Requiring budget neutrality for Medicaid demonstration projects under section 1115

Section 1115 of the Social Security Act (42 U.S.C. 1315) is amended by adding at the end the following new subsection: (g) Requirement of budget neutrality for Medicaid demonstration projects (1) In general Beginning on the date of the enactment of this subsection, the Secretary may not approve an application for (or renewal or amendment of) an experimental, pilot, or demonstration project undertaken under subsection (a) to promote the objectives of title XIX in a State (in this subsection referred to as a Medicaid demonstration project) unless the Secretary certifies that such project is not expected to result in an increase in the amount of expenditures compared to the amount that such expenditures would otherwise be in the absence of such project. (2) Treatment of savings In the event that expenditures with respect to a State under a Medicaid demonstration project are, during an approval period for such project, less than the amount of such expenditures that would have otherwise been made in the absence of such project, the Secretary shall specify the methodology to be used with respect to any subsequent approval period for such project for purposes of taking the difference between such expenditures into account..