,,ii  #aag? ,,congress  #b;d ,session   
,s4 #cfcj  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,febru>y #aj1 #bjbb,mr4
 ,scott ( ,s\? ,c>ol9a introduc$ !      
foll[+ bill2 :i* 0 read twice & ref]r$  
to ! ,committee on ,f9ance  ,a ,,bill   
,to e/abli% a ,dual ,eligible ,quality  
,c>e ,fund to provide grants to ,/ate   
,m$icaid programs to improve _! capacity
 to ensure ! provision ( quality        
integrat$ c>e = dual eligible           
b5efici>ies4  #a4 ,%ort title ,?is ,act 
may be cit$ z ! ,support+ ,c>e = ,dual  
,eligibles ,act4  #b4 ,improv+          
,m$icaid's capacity to protect dual     
eligible b5efici>ies  7a7 ,e/abli%m5t ( 
,dual ,eligible ,quality ,c>e ,fund     
7#a7 ,9 g5]al ,n lat] ?an #f mon?s aft] 
! date ( enactm5t ( ?is ,act1 !         
,secret>y ( ,heal? & ,human ,s]vices    
7ref]r$ to 9 ?is section z ! ,secret>y7 
%all e/abli% a fund to be kn[n z ! ,dual
 ,eligible ,quality ,c>e ,fund4  7#b7   
,e/abli%m5t )9 ,f$]al ,coord9at$ ,heal? 
,c>e ,(fice ,! ,dual ,eligible ,quality 

,c>e ,fund %all be e/abli%$ )91 &       
adm9i/]$ by ! ,director (1 ! ,f$]al     
,coord9at$ ,heal? ,c>e ,(fice e/abli%$  
"u section #bfjb ( ! ,pati5t ,protection
 & ,af=dable ,c>e ,act 7#db ,u4,s4,c4   
#acae;b74  7#c7 ,fund+ ,!re is          
appropriat$ to ! ,dual ,eligible        
,quality ,c>e ,fund = fiscal ye> #bjbb  
#ajj1jjj1jjj1 to rema9 available until  
exp5d$4  7b7 ,purpose ,! purpose ( !    
,dual ,eligible ,quality ,c>e ,fund is  
to provide timely1 t>get$ assi/ance 9 ! 
way ( grants to ,/ate ,m$icaid programs 
to improve _! capacity to ensure !      
provision ( quality integrat$ c>e = dual
 eligible b5efici>ies4  7c7 ,all[able   
uses ( grant funds ,a ,/ate ,m$icaid    
program may use am\nts receiv$ "u a     
grant f ! ,dual ,eligible ,quality ,c>e 
,fund to improve its capacity to provide
 quality integrat$ c>e = dual eligible  
b5efici>ies ?r\gh any ( ! foll[+3 7#a7  
,recruit+ & pay+ work]s ) ne$$ subject  
matt] k1 skills1 or capabilities4  7#b7 
,actu>ial support = rate developm5t &   

analysis & developm5t or pur*ase ( risk 
adju/m5t tools4  7#c7 ,in=mation        
te*nology sy/em *anges1 includ+ *anges  
t-- 7,a7 improve memb] enrollm5ts2  7,b7
 improve enc\nt] data collection &      
analysis2  7,c7 improve ! ability (     
,/ate ,m$icaid programs to develop      
cu/omiz$ data managem5t tools 7su* z    
qu]ies & da%bo>ds72  7,d7 improve       
compliance ) ,f$]al report+ requirem5ts2
  7,e7 enhance f9ancial analysis2  7,f7 
improve quality report+ & monitor+2     
7,g7 improve modifications to capitation
 paym5ts2  7,h7 transf] eligibility &   
enrollm5t data betwe5 sy/ems2  7,i7     
improve ! grievances & appeals process2 
&  7,j7 improve int]action ) ,m$ic>e    
data & relat$ sy/ems4  7#d7 ,provid+    
support = dual eligible b5efici>ies dur+
 enrollm5t processes1 assi/ance to dual 
eligible b5efici>ies evaluat+ _!        
enrollm5t *oices1 in=mational mat]ials  
to dual eligible b5efici>ies & ^? assi/+
 ) decision support1 & coord9ation )    
,m$ic>e enrollm5t processes4  7#e7      

,monitor+ & ov]sight ( ef=ts und]tak5 by
 ,/ate ,m$icaid us+ grant funds1 includ+
 measur+ ! level ( p>ticipation by      
/akehold]s & dual eligible b5efici>ies4 
7#f7 ,quality measurem5t & ,/ate        
evaluation activities1 developm5t &     
deploym5t ( survey tools1 & co/s (      
access+1 transf]r+1 & analyz+ data4     
7#g7 ,develop k & und]/&+ )9 ! ,/ate    
,m$icaid ag5cy ( ! ,m$ic>e program "u   
title ,,xviii ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acie et seq474  7#h7   
,support+ & improv+ ,m$ic>e initiatives1
 includ+ new initiatives & exi/+ or pa/ 
initiatives su* z ! ,f9ancial ,alignm5t 
,initiative = ,m$ic>e-,m$icaid          
,enrollees demon/ration projects        
conduct$ "u section #aaae;,a ( ! ,social
 ,security ,act 7#db ,u4,s4,c4 #acae;a74
  7d7 ,aw>d+ grants  7#a7 ,9 g5]al ,a   
,/ate ,m$icaid program t wi%es to       
receive a grant "u ?is section f ! ,dual
 ,eligible ,quality ,c>e ,fund %all     
submit an application to ! ,director ( !
 ,f$]al ,coord9at$ ,heal? ,c>e ,(fice   

7ref]r$ to 9 ?is subsection z !         
,director71 9 su* =m & mann] z !        
,director %all specify4 ,! ,director may
 aw>d a grant "u ?is section to any     
,/ate1 )\t reg>d to ! ,/ate's exi/+     
capacity to provide quality integrat$   
c>e = dual eligible b5efici>ies4  7#b7  
,application requirem5ts ,an application
 = a grant "u ?is section %all include  
an id5tification ( ! uses ( funds       
describ$ 9 subsection 7c7 = :i* ! ,/ate 
,m$icaid program w use ! grant funds4   
7#c7 ,me?odology = disburs+ funds  7,a7 
,9 g5]al ,n lat] ?an #f mon?s aft] !    
date ( enactm5t ( ?is ,act1 ! ,director 
%all issue guidance e/abli%+ a cle> &   
equitable me?odology = aw>d+ grants to  
,/ate ,m$icaid programs "u ?is section4 
7,b7 ,me?odology requirem5ts ,!         
me?odology e/abli%$ by ! ,director "u   
?is p>agraph %all1 to ! ext5t           
practical-- 7i7 ensure t grant funds are
 us$ 9 accordance ) subsection 7c72     
7ii7 provide t grants are aw>d$ by !    
,director 9 a mann] t is transp>5t &    

equitable to ,/ate ,m$icaid programs2 & 
7iii7 provide t1 9 det]m9+ ! grant am\nt
 to be aw>d$ to a ,/ate ,m$icaid        
program1 ! ,director %all take into     
consid]ation-- 7,i7 ! p]c5tage (        
enrollees 9 ! program :o are dual       
eligible b5efici>ies2 &  7,,ii7 ! total 
numb] ( dual eligible b5efici>ies       
enroll$ 9 ! program4  7,c7 ,limitations 
,! ,director %all n aw>d m ?an #a grant 
"u ?is section to any ,/ate ,m$icaid    
program1 & 9 no case may ! am\nt ( a    
grant aw>d$ "u ?is section exce$        
#b1jjj1jjj4  7e7 ,/ate program report+  
7#a7 ,qu>t]ly ,report+ ,/ates receiv+ a 
grant "u ?is section %all1 9 a =m &     
mann] specifi$ by ! ,director ( ! ,f$]al
 ,coord9at$ ,heal? ,c>e ,(fice 7ref]r$  
to 9 ?is subsection z ! ,director71     
report no less frequ5tly ?an once a     
qu>t] reg>d+ ! am\nt ( grant funds sp5t 
by ! ,/ate & h[ funds receiv$ f ! grant 
are be+ us$ )9 ! ,/ate4  7#b7           
,longitud9al ,report ,/ates receiv+ a   
grant "u ?is section %all1 no lat] ?an  

#b ye>s aft] ! receipt ( su* grant1     
submit to ! ,director & make available  
on a ,/ate website a report summ>iz+ h[ 
! funds receiv$ "u su* grant 7 us$4 ,su*
 report %all include ! foll[+3 7,a7 ,an 
explanation ( :i* uses ( funds describ$ 
9 subsection 7c7 ! grant funds support$4
  7,b7 ,an assessm5t ( ea* ( ! foll[+3  
7i7 ,! mann] 9 :i* ! grant funds improv$
 ! ,/ate ,m$icaid program's capacity to 
provide quality integrat$ c>e = dual    
eligible b5efici>ies4  7ii7 ,! mann] 9  
:i* ! grant funds improv$ ! quality (   
c>e = dual eligible b5efici>ies4  7iii7 
,! mann] 9 :i* ! grant funds improv$ !  
integration & coord9ation ( c>e = dual  
eligible b5efici>ies4  7f7 ,def9itions  
,9 ?is section3 7#a7 ,dual eligible     
b5efici>y ,! t]m dual eligible b5efici>y
 means an individual :o is entitl$ to1  
or enroll$ =1 b5efits "u "p ,a ( title  
,,xviii ( ! ,social ,security ,act 7#db 
,u4,s4,c4 #acie et seq471 or enroll$ =  
b5efits "u "p ,b ( su* title1 & is      
eligible = m$ical assi/ance "u a ,/ate  

plan "u title ,,xix ( su* ,act 7#db     
,u4,s4,c4 #acif et seq47 or "u a waiv] (
 su* a plan4  7#b7 ,quality integrat$   
c>e ,! t]m quality integrat$ c>e means !
 provision ( s]vices provid$ "u !       
,m$ic>e program "u title ,,xviii ( !    
,social ,security ,act 7#db ,u4,s4,c4   
#acie et seq47 & s]vices provid$ "u a   
,/ate ,m$icaid program-- 7,a7 ?r\gh     
sy/ems 9 :i* ,m$icaid & ,m$ic>e program 
adm9i/rative requirem5ts1 f9anc+1       
b5efits1 or c>e deliv]y are align$2 &   
7,b7 9 a coord9at$ fa%ion1 :i* may      
include cov]age ( su* s]vices ?r\gh a   
s+le entity or coord9at+ entities4  7#c7
 ,/ate ,! t]m ,/ate has ! mean+ giv5 su*
 t]m = purposes ( title ,,xix ( !       
,social ,security ,act 7#db ,u4,s4,c4   
#acif et seq474  7#d7 ,/ate ,m$icaid    
program ,! t]m ,/ate ,m$icaid program   
means a ,/ate plan "u title ,,xix ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#acif et seq471 & includes any waiv] (  
su* a plan4  #c4 ,paym5t error rate     
measurem5t 7,,p]m7 audit requirem5ts    

7a7 ,bi5nial ,,p]m audit requirem5t     
,beg9n+ ) fiscal ye> #bjbc1 !           
,adm9i/rator %all conduct paym5t error  
rate measurem5t 7,,p]m7 audits ( ea*    
,/ate ,m$icaid program on a bi5nial     
basis4  7b7 ,notification2 id5tification
 ( s\rces ( improp] paym5ts  7#a7       
,notification ,n lat] ?an #f mon?s aft] 
! date ( enactm5t ( ?is ,act1 !         
,adm9i/rator %all notify ! contractor   
conduct+ ,,p]m audits ( ! ,adm9i/rator's
 int5t to modify contracts to require   
,,p]m audits n less ?an once e o!r ye> 9
 ea* ,/ate4  7#b7 ,id5tification (      
s\rces ( improp] paym5ts ,! ,adm9i/rator
 %all direct ! contractor conduct+ ,,p]m
 audits ( ,/ate ,m$icaid programs to    
id5tify areas kn[n to be s\rces (       
improp] paym5ts "u su* programs to      
id5tify program areas or compon5ts kn[n 
to be s\rces ( high risk = improp]      
paym5ts "u su* programs4  7c7 ,/ate     
,m$icaid director lett] ,n lat] ?an #ab 
mon?s aft] ! date ( enactm5t ( ?is ,act1
 ! ,adm9i/rator %all issue a ,/ate      

,m$icaid ,director lett] reg>d+ ,/ate   
requirem5ts "u ,f$]al law & regulations 
reg>d+ avoid+ & respond+ to improp]     
paym5ts "u ,/ate ,m$icaid programs4  7d7
 ,/ate improp] paym5t mitigation plans  
7#a7 ,9 g5]al ,n lat] ?an ,janu>y #a1   
#bjbc1 ea* ,/ate ,m$icaid program %all  
submit to ! ,adm9i/rator a plan1 :i*    
%all include specific actions &         
timeframes = tak+ su* actions & a*iev+  
specifi$ results1 = mitigat+ improp]    
paym5ts "u su* program4  7#b7           
,publication ( ,/ate plans ,!           
,adm9i/rator %all make ,/ate plans      
submitt$ "u p>agraph 7#a7 available to !
 public4  7e7 ,def9itions ,9 ?is        
section3 7#a7 ,adm9i/rator ,! t]m       
,adm9i/rator means ! ,adm9i/rator ( !   
,c5t]s = ,m$ic>e  ,m$icaid ,s]vices4    
7#b7 ,/ate ,! t]m ,/ate has ! mean+ giv5
 su* t]m = purposes ( title ,,xix ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#acif et seq474  7#c7 ,/ate ,m$icaid    
program ,! t]m ,/ate ,m$icaid program   
means a ,/ate plan "u title ,,xix ( !   

,social ,security ,act 7#db ,u4,s4,c4   
#acif et seq471 & includes any waiv] (  
su* a plan4