Home > 105th Congressional Bills > S. 1159 (rfh) To amend the Alaska Native Claims Settlement Act, regarding the Kake Tribal Corporation public interest land exchange. ...S. 1159 (rfh) To amend the Alaska Native Claims Settlement Act, regarding the Kake Tribal Corporation public interest land exchange. ...
health assistance furnished on or after such date.
SEC. 132. PERMITTING STATES AND LOCALITIES TO PROVIDE HEALTH CARE TO
ALL INDIVIDUALS.
(a) In General.--Section 411 of the Personal Responsibility and
Work Opportunity Reconciliation Act of 1996 (8 U.S.C. 1621) is
amended--
(1) in subsection (b)--
(A) by striking paragraphs (1) and (3); and
(B) by redesignating paragraphs (2) and (4) as
paragraphs (1) and (2), respectively; and
(2) in subsection (c)--
(A) in paragraph (1)--
(i) in the matter preceding subparagraph
(A), by striking ``(2) and (3)'' and inserting
``(2), (3), and (4)''; and
(ii) in subparagraph (B), by striking
``health,''; and
(B) by adding at the end the following new
paragraph
``(4) Such term does not include any health benefit for
which payments or assistance are provided to an individual,
household, or family eligibility unit by an agency of a State
or local government or by appropriated funds of a State or
local government.''.
(b) Effective Date.--The amendments made by subsection (a) shall
apply to health care furnished before, on, or after the date of the
enactment of this Act.
Subtitle E--Eligibility Simplification
SEC. 141. STATE OPTION TO PROVIDE FOR SIMPLIFIED DETERMINATIONS OF A
CHILD'S FINANCIAL ELIGIBILITY FOR MEDICAL ASSISTANCE
UNDER MEDICAID OR CHILD HEALTH ASSISTANCE UNDER SCHIP.
(a) Medicaid.--Section 1902(e) of the Social Security Act (42
U.S.C. 1396a(e)) is amended by adding at the end the following:
``(13)(A) At the option of the State, the plan may provide
that financial eligibility requirements for medical assistance
are met for an individual who is under an age specified by the
State (not to exceed 21 years of age) by using a determination
(made within a reasonable period, as found by the State, before
its use for this purpose) of the individual's family or
household income or resources, notwithstanding any differences
in budget unit, disregard, deeming, or other methodology, by a
Federal or State agency (or a public or private entity making
such determination on behalf of such agency) specified by the
plan, including but not limited to the agencies administering
the Food Stamp Act of 1977, the Richard B. Russell National
School Lunch Act, and the Child Nutrition Act of 1966, provided
that such agency has fiscal liabilities or responsibilities
affected or potentially affected by such determinations and
provided that all information furnished by such agency pursuant
to this subparagraph is used solely for purposes of determining
eligibility for medical assistance under the State plan
approved under this title or for child health assistance under
a State plan approved under title XXI.
``(B) Nothing in subparagraph (A) shall be construed--
``(i) to authorize the denial of medical assistance
under a State plan approved under this title or of
child health assistance under a State plan approved
under title XXI to an individual who, without the
application of this paragraph or an option exercised
thereunder, would qualify for such assistance;
``(ii) to relieve a State of the obligation under
subsection (a)(8) to furnish assistance with reasonable
promptness after the submission of an initial
application that is evaluated or for which evaluation
is requested pursuant to this paragraph; or
``(iii) to relieve a State of the obligation to
determine eligibility on other grounds for an
individual found to be ineligible under this paragraph.
``(C) At the option of a State, the financial eligibility
process described in subparagraph (A) may apply to an
individual who is older than age 21 if such individual's
eligibility for medical assistance is based on pregnancy or if
such individual is a parent, guardian, or other caretaker
relative of an individual found eligible under subparagraph
(A).''.
(b) SCHIP.--Section 2107(e)(1) of the Social Security Act (42
U.S.C. 1397gg(e)(1)) is amended by adding at the end the following:
``(E) Section 1902(e)(13) (relating to the State
option to base a child's eligibility for assistance on
financial determinations made by a program providing
nutrition or other public assistance).''.
(c) Effective Date.--The amendments made by this section take
effect on October 1, 2003.
SEC. 142. APPLICATION OF SIMPLIFIED TITLE XXI PROCEDURES UNDER THE
MEDICAID PROGRAM.
(a) Presumptive Eligibility.--
(1) In general.--Section 1920A(b)(3)(A)(i) of the Social
Security Act (42 U.S.C. 1396r-1a(b)(3)(A)(i)) is amended by
inserting ``a child care resource and referral agency,'' after
``a State or tribal child support enforcement agency,''.
(2) Application to presumptive eligibility for pregnant
women under medicaid.--Section 1920(b) of the Social Security
Act (42 U.S.C. 1396r-1(b)) is amended by adding at the end
after and below paragraph (2) the following flush sentence:
``The term `qualified provider' includes a qualified entity as defined
in section 1920A(b)(3).''.
(3) Application under title xxi.--Section 2107(e)(1)(D) of
the Social Security Act (42 U.S.C. 1397gg(e)(1)) is amended to
read as follows:
``(D) Sections 1920 and 1920A (relating to
presumptive eligibility).''.
(b) Automatic Reassessment of Eligibility for Title XXI and
Medicaid Benefits for Children Losing Medicaid or Title XXI
Eligibility.--
(1) Loss of medicaid eligibility.--Section 1902(a) of the
Social Security Act (42 U.S.C. 1396a(a)) is amended--
(A) by striking the period at the end of paragraph
(65) and inserting ``; and'', and
(B) by inserting after paragraph (65) the
following:
``(66) provide, in the case of a State with a State child
health plan under title XXI, that before medical assistance to
a child (or a parent of a child) is discontinued under this
title, a determination of whether the child (or parent) is
eligible for benefits under title XXI shall be made and, if
determined to be so eligible, the child (or parent) shall be
automatically enrolled in the program under such title without
the need for a new application.''.
(2) Loss of title xxi eligibility and coordination with
medicaid.--Section 2102(b) of the Social Security Act (42
U.S.C. 1397bb(b)) is amended--
(A) in paragraph (3), by redesignating
subparagraphs (D) and (E) as subparagraphs (E) and (F),
respectively, and by inserting after subparagraph (C)
the following:
``(D) that before health assistance to a child (or
a parent of a child) is discontinued under this title,
a determination of whether the child (or parent) is
eligible for benefits under title XIX is made and, if
determined to be so eligible, the child (or parent) is
automatically enrolled in the program under such title
without the need for a new application;'';
(B) by redesignating paragraph (4) as paragraph
(5); and
(C) by inserting after paragraph (3) the following
new paragraph:
``(4) Coordination with medicaid.--The State shall
coordinate the screening and enrollment of individuals under
this title and under title XIX consistent with the following:
``(A) Information that is collected under this
title or under title XIX which is needed to make an
eligibility determination under the other title shall
be transmitted to the appropriate administering entity
under such other title in a timely manner so that
coverage is not delayed and families do not have to
submit the same information twice. Families shall be
provided the information they need to complete the
application process for coverage under both titles and
be given appropriate notice of any determinations made
on their applications for such coverage.
``(B) If a State does not use a joint application
under this title and such title, the State shall--
``(i) promptly inform a child's parent or
caretaker in writing and, if appropriate,
orally, that a child has been found likely to
be eligible under title XIX;
``(ii) provide the family with an
application for medical assistance under such
title and offer information about what (if any)
further information, documentation, or other
steps are needed to complete such application
process;
``(iii) offer assistance in completing such
application process; and
``(iv) promptly transmit the separate
application under this title or the information
obtained through such application, and all
other relevant information and documentation,
including the results of the screening process,
to the State agency under title XIX for a final
determination on eligibility under such title.
``(C) Applicants are notified in writing of--
``(i) benefits (including restrictions on
cost-sharing) under title XIX; and
``(ii) eligibility rules that prohibit
children who have been screened eligible for
medical assistance under such title from being
enrolled under this title, other than
provisional temporary enrollment while a final
eligibility determination is being made under
such title.
``(D) If the agency administering this title is
different from the agency administering a State plan
under title XIX, such agencies shall coordinate the
screening and enrollment of applicants for such
coverage under both titles.
``(E) The coordination procedures established
between the program under this title and under title
XIX shall apply not only to the initial eligibility
determination of a family but also to any renewals or
redeterminations of such eligibility.''.
(3) Effective date.--The amendments made by paragraphs (1)
and (2) apply to individuals who lose eligibility under the
medicaid program under title XIX, or under a State child health
insurance plan under title XXI, respectively, of the Social
Security Act on or after October 1, 2003, without regard to
whether regulations implementing such amendments have been
issued.
(c) Provision of Medicaid and CHIP Applications and Information
Under the School Lunch Program.--Section 9(b)(2)(B) of the Richard B.
Russell National School Lunch Act (42 U.S.C. 1758(b)(2)(B)) is
amended--
(1) by striking ``(B) Applications'' and inserting ``(B)(i)
Applications''; and
(2) by adding at the end the following:
``(ii)(I) Applications for free and reduced price lunches that are
distributed pursuant to clause (i) to parents or guardians of children
in attendance at schools participating in the school lunch program
under this Act shall also contain information on the availability of
medical assistance under title XIX of the Social Security Act (42
U.S.C. 1396 et seq.) and of child health and other assistance under
title XXI of such Act, including information on how to obtain an
application for assistance under such programs.
``(II) Information on the programs referred to in subclause (I)
shall be provided on a form separate from the application form for free
and reduced price lunches under clause (i).''.
Subtitle F--SCHIP Wrap-Around Benefits
SEC. 151. STATE OPTION TO PROVIDE WRAP-AROUND SCHIP COVERAGE TO
CHILDREN WHO HAVE OTHER HEALTH COVERAGE.
(a) In General.--
(1) SCHIP.--
(A) State option to provide wrap-around coverage.--
Section 2110(b) of the Social Security Act (42 U.S.C.
1397jj(b)) is amended--
(i) in paragraph (1)(C), by inserting ``,
subject to paragraph (5),'' after ``under title
XIX or''; and
(ii) by adding at the end the following new
paragraph:
``(5) State option to provide wrap-around coverage.--A
State may waive the requirement of paragraph (1)(C) that a
targeted low-income child may not be covered under a group
health plan or under health insurance coverage, if the State
satisfies the conditions described in subsection (c)(8). The
State may waive such requirement in order to provide--
``(A) dental services;
``(B) cost-sharing protection; or
``(C) all services.
In waiving such requirement, a State may limit the application
of the waiver to children whose family income does not exceed a
level specified by the State, so long as the level so specified
does not exceed the maximum income level otherwise established
for other children under the State child health plan.''; and
(B) Conditions described.--Section 2105(c) of such
Act (42 U.S.C. 1397ee(c)) is amended by adding at the
end the following new paragraph:
``(8) Conditions for provision of wrap around coverage.--
For purposes of section 2110(b)(5), the conditions described in
this paragraph are the following:
``(A) Income eligibility.--The State child health
plan (whether implemented under title XIX or this
XXI)--
``(i) has an income eligibility standard
not less than that described in paragraph (4)
of such section;
``(ii) subject to subparagraph (B), does
not limit the acceptance of applications for
children; and
``(iii) provides benefits to all children
in the State who apply for and meet eligibility
standards.
``(B) No waiting list imposed.--With respect to
children whose family income is at or below 200 percent
of the poverty line, the State does not impose any
numerical limitation, waiting list, or similar
limitation on the eligibility of such children for
child health assistance under such State plan.
``(C) No more favorable treatment.--The State child
health plan may not provide more favorable coverage of
dental services to the children covered under section
2110(b)(5) than to children otherwise covered under
this title.''.
(C) State option to waive waiting period.--Section
2102(b)(1)(B) of such Act (42 U.S.C. 1397bb(b)(1)(B)),
as amended by section 101(c)(3), is amended--
(i) in clause (ii), by striking ``and'' at
the end;
(ii) in clause (iii), by striking the
period and inserting ``; and''; and
(iii) by adding at the end the following
new clause:
``(iv) at State option, may not apply a
waiting period in the case of child described
in section 2110(b)(5), if the State satisfies
the requirements of section 2105(c)(8).''.
(2) Application of enhanced match under medicaid.--Section
1905 of such Act (42 U.S.C. 1396d), as amended by section
101(a)(1)(C), is amended--
(A) in subsection (b), in the fourth sentence, by
striking ``or (u)(4)'' and inserting ``(u)(4), or
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