#aafth ,,congress #ast ,session ,h4 ,r4 #cbec ,,an ,,act ,to provide for certain extensions with respect to the ,medicaid program under title ,,xix of the ,social ,security ,act1 and for other purposes4 #a4 ,short title2 ,table of contents 7a7 ,short title ,this ,act may be cited as the ,empowering ,beneficiaries1 ,ensuring ,access1 and ,strengthening ,accountability ,act of #bjai4 7b7 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title2 ,table of contents4 ,sec4 #b4 ,extension of ,money ,follows the ,person ,rebalancing ,demonstration4 ,sec4 #c4 ,clarifying authority of ,state ,medicaid fraud and abuse control units to investigate and prosecute cases of ,medicaid patient abuse and neglect in any setting4 ,sec4 #d4 ,extension of protection for ,medicaid recipients of home and community-based services against spousal impoverishment4 ,sec4 #e4 ,extension of the ,community ,mental ,health ,services ,demonstration ,program4 ,sec4 #f4 ,preventing inappropriately low rebates under ,medicaid drug rebate program4 ,sec4 #g4 ,medicaid ,improvement ,fund4 ,sec4 #h4 ,determination of budgetary effects4 #b4 ,extension of ,money ,follows the ,person ,rebalancing ,demonstration 7a7 ,in general 7#a7 ,funding ,section #fjga7;h7 of the ,deficit ,reduction ,act of #bjje 7#db ,u4,s4,c4 #acif;a note7 is amended-- 7,a7 in paragraph 7#a7-- 7i7 in subparagraph 7,e71 by striking and at the end2 7ii7 in subparagraph 7,f7-- 7,i7 by striking subject to paragraph 7#c71 #acb1jjj1jjj and inserting #acb1jjj1jjj2 and 7,,ii7 by striking the period at the end and inserting a semicolon2 and 7iii7 by adding at the end the following new subparagraphs3 7,g7 #dag1jjj1jjj for fiscal year #bjbj2 7,h7 #dej1jjj1jjj for each of fiscal years #bjba through #bjbc2 and 7,i7 #bbe1jjj1jjj for fiscal year #bjbd4 2 7,b7 in paragraph 7#b7-- 7i7 by striking ,subject to paragraph 7#c71 amounts and inserting ,amounts2 and 7ii7 by striking #bjba and inserting #bjbd2 and 7,c7 by striking paragraph 7#c74 7#b7 ,research and evaluation ,section #fjga7;g7 of the ,deficit ,reduction ,act of #bjje 7#db ,u4,s4,c4 #acif;a note7 is amended-- 7,a7 in paragraph 7#b71 by striking #bjaf and inserting #bjbd2 and 7,b7 in paragraph 7#c71 by inserting and for each of fiscal years #bjai through #bjbd1 after #bjaf14 7b7 ,changes to institutional residency period requirement 7#a7 ,in general ,section #fjga7;b77#b7 of the ,deficit ,reduction ,act of #bjje 7#db ,u4,s4,c4 #acif;a note7 is amended-- 7,a7 in subparagraph 7,a77i71 by striking #ij and inserting #fj2 and 7,b7 by striking the flush sentence after subparagraph 7,b74 7#b7 ,effective date ,the amendments made by paragraph 7#a7 shall take effect on the date that is #cj days after the date of the enactment of this ,act4 7c7 ,updates to ,state application requirements ,section #fjga7;c7 of the ,deficit ,reduction ,act of #bjje 7#db ,u4,s4,c4 #acif;a note7 is amended-- 7#a7 in paragraph 7#c71 by striking 1 which shall include and all that follows through #bjjg2 7#b7 in paragraph 7#g7-- 7,a7 in the paragraph heading1 by striking ,rebalancing and inserting ,expenditures2 7,b7 in subparagraph 7,a71 by adding and at the end2 and 7,c7 in subparagraph 7,b7-- 7i7 in clause 7i71 by striking and at the end2 7ii7 in clause 7ii71 by striking the period at the end and inserting a semicolon2 and 7iii7 by adding at the end the following3 7iii7 include a work plan that describes for each ,federal fiscal year that occurs during the proposed ,,mfp demonstration project-- 7,i7 the use of grant funds for each proposed initiative that is designed to accomplish the objective described in subsection 7a77#a71 including a funding source for each activity that is part of each such proposed initiative2 7,,ii7 an evaluation plan that identifies expected results for each such proposed initiative2 and 7,,iii7 a sustainability plan for components of such proposed initiatives that are intended to improve transitions1 which shall be updated with actual expenditure information for each ,federal fiscal year that occurs during the ,,mfp demonstration project2 and 7iv7 contain assurances that grant funds used to accomplish the objective described in subsection 7a77#a7 shall be obligated not later than #bd months after the date on which the funds are awarded and shall be expended not later than #fj months after the date on which the funds are awarded 7unless the ,secretary approves a waiver of either such requirement74 2 and 7#c7 in paragraph 7#ac7-- 7,a7 in subparagraph 7,a71 by striking 2 and and inserting 1 and in such manner as will meet the reporting requirements set forth for the ,transformed ,medicaid ,statistical ,management ,information ,system 7,t-,,msis722 7,b7 by redesignating subparagraph 7,b7 as subparagraph 7,d72 and 7,c7 by inserting after subparagraph 7,a7 the following3 7,b7 the ,state shall report on a quarterly basis on the use of grant funds by distinct activity1 as described in the approved work plan1 and by specific population as targeted by the ,state2 7,c7 if the ,state fails to report the information required under subparagraph 7,b71 fails to report such information on a quarterly basis1 or fails to make progress under the approved work plan1 the ,state shall implement a corrective action plan and any lack of progress under the approved work plan may result in withholding of grant funds made available to the ,state2 and 4 7d7 ,funding for quality assurance and improvement2 ,technical assistance2 ,oversight ,section #fjga7;f7 of the ,deficit ,reduction ,act of #bjje 7#db ,u4,s4,c4 #acif;a note7 is amended by striking paragraph 7#b7 and inserting the following3 7#b7 ,funding ,from the amounts appropriated under subsection 7h77#a7 for each of fiscal years #bjai through #bjbd1 #a1jjj1jjj shall be available to the ,secretary for each such fiscal year to carry out this subsection4 4 7e7 ,best practices evaluation ,section #fjga of the ,deficit ,reduction ,act of #bjje 7#db ,u4,s4,c4 #acif;a note7 is amended by adding at the end the following3 7i7 ,best practices 7#a7 ,report ,the ,secretary1 directly or through grant or contract1 shall submit a report to the ,president and ,congress not later than ,september #cj1 #bjbj1 that contains findings and conclusions on best practices from the ,state ,,mfp demonstration projects carried out with grants made under this section4 ,the report shall include information and analyses with respect to the following3 7,a7 ,the most effective ,state strategies for transitioning beneficiaries from institutional to qualified community settings carried out under the ,state ,,mfp demonstration projects and how such strategies may vary for different types of beneficiaries1 such as beneficiaries who are aged1 physically disabled1 intellectually or developmentally disabled1 or individuals with serious mental illnesses1 and other targeted waiver beneficiary populations4 7,b7 ,the most common and the most effective ,state uses of grant funds carried out under the ,state ,,mfp demonstration projects for transitioning beneficiaries from institutional to qualified community settings and improving health outcomes1 including differentiating funding for current initiatives that are designed for such purpose and funding for proposed initiatives that are designed for such purpose4 7,c7 ,the most effective ,state approaches carried out under ,state ,,mfp demonstration projects for improving person-centered care and planning4 7,d7 ,identification of program1 financing1 and other flexibilities available under the ,state ,,mfp demonstration projects1 that are not available under the traditional ,medicaid program1 and which directly contributed to successful transitions and improved health outcomes under the ,state ,,mfp demonstration projects4 7,e7 ,state strategies and financing mechanisms for effective coordination of housing financed or supported under ,state ,,mfp demonstration projects with local housing authorities and other resources4 7,f7 ,effective ,state approaches for delivering ,money ,follows the ,person transition services through managed care entities4 7,g7 ,other best practices and effective transition strategies demonstrated by ,states with approved ,,mfp demonstration projects1 as determined by the ,secretary4 7,h7 ,identification and analyses of opportunities and challenges to integrating effective ,money ,follows the ,person practices and ,state strategies into the traditional ,medicaid program4 7#b7 ,collaboration ,in preparing the report required under this subsection1 the ,secretary shall collect and incorporate information from ,states with approved ,,mfp demonstration projects and beneficiaries participating in such projects1 and providers participating in such projects4 7#c7 ,funding ,from the amounts appropriated under subsection 7h77#a7 for each of fiscal years #bjbj and #bjba1 not more than #cjj1jjj shall be available to the ,secretary for each such fiscal year to carry out this subsection4 4 7f7 ,,macpac report on qualified settings criteria ,section #fjga of the ,deficit ,reduction ,act of #bjje 7#db ,u4,s4,c4 #acif;a note71 as amended by subsection 7e71 is further amended by adding at the end the following3 7j7 ,,macpac report ,prior to the final implementation date established by the ,secretary for the criteria established for home and community-based settings in section #dda4cja7;c77#d7 of title #db1 ,code of ,federal ,regulations1 as part of final implementation of the ,home and ,community ,based ,services 7,,hcbs7 ,final ,rule published on ,january #af1 #bjad 7#gi ,fed4 ,reg4 #bidg7 7referred to in this subsection as the ,,hcbs final rule71 the ,medicaid and ,,chip ,payment and ,access ,commission 7,,macpac7 shall submit to ,congress a report that-- 7#a7 identifies the types of home and community-based settings and associated services that are available to eligible individuals in both the ,,mfp demonstration program and sites in compliance with the ,,hcbs final rule2 and 7#b7 if determined appropriate by the ,commission1 recommends policies to align the criteria for a qualified residence under subsection 7b77#f7 7as in effect on ,october #a1 #bjag7 with the criteria in the ,,hcbs final rule4 4 7g7 ,application to current projects ,not later than #a year after the date of the enactment of this ,act1 any ,state with an approved ,,mfp demonstration project under section #fjga of the ,deficit ,reduction ,act of #bjje 7#db ,u4,s4,c4 #acif;a note7 on the date of the enactment of this ,act shall submit a revised application to the ,secretary that contains the same information and assurances as are required for any new ,state applicant under the amendments made by this section4 #c4 ,clarifying authority of ,state ,medicaid fraud and abuse control units to investigate and prosecute cases of ,medicaid patient abuse and neglect in any setting 7a7 ,in general ,section #aijc7q77#d77;,a77ii7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7q77#d77;,a77ii77 is amended by inserting after patients residing in board and care facilities the following3 and of patients 7who are receiving medical assistance under the ,state plan under this title7 in a noninstitutional or other setting4 7b7 ,availability of funding ,section #aijc7;a77#f7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7a77#f77 is amended1 in the matter following subparagraph 7,b71 by striking 7as found necessary by the ,secretary for the elimination of fraud in the provision and administration of medical assistance provided under the ,state plan74 #d4 ,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 ,march #ca1 #bjbd4 7b7 ,rule of construction ,nothing in section #bdjd of ,public ,law #aaa-adh 7#db ,u4,s4,c4 #acifr-#e note71 section #aibd of the ,social ,security ,act 7#db ,u4,s4,c4 #acifr-#e71 or section #aijb7;a77#ag7 of such ,act 7#db ,u4,s4,c4 #acif;a7a77#ag77 shall be construed as prohibiting a ,state from applying an income or resource disregard authorized under section #aijb7r77#b7 of such ,act 7#db ,u4,s4,c4 #acif;a7r77#b77-- 7#a7 to the income or resources of individuals 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 #e4 ,extension of the ,community ,mental ,health ,services ,demonstration ,program ,section #bbc7;d7 of the ,protecting ,access to ,medicare ,act of #bjad 7#db ,u4,s4,c4 #acif;a note7 is amended-- 7#a7 in paragraph 7#c71 by striking ,june #cj1 #bjai and inserting ,december #ca1 #bjba2 and 7#b7 in paragraph 7#g77;,b71 by striking ,december #ca1 #bjba and inserting ,june #cj1 #bjba4 #f4 ,preventing inappropriately low rebates under ,medicaid drug rebate program 7a7 ,prohibiting manufacturers from blending average manufacturer price of brand drug and any authorized generic of such drug ,section #aibg7k77#a77;,c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifr-#h7k77#a77;,c77 is amended-- 7#a7 in the subparagraph heading1 by striking ,inclusion and inserting ,exclusion2 7#b7 by striking a new drug application and inserting the manufacturer's new drug application2 and 7#c7 by striking inclusive and inserting exclusive4 7b7 ,eliminating manufacturers from definition of wholesaler ,section #aibg7k77#aa7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifr-#h7k77#aa77 is amended-- 7#a7 by striking manufacturers12 and 7#b7 by striking manufacturer's and4 7c7 ,effective date ,the amendments made by this section shall apply with respect to covered outpatient drugs dispensed on or after ,january #a1 #bjbj4 #g4 ,medicaid ,improvement ,fund ,section #aida7;b77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifw-#a7;b77#a77 is amended by striking #f1jjj1jjj and inserting #de1ejj1jjj4 #h4 ,determination of budgetary effects ,the budgetary effects of this ,act1 for the purpose of complying with the ,statutory ,pay-,as-,you-,go ,act of #bjaj1 shall be determined by reference to the latest statement titled ,budgetary ,effects of ,,paygo ,legislation for this ,act1 submitted for printing in the ,congressional ,record by the ,chairman of the ,house ,budget ,committee1 provided that such statement has been submitted prior to the vote on passage4 ,passed the ,house of ,representatives ,june #ah1 #bjai4;,clerk4