,i  #aae? ,,congress  #a/ ,session  ,h4 
,r4 #gje  ,,9 ,,! ,,h\se ,,(            
,,repres5tatives  ,janu>y #bg1 #bjag,mr4
 ,flores 7= himself1 ,mr4 ,mull91 ,mr4  
,gu?rie1 & ,mr4 ,coll9s ( ,new ,york7   
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce  ,a  
,,bill  ,to am5d titles ,,xi & ,,xix ( !
 ,social ,security ,act to promote      
program integrity ) respect to !        
enrollm5t ( c]ta9 immigrants 9 ,/ate    
plans "u ,m$icaid1 & = o!r purposes4    
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,v]ify ,eligibility ,cov]age ,act4    
#b4 ,promot+ program integrity 9 enroll+
 c]ta9 immigrants "u ,m$icaid  7a7 ,9   
g5]al ,section #aacg7;f7 ( ! ,social    
,security ,act 7#db ,u4,s4,c4           
#acbj;b-#g7;f77 is am5d$--  7#a7 by     
/rik+ ,subsections 7a77#a7 & 7d7 &      
ins]t+ 7#a7 ,subsections 7a77#a7 & 7d72 
&  7#b7 by add+ at ! end ! foll[+ new   
p>agraph3  7#b7  7,a7 ,subp>agraphs 7,a7
 & 7,b77ii7 ( subsection 7d77#d7 %all n 
apply 9 ! case ( an initial det]m9ation 

made on or aft] ! date t is #f mon?s    
aft] ! date ( ! enactm5t ( ?is p>agraph 
) respect to ! eligibility ( an ali5    
describ$ 9 subp>agraph 7,b7 = b5efits "u
 ! program li/$ 9 subsection 7b77#b74   
7,b7 ,an ali5 describ$ 9 ?is subp>agraph
 is an individual decl>+ to be a citiz5 
or national ( ! ,unit$ ,/ates ) respect 
to :om a ,/ate1 9 accordance ) section  
#aijb7;a77#df77;,b71 requires--  7i7    
pursuant to section #aijb7;ee71 !       
submission ( a social security numb]2 or
  7ii7 pursuant to section #aijc7x71 !  
pres5tation ( satisfactory docum5t>y    
evid5ce ( citiz5%ip or nationality4  4  
7b7 ,no paym5ts = m$ical assi/ance      
provid$ be=e pres5tation ( evid5ce      
,section #aijc7;i77#bb7 ( ! ,social     
,security ,act 7#db ,u4,s4,c4           
#acif;b7i77#bb77 is am5d$-- 7#a7 by     
/rik+ ) respect to am\nts exp5d$ &      
ins]t+ 7,a7 ) respect to am\nts exp5d$2 
7#b7 by ins]t+ & at ! end2 &  7#c7 by   
add+ at ! end ! foll[+ new subp>agraph3 
7,b7 9 ! case ( a ,/ate t elects to     

provide a reasonable p]iod to pres5t    
satisfactory docum5t>y evid5ce ( su*    
citiz5%ip or nationality pursuant to    
p>agraph 7#b77;,c7 ( section #aijb7;ee7 
or p>agraph 7#d7 ( subsection 7x7 ( ?is 
section1 = am\nts exp5d$ = m$ical       
assi/ance = su* an individual 7o!r ?an  
an individual describ$ 9 p>agraph 7#b7 (
 su* subsection 7x77 dur+ su* p]iod2  4 
7c7 ,con=m+ am5dm5ts ,section           
#aacg7;d77#d7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acbj;b-#g7;d77#d77 is  
am5d$-- 7#a7 9 subp>agraph 7,a71 9 !    
matt] prec$+ clause 7i71 by ins]t+      
subject to subsection 7f77#b71 be=e !   
,/ate2 &  7#b7 9 subp>agraph 7,b77ii71  
by ins]t+ subject to subsection 7f77#b71
 be=e p5d+ su* v]ification4  #c4        
,m$icaid ,improvem5t ,fund ,section     
#aida ( ! ,social ,security ,act 7#db   
,u4,s4,c4 #acifw-#a7;b77 is am5d$ to    
read z foll[s3  #aida4 ,m$icaid         
,improvem5t ,fund  7a7 ,9 g5]al ,!      
,secret>y %all e/abli%1 & adm9i/]1 "u   
?is title a ,m$icaid ,improvem5t ,fund  

79 ?is section ref]r$ to z ! ,fund7 :i* 
%all be available to ! ,secret>y = !    
foll[+ purposes3  7#a7 ,to improve !    
managem5t ( ! ,m$icaid program by !     
,c5t]s = ,m$ic>e  ,m$icaid ,s]vices1    
includ+ ov]sight ( contracts &          
contractors & evaluation ( demon/ration 
projects4  7#b7 ,to improve access to   
c>e = ! mo/ vuln]able individuals       
eligible to receive m$ical assi/ance "u 
! ,/ate plan "u ?is title 7or a waiv] ( 
su* plan71 includ+ by c>ry+ out section 
#d ( ! ,v]ify ,eligibility ,cov]age ,act
 7relat+ to r$uc+ wait+ li/s = m$ical   
assi/ance = home & community-bas$       
s]vices "u a ,/ate plan waiv] "u        
subsection 7c71 7d71 or 7i7 ( section   
#aiae or section #aaae74  7b7           
,supplem5t1 n supplant ,paym5ts made =  
activities "u ?is section %all be 9     
addition to paym5ts t w\ld o!rwise be   
made = activities describ$ 9 subsection 
7a74  7c7 ,fund+  7#a7 ,9 g5]al  7,a7   
,managem5t improvem5ts ,!re %all be     
available to ! ,fund1 = ! purposes      

describ$ 9 subsection 7a77#a71 =        
exp5ditures f ! ,fund = fiscal ye> #bjba
 & !reaft]1 #e1jjj1jjj4  7,b7 ,increas+ 
access ,!re %all be available to !      
,fund1 = ! purposes describ$ 9          
subsection 7a77#b71 = exp5ditures f !   
,fund = fiscal ye> #bjah & !reaft]1 4   
7#b7 ,fund+ limitation ,am\nts 9 ! ,fund
 %all be available 9 advance (          
appropriations b only if ! total am\nt  
obligat$ f ! ,fund does n exce$ ! am\nt 
available to ! ,fund "u subp>agraphs    
7,a7 & 7,b7 ( p>agraph 7#a74 ,!         
,secret>y may obligate funds f ! ,fund  
only if ! ,secret>y det]m9es 7& ! ,*ief 
,actu>y ( ! ,c5t]s = ,m$ic>e  ,m$icaid  
,s]vices & ! appropriate budget (fic]   
c]tify7 t !re are available 9 ! ,fund   
suffici5t am\nts to cov] all su*        
obligations incurr$ consi/5t ) ! previ\s
 s5t5ce4  4  #d4 ,provid+ ,c>e = ! mo/  
vuln]able pati5ts on wait+ li/s  7a7 ,9 
g5]al ,subject to subsection 7d71 !     
,secret>y ( ,heal? & ,human ,s]vices    
%all provide1 = ea* ( fiscal ye>s #bjah 

?r\gh #bjbf1 paym5t to eligible ,/ates  
select$ "u subsection 7c7 to provide =  
m$ical assi/ance = home & community-bas$
 s]vices "u a ,/ate plan waiv] "u       
subsection 7c71 7d71 or 7i7 ( section   
#aiae ( ! ,social ,security ,act 7#db   
,u4,s4,c4 #acifn7 or section #aaae ( !  
,social ,security ,act 7#db ,u4,s4,c4   
#acae7 to individuals :o are eligible b1
 z ( ,janu>y #a1 #bjag1 are on a wait+  
li/ = su* s]vices ?r\gh su* waiv]4  7b7 
,/ate eligibility ,a ,/ate is eligible =
 a paym5t "u ?is section if ! ,/ate     
submits an application to ! ,secret>y at
 su* "t1 9 su* =m & mann]1 & conta9+ su*
 in=mation1 provisions1 & assurances1 z 
specifi$ by ! ,secret>y4  7c7 ,selection
 ,subject to subsection 7d71 ! ,secret>y
 %all1 = ea* ( fiscal ye>s #bjah ?r\gh  
#bjbf1 select1 on a competitive basis1 f
 among eligible ,/ates1 ! ,/ates t w    
receive paym5t "u ?is section4 ,9 mak+  
su* selections1 ! ,secret>y %all give   
priority to--  7#a7 ,/ates ) ! highe/   
numb] ( individuals on a wait+ li/      

describ$ 9 subsection 7a72  7#b7 ,/ates 
) ! highe/ av]age or highe/ m$ian p]iods
 individuals h be5 on su* a li/2 &  7#c7
 ,/ates ) individuals on su* a li/ :o h 
! l[e/ income levels1 z comp>$ to !     
income ( individuals on su* a li/ ( o!r 
eligible ,/ates4  7d7 ,fund+  7#a7      
,funds allocat$ to ,/ates ,( ! funds    
available = purposes ( c>ry+ out ?is    
section "u section #aida7;c7 ( ! ,social
 ,security ,act 7#db ,u4,s4,c4          
#acifw-#a7;c771 ! ,secret>y %all        
allocate su* funds to ,/ates select$ "u 
subsection 7c7 on ! basis ( crit]ia1    
includ+ a ,/ate's application submitt$  
"u subsection 7b71 ! availability (     
funds "u su* section #aida7;c71 &       
crit]ia specifi$ "u subsection 7c71 z   
det]m9$ by ! ,secret>y4  7#b7 ,paym5ts  
to ,/ates ,= ea* cal5d> qu>t] beg9n+ on 
or aft] ,octob] #a1 #bjag1 ! ,secret>y  
%all pay to ea* ,/ate select$ "u        
subsection 7c71 f ! allocation made to !
 ,/ate "u p>agraph 7#a71 an am\nt equal 
to #ij p]c5t ( ! ,f$]al m$ical assi/ance

 p]c5tage ( ! am\nt exp5d$ dur+ su*     
qu>t] = ! m$ical assi/ance describ$ 9   
subsection 7a74  7e7 ,def9itions ,9 ?is 
section3 7#a7 ,f$]al m$ical assi/ance   
p]c5tage ,! t]m ,f$]al m$ical assi/ance 
p]c5tage has ! mean+ giv5 su* t]m 9     
section #aije7;b7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #acif;d7b774  7#b7  
,m$ical assi/ance ,! t]m m$ical         
assi/ance has ! mean+ giv5 su* t]m 9    
section #aije7;a7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #acif;d7a774  7#c7  
,/ate ,! t]m ,/ate has ! mean+ giv5 su* 
t]m = purposes ( title ,,xix ( ! ,social
 ,security ,act 7#db ,u4,s4,c4 #acif et 
seq474