113 HR 5364 IH: CHIP Extension and Improvement Act of 2014
U.S. House of Representatives
2014-07-31
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
1.Short title; amendments to Social Security Act; references; table of contents
(a)This Act may be cited as the CHIP Extension and Improvement Act of 2014
.
(b)References to CHIP; Medicaid; SecretaryIn this Act:
(1)The term CHIP means the State Children’s Health Insurance Program established under title XXI of the Social
Security Act (42 U.S.C. 1397aa et seq.) (whether implemented under title
XIX, XXI, or both, of the Social Security Act).
(2)The term Medicaid means the program for medical assistance established under title XIX of the Social Security Act
(42 U.S.C. 1396 et seq.).
(3)The term Secretary means the Secretary of Health and Human Services.
(c)The table of contents for this Act is as follows:
Sec. 1. Short title; amendments to Social Security Act; references; table of contents.
Sec. 2. General effective date; exception for State legislation; reliance on law.
Title I—Financing
Sec. 101. 4-year extension of CHIP funding.
Sec. 102. Performance incentive program improvements.
Sec. 103. Child enrollment contingency fund adjustment.
Title II—Coverage Stability and Reduced Bureaucracy
Sec. 201. Improving coverage stability.
Sec. 202. Assuring care continuity during transitions among CHIP, Medicaid, and qualified health
plans.
Sec. 203. Continuous eligibility option for certain adults.
Sec. 204. State flexibility to use administrative simplification policies for enrollment.
Sec. 205. Outreach to targeted populations.
Title III—Benefits and Affordability
Sec. 301. Strengthened cost-sharing protections under CHIP.
Sec. 302. Ensuring coverage of preventive health services under Medicaid and CHIP.
Sec. 303. Timely immunization coverage.
Sec. 304. Payment parity for Medicaid primary care services.
Title IV—Access and Quality
Subtitle A—Pediatric Quality Measures
Sec. 401. Extending the pediatric quality measures program.
Sec. 402. Enhanced FMAP for activities related to pediatric quality measures.
Sec. 403. Reporting of full set of pediatric quality measures.
Sec. 404. Technical assistance to States for adopting and utilizing pediatric quality measures.
Sec. 405. Improving the effectiveness of the pediatric quality measures.
Sec. 406. Reports regarding State-specific quality of care measures applied under Medicaid or CHIP.
Sec. 407. Advisory panel regarding pediatric quality.
Sec. 408. Extending and expanding demonstration projects.
Subtitle B—Continuing Delivery System Reform
Sec. 411. Supporting evidence-based care coordination in communities.
Sec. 412. Ensuring care coordination for children.
Subtitle C—Miscellaneous
Sec. 421. Assuring coverage continuity for former foster care children.
Sec. 422. Definition of therapeutic foster care as medical assistance.
Sec. 423. Technical correction.
2.General effective date; exception for State legislation; reliance on law
(a)Unless otherwise provided in this Act, subject to subsections (b) and (c), this Act (and the
amendments made by this Act) shall take effect on October 1, 2014, and
shall apply to medical assistance and child health assistance furnished
under titles XIX and XXI, respectively, of the Social Security Act on or
after that date.
(b)Exception for State legislationIn the case of a State plan under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) or
a State child health plan under title XXI of such Act (42 U.S.C. 1397aa et
seq.), which the Secretary determines requires State legislation in order
for the respective plan to meet one or more additional requirements
imposed by amendments made by this Act, the respective plan shall not be
regarded as failing to comply with the requirements of such title solely
on the basis of its failure to meet such an additional requirement before
the first day of the first calendar quarter beginning after the close of
the first regular session of the State legislature that begins after the
date of enactment of this Act. For purposes of the previous sentence, in
the case of a State that has a 2-year legislative session, each year of
the session shall be considered to be a separate regular session of the
State legislature.
(c)Coordination of CHIP funding for fiscal year 2015Notwithstanding any other provision of law, insofar as funds have been appropriated under
subsection (a)(18) or (m) of section 2104 of the Social Security Act (42
U.S.C. 1397dd), as such subsections are in effect on the day before the
date of the enactment of this Act, to provide allotments to States under
CHIP for fiscal year 2015—
(1)any amounts that are so appropriated that are not so allotted and obligated before April 1, 2015,
are rescinded; and
(2)any amount provided for CHIP allotments to a State under this Act (and the amendments made by this
Act) for such fiscal year shall be reduced by the amount of such
appropriations so allotted and obligated before such date.
(d)With respect to amendments made by this Act that become effective as of a date—
(1)such amendments are effective as of such date whether or not regulations implementing such
amendments have been issued; and
(2)Federal financial participation for medical assistance or child health assistance furnished under
title XIX or XXI, respectively, of the Social Security Act on or after
such date by a State in good faith reliance on such amendments before the
date of promulgation of final regulations, if any, to carry out such
amendments (or before the date of guidance, if any, regarding the
implementation of such amendments) shall not be denied on the basis of the
State’s failure to comply with such regulations or guidance.
<enum>I</enum><header>Financing</header>
<section id="H048804A76DC544DC95E8157A0ABBD13B"><enum>101.</enum><header>4-year extension of CHIP funding</header>
<subsection id="H8EBE21E1F04948DC9A1F93C2D263AFE9"><enum>(a)</enum><header>Funding</header><text display-inline="yes-display-inline">Section 2104(a) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397dd">42 U.S.C. 1397dd(a)</external-xref>) is amended—</text>
<paragraph id="HD990838632D945F7BC2BC61B5687D322"><enum>(1)</enum><text>in paragraph (17), by striking <quote>and</quote> at the end;</text>
</paragraph><paragraph id="HEC228029817045A9877E6F9B4FE2F182"><enum>(2)</enum><text>by striking paragraph (18) and inserting the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="HFB35C14A7B7844BBA71F7350E427796B" style="OLC">
<paragraph id="HFE38C02198E84FF98888E6B43DEC0C50"><enum>(18)</enum><text>for fiscal year 2015, $21,061,000,000;</text></paragraph><after-quoted-block>; and</after-quoted-block></quoted-block>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H26908BEF27D242D9B3B2ECF25E8E2FC1"><enum>(3)</enum><text>by adding at the end the following new paragraphs:</text>
<quoted-block display-inline="no-display-inline" id="H893595D5336A430BAA5C0C8CFC52556C" style="OLC">
<paragraph commented="no" display-inline="no-display-inline" id="H8DBE01766A084EB294EC5D2D1C0D4268"><enum>(19)</enum><text display-inline="yes-display-inline">for fiscal year 2016, $19,300,000,000;</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H23B8C10320CF4D398AE69BC382D61BC7"><enum>(20)</enum><text display-inline="yes-display-inline">for fiscal year 2017, $20,300,000,000;</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H13B4B4BE891E42D29EFB74D2A3809A67"><enum>(21)</enum><text display-inline="yes-display-inline">for fiscal year 2018, $21,300,000,000; and</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HF763F9B2EC8F4D3E916815327179D857"><enum>(22)</enum><text display-inline="yes-display-inline">for fiscal year 2019, for purposes of making 2 semi-annual allotments—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H376C06AAC6844A90977EE5B2DEAD5E9B"><enum>(A)</enum><text display-inline="yes-display-inline">$2,850,000,000 for the period beginning on October 1, 2018, and ending on March 31, 2019; and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H903E4F15ACD142B6876AF7D53693BDFB"><enum>(B)</enum><text display-inline="yes-display-inline">$2,850,000,000 for the period beginning on April 1, 2019, and ending on September 30, 2019.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H89D15F39FE054C2BA3E418971C0F145C"><enum>(b)</enum><header>Allotments</header>
<paragraph commented="no" display-inline="no-display-inline" id="HF90CDFC51A5345708F716D4975A2F173"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Section 2104(m) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397dd">42 U.S.C. 1397dd(m)</external-xref>) is amended—</text>
<subparagraph id="H45C54982D6D149509AE3FA6DCBD34B8C"><enum>(A)</enum><text>in the subsection heading, by striking <quote><header-in-text level="subsection" style="OLC"><enum-in-header>2015</enum-in-header></header-in-text></quote> and inserting <quote><header-in-text level="subsection" style="OLC"><enum-in-header>2019</enum-in-header></header-in-text></quote>;</text>
</subparagraph><subparagraph id="H7A52D39E3C1844AE8A2CB23C19F38BC6"><enum>(B)</enum><text>in paragraph (2)—</text>
<clause id="HE60BE148CE43431BBCA6BECB3C38E803"><enum>(i)</enum><text>in the paragraph heading, by striking <quote><header-in-text level="paragraph" style="OLC"><enum-in-header>2014</enum-in-header></header-in-text></quote> and inserting <quote><header-in-text level="paragraph" style="OLC"><enum-in-header>2018</enum-in-header></header-in-text></quote>; and</text>
</clause><clause id="H4664806022E94A5FAF08405B91B70024"><enum>(ii)</enum><text>by striking subparagraph (B) and inserting the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H772F6C89407D4C6FA2649DEF59C3D8D5" style="OLC">
<subparagraph id="HB78A235850CE43CDA35B578B45C4C29B"><enum>(B)</enum><header>Fiscal year 2013 and each succeeding fiscal year</header><text display-inline="yes-display-inline">Subject to paragraphs (4) and (6), from the amount made available under paragraphs (16) through
(21) of subsection (a) for fiscal year 2013 and each succeeding fiscal
year, respectively, the Secretary shall compute a State allotment for each
State (including the District of Columbia and each commonwealth and
territory) for each such fiscal year as follows:</text>
<clause id="HBD47D5EF20C245D8BBC61FC4BFD4F830"><enum>(i)</enum><header>Rebasing in fiscal year 2013 and each succeeding odd-numbered fiscal year</header><text display-inline="yes-display-inline">For fiscal year 2013 and each succeeding odd-numbered fiscal year, the allotment of the State is
equal to the Federal payments to the State that are attributable to (and
countable toward) the total amount of allotments available under this
section to the State in the preceding fiscal year (including payments made
to the State under subsection (n) for such preceding fiscal year as well
as amounts redistributed to the State in such preceding fiscal year),
multiplied by the allotment increase factor under paragraph (5) for such
odd-numbered fiscal year.</text>
</clause><clause id="H07CC4CA36F8147908D02F802BE2B7D46"><enum>(ii)</enum><header>Growth factor update for fiscal year 2014 and each succeeding even-numbered fiscal year</header><text display-inline="yes-display-inline">For fiscal year 2014 and each succeeding even-numbered fiscal year, the allotment of the State is
equal to the sum of—</text>
<subclause id="HEC2FB0ED24D34D0488B82DBBC89B8884"><enum>(I)</enum><text>the amount of the State allotment under clause (i) for the preceding fiscal year; and</text>
</subclause><subclause id="H604D32F34D8E41998D80A20A76407D5A"><enum>(II)</enum><text>the amount of any payments made to the State under subsection (n) for such preceding fiscal year,</text></subclause><continuation-text continuation-text-level="clause">multiplied by the allotment increase factor under paragraph (5) for such even-numbered fiscal year.</continuation-text></clause></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block>
</clause></subparagraph><subparagraph id="H44CAF91491004EB7A5F5AB7D743130E4"><enum>(C)</enum><text>in paragraph (3)—</text>
<clause commented="no" display-inline="no-display-inline" id="H6DDF0B1C0FFB4E51BF0BEB17D3D9E369"><enum>(i)</enum><text>in the heading, by striking <quote><header-in-text level="paragraph" style="OLC"><enum-in-header>2015</enum-in-header></header-in-text></quote> and inserting <quote><header-in-text level="paragraph" style="OLC"><enum-in-header>2019</enum-in-header></header-in-text></quote>;</text>
</clause><clause commented="no" display-inline="no-display-inline" id="HBDAC02A6E6F34AACB4B060DB4F5508D3"><enum>(ii)</enum><text>in subparagraph (A), by striking <quote>paragraph (18)</quote> and inserting <quote>paragraph (22)</quote>;</text>
</clause><clause commented="no" display-inline="no-display-inline" id="HD7858568479544C783C0A59AE050ACEC"><enum>(iii)</enum><text>in subparagraph (B), by striking <quote>paragraph (18)</quote> and inserting <quote>paragraph (22)</quote>;</text>
</clause><clause commented="no" display-inline="no-display-inline" id="H06B8C6BE49C44959850C40C37CF78FA8"><enum>(iv)</enum><text>in subparagraph (C)—</text>
<subclause commented="no" display-inline="no-display-inline" id="H36254BB997E0424AB1CB938C1159B89F"><enum>(I)</enum><text>by striking <quote>2014</quote> each place it appears and inserting <quote>2018</quote>; and</text>
</subclause><subclause commented="no" display-inline="no-display-inline" id="H9E07F89A95F440A2B43615ABE660F34D"><enum>(II)</enum><text>by striking <quote>2015</quote> and inserting <quote>2019</quote>; and</text>
</subclause></clause><clause commented="no" display-inline="no-display-inline" id="H82BF4EF3554441D184B802D72482DB1E"><enum>(v)</enum><text>in subparagraph (D)—</text>
<subclause commented="no" display-inline="no-display-inline" id="HAF18E585F523493182ACD5C5FA31F163"><enum>(I)</enum><text>in clause (i)—</text>
<item id="HBB262686F0534360B9AE38FA9482B83E"><enum>(aa)</enum><text display-inline="yes-display-inline">in subclause (I), by striking <quote>subsection (a)(18)(A)</quote> and inserting <quote>subsection (a)(22)(A)</quote>; and</text>
</item><item id="H16198F6794AD4390971AB5D1042D2A7D"><enum>(bb)</enum><text>in subclause (II), by striking <quote>section 108 of the Children's Health Insurance Program Reauthorization Act of 2009</quote> and inserting <quote>section 101(b)(2) of the CHIP Extension and Improvement Act of 2014</quote>; and</text>
</item></subclause><subclause commented="no" display-inline="no-display-inline" id="H70DA9BFF871C446991BA91A92EEB5C2A"><enum>(II)</enum><text>in clause (ii)(II), by striking <quote>subsection (a)(18)(B)</quote> and inserting <quote>subsection (a)(22)(B)</quote>;</text>
</subclause></clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HA602109B4E7E4F0B838AA67A13FA093D"><enum>(D)</enum><text>in paragraph (4), by striking <quote>2015</quote> and inserting <quote>2019</quote>;</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HB2F35A190EE048DBA01543ABECFB9915"><enum>(E)</enum><text>in paragraph (6)—</text>
<clause commented="no" display-inline="no-display-inline" id="H608E4F187ADE4DD4B476E498B9E9F6C6"><enum>(i)</enum><text>in subparagraph (A), by striking <quote>2015</quote> and inserting <quote>2019</quote>; and</text>
</clause><clause commented="no" display-inline="no-display-inline" id="H9439C37CA81445FB8F6B8F493E25F1FC"><enum>(ii)</enum><text>in the second sentence, by striking <quote>or fiscal year 2014</quote> and inserting <quote>fiscal year 2014, fiscal year 2016, or fiscal year 2018</quote>; and</text>
</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HC36E3A6795794054AACB35EF06E9495C"><enum>(F)</enum><text>in paragraph (8)—</text>
<clause commented="no" display-inline="no-display-inline" id="HE513F5F0CD24498788CE01D3EC90E367"><enum>(i)</enum><text display-inline="yes-display-inline">in the paragraph heading, by striking <quote><header-in-text level="paragraph" style="OLC"><enum-in-header>2015</enum-in-header></header-in-text></quote> and inserting <quote><header-in-text level="paragraph" style="OLC"><enum-in-header>2019</enum-in-header></header-in-text></quote>; and</text>
</clause><clause commented="no" display-inline="no-display-inline" id="H98500A6401B5446080FD11E266DBA038"><enum>(ii)</enum><text>by striking <quote>for a period in fiscal year 2015</quote> and inserting <quote>for a period in fiscal year 2019</quote>.</text>
</clause></subparagraph></paragraph><paragraph id="HB85CDE85C4464342968A485769B061F3"><enum>(2)</enum><header>Supplemental appropriation for fiscal year 2019</header><text display-inline="yes-display-inline">There is appropriated to the Secretary, out of any money in the Treasury not otherwise
appropriated, $16,700,000,000 to accompany the allotment made for the
period beginning on October 1, 2018, and ending on March 31, 2019, under
section 2104(a)(22)(A) of the Social Security Act (42 U.S.C.
1397dd(a)(22)(A)) (as added by subsection (a)), to remain available until
expended. Such amount shall be used to provide allotments to States under
paragraph (3) of section 2104(m) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397dd">42 U.S.C. 1397dd(m)</external-xref>) (as
amended by paragraph (1)(C)) for the first 6 months of fiscal year 2019 in
the same manner as allotments are provided under subsection (a)(22)(A) of
such section 2104 and subject to the same terms and conditions as apply to
the allotments provided from such subsection (a)(22)(A).</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HC5BA0769F3AA4FABA2771373D7E6E109"><enum>(c)</enum><header>Extension of qualifying states option</header><text display-inline="yes-display-inline">Section 2105(g)(4) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397ee">42 U.S.C. 1397ee(g)(4)</external-xref>) is amended—</text>
<paragraph commented="no" display-inline="no-display-inline" id="H3531AC35C3C941BB98A06FAEC8BC220F"><enum>(1)</enum><text>in the paragraph heading, by striking <quote><header-in-text level="paragraph" style="OLC"><enum-in-header>2015</enum-in-header></header-in-text></quote> and inserting <quote><header-in-text level="paragraph" style="OLC"><enum-in-header>2019</enum-in-header></header-in-text></quote>; and</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HA158B6D58A69486D936D9B33E5C3D362"><enum>(2)</enum><text>in subparagraph (A), by striking <quote>2015</quote> and inserting <quote>2019</quote>.</text>
</paragraph></subsection></section><section id="H9839BE4447414DBBA74851ED14EE596E"><enum>102.</enum><header>Performance incentive program improvements</header>
<subsection id="HCD8A5418B32E48D9BCC5824FA3747B1D"><enum>(a)</enum><header>Extension through fiscal year <enum-in-header>2019</enum-in-header></header><text display-inline="yes-display-inline">Section 2105(a)(3) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397ee">42 U.S.C. 1397ee(a)(3)</external-xref>) is amended—</text>
<paragraph id="HA68A1EAB9F57458FAFD669BF893671C3"><enum>(1)</enum><text>in subparagraph (A), by striking <quote>2013</quote> and inserting <quote>2019</quote>;</text>
</paragraph><paragraph commented="no" id="H2BDC9029CCB9442FBB616E35200D1E21"><enum>(2)</enum><text>in subparagraph (E)—</text>
<subparagraph commented="no" id="H82A5A9E16A9C4C97B531344A1C00B3FB"><enum>(A)</enum><text>in clause (ii)—</text>
<clause id="H99D9240E4B834ADF912CD3FB2EDE6120"><enum>(i)</enum><text>in the matter preceding subclause (I), by inserting <quote>after the application of section 2104(n)(3)(D)(ii) with respect to such amounts,</quote> after <quote>limitation,</quote>;</text>
</clause><clause id="H09D65051D1BE49779D371A1BC58E46E7"><enum>(ii)</enum><text>by striking subclause (I) and inserting the following new subclause:</text>
<quoted-block display-inline="no-display-inline" id="H46302CC50C774F1DB92E29F01FA2DE1A" style="OLC">
<subclause id="HA65E5BF0ADF04D05A2CD0B2652115094"><enum>(I)</enum><header>Unobligated national allotment for fiscal years 2009 through 2015</header><text display-inline="yes-display-inline">As of December 31 of fiscal year 2009, and as of December 31 of each succeeding fiscal year through
fiscal year 2015, the portion, if any, of the amount appropriated under
section 2104(a) for such fiscal year that is unobligated for allotment to
a State under section 2104(m) for such fiscal year or set aside under
subsection (a)(3) or (b)(2) of section 2111 for such fiscal year.</text></subclause><after-quoted-block>;</after-quoted-block></quoted-block>
</clause><clause commented="no" id="H9B8479A4E45042218CFE82A3ED1E1F36"><enum>(iii)</enum><text>in subclause (II), by striking <quote>2013</quote> and inserting <quote>2015</quote>; and</text>
</clause><clause commented="no" id="H6A0D5F76D20B4E5885603C1F7C80D48F"><enum>(iv)</enum><text>in subclause (III), by striking <quote>2013</quote> and inserting <quote>2015</quote>;</text>
</clause></subparagraph><subparagraph commented="no" id="H3D867AC44A1D4AFDA258E727182E0A63"><enum>(B)</enum><text>by redesignating clause (iii) as clause (iv); and</text>
</subparagraph><subparagraph commented="no" id="H95F02DDB047245FCA76C8A882E1AFD4D"><enum>(C)</enum><text>by inserting after clause (ii), the following new clause:</text>
<quoted-block display-inline="no-display-inline" id="H674E368891FF4FE7BBAA9E6E0E6EC95B" style="OLC">
<clause commented="no" display-inline="no-display-inline" id="H384E9213B23744FA9ED8A9756417EBD5"><enum>(iii)</enum><header display-inline="yes-display-inline">Appropriation for fiscal years 2016 through 2019</header><text display-inline="yes-display-inline">Out of any money in the Treasury not otherwise appropriated, there are appropriated $500,000,000
for each of fiscal years 2016 through 2019 for making payments under this
paragraph. Amounts appropriated for a fiscal year under this clause shall
remain available for making payments under this paragraph until January 1
of the following fiscal year. Any amounts of such appropriations that
remain unexpended or unobligated as of such date shall be transferred and
made available for making payments under section 2104(n).</text></clause><after-quoted-block>; and</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H1908A8CC25DD426E8E3F4CD07A63903F"><enum>(3)</enum><text display-inline="yes-display-inline">in subparagraph (F)(iii), by striking <quote>2013</quote> and inserting <quote>2019</quote>.</text>
</paragraph></subsection><subsection id="HEB558E2E65F64F7AB46FB96C2EA00E6A"><enum>(b)</enum><header>Updated performance incentive criteria for fiscal years 2015 through 2019</header><text display-inline="yes-display-inline">Section 2105(a) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397ee">42 U.S.C. 1397ee(a)</external-xref>) is amended—</text>
<paragraph id="H23C6C179771F4172BDECCB097D84971C"><enum>(1)</enum><text>in paragraph (3)(A), by inserting <quote>or (5)</quote> after <quote>paragraph (4)</quote>;</text>
</paragraph><paragraph id="H0F8B4C60BB4D4884B3D771C8C5A2F961"><enum>(2)</enum><text>in paragraph (4)—</text>
<subparagraph id="H0E640C0134DE4204B7EC3450032B7A11"><enum>(A)</enum><text>in the heading, by inserting <quote><header-in-text level="paragraph" style="OLC">fiscal years 2009 through 2014</header-in-text></quote> after <quote><header-in-text level="paragraph" style="OLC">for children</header-in-text></quote>; and</text>
</subparagraph><subparagraph id="H399B392708644A6FBFDB179985A0DF3A"><enum>(B)</enum><text>in the matter preceding subparagraph (A), by striking <quote>for a fiscal year if </quote> and inserting <quote>for fiscal years 2009 through 2014 if</quote>; and</text>
</subparagraph></paragraph><paragraph id="H1AAA452CFA6844FE9D4FBAA903B8CE95"><enum>(3)</enum><text>by adding at the end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H23B1E212A0554C8096E7A2C2FF13D185" style="OLC">
<paragraph id="H3609BB42EE524EC78673DF0540EFAF8B"><enum>(5)</enum><header>Enrollment and retention provisions for children for fiscal year 2015 and succeeding fiscal years</header>
<subparagraph id="HA5CAB0BFB84941BEB461AC25FEC2DDCF"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">For purposes of paragraph (3)(A), a State meets the condition of this paragraph for fiscal year
2015 and any succeeding fiscal year if it is implementing at least 5 of
the enrollment and retention provisions specified in subparagraph (B)
(treating each clause as a separate enrollment and retention provision)
throughout the entire fiscal year.</text>
</subparagraph><subparagraph id="H6C0C11A733514433AA5556C48E4B2CF0"><enum>(B)</enum><header>Enrollment and retention provisions</header><text>The enrollment and retention provisions specified in this subparagraph are the following:</text>
<clause id="HDE5DAB8B9F484E12A529F5E1BBE03C02"><enum>(i)</enum><header>Continuous eligibility</header><text>The State has elected the option of continuous eligibility for a full 12 months for all children
(as defined in section 1902(e)(13)(G)), as well as applying such policy
under its State child health plan under this title.</text>
</clause><clause id="HF17BB2665C3C4F2FAB44108BB03303EA"><enum>(ii)</enum><header>Express Lane eligibility</header><text>The State is implementing the option described in section 1902(e)(13) under title XIX as well as,
pursuant to section 2107(e)(1), under this title.</text>
</clause><clause id="HFD09B7B80DF9442F8D6B0B29A5006707"><enum>(iii)</enum><header>Presumptive eligibility</header><text>The State is implementing section 1920A under title XIX as well as, pursuant to section 2107(e)(1),
under this title.</text>
</clause><clause id="HDBBB0764502B4517BB2016750FEDF1C5"><enum>(iv)</enum><header>Premium assistance for employer-sponsored plans</header><text>The State is implementing section 1906A under title XIX or the option described in section
2105(c)(10) under this title.</text>
</clause><clause commented="no" id="H42E382A4481E491A8F253A83501547F9"><enum>(v)</enum><header>Seamless coverage options</header><text display-inline="yes-display-inline">In the case of a State that provides medical assistance under the State plan under title XIX
through managed care entities (as defined in section 1932(a)(1)(B)) or
health benefits coverage under the State child health plan through such
entities, the State shall ensure that at least one such entity offers a
qualified health plan through the Exchange established under title I of
the Patient Protection and Affordable Care Act in the State.</text>
</clause><clause commented="no" id="HF9C124D27E33483293C018F44BBAADE5"><enum>(vi)</enum><header>Retroactive coverage reinstatement upon premium payment</header><text>The State child health plan, in the case of an individual whose coverage under the plan has been
terminated for failure to make premium payments, provides assistance to
such individual for purposes of the immediate reenrollment of the
individual upon payment of outstanding premiums, with coverage retroactive
to the beginning of the most recent month for which an outstanding premium
has been paid, and shall not impose any waiting period or fee as a
condition of such reenrollment.</text>
</clause><clause commented="no" id="HB19CA512DD9D4E6A8F32CA599E52EED6"><enum>(vii)</enum><header>Effective transition to the community for vulnerable youth</header>
<subclause commented="no" id="H9B4E42809CD7471396BDB6C6C30F84A7"><enum>(I)</enum><header>In general</header><text display-inline="yes-display-inline">Subject to the subdivision (A) following paragraph (29) of section 1905(a), the State, before the
date of the release of an eligible juvenile from any public institution,
and notwithstanding that the juvenile is an inmate of a public
institution—</text>
<item id="HA16D08ADE62A49DEBF1110D10378292B"><enum>(aa)</enum><text>screens for eligibility for and processes any application for medical assistance submitted by, or
on behalf of, such an eligible juvenile; and</text>
</item><item id="H10C48DBDFFEC4DCF98E63A3574758AE1"><enum>(bb)</enum><text display-inline="yes-display-inline">refers such juvenile to health care providers for purposes of receiving the services described in
section 1905(a)(4)(B) (relating to early and periodic screening,
diagnostic, and treatment services defined in section 1905(r)).</text>
</item></subclause><subclause commented="no" id="H08AE19962331411CBE0A8CD588F0F49D"><enum>(II)</enum><header>Eligible juvenile</header><text>For purposes of subclause (I), the term <quote>eligible juvenile</quote> means an individual who—</text>
<item commented="no" id="H8891E550F9C8494983A341079BC6B804"><enum>(aa)</enum><text display-inline="yes-display-inline">is under 19 years of age (or such higher age as the State has elected under section
475(8)(B)(iii)); and</text>
</item><item commented="no" id="HE4AAD3A50C2740B78B7257BCFC095448"><enum>(bb)</enum><text display-inline="yes-display-inline">is an inmate of a public institution.</text>
</item></subclause><subclause commented="no" id="HBF6A776E8C494E39B4DC52604C163FBA"><enum>(III)</enum><header>Inmate of a public institution</header><text display-inline="yes-display-inline">For purposes of this clause, the term <term>inmate of a public institution</term> has the meaning given such term for purposes of applying the subdivision (A) following paragraph
(29) of section 1905(a), taking into account the exception in such
subdivision for a patient of a medical institution.</text>
</subclause></clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section><section id="HD31E4AE578CF4BFFA2A4B9B005E1BCC8"><enum>103.</enum><header>Child enrollment contingency fund adjustment</header>
<subsection id="H48AEF7B241D44B4293EC18A604A56B9D"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 2104(n) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397dd">42 U.S.C. 1397dd(n)</external-xref>) is amended—</text>
<paragraph id="H12C732BA4AE64B5B8589F868AD1F6864"><enum>(1)</enum><text>in paragraph (2)—</text>
<subparagraph id="H3F59B7B00D3A4106B52EE6D844C0398C"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>2014</quote> and inserting <quote>2018</quote> each place it appears in subparagraphs (A)(ii) and (B); and</text>
</subparagraph><subparagraph id="H301937D90E804606A66D87D4DF943F78"><enum>(B)</enum><text display-inline="yes-display-inline">by striking <quote>2015</quote> and inserting <quote>2019</quote> each place it appears in subparagraphs (A)(ii) and (B);</text>
</subparagraph></paragraph><paragraph id="H1C05AA9E893746BEA42539A2C520CC89"><enum>(2)</enum><text>in paragraph (3)—</text>
<subparagraph id="H6AACD33AA0544E96BBA8E399C59D8938"><enum>(A)</enum><text>in subparagraph (A)—</text>
<clause id="H5A678D6F2AD9415C86E3B51A6BE43143"><enum>(i)</enum><text>in the heading, by striking <quote><header-in-text level="subparagraph" style="OLC">In general</header-in-text></quote> and inserting <quote><header-in-text level="subparagraph" style="OLC">Fiscal years 2009 through 2015</header-in-text></quote>;</text>
</clause><clause id="HA0A3D58013B04770A2D9BB291419F5C6"><enum>(ii)</enum><text>in the matter preceding clause (i)—</text>
<subclause id="H735EA48C90B34ADC96D2263609C8FAD4"><enum>(I)</enum><text>by striking <quote>a semi-annual allotment period for</quote>; and</text>
</subclause><subclause id="H7525A11092954BE69586ED097C73B5A5"><enum>(II)</enum><text>by striking <quote>(determined without regard to any redistribution it receives under subsection (f) that is available
for expenditure during such fiscal year or period, but including any
carryover from a previous fiscal year)</quote>;</text>
</subclause></clause><clause id="HA95AC32E73194B619C6EE4803D19524E"><enum>(iii)</enum><text>by striking <quote>or period</quote> each place it appears; and</text>
</clause><clause id="H0488ACA985DE4FE5BE42D6FAB126B545"><enum>(iv)</enum><text>in clause (ii), by striking <quote>(or in which the period occurs)</quote>;</text>
</clause></subparagraph><subparagraph id="H576A6DAC19B54EE382CC76D4E0F03BF8"><enum>(B)</enum><text display-inline="yes-display-inline">in subparagraph (B)(ii), by striking <quote>(or semi-annual period occurring in a fiscal year)</quote>;</text>
</subparagraph><subparagraph id="H602B594900A04895B5A8E6892FF2069C"><enum>(C)</enum><text>in subparagraph (C)(ii), by striking <quote>(or semi-annual period occurring in a fiscal year)</quote>;</text>
</subparagraph><subparagraph id="H765C9AC187EB43E59FCC4F245711CB8B"><enum>(D)</enum><text>by redesignating subparagraphs (D), (E), (F), and (G) as subparagraphs (E), (F), (G), and (H),
respectively;</text>
</subparagraph><subparagraph id="H076CFBFD8E8949D4905D1264DA5935DD"><enum>(E)</enum><text>by inserting after subparagraph (C) the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H419EFCF6A0D0489CBAD21BC2FD59DD8D" style="OLC">
<subparagraph id="HF75A31F71D6A4B15B0BC4D23B55E69EF"><enum>(D)</enum><header>Fiscal years 2016 through 2019</header>
<clause id="HCB7D9B09154B4C4B8D7454B51ED0C351"><enum>(i)</enum><header>In general</header><text>For each of fiscal years 2016 through 2018 and each semi-annual allotment period for fiscal year
2019, if the Secretary determines that a State is a shortfall State
described in subparagraph (I) for that fiscal year or period, the
Secretary shall pay the State from the Fund, in addition to any other
payments made to a State under this title for the fiscal year or period an
amount equal to the amount of projected expenditures for the State under
this title for the fiscal year or period that exceeds the sum determined
under subparagraph (I) for the State and fiscal year or period.</text>
</clause><clause commented="no" display-inline="no-display-inline" id="H0A814A587AB24F5C9B5C7F60303D8028"><enum>(ii)</enum><header>Transfers</header><text>Notwithstanding any other provision of this title, the following amounts shall also be available,
without fiscal year limitation, for making payments from the Fund:</text>
<subclause commented="no" display-inline="no-display-inline" id="HD5B262D349EC4D6895774829706F9BED"><enum>(I)</enum><header>Unobligated national allotment for fiscal years beginning with fiscal year 2016</header><text display-inline="yes-display-inline">As of December 31 of fiscal year 2016, and as of December 31 of each succeeding fiscal year, the
portion, if any, of the amount appropriated under subsection (a) for such
fiscal year that is unobligated for allotment to a State under subsection
(m) for such fiscal year.</text>
</subclause><subclause id="H99E476E20A63410A917D81589D07C9A0"><enum>(II)</enum><header>Unexpended allotments not used for redistribution</header><text>As of November 15 of fiscal year 2016 and each succeeding fiscal year, the total amount of
allotments made to States under subsection (a) for the second preceding
fiscal year that is not expended or redistributed under subsection (f)
during the period in which such allotments are available for obligation.</text>
</subclause><subclause commented="no" display-inline="no-display-inline" id="H0C4A780C42ED4820AD0FD975297E7AC0"><enum>(III)</enum><header>Unexpended performance incentive funds</header><text>As of September 1, 2017, and as of September 1 of each succeeding calendar year, the portion, if
any, of the amount appropriated under subparagraph (E)(iii) of section
2105(a)(3) for the preceding fiscal year that is not expended or obligated
under such section.</text>
</subclause></clause><clause commented="no" display-inline="no-display-inline" id="H41AE269ABF574600948203F8189EBA80"><enum>(iii)</enum><header display-inline="yes-display-inline">Investment of fund</header><text display-inline="yes-display-inline">The Secretary of the Treasury shall invest, in interest bearing securities of the United States,
such currently available portions of the Fund as are not immediately
required for payments from the Fund. The income derived from these
investments constitutes a part of the Fund.</text>
</clause></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="H4E6C966FF32946E589BCA9D2F22E2A3E"><enum>(F)</enum><text>in subparagraph (E) (as so redesignated), by inserting <quote>or (D)</quote> after <quote>subparagraph (A)</quote>; and</text>
</subparagraph><subparagraph id="H8513311E6D9A4C19BAFF7D82F1E9F7F4"><enum>(G)</enum><text display-inline="yes-display-inline">in subparagraph (H) (as so redesignated), by inserting <quote>and regarding the expenditures under the State child health plan</quote> after <quote>subparagraphs (A) and (B)</quote>; and</text>
</subparagraph></paragraph><paragraph id="H4F5B4C0387514F7EA58DF2465D44DD1B"><enum>(3)</enum><text>by adding at the end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H94BB89DCEF05461D9063BE36C0905F9E" style="OLC">
<subparagraph id="H7CBEE1FE77DB4A16A97B0A4419856228"><enum>(I)</enum><header>Shortfall States described</header><text display-inline="yes-display-inline">For purposes of subparagraph (D), with respect to a fiscal year or semi-annual allotment period, a
shortfall State is a State for which the Secretary estimates, on the basis
of the most recent data available to the Secretary, that the projected
expenditures for the State for the fiscal year or period under this title
(including in the form of coverage described in paragraph (1) or (2) of
section 2101, or both) will exceed the sum of—</text>
<clause id="H419B7DE9822B4B22BE27C9A149190B1D"><enum>(i)</enum><text>the amount of the State’s allotments for any preceding fiscal year or period that remains available
for expenditure and that will not be expended by the end of the
immediately preceding fiscal year;</text>
</clause><clause id="H28A2DF31D8444B93B51A867FD4C57190"><enum>(ii)</enum><text>the amount (if any) that will be redistributed to the State under subsection (f) for the fiscal
year or period;</text>
</clause><clause id="H4980FBB8009F43B2AE008D321D048CEE"><enum>(iii)</enum><text display-inline="yes-display-inline">the portion, if any, of the amount appropriated under subparagraph (E)(iii) of section 2105(a)(3)
for the preceding fiscal year or period that is not expended or obligated
under such section; and</text>
</clause><clause id="H6111A44C01A045E090397402272D5B10"><enum>(iv)</enum><text>the amount of the State’s allotment for the fiscal year or period.</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="HC341E6477B4E4E0EB0A2D5E9C4AB2C67"><enum>(b)</enum><header>Conforming amendments</header><text>Section 2104(f)(2)(A) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/13957dd">42 U.S.C. 13957dd(f)(2)(A)</external-xref>) is amended—</text>
<paragraph id="H756C34C78AFA4614A80F795CCDB55734"><enum>(1)</enum><text>in clause (i), by inserting <quote>and</quote> at the end;</text>
</paragraph><paragraph id="H238610A46A4C4FC18FFF34054B91B442"><enum>(2)</enum><text>by striking clause (ii); and</text>
</paragraph><paragraph id="H545DFE780E634BB0AF2982B6B64F8FF7"><enum>(3)</enum><text>by redesignating clause (iii) as clause (ii).</text>
</paragraph></subsection></section><enum>II</enum><header>Coverage Stability and Reduced Bureaucracy</header>
<section id="H4978D558FC00474892E3F0B00A4CD84F"><enum>201.</enum><header>Improving coverage stability</header>
<subsection id="H1B2DDA3C1EBD4F6D866A54FE49B3D3B0"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 2102(b)(1)(B) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397bb">42 U.S.C. 1397bb(b)(1)(B)</external-xref>) is amended—</text>
<paragraph id="H4435128A08BC4E53841E7E564258A018"><enum>(1)</enum><text>in clause (iii), by striking <quote>in the case of a targeted low-income pregnant woman provided pregnancy-related assistance under
section 2112</quote>; and</text>
</paragraph><paragraph id="H2C4B10ADCA1D40F0965817F08BEBDFBB"><enum>(2)</enum><text>in clause (iv), by striking <quote>at State option,</quote>.</text>
</paragraph></subsection><subsection id="HE7EC98A4F6004C2EB9ECB951A0AC7793"><enum>(b)</enum><header>Conforming amendments</header>
<paragraph id="H147D912A81A44F948EE9882F6B693321"><enum>(1)</enum><text>Section 2105(c)(10) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397">42 U.S.C. 1397(ee)(10)</external-xref>) is amended—</text>
<subparagraph id="H918B1CC4D735412880A5A42FA58FF1F0"><enum>(A)</enum><text>by striking subparagraph (F); and</text>
</subparagraph><subparagraph id="HF0249189B2AB4B2AAD9680F2405E865B"><enum>(B)</enum><text>by redesignating subparagraphs (G) through (M) as subparagraphs (F) through (L), respectively.</text>
</subparagraph></paragraph><paragraph id="HBB62B130EE2B466093F536C9837F5B55"><enum>(2)</enum><text display-inline="yes-display-inline">Section 2112(b)(5) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397ll">42 U.S.C. 1397ll(b)(5)</external-xref>) is amended—</text>
<subparagraph id="H14D2187711684F1CA45C62D4F85D2B36"><enum>(A)</enum><text>in the heading, by striking <quote><header-in-text level="paragraph" style="OLC">or waiting period</header-in-text></quote>; and</text>
</subparagraph><subparagraph id="HD5FE776DA2FF4045B4FD7D11AA585EFD"><enum>(B)</enum><text>by striking <quote>or any waiting period</quote> and all that follows through <quote>receipt of such assistance</quote>.</text>
</subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H546737CBA35C448D83612C91ECFD45C4"><enum>(c)</enum><header>Effective date</header><text>The amendments made by this section shall take effect on the date of enactment of this Act.</text>
</subsection></section><section commented="no" id="HD0CBB600F04244C3981474533163CCC3"><enum>202.</enum><header>Assuring care continuity during transitions among CHIP, Medicaid, and qualified health plans</header>
<subsection commented="no" id="H3E94BD2A7F1A4714A0157629B6F00A99"><enum>(a)</enum><header>Minimum essential coverage</header>
<paragraph commented="no" id="H4BDE528D03644F4D9AB1EE1B237B9877"><enum>(1)</enum><header>In general</header><text><external-xref legal-doc="usc" parsable-cite="usc/26/5000A">Section 5000A(f)</external-xref> of the Internal Revenue Code of 1986 is amended by adding at the end the
following:</text>
<quoted-block display-inline="no-display-inline" id="HED394091BFEE4E6F8B4B84B47060254D" style="OLC">
<paragraph commented="no" id="H1319CB7E17EF4C7CA9BC33AF0845E853"><enum>(6)</enum><header>Pregnancy-related assistance under CHIP</header><text>With respect to a targeted low-income pregnant woman (as defined in section 2112(d)(2) of the
Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397ll">42 U.S.C. 1397ll(d)(2)</external-xref>)), notwithstanding paragraph
(1)(A)(iii), the term <term>minimum essential coverage</term>, at the option of such a woman, shall not include pregnancy-related assistance (as defined in
section 2112(d)(1) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397ll">42 U.S.C. 1397ll(d)(1)</external-xref>)).</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph commented="no" id="H075E372B5E13487A9DBB2AFF4E66FB93"><enum>(2)</enum><header>Effective date</header><text>The amendment made by this subsection applies to taxable years beginning after December 31, 2014.</text>
</paragraph></subsection><subsection id="H51BBF400EDDB4F1B96A5F1599E093609"><enum>(b)</enum><header>Continuity of care</header><text>The Secretary of Health and Human Services shall issue regulations for purposes of ensuring
continuity of care for children who—</text>
<paragraph id="HEB9A4D8CEE36444E827959759AD0688C"><enum>(1)</enum><text>are undergoing an active course of treatment; and</text>
</paragraph><paragraph id="HC68A4D7737FC401BB32392F4EFE4A910"><enum>(2)</enum><text>involuntarily change coverage under health insurance, the State plan under the Medicaid program
under title XIX of the Social Security Act, or the State child health plan
under title XXI of such Act during such course of treatment for any
reason, including a reason related to a change in income, health plan
termination, or a material change or changes to the plan’s health benefits
coverage.</text>
</paragraph></subsection><subsection commented="no" id="H46FE561BB6834E548F468965EF67DEEA"><enum>(c)</enum><header>Ensuring comparability of coverage</header>
<paragraph commented="no" id="HF4F45EA30F604727B916289FFB8C348D"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than 18 months after the date of the enactment of the <short-title>CHIP Extension and Improvement Act of 2014</short-title>, the Secretary of Health and Human Services shall review, with respect to a State, the benefits
(by each benefit class) offered for children and the cost-sharing imposed
with respect to such benefits by qualified health plans offered through an
Exchange established under title I of the Patient Protection and
Affordable Care Act in the State. The Secretary shall make the findings of
such review available on the public Internet site of the Department of
Health and Human Services.</text>
</paragraph><paragraph commented="no" id="H1D222281D8FF42BAA1974C13B724FE2B"><enum>(2)</enum><header>Regulations required</header><text display-inline="yes-display-inline">If, following such review, the Secretary determines that benefits and cost-sharing protections
referred to in paragraph (1) are not comparable to the benefits (by each
benefit class) offered and cost-sharing protections provided under the
State child health plan under title XXI of the Social Security Act (42
U.S.C. 1397aa et seq.) in the State, the Secretary, not later than January
1, 2017, shall issue a rule, to apply with respect to plan years beginning
in 2019, establishing requirements designed to ensure that such qualified
health plans offer benefits and cost-sharing protections that are
comparable to the benefits and cost-sharing protections provided under
such State child health plan for plan year 2019.</text>
</paragraph></subsection></section><section id="H75E843DCF6204D4B9357D229DE9E49E0"><enum>203.</enum><header>State flexibility to provide for continuous eligibility</header><text display-inline="no-display-inline">Section 1902(e)(12) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a(e)(12)</external-xref>) is amended to read as
follows:</text>
<quoted-block display-inline="no-display-inline" id="HDA02E1748B2F437C9A5FC436F0B4354B" style="OLC">
<paragraph id="H6F05C9944D2448C1BC7CAD200C84421C"><enum>(12)</enum><header>Continuous eligibility option</header>
<subparagraph id="H6BAF4FBD05A84764A16F6504FAF7E497"><enum>(A)</enum><header>Children</header><text display-inline="yes-display-inline">At the option of the State, the plan may provide that a child (as defined in paragraph (13)(G)) who
is determined to be eligible for benefits under a State plan approved
under this title under subsection (a)(10)(A) shall remain eligible for
those benefits until the earlier of—</text>
<clause id="H0BCB8EF9511B4339BC743A7AED62C2CD"><enum>(i)</enum><text>the end of a period (not to exceed 12 months) following the determination; or</text>
</clause><clause id="H5E53892A4E6147D39482A7A10AE706B4"><enum>(ii)</enum><text>the time that the child exceeds the age specified in such paragraph (13)(G).</text>
</clause></subparagraph><subparagraph id="HB60179A6573740C4BF5B9362FDC3F041"><enum>(B)</enum><header>Certain nonelderly adults</header>
<clause id="H770DC59DEA714853AB577FB535D9417C"><enum>(i)</enum><header>In general</header><text display-inline="yes-display-inline">At the option of the State, the plan may provide that in the case of an eligible adult who is
determined to be eligible for benefits under a State plan approved under
this title (or a waiver of such plan), the eligible adult shall remain
eligible for those benefits until the end of a period (not to exceed 12
months) following the determination.</text>
</clause><clause id="H2D60EC8ED2F841C9A10C6BC1708D23C7"><enum>(ii)</enum><header>Eligible adult defined</header><text>In this subparagraph, the term <quote>eligible adult</quote> means—</text>
<subclause id="HB996AF0E470D486FB521C2FB6EA9EF41"><enum>(I)</enum><text>an individual (other than a child) whose income eligibility under the State plan or under a waiver
of the plan for medical assistance is determined under paragraph (14); and</text>
</subclause><subclause id="H96A1E5508BE6427097E740BF6D4D18D1"><enum>(II)</enum><text>an individual included in any other group of individuals the Secretary determines appropriate.</text></subclause></clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HE7EC74C64F7B455F88D7A93C045D0D18"><enum>204.</enum><header>State flexibility to use administrative simplification policies for enrollment</header>
<subsection id="H50E78A64E6E74B06B782FC36901FB168"><enum>(a)</enum><header>Permanent extension of Medicaid and CHIP express lane option</header><text display-inline="yes-display-inline">Section 1902(e)(13) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a(e)(13)</external-xref>) is amended by striking
subparagraph (I).</text>
</subsection><subsection id="H7A10B24788A54C568F5F9286C08B06E0"><enum>(b)</enum><header>Extending Express Lane eligibility to adults</header><text display-inline="yes-display-inline">Section 1902(e)(13)(A) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a(e)(13)(A)</external-xref>) is amended by adding
at the end the following new clause:</text>
<quoted-block display-inline="no-display-inline" id="H27B8007446AC498199B71EE927979F5B" style="OLC">
<clause id="H92BAF64CA2F244D092A440CA63E70892" indent="up1"><enum>(iii)</enum><header>State option to extend express lane eligibility to adults</header>
<subclause id="HB13144B5CA9B4FB895896AA57BAE331B"><enum>(I)</enum><header>In general</header><text display-inline="yes-display-inline">At the option of the State, the State may apply the provisions of this paragraph with respect to
determining eligibility under this title for an eligible individual (as
defined in subclause (II)). In applying this paragraph in the case of a
State making such an option, any reference in this paragraph to a child
with respect to this title (other than a reference to child health
assistance) shall be deemed to be a reference to an eligible individual.</text>
</subclause><subclause id="HA9E84DB6A08041189ECC9E4C9FAE1AC0"><enum>(II)</enum><header>Eligible individual defined</header><text display-inline="yes-display-inline">In this clause, the term <quote>eligible individual</quote> means—</text>
<item id="H64D11B4BB50F4CC38B3C1AFF3CC740DE"><enum>(aa)</enum><text>any individual (other than a child) whose income eligibility under the State plan or under a waiver
of the plan for medical assistance is determined under paragraph (14); and</text>
</item><item id="H131BE5A231864B68B4511C0F77856B4A"><enum>(bb)</enum><text display-inline="yes-display-inline">an individual included in any other group of individuals the Secretary determines appropriate.</text></item></subclause></clause><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section><section id="H7B853CAF6D704227A036288455461956"><enum>205.</enum><header>Outreach to targeted populations</header>
<subsection id="H63B36C3E59C944139B9469854212F795"><enum>(a)</enum><header>Outreach and enrollment grants</header><text display-inline="yes-display-inline">Section 2113 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397mm">42 U.S.C. 1397mm</external-xref>) is amended—</text>
<paragraph id="H419A27A4A66A47A8AC76900363F7AE62"><enum>(1)</enum><text>in subsection (a)—</text>
<subparagraph id="H6A97868CD8E044438CDA331ED9AE8F2F"><enum>(A)</enum><text>in paragraph (1), by striking <quote>during the period of fiscal years 2009 through 2015 </quote>; and</text>
</subparagraph><subparagraph id="HBA781D8E6DF24AB8B408AA47570A4FF7"><enum>(B)</enum><text>in paragraph (2)—</text>
<clause id="HFE3328F9D6244FC8A6FE86A618775885"><enum>(i)</enum><text>in the heading, by striking <quote><header-in-text level="paragraph" style="OLC">Ten percent set aside</header-in-text></quote> and inserting <quote><header-in-text level="paragraph" style="OLC">Set aside</header-in-text></quote>; and</text>
</clause><clause id="H017FE1FA34844244BD3D21EC5D8F82A1"><enum>(ii)</enum><text>by striking <quote>10 percent</quote> and inserting <quote>15 percent</quote>; and</text>
</clause></subparagraph></paragraph><paragraph id="H679447678AF0494C86A2E67A2AEAE74A"><enum>(2)</enum><text>in subsection (g), by inserting <quote>and $40,000,000 for each fiscal year thereafter, to remain available until expended</quote> after <quote>2015,</quote>.</text>
</paragraph></subsection><subsection id="H87DE37D900EF4093BA9F523EFDD96531"><enum>(b)</enum><header>Requirement that managed care organizations provide language services to enrollees</header><text display-inline="yes-display-inline">Section 1932(b) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396u-2">42 U.S.C. 1396u–2(b)</external-xref>) is amended by adding at the end
the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="HD044F854E3324A269F79BCF8EC1650F0" style="OLC">
<paragraph id="HB3507DEED7134446ABFD92D772DF9829"><enum>(9)</enum><header>Language services</header><text display-inline="yes-display-inline">Each contract with a managed care entity under section 1903(m) or under section 1905(t)(3) shall
require the entity to provide and pay for language services, including
oral interpretation and written translation services, for an individual
and the parent or guardian of such individual who is eligible for medical
assistance under the State plan under this title and is enrolled with the
entity and is limited English proficient when interacting with the entity
or with any provider receiving payment from the entity. Such language
services shall be provided in conjunction with all covered items and
services that are available to such individuals under the contract.</text></paragraph><after-quoted-block>. </after-quoted-block></quoted-block>
</subsection><subsection id="H34EBCA6E12474059BE6DE5BA485D93A6"><enum>(c)</enum><header>Medicaid health care disparities</header><text display-inline="yes-display-inline">Section 1946 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396w-5">42 U.S.C. 1396w–5</external-xref>) is amended by adding at the end the
following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="H40A61736736946E3AAF9F9702377B2A3" style="OLC">
<subsection id="HB6C343B17C784B2FA087C877A11A1BEF"><enum>(d)</enum><header>Appropriation</header><text display-inline="yes-display-inline">Out of any funds in the Treasury not otherwise appropriated, there are appropriated to carry out
this section $20,000,000, to remain available until expended.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H5A2F38E1D0BC466AA19513444A8B4558"><enum>(d)</enum><header>Effective date</header><text>The amendments made by this section take effect on the date of enactment of this Act.</text>
</subsection></section><enum>III</enum><header>Benefits and Affordability</header>
<section commented="no" id="HA25305A0231F48C7B14B3AE4A58EC02F"><enum>301.</enum><header>Strengthened cost-sharing protections under CHIP</header>
<text display-inline="no-display-inline">Section 2103(e) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397cc">42 U.S.C. 1397cc(e)</external-xref>) is amended—</text>
<paragraph commented="no" id="HD5C4C88BBBD34623868B166BF262E323"><enum>(1)</enum><text>in paragraph (3)(B)—</text>
<subparagraph id="H26C14A35E0A149CA9E48F01A16016883"><enum>(A)</enum><text>by inserting <quote>, including with respect to benefits for dental services, </quote> after <quote>State child health plan</quote>;</text>
</subparagraph><subparagraph id="HB0F445FCED304AACA91FC41AD2B03B14"><enum>(B)</enum><text>by striking <quote>annual aggregate cost-sharing</quote> and inserting <quote>aggregate cost-sharing</quote>; and</text>
</subparagraph><subparagraph id="H183349BC71AA43D383538033B9365E97"><enum>(C)</enum><text>by striking <quote>for the year involved</quote> and inserting <quote>, as applied on a quarterly or monthly basis (as specified by the State)</quote>; and</text>
</subparagraph></paragraph><paragraph commented="no" id="HFF6924DA84CE49FC82D17FFF82556583"><enum>(2)</enum><text>by adding at the end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H11BBFE5DE88A4259BD42D3A1EFE781B2" style="OLC">
<paragraph commented="no" display-inline="no-display-inline" id="H6735E1B308814AB0AAD00691D7999078"><enum>(5)</enum><header>Additional requirements</header>
<subparagraph commented="no" id="HBF76410AEB124DACA963DB2EFCA5C0B5"><enum>(A)</enum><header>Tracking of expenses; notice</header><text display-inline="yes-display-inline">Except as provided in subparagraph (B), in the case of a State child health plan that imposes
premiums, deductibles, cost sharing, or similar charges that could (as
determined by the Secretary) cause families that include a targeted
low-income child or a targeted low-income pregnant woman to have
out-of-pocket expenses that exceed the limit imposed under paragraph
(3)(B) for a month or quarter (as applicable under the State plan), the
State child health plan shall—</text>
<clause commented="no" id="H7E296FFD931841F1B2D2FC8683B3606D"><enum>(i)</enum><text>establish an electronic process for tracking such expenses that does not rely on documentation
provided by the targeted low-income child, the targeted low-income
pregnant woman, or the family; and</text>
</clause><clause commented="no" id="H10CAD057FD514901A6FA5725C94986A3"><enum>(ii)</enum><text>notify each such family—</text>
<subclause commented="no" id="H2790D55866364206863C06DA8E3C9DEC"><enum>(I)</enum><text>of the aggregate monthly or quarterly limits on out-of-pocket expenses applicable to the family
imposed under paragraph (3)(B); and</text>
</subclause><subclause commented="no" id="H95B3CF83B4054905BD2B46C2B3A881EF"><enum>(II)</enum><text display-inline="yes-display-inline">that no premiums, deductibles, cost sharing, or similar charges shall be imposed on any targeted
low-income child or targeted low-income pregnant woman in the family for
the remainder of any month or quarter with respect to which the family has
reached the aggregate monthly or quarterly family limit imposed under such
paragraph applicable to the family.</text>
</subclause></clause></subparagraph><subparagraph commented="no" id="H6804EFB7393E482A8D4A4DAAE369DD22"><enum>(B)</enum><header>Managed care entities or organizations</header><text display-inline="yes-display-inline">In the case of a State child health plan that provides child health assistance through managed care
entities or organizations, the entities or organizations shall, with
respect to families described in subparagraph (A)—</text>
<clause commented="no" id="H20919DC2EA00417CBC4B873FC9838E3C"><enum>(i)</enum><text display-inline="yes-display-inline">establish an electronic process described in subparagraph (A)(i); and</text>
</clause><clause commented="no" id="HE779D0ADCC1046A5BCCBCEAF8CFCFFA1"><enum>(ii)</enum><text display-inline="yes-display-inline">coordinate with the State agency responsible for implementing the State child health plan under
this title to ensure that any premiums, deductibles, cost sharing, or
similar charges imposed on such a family are included in the aggregate
limit applicable to the family under paragraph (3)(B).</text>
</clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section id="HB0DC15774A5D4B6E9266886ACBC72863"><enum>302.</enum><header>Ensuring coverage of preventive health services under Medicaid and CHIP</header>
<subsection id="HDF4BC663B3E948829DECD6BAA6A33551"><enum>(a)</enum><header>Medicaid</header>
<paragraph id="HC355021C832B4F38B3F19B9F7E78756B"><enum>(1)</enum><header>Clarifying preventive coverage</header><text>Section 1905(a)(13) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d(a)(13)</external-xref>) is amended—</text>
<subparagraph id="HE85C28F4C60848C482A5C6EAE5448DC1"><enum>(A)</enum><text>by striking subparagraphs (A) and (B);</text>
</subparagraph><subparagraph id="H839C21F5E78445EFB8228D00FCF7DAE0"><enum>(B)</enum><text>by redesignating subparagraph (C) as subparagraph (B); and</text>
</subparagraph><subparagraph id="HE6066ECB9B5C40EEB85968A45EB0297E"><enum>(C)</enum><text>by inserting before subparagraph (B) (as so redesignated) the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H4266DE76954F4CA7B3874024F40BE492" style="OLC">
<subparagraph id="HC07A1BFA67E247298DE2D41446F2B2B8"><enum>(A)</enum><text display-inline="yes-display-inline">the items and services described in paragraphs (1) through (5) of section 2713(a) of the Public
Health Service Act; and</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="HC46C09908021443EA456B27D723035FA"><enum>(2)</enum><header>Conforming amendment</header><text>Section 1902(a)(10)(A) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a(a)(10)(A)</external-xref>) is amended in the
matter preceding clause (i), by inserting <quote>, (13)(A)</quote> before <quote>, (17)</quote>.</text>
</paragraph></subsection><subsection id="HA38BCDBB05AC49988849402E578AEA4C"><enum>(b)</enum><header>CHIP</header><text>Section 2103(c)(1)(D) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397cc">42 U.S.C. 1397cc(c)(1)(D)</external-xref>) is amended by striking <quote>Well-baby</quote> and inserting <quote>Items and services described in paragraphs (1) through (5) of section 2713(a) of the Public Health
Service Act, including well-baby</quote>.</text>
</subsection><subsection id="H9C40DE255D1B4ED1896C0640AFE86488"><enum>(c)</enum><header>Cost-Sharing prohibitions</header>
<paragraph id="H96E238620A7041F9BDB32128A8655A51"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1916 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396(o)</external-xref>) is amended—</text>
<subparagraph id="H879344AA8A3543028E07197369A3209E"><enum>(A)</enum><text>in subsection (a)(2)—</text>
<clause id="H2166DB389B0443A4828DEFEF621722E1"><enum>(i)</enum><text>in subparagraph (D), by striking <quote>or</quote> at the end;</text>
</clause><clause id="H9515921CA0544FD69DE14118CE4F2BF3"><enum>(ii)</enum><text display-inline="yes-display-inline">in subparagraph (E), by striking <quote>hospice care (as defined in section 1905(o)); and</quote> at the end and inserting <quote>hospice care (as defined in section 1905(o)), or</quote>; and</text>
</clause><clause id="H8A0B1CDC97704B9496DFFD71A26E3FAE"><enum>(iii)</enum><text>by adding at the end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H7F64EFFC736344318BA60E0107D01963" style="OLC">
<subparagraph id="H370F7211F6FB46618887C2F9B82C2A5C"><enum>(F)</enum><text display-inline="yes-display-inline">items and services described in section 1905(a)(13)(A); and</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block>
</clause></subparagraph><subparagraph id="H794D2903C9444098AE0CDFEBCE898274"><enum>(B)</enum><text>in subsection (b)(2)—</text>
<clause id="H35EDFD84FEBB4077A29C6CE8A6429631"><enum>(i)</enum><text>in subparagraph (D), by striking <quote>or</quote> at the end;</text>
</clause><clause id="HE0EF9B9D18D04A8A9412161B332C38DF"><enum>(ii)</enum><text display-inline="yes-display-inline">in subparagraph (E), by striking <quote>hospice care (as defined in section 1905(o)); and</quote> at the end and inserting <quote>hospice care (as defined in section 1905(o)), or</quote>; and</text>
</clause><clause id="H6028AFD02F2642BA82D230A317C991E0"><enum>(iii)</enum><text>by adding at the end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H18721CB8ACEB4E389DC6D67058E86D12" style="OLC">
<subparagraph id="H4266354847664CDA8E9A5F692F4149C0"><enum>(F)</enum><text display-inline="yes-display-inline">items and services described in section 1905(a)(13)(A); and</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</clause></subparagraph></paragraph><paragraph id="HBA6F11AFF14C49AD978D8EE929A8E5C3"><enum>(2)</enum><header>State option</header><text>Section 1916A(b)(3)(B) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396o-1">42 U.S.C. 1396o–1(b)(3)(B)</external-xref>) is amended by adding
at the end the following new clause:</text>
<quoted-block display-inline="no-display-inline" id="H8FE92ACE3FDC42B7900380A26171C931" style="OLC">
<clause id="H4DFBC81D39DB48F7A5F0D840DAFA5DE2"><enum>(xi)</enum><text display-inline="yes-display-inline">Items and services described in section 1905(a)(13)(A).</text></clause><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section><section id="HD85BB85179EB43458EC9A58A891EFDAE"><enum>303.</enum><header>Timely immunization coverage</header>
<subsection id="HA1F356C1E2DC4944ACCC0944556618F9"><enum>(a)</enum><header>Coverage for newly approved vaccines within 30 days</header>
<paragraph id="H7D163CF27FF8428AB3603EC75148DE08"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1928(e) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396s">42 U.S.C. 1396s(e)</external-xref>) is amended by adding at the end the
following new sentence: <quote>Each revision of the list established by such Advisory Committee shall apply to the purchase,
delivery, and administration of pediatric vaccines under this section not
later than 30 days after the date such Advisory Committee approves the
revision.</quote>.</text>
</paragraph><paragraph id="HF323897ED8B64297B5F3EC90CBBB5948"><enum>(2)</enum><header>Conforming amendment</header><text display-inline="yes-display-inline">Section 2103(c)(1)(D) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397cc">42 U.S.C. 1397cc(c)(1)(D)</external-xref>) is amended by
inserting <quote>, administered in accordance with the schedule referred to in section 1928(c)(2)(B)(i) for
pediatric vaccines</quote> after <quote>immunizations</quote>.</text>
</paragraph></subsection><subsection id="H473D4F2D9B8744A79F778A2FD2085902"><enum>(b)</enum><header>Treatment of CHIP-Eligible children as federally vaccine-Eligible children</header><text display-inline="yes-display-inline">Section 1928(b)(2) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396s">42 U.S.C. 1396s(b)(2)</external-xref>) is amended—</text>
<paragraph id="HEB7AD4D705BB4DB0971B8C6F3449B130"><enum>(1)</enum><text>in subparagraph (A)(i), by inserting <quote>or CHIP-eligible</quote> after <quote>medicaid-eligible</quote>; and</text>
</paragraph><paragraph id="H0D528F5EF4024F32AF149A7F2494C3EE"><enum>(2)</enum><text>in subparagraph (B), by striking clause (i) and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="HDF0DA283CBFF42A9AB9A78F54973EAF9" style="OLC">
<clause commented="no" display-inline="no-display-inline" id="H40242562F21445CA95E7723B37720081"><enum>(i)</enum><text display-inline="yes-display-inline">The term <term>medicaid-eligible or CHIP-eligible child</term> means, with respect to a child, a child who is entitled to medical assistance under a State plan
approved under this title or a waiver of such plan, or who is eligible for
child health assistance under a State child health plan approved under
title XXI.</text></clause><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="HF0ED08A8AC3844D8BD12DB6525F11A77"><enum>(c)</enum><header>Effective date</header><text>The amendments made by this section take effect on the date of enactment of this Act.</text>
</subsection></section><section id="HC6030E8232F945828EFE9BF1376D62ED"><enum>304.</enum><header>Payment parity for Medicaid primary care services</header>
<subsection id="H11A82CEE531E418FAFE1A1BE3CBCD371"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1902(a)(13)(C) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a(a)(13)(C)</external-xref>) is amended—</text>
<paragraph id="H160B59D909494FBD987C9D22854D4916"><enum>(1)</enum><text>by striking <quote>2013 and 2014</quote> and inserting <quote>calendar years 2014 through 2019</quote>;</text>
</paragraph><paragraph id="HAB976D57D9F941F3861C53BC88F550E7"><enum>(2)</enum><text>by striking <quote>, general internal medicine</quote> and inserting <quote>, general internal medicine, neurology, psychiatry, obstetrics and gynecology</quote>;</text>
</paragraph><paragraph id="H87E2D94D5B0643F990E6E65A480DE550"><enum>(3)</enum><text display-inline="yes-display-inline">by inserting <quote>or a health care practitioner who is a nurse practitioner, physician assistant, or clinical nurse
specialist (as such terms are defined in section 1861(aa)(5)) or a
certified nurse midwife (as defined in section 1861(gg)(2))</quote> after <quote>pediatric medicine</quote>; and</text>
</paragraph><paragraph id="H7345E0129734479682D8A2C770EB5138"><enum>(4)</enum><text display-inline="yes-display-inline">by striking <quote>such services and physician</quote> and inserting <quote>such services and physician or health care practitioner</quote>.</text>
</paragraph></subsection><subsection id="H8F048830384149ECA8FA00B22BD03253"><enum>(b)</enum><header>Effective date</header><text>The amendments made by this section shall apply to items and services furnished on or after the
first day of the first calendar quarter that begins after the date of the
enactment of this Act.</text>
</subsection></section><enum>IV</enum><header>Access and Quality</header>
<subtitle id="HD67EB9C60C27405488E92D0C94A2D1C8" style="OLC"><enum>A</enum><header>Pediatric Quality Measures</header>
<section id="HCE0BB793214D4D7D9B670C40DF3969EB"><enum>401.</enum><header>Extending the pediatric quality measures program</header><text display-inline="no-display-inline">Section 1139A(i) of the Social Security Act (42 U.S.C. 1320b–9a(i)) is amended by inserting <quote>, and for each of fiscal years 2015 through 2019, $50,000,000,</quote> after <quote>$45,000,000</quote>.</text>
</section><section commented="no" id="HB53ADCE745224E5B961B0EB9E5CB78BF"><enum>402.</enum><header>Enhanced FMAP for activities related to pediatric quality measures</header><text display-inline="no-display-inline">Section 1903(a)(3)(A)(iii) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396b">42 U.S.C. 1396b(a)(3)(A)(iii)</external-xref>) is amended to
read as follows:</text>
<quoted-block display-inline="no-display-inline" id="HCE1C7F1E6CE64F03993A14B2B9E5A0EC" style="OLC">
<clause commented="no" id="H1DCADCC2B10A41D28C05F7AFBB512CDC" indent="up1"><enum>(iii)</enum><text display-inline="yes-display-inline">95 percent of so much of the sums expended during any such quarter in fiscal years 2015, 2016, and
2017, 90 percent of so much of the sums expended during any such quarter
in fiscal years 2018 and 2019, and the higher of an amount equal to the
Federal medical assistance percentage (as defined in section 1905(b)) or
75 percent of so much of the sums expended during any such quarter in any
fiscal year thereafter (as found necessary by the Secretary for the proper
and efficient administration of the State plan) as are attributable to
such developments or modifications of systems of the type described in
clause (i) as are necessary for the efficient collection and reporting on
the core set of child health quality measures under subsections (a), (b),
(c), and (f) of section 1139A; and</text></clause><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H61A7F94D48B1478D8608ADDA06832045"><enum>403.</enum><header>Reporting of full set of pediatric quality measures</header><text display-inline="no-display-inline">Section 1139A(a)(4) of the Social Security Act (42 U.S.C. 1320b–9a(a)(4)) is amended—</text>
<paragraph id="HF62C68B6492D44EC9F57662D16005B4F"><enum>(1)</enum><text>in the heading, by striking <quote><header-in-text level="paragraph" style="OLC">Encourage voluntary and standardized</header-in-text></quote> and inserting <quote><header-in-text level="paragraph" style="OLC">Standardized</header-in-text></quote>;</text>
</paragraph><paragraph id="H77006623116F48A5B9BC43702E5DFA6F"><enum>(2)</enum><text>by striking <quote>Not later than</quote> and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="H30E809DA77A34FC796FC667327E32D84" style="OLC">
<subparagraph id="H99F102172E9C4D4483CDB1E3A03E9FC8"><enum>(A)</enum><header>Encouraging voluntary reporting</header><text display-inline="yes-display-inline">Not later than</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block>
</paragraph><paragraph id="H121EB97E08944E71A0F7345F75911207"><enum>(3)</enum><text>by adding at the end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H0B55915C386B499994E09875FFF020FF" style="OLC">
<subparagraph id="H8E0D380289FD45EA80B7F895A5BB9C13"><enum>(B)</enum><header>Other reporting</header><text display-inline="yes-display-inline">Not later than five years after the date of the enactment of the <short-title>CHIP Extension and Improvement Act of 2014</short-title>, the Secretary shall require that each State submit information on the core set of child health
quality measures (as in effect on such date of enactment), as updated
under subsection (b)(5).</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section id="H0A9B631699784B4689C0CDED60857210"><enum>404.</enum><header>Technical assistance to States for adopting and utilizing pediatric quality measures</header><text display-inline="no-display-inline">Section 1139A(a)(7) of the Social Security Act (42 U.S.C. 1320b–9a(a)(7)) is amended to read as
follows:</text>
<quoted-block display-inline="no-display-inline" id="HFAF2D3F6DAC3441A9904EA66AB9D166D" style="OLC">
<paragraph id="HF10FC0A2B531447687ADDCA38E41A03E"><enum>(7)</enum><header>Technical assistance</header>
<subparagraph id="HD91ECF9F486149DA82CD4A330242C070"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary shall provide technical assistance to States to assist them in adopting and utilizing
the core set of child health measures in administering the State plans
under titles XIX and XXI, including by assisting States in
building their data collection infrastructures.</text>
</subparagraph><subparagraph id="H316DAE12BEEB4D3FA57977C3A830E663"><enum>(B)</enum><header>Funding</header><text>$5,000,000 of the amount appropriated under subsection (i) for a fiscal year shall be used to carry
out this paragraph.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H3EFF612455454284B9ACB3B2E1833B6A"><enum>405.</enum><header>Improving the effectiveness of the pediatric quality measures</header><text display-inline="no-display-inline">Section 1139A(b) of the Social Security Act (42 U.S.C. 1320b–9a(b)) is amended—</text>
<paragraph id="HA2CBB815B6744CE9B3AA0E7BEE23A9FA"><enum>(1)</enum><text>in paragraph (4)—</text>
<subparagraph id="H6652DB0B91074A71AEA9A4E9B29135F3"><enum>(A)</enum><text display-inline="yes-display-inline">by striking the paragraph heading and inserting the following: <quote><header-in-text level="paragraph" style="OLC">Ensuring the development, maintenance, and reporting of a portfolio of pediatric quality measures</header-in-text></quote>;</text>
</subparagraph><subparagraph id="H798570D415804221A3B69937BCB858EB"><enum>(B)</enum><text>in subparagraph (A), by striking <quote>and</quote> at the end;</text>
</subparagraph><subparagraph id="HE223B7FCDCD4455198A8C91827832B7A"><enum>(C)</enum><text>in subparagraph (B)(iii)—</text>
<clause id="HB2C652F3F8384F08AE04D9DBA39701E9"><enum>(i)</enum><text>by inserting <quote>establishment of a sustainable mechanism for maintaining and</quote> before <quote>updating</quote>; and</text>
</clause><clause id="H22A54FD0B6434983895AAD2DD8AFDA12"><enum>(ii)</enum><text display-inline="yes-display-inline">by striking <quote>as necessary.</quote> and inserting <quote>in alignment with the most recent version of the <quote>Blueprint for the Measures Management System</quote> published by the Centers for Medicare & Medicaid Services, as necessary; and</quote>; and</text>
</clause></subparagraph><subparagraph id="H1D05D54ED5724CBEB690A3654FCE5B4F"><enum>(D)</enum><text>by adding at the end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="HC5070E1E78E147B2B48E114B711FD378" style="OLC">
<subparagraph id="H13AB12AB79134A94934A859945001612"><enum>(C)</enum><text display-inline="yes-display-inline">award grants or contracts to continue and enhance the pediatric quality measures program, which
shall include awarding grants and contracts with a particular emphasis on—</text>
<clause id="HB18F743664C6464B967C79EB40F4B3FD"><enum>(i)</enum><text display-inline="yes-display-inline">patient and family experience or coordination of care;</text>
</clause><clause id="H2A7469DC129B46E598232C0C9330AD79"><enum>(ii)</enum><text display-inline="yes-display-inline">pediatric populations that are small in size and may be most effectively addressed by aggregating
data across multiple States, including pediatric populations with medical
complexity and pediatric populations with rare conditions;</text>
</clause><clause id="H48D6FF48F4F84F8595B80F27A5541785"><enum>(iii)</enum><text display-inline="yes-display-inline">the impacts of changes in life events over various stages of child and adolescent development,
including changes in morbidity and mortality, dependence status, and
developmental stages, and the impacts of such changes on subsequent health
and health care quality; and</text>
</clause><clause id="H7C0EB54B686B4BF389A358243F17C546"><enum>(iv)</enum><text display-inline="yes-display-inline">establishing a sustainable mechanism for identifying and assisting States in developing a
standardized data infrastructure for the collection and national reporting
of pediatric quality measures, including developing precise data element
definitions and utilizing consistent data collection methods.</text></clause></subparagraph><after-quoted-block>; </after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H63CF784FF00C4C4A862A1B09F506A877"><enum>(2)</enum><text>by striking paragraph (5) and inserting the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H6EDD7AEEA57D496088F25527693D62DC" style="OLC">
<paragraph id="H49C9EC94B0394338933D93EA553E463B"><enum>(5)</enum><header>Revising, strengthening, and improving initial core measures</header>
<subparagraph id="HAFDE447A40F84C30A908B2B877A4B99E"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary shall annually issue a rule (in accordance with <external-xref legal-doc="usc" parsable-cite="usc/5/553">section 553</external-xref> of title 5, United States
Code) to amend the core set of child health quality measures described in
subsection (a) so that such core set—</text>
<clause id="H3A2739E7B6E0483882F549DD1F7AEC6E"><enum>(i)</enum><text display-inline="yes-display-inline">is consistent with the purposes of the pediatric quality measures program established under
paragraph (1);</text>
</clause><clause id="HAF4D9FD9563F495D9FF66F25A240E140"><enum>(ii)</enum><text>meets the conditions specified in paragraph (2);</text>
</clause><clause id="H4549BBE5FD644E09BE2AAE5BC43EEA74"><enum>(iii)</enum><text>includes measures that—</text>
<subclause id="HBDB93ED391A049D0A53AA781E97996A1"><enum>(I)</enum><text>were developed by the Secretary in consultation with the entities specified in subparagraphs (A)
through (H) of paragraph (3);</text>
</subclause><subclause id="H2A5F2D91AEA44DC799F85B8CE3FED394"><enum>(II)</enum><text display-inline="yes-display-inline">were developed, validated, tested, or maintained through a grant or contract awarded under
paragraph (4); and</text>
</subclause><subclause id="H9433395FA04A4A79A79685944204CD44"><enum>(III)</enum><text>were submitted to the Secretary for consideration that were not developed under such a grant or
contract; and</text>
</subclause></clause><clause id="H6C88B95986BC4A1E9476495837CB0D79"><enum>(iv)</enum><text display-inline="yes-display-inline">takes into account the reports and demonstration projects described in subparagraphs (c), (d), (e),
and (f) of this section.</text>
</clause></subparagraph><subparagraph id="H957BB8BB75014DDE9CD3A5FD21D72DF1"><enum>(B)</enum><header>Additional changes</header><text display-inline="yes-display-inline">Beginning not later than one year after the date of the enactment of the <short-title>CHIP Extension and Improvement Act of 2014</short-title>, the amendments made to the core set of measures under subparagraph (A) shall include changes—</text>
<clause id="H0388063251BD472294FB93EB5AA0F055"><enum>(i)</enum><text>to measure the type of children’s health insurance coverage or other health benefits coverage
available over time, in addition to the presence, stability, and duration
of such health insurance coverage or such health benefits coverage over
time, for purposes of examining enrollment changes of a child from one
type of coverage to another;</text>
</clause><clause id="HB8B53D94BE294DDB8EF2D3986706B1CF"><enum>(ii)</enum><text>to ensure that the measures reflect the care provided to the diverse pediatric population,
including adolescents and children with special health care needs and the
management of acute and chronic conditions;</text>
</clause><clause id="H45AB55C430A24DD3A68AE355915AA4BA"><enum>(iii)</enum><text display-inline="yes-display-inline">to ensure that the measures reflect care provided in all health care settings in which an
individual enrolled in the State plan under title XIX receives care; and</text>
</clause><clause id="HA2AE2414205F431289F3F89F5B1CC9B5"><enum>(iv)</enum><text display-inline="yes-display-inline">to encourage the adoption of pediatric quality measures at the State, plan, community, facility,
and provider level attribution, as well as across different health care
delivery and coverage systems, including coverage provided through the
Exchanges established under title I of the Patient Protection and
Affordable Care Act.</text>
</clause></subparagraph></paragraph><after-quoted-block>; </after-quoted-block></quoted-block>
</paragraph><paragraph id="HD6395EA27EBE4F1FAD44FC0A0015D5BA"><enum>(3)</enum><text>in paragraph (6)—</text>
<subparagraph id="H66BABEA260EB440A94573E8B1871E91D"><enum>(A)</enum><text>by striking <quote>clinical care</quote> and inserting <quote>clinical effectiveness, patient safety, population and public health, patient and family
engagement, care coordination, or efficiency</quote>; and</text>
</subparagraph><subparagraph id="HA7907C5C2FED4F6E873508256FB1BB62"><enum>(B)</enum><text>by striking <quote>in various institutional and ambulatory health care settings</quote>; and</text>
</subparagraph></paragraph><paragraph id="H6AFA3574DF5448F5A75BB085C869862A"><enum>(4)</enum><text>by adding at the end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H2741B68E67574646BD16359B0C14E970" style="OLC">
<paragraph id="HE7C1697EDC0B4C33971859C880A8D859"><enum>(8)</enum><header>Funding</header><text display-inline="yes-display-inline">$20,000,000 of the amount appropriated under subsection (i) for a fiscal year shall be used to
carry out this subsection.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section id="H7D4F259C4D9848EF84A46151426034CE"><enum>406.</enum><header>Reports regarding State-specific quality of care measures applied under Medicaid or CHIP</header><text display-inline="no-display-inline">Section 1139A(c)(1) of the Social Security Act (42 U.S.C. 1320b–9a(c)) is amended—</text>
<paragraph id="H204E7B1245C6483B9F12EBF54CAB945E"><enum>(1)</enum><text>in subparagraph (A), by striking <quote>and</quote> at the end;</text>
</paragraph><paragraph id="H611AAE5AB4B1444AB24BBC908F795652"><enum>(2)</enum><text>in subparagraph (B), by striking the period at the end and inserting a semicolon; and</text>
</paragraph><paragraph id="H55A73F75EAA5448DA2FBEB1F6BB22A83"><enum>(3)</enum><text>by adding at the end the following new subparagraphs:</text>
<quoted-block display-inline="no-display-inline" id="HE1923F1753FC4C3085E37D7943856E89" style="OLC">
<subparagraph id="HBE98A38A56384A1E80F62E16FDAE28D5"><enum>(C)</enum><text display-inline="yes-display-inline">State-specific information on the annual progress toward, and efforts to overcome barriers to,
reporting on all quality measures within the core set of child health
quality measures, as updated under subsection (b)(5); and</text>
</subparagraph><subparagraph id="H7CAC838AFA7D49CE9D42DD0F8CA2E3C0"><enum>(D)</enum><text display-inline="yes-display-inline">beginning not later than 5 years after the date of the enactment of this subparagraph,
State-specific information on all quality measures within the core set of
child health quality measures, as updated under subsection (b)(5).</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section commented="no" id="HA18AE85951324D4CB5E651405F773E1E"><enum>407.</enum><header>Advisory panel regarding pediatric quality</header>
<subsection id="H0D32FCC47A3F4191AAE3C8438D9B9AD6"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1139A(g) of the Social Security Act (42 U.S.C. 1320b–9a(g)) is amended—</text>
<paragraph commented="no" id="H85221AF1C4914407A8A3BAB40177F480"><enum>(1)</enum><text>in the heading, by striking <quote><header-in-text level="subsection" style="OLC">Study of</header-in-text></quote> and inserting <quote><header-in-text level="subsection" style="OLC">Stakeholder input and reports on</header-in-text></quote>;</text>
</paragraph><paragraph commented="no" id="HB9775AA1BBD74C00AF72CE3ABEB2D345"><enum>(2)</enum><text>by redesignating paragraph (2) as paragraph (3); and</text>
</paragraph><paragraph commented="no" id="HBB4F3E8BBA64486493E5A368AA4107C6"><enum>(3)</enum><text>by inserting after paragraph (1) the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H399303F5E31C4F6791A8C8DA35CC9CD8" style="OLC">
<paragraph commented="no" id="H9807A429012F45928CED5F84B305BC4E"><enum>(2)</enum><header>Pediatric Quality Measurement</header><text display-inline="yes-display-inline">Not later than 18 months after the date of the enactment of this paragraph, the Secretary, in
consultation with representatives of State agencies responsible for
administering the Medicaid program under title XIX and the Children’s
Health Insurance Program under title XXI and representatives of relevant
provider organizations, shall submit (and periodically update) to the
Committee on Energy and Commerce of the House of Representatives and the
Committee on Finance of the Senate a report that takes into account the
priorities and goals to be established pursuant to section 1890(b)(7)(E).
Such report shall include—</text>
<subparagraph id="H4A29785F680A42038BA14659F3C6689F"><enum>(A)</enum><text display-inline="yes-display-inline">strategic and detailed operational plans to address and overcome barriers to State collection of,
and reporting of, all quality measures within the core set of child health
quality measures, as updated under subsection (b)(5);</text>
</subparagraph><subparagraph id="H2D7062C47CA648B7A3DBA7CD8F5A46D2"><enum>(B)</enum><text display-inline="yes-display-inline">an analysis of the types of incentives, including Federal funding and any associated amounts
necessary for States to collect and report on all quality measures within
the core set of child health quality measures, as updated under subsection
(b)(5); and</text>
</subparagraph><subparagraph id="H9AABD7E0547C459E97512871908297A1"><enum>(C)</enum><text display-inline="yes-display-inline">a standardized format and plan for States to collect and report on all quality measures within the
core set of child health quality measures, as updated under subsection
(b)(5).</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H220FC5D898FD4318AC291FCA9DD72D50"><enum>(b)</enum><header>Inclusion of child and adult health quality measures for multi-Stakeholder group input</header><text>Section 1890(b)(7) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395aaa">42 U.S.C. 1395aaa(b)(7)</external-xref>) is amended—</text>
<paragraph id="H9B09D0158FE448EDAB34DE4872A123AA"><enum>(1)</enum><text display-inline="yes-display-inline">in subparagraph (B)(i)(I), by inserting <quote>1139A(a), 1139B,</quote> after <quote>sections</quote>; and</text>
</paragraph><paragraph id="H61886704E1A541C9BC647F0B444E173A"><enum>(2)</enum><text>by adding at the end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H3C3A7BD5B0C54B2892E08DF7CCADB3F6" style="OLC">
<subparagraph id="HA73246ECFF6147E4A6F33C0CD390D348"><enum>(E)</enum><header>Pediatric Quality Measurement</header><text display-inline="yes-display-inline">With respect to quality and efficiency measures for use pursuant to section 1139A(a), the entity
shall convene a panel, composed of health experts (including experts
employed by the Federal Government and experts not so employed) to
establish priorities and goals for child health to—</text>
<clause id="H3D90797C3410484A8648969913300D10"><enum>(i)</enum><text display-inline="yes-display-inline">advise and make recommendations to the Secretary regarding changes that may be made to the core set
of child health quality measures, as updated under section 1139A(b)(5);</text>
</clause><clause commented="no" id="H7A8A1E2B850B406C92331663342FA46B"><enum>(ii)</enum><text>establish standards for the timeliness and accuracy of data collected and reported for purposes of
such measures; and</text>
</clause><clause id="H2C6D26A2F15649BB9FC321B1BFCB49E4"><enum>(iii)</enum><text>review and make recommendations, at least annually, for strategies to enhance the timeliness,
accuracy, and utility of such measures.</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section><section id="H9367E2FD049E49838321D7CD08F7C502"><enum>408.</enum><header>Extending and expanding demonstration projects</header>
<subsection id="HB12BCD5483B14D7EBFF408350E0F1D5C"><enum>(a)</enum><header>Strengthening demonstration projects for improving the quality of children’s health care and the
use of health information technology</header><text display-inline="yes-display-inline">Section 1139A(d) of the Social Security Act (42 U.S.C. 1320b–9a(d)) is amended—</text>
<paragraph id="HC43211B281B346B990C05475FACE9E50"><enum>(1)</enum><text>in paragraph (1)—</text>
<subparagraph id="H22C333DEC53043B2938ED27B275C4DC1"><enum>(A)</enum><text>in the matter preceding subparagraph (A)—</text>
<clause id="HE262438B509B4D26B902860276828C1E"><enum>(i)</enum><text>by striking <quote>2009 through 2013, the Secretary shall award not more than 10 grants</quote> and inserting <quote>2015 through 2019, the Secretary shall award not fewer than 10 grants,</quote>; and</text>
</clause><clause id="H448CF3A6FDCF4990900E22650410540B"><enum>(ii)</enum><text>by inserting <quote>(including oral care)</quote> after <quote>health care</quote>;</text>
</clause></subparagraph><subparagraph id="H74CBA1C3441A44DA82BB23E9F49BB10A"><enum>(B)</enum><text>in subparagraph (C), by striking <quote>or</quote> at the end;</text>
</subparagraph><subparagraph id="H6009128B637E4F76A5DF780181034AF5"><enum>(C)</enum><text>in subparagraph (D), by striking the period at the end and inserting a semicolon; and</text>
</subparagraph><subparagraph id="HADE6D37473EB4880835189C36681AE62"><enum>(D)</enum><text>by adding at the end the following new subparagraphs:</text>
<quoted-block id="HF1A544F4306D4E9FA6F6318C269F0106" style="OLC">
<subparagraph id="H5FB70C1B85034A27962F1C591B5D59B0"><enum>(E)</enum><text display-inline="yes-display-inline">examine and address barriers to effective delivery of perinatal care and its impact on birth
outcomes and subsequent pregnancies and children’s health;</text>
</subparagraph><subparagraph id="H8CB6D97C80574438AACC4D32844CB25E"><enum>(F)</enum><text display-inline="yes-display-inline">implement and expand pediatric and perinatal learning and quality improvement collaboratives on the
quality of children’s and pregnant women’s health care, including
improving patient outcomes, reducing health costs, and addressing health
disparities;</text>
</subparagraph><subparagraph commented="no" id="HC3EA775AC0D547C8A0636FA8260DDC25"><enum>(G)</enum><text display-inline="yes-display-inline">encourage and evaluate the use at the State level of payment reform and related policy proposals
for purposes of promoting higher quality of care for children, including
the shared savings program established under section 1899 and other
methods of encouraging integrated care models; or</text>
</subparagraph><subparagraph commented="no" id="H9359D8BD85A0451898C7B4AC80B95D98"><enum>(H)</enum><text display-inline="yes-display-inline">with respect to the model electronic health record format for children developed and disseminated
under subsection (f)—</text>
<clause id="H1160D370EDE943BC86D3A2B1446D2EE9"><enum>(i)</enum><text display-inline="yes-display-inline">assess the extent to which the format has been incorporated into widely used electronic health
record formats;</text>
</clause><clause id="H94BAD73340A34E15AEFED8D5E746C787"><enum>(ii)</enum><text>implement standards and activities that result in increased use of such format; and</text>
</clause><clause id="H3EE0C279DCE041AF92ACC055982A04AF"><enum>(iii)</enum><text>evaluate the impact of the increased use of such format.</text></clause></subparagraph><after-quoted-block>; </after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="HE5F74903982D4A94B178F93B626AAC7D"><enum>(2)</enum><text>in paragraph (2)—</text>
<subparagraph id="HCACE45C85FF14386B5D9DB9503D67C46"><enum>(A)</enum><text>in subparagraph (A), by striking <quote>and</quote> at the end;</text>
</subparagraph><subparagraph id="HC744F89763A847EDAE5797B4B7B1B1A8"><enum>(B)</enum><text>in subparagraph (B), by striking the period at the end and inserting <quote>; and</quote>; and</text>
</subparagraph><subparagraph id="H007C9E08955C43F89FC544F86004D40F"><enum>(C)</enum><text>by adding at the end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H934E04910B04424EA59A3CB337A83285" style="OLC">
<subparagraph id="HB202F47B44144CA899DC02C3F9596483"><enum>(C)</enum><text display-inline="yes-display-inline">with respect to grants awarded for projects described in paragraph (1)(F)—</text>
<clause id="HAB355146BAB24B0DA5040A1A323B5623"><enum>(i)</enum><text>give priority to collaboratives that would demonstrate substantial impacts on the pediatric
population by—</text>
<subclause id="H858718D4B4944C618A3E87605B29CA5E"><enum>(I)</enum><text>affecting a large percentage of such population or by substantially improving outcomes in a smaller
population;</text>
</subclause><subclause id="HB60B3E841F904DD5807BF62808210E8B"><enum>(II)</enum><text>reducing the cost of, and other barriers to access to, health care for children, including children
with medically complex illnesses or chronic conditions;</text>
</subclause><subclause id="H6DC9C7789A5544C2928F16DE2028C298"><enum>(III)</enum><text>having a high likelihood to reduce disparities in health status; or</text>
</subclause><subclause id="H60A6B9C9717A4F5492F308B96C59135F"><enum>(IV)</enum><text>potentially having long-term health impacts by addressing childhood precursors to adult conditions;
and</text>
</subclause></clause><clause id="H16B2FDC4236A47ECA0D07251F851FA1B"><enum>(ii)</enum><text display-inline="yes-display-inline">encourage coordination with other sources of funding in the expansion of pediatric learning
collaboratives, including by coordinating care and utilizing community
health workers (as defined in section 399V(k) of the Public Health Service
Act (<external-xref legal-doc="usc" parsable-cite="usc/42/280g-11">42 U.S.C. 280g–11(k)</external-xref>)).</text></clause></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H634996478B6043C68A086EBB490C3212"><enum>(3)</enum><text>in paragraph (4)—</text>
<subparagraph id="H4D34BA78CE6841C991FA75F96D24DCB4"><enum>(A)</enum><text>by inserting <quote>For each of fiscal years 2009 through 2013,</quote> before <quote>$20,000,000</quote>; and</text>
</subparagraph><subparagraph id="H13107D9F1FE849088FF43E43EE57E973"><enum>(B)</enum><text display-inline="yes-display-inline">by adding at the end the following new sentence: <quote>For each of fiscal years 2015 through 2019, $25,000,000 of the amount appropriated under subsection
(i) for a fiscal year shall be used to carry out this subsection.</quote>.</text>
</subparagraph></paragraph></subsection><subsection id="H54AB27AAA6C745E58191F3A204C947F5"><enum>(b)</enum><header>Extending funding for childhood obesity demonstration projects</header><text display-inline="yes-display-inline">Section 1139A(e)(8) of the Social Security Act (42 U.S.C. 1320b–9a(e)(8)) is amended by inserting <quote>, and for the period of fiscal years 2015 through 2019, $25,000,000</quote> after <quote>2014</quote>.</text>
</subsection></section></subtitle><subtitle id="H878B0534C3DE45E19875C37281436766" style="OLC"><enum>B</enum><header>Continuing Delivery System Reform</header>
<section id="H546766E282DD47A6BAE195A6CFF9BE25"><enum>411.</enum><header>Supporting evidence-based care coordination in communities</header>
<subsection id="HD9C1B5954289413898040B2A17A02D2F"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 511(j)(1) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/711">42 U.S.C. 711(j)(1)</external-xref>) is amended—</text>
<paragraph id="H6266761A8E05431795A73182952E5544"><enum>(1)</enum><text>in subparagraph (D), by inserting <quote>and</quote> at the end;</text>
</paragraph><paragraph id="H87F288E246F84F6DBADE3218F7F8D11A"><enum>(2)</enum><text>in subparagraph (E), by striking <quote>fiscal year 2014; and</quote> and inserting <quote>each of fiscal years 2014 through 2019.</quote>; and</text>
</paragraph><paragraph commented="no" id="H06139D9A7E0E437D94F8ADACA4CFB6B1"><enum>(3)</enum><text display-inline="yes-display-inline">by striking subparagraph (F).</text>
</paragraph></subsection><subsection id="H1663455105EE47AEAC3D7E7283217713"><enum>(b)</enum><header>Effective date</header><text>The amendments made by this section shall take effect on the date of enactment of this Act.</text>
</subsection></section><section id="H2A85028C166049989FF1245AA1B4D7F0"><enum>412.</enum><header>Ensuring care coordination for children</header><text display-inline="no-display-inline">Section 2706 of the Patient Protection and Affordable Care Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a</external-xref> note) is amended—</text>
<paragraph id="H84C1746A4AA74B078B060E9338938240"><enum>(1)</enum><text>in subsection (a)(2), by striking <quote>2016</quote> and inserting <quote>2019</quote>; and</text>
</paragraph><paragraph id="H60677899EB894369937C3C4A0779B9A0"><enum>(2)</enum><text>in subsection (e), by striking <quote>appropriated</quote> and all that follows through the period at the end and inserting the following:</text>
<quoted-block display-inline="yes-display-inline" id="H166190BE750F4A478865B20B16D87B52" style="OLC"><text>appropriated to carry out this section—</text><paragraph id="HBDF6061197224838BAFC1495EC5097F7"><enum>(1)</enum><text display-inline="yes-display-inline">for fiscal year 2014, such sums as are necessary;</text>
</paragraph><paragraph id="H028E01D37DFE49DBAE27870DF9ACD0BB"><enum>(2)</enum><text>for each of fiscal years 2015 through 2019, $100,000,000; and</text>
</paragraph><paragraph id="H43DFB3AF6CB848C58F6929E2C05032E8"><enum>(3)</enum><text>for the period beginning on October 1, 2019, and ending on December 31, 2019, $25,000,000.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section></subtitle><subtitle id="H154C1CEAEA46415B94436C792E2B349B"><enum>C</enum><header>Miscellaneous</header>
<section commented="no" id="HD2FC2FD9D9A942198C08515D565080FA"><enum>421.</enum><header>Assuring coverage continuity for former foster care children</header>
<subsection commented="no" id="H9C7605B2B55E4A5DAB84EBA56A52880B"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1902(a)(10)(A)(i)(IX) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a(a)(10)(A)(i)(IX)</external-xref>) is
amended—</text>
<paragraph commented="no" id="H030863F5E4584AF68AAA54F350B551AF"><enum>(1)</enum><text>in item (bb), by striking <quote>are not described in or enrolled under</quote> and inserting <quote>are not described in and are not enrolled under</quote>;</text>
</paragraph><paragraph commented="no" id="H3B3BF8FBDD054B6F89F283531F832EFB"><enum>(2)</enum><text>in item (cc), by striking <quote>responsibility of the State</quote> and inserting <quote>responsibility of a State</quote>; and</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H5F60D8D0F3CE43E9BA7ADFF821B8A420"><enum>(3)</enum><text display-inline="yes-display-inline">in item (dd), by striking <quote>the State plan under this title or under a waiver of the</quote> and inserting <quote>a State plan under this title or under a waiver of such a</quote>.</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H96BFAADCFA5C4C7A9D0398545C0A6538"><enum>(b)</enum><header>Effective date</header><text>The amendments made by this section shall take effect on July 1, 2015.</text>
</subsection></section><section id="H7ABC9DD47AA14E609B6BA13B9FF6BCE7"><enum>422.</enum><header>Definition of therapeutic foster care as medical assistance</header>
<subsection id="H2DDE1EF6194541F6923FE1C19147B084"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1905 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d</external-xref>) is amended—</text>
<paragraph id="HFBE67BEFACD64008AFA6FFC422968ADB"><enum>(1)</enum><text>in subsection (a)—</text>
<subparagraph id="H8C1ACFD95305483B901D00DF4C0F26AD"><enum>(A)</enum><text>in paragraph (28), by striking <quote>and</quote> at the end;</text>
</subparagraph><subparagraph id="H4510F0FCF53542008083F1A7F0C3E690"><enum>(B)</enum><text>by redesignating paragraph (29) as paragraph (30); and</text>
</subparagraph><subparagraph id="H69530DBACCFF4217A21AD227935B029F"><enum>(C)</enum><text>by inserting after paragraph (28) the following new paragraph:</text>
<quoted-block id="H32149837162C459D98D402EC45078FA9" style="OLC">
<paragraph id="H27CF5953A54B40C9B08B886435D1D509"><enum>(29)</enum><text>therapeutic foster care services described in subsection (ee); and</text></paragraph><after-quoted-block>; and</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="HFC5ACA0D6A6F42748D6E325DFBF10839"><enum>(2)</enum><text>by adding at the end the following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="HF3207B9F87864B639EADC3E039AF1305" style="traditional">
<subsection id="HD940C5B357A64515B56ACFB3129A9B18"><enum>(ee)</enum>
<paragraph commented="no" display-inline="yes-display-inline" id="H00D5263722104660B62E6FCFBF399B73"><enum>(1)</enum><text display-inline="yes-display-inline">For purposes of subsection (a)(29), subject to subparagraph (C), therapeutic foster care services
described in this subsection are services provided for children who have
not attained age 21, and who, as a result of mental illness, other
emotional or behavioral disorders, medically fragile conditions, or
developmental disabilities, need the level of care provided in an
institution (including a psychiatric residential treatment facility) or
nursing facility the cost of which could be reimbursed under the State
plan but who can be cared for or maintained in a community placement,
through a qualified therapeutic foster care program described in paragraph
(2).</text>
</paragraph><paragraph id="HAF9859269B1A402EB1C142D0D2D0392E" indent="up1"><enum>(2)</enum><text display-inline="yes-display-inline">A qualified therapeutic foster care program described in this paragraph is a program that—</text>
<subparagraph id="HA4C90116A8B74B01BFE7CEE5425A5002"><enum>(A)</enum><text display-inline="yes-display-inline">is licensed by the State and accredited by the Joint Commission on Accreditation of Healthcare
Organizations, the Commission on Accreditation of Rehabilitation
Facilities, the Council on Accreditation, or by another equivalent
accreditation agency (or agencies) as the Secretary may recognize;</text>
</subparagraph><subparagraph id="H77FD52D242894452BB122C575DA1A0E2"><enum>(B)</enum><text display-inline="yes-display-inline">provides structured daily activities, including the development, improvement, monitoring, and
reinforcing of age-appropriate social, communication and behavioral
skills, trauma-informed and gender-responsive services, crisis
intervention and crisis support services, medication monitoring,
counseling, and case management, and may furnish other intensive community
services; and</text>
</subparagraph><subparagraph id="H1C631619AEB34932BCA202E7D2D5C3D8"><enum>(C)</enum><text display-inline="yes-display-inline">provides foster care parents with specialized training and consultation in the management of
children with mental illness, trauma, other emotional or behavioral
disorders, medically fragile conditions, or developmental disabilities,
and specific additional training on the needs of each child provided such
services.</text>
</subparagraph></paragraph><paragraph id="HA9A04841AC914E06AD92F52E126E01C6" indent="up1"><enum>(3)</enum><text>In making coverage determinations under paragraph (1), a State may employ medical necessity
criteria that are similar to the medical necessity criteria applied to
coverage determinations for other services and supports under this title.</text>
</paragraph><paragraph id="H939C021BF0CF494FBB389722C557D6BB" indent="up1"><enum>(4)</enum><text>The services described in this subsection do not include the training referred to in paragraph
(2)(C).</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="HBAEF3D2AB7E84DFC9B27068C363C64B3"><enum>(b)</enum><header>Effective date</header><text>The amendments made by subsection (a) shall apply to calendar quarters beginning on or after the
date of enactment of this Act.</text>
</subsection></section><section id="H7A6CAE8508D34452BA983A9C298C3393"><enum>423.</enum><header>Technical correction</header>
<subsection id="HBBBB3DAE928545EC9A7C620EBAFB2776"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1917(d)(4)(A) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396p">42 U.S.C. 1396p(d)(4)(A)</external-xref>) is amended by inserting <quote>the individual,</quote> after <quote>for the benefit of such individual by</quote>.</text>
</subsection><subsection id="HBB0452D013B04EAC9B191973E1E6784E"><enum>(b)</enum><header>Effective date</header><text display-inline="yes-display-inline">The amendment made by subsection (a) shall apply to trusts established on or after the date of the
enactment of this Act.</text>
</subsection></section></subtitle>