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809
1 carry out such amendments have been promulgated
2 by such date.
3 (2) In the case of a State plan for medical as-
4 sistance under title XIX of the Social Security Act
5 or a child health plan under title XXI of such Act
6 which the Secretary of Health and Human Services
7 determines requires State legislation (other than leg-
8 islation appropriating funds) in order for the plan to
9 meet the additional requirement imposed by the
10 amendments made by this section, the State plan or
11 child health plan shall not be regarded as failing to
12 comply with the requirements of such title solely on
13 the basis of its failure to meet this additional re-
14 quirement before the first day of the first calendar
15 quarter beginning after the close of the first regular
16 session of the State legislature that begins after the
17 date of the enactment of this Act. For purposes of
18 the previous sentence, in the case of a State that has
19 a 2-year legislative session, each year of such session
20 shall be deemed to be a separate regular session of
21 the State legislature.

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1 SEC. 1758. REQUIREMENT TO REPORT EXPANDED SET OF

2 DATA ELEMENTS UNDER MMIS TO DETECT

3 FRAUD AND ABUSE.

4 Section 1903(r)(1)(F) of the Social Security Act (42

5 U.S.C. 1396b(r)(1)(F)) is amended by inserting after
6 ‘‘necessary’’ the following: ‘‘and including, for data sub-
7 mitted to the Secretary on or after July 1, 2010, data
8 elements from the automated data system that the Sec-
9 retary determines to be necessary for detection of waste,
10 fraud, and abuse’’.
11 SEC. 1759. BILLING AGENTS, CLEARINGHOUSES, OR OTHER

12 ALTERNATE PAYEES REQUIRED TO REG-

13 ISTER UNDER MEDICAID.

14 (a) IN GENERAL.—Section 1902(a) of the Social Se-

15 curity Act (42 U.S.C. 42 U.S.C. 1396a(a)), as amended
16 by sections 1631(b), 1703, 1753, and 1757, is further
17 amended—
18 (1) in paragraph (76); by striking at the end
19 ‘‘and’’;
20 (2) in paragraph (77), by striking the period at
21 the end and inserting ‘‘and’’; and
22 (3) by inserting after paragraph (77) the fol-
23 lowing new paragraph:
24 ‘‘(78) provide that any agent, clearinghouse, or
25 other alternate payee that submits claims on behalf
26 of a health care provider must register with the
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811
1 State and the Secretary in a form and manner speci-
2 fied by the Secretary under section 1866(j)(1)(D).’’.
3 (b) DENIAL OF PAYMENT.—Section 1903(i) of such
4 Act (42 U.S.C. 1396b(i)), as amended by section 1753,
5 is amended—
6 (1) by striking ‘‘or’’ at the end of paragraph
7 (24);
8 (2) by striking the period at the end of para-
9 graph (25) and inserting ‘‘; or’’; and
10 (3) by inserting after paragraph (25) the fol-
11 lowing new paragraph:
12 ‘‘(26) with respect to any amount paid to a bill-
13 ing agent, clearinghouse, or other alternate payee
14 that is not registered with the State and the Sec-
15 retary as required under section 1902(a)(78).’’.
16 (c) EFFECTIVE DATE.—
17 (1) Except as provided in paragraph (2), the
18 amendments made by this section shall apply to
19 claims submitted on or after January 1, 2012, with-
20 out regard to whether or not final regulations to
21 carry out such amendments have been promulgated
22 by such date.
23 (2) In the case of a State plan for medical as-
24 sistance under title XIX of the Social Security Act
25 which the Secretary of Health and Human Services

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812
1 determines requires State legislation (other than leg-
2 islation appropriating funds) in order for the plan to
3 meet the additional requirement imposed by the
4 amendments made by this section, the State plan or
5 child health plan shall not be regarded as failing to
6 comply with the requirements of such title solely on
7 the basis of its failure to meet this additional re-
8 quirement before the first day of the first calendar
9 quarter beginning after the close of the first regular
10 session of the State legislature that begins after the
11 date of the enactment of this Act. For purposes of
12 the previous sentence, in the case of a State that has
13 a 2-year legislative session, each year of such session
14 shall be deemed to be a separate regular session of
15 the State legislature.
16 SEC. 1760. DENIAL OF PAYMENTS FOR LITIGATION-RE-

17 LATED MISCONDUCT.

18 (a) IN GENERAL.—Section 1903(i) of the Social Se-

19 curity Act (42 U.S.C. 1396b(i)), as previously amended
20 is amended—
21 (1) by striking ‘‘or’’ at the end of paragraph
22 (25);
23 (2) by striking the period at the end of para-
24 graph (26) and inserting a semicolon; and

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813
1 (3) by inserting after paragraph (26) the fol-
2 lowing new paragraphs:
3 ‘‘(27) with respect to any amount expended—
4 ‘‘(A) on litigation in which a court imposes
5 sanctions on the State, its employees, or its
6 counsel for litigation-related misconduct; or
7 ‘‘(B) to reimburse (or otherwise com-
8 pensate) a managed care entity for payment of
9 legal expenses associated with any action in
10 which a court imposes sanctions on the man-
11 aged care entity for litigation-related mis-
12 conduct.’’.
13 (b) EFFECTIVE DATE.—The amendments made by
14 subsection (a) shall apply to amounts expended on or after
15 January 1, 2010.
16 Subtitle G—Puerto Rico and the
17 Territories
18 SEC. 1771. PUERTO RICO AND TERRITORIES.

19 (a) INCREASE IN CAP.—

20 (1) IN GENERAL.—Section 1108(g) of the So-
21 cial Security Act (42 U.S.C. 1308(g)) is amended—
22 (A) in paragraph (4) by striking ‘‘and (3)’’
23 and by inserting ‘‘(3), (6), and (7)’’; and

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814
1 (B) by inserting after paragraph (5), as
2 added by section 1731(d), the following new
3 paragraph:
4 ‘‘(6) FISCAL YEARS 2011 THROUGH 2019.—The

5 amounts otherwise determined under this subsection

6 for Puerto Rico, the Virgin Islands, Guam, the
7 Northern Mariana Islands, and American Samoa for
8 fiscal year 2011 and each succeeding fiscal year
9 through fiscal year 2019 shall be increased by the
10 percentage specified under section 1771(c) of the
11 America’s Affordable Health Choices Act of 2009
12 for purposes of this paragraph of the amounts other-
13 wise determined under this section (without regard
14 to this paragraph).
15 ‘‘(7) FISCAL YEAR 2020 AND SUBSEQUENT FIS-

16 CAL YEARS.—The amounts otherwise determined

17 under this subsection for Puerto Rico, the Virgin Is-
18 lands, Guam, the Northern Mariana Islands, and
19 American Samoa for fiscal year 2020 and each suc-
20 ceeding fiscal year shall be the amount provided in
21 paragraph (6) or this paragraph for the preceding
22 fiscal year for the respective territory increased by
23 the percentage increase referred to in paragraph
24 (1)(B), rounded to the nearest $10,000 (or
25 $100,000 in the case of Puerto Rico).’’.

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815
1 (2) COORDINATION WITH ARRA.—Section

2 5001(d) of the American Recovery and Reinvestment

3 Act of 2009 shall not apply during any period for
4 which section 1108(g)(6) of the Social Security Act,
5 as added by paragraph (1), applies.
6 (b) INCREASE IN FMAP.—
7 (1) IN GENERAL.—Section 1905(b)(2) of the
8 Social Security Act (42 U.S.C. 1396d(b)(2)) is
9 amended by striking ‘‘50 per centum’’ and inserting
10 ‘‘for fiscal years 2011 through 2019, the percentage
11 specified under section 1771(c) of the America’s Af-
12 fordable Health Choices Act of 2009 for purposes of
13 this clause for such fiscal year and for subsequent
14 fiscal years the percentage so specified for fiscal
15 year 2019’’.
16 (2) EFFECTIVE DATE.—The amendment made
17 by subsection (a) shall apply to items and services
18 furnished on or after October 1, 2010.
19 (c) SPECIFICATION OF PERCENTAGES.—The Sec-
20 retary of Health and Human Services shall specify, before
21 January 1, 2011, the percentages to be applied under sec-
22 tion 1108(g)(6) of the Social Security Act, as added by
23 subsection (a)(1), and under section 1905(b)(2) of such
24 Act, as amended by subsection (b)(1), in a manner so that
25 for the period beginning with 2011 and ending with 2019

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816
1 the total estimated additional Federal expenditures result-
2 ing from the application of such percentages will be equal
3 to $10,350,000,000.
4 Subtitle H—Miscellaneous
5 SEC. 1781. TECHNICAL CORRECTIONS.

6 (a) TECHNICAL CORRECTION TO SECTION 1144 OF

7 THE SOCIAL SECURITY ACT.—The first sentence of sec-

8 tion 1144(c)(3) of the Social Security Act (42 U.S.C.
9 1320b—14(c)(3)) is amended—
10 (1) by striking ‘‘transmittal’’; and
11 (2) by inserting before the period the following:
12 ‘‘as specified in section 1935(a)(4)’’.
13 (b) CLARIFYING AMENDMENT TO SECTION 1935 OF

14 THE SOCIAL SECURITY ACT.—Section 1935(a)(4) of the

15 Social Security Act (42 U.S.C. 1396u—5(a)(4)), as
16 amended by section 113(b) of Public Law 110–275, is
17 amended—
18 (1) by striking the second sentence;
19 (2) by redesignating the first sentence as a sub-
20 paragraph (A) with appropriate indentation and
21 with the following heading: ‘‘IN GENERAL’’;

22 (3) by adding at the end the following subpara-

23 graphs:
24 ‘‘(B) FURNISHING MEDICAL ASSISTANCE

25 WITH REASONABLE PROMPTNESS.—For the

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