,i  #aafth ,,congress  #ast ,session    
,h4 ,r4 #cfca  ,,in ,,the ,,house ,,of  
,,representatives  ,july #i1 #bjai,mr4  
,soto 7for himself1 ,mr4 ,bilirakis1    
,ms4 ,velzquez1 ,miss ,gonzlez-,coln of 
,puerto ,rico1 ,ms4 ,plaskett1 ,mr4     
,sablan1 ,mrs4 ,radewagen1 ,mr4 ,san    
,nicolas1 ,mr4 ,serrano1 and ,mr4       
,fitzpatrick7 introduced the following  
bill2 which was referred to the         
,committee on ,energy and ,commerce  ,a 
,,bill  ,to amend titles ,,xi and ,,xix 
of the ,social ,security ,act to provide
 for a temporary increase to the limit  
on ,medicaid payments for territories of
 the ,united ,states and the ,federal   
medical assistance percentage for such  
territories under the ,medicaid program1
 and for other purposes4  #a4 ,short    
title ,this ,act may be cited as the    
,territories ,health ,care ,improvement 
,act4  #b4 ,medicaid payments for       
,puerto ,rico and the other territories 
for certain fiscal years  7a7 ,treatment
 of cap ,section #aajh7;g7 of the       

,social ,security ,act 7#db ,u4,s4,c4   
#acjh7;g77 is amended--  7#a7 in        
paragraph 7#b7-- 7,a7 in the matter     
preceding subparagraph 7,a71 by striking
 subject to and section #acbc7;a77#b7 of
 the ,patient ,protection and           
,affordable ,care ,act paragraphs 7#c7  
and 7#e7 and inserting subject to       
section #acbc7;a77#b7 of the ,patient   
,protection and ,affordable ,care ,act  
and paragraphs 7#c7 and 7#e72  7,b7 in  
subparagraph 7,a7-- 7i7 by striking     
,puerto ,rico shall not exceed the sum  
of and inserting  ,puerto ,rico shall   
not exceed-- 7i7 except as provided in  
clause 7ii71 the sum of  2  7ii7 by     
striking #ajj1jjj2 and inserting        
#ajj1jjj2 and2 and  7iii7 by adding at  
the end the following new clause3  7ii7 
for each of fiscal years #bjbj through  
#bjbc1 the amount specified in paragraph
 7#f7 for each such fiscal year2  2     
7,c7 in subparagraph 7,b7-- 7i7 by      
striking the ,virgin ,islands shall not 
exceed the sum of and inserting  the    

,virgin ,islands shall not exceed-- 7i7 
except as provided in clause 7ii71 the  
sum of  2  7ii7 by striking #aj1jjj2 and
 inserting #aj1jjj2 and2 and  7iii7 by  
adding at the end the following new     
clause3  7ii7 for each of fiscal years  
#bjbj through #bjbe1 #abf1jjj1jjj2  2   
7,d7 in subparagraph 7,c7-- 7i7 by      
striking ,guam shall not exceed the sum 
of and inserting  ,guam shall not       
exceed-- 7i7 except as provided in      
clause 7ii71 the sum of  2  7ii7 by     
striking #aj1jjj2 and inserting #aj1jjj2
 and2 and  7iii7 by adding at the end   
the following new clause3  7ii7 for each
 of fiscal years #bjbj through #bjbe1   
#abg1jjj1jjj2  2  7,e7 in subparagraph  
7,d7-- 7i7 by striking the ,northern    
,mariana ,islands shall not exceed the  
sum of and inserting  the ,northern     
,mariana ,islands shall not exceed-- 7i7
 except as provided in clause 7ii71 the 
sum of  2 and  7ii7 by adding at the end
 the following new clause3  7ii7 for    
each of fiscal years #bjbj through      

#bjbe1 #fj1jjj1jjj2 and  2 and  7,f7 in 
subparagraph 7,e7--  7i7 by striking    
,american ,samoa shall not exceed the   
sum of and inserting ,american ,samoa   
shall not exceed-- 7i7 except as        
provided in clause 7ii71 the sum of  2  
7ii7 by striking #aj1jjj4 and inserting 
#aj1jjj2 and2 and  7iii7 by adding at   
the end the following new clause3  7ii7 
for each of fiscal years #bjbj through  
#bjbe1 #hd1jjj1jjj4  2 and  7#b7 by     
adding at the end the following new     
paragraph3  7#f7 ,application to ,puerto
 ,rico for fiscal years #bjbj through   
#bjbc ,for purposes of paragraph        
7#b77;,a77ii71 the amount specified in  
this paragraph is--  7,a7 for fiscal    
year #bjbj1 #b1hbc1ahh1jjj2  7,b7 for   
fiscal year #bjba1 #b1iai1jgb1jjj2  7,c7
 for fiscal year #bjbb1 #c1jab1faj1jjj2 
and  7,d7 for fiscal year #bjbc1        
#c1aad1cca1jjj4  4  7b7 ,treatment of   
funding under enhanced allotment program
 ,section #aice7;e7 of the ,social      
,security ,act 7#db ,u4,s4,c4           

#acifu-#e7;e77 is amended-- 7#a7 in     
paragraph 7#a77;,b71 by striking if the 
,state and inserting subject to         
paragraph 7#d71 if the ,state2  7#b7 by 
redesignating paragraph 7#d7 as         
paragraph 7#e72 and  7#c7 by inserting  
after paragraph 7#c7 the following new  
paragraph3  7#d7 ,treatment of funding  
for certain fiscal years  7,a7 ,puerto  
,rico ,notwithstanding paragraph        
7#a77;,b71 in the case that ,puerto     
,rico establishes and submits to the    
,secretary a plan described in paragraph
 7#b7 with respect to any of fiscal     
years #bjbj through #bjbb1 the amount   
specified in paragraph 7#c7 for ,puerto 
,rico for such a year shall be taken    
into account in applying subparagraph   
7,a77ii7 of section #aajh7;g77#b7 for   
such year4  7,b7 ,other territories     
,notwithstanding paragraph 7#a77;,b71 in
 the case that the ,virgin ,islands1    
,guam1 the ,northern ,mariana ,islands1 
or ,american ,samoa establishes and     
submits to the ,secretary a plan        

described in paragraph 7#b7 with respect
 to any of fiscal years #bjbj through   
#bjbe1 the amount specified in paragraph
 7#c7 for the ,virgin ,islands1 ,guam1  
the ,northern ,mariana ,islands1 or     
,american ,samoa1 as the case may be1   
shall be taken into account in applying1
 as applicable1 subparagraph 7,b77ii71  
7,c77ii71 7,d77ii71 or 7,e77ii7 of      
section #aajh7;g77#b7 for such year4  4 
7c7 ,increased ,,fmap ,section #aije of 
the ,social ,security ,act 7#db         
,u4,s4,c4 #acif;d7b77 is amended-- 7#a7 
in subsection 7b71 by striking and 7aa7 
and inserting 7aa71 and 7ff72 and  7#b7 
by adding at the end the following new  
subsection3  7ff7 ,temporary increase in
 ,,fmap for territories for certain     
fiscal years  7#a7 ,puerto ,rico        
,notwithstanding subsection 7b71 the    
,federal medical assistance percentage  
for ,puerto ,rico shall be equal to--   
7,a7 #hc percent for fiscal years #bjbj 
and #bjba2 and  7,b7 #gf percent for    
fiscal years #bjbb and #bjbc4  7#b7     

,virgin ,islands ,notwithstanding       
subsection 7b71 the ,federal medical    
assistance percentage for the ,virgin   
,islands shall be equal to--  7,a7 #ajj 
percent for fiscal year #bjbj2  7,b7 #hc
 percent for fiscal years #bjba through 
#bjbd2 and  7,c7 #gf percent for fiscal 
year #bjbe4  7#c7 ,other territories    
,notwithstanding subsection 7b71 the    
,federal medical assistance percentage  
for ,guam1 the ,northern ,mariana       
,islands1 and ,american ,samoa shall be 
equal to--  7,a7 #ajj percent for fiscal
 years #bjbj and #bjba2  7,b7 #hc       
percent for fiscal years #bjbb through  
#bjbd2 and  7,c7 #gf percent for fiscal 
year #bjbe4  4  7d7 ,annual report      
,section #aajh7;g7 of the ,social       
,security ,act 7#db ,u4,s4,c4           
#acjh7;g771 as amended by subsection    
7a71 is further amended by adding at the
 end the following new paragraph3  7#g7 
,annual report  7,a7 ,in general ,not   
later than the date that is #cj days    
after the end of each fiscal year       

7beginning with fiscal year #bjbj and   
ending with fiscal year #bjbe71 in the  
case that a specified territory receives
 a ,medicaid cap increase1 or an        
increase in the ,federal medical        
assistance percentage for such territory
 under section #aije7;ff71 for such     
fiscal year1 such territory shall submit
 to the ,chair and ,ranking ,member of  
the ,committee on ,energy and ,commerce 
of the ,house of ,representatives and   
the ,chair and ,ranking ,member of the  
,committee on ,finance of the ,senate a 
report that describes how such territory
 has used such ,medicaid cap increase1  
or such increase in the ,federal medical
 assistance percentage1 as applicable1  
to increase access to health care under 
the ,state ,medicaid plan of such       
territory under title ,,xix 7or a waiver
 of such plan74 ,such report may        
include--  7i7 the extent to which such 
territory has1 with respect to such plan
 7or waiver7-- 7,i7 increased payments  
to health care providers2  7,,ii7       

increased covered benefits2  7,,iii7    
expanded health care provider networks2 
or  7,,iv7 improved in any other manner 
the carrying out of such plan 7or       
waiver72 and  7ii7 any other information
 as determined necessary by such        
territory4  7,b7 ,definitions ,in this  
paragraph3 7i7 ,medicaid cap increase   
,the term ,medicaid cap increase means1 
with respect to a specified territory   
and fiscal year1 any increase in the    
amounts otherwise determined under this 
subsection for such territory for such  
fiscal year by reason of the amendments 
made by section #b7;a7 of the           
,territories ,health ,care ,improvement 
,act4  7ii7 ,specified territory ,the   
term specified territory means ,puerto  
,rico1 the ,virgin ,islands1 ,guam1 the 
,northern ,mariana ,islands1 and        
,american ,samoa4  4  #c4 ,application  
of certain requirements under ,medicaid 
program to certain territories  7a7     
,application of payment error rate      
measurement requirements to ,puerto     

,rico ,section #aijc7u77#d7 of the      
,social ,security ,act 7#db ,u4,s4,c4   
#acif;b7u77#d77 is amended--  7#a7 by   
striking to ,puerto ,rico1 ,guam and    
inserting to ,guam2 and  7#b7 by        
striking or ,american ,samoa4 and       
inserting or ,american ,samoa1 or1 for  
fiscal years before fiscal year #bjbc1  
to ,puerto ,rico44  7b7 ,application of 
asset verification program requirements 
to ,puerto ,rico and ,virgin ,islands   
,section #aidj7;a7 of the ,social       
,security ,act 7#db ,u4,s4,c4 #acifw7a77
 is amended-- 7#a7 in paragraph         
7#c77;,a71 by adding at the end the     
following new clause3  7iii7            
,implementation in ,puerto ,rico and    
,virgin ,islands ,the ,secretary shall  
require ,puerto ,rico to implement an   
asset verification program under this   
subsection by the end of fiscal year    
#bjbb and the ,virgin ,islands to       
implement such a program by the end of  
fiscal year #bjbc4  2 and  7#b7 in      
paragraph 7#d7-- 7,a7 in the paragraph  

heading1 by striking ,exemption of      
territories and inserting ,exemption of 
certain territories2 and  7,b7 by       
striking and the ,district of ,columbia 
and inserting 1 the ,district of        
,columbia1 ,puerto ,rico1 and the       
,virgin ,islands4  7c7 ,application of  
certain data reporting and program      
integrity requirements to ,northern     
,mariana ,islands1 ,american ,samoa1 and
 ,guam  7#a7 ,in general ,section #aijb 
of the ,social ,security ,act 7#db      
,u4,s4,c4 #acif;a7 is amended by adding 
at the end the following new subsection3
  7qq7 ,application of certain data     
reporting and program integrity         
requirements to ,northern ,mariana      
,islands1 ,american ,samoa1 and ,guam   
,not later than ,october #a1 #bjbc1 the 
,northern ,mariana ,islands1 ,american  
,samoa1 and ,guam shall-- 7#a7 implement
 methods1 satisfactory to the           
,secretary1 for the collection and      
reporting of reliable data to the       
,transformed ,medicaid ,statistical     

,information ,system 7,t-,,msis7 7or a  
successor system72 and  7#b7 demonstrate
 progress in establishing a ,state      
medicaid fraud control unit described in
 section #aijc7q74  4  7#b7 ,conforming 
amendment ,section #aijb7;j7 of the     
,social ,security ,act 7#db ,u4,s4,c4   
#acif;a7j77 is amended-- 7,a7 by        
striking or the requirement and         
inserting 1 the requirement2 and  7,b7  
by inserting before the period at the   
end the following3 1 or the requirements
 under subsection 7qq7 7relating to data
 reporting and program integrity74