,,ii  #aaf? ,,congress  #a/ ,session    
,s4 #aca  ,,9 ,,! ,,s5ate ,,( ,,!       
,,unit$ ,,/ates  ,janu>y #ae1 #bjai ,mr4
 ,cassidy 7= himself1 ,mr4 ,inh(e1 ,mr4 
,b>rasso1 ,mrs4 ,hyde-,smi?1 ,mr4       
,wick]1 ,mrs4 ,blackburn1 & ,mr4 ,p]due7
 introduc$ ! foll[+ bill2 :i* 0 read    
twice & ref]r$ to ! ,committee on       
,f9ance  ,a ,,bill  ,to am5d title ,,xix
 ( ! ,social ,security ,act to prohibit 
,f$]al ,m$icaid fund+ = ! adm9i/rative  
co/s ( provid+ heal? b5efits to         
individuals :o are unau?oriz$           
immigrants4  #a4 ,%ort title  ,?is ,act 
may be cit$ z ! ,protect ,m$icaid ,act4 
#b4 ,prohibit+ ,f$]al ,m$icaid fund+ = !
 adm9i/rative co/s ( provid+ heal?      
b5efits to individuals :o are unau?oriz$
 immigrants ,section #aijc7;i7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#acif;b7i77 is am5d$-- 7#a7 9 p>agraph  
7#bf71 by /rik+ 2 or & ins]t+ a         
semicolon2  7#b7 9 p>agraph 7#bg71 by   
/rik+ ! p]iod at ! end & ins]t+ 2 or2 & 
7#c7 by ins]t+ aft] p>agraph 7#bg7 !    

foll[+ new p>agraph3  7#bh7 ) respect to
 any am\nts exp5d$ = ! adm9i/ration ( a 
,/ate program t provides heal? b5efits  
to noncitiz5s :o are ineligible = m$ical
 assi/ance "u ?is title on ! basis ( n  
hav+ a satisfactory immigration /atus 7z
 def9$ 9 section                        
#aacg7;d77#a77;,b77iii77 7except t su*  
prohibition %all n be con/ru$ z         
prohibit+ paym5t "u ! prec$+ provisions 
( ?is section = co/s attributable to !  
e/abli%m5t or op]ation ( a sy/em design$
 to ensure compliance ) su*             
prohibition74  4  #c4 ,inspector ,g5]al 
report ,n lat] ?an #ahj days aft] ! date
 ( enactm5t ( ?is ,act1 ! ,inspector    
,g5]al ( ! ,dep>tm5t ( ,heal? & ,human  
,s]vices %all submit to ,congress a     
report t includes ! foll[+ in=mation )  
respect to ,/ates t provide heal?       
b5efits to noncitiz5s :o are ineligible 
on ! basis ( immigration /atus = m$ical 
assi/ance "u title ,,xix ( ! ,social    
,security ,act 7#db ,u4,s4,c4 #acif et  
seq473  7#a7 ,h[ su* ,/ates sep>ate     

am\nts exp5d$ on ! adm9i/rative co/s    
relat$ to ! ,/ate's ,m$icaid program &  
am\nts exp5d$ on adm9i/rative co/s      
relat$ to provid+ heal? b5efits to su*  
noncitiz5s4  7#b7 ,! types ( proc$ures1 
protocols1 or sy/ems t su* ,/ates employ
 to ensure t !y are 9 full compliance ) 
prohibitions on ! use ( ,f$]al fund+ to 
provide heal? b5efits to su* noncitiz5s 
& h[ effective !y are at ensur+         
compliance4  7#c7 ,a description (      
,/ates' me?ods ( f9anc+ ,/ate programs t
 provide heal? b5efits to noncitiz5s :o 
are ineligible = m$ical assi/ance due to
 n hav+ a satisfactory immigration      
/atus1 includ+ ?r\gh ! increas$ use (   
provid] taxes & int]gov]nm5tal transf]s 
to f9ance ! non-,f$]al %>e ( exp5ditures
 "u ! ,/ate ,m$icaid program = m$ical   
assi/ance provid$ to individuals :o are 
n s ineligible4  7#d7 ,an analysis (--  
7,a7 ! ext5t to :i* su* noncitiz5s are  
provid$ cov]$ outpati5t drugs pur*as$   
"u--  7i7 ! ,m$icaid ,drug ,rebate      
,program "u section #aibg ( ! ,social   

,security ,act 7#db ,u4,s4,c4           
#acifr-#h72 or  7ii7 ! drug disc\nt     
program "u section #cdj;,b ( ! ,public  
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#bef;b72 &  7,b7 ! effect t ! provision 
to su* noncitiz5s ( cov]$ outpati5t     
drugs pur*as$ "u ! programs describ$ 9  
subp>agraph 7,a7 has on ! av]age        
manufactur] price 7z def9$ 9 section    
#aibg7k77#a7 ( ! ,social ,security ,act 
7#db ,u4,s4,c4 #acifr-#h7k77#a777 ( su* 
drugs1 includ+ :e!r ! av]age manufactur]
 price = su* drugs w\ld be l[] if no    
drugs pur*as$ "u su* programs 7 provid$ 
to su* noncitiz5s4