,i  #aaf? ,,congress  #a/ ,session  ,h4 
,r4 #cfca  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,july #i1 #bjai,mr4   
,soto 7= himself1 ,mr4 ,bilirakis1 ,ms4 
,velzquez1 ,miss ,gonzlez-,coln ( ,pu]to
 ,rico1 ,ms4 ,plaskett1 ,mr4 ,sablan1   
,mrs4 ,radewag51 ,mr4 ,san ,nicolas1    
,mr4 ,s]rano1 & ,mr4 ,fitzpatrick7      
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 provide = a  
tempor>y increase to ! limit on ,m$icaid
 paym5ts = t]ritories ( ! ,unit$ ,/ates 
& ! ,f$]al m$ical assi/ance p]c5tage =  
su* t]ritories "u ! ,m$icaid program1 & 
= o!r purposes4  #a4 ,%ort title ,?is   
,act may be cit$ z ! ,t]ritories ,heal? 
,c>e ,improvem5t ,act4  #b4 ,m$icaid    
paym5ts = ,pu]to ,rico & ! o!r          
t]ritories = c]ta9 fiscal ye>s  7a7     
,treatm5t ( cap ,section #aajh7;g7 ( !  
,social ,security ,act 7#db ,u4,s4,c4   
#acjh7;g77 is am5d$--  7#a7 9 p>agraph  
7#b7-- 7,a7 9 ! matt] prec$+ subp>agraph

 7,a71 by /rik+ subject to & section    
#acbc7;a77#b7 ( ! ,pati5t ,protection & 
,af=dable ,c>e ,act p>agraphs 7#c7 &    
7#e7 & ins]t+ subject to section        
#acbc7;a77#b7 ( ! ,pati5t ,protection & 
,af=dable ,c>e ,act & p>agraphs 7#c7 &  
7#e72  7,b7 9 subp>agraph 7,a7-- 7i7 by 
/rik+ ,pu]to ,rico %all n exce$ ! sum ( 
& ins]t+  ,pu]to ,rico %all n exce$--   
7i7 except z provid$ 9 clause 7ii71 !   
sum (  2  7ii7 by /rik+ #ajj1jjj2 &     
ins]t+ #ajj1jjj2 &2 &  7iii7 by add+ at 
! end ! foll[+ new clause3  7ii7 = ea* (
 fiscal ye>s #bjbj ?r\gh #bjbc1 ! am\nt 
specifi$ 9 p>agraph 7#f7 = ea* su*      
fiscal ye>2  2  7,c7 9 subp>agraph      
7,b7-- 7i7 by /rik+ ! ,virg9 ,isl&s %all
 n exce$ ! sum ( & ins]t+  ! ,virg9     
,isl&s %all n exce$-- 7i7 except z      
provid$ 9 clause 7ii71 ! sum (  2  7ii7 
by /rik+ #aj1jjj2 & ins]t+ #aj1jjj2 &2 &
  7iii7 by add+ at ! end ! foll[+ new   
clause3  7ii7 = ea* ( fiscal ye>s #bjbj 
?r\gh #bjbe1 #abf1jjj1jjj2  2  7,d7 9   
subp>agraph 7,c7-- 7i7 by /rik+ ,guam   

%all n exce$ ! sum ( & ins]t+  ,guam    
%all n exce$-- 7i7 except z provid$ 9   
clause 7ii71 ! sum (  2  7ii7 by /rik+  
#aj1jjj2 & ins]t+ #aj1jjj2 &2 &  7iii7  
by add+ at ! end ! foll[+ new clause3   
7ii7 = ea* ( fiscal ye>s #bjbj ?r\gh    
#bjbe1 #abg1jjj1jjj2  2  7,e7 9         
subp>agraph 7,d7-- 7i7 by /rik+ !       
,nor!rn ,m>iana ,isl&s %all n exce$ !   
sum ( & ins]t+  ! ,nor!rn ,m>iana ,isl&s
 %all n exce$-- 7i7 except z provid$ 9  
clause 7ii71 ! sum (  2 &  7ii7 by add+ 
at ! end ! foll[+ new clause3  7ii7 =   
ea* ( fiscal ye>s #bjbj ?r\gh #bjbe1    
#fj1jjj1jjj2 &  2 &  7,f7 9 subp>agraph 
7,e7--  7i7 by /rik+ ,am]ican ,samoa    
%all n exce$ ! sum ( & ins]t+ ,am]ican  
,samoa %all n exce$-- 7i7 except z      
provid$ 9 clause 7ii71 ! sum (  2  7ii7 
by /rik+ #aj1jjj4 & ins]t+ #aj1jjj2 &2 &
  7iii7 by add+ at ! end ! foll[+ new   
clause3  7ii7 = ea* ( fiscal ye>s #bjbj 
?r\gh #bjbe1 #hd1jjj1jjj4  2 &  7#b7 by 
add+ at ! end ! foll[+ new p>agraph3    
7#f7 ,application to ,pu]to ,rico =     

fiscal ye>s #bjbj ?r\gh #bjbc ,=        
purposes ( p>agraph 7#b77;,a77ii71 !    
am\nt specifi$ 9 ?is p>agraph is--  7,a7
 = fiscal ye> #bjbj1 #b1hbc1ahh1jjj2    
7,b7 = fiscal ye> #bjba1 #b1iai1jgb1jjj2
  7,c7 = fiscal ye> #bjbb1              
#c1jab1faj1jjj2 &  7,d7 = fiscal ye>    
#bjbc1 #c1aad1cca1jjj4  4  7b7 ,treatm5t
 ( fund+ "u enhanc$ allotm5t program    
,section #aice7;e7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #acifu-#e7;e77 is  
am5d$-- 7#a7 9 p>agraph 7#a77;,b71 by   
/rik+ if ! ,/ate & ins]t+ subject to    
p>agraph 7#d71 if ! ,/ate2  7#b7 by     
r$esignat+ p>agraph 7#d7 z p>agraph     
7#e72 &  7#c7 by ins]t+ aft] p>agraph   
7#c7 ! foll[+ new p>agraph3  7#d7       
,treatm5t ( fund+ = c]ta9 fiscal ye>s   
7,a7 ,pu]to ,rico ,not)/&+ p>agraph     
7#a77;,b71 9 ! case t ,pu]to ,rico      
e/abli%es & submits to ! ,secret>y a    
plan describ$ 9 p>agraph 7#b7 ) respect 
to any ( fiscal ye>s #bjbj ?r\gh #bjbb1 
! am\nt specifi$ 9 p>agraph 7#c7 =      
,pu]to ,rico = su* a ye> %all be tak5   

into acc\nt 9 apply+ subp>agraph        
7,a77ii7 ( section #aajh7;g77#b7 = su*  
ye>4  7,b7 ,o!r t]ritories ,not)/&+     
p>agraph 7#a77;,b71 9 ! case t ! ,virg9 
,isl&s1 ,guam1 ! ,nor!rn ,m>iana ,isl&s1
 or ,am]ican ,samoa e/abli%es & submits 
to ! ,secret>y a plan describ$ 9        
p>agraph 7#b7 ) respect to any ( fiscal 
ye>s #bjbj ?r\gh #bjbe1 ! am\nt specifi$
 9 p>agraph 7#c7 = ! ,virg9 ,isl&s1     
,guam1 ! ,nor!rn ,m>iana ,isl&s1 or     
,am]ican ,samoa1 z ! case may be1 %all  
be tak5 into acc\nt 9 apply+1 z         
applicable1 subp>agraph 7,b77ii71       
7,c77ii71 7,d77ii71 or 7,e77ii7 (       
section #aajh7;g77#b7 = su* ye>4  4  7c7
 ,increas$ ,,fmap ,section #aije ( !    
,social ,security ,act 7#db ,u4,s4,c4   
#acif;d7b77 is am5d$-- 7#a7 9 subsection
 7b71 by /rik+ & 7aa7 & ins]t+ 7aa71 &  
7ff72 &  7#b7 by add+ at ! end ! foll[+ 
new subsection3  7ff7 ,tempor>y increase
 9 ,,fmap = t]ritories = c]ta9 fiscal   
ye>s  7#a7 ,pu]to ,rico ,not)/&+        
subsection 7b71 ! ,f$]al m$ical         

assi/ance p]c5tage = ,pu]to ,rico %all  
be equal to--  7,a7 #hc p]c5t = fiscal  
ye>s #bjbj & #bjba2 &  7,b7 #gf p]c5t = 
fiscal ye>s #bjbb & #bjbc4  7#b7 ,virg9 
,isl&s ,not)/&+ subsection 7b71 ! ,f$]al
 m$ical assi/ance p]c5tage = ! ,virg9   
,isl&s %all be equal to--  7,a7 #ajj    
p]c5t = fiscal ye> #bjbj2  7,b7 #hc     
p]c5t = fiscal ye>s #bjba ?r\gh #bjbd2 &
  7,c7 #gf p]c5t = fiscal ye> #bjbe4    
7#c7 ,o!r t]ritories ,not)/&+ subsection
 7b71 ! ,f$]al m$ical assi/ance p]c5tage
 = ,guam1 ! ,nor!rn ,m>iana ,isl&s1 &   
,am]ican ,samoa %all be equal to--  7,a7
 #ajj p]c5t = fiscal ye>s #bjbj & #bjba2
  7,b7 #hc p]c5t = fiscal ye>s #bjbb    
?r\gh #bjbd2 &  7,c7 #gf p]c5t = fiscal 
ye> #bjbe4  4  7d7 ,annual report       
,section #aajh7;g7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #acjh7;g771 z am5d$
 by subsection 7a71 is fur!r am5d$ by   
add+ at ! end ! foll[+ new p>agraph3    
7#g7 ,annual report  7,a7 ,9 g5]al ,n   
lat] ?an ! date t is #cj days aft] ! end
 ( ea* fiscal ye> 7beg9n+ ) fiscal ye>  

#bjbj & end+ ) fiscal ye> #bjbe71 9 !   
case t a specifi$ t]ritory receives a   
,m$icaid cap increase1 or an increase 9 
! ,f$]al m$ical assi/ance p]c5tage = su*
 t]ritory "u section #aije7;ff71 = su*  
fiscal ye>1 su* t]ritory %all submit to 
! ,*air & ,rank+ ,memb] ( ! ,committee  
on ,en]gy & ,comm]ce ( ! ,h\se (        
,repres5tatives & ! ,*air & ,rank+      
,memb] ( ! ,committee on ,f9ance ( !    
,s5ate a report t describes h[ su*      
t]ritory has us$ su* ,m$icaid cap       
increase1 or su* increase 9 ! ,f$]al    
m$ical assi/ance p]c5tage1 z applicable1
 to increase access to heal? c>e "u !   
,/ate ,m$icaid plan ( su* t]ritory "u   
title ,,xix 7or a waiv] ( su* plan74    
,su* report may include--  7i7 ! ext5t  
to :i* su* t]ritory has1 ) respect to   
su* plan 7or waiv]7-- 7,i7 increas$     
paym5ts to heal? c>e provid]s2  7,,ii7  
increas$ cov]$ b5efits2  7,,iii7 exp&$  
heal? c>e provid] networks2 or  7,,iv7  
improv$ 9 any o!r mann] ! c>ry+ out (   
su* plan 7or waiv]72 &  7ii7 any o!r    

in=mation z det]m9$ necess>y by su*     
t]ritory4  7,b7 ,def9itions ,9 ?is      
p>agraph3 7i7 ,m$icaid cap increase ,!  
t]m ,m$icaid cap increase means1 )      
respect to a specifi$ t]ritory & fiscal 
ye>1 any increase 9 ! am\nts o!rwise    
det]m9$ "u ?is subsection = su* t]ritory
 = su* fiscal ye> by reason ( ! am5dm5ts
 made by section #b7;a7 ( ! ,t]ritories 
,heal? ,c>e ,improvem5t ,act4  7ii7     
,specifi$ t]ritory ,! t]m specifi$      
t]ritory means ,pu]to ,rico1 ! ,virg9   
,isl&s1 ,guam1 ! ,nor!rn ,m>iana ,isl&s1
 & ,am]ican ,samoa4  4  #c4 ,application
 ( c]ta9 requirem5ts "u ,m$icaid program
 to c]ta9 t]ritories  7a7 ,application (
 paym5t error rate measurem5t           
requirem5ts to ,pu]to ,rico ,section    
#aijc7u77#d7 ( ! ,social ,security ,act 
7#db ,u4,s4,c4 #acif;b7u77#d77 is       
am5d$--  7#a7 by /rik+ to ,pu]to ,rico1 
,guam & ins]t+ to ,guam2 &  7#b7 by     
/rik+ or ,am]ican ,samoa4 & ins]t+ or   
,am]ican ,samoa1 or1 = fiscal ye>s be=e 
fiscal ye> #bjbc1 to ,pu]to ,rico44  7b7

 ,application ( asset v]ification       
program requirem5ts to ,pu]to ,rico &   
,virg9 ,isl&s ,section #aidj7;a7 ( !    
,social ,security ,act 7#db ,u4,s4,c4   
#acifw7a77 is am5d$-- 7#a7 9 p>agraph   
7#c77;,a71 by add+ at ! end ! foll[+ new
 clause3  7iii7 ,implem5tation 9 ,pu]to 
,rico & ,virg9 ,isl&s ,! ,secret>y %all 
require ,pu]to ,rico to implem5t an     
asset v]ification program "u ?is        
subsection by ! end ( fiscal ye> #bjbb &
 ! ,virg9 ,isl&s to implem5t su* a      
program by ! end ( fiscal ye> #bjbc4  2 
&  7#b7 9 p>agraph 7#d7-- 7,a7 9 !      
p>agraph head+1 by /rik+ ,exemption (   
t]ritories & ins]t+ ,exemption ( c]ta9  
t]ritories2 &  7,b7 by /rik+ & !        
,di/rict ( ,columbia & ins]t+ 1 !       
,di/rict ( ,columbia1 ,pu]to ,rico1 & ! 
,virg9 ,isl&s4  7c7 ,application ( c]ta9
 data report+ & program integrity       
requirem5ts to ,nor!rn ,m>iana ,isl&s1  
,am]ican ,samoa1 & ,guam  7#a7 ,9 g5]al 
,section #aijb ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acif;a7 is am5d$ by

 add+ at ! end ! foll[+ new subsection3 
7qq7 ,application ( c]ta9 data report+ &
 program integrity requirem5ts to       
,nor!rn ,m>iana ,isl&s1 ,am]ican ,samoa1
 & ,guam ,n lat] ?an ,octob] #a1 #bjbc1 
! ,nor!rn ,m>iana ,isl&s1 ,am]ican      
,samoa1 & ,guam %all-- 7#a7 implem5t    
me?ods1 satisfactory to ! ,secret>y1 = !
 collection & report+ ( reliable data to
 ! ,trans=m$ ,m$icaid ,/ati/ical        
,in=mation ,sy/em 7,t-,,msis7 7or a     
successor sy/em72 &  7#b7 demon/rate    
progress 9 e/abli%+ a ,/ate m$icaid     
fraud control unit describ$ 9 section   
#aijc7q74  4  7#b7 ,con=m+ am5dm5t      
,section #aijb7;j7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #acif;a7j77 is     
am5d$-- 7,a7 by /rik+ or ! requirem5t & 
ins]t+ 1 ! requirem5t2 &  7,b7 by ins]t+
 be=e ! p]iod at ! end ! foll[+3 1 or ! 
requirem5ts "u subsection 7qq7 7relat+  
to data report+ & program integrity74