1. Short title
This Act may be cited as the “Healthcare Expenditures for Low-income Populations in Puerto Rico Act” or the “HELP Puerto Rico Act”.
Healthcare Expenditures for Low-income Populations in Puerto Rico Act
A BILL
To amend title XI of the Social Security Act to provide for increased Puerto Rico Medicaid payments, and for other purposes.
2. Puerto Rico Medicaid payments
in paragraph (2)(A), by inserting “(or, with respect to fiscal years 2018 and 2019, increased by such percentage increase plus one percentage point)” after “beginning of the fiscal year”; and
in paragraph (5)—
in subparagraph (A), by striking “subparagraph (B)” and inserting “subparagraphs (B), (C), (D), and (E)”; and
by adding at the end the following new subparagraphs:
“(C) The amount of the increase otherwise provided under subparagraph (A) for Puerto Rico shall be further increased by $880,000,000.
“(D)
“(i) For the period beginning October 1, 2017, and ending December 31, 2019, the amount of the increase otherwise provided under subparagraph (A) for Puerto Rico shall be further increased by $120,000,000 if the Financial Oversight and Management Board for Puerto Rico established under section 101 of the Puerto Rico Oversight, Management, and Economic Stability Act (48 U.S.C. 2121) certifies by a majority vote that Puerto Rico has taken reasonable and appropriate steps during such period to—
“(I) reduce fraud, waste, and abuse under the program under title XIX;
“(II) implement strategies to reduce unnecessary, inefficient, or excessive spending under title XIX;
“(III) improve the use and availability of Medicaid data for program operation and oversight; and
“(IV) improve the quality of care and patient experience for individuals enrolled under the program under title XIX.
“(ii) As a condition of any additional increase pursuant to clause (i), not later than October 1, 2018, Puerto Rico shall submit to the Financial Oversight and Management Board for Puerto Rico a report regarding steps taken to achieve each of the goals described in subclauses (I) through (IV) of clause (i).
“(E) Payments under section 1903(a)(8) for a quarter of a fiscal year shall not be taken into account in applying subsection (f) (as increased in accordance with this paragraph and paragraphs (1), (2), (3), and (4)) to Puerto Rico for such fiscal year.”
Federal match for medical personnel and fraud reduction— Section 1903(a) of the Social Security Act (42 U.S.C. 1396b(a)) is amended—
in paragraph (2)(A), by inserting “subject to paragraph (8),” before “an amount”;
in paragraph (6)—
in subparagraph (B), by inserting “subject to paragraph (8),” before “75 per centum”; and
by striking at the end “plus”;
in paragraph (7), by striking at the end the period and inserting “; plus”; and
by adding at the end the following new paragraph:
“(8) for quarters during the period beginning January 1, 2018, and ending December 31, 2019, paragraphs (2)(A) and (6) shall apply with respect to Puerto Rico as if—
“(A) the reference to “75 per centum” in paragraph (2)(A) were a reference to “90 per centum”; and
“(B) the reference to “75 per centum” in paragraph (6)(B) were a reference to “90 per centum”.”