[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2627 Introduced in House (IH)]







107th CONGRESS
  1st Session
                                H. R. 2627

   To amend title XIX of the Social Security Act to permit uninsured 
families and individuals to obtain coverage under the medicaid program, 
   to assure coverage of doctor's visits, prescription drugs, mental 
   health services, long-term care services, alcohol and drug abuse 
treatment services, and all other medically necessary services, and for 
                            other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 25, 2001

 Mr. Conyers (for himself, Mrs. Christensen, Mr. Bonior, Mrs. Jones of 
 Ohio, Ms. Solis, Mr. Davis of Illinois, Ms. Lee, Ms. Schakowsky, Mr. 
 Thompson of Mississippi, and Mr. Rush) introduced the following bill; 
       which was referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
   To amend title XIX of the Social Security Act to permit uninsured 
families and individuals to obtain coverage under the medicaid program, 
   to assure coverage of doctor's visits, prescription drugs, mental 
   health services, long-term care services, alcohol and drug abuse 
treatment services, and all other medically necessary services, and for 
                            other purposes.

    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 ``Working American Families Access to 
Health Care Act of 2001'' or ``Medi-Access Act of 2001''.

SEC. 2. MEDI-ACCESS PROGRAM PROVIDING INSURANCE COVERAGE FOR LOW TO 
              MODERATE INCOME UNINSURED WORKING FAMILIES .

    (a) Availability of Medicaid Coverage for Uninsured Families Under 
Medi-Access.--
            (1) In general.--
                    (A) Coverage for families with income below 200 
                percent of the poverty line with no premium required.--
                Section 1916 of the Social Security Act (42 U.S.C. 
                1396o) is amended--
                            (i) in subsection (a), by striking 
                        ``Subject to subsection (g)'' and inserting 
                        ``Subject to subsections (g) and (h)''; and
                            (ii) by adding at the end the following:
    ``(h)(1) With respect to an individual provided medical assistance 
only under subclause (VIII) of section 1902(a)(10)(A)(i), if the 
individual's family income--
            ``(A) does not exceed 200 percent of the poverty line (as 
        defined in section 2110(c)(5)) applicable to a family of the 
        size involved, a State shall not require payment of any monthly 
        premium;''.
                    (B) Coverage for uninsured lower middle class 
                families.--Section 1916(h) of such Act, as so added, is 
                amended--
                            (i) by adding at the end of paragraph (1) 
                        the following new subparagraphs:
            ``(B) exceeds 200 percent (but does not exceed 250 percent) 
        of such poverty line applicable to a family of the size 
        involved, a State shall require such individuals to pay a 
        monthly premium equal to $15 per month for each individual in 
        the family so covered, but not to exceed $25 per month for all 
        individuals in the family;
            ``(C) exceeds 250 percent (but does not exceed 300 percent) 
        of such poverty line applicable to a family of the size 
        involved, a State shall require such individuals to pay a 
        monthly premium equal to $25 per month for each individual in 
        the family so covered, but not to exceed $50 per month for all 
        individuals in the family;
            ``(D) exceeds 300 percent (but does not exceed 350 percent) 
        of such poverty line, the State shall require such individuals 
        to pay a monthly premium equal to $50 per month for each 
        individual in the family so covered, but not to exceed $150 per 
        month for all individuals in the family;''; and
                            (ii) by adding at the end the following new 
                        paragraphs:
    ``(2) A State may enter into an arrangement with an employer that 
employs at least 2, but fewer than 51, employees under which the 
employer will pay directly for premiums established under this 
subsection.
    ``(3) A State shall provide for billing for premiums under this 
subsection once every month. The State shall include in such a billing 
information on any changes or information alerts relevant to coverage 
under this title. The State shall have a toll-free number where an 
enrollee may call for any information about the Medi-Access program or 
in the event that the State seeks to terminate coverage of a family or 
individual under this title due to nonpayment of a premium or any other 
reason.
    ``(4) Nothing in this subsection shall be construed as authorizing 
the use of premiums collected under this subsection for vouchers for 
the purchase of private health insurance.''.
                    (C) Expansion of eligibility for uninsured middle 
                class families with income between 350 and 600 percent 
                of the poverty line.--Section 1902 of such Act (42 
                U.S.C. 1396a) is amended--
                            (i) in subsection (a)(10)(A)(i)--
                                    (I) by striking ``or'' at the end 
                                of subclause (VI);
                                    (II) by striking the semicolon at 
                                the end of subclause (VII) and 
                                inserting ``, or''; and
                                    (III) by adding at the end the 
                                following new subclause:
                                    ``(VIII) described in subsection 
                                (cc);''; and
                            (ii) by adding at the end, as amended by 
                        section 2(a) of the Breast and Cervical Cancer 
                        Prevention and Treatment Act of 2000 (Public 
                        Law 106-354; 114 Stat. 1381) and section 702(b) 
                        of the Medicare, Medicaid, and SCHIP Benefits 
                        Improvement and Protection Act of 2000 (as 
                        enacted into law by section 1(a)(6) of Public 
                        Law 106-554), the following new subsection:
    ``(cc)(1) For purposes of (a)(10)(A)(i)(VIII), individuals 
described in this subsection are individuals who meet the following 
requirements:
            ``(A) The income of the individual's family does not exceed 
        350 percent of the poverty line (as defined in section 
        2110(c)(5)) applicable to a family of the size involved; except 
        that beginning on January 1, 2004, the requirement of this 
        subparagraph shall or may be waived under paragraph (2).
            ``(B) The individual is not otherwise described or covered 
        under this title under any other provision.
            ``(C) Subject to paragraph (2), the individual does not 
        have creditable coverage (described in section 2701(c)(1) of 
        the Public Health Service Act, but not taking into account 
        subparagraph (F) of that section or eligibility for benefits 
        under title XXI).
    ``(2) The requirements of subparagraphs (A) and (C) of paragraph 
(1) shall not apply, on or after January 1, 2004, in the case of a 
family or individual the income of which does not exceed 600 percent of 
the poverty line (as defined in section 2110(c)(5)), if any of the 
following is demonstrated with respect to that family or individual:
            ``(A) The family or individual has applied for and been 
        denied in writing coverage under private health insurance 
        coverage for reasons relating to medical underwriting.
            ``(B) The family or individual is covered under private 
        health insurance coverage, has sought benefits under the 
        coverage for specific procedures, medications, or tests 
        recommended by a physician, but has been denied in writing such 
        benefits, whether or not such denial is due to limitations of 
        such coverage, the application of any pre-existing condition 
        exclusion, or any other reason.
            ``(C) Because of pre-existing conditions or risks of the 
        family, the premiums for coverage of the family or individual 
        under private health insurance coverage are at least 200 
        percent of the average private market premium rate for the same 
        or similar coverage of such a family or individual in the area 
        involved.
    ``(3) An individual who is described in this subsection is eligible 
for medical assistance without regard to the value of the individual's 
or individual family's automobiles, land, or home or the amount of any 
other assets or resources of the individual or the individual's 
family.''.
                    (D) Expansion of eligibility on a case-by-case 
                hardship basis for uninsured families with income above 
                600 percent of the poverty line who cannot otherwise 
                access health insurance coverage and who have serious 
                or life-threatening illnesses.--Section 1902(cc)(1) of 
                such Act, as added by subparagraph (C)(ii), is 
                amended--
                            (i) in subparagraph (A) by inserting ``or 
                        (4)'' after ``paragraph (2)''; and
                            (ii) by adding at the end the following new 
                        paragraph:
    ``(4) A State may, in the State's discretion and effective on and 
after January 1, 2004, waive the requirements of subparagraphs (A) and 
(C) on a case-by-case basis based on hardship for individuals and 
families the income of which exceeds 600 percent of the poverty line 
(as defined in section 2110(c)(5)) and who meet any of the conditions 
described in paragraph (2).''.
                    (E) Premiums for uninsured individuals with incomes 
                higher than 350 percent of the poverty line.--Effective 
                January 1, 2004, section 1916(h)(1) of the Social 
                Security Act, as added by subparagraph (A), is further 
                amended by adding at the end the following:
            ``(E) exceeds 350 percent (but does not exceed 400 percent) 
        of such poverty line, the State shall require such individuals 
        to pay a monthly premium equal to $50 per month for each 
        individual in the family so covered, but not to exceed $150 per 
        month for all individuals in the family;
            ``(F) exceeds 400 percent (but does not exceed 500 percent) 
        of such poverty line, the State shall require such individuals 
        to pay a monthly premium equal to $100 per month for each 
        individual in the family so covered, but not to exceed $250 per 
        month for all individuals in the family;
            ``(G) exceeds 500 percent (but does not exceed 600 percent) 
        of such poverty line, the State shall require such individuals 
        to pay a monthly premium equal to $150 per month for each 
        individual in the family so covered, but not to exceed $350 per 
        month for all individuals in the family; or
            ``(H) exceeds 600 percent of such poverty line, the State 
        shall require such individuals to pay a monthly premium equal 
        to $200 per month for each individual in the family so covered, 
        but not to exceed $550 per month for all individuals in the 
        family.''.
                    (F) Miscellaneous conforming amendment.--(i) 
                Section 1903(f)(4) of such Act (42 U.S.C. 1396b(f)(4)) 
                is amended by inserting ``1902(a)(10)(A)(i)(VIII),'' 
                after ``1902(a)(10)(A)(i)(VII),''.
                    (G) Technical amendments.--(i) Section 1902 of such 
                Act (42 U.S.C. 1396a), as amended by section 702(b) of 
                the Medicare, Medicaid, and SCHIP Benefits Improvement 
                and Protection Act of 2000 (as enacted into law by 
                section 1(a)(6) of Public Law 106-554), is amended by 
                redesignating the subsection (aa) added by such section 
                as subsection (bb).
                    (ii) Section 1902(a)(15) of such Act (42 U.S.C. 
                1396a(a)(15)), as added by section 702(a)(2) of the 
                Medicare, Medicaid, and SCHIP Benefits Improvement and 
                Protection Act of 2000 (as so enacted into law), is 
                amended by striking ``subsection (aa)'' and inserting 
                ``subsection (bb)''.
                    (iii) Section 1915(b) of such Act (42 U.S.C. 
                1396n(b)), as amended by section 702(c)(2) of the 
                Medicare, Medicaid, and SCHIP Benefits Improvement and 
                Protection Act of 2000 (as so enacted into law), is 
                amended by striking ``1902(aa)'' and inserting 
                ``1902(bb)''.
            (2) Clarification of coverage of uninsured men and women, 
        regardless of marital status.--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 (xi);
                    (B) by adding ``or'' at the end of clause (xii); 
                and
                    (C) by inserting after clause (xii) the following 
                new clause:
            ``(xiii) individuals described in section 1902(cc) (which 
        includes uninsured men and women, regardless of marital 
        status),''.
            (3) Making presumptive eligibility mandatory.--
                    (A) In general.--Sections 1920 and 1920A of such 
                Act (42 U.S.C. 1396r-1, 1396r-1a) are each amended by 
                striking ``may provide'' and inserting ``shall 
                provide''.
                    (B) Expansion of presumptive eligibility to all 
                individuals.--Title XIX of the Act is amended by 
                inserting after section 1920A the following new 
                section:

            ``presumptive eligibility for other individuals

    ``Sec. 1920B. (a) A State plan approved under section 1902 shall 
provide for making medical assistance with respect to health care items 
and services covered under the State plan available to all individuals 
during a presumptive eligibility period.
    ``(b) For purposes of this section:
            ``(1) The term `presumptive eligibility period' means, with 
        respect to an individual, the period that--
                    ``(A) begins with the date on which a qualified 
                entity determines, on the basis of preliminary 
                information, that the family income of the individual 
                does not exceed the applicable income level of 
                eligibility under the State plan, and
                    ``(B) ends with (and includes) the earlier of--
                            ``(i) the day on which a determination is 
                        made with respect to the eligibility of the 
                        individual for medical assistance under the 
                        State plan, or
                            ``(ii) in the case of an individual on 
                        whose behalf an application is not filed 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)(A) Subject to subparagraph (B), the term `qualified 
        entity' means any entity that--
                    ``(i)(I) is eligible for payments under a State 
                plan approved under this title and provides items and 
                services described in subsection (a) or (II) is a 
                qualified provider described in section 1920(b)(2); and
                    ``(ii) is determined by the State agency to be 
                capable of making determinations of the type described 
                in paragraph (1)(A).
            ``(B) 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) Nothing in this section 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)(1) The State agency shall provide qualified entities with--
            ``(A) such forms as are necessary for an application to be 
        made on behalf of a child for medical assistance under the 
        State plan, and
            ``(B) information on how to assist parents, guardians, and 
        other persons in completing and filing such forms.
    ``(2) A qualified entity that determines under subsection (b)(1)(A) 
that an individual 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 the 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) In the case of an individual who is determined by a qualified 
entity to be presumptively eligible for medical assistance under a 
State plan, the individual shall make application 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) Notwithstanding any other provision of this title, medical 
assistance for items and services described in subsection (a) that--
            ``(1) are furnished to an individual--
                    ``(A) during a presumptive eligibility period,
                    ``(B) by an entity that is eligible for payments 
                under the State plan; and
            ``(2) are included in the care and services covered by a 
        State plan;
shall be treated as medical assistance provided by such plan for 
purposes of section 1903.''.
                    (C) Conforming amendment.--Section 1902(a)(47) of 
                such Act (42 U.S.C. 1396a(a)(47)) is amended by 
                striking ``at the option of the State,''.
            (4) Minimum eligibility period for categorically needy.--
        Section 1902(e) of such Act (42 U.S.C. 1396a(e)) is amended by 
        adding at the end the following new paragraph:
    ``(13) The State plan shall provide that an individual 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 end of the 12-month period following the date 
of such determination.''.
            (5) Coverage of legal immigrants.--Section 1902 of such Act 
        (42 U.S.C. 1396a), as amended by paragraph (1)(C)(ii), is 
        amended by adding at the end the following new subsection:
    ``(dd) Notwithstanding any other provision of law, the provisions 
of title IV of the Personal Responsibility and Work Opportunity 
Reconciliation Act of 1996 (and of section 213A of the Immigration and 
Nationality Act) shall not apply to eligibility for medical assistance 
under this title for individuals who are lawful permanent residents of 
the United States.''.
            (6) Mail-in and on-line application process.--Section 
        1902(a)(8) of such Act (42 U.S.C. 1396a(a)(8)) is amended after 
        ``opportunity to do so'' the following: ``and may do so through 
        an application submitted by mail or through electronic means 
        through the Internet, provide that applications are not longer 
        than 2 pages and are made available in different languages in 
        order to provide a fair and accessible application process,''.
            (7) Limitations on other cost-sharing.--Section 1916 of 
        such Act (42 U.S.C. 1396o), as amended by paragraph (1)(A), is 
        further amended--
                    (A) in subsection (a), by striking ``(g) and (h)'' 
                and inserting ``(g), (h), and (i)''; and
                    (B) by adding at the end the following new 
                subsection:
    ``(i) With respect to an individual provided medical assistance 
only under subclause (VIII) of section 1902(a)(10)(A)(i), 
notwithstanding the preceding provisions of this section, if the 
individual's family income--
            ``(1) does not exceed 200 percent of the poverty line (as 
        defined in section 2110(c)(5)) applicable to a family of the 
        size involved, a State shall not impose any deduction, cost 
        sharing or similar charge; or
            ``(2) exceeds 200 percent of such poverty line, a State 
        shall impose--
                    ``(A) a copayment of $10 for each chiropractic 
                service visit; and
                    ``(B) $5 for each doctor's visit, prescription 
                dispensed, laboratory test, or other item or service;
        except that no copayment shall be imposed under this paragraph 
        with respect to preventive services (including pap smears, 
        immunizations, vaccinations, flu shots, annual check-ups, 
        screening mammography, and pre-natal and post-natal care), or 
        with respect to early and periodic screening, diagnosis, and 
        treatment services under section 1905(a)(4)(B) and the total of 
        such copayments may not exceed $30 in a month for a family the 
        income of which does not exceed 300 percent of such poverty 
        line. No individual may be denied benefits under this title by 
        virtue of a failure to pay a copayment under this section.''.
            (8) Conforming termination of schip.--With respect to items 
        and services furnished on or after October 1, 2002, no Federal 
        payments shall be made under section 2105(a) of the Social 
        Security Act (42 U.S.C. 1397ee(a)).
            (9) Requiring crowd-out plan.--No payment may be made to a 
        State under title XIX of the Social Security Act under the 
        amendments made by this subsection unless the State has 
        developed and implemented a plan that, to the maximum extent 
        possible, would minimize businesses terminating private group 
        health coverage for employees who would be eligible for medical 
        assistance under the Medi-Access program provided under such 
        amendments.
    (b) Requiring Coverage of Early and Periodic Screening, Diagnostic, 
and Treatment Services (EPSDT), Coverage of Rehabilitative Services for 
Disabled or Developmentally Delayed Children, Prescription Drugs, 
Mental Health and Psychiatric Services, Assistive Technology Devices 
and Services, Durable Medical Equipment, Drug and Alcohol Treatment 
Services for All Medicaid Eligible Individuals, Assistive Technology 
Devices and Services, Durable Medical Equipment, Prenatal and Postnatal 
Care, Reproductive Health Services, and Personal Assistive Services.--
            (1) Requiring coverage of screening, dental, vision, 
        hearing, and followup services (epsdt) for individuals of all 
        ages.--
                    (A) In general.--Section 1905(a)(4)(B) of such Act 
                (42 U.S.C. 1396d(a)(4)(B)) is amended by striking `` 
                and are under the age of 21''.
                    (B) Conforming amendments.--Section 1905(r) of such 
                Act (42 U.S.C. 1396d(r)) is amended, in each of 
                paragraphs (1)(A)(i), (2)(A)(i), (3)(A)(i), and 
                (4)(A)(i), by inserting ``, including for children, 
                organizations'' after ``organizations''.
            (2) Requiring coverage of rehabilitative services and 
        assistive technologies for disabled or developmentally delayed 
        children.--Section 1905(r)(5) of such Act (42 U.S.C. 
        1396d(r)(5)) is amended by inserting before the period at the 
        end the following: ``, and including rehabilitative services 
        and assistive technologies for disabled or developmentally 
        disabled children, regardless of whether the disability was 
        discovered by the screening services''.
            (3) Requiring coverage of prescription drugs, including 
        drugs and services for treatment of hiv infection or aids.--
        Section 1902(a)(10) of such Act (42 U.S.C. 1396a(a)(10)) is 
        amended--
                    (A) in subparagraph (A), by inserting ``(12),'' 
                after ``(5),'';
                    (B) in subparagraph (D)(iv), by inserting ``, 
                (12),'' after ``(5)'';
                    (C) by striking ``and'' at the end of subparagraph 
                (F);
                    (D) by adding ``and'' at the end of subparagraph 
                (G); and
                    (E) by inserting after subparagraph (G) the 
                following new subparagraph:
                    ``(H) that the plan shall not deny medical 
                assistance for prescribed drugs for individuals 
                described in subparagraph (A)(i) if the drugs have been 
                prescribed by a treating physician (or any other 
                treating health care professional authorized under law 
                to prescribe the drugs), including drugs and services 
                prescribed for treatment of HIV infection or AIDS;''.
            (4) Requiring coverage of drug and alcohol treatment 
        services.--
                    (A) Requirement.--Section 1902(a)(10) of such Act 
                (42 U.S.C. 1396a(a)(10)) is amended--
                            (i) in subparagraph (A), by striking ``(17) 
                        and (21)'' and inserting ``(10), (17), (21), 
                        and (27)''; and
                            (ii) in subparagraph (D)(iv), by striking 
                        ``and (17)'' and inserting ``(10), (17), and 
                        (27)'' and by striking ``through (24)'' and 
                        inserting ``through (27)''.
                    (B) Drug and alcohol treatment services 
                described.--Section 1905(a) of such Act (42 U.S.C. 
                1396d(a)) is amended--
                            (i) by striking ``and'' at the end of 
                        paragraph (26);
                            (ii) by redesignating paragraph (27) as 
                        paragraph (28); and
                            (iii) by inserting after paragraph (26) the 
                        following new paragraph:
            ``(27) alcohol and drug treatment services, including 
        coverage of inpatient and outpatient treatment without 
        durational restriction; and''.
            (5) Requiring coverage of inpatient and outpatient mental 
        health and psychiatric services.--Section 1905(a)(5) of such 
        Act (42 U.S.C. 1396d(a)(5)) is amended--
                    (A) by striking ``and'' before ``(B)''; and
                    (B) by inserting before the semicolon at the end 
                the following: ``, and (C) mental health services and 
                psychiatric services furnished by a physician or other 
                qualified mental health professional, whether furnished 
                on an inpatient or outpatient basis''.
            (6) Requiring coverage of mental health services without 
        durational restriction.--Section 1902(a)(10) of such Act (42 
        U.S.C. 1396a(a)(10)) is amended--
                    (A) by striking ``and'' at the end of subparagraph 
                (F);
                    (B) by adding ``and'' at the end of subparagraph 
                (G); and
                    (C) by inserting after subparagraph (G) the 
                following new subparagraph:
                    ``(H) that does not impose durational limits with 
                respect to medical assistance for mental health 
                services;''.
            (7) Requiring coverage of some chiropractic services.--
        Section 1902(a)(10)(A) of such Act (42 U.S.C. 1396a(a)(10)(A)) 
        is amended, in the matter before clause (i), by inserting ``and 
        professional services of chiropractors (other than electrical 
        stimulation and for up to 2 visits per month)'' after ``(21) of 
        section 1905(a)''.
            (8) Requiring coverage of assistive technology devices and 
        services, durable medical equipment, sexually-transmitted 
        disease (std) diagnosis and treatment, and prenatal and post-
        natal care.--Section 1905(a)(3) of such Act (42 U.S.C. 
        1396d(a)(3)) is amended by inserting before the semicolon at 
        the end the following: ``, assistive technology devices and 
        services, durable medical equipment, diagnosis and treatment 
        for sexually-transmitted disease, and prenatal and postnatal 
        care''.
            (9) Requiring coverage of reproductive health services.--
        Section 1905(a)(4)(C) of such Act (42 U.S.C. 1396d(a)(4)(C)) is 
        amended by inserting ``, including reproductive health services 
        such as fertility drugs and contraceptives'' after ``such 
        services and supplies''.
            (10) Requiring coverage for licensed personal assistive 
        services (home health aides) for the physically or mentally 
        disabled who need assistance with daily living chores.--
                    (A) Requirement.--Section 1902(a)(10) of such Act 
                (42 U.S.C. 1396a(a)(10)), as amended by paragraph 
                (4)(A), is amended--
                            (i) in subparagraph (A), by striking ``and 
                        (27)'' and inserting ``(27), and (28); and
                            (ii) in subparagraph (D)(iv), by striking 
                        ``and (27)'' and inserting ``(27), and (28)'' 
                        and by striking ``through (27)'' and inserting 
                        ``through (28)''.
                    (B) Personal assistive services described.--Section 
                1905(a) of such Act (42 U.S.C. 1396d(a)), as amended by 
                paragraph (4)(B), is amended--
                            (i) by striking ``and'' at the end of 
                        paragraph (27);
                            (ii) by redesignating paragraph (28) as 
                        paragraph (29); and
                            (iii) by inserting after paragraph (27) the 
                        following new paragraph:
            ``(28) licensed personal assistive services provided by a 
        home health aide or similarly trained individual for the 
        physically or mentally disabled who need assistance with daily 
        living chores; and''.
    (c) FMAP.--
            (1) Federal assumption of increased expenses.--Section 1903 
        of such Act (42 U.S.C. 1396b) is amended by inserting after 
        subsection (g) the following new subsection:
    ``(h) Notwithstanding subsection (a), with respect to expenditures 
incurred under the plan which are attributable to additional 
populations, or services, covered as a result of the implementation of 
the amendments made by the Working American Families Access to Health 
Care Act of 2001 (including administrative costs related to such 
implementation), the percentages otherwise specified under such 
subsection with respect to such expenditures shall be increased to 100 
percent. For purposes of applying the previous sentence, the fact that 
a population or service was covered under this title under a waiver 
under section 1115 shall not be taken into account and shall not 
prevent such sentence applying to such population or service.''.
            (2) Special rules in applying to territories.--(A) Section 
        1905(b)(2) of such Act (42 U.S.C. 1396d(b)(2)) is amended by 
        striking ``50 percent'' and inserting ``70 percent''.
            (B) Section 1108 of such Act (42 U.S.C. 1308) is amended--
                    (i) in subsection (f), by striking ``subsection 
                (g)'' and inserting ``subsections (g) and (h)''; and
                    (ii) by adding at the end the following new 
                subsection:
    ``(h) The limitations under subsection (f)--
            ``(1) shall not apply with respect to expenditures 
        described in section 1903(h); and
            ``(2) with respect to other expenditures made for fiscal 
        years beginning with fiscal year 2002 with respect to a 
        territory shall be 250 percent of the amount otherwise 
        permitted under such subsection and subsection (g) with respect 
        to such territory.''.
    (d) State-Like Treatment of Territories.--Section 1108 of such Act 
(42 U.S.C. 1308) is amended--
            (1) in subsection (f), by striking ``subsection (g)'' and 
        inserting ``subsections (g) and (h)''; and
            (2) by adding at the end the following new subsection:
    ``(h) Exemption of Certain Expenditures From Limitation.--Amounts 
of expenditures attributable to medical assistance provided under 
section 1902(a)(10)(A)(i)(VIII) (or otherwise required to carry out the 
amendments made by the Working American Families Access to Health Care 
Act of 2001) shall not be taken into account in applying subsections 
(f) and (g).''.
    (e) Required Use of Community-Based Organizations in Expenditures 
for Outreach and Media.--Section 1903(i) of such Act (42 U.S.C. 
1396b(i)) is amended by inserting after paragraph (8) the following new 
paragraph:
            ``(9) with respect to amounts expended for outreach and 
        media education campaigns (including amounts expended for 
        assistance to those applying for medical assistance), unless at 
        least 25 percent of such amounts are made available for such 
        expenditures through community-based organizations; or''.
    (f) Floor for Medicaid HMO Payment for All Services; Access to 
Specialists.--Section 1932(b) of such Act (42 U.S.C. 1396u-2(b)) is 
amended by adding at the end the following new paragraphs:
            ``(9) Payment floor for all services.--A medicaid managed 
        care organization shall not reimburse a hospital or other 
        health care provider or professional for the provision of 
        services under this section at a rate that is less the fee-for-
        service rate provided by the State for payment for such a 
        hospital, provider, or professional for such services under 
        this title in the case of individuals who are not enrolled with 
        such an organization under this section.
            ``(10) Access to specialists.--A medicaid managed care 
        organization shall assure access to specialty care with 
        appropriate competence and expertise to provide all specialty 
        care required by members enrolled under this section. The State 
        shall establish safeguards and access to specialists of an 
        enrollee's choice in case of a failure to provide timely access 
        through the organization.''.
    (g) Toll-Free Number.--Section 1902 of such Act (42 U.S.C. 1396a) 
is amended by inserting after subsection (j) the following new 
subsection:
    ``(k) The Secretary shall establish a toll-free telephone number at 
which individuals who are eligible for medical assistance under this 
title may file complaints concerning health care providers who do not 
accept medical assistance under this title for services they provide or 
concerning other problems they have with the program under this 
title.''.
    (h) Collection of Data by Race and Ethnicity.--The Secretary of 
Health and Human Services shall provide for the collection of data on 
enrollment, receipt of services, and health outcomes under the medicaid 
program under title XIX of the Social Security Act, broken down at 
least by the race and ethnicity of medicaid recipients. The Director of 
the Office of Management and Budget shall make such revisions in data 
collection standards as may be necessary to carry out this subsection.
    (i) Effective Date.--The amendments made by this section shall take 
effect on January 1, 2002.
                                 <all>