MEDICAID IMPROVEMENT FUND

Sec1941[42 U.S.C. 1396w-1] (a) Authority or Requirements to Cover Additional Individuals.—The Secretary shall establish under this title 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. Payments made for activities under this subsection shall be in addition to payments that would otherwise be made for such activities, and, in accordance with subsection (b)(3), for the purposes of subparagraph (B) of such subsection.[402]

(b) Funding.—

(1) In general.—[403]There shall be available to the Fund, for expenditures from the Fund for fiscal year 2021 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.[404]

(3)Additional funding for state activities relating to mechanized claims systems.—[405]

(A) In general.—[406]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 2025 and thereafter, $2,387,000,000 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 title, for each quarter beginning during or after fiscal year 2023 an amount equal to—

(i) 100 percent minus the percent specified in clause (i) of section 1903(a)(3)(A) 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 1903(a)(3)(B) of so much of the sums expended by the State during such quarter as are attributable to the activities described in such section.


[402]  P.L. 115–120, §3006(1) inserted “, and, in accordance with subsection (b)(3), for the purposes of subparagraph (B) of such subsection” at the end of the sentence. Effective January 22, 2018.

[403]  P.L.114-255, §707 struck paragraph 1941(b)(1); inserted new paragraph 1941(b)(1). Effective December 10, 2016.

P.L. 115–123, §53105(1), struck “$5,000,000” and inserted “$0”. Effective February 9, 2018.

P.L. 115–271, §5061, struck $0 and inserted “$31,000,000”. Effective October 24, 2018.

P.L. 116–3, §5, struck “$31,000,000” and inserted “$6,000,000”. Effective January 1, 2019.

P.L. 116–29, §2, struck “$6,000,000” and inserted “$1,000,000”. Effective July 5, 2019.

P.L. 116–59, §1604, struck “$1,000,000” and inserted “$0”. Effective September 27, 2019.

[404]  P.L. 115–120, §3006(2)(A) inserted “pursuant to paragraph (1)” after “in the Fund” in the first sentence; inserted “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)” after the first sentence; and struck “sentence” in the last sentence and inserted “sentences”. Effective January 22, 2018.

[405]  P.L. 115–120, §3006(2)(B), added new paragraph (3). Effective January 22, 2018.

P.L. 115–123, §53105(2), in subparagraph (A), struck “$980,000,000” and inserted “$0”. Effective February 9, 2018.

P.L. 116–59, §1604(2), struck “2023” each place it appeared and inserted “2025”; and in subparagraph (A), struck “$0” and inserted “$2,387,000,000”. Effective September 27, 2019.

P.L. 116–69, §1602, in subparagraph (A), struck “$2,387,000,000” and inserted “$1,960,000,000”. Effective November 21, 2019.