Home > 106th Congressional Bills > H.R. 4386 (eh) To amend title XIX of the Social Security Act to provide medical [Engrossed in House] ...

H.R. 4386 (eh) To amend title XIX of the Social Security Act to provide medical [Engrossed in House] ...


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                  In the Senate of the United States,

                       October 4 (legislative day, September 22), 2000.
    Resolved, That the bill from the House of Representatives (H.R. 
4386) entitled ``An Act to amend title XIX of the Social Security Act 
to provide medical assistance for certain women screened and found to 
have breast or cervical cancer under a federally funded screening 
program, to amend the Public Health Service Act and the Federal Food, 
Drug, and Cosmetic Act with respect to surveillance and information 
concerning the relationship between cervical cancer and the human 
papillomavirus (HPV), and for other purposes.'', do pass with the 
following

                               AMENDMENT:

            Strike out all after the enacting clause and insert:

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Breast and Cervical Cancer 
Prevention and Treatment Act of 2000''.

SEC. 2. OPTIONAL MEDICAID COVERAGE OF CERTAIN BREAST OR CERVICAL CANCER 
              PATIENTS.

    (a) Coverage as Optional Categorically Needy Group.--
            (1) In general.--Section 1902(a)(10)(A)(ii) of the Social 
        Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)) is amended--
                    (A) in subclause (XVI), by striking ``or'' at the 
                end;
                    (B) in subclause (XVII), by adding ``or'' at the 
                end; and
                    (C) by adding at the end the following:
                                    ``(XVIII) who are described in 
                                subsection (aa) (relating to certain 
                                breast or cervical cancer patients);''.
            (2) Group described.--Section 1902 of the Social Security 
        Act (42 U.S.C. 1396a) is amended by adding at the end the 
        following:
    ``(aa) Individuals described in this subsection are individuals 
who--
            ``(1) are not described in subsection (a)(10)(A)(i);
            ``(2) have not attained age 65;
            ``(3) have been screened for breast and cervical cancer 
        under the Centers for Disease Control and Prevention breast and 
        cervical cancer early detection program established under title 
        XV of the Public Health Service Act (42 U.S.C. 300k et seq.) in 
        accordance with the requirements of section 1504 of that Act 
        (42 U.S.C. 300n) and need treatment for breast or cervical 
        cancer; and
            ``(4) are not otherwise covered under creditable coverage, 
        as defined in section 2701(c) of the Public Health Service Act 
        (42 U.S.C. 300gg(c)).''.
            (3) Limitation on Benefits.--Section 1902(a)(10) of the 
        Social Security Act (42 U.S.C. 1396a(a)(10)) is amended in the 
        matter following subparagraph (G)--
                    (A) by striking ``and (XIII)'' and inserting 
                ``(XIII)''; and
                    (B) by inserting ``, and (XIV) the medical 
                assistance made available to an individual described in 
                subsection (aa) who is eligible for medical assistance 
                only because of subparagraph (A)(10)(ii)(XVIII) shall 
                be limited to medical assistance provided during the 
                period in which such an individual requires treatment 
                for breast or cervical cancer'' before the semicolon.
            (4) Conforming amendments.--Section 1905(a) of the Social 
        Security Act (42 U.S.C. 1396d(a)) is amended in the matter 
        preceding paragraph (1)--
                    (A) in clause (xi), by striking ``or'' at the end;
                    (B) in clause (xii), by adding ``or'' at the end; 
                and
                    (C) by inserting after clause (xii) the following:
            ``(xiii) individuals described in section 1902(aa),''.
    (b) Presumptive Eligibility.--
            (1) In general.--Title XIX of the Social Security Act (42 
        U.S.C. 1396 et seq.) is amended by inserting after section 
        1920A the following:

    ``presumptive eligibility for certain breast or cervical cancer 
                                patients

    ``Sec. 1920B. (a) State Option.--A State plan approved under 
section 1902 may provide for making medical assistance available to an 
individual described in section 1902(aa) (relating to certain breast or 
cervical cancer patients) during a presumptive eligibility period.
    ``(b) Definitions.--For purposes of this section:
            ``(1) Presumptive eligibility period.--The term 
        `presumptive eligibility period' means, with respect to an 
        individual described in subsection (a), the period that--
                    ``(A) begins with the date on which a qualified 
                entity determines, on the basis of preliminary 
                information, that the individual is described in 
                section 1902(aa); and
                    ``(B) ends with (and includes) the earlier of--
                            ``(i) the day on which a determination is 
                        made with respect to the eligibility of such 
                        individual for services under the State plan; 
                        or
                            ``(ii) in the case of such an individual 
                        who does not file an application by the last 
                        day of the month following the month during 
                        which the entity makes the determination 
                        referred to in subparagraph (A), such last day.
            ``(2) Qualified entity.--
                    ``(A) In general.--Subject to subparagraph (B), the 
                term `qualified entity' means any entity that--
                            ``(i) is eligible for payments under a 
                        State plan approved under this title; and
                            ``(ii) is determined by the State agency to 
                        be capable of making determinations of the type 
                        described in paragraph (1)(A).
                    ``(B) Regulations.--The Secretary may issue 
                regulations further limiting those entities that may 
                become qualified entities in order to prevent fraud and 
                abuse and for other reasons.
                    ``(C) Rule of construction.--Nothing in this 
                paragraph shall be construed as preventing a State from 
                limiting the classes of entities that may become 
                qualified entities, consistent with any limitations 
                imposed under subparagraph (B).
    ``(c) Administration.--
            ``(1) In general.--The State agency shall provide qualified 
        entities with--
                    ``(A) such forms as are necessary for an 
                application to be made by an individual described in 
                subsection (a) for medical assistance under the State 
                plan; and
                    ``(B) information on how to assist such individuals 
                in completing and filing such forms.
            ``(2) Notification requirements.--A qualified entity that 
        determines under subsection (b)(1)(A) that an individual 
        described in subsection (a) is presumptively eligible for 
        medical assistance under a State plan shall--
                    ``(A) notify the State agency of the determination 
                within 5 working days after the date on which 
                determination is made; and
                    ``(B) inform such individual at the time the 
                determination is made that an application for medical 
                assistance under the State plan is required to be made 
                by not later than the last day of the month following 
                the month during which the determination is made.
            ``(3) Application for medical assistance.--In the case of 
        an individual described in subsection (a) who is determined by 
        a qualified entity to be presumptively eligible for medical 
        assistance under a State plan, the individual shall apply for 
        medical assistance under such plan by not later than the last 
        day of the month following the month during which the 
        determination is made.
    ``(d) Payment.--Notwithstanding any other provision of this title, 
medical assistance that--
            ``(1) is furnished to an individual described in subsection 
        (a)--
                    ``(A) during a presumptive eligibility period;
                    ``(B) by a entity that is eligible for payments 
                under the State plan; and
            ``(2) is included in the care and services covered by the 
        State plan,
shall be treated as medical assistance provided by such plan for 
purposes of clause (4) of the first sentence of section 1905(b).''.
            (2) Conforming amendments.--
                    (A) Section 1902(a)(47) of the Social Security Act 
                (42 U.S.C. 1396a(a)(47)) is amended by inserting before 
                the semicolon at the end the following: ``and provide 
                for making medical assistance available to individuals 
                described in subsection (a) of section 1920B during a 
                presumptive eligibility period in accordance with such 
                section''.
                    (B) Section 1903(u)(1)(D)(v) of such Act (42 U.S.C. 
                1396b(u)(1)(D)(v)) is amended--
                            (i) by striking ``or for'' and inserting 
                        ``, for''; and
                            (ii) by inserting before the period the 
                        following: ``, or for medical assistance 
                        provided to an individual described in 
                        subsection (a) of section 1920B during a 
                        presumptive eligibility period under such 
                        section''.
    (c) Enhanced Match.--The first sentence of section 1905(b) of the 
Social Security Act (42 U.S.C. 1396d(b)) is amended--
            (1) by striking ``and'' before ``(3)''; and
            (2) by inserting before the period at the end the 
        following: ``, and (4) the Federal medical assistance 
        percentage shall be equal to the enhanced FMAP described in 
        section 2105(b) with respect to medical assistance provided to 
        individuals who are eligible for such assistance only on the 
        basis of section 1902(a)(10)(A)(ii)(XVIII)''.
    (d) Effective Date.--The amendments made by this section apply to 
medical assistance for items and services furnished on or after October 
1, 2000, without regard to whether final regulations to carry out such 
amendments have been promulgated by such date.

            Attest:

                                                             Secretary.
106th CONGRESS

  2d Session

                               H. R. 4386

_______________________________________________________________________

                               AMENDMENT

Pages: 1

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