]m9ation ( h\sehold income = purposes ( a det]m9ation ( eligibility = m$ical assi/ance "u ! ,/ate plan "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 7or a waiv] ( su* plan7 made by apply+ modifi$ adju/$ gross income "u subp>agraph 7,a7 ( section #aijb7;e77#ad7 ( su* ,act 7#db ,u4,s4,c4 #acif;a7e77#ad771 z limit+ ! eligibility = su* m$ical assi/ance ( any individual t is a memb] ( ! h\sehold o!r ?an ! individual :o receiv$ qualifi$ lott]y w9n+s or qualifi$ lump-sum income 7z def9$ 9 subp>agraph 7,j7 ( su* section #aijb7;e77#ad71 z add$ by subsection 7a77#b77;,a7 ( ?is section74 #bjc4 ,adju/m5ts to ,m$ic>e "p ,b & "p ,d premium subsidies = high] income individuals 7a7 ,9 g5]al ,section #ahci7;i77#c77;,c77i77,,ii7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acier7i77#c77;,c77i77,,ii77 is am5d$1 9 ! table1 by /rik+ ! la/ r[ & ins]t+ ! foll[+ new r[s3 ,m ?an #afj1jjj b less ?an #ejj1jjjhj percent,at lea/ #ejj1jjjajj p]c5t4 4 7b7 ,jo9t returns ,section #ahci7;i77#c77;,c77ii7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acier7i77#c77;,c77ii77 is am5d$ by ins]t+ be=e ! p]iod ! foll[+3 except1 ) respect to ! doll> am\nts appli$ 9 ! la/ r[ ( ! table "u subclause 7,,ii7 ( su* clause 7& ! second doll> am\nt specifi$ 9 ! second to la/ r[ ( su* table71 clause 7i7 %all be appli$ by sub/itut+ doll> am\nts :i* are #age p]c5t ( su* doll> am\nts = ! cal5d> ye>4 7c7 ,inflation adju/m5t ,section #ahci7;i7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acier7i77 is am5d$-- 7#a7 9 p>agraph 7#e7-- 7,a7 9 subp>agraph 7,a71 by /rik+ ,9 ! case & ins]t+ ,subject to subp>agraph 7,c71 9 ! case2 7,b7 9 subp>agraph 7,b71 by /rik+ subp>agraph 7,a7 & ins]t+ subp>agraph 7,a7 or 7,c72 & 7,c7 by add+ at ! end ! foll[+ new subp>agraph3 7,c7 ,treatm5t ( adju/m5ts = c]ta9 high] income individuals 7i7 ,9 g5]al ,subp>agraph 7,a7 %all n apply ) respect to ea* doll> am\nt 9 p>agraph 7#c7 ( #ejj1jjj4 7ii7 ,adju/m5t beg9n+ #bjbg ,9 ! case ( any cal5d> ye> beg9n+ aft] #bjbf1 ea* doll> am\nt 9 p>agraph 7#c7 ( #ejj1jjj %all be increas$ by an am\nt equal to-- 7,i7 su* doll> am\nt1 multipli$ by 7,,ii7 ! p]c5tage 7if any7 by :i* ! av]age ( ! ,consum] ,price ,index = all urban consum]s 7,unit$ ,/ates city av]age7 = ! #ab-mon? p]iod end+ ) ,augu/ ( ! prec$+ cal5d> ye> exce$s su* av]age = ! #ab-mon? p]iod end+ ) ,augu/ #bjbe4 2 & 7#b7 9 p>agraph 7#f77;,b71 by ins]t+ 7o!r ?an #ejj1jjj7 aft] ! doll> am\nts4