Page:United States Statutes at Large Volume 105 Part 2.djvu/850

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105 STAT. 1802 PUBLIC LAW 102-234—DEC. 12, 1991 "(B) DISTRIBUTION OF POOL BASED ON TOTAL MEDICAID EXPENDITURES FOR MEDICAL ASSISTANCE. —The Supplemental amount for a State for a fiscal year is equal to the lesser of— "(i) the product of the amount determined under subparagraph (A) and the ratio of— "(I) the total amount of expenditures made under the State plan under this title for medical • assistance during the fiscal year, to "(II) the total amount of expenditures made under the State plans under this title for medical assistance during the fiscal year for all States which are not high DSH States in the fiscal year, or "(ii) the amount that would raise the State DSH allotment to the maximum permitted under paragraph (2)(B). "(4) DEFINITIONS.— In this subsection: "(A) HIGH DSH STATE. —The term 'high DSH State' means, for a fiscal year, a State for which the State base allotment exceeds 12 percent of the total amount of expenditures made under the State plan under this title for medical assistance during the fiscal year. "(B) STATE.— The term 'State' means only the 50 States and the District of Columbia but does not include any State whose entire program under this title is operated under a waiver granted under section 1115. "(C) STATE BASE ALLOTMENT. — The term 'State base allotment' means, with respect to a State, the greater of— "(i) the total amount of payment adjustments made under subsection (c) under the State plan during fiscal year 1992 (excluding any such payment adjustments for which a reduction may be made under paragraph (l)(A)(i)), or "(ii) $1,000,000. The amount under clause (i) shall be determined by the Secretary and shall include only payment adjustments described in paragraph (l)(A)(i)(I). "(D) STATE GROWTH AMOUNT.—The term 'State growth amount' means, with respect to a State for a fiscal year, the lesser of— "(i) the product of the State growth factor and the State DSH payment limit for the previous fiscal year, or "(ii) the amount by which 12 percent of the total amount of expenditures made under the State plan under this title for medical assistance during the fiscal year exceeds the State DSH allotment for the previous fiscal year. "(E) STATE GROWTH FACTOR. —The term 'State growth factor' means, for a State for a fiscal year, the percentage by which the expenditures described in section 1903(a) in the State in the fiscal year exceed such expenditures in the previous fiscal year.". (2) CONFORMING AMENDMENTS.—(A) Such section 1923 is further amended—