,,ii #aaf? ,,congress #a/ ,session ,h4 ,r4 #cbec ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,june #ai1 #bjai,receiv$ ,,an ,,act ,to provide = c]ta9 ext5sions ) respect to ! ,m$icaid program "u title ,,xix ( ! ,social ,security ,act1 & = o!r purposes4 #a4 ,%ort title2 ,table ( cont5ts 7a7 ,%ort title ,?is ,act may be cit$ z ! ,emp[]+ ,b5efici>ies1 ,ensur+ ,access1 & ,/r5g!n+ ,acc\ntability ,act ( #bjai4 7b7 ,table ( cont5ts ,! table ( cont5ts = ?is ,act is z foll[s3 ,sec4 #a4 ,%ort title2 ,table ( cont5ts4 ,sec4 #b4 ,ext5sion ( ,money ,foll[s ! ,p]son ,rebalanc+ ,demon/ration4 ,sec4 #c4 ,cl>ify+ au?ority ( ,/ate ,m$icaid fraud & abuse control units to inve/igate & prosecute cases ( ,m$icaid pati5t abuse & neglect 9 any sett+4 ,sec4 #d4 ,ext5sion ( protection = ,m$icaid recipi5ts ( home & community-bas$ s]vices aga9/ sp\sal impov]i%m5t4 ,sec4 #e4 ,ext5sion ( ! ,community ,m5tal ,heal? ,s]vices ,demon/ration ,program4 ,sec4 #f4 ,prev5t+ inappropriately l[ rebates "u ,m$icaid drug rebate program4 ,sec4 #g4 ,m$icaid ,improvem5t ,fund4 ,sec4 #h4 ,det]m9ation ( budget>y effects4 #b4 ,ext5sion ( ,money ,foll[s ! ,p]son ,rebalanc+ ,demon/ration 7a7 ,9 g5]al 7#a7 ,fund+ ,section #fjga7;h7 ( ! ,deficit ,r$uction ,act ( #bjje 7#db ,u4,s4,c4 #acif;a note7 is am5d$-- 7,a7 9 p>agraph 7#a7-- 7i7 9 subp>agraph 7,e71 by /rik+ & at ! end2 7ii7 9 subp>agraph 7,f7-- 7,i7 by /rik+ subject to p>agraph 7#c71 #acb1jjj1jjj & ins]t+ #acb1jjj1jjj2 & 7,,ii7 by /rik+ ! p]iod at ! end & ins]t+ a semicolon2 & 7iii7 by add+ at ! end ! foll[+ new subp>agraphs3 7,g7 #dag1jjj1jjj = fiscal ye> #bjbj2 7,h7 #dej1jjj1jjj = ea* ( fiscal ye>s #bjba ?r\gh #bjbc2 & 7,i7 #bbe1jjj1jjj = fiscal ye> #bjbd4 2 7,b7 9 p>agraph 7#b7-- 7i7 by /rik+ ,subject to p>agraph 7#c71 am\nts & ins]t+ ,am\nts2 & 7ii7 by /rik+ #bjba & ins]t+ #bjbd2 & 7,c7 by /rik+ p>agraph 7#c74 7#b7 ,rese>* & evaluation ,section #fjga7;g7 ( ! ,deficit ,r$uction ,act ( #bjje 7#db ,u4,s4,c4 #acif;a note7 is am5d$-- 7,a7 9 p>agraph 7#b71 by /rik+ #bjaf & ins]t+ #bjbd2 & 7,b7 9 p>agraph 7#c71 by ins]t+ & = ea* ( fiscal ye>s #bjai ?r\gh #bjbd1 aft] #bjaf14 7b7 ,*anges to in/itutional resid5cy p]iod requirem5t 7#a7 ,9 g5]al ,section #fjga7;b77#b7 ( ! ,deficit ,r$uction ,act ( #bjje 7#db ,u4,s4,c4 #acif;a note7 is am5d$-- 7,a7 9 subp>agraph 7,a77i71 by /rik+ #ij & ins]t+ #fj2 & 7,b7 by /rik+ ! flu% s5t5ce aft] subp>agraph 7,b74 7#b7 ,effective date ,! am5dm5ts made by p>agraph 7#a7 %all take effect on ! date t is #cj days aft] ! date ( ! enactm5t ( ?is ,act4 7c7 ,updates to ,/ate application requirem5ts ,section #fjga7;c7 ( ! ,deficit ,r$uction ,act ( #bjje 7#db ,u4,s4,c4 #acif;a note7 is am5d$-- 7#a7 9 p>agraph 7#c71 by /rik+ 1 :i* %all include & all t foll[s ?r\gh #bjjg2 7#b7 9 p>agraph 7#g7-- 7,a7 9 ! p>agraph head+1 by /rik+ ,rebalanc+ & ins]t+ ,exp5ditures2 7,b7 9 subp>agraph 7,a71 by add+ & at ! end2 & 7,c7 9 subp>agraph 7,b7-- 7i7 9 clause 7i71 by /rik+ & at ! end2 7ii7 9 clause 7ii71 by /rik+ ! p]iod at ! end & ins]t+ a semicolon2 & 7iii7 by add+ at ! end ! foll[+3 7iii7 include a "w plan t describes = ea* ,f$]al fiscal ye> t occurs dur+ ! propos$ ,,mfp demon/ration project-- 7,i7 ! use ( grant funds = ea* propos$ initiative t is design$ to accompli% ! objective describ$ 9 subsection 7a77#a71 includ+ a fund+ s\rce = ea* activity t is "p ( ea* su* propos$ initiative2 7,,ii7 an evaluation plan t id5tifies expect$ results = ea* su* propos$ initiative2 & 7,,iii7 a su/a9ability plan = compon5ts ( su* propos$ initiatives t are int5d$ to improve transitions1 :i* %all be updat$ ) actual exp5diture in=mation = ea* ,f$]al fiscal ye> t occurs dur+ ! ,,mfp demon/ration project2 & 7iv7 conta9 assurances t grant funds us$ to accompli% ! objective describ$ 9 subsection 7a77#a7 %all be obligat$ n lat] ?an #bd mon?s aft] ! date on :i* ! funds are aw>d$ & %all be exp5d$ n lat] ?an #fj mon?s aft] ! date on :i* ! funds are aw>d$ 7unless ! ,secret>y approves a waiv] ( ei!r su* requirem5t74 2 & 7#c7 9 p>agraph 7#ac7-- 7,a7 9 subp>agraph 7,a71 by /rik+ 2 & & ins]t+ 1 & 9 su* mann] z w meet ! report+ requirem5ts set =? = ! ,trans=m$ ,m$icaid ,/ati/ical ,managem5t ,in=mation ,sy/em 7,t-,,msis722 7,b7 by r$esignat+ subp>agraph 7,b7 z subp>agraph 7,d72 & 7,c7 by ins]t+ aft] subp>agraph 7,a7 ! foll[+3 7,b7 ! ,/ate %all report on a qu>t]ly basis on ! use ( grant funds by di/9ct activity1 z describ$ 9 ! approv$ "w plan1 & by specific population z t>get$ by ! ,/ate2 7,c7 if ! ,/ate fails to report ! in=mation requir$ "u subp>agraph 7,b71 fails to report su* in=mation on a qu>t]ly basis1 or fails to make progress "u ! approv$ "w plan1 ! ,/ate %all implem5t a corrective action plan & any lack ( progress "u ! approv$ "w plan may result 9 )hold+ ( grant funds made available to ! ,/ate2 & 4 7d7 ,fund+ = quality assurance & improvem5t2 ,te*nical assi/ance2 ,ov]sight ,section #fjga7;f7 ( ! ,deficit ,r$uction ,act ( #bjje 7#db ,u4,s4,c4 #acif;a note7 is am5d$ by /rik+ p>agraph 7#b7 & ins]t+ ! foll[+3 7#b7 ,fund+ ,f ! am\nts appropriat$ "u subsection 7h77#a7 = ea* ( fiscal ye>s #bjai ?r\gh #bjbd1 #a1jjj1jjj %all be available to ! ,secret>y = ea* su* fiscal ye> to c>ry out ?is subsection4 4 7e7 ,be/ practices evaluation ,section #fjga ( ! ,deficit ,r$uction ,act ( #bjje 7#db ,u4,s4,c4 #acif;a note7 is am5d$ by add+ at ! end ! foll[+3 7i7 ,be/ practices 7#a7 ,report ,! ,secret>y1 directly or ?r\gh grant or contract1 %all submit a report to ! ,presid5t & ,congress n lat] ?an ,septemb] #cj1 #bjbj1 t conta9s f9d+s & conclusions on be/ practices f ! ,/ate ,,mfp demon/ration projects c>ri$ out ) grants made "u ?is section4 ,! report %all include in=mation & analyses ) respect to ! foll[+3 7,a7 ,! mo/ effective ,/ate /rategies = transition+ b5efici>ies f in/itutional to qualifi$ community sett+s c>ri$ out "u ! ,/ate ,,mfp demon/ration projects & h[ su* /rategies may v>y = diff]5t types ( b5efici>ies1 su* z b5efici>ies :o are ag$1 physically disabl$1 intellectually or developm5tally disabl$1 or individuals ) s]i\s m5tal illnesses1 & o!r t>get$ waiv] b5efici>y populations4 7,b7 ,! mo/ common & ! mo/ effective ,/ate uses ( grant funds c>ri$ out "u ! ,/ate ,,mfp demon/ration projects = transition+ b5efici>ies f in/itutional to qualifi$ community sett+s & improv+ heal? outcomes1 includ+ diff]5tiat+ fund+ = curr5t initiatives t are design$ = su* purpose & fund+ = propos$ initiatives t are design$ = su* purpose4 7,c7 ,! mo/ effective ,/ate approa*es c>ri$ out "u ,/ate ,,mfp demon/ration projects = improv+ p]son-c5t]$ c>e & plann+4 7,d7 ,id5tification ( program1 f9anc+1 & o!r flexibilities available "u ! ,/ate ,,mfp demon/ration projects1 t are n available "u ! traditional ,m$icaid program1 & :i* directly contribut$ to successful transitions & improv$ heal? outcomes "u ! ,/ate ,,mfp demon/ration projects4 7,e7 ,/ate /rategies & f9anc+ me*anisms = effective coord9ation ( h\s+ f9anc$ or support$ "u ,/ate ,,mfp demon/ration projects ) local h\s+ au?orities & o!r res\rces4 7,f7 ,effective ,/ate approa*es = deliv]+ ,money ,foll[s ! ,p]son transition s]vices ?r\gh manag$ c>e entities4 7,g7 ,o!r be/ practices & effective transition /rategies demon/rat$ by ,/ates ) approv$ ,,mfp demon/ration projects1 z det]m9$ by ! ,secret>y4 7,h7 ,id5tification & analyses ( opportunities & *all5ges to integrat+ effective ,money ,foll[s ! ,p]son practices & ,/ate /rategies into ! traditional ,m$icaid program4 7#b7 ,collaboration ,9 prep>+ ! report requir$ "u ?is subsection1 ! ,secret>y %all collect & incorporate in=mation f ,/ates ) approv$ ,,mfp demon/ration projects & b5efici>ies p>ticipat+ 9 su* projects1 & provid]s p>ticipat+ 9 su* projects4 7#c7 ,fund+ ,f ! am\nts appropriat$ "u subsection 7h77#a7 = ea* ( fiscal ye>s #bjbj & #bjba1 n m ?an #cjj1jjj %all be available to ! ,secret>y = ea* su* fiscal ye> to c>ry out ?is subsection4 4 7f7 ,,macpac report on qualifi$ sett+s crit]ia ,section #fjga ( ! ,deficit ,r$uction ,act ( #bjje 7#db ,u4,s4,c4 #acif;a note71 z am5d$ by subsection 7e71 is fur!r am5d$ by add+ at ! end ! foll[+3 7j7 ,,macpac report ,prior to ! f9al implem5tation date e/abli%$ by ! ,secret>y = ! crit]ia e/abli%$ = home & community-bas$ sett+s 9 section #dda4cja7;c77#d7 ( title #db1 ,code ( ,f$]al ,regulations1 z "p ( f9al implem5tation ( ! ,home & ,community ,bas$ ,s]vices 7,,hcbs7 ,f9al ,rule publi%$ on ,janu>y #af1 #bjad 7#gi ,f$4 ,reg4 #bidg7 7ref]r$ to 9 ?is subsection z ! ,,hcbs f9al rule71 ! ,m$icaid & ,,*ip ,paym5t & ,access ,commission 7,,macpac7 %all submit to ,congress a report t-- 7#a7 id5tifies ! types ( home & community-bas$ sett+s & associat$ s]vices t are available to eligible individuals 9 bo? ! ,,mfp demon/ration program & sites 9 compliance ) ! ,,hcbs f9al rule2 & 7#b7 if det]m9$ appropriate by ! ,commission1 recomm5ds policies to align ! crit]ia = a qualifi$ resid5ce "u subsection 7b77#f7 7z 9 effect on ,octob] #a1 #bjag7 ) ! crit]ia 9 ! ,,hcbs f9al rule4 4 7g7 ,application to curr5t projects ,n lat] ?an #a ye> aft] ! date ( ! enactm5t ( ?is ,act1 any ,/ate ) an approv$ ,,mfp demon/ration project "u section #fjga ( ! ,deficit ,r$uction ,act ( #bjje 7#db ,u4,s4,c4 #acif;a note7 on ! date ( ! enactm5t ( ?is ,act %all submit a revis$ application to ! ,secret>y t conta9s ! same in=mation & assurances z are requir$ = any new ,/ate applicant "u ! am5dm5ts made by ?is section4 #c4 ,cl>ify+ au?ority ( ,/ate ,m$icaid fraud & abuse control units to inve/igate & prosecute cases ( ,m$icaid pati5t abuse & neglect 9 any sett+ 7a7 ,9 g5]al ,section #aijc7q77#d77;,a77ii7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7q77#d77;,a77ii77 is am5d$ by ins]t+ aft] pati5ts resid+ 9 bo>d & c>e facilities ! foll[+3 & ( pati5ts 7:o are receiv+ m$ical assi/ance "u ! ,/ate plan "u ?is title7 9 a non9/itutional or o!r sett+4 7b7 ,availability ( fund+ ,section #aijc7;a77#f7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7a77#f77 is am5d$1 9 ! matt] foll[+ subp>agraph 7,b71 by /rik+ 7z f\nd necess>y by ! ,secret>y = ! elim9ation ( fraud 9 ! provision & adm9i/ration ( m$ical assi/ance provid$ "u ! ,/ate plan74 #d4 ,ext5sion ( protection = ,m$icaid recipi5ts ( home & community-bas$ s]vices aga9/ sp\sal impov]i%m5t 7a7 ,9 g5]al ,section #bdjd ( ,public ,law #aaa-adh 7#db ,u4,s4,c4 #acifr-#e note7 is am5d$ by /rik+ ,septemb] #cj1 #bjai & ins]t+ ,m>* #ca1 #bjbd4 7b7 ,rule ( con/ruction ,no?+ 9 section #bdjd ( ,public ,law #aaa-adh 7#db ,u4,s4,c4 #acifr-#e note71 section #aibd ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acifr-#e71 or section #aijb7;a77#ag7 ( su* ,act 7#db ,u4,s4,c4 #acif;a7a77#ag77 %all be con/ru$ z prohibit+ a ,/ate f apply+ an income or res\rce disreg>d au?oriz$ "u section #aijb7r77#b7 ( su* ,act 7#db ,u4,s4,c4 #acif;a7r77#b77-- 7#a7 to ! income or res\rces ( individuals describ$ 9 section #aijb7;a77#aj77;,a77ii77,,vi7 ( su* ,act 7#db ,u4,s4,c4 #acif;a7a77#aj77;,a77ii77,,vi77 7includ+ a disreg>d ( ! income or res\rces ( su* individual's sp\se72 or 7#b7 on ! basis ( an individual's ne$ = home & community-bas$ s]vices au?oriz$ "u subsection 7c71 7d71 7i71 or 7k7 ( section #aiae ( su* ,act 7#db ,u4,s4,c4 #acifn7 or "u section #aaae ( su* ,act 7#db ,u4,s4,c4 #acae74 #e4 ,ext5sion ( ! ,community ,m5tal ,heal? ,s]vices ,demon/ration ,program ,section #bbc7;d7 ( ! ,protect+ ,access to ,m$ic>e ,act ( #bjad 7#db ,u4,s4,c4 #acif;a note7 is am5d$-- 7#a7 9 p>agraph 7#c71 by /rik+ ,june #cj1 #bjai & ins]t+ ,decemb] #ca1 #bjba2 & 7#b7 9 p>agraph 7#g77;,b71 by /rik+ ,decemb] #ca1 #bjba & ins]t+ ,june #cj1 #bjba4 #f4 ,prev5t+ inappropriately l[ rebates "u ,m$icaid drug rebate program 7a7 ,prohibit+ manufactur]s f bl5d+ av]age manufactur] price ( br& drug & any au?oriz$ g5]ic ( su* drug ,section #aibg7k77#a77;,c7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acifr-#h7k77#a77;,c77 is am5d$-- 7#a7 9 ! subp>agraph head+1 by /rik+ ,inclusion & ins]t+ ,exclusion2 7#b7 by /rik+ a new drug application & ins]t+ ! manufactur]'s new drug application2 & 7#c7 by /rik+ inclusive & ins]t+ exclusive4 7b7 ,elim9at+ manufactur]s f def9ition ( :olesal] ,section #aibg7k77#aa7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acifr-#h7k77#aa77 is am5d$-- 7#a7 by /rik+ manufactur]s12 & 7#b7 by /rik+ manufactur]'s &4 7c7 ,effective date ,! am5dm5ts made by ?is section %all apply ) respect to cov]$ outpati5t drugs disp5s$ on or aft] ,janu>y #a1 #bjbj4 #g4 ,m$icaid ,improvem5t ,fund ,section #aida7;b77#a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acifw-#a7;b77#a77 is am5d$ by /rik+ #f1jjj1jjj & ins]t+ #de1ejj1jjj4 #h4 ,det]m9ation ( budget>y effects ,! budget>y effects ( ?is ,act1 = ! purpose ( comply+ ) ! ,/atutory ,pay-,z-,y-,g ,act ( #bjaj1 %all be det]m9$ by ref]5ce to ! late/ /atem5t titl$ ,budget>y ,effects ( ,,paygo ,legislation = ?is ,act1 submitt$ = pr9t+ 9 ! ,congressional ,record by ! ,*airman ( ! ,h\se ,budget ,committee1 provid$ t su* /atem5t has be5 submitt$ prior to ! vote on passage4 ,pass$ ! ,h\se ( ,repres5tatives ,june #ah1 #bjai4;,*]yl ,l4 ,johnson1,cl]k