US Code

Public Law 119-73 (01/23/2026)

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

Aug. 14, 1935, ch. 531Pub. L. 110–252, title VII, § 7002(b)122 Stat. 2395Pub. L. 111–8, div. F, title II, § 226123 Stat. 784Pub. L. 111–127, § 4124 Stat. 5Pub. L. 111–148, title II, § 2007(b)124 Stat. 285Pub. L. 114–198, title VII, § 707130 Stat. 754Pub. L. 115–120, div. C, § 3006132 Stat. 37Pub. L. 115–123, div. E, title XII, § 53105132 Stat. 302Pub. L. 115–271, title V, § 5061132 Stat. 3976Pub. L. 116–3, § 5133 Stat. 8Pub. L. 116–29, § 2133 Stat. 1031Pub. L. 116–59, div. B, title VI, § 1604133 Stat. 1108Pub. L. 116–69, div. B, title VI, § 1602133 Stat. 1139Pub. L. 116–159, div. C, title VI, § 2602134 Stat. 738Pub. L. 116–215, div. B, title III, § 1303134 Stat. 1046Pub. L. 116–260, div. CC, title IV, § 406134 Stat. 3003Pub. L. 117–328, div. FF, title V, § 5141136 Stat. 5953Pub. L. 118–15, div. B, title III, § 2342137 Stat. 96Pub. L. 118–22, div. B, title II, § 302137 Stat. 121Pub. L. 118–35, div. B, title I, § 122138 Stat. 6Pub. L. 118–42, div. G, title I, § 212138 Stat. 414(, title XIX, § 1941, as added , , ; amended , , ; , , ; , , ; , , ; , , ; , , ; , , ; , , ; , , ; , , ; , , ; , , ; , , ; , , ; , , ; , , ; , , ; , , ; , , .)

Editorial Notes

Amendments

Pub. L. 118–422024—Subsec. (b)(3)(A). substituted “$0” for “$5,140,428,729”.

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

Pub. L. 118–222023—Subsec. (b)(3)(A). substituted “$5,796,117,810” for “$6,357,117,810”.

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

Pub. L. 117–3282022—Subsec. (b)(3)(A). substituted “for fiscal year 2028 and thereafter, $7,000,000,000” for “for fiscal year 2025 and thereafter, $0”.

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

Pub. L. 116–260Subsec. (b)(3)(A). 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”.

Pub. L. 116–59, § 1604(1)2019—Subsec. (b)(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”.

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

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

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

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

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

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

Pub. L. 115–120, § 3006(2)(A)Subsec. (b)(2). , 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.

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

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

Pub. L. 114–1982016—Subsec. (b)(1). 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.”

Pub. L. 111–148, § 2007(b)(1)Pub. L. 111–1272010—Subsec. (b)(1)(A). , 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 . See below.

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

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

Pub. L. 111–82009—Subsec. (b)(1)(B). inserted “each of” after “for”.