Medicare, Medicaid, and SCHIP Extension Act of 2007/Title II

TITLE II — MEDICAID AND SCHIP

SEC. 201. EXTENDING SCHIP FUNDING THROUGH MARCH 31, 2009.

(a) Through the Second Quarter of Fiscal Year 2009.—

(1) In General.—

Section 2104 of the Social Security Act (42 U.S.C. 1397dd) is amended—

(A) in subsection (a)—

(i) by striking ``and´´ at the end of paragraph (9);

(ii) by striking the period at the end of paragraph (10) and inserting ``; and´´; and

(iii) by adding at the end the following new paragraph:

``(11) for each of fiscal years 2008 and 2009, $5,000,000,000.´´; and

(B) in subsection (c)(4)(B), by striking ``for fiscal year 2007´´ and inserting ``for each of fiscal years 2007 through 2009´´.

(2) Availability of Extended Funding.—

Funds made available from any allotment made from funds appropriated under subsection (a)(11) or (c)(4)(B) of section 2104 of the Social Security Act (42 U.S.C. 1397dd) for fiscal year 2008 or 2009 shall not be available for child health assistance for items and services furnished after March 31, 2009, or, if earlier, the date of the enactment of an Act that provides funding for fiscal years 2008 and 2009, and for one or more subsequent fiscal years for the State Children's Health Insurance Program under title XXI of the Social Security Act.

(3) End of Funding Under Continuing Resolution.—

Section 136(a)(2) of Public Law 110-92 is amended by striking ``after the termination date´´ and all that follows and inserting ``after the date of the enactment of the Medicare, Medicaid, and SCHIP Extension Act of 2007.´´.

(4) Clarification of Application of Funding Under Continuing Resolution.—

Section 107 of Public Law 110-92 shall apply with respect to expenditures made pursuant to section 136(a)(1) of such Public Law.

(b) Extension of Treatment of Qualifying States; Rules on Redistribution of Unspent Fiscal Year 2005 Allotments Made Permanent.—

(1) In General.—

Section 2105(g)(1)(A) of the Social Security Act (42 U.S.C. 1397ee(g)(1)(A)), as amended by subsection (d) of section 136 of Public Law 110-92, is amended by striking ``or 2008´´ and inserting ``2008, or 2009´´.

(2) Applicability.—

The amendment made by paragraph (1) shall be in effect through March 31, 2009.

(3) Certain Rules Made Permanent.—

Subsection (e) of section 136 of Public Law 110-92 is repealed.

(c) Additional Allotments to Eliminate Remaining Funding Shortfalls Through March 31, 2009.—

(1) In General.—

Section 2104 of the Social Security Act (42 U.S.C. 1397dd) is amended by adding at the end the following new subsections:

``(j) Additional Allotments To Eliminate Funding Shortfalls for Fiscal Year 2008.—

``(1) Appropriation; allotment authority.—For the purpose of providing additional allotments described in subparagraphs (A) and (B) of paragraph (3), there is appropriated, out of any money in the Treasury not otherwise appropriated, such sums as may be necessary, not to exceed $1,600,000,000 for fiscal year 2008.

``(2) Shortfall states described.—For purposes of paragraph (3), a shortfall State described in this paragraph is a State with a State child health plan approved under this title for which the Secretary estimates, on the basis of the most recent data available to the Secretary as of November 30, 2007, that the Federal share amount of the projected expenditures under such plan for such State for fiscal year 2008 will exceed the sum of—

``(A) the amount of the State's allotments for each of fiscal years 2006 and 2007 that will not be expended by the end of fiscal year 2007;

``(B) the amount, if any, that is to be redistributed to the State during fiscal year 2008 in accordance with subsection (i); and

``(C) the amount of the State's allotment for fiscal year 2008.

``(3) Allotments.—In addition to the allotments provided under subsections (b) and (c), subject to paragraph (4), of the amount available for the additional allotments under paragraph (1) for fiscal year 2008, the Secretary shall allot—

``(A) to each shortfall State described in paragraph (2) not described in subparagraph (B), such amount as the Secretary determines will eliminate the estimated shortfall described in such paragraph for the State; and

``(B) to each commonwealth or territory described in subsection (c)(3), an amount equal to the percentage specified in subsection (c)(2) for the commonwealth or territory multiplied by 1.05 percent of the sum of the amounts determined for each shortfall State under subparagraph (A).

``(4) Proration rule.—If the amounts available for additional allotments under paragraph (1) are less than the total of the amounts determined under subparagraphs (A) and (B) of paragraph (3), the amounts computed under such subparagraphs shall be reduced proportionally.

``(5) Retrospective adjustment.—The Secretary may adjust the estimates and determinations made to carry out this subsection as necessary on the basis of the amounts reported by States not later than November 30, 2008, on CMS Form 64 or CMS Form 21, as the case may be, and as approved by the Secretary.

``(6) One-year availability; no redistribution of unexpended additional allotments.—Notwithstanding subsections (e) and (f), amounts allotted to a State pursuant to this subsection for fiscal year 2008, subject to paragraph (5), shall only remain available for expenditure by the State through September 30, 2008. Any amounts of such allotments that remain unexpended as of such date shall not be subject to redistribution under subsection (f).

``(k) Redistribution of Unused Fiscal Year 2006 Allotments to States With Estimated Funding Shortfalls During the First 2 Quarters of Fiscal Year 2009.—

``(1) In general.—Notwithstanding subsection (f) and subject to paragraphs (3) and (4), with respect to months beginning during the first 2 quarters of fiscal year 2009, the Secretary shall provide for a redistribution under such subsection from the allotments for fiscal year 2006 under subsection (b) that are not expended by the end of fiscal year 2008, to a fiscal year 2009 shortfall State described in paragraph (2), such amount as the Secretary determines will eliminate the estimated shortfall described in such paragraph for such State for the month.

``(2) Fiscal year 2009 shortfall state described.—A fiscal year 2009 shortfall State described in this paragraph is a State with a State child health plan approved under this title for which the Secretary estimates, on a monthly basis using the most recent data available to the Secretary as of such month, that the Federal share amount of the projected expenditures under such plan for such State for the first 2 quarters of fiscal year 2009 will exceed the sum of—

``(A) the amount of the State's allotments for each of fiscal years 2007 and 2008 that was not expended by the end of fiscal year 2008; and

``(B) the amount of the State's allotment for fiscal year 2009.

``(3) Funds redistributed in the order in which states realize funding shortfalls.—The Secretary shall redistribute the amounts available for redistribution under paragraph (1) to fiscal year 2009 shortfall States described in paragraph (2) in the order in which such States realize monthly funding shortfalls under this title for fiscal year 2009. The Secretary shall only make redistributions under this subsection to the extent that there are unexpended fiscal year 2006 allotments under subsection (b) available for such redistributions.

``(4) Proration rule.—If the amounts available for redistribution under paragraph (1) are less than the total amounts of the estimated shortfalls determined for the month under that paragraph, the amount computed under such paragraph for each fiscal year 2009 shortfall State for the month shall be reduced proportionally.

``(5) Retrospective adjustment.—The Secretary may adjust the estimates and determinations made to carry out this subsection as necessary on the basis of the amounts reported by States not later than May 31, 2009, on CMS Form 64 or CMS Form 21, as the case may be, and as approved by the Secretary.

``(6) Availability; no further redistribution.—Notwithstanding subsections (e) and (f), amounts redistributed to a State pursuant to this subsection for the first 2 quarters of fiscal year 2009 shall only remain available for expenditure by the State through March 31, 2009, and any amounts of such redistributions that remain unexpended as of such date, shall not be subject to redistribution under subsection (f).

``(l) Additional Allotments To Eliminate Funding Shortfalls for the First 2 Quarters of Fiscal Year 2009.—

``(1) Appropriation; allotment authority.—For the purpose of providing additional allotments described in subparagraphs (A) and (B) of paragraph (3), there is appropriated, out of any money in the Treasury not otherwise appropriated, such sums as may be necessary, not to exceed $275,000,000 for the first 2 quarters of fiscal year 2009.

``(2) Shortfall states described.—For purposes of paragraph (3), a shortfall State described in this paragraph is a State with a State child health plan approved under this title for which the Secretary estimates, on the basis of the most recent data available to the Secretary, that the Federal share amount of the projected expenditures under such plan for such State for the first 2 quarters of fiscal year 2009 will exceed the sum of—

``(A) the amount of the State's allotments for each of fiscal years 2007 and 2008 that will not be expended by the end of fiscal year 2008;

``(B) the amount, if any, that is to be redistributed to the State during fiscal year 2009 in accordance with subsection (k); and

``(C) the amount of the State's allotment for fiscal year 2009.

``(3) Allotments.—In addition to the allotments provided under subsections (b) and (c), subject to paragraph (4), of the amount available for the additional allotments under paragraph (1) for the first 2 quarters of fiscal year 2009, the Secretary shall allot—

``(A) to each shortfall State described in paragraph (2) not described in subparagraph (B) such amount as the Secretary determines will eliminate the estimated shortfall described in such paragraph for the State; and

``(B) to each commonwealth or territory described in subsection (c)(3), an amount equal to the percentage specified in subsection (c)(2) for the commonwealth or territory multiplied by 1.05 percent of the sum of the amounts determined for each shortfall State under subparagraph (A).

``(4) Proration rule.—If the amounts available for additional allotments under paragraph (1) are less than the total of the amounts determined under subparagraphs (A) and (B) of paragraph (3), the amounts computed under such subparagraphs shall be reduced proportionally.

``(5) Retrospective adjustment.—The Secretary may adjust the estimates and determinations made to carry out this subsection as necessary on the basis of the amounts reported by States not later than May 31, 2009, on CMS Form 64 or CMS Form 21, as the case may be, and as approved by the Secretary.

``(6) Availability; no redistribution of unexpended additional allotments.—Notwithstanding subsections (e) and (f), amounts allotted to a State pursuant to this subsection for fiscal year 2009, subject to paragraph (5), shall only remain available for expenditure by the State through March 31, 2009. Any amounts of such allotments that remain unexpended as of such date shall not be subject to redistribution under subsection (f).´´.

SEC. 202. EXTENSION OF TRANSITIONAL MEDICAL ASSISTANCE (TMA) AND ABSTINENCE EDUCATION PROGRAM.

Section 401 of division B of the Tax Relief and Health Care Act of 2006 (Public Law 109-432, 120 Stat. 2994), as amended by section 1 of Public Law 110-48 (121 Stat. 244) and section 2 of the TMA, Abstinence, Education, and QI Programs Extension Act of 2007 (Public Law 110-90, 121 Stat. 984), is amended—

(1) by striking ``December 31, 2007´´ and inserting ``June 30, 2008´´; and

(2) by striking ``first quarter´´ and inserting ``third quarter´´ each place it appears.

SEC. 203. EXTENSION OF QUALIFYING INDIVIDUAL (QI) PROGRAM.

(a) Extension.—

Section 1902(a)(10)(E)(iv) of the Social Security Act (42 U.S.C. 1396a(a)(10)(E)(iv)) is amended by striking ``December 2007´´ and inserting ``June 2008´´.

(b) Extending Total Amount Available for Allocation.—

Section 1933(g)(2) of the Social Security Act (42 U.S.C. 1396u-3(g)(2)) is amended—

(1) in subparagraph (G), by striking ``and´´ at the end;

(2) in subparagraph (H), by striking the period at the end and inserting ``; and´´; and

(3) by adding at the end the following new subparagraph:

``(I) for the period that begins on January 1, 2008, and ends on June 30, 2008, the total allocation amount is $200,000,000.´´.

SEC. 204. MEDICAID DSH EXTENSION.

Section 1923(f)(6) of the Social Security Act (42 U.S.C. 1396r-4(f)(6)) is amended—

(1) in the heading, by inserting ``and portions of fiscal year 2008´´ after ``fiscal year 2007´´; and

(2) in subparagraph (A)—

(A) in clause (i), by adding at the end (after and below subclause (II)) the following:

``Only with respect to fiscal year 2008 for the period ending on June 30, 2008, the DSH allotment for Tennessee for such portion of the fiscal year, notwithstanding such table or terms, shall be ¾ of the amount specified in the previous sentence for fiscal year 2007.´´;

(B) in clause (ii)—

(i) by inserting ``or for a period in fiscal year 2008 described in clause (i)´´ after ``fiscal year 2007´´; and

(ii) by inserting ``or period´´ after ``such fiscal year´´; and

(C) in clause (iv)—

(i) in the heading, by inserting ``and fiscal year 2008´´ after ``fiscal year 2007´´;

(ii) in subclause (I)—

(I) by inserting ``or for a period in fiscal year 2008 described in clause (i)´´ after ``fiscal year 2007´´; and

(II) by inserting ``or period´´ after ``for such fiscal year´´; and

(iii) in subclause (II)—

(I) by inserting ``or for a period in fiscal year 2008 described in clause (i)´´ after ``fiscal year 2007´´; and

(II) by inserting ``or period´´ after ``such fiscal year´´ each place it appears; and

(3) in subparagraph (B)(i), by adding at the end the following: ``Only with respect to fiscal year 2008 for the period ending on June 30, 2008, the DSH allotment for Hawaii for such portion of the fiscal year, notwithstanding the table set forth in paragraph (2), shall be $7,500,000.´´.

SEC. 205. IMPROVING DATA COLLECTION.

Section 2109(b)(2) of the Social Security Act (42 U.S.C. 1397ii(b)(2)) is amended by inserting before the period at the end the following ``(except that only with respect to fiscal year 2008, there are appropriated $20,000,000 for the purpose of carrying out this subsection, to remain available until expended)´´.

SEC. 206. MORATORIUM ON CERTAIN PAYMENT RESTRICTIONS.

Notwithstanding any other provision of law, the Secretary of Health and Human Services shall not, prior to June 30, 2008, take any action (through promulgation of regulation, issuance of regulatory guidance, use of Federal payment audit procedures, or other administrative action, policy, or practice, including a Medical Assistance Manual transmittal or letter to State Medicaid directors) to impose any restrictions relating to coverage or payment under title XIX of the Social Security Act for rehabilitation services or school-based administration and school-based transportation if such restrictions are more restrictive in any aspect than those applied to such areas as of July 1, 2007.