42 U.S.C. § 1396w-1

Current through P.L. 118-107 (published on www.congress.gov on 11/21/2024)

Section 1396w-1 - Medicaid Improvement Fund

(a) Establishment

The Secretary shall establish under this subchapter 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, and, in accordance with subsection (b)(3), for the purposes of subparagraph (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 2023 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.

(3) Additional funding for State activities relating to mechanized claims systems

(A) In general

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 2028 and thereafter, $0, 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 subchapter, for each quarter beginning during or after fiscal year 2025 an amount equal to-

(i) 100 percent minus the percent specified in clause (i) of section 1396b(a)(3)(A) of this title 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 1396b(a)(3)(B) of this title of so much of the sums expended by the State during such quarter as are attributable to the activities described in such section.

42 U.S.C. § 1396w-1

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, §30063006,, 132 Stat. 37; Pub. L. 115-123, div. E, title XII, §531053105,, 132 Stat. 302; Pub. L. 115-271, title V, §50615061,, 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, §16041604,, 133 Stat. 1108; Pub. L. 116-69, div. B, title VI, §16021602,, 133 Stat. 1139; Pub. L. 116-159, div. C, title VI, §26022602,, 134 Stat. 738; Pub. L. 116-215, div. B, title III, §13031303,, 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, §23422342,, 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.

EDITORIAL NOTES

AMENDMENTS2024-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".

Secretary

the term "Secretary" means- (A) the Secretary of Education for purposes of subtitle A (other than section 3201),(B) the Secretary of Agriculture for purposes of the amendments made by section 3201, and(C) the Secretary of Health and Human Services for purposes of subtitle B,