42 U.S.C. § 1396u–3
State coverage of medicare cost-sharing for additional low-income medicare beneficiaries
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).
The State shall permit all qualifying individuals to apply for assistance during a calendar year.
For each calendar year (beginning with 1998), from (and to the extent of) the amount of the allocation under subsection (c) 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.
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.
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) for the fiscal year ending in such calendar 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.
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.
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.
In the case of 2017, the allocation amount for 2016, or in the case of a subsequent year, the maximum allocation amount allowed under this paragraph for the previous year.
The monthly premium rate determined under section 1395r of this title for the year divided by the monthly premium rate determined under such section for the previous year.
The average number of individuals (as estimated by the Chief Actuary of the Centers for Medicare & Medicaid Services in September of the previous year) to be enrolled under part B of subchapter XVIII for months in the year divided by the average number of such individuals (as so estimated) under this subparagraph with respect to enrollments in months in the previous year.
A prior section 1933 of act
2015—Subsec. (g)(2). Pub. L. 114–10, § 211(b)(1), redesignated subpars. (I) to (W) as (A) to (O), respectively, added subpars. (P) and (Q), and struck out former subpars. (A) to (H) which related to total allocation amounts for various periods beginning on
Subsec. (g)(3). Pub. L. 114–10, § 211(b)(2), substituted “or (P)” for “(P), (R), (T), or (V)” in introductory provisions.
Subsec. (g)(4). Pub. L. 114–10, § 211(b)(3), added par. (4).
2014—Subsec. (g)(2)(T). Pub. L. 113–93, § 201(b)(1)(A), struck out “and” at end.
Subsec. (g)(2)(U). Pub. L. 113–93, § 201(b)(1)(B), substituted “
Subsec. (g)(2)(V), (W). Pub. L. 113–93, § 201(b)(1)(C), added subpars. (V) and (W).
Subsec. (g)(3). Pub. L. 113–93, § 201(b)(2), substituted “(T), or (V)” for “or (T)” in introductory provisions.
2013—Subsec. (g)(2)(S), (T). Pub. L. 112–240, § 621(b)(1), added subpars. (S) and (T).
Subsec. (g)(2)(U). Pub. L. 113–67 added subpar. (U).
Subsec. (g)(3). Pub. L. 112–240, § 621(b)(2), substituted “(R), or (T)” for “or (R)” in introductory provisions.
2012—Subsec. (g)(2)(Q), (R). Pub. L. 112–96, § 3101(b)(1), substituted “
Subsec. (g)(3). Pub. L. 112–96, § 3101(b)(2), substituted “(P), or (R)” for “or (P)” in introductory provisions.
2011—Subsec. (g)(2)(Q). Pub. L. 112–78 added subpar. (Q).
2010—Subsec. (g)(2)(M). Pub. L. 111–127, § 3(1), substituted “$462,500,000” for “$412,500,000”.
Subsec. (g)(2)(N). Pub. L. 111–127, § 3(2), substituted “$165,000,000” for “$150,000,000”.
Subsec. (g)(2)(O), (P). Pub. L. 111–309, § 110(b)(1), added subpars. (O) and (P).
Subsec. (g)(3). Pub. L. 111–309, § 110(b)(2), substituted “(N), or (P)” for “or (N)” in introductory provisions.
2009—Subsec. (g)(2)(M), (N). Pub. L. 111–5, § 5005(b)(1), added subpars. (M) and (N).
Subsec. (g)(3). Pub. L. 111–5, § 5005(b)(2), substituted “(L), or (N)” for “or (L)” in introductory provisions.
2008—Subsec. (g)(2)(I). Pub. L. 110–379, § 2(1), substituted “$315,000,000” for “$300,000,000”.
Pub. L. 110–275, § 111(b)(1)(B)(i), (ii), substituted “September 30” for “June 30” and “$300,000,000” for “$200,000,000”.
Subsec. (g)(2)(J). Pub. L. 110–379, § 2(2), substituted “$130,000,000” for “$100,000,000”.
Pub. L. 110–275, § 111(b)(1)(A), (B)(iii), (C), added subpar. (J).
Subsec. (g)(2)(K), (L). Pub. L. 110–275, § 111(b)(1)(C), added subpars. (K) and (L).
Subsec. (g)(3). Pub. L. 110–275, § 111(b)(2), substituted “(H), (J), or (L)” for “or (H)” in introductory provisions.
2007—Subsec. (g)(2)(H). Pub. L. 110–90, § 3(b)(1), added subpar. (H).
Subsec. (g)(2)(I). Pub. L. 110–173 added subpar. (I).
Subsec. (g)(3). Pub. L. 110–90, § 3(b)(2), substituted “(F), or (H)” for “or (F)” in introductory provisions.
2005—Subsec. (g)(2)(D) to (G). Pub. L. 109–91, § 101(b)(1), added subpars. (D) to (G).
Subsec. (g)(3). Pub. L. 109–91, § 101(b)(2), inserted “, (D), or (F)” after “subparagraph (B)” in introductory provisions.
2004—Subsec. (g). Pub. L. 108–448 amended heading and text of subsec. (g) generally. Prior to amendment, text read as follows: “With respect to the period that begins on
“(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.”
2003—Subsec. (c)(1)(E). Pub. L. 108–89, § 401(b)(1), substituted “each of fiscal years 2002 and 2003” for “fiscal year 2002”.
Subsec. (c)(2)(A). Pub. L. 108–89, § 401(b)(2), substituted “the total number of individuals described in section 1396a(a)(10)(E)(iv) of this title in the State; to” for “the sum of—
“(i) twice the total number of individuals described in section 1396a(a)(10)(E)(iv)(I) of this title in the State, and
“(ii) the total number of individuals described in section 1396a(a)(10)(E)(iv)(II) of this title in the State; to”.
Subsec. (g). Pub. L. 108–173, § 103(f)(2)(A), substituted “
Pub. L. 108–89, § 401(c), added subsec. (g).
Subsec. (g)(2). Pub. L. 108–173, § 103(f)(2)(B), substituted “$300,000,000” for “$100,000,000”.
1999—Subsec. (b)(4). Pub. L. 106–113 inserted “a” after “for a month in”.
Amendment by Pub. L. 110–90 effective as of
Amendment by Pub. L. 109–91 effective
Amendment by Pub. L. 108–173 applicable to calendar quarters beginning on or after