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This bill — the Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019 — would extend a number of provisions within the Medicaid program that serve to make the program more effective. A breakdown of the extensions can be found below.

Money Follows the Program Rebalancing Demonstration (MFP)

This bill would extend the Money Follows the Person Rebalancing Demonstration (MFP), which helps states rebalance their Medicaid long-term care systems by transitioning people with chronic conditions and disabilities into community-based care, through FY 2024. It’d also extend research and evaluation requirements for MFP through FY 2024 and clarify the process by which states apply for the MFP by requiring each state to include a description of their planned use of MFP funds and program evaluation plans in their applications.

Additionally, this bill would require a report to the president and Congress describing findings and conclusions on best practices for MFP implementation. Finally, it’d require a Medicaid and CHIP Payment and Access Commission (MACPAC) report to Congress on the Commission’s position on the Home and Community Based Services (HCBS) Final Rule published on January 16, 2014.

State Medicaid Fraud and Abuse Control Units’ Authority to Investigate and Prosecute Medicaid Patient Abuse and Neglect

This bill would clarify that state Medicaid fraud and abuse control units are authorized to investigate abuse and neglect of Medicaid patients in board and care facilities, as well as patients receiving Medicaid-funded care in noninstitutional settings.

Protection for Medicaid Recipients Against Spousal Impoverishment

This bill would extend spousal impoverishment protections for seniors who receive long-term care in their homes or community settings through March 31, 2024.

Community Mental Health Services Demonstration Program

This bill would extend the Community Mental Health Services Demonstration Program through December 21, 2021 and require a report to Congress recommending whether the program should be continued, expanded, modified or terminated by June 30, 2021.

Inappropriately Low Rebates Under Medicaid Drug Rebate Program

This bill would prohibit drug manufacturers from blending the average manufacturer price of branded drugs and their authorized generics for the purposes of determining Medicaid rebates. It’d also eliminate drug manufacturers from being defined as drug wholesalers.

Medicaid Improvement Fund

Finally, this bill would appropriate $45.5 million for the Medicaid Improvement Fund.","official_title":"To provide for certain extensions with respect to the Medicaid program under title XIX of the Social Security Act, and for other purposes.","short_title":"Sustaining Excellence in Medicaid Act of 2019","popular_title":null,"short_summary":"Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019 This bill alters several Medicaid programs and funding mechanisms. Specifically, the bill makes appropriations through FY2024 for, and otherwise revises, the Money Follows the Person Rebalancing Demonstration Program; allows state Medicaid fraud control units to review complaints regarding patients who are in noninstitutional or other settings; temporarily extends the applicability of Medicaid eligibili...","summarized":true,"cost":null,"cost_commentary":"A CBO cost estimate is unavailable.","impact":"Medicaid beneficiaries; state health systems; states; Medicaid; state Medicaid fraud and abuse control units; drug manufacturers; drug prices; Money Follows the Program Rebalancing Demonstration (MFP); Medicaid spousal impoverishment protection; Community Mental Health Services Demonstration Program; inappropriately low rebates under the Medicaid drug rebate program; and the Medicaid Improvement Fund.","argument_for":"This bill’s proposed reforms would collectively strengthen Medicaid by making it more responsive to beneficiaries’ needs, protecting vulnerable Medicaid beneficiary populations and their spouses and ensuring that Medicaid drug prices are reasonable.","argument_against":"This bill combines too many disparate Medicaid reforms & extensions, not all of which are urgent. 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Should Medicaid Provisions to Protect Vulnerable Populations & Enable Community-Based Care Be Extended?