[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3072 Introduced in House (IH)]







105th CONGRESS
  1st Session
                                H. R. 3072

  To amend title XIX of the Social Security Act and title XXVI of the 
    Public Health Service Act with respect to treatments regarding 
            infection with the virus commonly known as HIV.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           November 13, 1997

Ms. Pelosi (for herself, Mr. Gephardt, Mrs. Morella, Mr. Cummings, Mr. 
Frank of Massachusetts, Mr. Abercrombie, Mr. Ackerman, Mr. Bonior, Ms. 
  DeLauro, Mr. Engel, Ms. Eshoo, Mr. Farr of California, Mr. Fazio of 
  California, Mr. Filner, Mr. Frost, Mr. Gutierrez, Mr. Hinchey, Mr. 
  Lantos, Mr. McDermott, Mr. McGovern, Mrs. Maloney of New York, Mr. 
 Matsui, Mr. Meehan, Mrs. Meek of Florida, Ms. Millender-McDonald, Mr. 
Miller of California, Mrs. Mink of Hawaii, Mr. Payne, Ms. Sanchez, Mr. 
Towns, Ms. Waters, Ms. Woolsey, Ms. Roybal-Allard, and Ms. Jackson-Lee 
  of Texas) introduced the following bill; which was referred to the 
                         Committee on Commerce

_______________________________________________________________________

                                 A BILL


 
  To amend title XIX of the Social Security Act and title XXVI of the 
    Public Health Service Act with respect to treatments regarding 
            infection with the virus commonly known as HIV.

    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 ``HIV Treatment Improvement Act of 
1997''.

SEC. 2. MEDICAID COVERAGE OF HIV-INFECTION-RELATED DRUG TREATMENT FOR 
              CERTAIN INDIVIDUALS.

    (a) In General.--Section 1902 of the Social Security Act (42 U.S.C. 
1396a) is amended--
            (1) in subsection (a)(10)--
                    (A) by striking ``and'' at the end of subparagraph 
                (E);
                    (B) by adding ``and'' at the end of subparagraph 
                (F); and
                    (C) by inserting after subparagraph (F) the 
                following new subparagraph:
                    ``(G) for making medical assistance available for 
                HIV-infection-related drug treatment (as defined in 
                subsection (aa)(2)) for certain HIV-infected 
                individuals (as defined in subsection (aa)(1));''; and
            (2) by adding at the end the following new subsection:
    ``(aa)(1) HIV-infected individuals described in this paragraph are 
individuals not described in subsection (a)(10)(A)(i)--
            ``(A) who have HIV infection;
            ``(B) whose income (as determined under the State plan 
        under this title with respect to disabled individuals) does not 
        exceed the maximum amount of income a disabled individual 
        described in subsection (a)(10)(A)(i) may have and obtain 
        medical assistance under the plan; and
            ``(C) whose resources (as determined under the State plan 
        under this title with respect to disabled individuals) do not 
        exceed the maximum amount of resources a disabled individual 
        described in subsection (a)(10)(A)(i) may have and obtain 
        medical assistance under the plan.
    ``(2) For purposes of subsection (a)(10), subject to paragraph (3), 
the term `HIV-infection-related drug treatment' means each of the 
following services to monitor and treat HIV infection through drug 
treatment:
            ``(A) Prescribed drugs.
            ``(B) Physicians' services and services described in 
        section 1905(a)(2).
            ``(C) Diagnostic tests described in paragraphs (3) and (13) 
        of section 1905(a).
            ``(D) Services, such as substance abuse and mental health 
        treatment and medical case management services, to the extent 
        required in order to assure compliance with a regimen of drug 
        treatment.
    ``(3) HIV-infection-related drug treatment under a State plan shall 
be such services described in paragraph (2) as meet the needs of HIV-
infected individuals, based on the most current national guidelines 
that are recognized by the Secretary and that relate to the treatment 
of HIV infection through drug treatment and without regard to any 
prescription drug formulary that would otherwise be applied under the 
State plan.''.
    (b) Conforming Amendments.--
            (1) Section 1902(a)(10) of such Act (42 U.S.C. 
        1396a(a)(10)) is further amended, in the matter following 
        subparagraph (G), as inserted by subsection (a)(1)--
                    (A) by striking ``and'' before ``(XIII)'', and
                    (B) by inserting before the semicolon at the end 
                the following: ``and (XIV) the medical assistance made 
                available to an individual described in subparagraph 
                (G) who is eligible for medical assistance only because 
                of such subparagraph shall be limited to medical 
                assistance for HIV-infection-related drug treatment (as 
                defined in subsection (aa)(2))''.
            (2) Section 1905(a) of such Act (42 U.S.C. 1396d(a)) is 
        amended, in the matter before paragraph (1)--
                    (A) by striking ``or'' at the end of clause (x),
                    (B) by adding ``or'' at the end of clause (xi), and
                    (C) by inserting after clause (xii) the following 
                new clause:
            ``(xii) individuals described in section 1902(aa)(1);''.
    (c) Effective Date.--(1) Except as provided in paragraph (2), the 
amendments made by subsections (a) and (b) shall apply to calendar 
quarters beginning on or after the date of the enactment of this Act, 
without regard to whether or not final regulations to carry out such 
amendments have been promulgated by such date.
    (2) 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 subsections (a) and (b), 
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.

SEC. 3. PUBLIC HEALTH SERVICE ACT; MODIFICATIONS TO PROGRAM OF 
              TREATMENTS FOR HIV DISEASE.

    (a) Requirements Regarding Types of Treatments.--Section 2616(c)) 
of the Public Health Service Act (42 U.S.C. 300ff-26(c)) is amended--
            (1) in the matter preceding paragraph (1), by striking 
        ``the State shall--'' and inserting ``the State--'';
            (2) by redesignating paragraphs (3) through (5) as 
        paragraphs (5) through (7);
            (3) by striking paragraphs (1) and (2); and
            (4) by inserting before paragraph (5) (as redesignated by 
        paragraph (2)) the following paragraphs:
            ``(1) shall determine, in accordance with guidelines issued 
        by the Secretary, which treatments and which laboratory 
        services are to be included in the program under subsection 
        (a);
            ``(2) shall provide for the medical administration of such 
        drugs in accordance with guidelines issued by the Secretary for 
        treatments described in subsection (a) (or in accordance with 
        guidelines recognized by the Secretary as appropriate 
        guidelines for such treatment);
            ``(3) shall not for purposes of this section adopt any 
        policy medically inconsistent with the guidelines of the 
        Secretary that are referred to in paragraphs (1) and (2);
            ``(4) shall provide assistance for the purchase of 
        treatments and laboratory services included in the program, and 
        the provision of such ancillary devices as are essential to 
        administer the treatments;''.
    (b) Non-Federal Contributions as Condition for Receipt of Certain 
Amounts.--Section 2618(b)(2)(H) of the Public Health Service Act (42 
U.S.C. 300ff-28(b)(2)(H)) is amended to read as follows:
                    ``(H) Appropriations for treatment drug program.--
                            ``(i) With respect to the fiscal year 
                        involved, if under section 2677 an 
                        appropriations Act provides an amount 
                        exclusively for carrying out section 2616, the 
                        portion of such amount allocated to a State 
                        shall, subject to clause (ii), be the product 
                        of--
                                    ``(I) 100 percent of such amount; 
                                and
                                    ``(II) the percentage constituted 
                                by the ratio of the State distribution 
                                factor for the State (as determined 
                                under subparagraph (B)) to the sum of 
                                the State distribution factors for all 
                                States.
                            ``(ii)(I) In the case of a State for which 
                        the allocation determined under clause (i) for 
                        the fiscal year involved exceeds $1,000,000, 
                        the State may not receive the allocation unless 
                        the State agrees that, with respect to the 
                        costs to be incurred by the State in carrying 
                        out section 2616, the State will make available 
                        (directly or through donations from public or 
                        private entities) non-Federal contributions 
                        toward such costs in an amount that is not less 
                        than 20 percent of such costs ($1 for each $4 
                        of Federal funds provided in the allocation).
                            ``(II) Non-Federal contributions required 
                        in clause (i) may be in cash or in kind, fairly 
                        evaluated, including plant, equipment, or 
                        services. Amounts provided by the Federal 
                        Government, and any portion of any service 
                        subsidized by the Federal Government, may not 
                        be included in determining the amount of such 
                        non-Federal contributions.''.
    (c) Technical and Conforming Amendments.--Section 2616 of the 
Public Health Service Act (42 U.S.C. 300ff-26) is amended--
            (1) in subsection (a)--
                    (A) by striking ``to provide'' and all that follows 
                through ``prevent'' and inserting ``to provide 
                treatments for HIV disease and for the prevention of''; 
                and
                    (B) by inserting before the period ``, and to 
                provide related laboratory services''; and
            (2) in subsection (c)--
                    (A) in each of paragraphs (5) through (7) (as 
                redesignated by subsection (a)(2) of this section), by 
                inserting ``shall'' after the paragraph designation; 
                and
                    (B) in paragraph (7) (as so redesignated), by 
                striking ``progress'' and all that follows through 
                ``subsection (a)'' and inserting ``progress made in 
                making treatments described in subsection (a)''.

SEC. 4. PUBLIC HEALTH SERVICE ACT; MINIMUM GRANT UNDER CARE GRANT 
              PROGRAM REGARDING HIV DISEASE.

    Section 2618(b)(1)(A) of the Public Health Service Act (42 U.S.C. 
300ff-28(b)(1)(A)) is amended to read as follows:
                    ``(A) each of the several States and the District 
                of Columbia for a fiscal year shall be the greater of--
                            ``(i) $250,000; or
                            ``(ii) an amount determined under paragraph 
                        (2); and''.
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