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Calendar No. 641
106th CONGRESS
2d Session
S. 662
[Report No. 106-323]
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.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
March 18, 1999
Mr. Chafee (for himself, Ms. Mikulski, Mr. Moynihan, Ms. Snowe, Mr.
Smith of Oregon, Mr. Harkin, Mr. Cochran, Mr. Durbin, Mrs. Murray, Mr.
Leahy, Mr. Rockefeller, Mr. Lieberman, Mr. Lautenberg, Mrs. Feinstein,
Mr. Bingaman, Mr. Sarbanes, Mr. Hollings, Mr. Wellstone, Mr. Cleland,
Mr. Kennedy, Mr. Johnson, Mr. Robb, Mrs. Boxer, Mr. Reid, Mr. Kerrey,
Ms. Collins, Mr. Conrad, Mr. Bayh, Mr. Inouye, Mr. Torricelli, Mr.
Reed, Mr. Dodd, Mr. Akaka, Mr. Kerry, Mr. Dorgan, Mrs. Lincoln, Mr.
Murkowski, Mr. Schumer, Mr. Bond, Mr. Graham, Mr. Grassley, Mr.
Jeffords, Mr. Baucus, Ms. Landrieu, Mr. Edwards, Mr. Daschle, Mr.
Bryan, Mr. Byrd, Mr. Breaux, Mr. Hagel, Mr. Levin, Mr. Kohl, Mr.
Specter, Mr. Wyden, Mr. Ashcroft, Mr. L. Chafee, Mr. Grams, Mr. Hatch,
Mr. Warner, Mr. Abraham, Mr. Bennett, Mrs. Hutchison, Mr. Crapo, Mr.
McCain, Mr. Helms, Mr. Allard, Mr. Stevens, Mr. Lugar, Mr. Smith of New
Hampshire, Mr. Biden, Mr. Frist, Mr. Gorton, and Mr. DeWine) introduced
the following bill; which was read twice and referred to the Committee
on Finance
June 27, 2000
Reported by Mr. Roth with an amendment
[Strike out all after the enacting clause and insert the part printed
in italic]
_______________________________________________________________________
A BILL
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.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
<DELETED>SECTION 1. OPTIONAL MEDICAID COVERAGE OF CERTAIN BREAST OR
CERVICAL CANCER PATIENTS.</DELETED>
<DELETED> (a) Coverage as Optional Categorically Needy Group.--
</DELETED>
<DELETED> (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--</DELETED>
<DELETED> (A) in subclause (XIII), by striking
``or'' at the end;</DELETED>
<DELETED> (B) in subclause (XIV), by adding ``or''
at the end; and</DELETED>
<DELETED> (C) by adding at the end the
following:</DELETED>
<DELETED> ``(XV) who are described
in subsection (aa) (relating to certain
breast or cervical cancer
patients);''.</DELETED>
<DELETED> (2) Group described.--Section 1902 of the Social
Security Act (42 U.S.C. 1396a) is amended by adding at the end
the following:</DELETED>
<DELETED> ``(aa) Individuals described in this paragraph are
individuals who--</DELETED>
<DELETED> ``(1) are not described in subsection
(a)(10)(A)(i);</DELETED>
<DELETED> ``(2) have not attained age 65;</DELETED>
<DELETED> ``(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</DELETED>
<DELETED> ``(4) are not otherwise covered under creditable
coverage, as defined in section 2701(c) of the Public Health
Service Act (45 U.S.C. 300gg(c)).''.</DELETED>
<DELETED> (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 (F)--</DELETED>
<DELETED> (A) by striking ``and (XIII)'' and
inserting ``(XIII)''; and</DELETED>
<DELETED> (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)(ii)(XV) 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.</DELETED>
<DELETED> (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)--</DELETED>
<DELETED> (A) in clause (x), by striking ``or'' at
the end;</DELETED>
<DELETED> (B) in clause (xi), by adding ``or'' at
the end; and</DELETED>
<DELETED> (C) by inserting after clause (xi) the
following:</DELETED>
<DELETED> ``(xii) individuals described in section
1902(aa),''.</DELETED>
<DELETED> (b) Presumptive Eligibility.--</DELETED>
<DELETED> (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:</DELETED>
<DELETED>``presumptive eligibility for certain breast or cervical
cancer patients</DELETED>
<DELETED> ``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.</DELETED>
<DELETED> ``(b) Definitions.--For purposes of this
section:</DELETED>
<DELETED> ``(1) Presumptive eligibility period.--The term
`presumptive eligibility period' means, with respect to an
individual described in subsection (a), the period that--
</DELETED>
<DELETED> ``(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</DELETED>
<DELETED> ``(B) ends with (and includes) the earlier
of--</DELETED>
<DELETED> ``(i) the day on which a
determination is made with respect to the
eligibility of such individual for services
under the State plan; or</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(2) Qualified entity.--</DELETED>
<DELETED> ``(A) In general.--Subject to subparagraph
(B), the term `qualified entity' means any entity
that--</DELETED>
<DELETED> ``(i) is eligible for payments
under a State plan approved under this title;
and</DELETED>
<DELETED> ``(ii) is determined by the State
agency to be capable of making determinations
of the type described in paragraph
(1)(A).</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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).</DELETED>
<DELETED> ``(c) Administration.--</DELETED>
<DELETED> ``(1) In general.--The State agency shall provide
qualified entities with--</DELETED>
<DELETED> ``(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</DELETED>
<DELETED> ``(B) information on how to assist such
individuals in completing and filing such
forms.</DELETED>
<DELETED> ``(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--
</DELETED>
<DELETED> ``(A) notify the State agency of the
determination within 5 working days after the date on
which determination is made; and</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(d) Payment.--Notwithstanding any other provision of
this title, medical assistance that--</DELETED>
<DELETED> ``(1) is furnished to an individual described in
subsection (a)--</DELETED>
<DELETED> ``(A) during a presumptive eligibility
period;</DELETED>
<DELETED> ``(B) by a entity that is eligible for
payments under the State plan; and</DELETED>
<DELETED> ``(2) is included in the care and services covered
by the State plan;</DELETED>
<DELETED>shall be treated as medical assistance provided by such plan
for purposes of section 1903(a)(5)(B).''.</DELETED>
<DELETED> (2) Conforming amendments.--</DELETED>
<DELETED> (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''.</DELETED>
<DELETED> (B) Section 1903(u)(1)(D)(v) of such Act
(42 U.S.C. 1396b(u)(1)(D)(v)) is amended--</DELETED>
<DELETED> (i) by striking ``or for'' and
inserting ``, for''; and</DELETED>
<DELETED> (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''.</DELETED>
<DELETED> (c) Enhanced Match.--Section 1903(a)(5) of the Social
Security Act (42 U.S.C. 1396b(a)(5)) is amended--</DELETED>
<DELETED> (1) by striking ``an'' and inserting ``(A)
an'';</DELETED>
<DELETED> (2) by adding ``plus'' after the semicolon;
and</DELETED>
<DELETED> (3) by adding at the end the following:</DELETED>
<DELETED> ``(B) an amount equal to 75 percent of the sums
expended during such quarter which are attributable to the
offering, arranging, and furnishing (directly or on a contract
basis) of medical assistance to an individual described in
section 1902(aa); plus''.</DELETED>
<DELETED> (d) Effective Date.--The amendments made by this section
apply to medical assistance furnished on or after October 1, 1999,
without regard to whether final regulations to carry out such
amendments have been promulgated by such date.</DELETED>
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
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