[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[S. 662 Reported in Senate (RS)]






                                                       Calendar No. 641
106th CONGRESS
  2d Session
                                 S. 662

                          [Report No. 106-323]

   To amend title XIX of the Social Security Act to provide medical 
   assistance for certain women screened and found to have breast or 
      cervical cancer under a federally funded screening program.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 18, 1999

  Mr. Chafee (for himself, Ms. Mikulski, Mr. Moynihan, Ms. Snowe, Mr. 
Smith of Oregon, Mr. Harkin, Mr. Cochran, Mr. Durbin, Mrs. Murray, Mr. 
Leahy, Mr. Rockefeller, Mr. Lieberman, Mr. Lautenberg, Mrs. Feinstein, 
 Mr. Bingaman, Mr. Sarbanes, Mr. Hollings, Mr. Wellstone, Mr. Cleland, 
 Mr. Kennedy, Mr. Johnson, Mr. Robb, Mrs. Boxer, Mr. Reid, Mr. Kerrey, 
  Ms. Collins, Mr. Conrad, Mr. Bayh, Mr. Inouye, Mr. Torricelli, Mr. 
  Reed, Mr. Dodd, Mr. Akaka, Mr. Kerry, Mr. Dorgan, Mrs. Lincoln, Mr. 
    Murkowski, Mr. Schumer, Mr. Bond, Mr. Graham, Mr. Grassley, Mr. 
   Jeffords, Mr. Baucus, Ms. Landrieu, Mr. Edwards, Mr. Daschle, Mr. 
   Bryan, Mr. Byrd, Mr. Breaux, Mr. Hagel, Mr. Levin, Mr. Kohl, Mr. 
Specter, Mr. Wyden, Mr. Ashcroft, Mr. L. Chafee, Mr. Grams, Mr. Hatch, 
 Mr. Warner, Mr. Abraham, Mr. Bennett, Mrs. Hutchison, Mr. Crapo, Mr. 
McCain, Mr. Helms, Mr. Allard, Mr. Stevens, Mr. Lugar, Mr. Smith of New 
Hampshire, Mr. Biden, Mr. Frist, Mr. Gorton, and Mr. DeWine) introduced 
the following bill; which was read twice and referred to the Committee 
                               on Finance

                             June 27, 2000

                 Reported by Mr. Roth with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 A BILL


 
   To amend title XIX of the Social Security Act to provide medical 
   assistance for certain women screened and found to have breast or 
      cervical cancer under a federally funded screening program.

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

<DELETED>SECTION 1. OPTIONAL MEDICAID COVERAGE OF CERTAIN BREAST OR 
              CERVICAL CANCER PATIENTS.</DELETED>

<DELETED>    (a) Coverage as Optional Categorically Needy Group.--
</DELETED>
        <DELETED>    (1) In general.--Section 1902(a)(10)(A)(ii) of the 
        Social Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)) is 
        amended--</DELETED>
                <DELETED>    (A) in subclause (XIII), by striking 
                ``or'' at the end;</DELETED>
                <DELETED>    (B) in subclause (XIV), by adding ``or'' 
                at the end; and</DELETED>
                <DELETED>    (C) by adding at the end the 
                following:</DELETED>
                                <DELETED>    ``(XV) who are described 
                                in subsection (aa) (relating to certain 
                                breast or cervical cancer 
                                patients);''.</DELETED>
        <DELETED>    (2) Group described.--Section 1902 of the Social 
        Security Act (42 U.S.C. 1396a) is amended by adding at the end 
        the following:</DELETED>
<DELETED>    ``(aa) Individuals described in this paragraph are 
individuals who--</DELETED>
        <DELETED>    ``(1) are not described in subsection 
        (a)(10)(A)(i);</DELETED>
        <DELETED>    ``(2) have not attained age 65;</DELETED>
        <DELETED>    ``(3) have been screened for breast and cervical 
        cancer under the Centers for Disease Control and Prevention 
        breast and cervical cancer early detection program established 
        under title XV of the Public Health Service Act (42 U.S.C. 300k 
        et seq.) in accordance with the requirements of section 1504 of 
        that Act (42 U.S.C. 300n) and need treatment for breast or 
        cervical cancer; and</DELETED>
        <DELETED>    ``(4) are not otherwise covered under creditable 
        coverage, as defined in section 2701(c) of the Public Health 
        Service Act (45 U.S.C. 300gg(c)).''.</DELETED>
        <DELETED>    (3) Limitation on Benefits.--Section 1902(a)(10) 
        of the Social Security Act (42 U.S.C. 1396a(a)(10)) is amended 
        in the matter following subparagraph (F)--</DELETED>
                <DELETED>    (A) by striking ``and (XIII)'' and 
                inserting ``(XIII)''; and</DELETED>
                <DELETED>    (B) by inserting ``, and (XIV) the medical 
                assistance made available to an individual described in 
                subsection (aa) who is eligible for medical assistance 
                only because of subparagraph (A)(ii)(XV) shall be 
                limited to medical assistance provided during the 
                period in which such an individual requires treatment 
                for breast or cervical cancer'' before the 
                semicolon.</DELETED>
        <DELETED>    (4) Conforming amendments.--Section 1905(a) of the 
        Social Security Act (42 U.S.C. 1396d(a)) is amended in the 
        matter preceding paragraph (1)--</DELETED>
                <DELETED>    (A) in clause (x), by striking ``or'' at 
                the end;</DELETED>
                <DELETED>    (B) in clause (xi), by adding ``or'' at 
                the end; and</DELETED>
                <DELETED>    (C) by inserting after clause (xi) the 
                following:</DELETED>
        <DELETED>    ``(xii) individuals described in section 
        1902(aa),''.</DELETED>
<DELETED>    (b) Presumptive Eligibility.--</DELETED>
        <DELETED>    (1) In general.--Title XIX of the Social Security 
        Act (42 U.S.C. 1396 et seq.) is amended by inserting after 
        section 1920A the following:</DELETED>

   <DELETED>``presumptive eligibility for certain breast or cervical 
                       cancer patients</DELETED>

<DELETED>    ``Sec. 1920B. (a) State Option.--A State plan approved 
under section 1902 may provide for making medical assistance available 
to an individual described in section 1902(aa) (relating to certain 
breast or cervical cancer patients) during a presumptive eligibility 
period.</DELETED>
<DELETED>    ``(b) Definitions.--For purposes of this 
section:</DELETED>
        <DELETED>    ``(1) Presumptive eligibility period.--The term 
        `presumptive eligibility period' means, with respect to an 
        individual described in subsection (a), the period that--
        </DELETED>
                <DELETED>    ``(A) begins with the date on which a 
                qualified entity determines, on the basis of 
                preliminary information, that the individual is 
                described in section 1902(aa); and</DELETED>
                <DELETED>    ``(B) ends with (and includes) the earlier 
                of--</DELETED>
                        <DELETED>    ``(i) the day on which a 
                        determination is made with respect to the 
                        eligibility of such individual for services 
                        under the State plan; or</DELETED>
                        <DELETED>    ``(ii) in the case of such an 
                        individual who does not file an application by 
                        the last day of the month following the month 
                        during which the entity makes the determination 
                        referred to in subparagraph (A), such last 
                        day.</DELETED>
        <DELETED>    ``(2) Qualified entity.--</DELETED>
                <DELETED>    ``(A) In general.--Subject to subparagraph 
                (B), the term `qualified entity' means any entity 
                that--</DELETED>
                        <DELETED>    ``(i) is eligible for payments 
                        under a State plan approved under this title; 
                        and</DELETED>
                        <DELETED>    ``(ii) is determined by the State 
                        agency to be capable of making determinations 
                        of the type described in paragraph 
                        (1)(A).</DELETED>
                <DELETED>    ``(B) Regulations.--The Secretary may 
                issue regulations further limiting those entities that 
                may become qualified entities in order to prevent fraud 
                and abuse and for other reasons.</DELETED>
                <DELETED>    ``(C) Rule of construction.--Nothing in 
                this paragraph shall be construed as preventing a State 
                from limiting the classes of entities that may become 
                qualified entities, consistent with any limitations 
                imposed under subparagraph (B).</DELETED>
<DELETED>    ``(c) Administration.--</DELETED>
        <DELETED>    ``(1) In general.--The State agency shall provide 
        qualified entities with--</DELETED>
                <DELETED>    ``(A) such forms as are necessary for an 
                application to be made by an individual described in 
                subsection (a) for medical assistance under the State 
                plan; and</DELETED>
                <DELETED>    ``(B) information on how to assist such 
                individuals in completing and filing such 
                forms.</DELETED>
        <DELETED>    ``(2) Notification requirements.--A qualified 
        entity that determines under subsection (b)(1)(A) that an 
        individual described in subsection (a) is presumptively 
        eligible for medical assistance under a State plan shall--
        </DELETED>
                <DELETED>    ``(A) notify the State agency of the 
                determination within 5 working days after the date on 
                which determination is made; and</DELETED>
                <DELETED>    ``(B) inform such individual at the time 
                the determination is made that an application for 
                medical assistance under the State plan is required to 
                be made by not later than the last day of the month 
                following the month during which the determination is 
                made.</DELETED>
        <DELETED>    ``(3) Application for medical assistance.--In the 
        case of an individual described in subsection (a) who is 
        determined by a qualified entity to be presumptively eligible 
        for medical assistance under a State plan, the individual shall 
        apply for medical assistance under such plan by not later than 
        the last day of the month following the month during which the 
        determination is made.</DELETED>
<DELETED>    ``(d) Payment.--Notwithstanding any other provision of 
this title, medical assistance that--</DELETED>
        <DELETED>    ``(1) is furnished to an individual described in 
        subsection (a)--</DELETED>
                <DELETED>    ``(A) during a presumptive eligibility 
                period;</DELETED>
                <DELETED>    ``(B) by a entity that is eligible for 
                payments under the State plan; and</DELETED>
        <DELETED>    ``(2) is included in the care and services covered 
        by the State plan;</DELETED>
<DELETED>shall be treated as medical assistance provided by such plan 
for purposes of section 1903(a)(5)(B).''.</DELETED>
        <DELETED>    (2) Conforming amendments.--</DELETED>
                <DELETED>    (A) Section 1902(a)(47) of the Social 
                Security Act (42 U.S.C. 1396a(a)(47)) is amended by 
                inserting before the semicolon at the end the 
                following: ``and provide for making medical assistance 
                available to individuals described in subsection (a) of 
                section 1920B during a presumptive eligibility period 
                in accordance with such section''.</DELETED>
                <DELETED>    (B) Section 1903(u)(1)(D)(v) of such Act 
                (42 U.S.C. 1396b(u)(1)(D)(v)) is amended--</DELETED>
                        <DELETED>    (i) by striking ``or for'' and 
                        inserting ``, for''; and</DELETED>
                        <DELETED>    (ii) by inserting before the 
                        period the following: ``, or for medical 
                        assistance provided to an individual described 
                        in subsection (a) of section 1920B during a 
                        presumptive eligibility period under such 
                        section''.</DELETED>
<DELETED>    (c) Enhanced Match.--Section 1903(a)(5) of the Social 
Security Act (42 U.S.C. 1396b(a)(5)) is amended--</DELETED>
        <DELETED>    (1) by striking ``an'' and inserting ``(A) 
        an'';</DELETED>
        <DELETED>    (2) by adding ``plus'' after the semicolon; 
        and</DELETED>
        <DELETED>    (3) by adding at the end the following:</DELETED>
        <DELETED>    ``(B) an amount equal to 75 percent of the sums 
        expended during such quarter which are attributable to the 
        offering, arranging, and furnishing (directly or on a contract 
        basis) of medical assistance to an individual described in 
        section 1902(aa); plus''.</DELETED>
<DELETED>    (d) Effective Date.--The amendments made by this section 
apply to medical assistance furnished on or after October 1, 1999, 
without regard to whether final regulations to carry out such 
amendments have been promulgated by such date.</DELETED>

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Breast and Cervical Cancer 
Prevention and Treatment Act of 2000''.

SEC. 2. OPTIONAL MEDICAID COVERAGE OF CERTAIN BREAST OR CERVICAL CANCER 
              PATIENTS.

    (a) Coverage as Optional Categorically Needy Group.--
            (1) In general.--Section 1902(a)(10)(A)(ii) of the Social 
        Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)) is amended--
                    (A) in subclause (XVI), by striking ``or'' at the 
                end;
                    (B) in subclause (XVII), by adding ``or'' at the 
                end; and
                    (C) by adding at the end the following:
                                    ``(XVIII) who are described in 
                                subsection (aa) (relating to certain 
                                breast or cervical cancer patients);''.
            (2) Group described.--Section 1902 of the Social Security 
        Act (42 U.S.C. 1396a) is amended by adding at the end the 
        following:
    ``(aa) Individuals described in this subsection are individuals 
who--
            ``(1) are not described in subsection (a)(10)(A)(i);
            ``(2) have not attained age 65;
            ``(3) have been screened for breast and cervical cancer 
        under the Centers for Disease Control and Prevention breast and 
        cervical cancer early detection program established under title 
        XV of the Public Health Service Act (42 U.S.C. 300k et seq.) in 
        accordance with the requirements of section 1504 of that Act 
        (42 U.S.C. 300n) and need treatment for breast or cervical 
        cancer; and
            ``(4) are not otherwise covered under creditable coverage, 
        as defined in section 2701(c) of the Public Health Service Act 
        (42 U.S.C. 300gg(c)).''.
            (3) Limitation on Benefits.--Section 1902(a)(10) of the 
        Social Security Act (42 U.S.C. 1396a(a)(10)) is amended in the 
        matter following subparagraph (G)--
                    (A) by striking ``and (XIII)'' and inserting 
                ``(XIII)''; and
                    (B) by inserting ``, and (XIV) the medical 
                assistance made available to an individual described in 
                subsection (aa) who is eligible for medical assistance 
                only because of subparagraph (A)(10)(ii)(XVIII) shall 
                be limited to medical assistance provided during the 
                period in which such an individual requires treatment 
                for breast or cervical cancer'' before the semicolon.
            (4) Conforming amendments.--Section 1905(a) of the Social 
        Security Act (42 U.S.C. 1396d(a)) is amended in the matter 
        preceding paragraph (1)--
                    (A) in clause (xi), by striking ``or'' at the end;
                    (B) in clause (xii), by adding ``or'' at the end; 
                and
                    (C) by inserting after clause (xii) the following:
            ``(xiii) individuals described in section 1902(aa),''.
    (b) Presumptive Eligibility.--
            (1) In general.--Title XIX of the Social Security Act (42 
        U.S.C. 1396 et seq.) is amended by inserting after section 
        1920A the following:

    ``presumptive eligibility for certain breast or cervical cancer 
                                patients

    ``Sec. 1920B. (a) State Option.--A State plan approved under 
section 1902 may provide for making medical assistance available to an 
individual described in section 1902(aa) (relating to certain breast or 
cervical cancer patients) during a presumptive eligibility period.
    ``(b) Definitions.--For purposes of this section:
            ``(1) Presumptive eligibility period.--The term 
        `presumptive eligibility period' means, with respect to an 
        individual described in subsection (a), the period that--
                    ``(A) begins with the date on which a qualified 
                entity determines, on the basis of preliminary 
                information, that the individual is described in 
                section 1902(aa); and
                    ``(B) ends with (and includes) the earlier of--
                            ``(i) the day on which a determination is 
                        made with respect to the eligibility of such 
                        individual for services under the State plan; 
                        or
                            ``(ii) in the case of such an individual 
                        who does not file an application by the last 
                        day of the month following the month during 
                        which the entity makes the determination 
                        referred to in subparagraph (A), such last day.
            ``(2) Qualified entity.--
                    ``(A) In general.--Subject to subparagraph (B), the 
                term `qualified entity' means any entity that--
                            ``(i) is eligible for payments under a 
                        State plan approved under this title; and
                            ``(ii) is determined by the State agency to 
                        be capable of making determinations of the type 
                        described in paragraph (1)(A).
                    ``(B) Regulations.--The Secretary may issue 
                regulations further limiting those entities that may 
                become qualified entities in order to prevent fraud and 
                abuse and for other reasons.
                    ``(C) Rule of construction.--Nothing in this 
                paragraph shall be construed as preventing a State from 
                limiting the classes of entities that may become 
                qualified entities, consistent with any limitations 
                imposed under subparagraph (B).
    ``(c) Administration.--
            ``(1) In general.--The State agency shall provide qualified 
        entities with--
                    ``(A) such forms as are necessary for an 
                application to be made by an individual described in 
                subsection (a) for medical assistance under the State 
                plan; and
                    ``(B) information on how to assist such individuals 
                in completing and filing such forms.
            ``(2) Notification requirements.--A qualified entity that 
        determines under subsection (b)(1)(A) that an individual 
        described in subsection (a) is presumptively eligible for 
        medical assistance under a State plan shall--
                    ``(A) notify the State agency of the determination 
                within 5 working days after the date on which 
                determination is made; and
                    ``(B) inform such individual at the time the 
                determination is made that an application for medical 
                assistance under the State plan is required to be made 
                by not later than the last day of the month following 
                the month during which the determination is made.
            ``(3) Application for medical assistance.--In the case of 
        an individual described in subsection (a) who is determined by 
        a qualified entity to be presumptively eligible for medical 
        assistance under a State plan, the individual shall apply for 
        medical assistance under such plan by not later than the last 
        day of the month following the month during which the 
        determination is made.
    ``(d) Payment.--Notwithstanding any other provision of this title, 
medical assistance that--
            ``(1) is furnished to an individual described in subsection 
        (a)--
                    ``(A) during a presumptive eligibility period;
                    ``(B) by a entity that is eligible for payments 
                under the State plan; and
            ``(2) is included in the care and services covered by the 
        State plan,
shall be treated as medical assistance provided by such plan for 
purposes of clause (4) of the first sentence of section 1905(b).''.
            (2) Conforming amendments.--
                    (A) Section 1902(a)(47) of the Social Security Act 
                (42 U.S.C. 1396a(a)(47)) is amended by inserting before 
                the semicolon at the end the following: ``and provide 
                for making medical assistance available to individuals 
                described in subsection (a) of section 1920B during a 
                presumptive eligibility period in accordance with such 
                section''.
                    (B) Section 1903(u)(1)(D)(v) of such Act (42 U.S.C. 
                1396b(u)(1)(D)(v)) is amended--
                            (i) by striking ``or for'' and inserting 
                        ``, for''; and
                            (ii) by inserting before the period the 
                        following: ``, or for medical assistance 
                        provided to an individual described in 
                        subsection (a) of section 1920B during a 
                        presumptive eligibility period under such 
                        section''.
    (c) Enhanced Match.--The first sentence of section 1905(b) of the 
Social Security Act (42 U.S.C. 1396d(b)) is amended--
            (1) by striking ``and'' before ``(3)''; and
            (2) by inserting before the period at the end the 
        following: ``, and (4) the Federal medical assistance 
        percentage shall be equal to the enhanced FMAP described in 
        section 2105(b) with respect to medical assistance provided to 
        individuals who are eligible for such assistance only on the 
        basis of section 1902(a)(10)(A)(ii)(XVIII)''.
    (d) Effective Date.--The amendments made by this section apply to 
medical assistance for items and services furnished on or after October 
1, 2000, without regard to whether final regulations to carry out such 
amendments have been promulgated by such date.




                                                       Calendar No. 641

106th CONGRESS

  2d Session

                                 S. 662

                          [Report No. 106-323]

_______________________________________________________________________

                                 A BILL

   To amend title XIX of the Social Security Act to provide medical 
   assistance for certain women screened and found to have breast or 
      cervical cancer under a federally funded screening program.

_______________________________________________________________________

                             June 27, 2000

                       Reported with an amendment