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

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        H.R.4386

                       One Hundred Sixth Congress

                                 of the

                        United States of America


                          AT THE SECOND SESSION

           Begun and held at the City of Washington on Monday,
             the twenty-fourth day of January, two thousand


                                 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.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

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.

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.

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