---
kind: "section"
citation: "42 U.S.C. § 1396w–1"
title: "42"
title_heading: "The Public Health and Welfare"
number: "1396w–1"
heading: "Medicaid Improvement Fund"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/1396w-1"
units:
  - "Chapter 7 — Social Security"
  - "Subchapter XIX — Grants to States for Medical Assistance Programs"
---

# §1396w–1. Medicaid Improvement Fund

- (a) **Establishment—** The [Secretary](/usc/42/1301.md?p=a-6) shall establish under this subchapter a Medicaid Improvement Fund (in this section referred to as the “Fund”) which shall be available to the [Secretary](/usc/42/1301.md?p=a-6) to improve the management of the Medicaid program by the Centers for Medicare & Medicaid Services, [including](/usc/42/1301.md?p=b) oversight of contracts and contractors and evaluation of demonstration [projects](/usc/42/13641.md?p=2), and, in accordance with [subsection (b)(3)](#b-3), for the purposes of [subparagraph (B)](#b-3-B) of such subsection. Payments made for activities under this subsection shall be in addition to payments that would otherwise be made for such activities.
- (b) **Funding—**
  - (1) **In general—** There shall be available to the Fund, for expenditures from the Fund for [fiscal year](/usc/42/619.md?p=3) 2023 and thereafter, $0.
  - (2) **Funding limitation—** Amounts in the Fund pursuant to [paragraph (1)](#b-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)](#b-1). Amounts in the Fund pursuant to [paragraph (3)](#b-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)](#b-3). The [Secretary](/usc/42/1301.md?p=a-6) may obligate funds from the Fund only if the [Secretary](/usc/42/1301.md?p=a-6) 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.
  - (3) **Additional funding for State activities relating to mechanized claims systems—**
    - (A) **In general—** In addition to the amount made available under [paragraph (1)](#b-1), there shall be available to the Fund, for expenditures from the Fund in accordance with [subparagraph (B)](#b-3-B), for [fiscal year](/usc/42/619.md?p=3) 2028 and thereafter, $0, to remain available until expended.
    - (B) **Purposes—** The [Secretary](/usc/42/1301.md?p=a-6) shall use amounts made available to the Fund under [subparagraph (A)](#b-3-A) to pay to each [State](/usc/42/619.md?p=5) which has a plan approved under this subchapter, for each quarter beginning during or after [fiscal year](/usc/42/619.md?p=3) 2025 an amount equal to—
      - (i) 100 percent minus the percent specified in clause (i) of [section 1396b(a)(3)(A) of this title](/usc/42/1396b.md?p=a-3-A) of so much of the sums expended by the [State](/usc/42/619.md?p=5) during such quarter as are attributable to the activities described in such clause;
      - (ii) 100 percent minus the [Federal medical assistance percentage](/usc/42/1396d.md?p=b) applied under clause (iii) of such section of so much of the sums expended during such quarter (as found necessary by the [Secretary](/usc/42/1301.md?p=a-6) under such clause) by the [State](/usc/42/619.md?p=5) as are attributable to the activities described in such clause; and
      - (iii) 100 percent minus the percent specified in [section 1396b(a)(3)(B) of this title](/usc/42/1396b.md?p=a-3-B) of so much of the sums expended by the [State](/usc/42/619.md?p=5) during such quarter as are attributable to the activities described in such section.

## Source credit

(Aug. 14, 1935, ch. 531, title XIX, § 1941, as added Pub. L. 110–252, title VII, § 7002(b), June 30, 2008, 122 Stat. 2395; amended Pub. L. 111–8, div. F, title II, § 226, Mar. 11, 2009, 123 Stat. 784; Pub. L. 111–127, § 4, Jan. 27, 2010, 124 Stat. 5; Pub. L. 111–148, title II, § 2007(b), Mar. 23, 2010, 124 Stat. 285; Pub. L. 114–198, title VII, § 707, July 22, 2016, 130 Stat. 754; Pub. L. 115–120, div. C, § 3006, Jan. 22, 2018, 132 Stat. 37; Pub. L. 115–123, div. E, title XII, § 53105, Feb. 9, 2018, 132 Stat. 302; Pub. L. 115–271, title V, § 5061, Oct. 24, 2018, 132 Stat. 3976; Pub. L. 116–3, § 5, Jan. 24, 2019, 133 Stat. 8; Pub. L. 116–29, § 2, July 5, 2019, 133 Stat. 1031; Pub. L. 116–59, div. B, title VI, § 1604, Sept. 27, 2019, 133 Stat. 1108; Pub. L. 116–69, div. B, title VI, § 1602, Nov. 21, 2019, 133 Stat. 1139; Pub. L. 116–159, div. C, title VI, § 2602, Oct. 1, 2020, 134 Stat. 738; Pub. L. 116–215, div. B, title III, § 1303, Dec. 11, 2020, 134 Stat. 1046; Pub. L. 116–260, div. CC, title IV, § 406, Dec. 27, 2020, 134 Stat. 3003; Pub. L. 117–328, div. FF, title V, § 5141, Dec. 29, 2022, 136 Stat. 5953; Pub. L. 118–15, div. B, title III, § 2342, Sept. 30, 2023, 137 Stat. 96; Pub. L. 118–22, div. B, title II, § 302, Nov. 17, 2023, 137 Stat. 121; Pub. L. 118–35, div. B, title I, § 122, Jan. 19, 2024, 138 Stat. 6; Pub. L. 118–42, div. G, title I, § 212, Mar. 9, 2024, 138 Stat. 414.)

## Notes

### Editorial Notes

### Amendments

2024—Subsec. (b)(3)(A). Pub. L. 118–42 substituted “$0” for “$5,140,428,729”.

Pub. L. 118–35 substituted “$5,140,428,729” for “$5,796,117,810”.

2023—Subsec. (b)(3)(A). Pub. L. 118–22 substituted “$5,796,117,810” for “$6,357,117,810”.

Pub. L. 118–15 substituted “$6,357,117,810” for “$7,000,000,000”.

2022—Subsec. (b)(3)(A). Pub. L. 117–328 substituted “for fiscal year 2028 and thereafter, $7,000,000,000” for “for fiscal year 2025 and thereafter, $0”.

2020—Subsec. (b)(1). Pub. L. 116–159, § 2602(1), substituted “2023” for “2021”.

Subsec. (b)(3)(A). Pub. L. 116–260 substituted “$0” for “$3,464,000,000”.

Pub. L. 116–215 substituted “$3,464,000,000” for “$3,446,000,000”.

Pub. L. 116–159, § 2602(2), substituted “$3,446,000,000” for “$1,960,000,000”.

2019—Subsec. (b)(1). Pub. L. 116–59, § 1604(1), substituted “$0” for “$1,000,000”.

Pub. L. 116–29 substituted “$1,000,000” for “$6,000,000”.

Pub. L. 116–3 substituted “$6,000,000” for “$31,000,000”.

Subsec. (b)(3). Pub. L. 116–59, § 1604(2)(A), substituted “2025” for “2023” in subpars. (A) and (B).

Subsec. (b)(3)(A). Pub. L. 116–69 substituted “$1,960,000,000” for “$2,387,000,000”.

Pub. L. 116–59, § 1604(2)(B), substituted “$2,387,000,000” for “$0”.

2018—Subsec. (a). Pub. L. 115–120, § 3006(1), inserted before period at end of first sentence “, and, in accordance with subsection (b)(3), for the purposes of subparagraph (B) of such subsection”.

Subsec. (b)(1). Pub. L. 115–271 substituted “$31,000,000” for “$0”.

Pub. L. 115–123, § 53105(1), substituted “$0” for “$5,000,000”.

Subsec. (b)(2). Pub. L. 115–120, § 3006(2)(A), inserted “pursuant to paragraph (1)” after “in the Fund” in first sentence and “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 first sentence and substituted “the previous sentences” for “the previous sentence” in last sentence.

Subsec. (b)(3). Pub. L. 115–120, § 3006(2)(B), added par. (3).

Subsec. (b)(3)(A). Pub. L. 115–123, § 53105(2), substituted “$0” for “$980,000,000”.

2016—Subsec. (b)(1). Pub. L. 114–198 amended par. (1) generally. Prior to amendment, text read as follows: “There shall be available to the Fund, for expenditures from the Fund—

“(A) for fiscal year 2014, $0; and

“(B) for each of fiscal years 2015 through 2018, $0.”

2010—Subsec. (b)(1)(A). Pub. L. 111–148, § 2007(b)(1), which directed substitution of “$0” for “$100,000,000”, was executed by making the substitution for “$10,000,000”, to reflect the probable intent of Congress and intervening amendment by Pub. L. 111–127. See below.

Pub. L. 111–127 substituted “$10,000,000” for “$100,000,000”.

Subsec. (b)(1)(B). Pub. L. 111–148, § 2007(b)(2), substituted “$0” for “$150,000,000”.

2009—Subsec. (b)(1)(B). Pub. L. 111–8 inserted “each of” after “for”.