,i  #aae? ,,congress  #a/ ,session  ,h4 
,r4 #cicb  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,octob] #c1 #bjag,mr4 
,lance 7= himself & ,miss ,gonzlez-,coln
 ( ,pu]to ,rico7 introduc$ ! foll[+     
bill2 :i* 0 ref]r$ to ! ,committee on   
,en]gy & ,comm]ce  ,a ,,bill  ,to am5d  
title ,,xi ( ! ,social ,security ,act to
 provide = increas$ ,pu]to ,rico        
,m$icaid paym5ts1 & = o!r purposes4  #a4
 ,%ort title ,?is ,act may be cit$ z !  
,heal?c>e ,exp5ditures = ,l[-income     
,populations 9 ,pu]to ,rico ,act or !   
,,help ,pu]to ,rico ,act4  #b4 ,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