,,ii #aag? ,,congress #a/ ,session ,s4 #ahdd ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,may #bf1 #bjba ,mr4 ,casey 7= himself1 ,mr4 ,blum5?al1 ,ms4 ,/ab5[1 & ,mr4 ,s&]s7 introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,f9ance ,a ,,bill ,to am5d title ,,xviii ( ! ,social ,security ,act to move ,m$ic>e co/-%>+ b5efits f ,m$icaid to ,m$ic>e1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,l[]+ ,m$ic>e ,premiums & ,prescription ,drug ,co/s ,act4 #b4 ,m$ic>e ,co/ ,assi/ance ,program 7a7 ,9 g5]al ,title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq47 is am5d$ by add+ at ! end ! foll[+ new section3 #ahii;,b4 ,m$ic>e ,co/ ,assi/ance ,program 7a7 ,9 g5]al ,effective beg9n+ ,janu>y #a1 #bjbc1 9 ! case ( a ,m$ic>e ,co/ ,assi/ance ,program eligible individual 7z def9$ 9 subsection 7b77#a771 ! ,secret>y %all provide ,m$ic>e co/ assi/ance = ! foll[+ co/s incurr$ ) respect to ! individual3 7#a7 7,a7 premiums "u section #ahah2 & 7,b7 premiums "u section #ahci4 7#b7 ,co9surance "u ?is title 7includ+ co9surance describ$ 9 section #ahac74 7#c7 ,d$uctibles e/abli%$ "u ?is title 7includ+ ^? describ$ 9 section #ahac & section #ahcc7;b774 7#d7 ,! diff]5ce betwe5 ! am\nt t is paid "u section #ahcc7;a7 & ! am\nt t w\ld be paid "u su* section if any ref]5ce to a p]c5t less ?an #ajj p]c5t !re9 7 deem$ a ref]5ce to #ajj p]c5t4 7b7 ,det]m9ation ( eligibility 7#a7 ,m$ic>e ,co/ ,assi/ance ,program eligible individual def9$ ,! t]m ,m$ic>e ,co/ ,assi/ance ,program eligible individual means an individual :o-- 7,a7 is eligible = & is receiv+ m$ical assi/ance = ! paym5t ( m$ic>e co/-%>+ "u a ,/ate ,m$icaid program pursuant to clause 7i71 7iii71 or 7iv7 ( section #aijb7;a77#aj77;,e7 z ( ,decemb] #ca1 #bjbb2 or 7,b7 7i7 is entitl$ to hospital insurance b5efits "u "p ,a 7includ+ an individual entitl$ to su* b5efits pursuant to an enrollm5t "u section #ahah72 & 7ii7 has income at or bel[ #bjj p]c5t ( ! pov]ty l9e applicable to a family ( ! size involv$4 7#b7 ,jo9t det]m9ation by ,commission] ( ,social ,security = ,,lis & ,m$ic>e co/ assi/ance 7,a7 ,9 g5]al ,! det]m9ation ( :e!r an individual is a ,m$ic>e ,co/ ,assi/ance ,program eligible individual describ$ 9 p>agraph 7#a7 %all be det]m9$ by ! ,commission] ( ,social ,security jo9tly ) ! det]m9ation ( :e!r an individual is a subsidy eligible individual describ$ 9 section #ahfj;,d-#ad7;a77#c74 ,su* det]m9ation %all be made ) respect to eligibility = ,m$ic>e co/ assi/ance "u ?is section & premium & co/-%>+ subsidies "u section #ahfj;,d-#ad ^u application ( an individual = a det]m9ation ) respect to eligibility = ei!r su* assi/ance or su* subsidies4 ,!re are au?oriz$ to be appropriat$ to ! ,social ,security ,adm9i/ration su* sums z may be necess>y = ! det]m9ation ( eligibility "u ?is p>agraph4 7,b7 ,effective p]iod ,det]m9ations "u ?is p>agraph ) respect to eligibility = ea* ( su* assi/ance or su* subsidies %all be effective beg9n+ ) ! mon? 9 :i* ! individual applies = a det]m9ation describ$ 9 subp>agraph 7,a7 & %all rema9 9 effect until su* "t z ! ,secret>y det]m9es ! individual is no long] eligible z det]m9$ "u subp>agraph 7,c77ii74 7,c7 ,r$et]m9ations ,) respect to eligibility det]m9ations "u ?is p>agraph-- 7i7 r$et]m9ations %all be made at ! same "t ) respect to eligibility = ,m$ic>e co/ assi/ance "u ?is section & co/-%>+ subsidies "u section #ahfj;,d-#ad1 b n m frequ5tly ?an once e #ab mon?s2 7ii7 a r$et]m9ation %all automatically det]m9e t an individual rema9s eligible = su* assi/ance or subsidies unless-- 7,i7 ! ,commission] has in=mation indicat+ t ! individual's circum/ances h *ang$ su* t ! individual is no long] eligible = su* assi/ance or subsidies2 7,,ii7 ! ,commission] s5ds notice to ! individual reg>d+ su* in=mation t reque/s a response ei!r confirm+ or correct+ su* in=mation2 & 7,,iii7 ! individual ei!r confirms su* in=mation or fails to provide docum5tation indicat+ t su* circum/ances h n *ang$ )9 #fj days ( receiv+ ! notice describ$ 9 subclause 7,,ii72 7iii7 ! ,commission] %all e/abli% proc$ures = appeals ( su* det]m9ations t are simil> to ! proc$ures describ$ 9 ! ?ird s5t5ce ( section #afca7;c77#a77;,a72 & 7iv7 judicial review ( ! f9al decision ( ! ,commission] made aft] a he>+ %all be available to ! same ext5t1 & ) ! same limitations1 z provid$ 9 subsections 7g7 & 7h7 ( section #bje4 7,d7 ,treatm5t ( m$icaid b5efici>ies ,! ,secret>y %all provide t individuals :o are full-b5efit dual eligible individuals 7z def9$ 9 section #aice7;c77#f77 or :o are recipi5ts ( supplem5tal security income b5efits "u title ,,xvi %all be treat$ z a ,m$ic>e ,co/ ,assi/ance ,program eligible individual describ$ 9 p>agraph 7#a7 &1 9 ! case ( su* individual :o is a "p ,d eligible individual1 a subsidy eligible individual describ$ 9 section #ahfj;,d-#ad7;a77#c74 7,e7 ,simplifi$ application =m 7i7 ,9 g5]al ,! ,secret>y %all develop & di/ribute a simplifi$ application =m = use by individuals 9 apply+ = ,m$ic>e co/ assi/ance "u ?is section & premium & co/-%>+ subsidies "u section #ahfj;,d-#ad4 ,su* =m %all be easily readable by applicants & uni=m nationally4 ,! ,secret>y %all provide = ! translation ( su* application =m into at lea/ ! #aj languages 7o!r ?an ,engli%7 t are mo/ (t5 us$ by individuals apply+ = hospital insurance b5efits "u section #bbf or #bbf;,a & %all make ! translat$ =ms available to ! ,commission] ( ,social ,security4 7ii7 ,consultation ,9 develop+ su* =m1 ! ,secret>y %all consult ) b5efici>y gr\ps4 7#c7 ,income det]m9ations ,= purposes ( apply+ ?is section-- 7,a7 9 ! case ( an individual :o is n treat$ z a ,m$ic>e ,co/ ,assi/ance ,program eligible individual or a subsidy eligible individual "u p>agraph 7#b77;,d71 income %all be det]m9$ 9 ! mann] describ$ "u section #afab = purposes ( ! supplem5tal security income program1 except t support & ma9t5ance furni%$ 9 k9d %all n be c\nt$ z income2 & 7,b7 ! t]m pov]ty l9e has ! mean+ giv5 su* t]m 9 section #fgc7b7 ( ! ,community ,s]vices ,block ,grant ,act 7#db ,u4,s4,c4 #iijb7b771 includ+ any revision requir$ by su* section4 7c7 ,b5efici>y protections 7#a7 ,9 g5]al ,9 ! case 9 :i* ! paym5t = ,m$ic>e co/ assi/ance = a ,m$ic>e ,co/ ,assi/ance ,program eligible individual ) respect to an item or s]vice is r$uc$ or elim9at$ ! individual %all n h any legal liability to make paym5t to a provid] ( s]vices or suppli] or to an organization describ$ 9 section #aijc7m77#a77;,a7 = ! s]vice1 & any lawful sanction t may be impos$ ^u a provid] ( s]vices or suppli] or su* an organization = excess *>ges "u ?is title or title ,,xix %all apply to ! imposition ( any *>ge impos$ ^u ! individual 9 su* case4 7#b7 ,cl>ification ,?is p>agraph %all n be con/ru$ z prev5t+ paym5t ( any m$ic>e co/ assi/ance by a m$ic>e supplem5tal policy or an employ] retiree heal? plan on behalf ( an individual4 7d7 ,adm9i/ration 7#a7 ,9 g5]al ,! ,secret>y %all e/abli% proc$ures = ! adm9i/ration ( ! program "u ?is section4 7#b7 ,fund+ ,= purposes ( c>ry+ out ?is section1 ! ,secret>y %all make paym5ts f ! ,f$]al ,hospital ,insurance ,tru/ ,fund "u section #ahag & ! ,f$]al ,supplem5t>y ,m$ical ,insurance ,tru/ ,fund "u section #ahda1 9 su* proportion z ! ,secret>y det]m9es appropriate1 ( su* am\nts z ! ,secret>y det]m9es necess>y to provide ,m$ic>e co/ assi/ance "u ?is section4 7e7 ,ref]5ces to m$ic>e co/-,%>+ ,effective beg9n+ ,janu>y #a1 #bjbc1 any ref]5ce to m$ic>e co/-%>+ describ$ 9 section #aije7p7 %all be deem$ a ref]5ce to ,m$ic>e co/ assi/ance "u ?is section4 7f7 ,outrea* ef=ts ,= provisions relat+ to outrea* ef=ts to increase aw>5ess ( ! availability ( ,m$ic>e co/ assi/ance1 see section #aadd4 4 7b7 ,special enrollm5t p]iod 7#a7 ,no premium p5alty ,section #ahci7;b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acier7b77 is am5d$1 9 ! la/ s5t5ce1 by ins]t+ ! foll[+ be=e ! p]iod3 or1 effective beg9n+ ,janu>y #a1 #bjbc1 = individuals :o are ,m$ic>e ,co/ ,assi/ance ,program eligible individuals 7z def9$ 9 section #ahii;,b7b77#a7744 7#b7 ,special enrollm5t p]iod ,section #ahcg ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciep7 is am5d$ by add+ at ! end ! foll[+ new subsection3 7o7 ,special enrollm5t p]iod = ,m$ic>e ,co/ ,assi/ance ,program eligible individual 7#a7 ,9 g5]al ,effective beg9n+ ,janu>y #a1 #bjbc1 ! ,secret>y %all e/abli% special enrollm5t p]iods = ,m$ic>e ,co/ ,assi/ance ,program eligible individuals 7z def9$ 9 section #ahii;,b7b77#a774 7#b7 ,cov]age p]iod ,9 ! case ( an individual :o enrolls dur+ ! special enrollm5t p]iod provid$ "u p>agraph 7#a71 ! cov]age p]iod "u ?is "p %all-- 7,a7 beg9 on ! fir/ day ( ! fir/ mon? 9 :i* ! individual applies = a det]m9ation "u section #ahii;,b7b77#b77;,a72 & 7,b7 rema9 9 effect until su* "t z ! ,secret>y det]m9es ! individual no long] eligible z det]m9$ "u section #ahii;,b7b77#b77;,c77ii74 4 7#c7 ,con=m+ sunset ( ,/ate agreem5ts relat+ to enrollm5t ( qualifi$ m$ic>e b5efici>ies 7,a7 ,"p ,a ,section #ahah7;g7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie;i-#b7;g77 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#c7 ,sunset ,?is subsection %all n apply on or aft] ,janu>y #a1 #bjbc4 4 7,b7 ,"p ,b ,section #ahdc7;h7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciev7h77 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#c7 ,sunset ) respect to qualifi$ m$ic>e b5efici>ies ,?is subsection %all n apply ) respect to qualifi$ m$ic>e b5efici>ies on or aft] ,janu>y #a1 #bjbc4 4 7c7 ,public aw>5ess campaign ,section #aadd ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#ad7 is am5d$ by add+ at ! end ! foll[+ new subsection3 7d7 ,public aw>5ess campaign 7#a7 ,9 g5]al ,! ,commission] %all conduct a public aw>5ess campaign to educate ,m$ic>e b5efici>ies on ! availability ( ,m$ic>e co/ assi/ance = l[-income individuals "u section #ahii;,b4 7#b7 ,coord9ation ,9 c>ry+ out su* public aw>5ess campaign1 ! ,commission] %all coord9ate ) ,/ate heal? insurance assi/ance programs describ$ 9 subsection 7a77#a77;,a7 ( section #aai ( ! ,m$ic>e ,improvem5ts = ,pati5ts & ,provid]s ,act ( #bjjh 7#db ,u4,s4,c4 #acie;b-#c note771 ! ,adm9i/rator ( ! ,adm9i/ration = ,community ,liv+1 & ! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices4 7#c7 ,fund+ ,!re are h]eby appropriat$ to ! ,commission]1 out ( any funds 9 ! ,treasury n o!rwise appropriat$1 #aj1jjj1jjj = ea* ( fiscal ye>s #bjbc ?r\gh #bjbe1 to provide grants to ,/ate heal? insurance assi/ance programs to c>ry out outrea* & education activities "u ! public aw>5ess campaign pursuant to ?is subsection4 4 #c4 ,mov+ ,m$ic>e co/-%>+ b5efits f ,m$icaid to ,m$ic>e 7a7 ,end+ mo/ ,m$ic>e co/-,%>+ b5efits "u ,m$icaid ,section #aijb7;a77#aj7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#aj77 is am5d$-- 7#a7 by ins]t+ = cal5d> qu>t]s beg9n+ be=e ,janu>y #a1 #bjbc1 be=e = mak+ ea* place x appe>s 9 clauses 7i71 7iii71 & 7iv7 ( subp>agraph 7,e72 & 7#b7 9 ! matt] foll[+ subp>agraph 7,g7-- 7,a7 by ins]t+ furni%$ dur+ cal5d> qu>t]s beg9n+ be=e ,janu>y #a1 #bjbc aft] 7describ$ 9 section #aije7p77#c772 7,b7 by /rik+ 7,,xv7 & ins]t+ 1 7,,xv72 7,c7 by /rik+ & 7,,xviii7 & ins]t+ 1 7,,xviii72 & 7,d7 by ins]t+ 1 & 7,,xix7 no m$ical assi/ance = m$ic>e co/-%>+1 o!r ?an m$ical assi/ance = m$ic>e co/-%>+ = qualifi$ disabl$ & work+ individuals describ$ 9 section #aije7s71 %all be made available aft] ,janu>y #a1 #bjbc be=e ! semicolon at ! end4 7b7 ,con=m+ am5dm5ts 7#a7 ,title ,,xix 7,a7 ,section #aijc7;i7 ( su* ,act 7#db ,u4,s4,c4 #acif;b7i77 is am5d$-- 7i7 9 p>agraph 7#bf71 by /rik+ 2 & & ins]t+ a semicolon2 7ii7 9 p>agraph 7#bg71 by /rik+ ! p]iod at ! end & ins]t+ 2 &2 & 7iii7 by ins]t+ aft] p>agraph 7#bg7 ! foll[+ new p>agraph3 7#bh7 ) respect to any am\nt exp5d$ = m$ical assi/ance = m$ic>e co/-%>+ 7o!r ?an m$ical assi/ance = m$ic>e co/-%>+ = qualifi$ disabl$ & work+ individuals describ$ 9 section #aije7s77 furni%$ dur+ cal5d> qu>t]s beg9n+ on or aft] ,janu>y #a1 #bjbc4 4 7,b7 ,section #aije7;a7 ( su* ,act 7#db ,u4,s4,c4 #acif;d7a77 is am5d$1 9 ! fir/ s5t5ce1 by ins]t+ furni%$ dur+ cal5d> qu>t]s beg9n+ be=e ,janu>y #a1 #bjbc aft] m$ic>e co/-%>+4 7,c7 ,section #aicc7;g7 ( su* ,act 7#db ,u4,s4,c4 #acifu-#c7;g77 is am5d$-- 7i7 9 p>agraph 7#b77,q71 by /rik+ p>agraph 7#d71 = ea* subsequ5t ye> & ins]t+ p>agraphs 7#d7 & 7#e71 = ea* subsequ5t ye> be=e #bjbc2 & 7ii7 by add+ at ! end ! foll[+3 7#e7 ,sunset ,no individual %all be select$ to be a qualify+ individual = any cal5d> ye> or p]iod "u ?is section beg9n+ on or aft] ,janu>y #a1 #bjbc1 & no ,/ate allocation %all be made = any fiscal ye> or p]iod "u ?is section beg9n+ on or aft] ,janu>y #a1 #bjbc4 4 7,d7 ,section #aice7;a7 ( su* ,act 7#db ,u4,s4,c4 #acifu-#e7;a77 is am5d$-- 7i7 9 p>agraph 7#b71 by /rik+ make det]m9ations & ins]t+ prior to ,janu>y #a1 #bjbc1 make det]m9ations2 & 7ii7 9 p>agraph 7#c71 by ins]t+ prior to ,janu>y #a1 #bjbc1 be=e ! ,/ate %all4 7#b7 ,title ,,xi ,section #aadd ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#ad7 is am5d$-- 7,a7 9 subsection 7a7-- 7i7 9 p>agraph 7#a77;,a7-- 7,i7 by /rik+ sections #aijb7;a77#aj77;,e7 & #aicc & ins]t+ section #aijb7;a77#aj77;,e7 & 7prior to ,janu>y #a1 #bjbc7 section #aicc2 7,,ii7 by /rik+ = ! transitional assi/ance "u section #ahfj;,d-#ca7;f71 or & ins]t+ a comma2 & 7,,iii7 by ins]t+ 1 or = ,m$ic>e premium & co/-%>+ assi/ance "u section #ahii;,b 79 ! case ( mon?s beg9n+ on or aft] ,janu>y #a1 #bjbc7 be=e ! semicolon2 & 7ii7 by /rik+ p>agraph 7#b7 & ins]t+ ! foll[+3 7#b7 ,cont5t ( notice ,any notice furni%$ "u p>agraph 7#a7 %all /ate t eligibility = su* m$ical assi/ance1 subsidies1 or program is condition$ ^u meet+ ! applicable eligibility crit]ia4 2 7,b7 9 subsection 7b77#a77;,a7-- 7i7 by /rik+ sections #aijb7;a77#aj77;,e7 & #aicc & ins]t+ section #aijb7;a77#aj77;,e7 & 7prior to ,janu>y #a1 #bjbc7 section #aicc2 7ii7 by /rik+ = transitional assi/ance "u section #ahfj;,d-#ca7;f71 or2 & 7iii7 by ins]t+ 1 or = ,m$ic>e premium & co/-%>+ assi/ance "u section #ahii;,b be=e ! semicolon2 & 7,c7 9 subsection 7c7-- 7i7 9 p>agraph 7#a77;,b71 by ins]t+ 1 & 7beg9n+ ,janu>y #a1 #bjbc17 provide an application = enrollm5t "u ! ,m$ic>e ,sav+s ,program be=e ! p]iod2 7ii7 9 p>agraph 7#b71 9 ! p>agraph head]1 by ins]t+ m$ic>e sav+s program application & be=e lis application2 & 7iii7 9 p>agraph 7#g71 by /rik+ means ! program ( m$ical assi/ance & all t foll[s ?r\gh ! p]iod & ins]t+ 8means-- 7,a7 prior to ,janu>y #a1 #bjbc1 ! program ( m$ical assi/ance = paym5t ( ! co/ ( m$ic>e co/-%>+ "u ! ,m$icaid program pursuant to sections #aijb7;a77#aj77;,e7 & #aicc2 & 7,b7 beg9n+ ,janu>y #a1 #bjbc1 ! program = m$ical assi/ance = paym5t ( ! co/ ( m$ic>e co/-%>+ = qualifi$ disabl$ & work+ individuals describ$ 9 section #aije7s7 pursuant to section #aijb7;a77#aj77;,e77ii7 & m$ic>e premium & co/-%>+ assi/ance provid$ "u section #ahii;,b4 4 7c7 ,ensur+ t ,m$ic>e co/-,%>+ b5efici>ies "u ,m$icaid receive ,m$ic>e co/ assi/ance ,n lat] ?an ,june #a1 #bjbb1 ! ,secret>y ( ,heal? & ,human ,s]vices & ! ,commission] ( ,social ,security %all jo9tly develop & implem5t a transition plan to ensure t all individuals :o are eligible = & are receiv+ m$ical assi/ance = ! paym5t ( m$ic>e co/-%>+ "u a ,/ate ,m$icaid program pursuant to clauses 7i71 7iii71 & 7iv7 ( section #aijb7;a77#aj77;,e7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#aj77;,e77 z ( ,decemb] #ca1 #bjbb1 receive ,m$ic>e co/ assi/ance "u section #ahii;,b ( su* ,act1 z add$ by section #b1 z ( ,janu>y #a1 #bjbc4 #d4 ,enhanc+ prescription drug af=dability by exp&+ access to assi/ance ) out-(-pocket co/s "u ,m$ic>e "p ,d = l[-income s5iors & individuals ) disabilities 7a7 ,exp&+ access ,section #ahfj;,d-#ad ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#aad7 is am5d$-- 7#a7 9 subsection 7a7-- 7,a7 9 ! head+1 by /rik+ #aej p]c5t & ins]t+ #bjj p]c5t2 7,b7 9 p>agraph 7#a7-- 7i7 9 ! head+1 by /rik+ #ace p]c5t & ins]t+ #bjj p]c5t2 & 7ii7 9 ! matt] prec$+ subp>agraph 7,a7-- 7,i7 by /rik+ #ace p]c5t & ins]t+ #bjj p]c5t2 & 7,,ii7 by /rik+ & :o meets ! res\rces requirem5t describ$ 9 p>agraph 7#c77;,d7 or :o is cov]$ "u ?is p>agraph "u p>agraph 7#c77;,b77i7 & ins]t+ or :o is cov]$ "u ?is p>agraph "u p>agraph 7#c77;,b77v72 7,c7 by /rik+ p>agraph 7#b72 7,d7 9 p>agraph 7#c7-- 7i7 9 subp>agraph 7,a7-- 7,i7 9 clause 7i71 by add+ & at ! end2 7,,ii7 9 clause 7ii7-- 7aa7 by /rik+ #aej p]c5t & ins]t+ #bjj p]c5t2 & 7bb7 by /rik+ 2 & at ! end & ins]t+ a p]iod2 & 7,,iii7 by /rik+ clause 7iii72 7ii7 by /rik+ subp>agraphs 7,b7 & 7,c7 & ins]t+ ! foll[+3 7,b7 ,det]m9ations ,= provisions relat+ to jo9t det]m9ations ) respect to eligibility = ,m$ic>e co/ assi/ance "u section #ahii;,b & premium & co/-%>+ subsidies "u ?is section1 see section #ahii;,b7b77#b74 7,c7 ,income det]m9ations ,= purposes ( apply+ ?is section-- 7i7 9 ! case ( an individual :o is n treat$ z a ,m$ic>e co/-%>+ assi/ance eligible individual & a subsidy eligible individual "u section #ahii;,b7b77#b77;,d71 income %all be det]m9$ 9 ! mann] describ$ "u section #afab = purposes ( ! supplem5tal security income program1 except t support & ma9t5ance furni%$ 9 k9d %all n be c\nt$ z income2 & 7ii7 ! t]m pov]ty l9e has ! mean+ giv5 su* t]m 9 section #fgc7b7 ( ! ,community ,s]vices ,block ,grant ,act 7#db ,u4,s4,c4 #iijb7b771 includ+ any revision requir$ by su* section4 4 7iii7 by /rik+ subp>agraphs 7,d71 7,e71 & 7,g72 & 7,e7 9 p>agraph 7#d71 by /rik+ subp>agraph 7,b72 & 7#b7 9 subsection 7c77#a71 9 ! second s5t5ce1 by /rik+ subsections 7a77#a77;,d7 & 7a77#b77;,e7 & ins]t+ subsection 7a77#a77;,d74 7b7 ,treatm5t ( r$uction ( co/-,%>+ = individuals receiv+ home & community bas$ s]vices ,section #ahfj;,d-#ad7;a77#a77;,d7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#aad7;a77#a77;,d77 is am5d$-- 7#a7 by /rik+ :o w\ld be su* an in/itutionaliz$ individual or c\ple1 if ! full-b5efit dual eligible individual 7 n2 & 7#b7 by /rik+ or subsection 7c7 or 7d7 ( section #aiae or "u a ,/ate plan am5dm5t "u subsection 7i7 ( su* section & ins]t+ 1 section #aaae;,a1 section #aiae1 or "u a ,/ate plan am5dm5t4 7c7 ,effective date ,! am5dm5ts made by ?is section %all apply to plan ye> #bjbc & subsequ5t plan ye>s4