[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1503 Introduced in House (IH)]







104th CONGRESS
  1st Session
                                H. R. 1503

To amend title XIX of the Social Security Act to require State medicaid 
   plans to cover services of certain clinics operated by children's 
hospitals and to reimburse such clinics for such services in an amount 
 equal to 100 percent of the costs which are reasonable and related to 
                 the cost of furnishing such services.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 7, 1995

 Mrs. Lincoln introduced the following bill; which was referred to the 
                         Committee on Commerce

_______________________________________________________________________

                                 A BILL


 
To amend title XIX of the Social Security Act to require State medicaid 
   plans to cover services of certain clinics operated by children's 
hospitals and to reimburse such clinics for such services in an amount 
 equal to 100 percent of the costs which are reasonable and related to 
                 the cost of furnishing such services.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Access to Children's Health Care Act 
of 1995''.

SEC. 2. MANDATORY COVERAGE OF SERVICES OF CLINICS OPERATED BY 
              CHILDREN'S HOSPITALS UNDER STATE MEDICAID PLANS.

    (a) In General.--Section 1905(a)(2) of the Social Security Act (42 
U.S.C. 1396d(a)(2)) is amended--
            (1) by striking ``and (C)'' and inserting ``(C)''; and
            (2) by striking the semicolon at the end and inserting the 
        following: ``, and (D) qualified children's hospital clinic 
        services (as defined in subsection (l)(3));''.
    (b) Qualified Children's Hospital Clinic Services Described.--
Section 1905(l) of such Act (42 U.S.C. 1396d(l)) is amended by adding 
at the end the following new paragraph:
    ``(3)(A) The term `qualified children's hospital clinic services' 
means services of the type described in subparagraphs (A) through (C) 
of section 1861(aa)(1) and any other ambulatory services for which 
payment may be made under the State plan, when furnished to a patient 
of a qualified children's hospital clinic (as defined in subparagraph 
(B)).
    ``(B) The term `qualified children's hospital clinic' means an 
entity which--
            ``(i) is operated by a hospital whose inpatients are 
        predominantly individuals under 18 years of age;
            ``(ii) meets the requirements to receive a grant under 
        section 330 of the Public Health Service Act, or which would 
        meet such requirements but for the entity's failure to meet the 
        requirements of section 330(e)(3)(G) of such Act;
            ``(iii) has a consumer advisory board composed of 
        individuals, a majority of whom are immediate family members of 
        patients served by the entity, who advise the hospital 
        operating the entity on the entity's annual budget, the 
        selection of the entity's general director, and other general 
        policies for the entity; and
            ``(iv) has written inpatient and outpatient referral 
        arrangements in effect with each Federally-qualified health 
        center under paragraph (2)(B) that is located or provides 
        services within the service area of the hospital operating the 
        entity.''.

SEC. 3. REIMBURSEMENT OF QUALIFIED CHILDREN'S HOSPITAL CLINIC SERVICES 
              AT 100 PERCENT OF REASONABLE COST.

    Section 1902(a)(13)(E) of the Social Security Act (42 U.S.C. 
1396a(a)(13)(E)) is amended by striking ``(B) or (C)'' and inserting 
``(B), (C), or (D)''.

SEC. 4. EFFECTIVE DATE.

    (a) In General.--The amendments made by this Act shall apply to 
calendar quarters beginning on or after January 1, 1996, without regard 
to whether or not final regulations to carry out such amendments have 
been promulgated by such date.
    (b) Special Rule for States Requiring Legislation To Modify 
Medicaid Plans.--In the case of a State plan for medical assistance 
under title XIX of the Social Security Act which the Secretary of 
Health and Human Services determines requires State legislation (other 
than legislation appropriating funds) in order for the plan to meet the 
additional requirements imposed by the amendments made by this Act, the 
State plan shall not be regarded as failing to comply with the 
requirements of such title solely on the basis of its failure to meet 
these additional requirements 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 the 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 such session shall 
be deemed to be a separate regular session of the State legislature.
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