[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8106 Introduced in House (IH)]
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118th CONGRESS
2d Session
H. R. 8106
To amend title XIX of the Social Security Act to increase transparency
and expand coverage options with respect to home and community-based
services under a Medicaid waiver.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
April 23, 2024
Mrs. Rodgers of Washington (for herself and Mr. Pallone) introduced the
following bill; which was referred to the Committee on Energy and
Commerce
_______________________________________________________________________
A BILL
To amend title XIX of the Social Security Act to increase transparency
and expand coverage options with respect to home and community-based
services under a Medicaid waiver.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. INCREASING TRANSPARENCY AND EXPANDING HCBS COVERAGE OPTIONS.
Section 1915(c) of the Social Security Act (42 U.S.C. 1396n(c)) is
amended--
(1) in paragraph (2)--
(A) in subparagraph (E)--
(i) by inserting ``, not less frequently
than'' before ``annually''; and
(ii) by inserting ``(including, with
respect to such information provided on or
after January 1, 2028, the information
specified in paragraph (12))'' before the
period at the end; and
(B) by adding at the end the following flush
sentence:
``The Secretary shall make all information provided under subparagraph
(E) on or after January 1, 2028, publicly available on the website of
the Centers for Medicare & Medicaid Services.''; and
(2) by adding at the end the following new paragraphs:
``(11)(A) Notwithstanding paragraph (1), the Secretary may
approve a waiver under this subsection for a State to include
as medical assistance under the State plan of such State
payment for part or all of the cost of home or community-based
services (other than room and board (as described in such
paragraph)) approved by the Secretary which are provided
pursuant to a written plan of care to individuals other than
individuals described in such paragraph if such State meets the
requirements specified in subparagraph (B).
``(B) For purposes of paragraph (1), the requirements
specified in this paragraph are, with respect to a State, the
following:
``(i) As of the date that such State requests a
waiver under this subsection to provide home or
community-based services to individuals with respect to
whom there has not been a determination described in
such paragraph made, all other waivers (if any) granted
under this subsection with respect to the State plan
meet the requirements of this subsection.
``(ii) The State demonstrates to the Secretary that
approval of a waiver under this subsection with respect
to individuals described in clause (i) will have no
material impact on the average amount of time that
individuals with respect to whom a determination
described in paragraph (1) has been made will need to
wait to receive home or community-based services under
any waiver granted under this subsection.
``(iii) The State provides to the Secretary--
``(I) an estimate of the number of
individuals described in clause (i) that the
State will make such services available to
under a waiver under this subsection; and
``(II) a description of how the types and
quantities of such services furnished to such
individuals under such a waiver may differ from
the types and quantities of such services
furnished to individuals not described in
clause (i) under such a waiver.
``(12) For purposes of paragraph (2)(E), the information
specified in this paragraph is the following:
``(A) In the case of a State that limits the number
of individuals who may be provided home or community-
based services under a waiver granted under this
subsection--
``(i) a description of how the State
maintains its list of individuals who have
applied to receive such services under such
waiver but who, due to such limit, have not yet
been approved to receive such services;
``(ii) information on whether the State
screens individuals on such list to determine
whether such individuals are eligible to
receive such services under such waiver;
``(iii) information on whether (and, if
applicable, how often) the State periodically
re-screens such individuals to determine
whether such individuals are so eligible; and
``(iv) the average amount of time that
individuals approved to receive such services
were on such list.
``(B) A description of the types of services
furnished under waivers under this subsection,
including the following:
``(i) The average amount of time from when
such services are initially approved for an
individual to when such individual begins
receiving such services.
``(ii) With respect to the most recent 1-
year period ending on the date that such
information is provided to the Secretary for
which data is available (or such other period
as may be specified by the Secretary), the
average percentage of hours of home or
community-based services authorized under
written plans of care for individuals receiving
such services under a waiver granted under this
subsection that are actually furnished to such
individual.
``(C) Information regarding access to homemaker
services, home health aide services, and personal care
services under waivers under this subsection, including
the following:
``(i) With respect to the most recent 1-
year period ending on the date that such
information is provided to the Secretary for
which data is available, the average amount of
time from when homemaker services, home health
aide services, or personal care services are
initially approved to be furnished to
individuals under such a waiver to when
services began.
``(ii) With respect to the period described
in clause (i), the average percentage of hours
of homemaker services, home health aide
services, and personal care services authorized
under written plans of care for individuals
receiving such services under a waiver granted
under this subsection that are actually
furnished to such individual.''.
SEC. 2. CMS GUIDANCE TO STATES ON INTERIM COVERAGE UNDER WAIVER.
Not later than January 1, 2025, the Secretary of Health and Human
Services shall issue guidance to the States to clarify how a State with
a waiver in effect under section 1915(c) of the Social Security Act (42
U.S.C. 1396n(c)) may provide, with respect to an individual who is
eligible for home and community-based services (as such term is
described in such section) under such waiver, up to 60 days of coverage
of such services under an interim care plan for the period beginning on
the date such eligibility is determined and ending on the date that a
written plan of care (as such term is described in such section) with
respect to such individual is finalized.
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