,in the ,senate of the ,united ,states1 
,july #be1 #bjai4  ,amendment3  ,that   
the bill from the ,house of             
,representatives 7,h4,r4 #cbec7 entitled
 ,an ,act to provide for certain        
extensions with respect to the ,medicaid
 program under title ,,xix of the       
,social ,security ,act1 and for other   
purposes41 do pass with the following   
,strike all after the enacting clause   
and insert the following3 #a4 ,short    
title ,this ,act may be cited as the    
,sustaining ,excellence in ,medicaid    
,act of #bjai4  #b4 ,extension of the   
,community ,mental ,health ,services    
,demonstration ,program ,section        
#bbc7;d77#c7 of the ,protecting ,access 
to ,medicare ,act of #bjad 7#db         
,u4,s4,c4 #acif;a note71 as amended by  
,public ,law #aaf-bi1 is amended by     
striking ,july #ad1 #bjai and inserting 
,september #ac1 #bjai4  #c4 ,extension  
of protection for ,medicaid recipients  
of home and community-based services    
against spousal impoverishment  7a7 ,in 

general ,section #bdjd of ,public ,law  
#aaa-adh 7#db ,u4,s4,c4 #acifr-#e note7 
is amended by striking ,september #cj1  
#bjai and inserting ,december #ca1      
#bjai4  7b7 ,rule of construction       
,nothing in section #bdjd of ,public    
,law #aaa-adh 7#db ,u4,s4,c4 #acifr-#e  
note7 or section #aijb7;a77#ag7 or #aibd
 of the ,social ,security ,act 7#db     
,u4,s4,c4 #acif;a7a77#ag71 #acifr-#e7   
shall be construed as prohibiting a     
,state from applying an income or       
resource disregard under a methodology  
authorized under section #aijb7r77#b7 of
 such ,act 7#db ,u4,s4,c4               
#acif;a7r77#b77-- 7#a7 to the income or 
resources of an individual described in 
section #aijb7;a77#aj77;,a77ii77,,vi7 of
 such ,act 7#db ,u4,s4,c4               
#acif;a7a77#aj77;,a77ii77,,vi77         
7including a disregard of the income or 
resources of such individual's spouse72 
or  7#b7 on the basis of an individual's
 need for home and community-based      
services authorized under subsection    

7c71 7d71 7i71 or 7k7 of section #aiae  
of such ,act 7#db ,u4,s4,c4 #acifn7 or  
under section #aaae of such ,act 7#db   
,u4,s4,c4 #acae74  #d4 ,extension of    
,money ,follows the ,person ,rebalancing
 ,demonstration ,section                
#fjga7;h77#a77;,f7 of the ,deficit      
,reduction ,act of #bjje 7#db ,u4,s4,c4 
#acif;a note7 is amended by striking    
#acb1jjj1jjj and inserting #bed1ejj1jjj4
  #e4 ,extension for family-to-family   
health information centers ,section     
#eja7;c7 of the ,social ,security ,act  
7#db ,u4,s4,c4 #gja7;c77 is amended--   
7#a7 in paragraph 7#a77;,a77vii71 by    
striking and #bjai and inserting through
 #bjbd2 and  7#b7 in paragraph          
7#c77;,c71 by striking fiscal years     
#bjah and #bjai and inserting fiscal    
year #bjah and each fiscal year         
thereafter4  #f4 ,reduced wholesale     
acquisition cost 7,,wac7-based payments 
for new drugs and biologicals ,section  
#ahdg;,a7c77#d7 of the ,social ,security
 ,act 7#db ,u4,s4,c4 #aciew-#c;a7c77#d77

 is amended by striking payable under   
this section for the drug or biological 
based on-- and all that follows through 
the period at the end and inserting the 
following3 8payable under this section--
  7,a7 in the case of a drug or         
biological furnished prior to ,january  
#a1 #bjai1 based on-- 7i7 the wholesale 
acquisition cost2 or  7ii7 the          
methodologies in effect under this part 
on ,november #a1 #bjjc1 to determine    
payment amounts for drugs or            
biologicals2 and  7,b7 in the case of a 
drug or biological furnished on or after
 ,january #a1 #bjai-- 7i7 at an amount  
not to exceed #ajc percent of the       
wholesale acquisition cost2 or  7ii7    
based on the methodologies in effect    
under this part on ,november #a1 #bjjc1 
to determine payment amounts for drugs  
or biologicals4  4  ,secretary