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U.S. Code as of:
01/19/04
Section 1396u-3. State coverage of medicare cost-sharing for additional low-income medicare beneficiaries
(a) In general
A State plan under this subchapter shall provide, under section
1396a(a)(10)(E)(iv) of this title and subject to the succeeding
provisions of this section and through a plan amendment, for
medical assistance for payment of the cost of medicare cost-sharing
described in such section on behalf of all individuals described in
such section (in this section referred to as "qualifying
individuals") who are selected to receive such assistance under
subsection (b) of this section.
(b) Selection of qualifying individuals
A State shall select qualifying individuals, and provide such
individuals with assistance, under this section consistent with the
following:
(1) All qualifying individuals may apply
The State shall permit all qualifying individuals to apply for
assistance during a calendar year.
(2) Selection on first-come, first-served basis
(A) In general
For each calendar year (beginning with 1998), from (and to
the extent of) the amount of the allocation under subsection
(c) of this section for the State for the fiscal year ending in
such calendar year, the State shall select qualifying
individuals who apply for the assistance in the order in which
they apply.
(B) Carryover
For calendar years after 1998, the State shall give
preference to individuals who were provided such assistance (or
other assistance described in section 1396a(a)(10)(E) of this
title) in the last month of the previous year and who continue
to be (or become) qualifying individuals.
(3) Limit on number of individuals based on allocation
The State shall limit the number of qualifying individuals
selected with respect to assistance in a calendar year so that
the aggregate amount of such assistance provided to such
individuals in such year is estimated to be equal to (but not
exceed) the State's allocation under subsection (c) of this
section for the fiscal year ending in such calendar year.
(4) Receipt of assistance during duration of year
If a qualifying individual is selected to receive assistance
under this section for a month in a year, the individual is
entitled to receive such assistance for the remainder of the year
if the individual continues to be a qualifying individual. The
fact that an individual is selected to receive assistance under
this section at any time during a year does not entitle the
individual to continued assistance for any succeeding year.
(c) Allocation
(1) Total allocation
The total amount available for allocation under this section
for -
(A) fiscal year 1998 is $200,000,000;
(B) fiscal year 1999 is $250,000,000;
(C) fiscal year 2000 is $300,000,000;
(D) fiscal year 2001 is $350,000,000; and
(E) each of fiscal years 2002 and 2003 is $400,000,000.
(2) Allocation to States
The Secretary shall provide for the allocation of the total
amount described in paragraph (1) for a fiscal year, among the
States that executed a plan amendment in accordance with
subsection (a) of this section, based upon the Secretary's
estimate of the ratio of -
(A) an amount equal tothe total number of individuals
described in section 1396a(a)(10)(E)(iv) of this title in
the State; to
(B) the sum of the amounts computed under subparagraph (A)
for all eligible States.
(d) Applicable FMAP
With respect to assistance described in section
1396a(a)(10)(E)(iv) of this title furnished in a State for calendar
quarters in a calendar year -
(1) to the extent that such assistance does not exceed the
State's allocation under subsection (c) of this section for the
fiscal year ending in the calendar year, the Federal medical
assistance percentage shall be equal to 100 percent; and
(2) to the extent that such assistance exceeds such allocation,
the Federal medical assistance percentage is 0 percent.
(e) Limitation on entitlement
Except as specifically provided under this section, nothing in
this subchapter shall be construed as establishing any entitlement
of individuals described in section 1396a(a)(10)(E)(iv) of this
title to assistance described in such section.
(f) Coverage of costs through part B of medicare program
For each fiscal year, the Secretary shall provide for the
transfer from the Federal Supplementary Medical Insurance Trust
Fund under section 1395t of this title to the appropriate account
in the Treasury that provides for payments under section 1396b(a)
of this title with respect to medical assistance provided under
this section, of an amount equivalent to the total of the amount of
payments made under such section that is attributable to this
section and such transfer shall be treated as an expenditure from
such Trust Fund for purposes of section 1395r of this title.
(g) Special rule
With respect to the period that begins on January 1, 2004, and
ends on September 30, 2004, a State shall select qualifying
individuals, and provide such individuals with assistance, in
accordance with the provisions of this section as in effect with
respect to calendar year 2003, except that for such purpose -
(1) references in the preceding subsections of this section to
"fiscal year" and "calendar year" shall be deemed to be
references to such period; and
(2) the total allocation amount under subsection (c) of this
section for such period shall be $300,000,000.
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