Page 231

139 STAT. 301 PUBLIC LAW 119–21—JULY 4, 2025 (4) STATE.—The term ‘‘State’’ has the meaning given such term in section 1101 of the Social Security Act (42 U.S.C. 1301). (c) IMPLEMENTATION FUNDING.—For the purposes of carrying out this section, there are appropriated, out of any monies in the Treasury not otherwise appropriated, to the Administrator of the Centers for Medicare & Medicaid Services, $1,000,000 for fiscal year 2026, to remain available until expended. Subchapter C—Stopping Abusive Financing Practices SEC. 71114. SUNSETTING INCREASED FMAP INCENTIVE. Section 1905(ii)(3) of the Social Security Act (42 U.S.C. 1396d(ii)(3)) is amended— (1) by striking ‘‘which has not’’ and inserting the following: ‘‘which— ‘‘(A) has not’’; (2) in subparagraph (A), as so inserted, by striking the period at the end and inserting ‘‘; and’’; and (3) by adding at the end the following new subparagraph: ‘‘(B) begins to expend amounts for all such individuals prior to January 1, 2026.’’. SEC. 71115. PROVIDER TAXES. (a) CHANGE IN THRESHOLD FOR HOLD HARMLESS PROVISION OF BROAD-BASED HEALTH CARE RELATED TAXES.—Section 1903(w)(4) of the Social Security Act (42 U.S.C. 1396b(w)(4)) is amended— (1) in subparagraph (C)(ii), by inserting ‘‘, and for fiscal years beginning on or after October 1, 2026, the applicable percent determined under subparagraph (D) shall be sub- stituted for ‘6 percent’ each place it appears’’ after ‘‘each place it appears’’; and (2) by inserting after subparagraph (C)(ii), the following new subparagraph: ‘‘(D)(i) For purposes of subparagraph (C)(ii), the applicable percent determined under this subparagraph is— ‘‘(I) in the case of a non-expansion State or unit of local government in such State and a class of health care items or services described in section 433.56(a) of title 42, Code of Federal Regulations (as in effect on May 1, 2025)— ‘‘(aa) if, on the date of enactment of this subpara- graph, the non-expansion State or unit of local govern- ment in such State has enacted a tax and imposes such tax on such class and the Secretary determines that the tax is within the hold harmless threshold as of that date, the applicable percent of net patient revenue attributable to such class that has been so determined; and ‘‘(bb) if, on the date of enactment of this subpara- graph, the non-expansion State or unit of local govern- ment in such State has not enacted or does not impose a tax with respect to such class, 0 percent; and ‘‘(II) in the case of an expansion State or unit of local government in such State and a class of health care items or services described in section 433.56(a) of title 42, Code Applicability. Determinations. Effective dates. Time periods.