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42 U.S.C. § 1396w–1 — Medicaid Improvement Fund

submitted 91 years ago by Pub. L. 110-252 to r/title-42-THE-PUBLIC-HEALTH-AND-WELFARE · 463 words · no verdicts yet

in plain englishAI-generated · not legal advice

This section establishes the Medicaid Improvement Fund for CMS Medicaid-management activities. The supplied text makes $0 available for fiscal year 2023 and later, and separately makes $0 available from fiscal year 2028 onward for specified State mechanized-claims-system activities.

(a) Establishment. The Secretary must establish a Medicaid Improvement Fund under this subchapter. The Fund is available to improve CMS management of Medicaid, including contract and contractor oversight and demonstration-project evaluation, and, under subsection (b)(3), the purpose in that subsection’s subparagraph (B). Payments for these activities supplement payments otherwise made for them. (b)(1) General funding. For fiscal year 2023 and later, $0 is available to the Fund for spending. (2) Funding limit. Amounts under paragraph (1) may be used before an appropriation only up to the amount available under paragraph (1). Amounts under paragraph (3) may be used before an appropriation only up to the amount available under paragraph (3). The Secretary may obligate Fund money only after determining, and having the CMS Chief Actuary and the appropriate budget officer certify, that the Fund has enough money to cover all obligations incurred consistently with these limits. (3) Extra funding for State mechanized-claims-system activities. (A) In addition to paragraph (1), $0 is available for fiscal year 2028 and later for the purpose in (B), and remains available until spent. (B) For each quarter beginning during or after fiscal year 2025, the Secretary must pay each State with an approved plan an amount equal to: (i) 100 percent minus the percentage in section 1396b(a)(3)(A)(i), multiplied by the State’s quarter spending attributable to the activities described there; (ii) 100 percent minus the FMAP under section 1396b(a)(3)(A)(iii), multiplied by the quarter spending the Secretary finds necessary that is attributable to those activities; and (iii) 100 percent minus the percentage in section 1396b(a)(3)(B), multiplied by the State’s quarter spending attributable to the activities described there.

the actual law source: uscode.house.gov ↗public domain
(a) Establishment

The Secretary shall establish under this subchapter a Medicaid Improvement Fund (in this section referred to as the “Fund”) which shall be available to the Secretary to improve the management of the Medicaid program by the Centers for Medicare & Medicaid Services, including oversight of contracts and contractors and evaluation of demonstration projects, and, in accordance with subsection (b)(3), for the purposes of subparagraph (B) of such subsection. Payments made for activities under this subsection shall be in addition to payments that would otherwise be made for such activities.

(b) Funding
(1) In general

There shall be available to the Fund, for expenditures from the Fund for fiscal year 2023 and thereafter, $0.

(2) Funding limitation

Amounts in the Fund pursuant to paragraph (1) shall be available in advance of appropriations but only if the total amount obligated from the Fund does not exceed the amount available to the Fund under paragraph (1). Amounts in the Fund pursuant to paragraph (3) shall be available in advance of appropriations but only if the total amount obligated from the Fund does not exceed the amount available to the Fund under such paragraph (3). The Secretary may obligate funds from the Fund only if the Secretary determines (and the Chief Actuary of the Centers for Medicare & Medicaid Services and the appropriate budget officer certify) that there are available in the Fund sufficient amounts to cover all such obligations incurred consistent with the previous sentences.

(3) Additional funding for State activities relating to mechanized claims systems
(A) In general

In addition to the amount made available under paragraph (1), there shall be available to the Fund, for expenditures from the Fund in accordance with subparagraph (B), for fiscal year 2028 and thereafter, $0, to remain available until expended.

(B) Purposes

The Secretary shall use amounts made available to the Fund under subparagraph (A) to pay to each State which has a plan approved under this subchapter, for each quarter beginning during or after fiscal year 2025 an amount equal to—

(i)

100 percent minus the percent specified in clause (i) of section 1396b(a)(3)(A) of this title of so much of the sums expended by the State during such quarter as are attributable to the activities described in such clause;

(ii)

100 percent minus the Federal medical assistance percentage applied under clause (iii) of such section of so much of the sums expended during such quarter (as found necessary by the Secretary under such clause) by the State as are attributable to the activities described in such clause; and

(iii)

100 percent minus the percent specified in section 1396b(a)(3)(B) of this title of so much of the sums expended by the State during such quarter as are attributable to the activities described in such section.

Source credit: (Aug. 14, 1935, ch. 531, title XIX, § 1941, as added Pub. L. 110–252, title VII, § 7002(b), June 30, 2008, 122 Stat. 2395; amended Pub. L. 111–8, div. F, title II, § 226, Mar. 11, 2009, 123 Stat. 784; Pub. L. 111–127, § 4, Jan. 27, 2010, 124 Stat. 5; Pub. L. 111–148, title II, § 2007(b), Mar. 23, 2010, 124 Stat. 285; Pub. L. 114–198, title VII, § 707, July 22, 2016, 130 Stat. 754; Pub. L. 115–120, div. C, § 3006, Jan. 22, 2018, 132 Stat. 37; Pub. L. 115–123, div. E, title XII, § 53105, Feb. 9, 2018, 132 Stat. 302; Pub. L. 115–271, title V, § 5061, Oct. 24, 2018, 132 Stat. 3976; Pub. L. 116–3, § 5, Jan. 24, 2019, 133 Stat. 8; Pub. L. 116–29, § 2, July 5, 2019, 133 Stat. 1031; Pub. L. 116–59, div. B, title VI, § 1604, Sept. 27, 2019, 133 Stat. 1108; Pub. L. 116–69, div. B, title VI, § 1602, Nov. 21, 2019, 133 Stat. 1139; Pub. L. 116–159, div. C, title VI, § 2602, Oct. 1, 2020, 134 Stat. 738; Pub. L. 116–215, div. B, title III, § 1303, Dec. 11, 2020, 134 Stat. 1046; Pub. L. 116–260, div. CC, title IV, § 406, Dec. 27, 2020, 134 Stat. 3003; Pub. L. 117–328, div. FF, title V, § 5141, Dec. 29, 2022, 136 Stat. 5953; Pub. L. 118–15, div. B, title III, § 2342, Sept. 30, 2023, 137 Stat. 96; Pub. L. 118–22, div. B, title II, § 302, Nov. 17, 2023, 137 Stat. 121; Pub. L. 118–35, div. B, title I, § 122, Jan. 19, 2024, 138 Stat. 6; Pub. L. 118–42, div. G, title I, § 212, Mar. 9, 2024, 138 Stat. 414.)

history & why it existsrecord from the source credit
  • 1935Enacted · Pub. L. 110-252 · 122 Stat. 2395
  • 2009Amended · Pub. L. 111-8 · 123 Stat. 784
  • 2010Amended · Pub. L. 111-127 · 124 Stat. 5
  • 2010Amended · Pub. L. 111-148 · 124 Stat. 285
  • 2016Amended · Pub. L. 114-198 · 130 Stat. 754
  • 2018Amended · Pub. L. 115-120 · 132 Stat. 37
  • 2018Amended · Pub. L. 115-123 · 132 Stat. 302
  • 2018Amended · Pub. L. 115-271 · 132 Stat. 3976
  • 2019Amended · Pub. L. 116-3 · 133 Stat. 8
  • 2019Amended · Pub. L. 116-29 · 133 Stat. 1031
  • 2019Amended · Pub. L. 116-59 · 133 Stat. 1108
  • 2019Amended · Pub. L. 116-69 · 133 Stat. 1139
  • 2020Amended · Pub. L. 116-159 · 134 Stat. 738
  • 2020Amended · Pub. L. 116-215 · 134 Stat. 1046
  • 2020Amended · Pub. L. 116-260 · 134 Stat. 3003
  • 2022Amended · Pub. L. 117-328 · 136 Stat. 5953
  • 2023Amended · Pub. L. 118-15 · 137 Stat. 96
  • 2023Amended · Pub. L. 118-22 · 137 Stat. 121
  • 2024Amended · Pub. L. 118-35 · 138 Stat. 6
  • 2024Amended · Pub. L. 118-42 · 138 Stat. 414

A history note hasn’t been published yet. The record shows enactment by Pub. L. 110-252 on 1935-08-14.

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