,i  #aaf? ,,congress  #b;d ,session  ,h4
 ,r4 #gfjf  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,july #ac1 #bjbj,mr4  
,williams 7= himself & ,ms4 ,johnson (  
,texas7 introduc$ ! foll[+ bill2 :i* 0  
ref]r$ to ! ,committee on ,en]gy &      
,comm]ce  ,a ,,bill  ,to require !      
,comptroll] ,g5]al to submit to         
,congress a report on ! impact ( !      
,m$icaid ,fiscal ,acc\ntability         
,regulation1 to limit ! au?ority = !    
,secret>y ( ,heal? & ,human ,s]vices1 & 
= o!r purposes4  #a4 ,%ort title ,?is   
,act may be cit$ z ! ,,mf> ,transp>5cy  
,act4  #b4 ,report+ requirem5t relat+ to
 ! ,m$icaid ,fiscal ,acc\ntability      
,regulation  7a7 ,comptroll] ,g5]al     
report ,n lat] ?an #b ye>s aft] ! date (
 ! enactm5t ( ?is ,act1 ! ,comptroll]   
,g5]al %all submit to ,congress a report
 t-- 7#a7 id5tifies ! report+           
requirem5ts t are necess>y to ensure t  
,/ates comply ) laws & regulations )    
respect to ! f9anc+ ( ! non-,f$]al %>e (
 exp5ditures "u ,/ate plans "u title    

,,xix ( ! ,social ,security ,act 7#db   
,u4,s4,c4 #acif et seq472  7#b7 e/imates
 ! f9ancial impact ( ! propos$ rulemak+ 
entitl$1 ,m$icaid ,program2 ,m$icaid    
,fiscal ,acc\ntability ,regulation      
publi%$ by ! ,secret>y ( ,heal? & ,human
 ,s]vices on ,novemb] #ah1 #bjai )      
respect to all heal? c>e facilities t   
receive supplem5tal or direct paym5ts "u
 su* title ,,xix fund$ ?r\gh            
int]gov]nm5tal transf]s2  7#c7 evaluate 
! impact ( ! propos$ rulemak+ describ$ 9
 p>agraph 7#b7 ) respect to ,/ate &     
local budgets1 includ+ ! impact ( tax   
increases t w\ld be necess>y to ma9ta9  
curr5t fund+ = hospitals & nurs+ homes t
 receive paym5ts f int]gov]nm5tal       
transf]s 7z ( ! date ( enactm5t ( ?is   
,act72 &  7#d7 id5tifies ! impact ( !   
propos$ rulemak+ describ$ 9 p>agraph    
7#b7 ) respect to int]gov]nm5tal        
transf]s ( funds f units ( gov]nm5t )9 a
 ,/ate & provid] taxes paid au?oriz$ "u 
section #aijc7w7 ( ! ,social ,security  
,act 7#db ,u4,s4,c4 #acif;b7w774  7b7   

,limitation ( au?ority = ! ,secret>y (  
,heal? & ,human ,s]vices ,! ,secret>y ( 
,heal? & ,human ,s]vices may n take any 
action 7?r\gh promulgation ( regulation1
 issuance ( regulatory guidance1 or o!r 
adm9i/rative action71 unless ! #aaf?    
,congress enacts a resolution t         
au?orizes su* action1 to f9alize or     
o!rwise implem5t provisions conta9$ 9 ! 
propos$ rulemak+ describ$ 9 subsection  
7a77#b74