1.
This Act may be cited as the
Prevent Prematurity and Improve Child
Health Act of 2005
.
2.
State option to expand or add coverage of certain pregnant
women under medicaid and SCHIP
(a)
(1)
Authority to expand coverage
Section 1902(l)(2)(A)(i) of
the Social Security Act (42 U.S.C.
1396a(l)(2)(A)(i)) is amended by inserting (or such higher percentage as
the State may elect for purposes of expenditures for medical assistance for
pregnant women described in section 1905(u)(4)(A))
after 185
percent
.
(2)
Enhanced matching funds available if certain conditions
met
Section 1905 of the
Social Security Act (42 U.S.C. 1396d)
is amended—
(A)
in the fourth sentence of
subsection (b), by striking or subsection (u)(3)
and inserting
, (u)(3), or (u)(4)
; and
(B)
in subsection (u)—
(i)
by redesignating paragraph
(4) as paragraph (5); and
(ii)
by inserting after paragraph
(3) the following new paragraph:
(4)
For purposes of the fourth
sentence of subsection (b) and section 2105(a), the expenditures described in
this paragraph are the following:
(A)
If the conditions described
in subparagraph (B) are met, expenditures for medical assistance for pregnant
women described in subsection (n) or in section 1902(l)(1)(A) in a family the
income of which exceeds 185 percent of the poverty line, but does not exceed
the income eligibility level established under title XXI for a targeted
low-income child.
(B)
The conditions described in
this subparagraph are the following:
(i)
The State plans under this
title and title XXI do not provide coverage for pregnant women described in
subparagraph (A) with higher family income without covering such pregnant women
with a lower family income.
(ii)
The State does not apply an
effective income level for pregnant women that is lower than the effective
income level (expressed as a percent of the poverty line and considering
applicable income disregards) that has been specified under the State plan
under subsection (a)(10)(A)(i)(III) or (l)(2)(A) of section 1902, as of January
1, 2005, to be eligible for medical assistance as a pregnant woman.
(C)
Definition of poverty line
In this subsection, the
term poverty line has the meaning given such term in section
2110(c)(5).
.
(3)
Payment from title XXI allotment for medicaid expansion costs;
elimination of counting medicaid child presumptive eligibility costs against
title XXI allotment
Section 2105(a)(1) of the
Social Security Act (42 U.S.C.
1397ee(a)(1)) is amended—
(A)
in the matter preceding
subparagraph (A), by striking (or, in the case of expenditures described
in subparagraph (B), the Federal medical assistance percentage (as defined in
the first sentence of section 1905(b)))
; and
(B)
by striking subparagraph (B)
and inserting the following new subparagraph:
(B)
for the provision of
medical assistance that is attributable to expenditures described in section
1905(u)(4)(A);
.
(b)
(1)
Title XXI of the
Social Security Act (42 U.S.C. 1397aa
et seq.) is amended by adding at the end the following new section:
2111.
Optional coverage of targeted low-income pregnant
women
(a)
Notwithstanding any other
provision of this title, a State may provide for coverage, through an amendment
to its State child health plan under section 2102, of pregnancy-related
assistance for targeted low-income pregnant women in accordance with this
section, but only if—
(1)
the State has established
an income eligibility level for pregnant women under subsection
(a)(10)(A)(i)(III) or (l)(2)(A) of section 1902 that is at least 185 percent of
the income official poverty line; and
(2)
the State meets the
conditions described in section 1905(u)(4)(B).
(b)
For purposes of this
title:
(1)
Pregnancy-related assistance
The term
pregnancy-related assistance has the meaning given the term
child health assistance in section 2110(a) as if any reference to
targeted low-income children were a reference to targeted low-income pregnant
women, except that the assistance shall be limited to services related to
pregnancy (which include prenatal, delivery, and postpartum services and
services described in section 1905(a)(4)(C)) and to other conditions that may
complicate pregnancy.
(2)
Targeted low-income pregnant woman
The term targeted
low-income pregnant woman means a woman—
(A)
during pregnancy and
through the end of the month in which the 60-day period (beginning on the last
day of her pregnancy) ends;
(B)
whose family income exceeds
the effective income level (expressed as a percent of the poverty line and
considering applicable income disregards) that has been specified under
subsection (a)(10)(A)(i)(III) or (l)(2)(A) of section 1902, as of January 1,
2005, to be eligible for medical assistance as a pregnant woman under title XIX
but does not exceed the income eligibility level established under the State
child health plan under this title for a targeted low-income child; and
(C)
who satisfies the
requirements of paragraphs (1)(A), (1)(C), (2), and (3) of section 2110(b) in
the same manner as a child applying for child health assistance would have to
satisfy such requirements.
(c)
References to terms and special rules
In the case of, and with
respect to, a State providing for coverage of pregnancy-related assistance to
targeted low-income pregnant women under subsection (a), the following special
rules apply:
(1)
Any reference in this title
(other than in subsection (b)) to a targeted low-income child is deemed to
include a reference to a targeted low-income pregnant woman.
(2)
Any such reference to child
health assistance with respect to such women is deemed a reference to
pregnancy-related assistance.
(3)
Any such reference to a
child is deemed a reference to a woman during pregnancy and the period
described in subsection (b)(2)(A).
(4)
In applying section
2102(b)(3)(B), any reference to children found through screening to be eligible
for medical assistance under the State medicaid plan under title XIX is deemed
a reference to pregnant women.
(5)
There shall be no exclusion
of benefits for services described in subsection (b)(1) based on any
preexisting condition and no waiting period (including any waiting period
imposed to carry out section 2102(b)(3)(C)) shall apply.
(6)
Subsection (a) of section
2103 (relating to required scope of health insurance coverage) shall not apply
insofar as a State limits coverage to services described in subsection (b)(1)
and the reference to such section in section 2105(a)(1)(C) is deemed not to
require, in such case, compliance with the requirements of section
2103(a).
(7)
In applying section
2103(e)(3)(B) in the case of a pregnant woman provided coverage under this
section, the limitation on total annual aggregate cost-sharing shall be applied
to such pregnant woman.
(8)
The reference in section
2107(e)(1)(D) to section 1920A (relating to presumptive eligibility for
children) is deemed a reference to section 1920 (relating to presumptive
eligibility for pregnant women).
(d)
Automatic enrollment for children born to women receiving
Pregnancy-Related assistance
If a child is born to a
targeted low-income pregnant woman who was receiving pregnancy-related
assistance under this section on the date of the child’s birth, the child shall
be deemed to have applied for child health assistance under the State child
health plan and to have been found eligible for such assistance under such plan
or to have applied for medical assistance under title XIX and to have been
found eligible for such assistance under such title, as appropriate, on the
date of such birth and to remain eligible for such assistance until the child
attains 1 year of age. During the period in which a child is deemed under the
preceding sentence to be eligible for child health or medical assistance, the
child health or medical assistance eligibility identification number of the
mother shall also serve as the identification number of the child, and all
claims shall be submitted and paid under such number (unless the State issues a
separate identification number for the child before such period
expires).
.
(2)
Additional allotments for providing coverage of pregnant
women
(A)
Section 2104 of the
Social Security Act (42 U.S.C. 1397dd)
is amended by inserting after subsection (c) the following new
subsection:
(d)
Additional allotments for providing coverage of pregnant
women
(1)
Appropriation; total allotment
For the purpose of
providing additional allotments to States under this title, there is
appropriated, out of any money in the Treasury not otherwise appropriated, for
each of fiscal years 2006 and 2007, $200,000,000.
(2)
State and territorial allotments
In addition to the
allotments provided under subsections (b) and (c), subject to paragraphs (3)
and (4), of the amount available for the additional allotments under paragraph
(1) for a fiscal year, the Secretary shall allot to each State with a State
child health plan approved under this title—
(A)
in the case of such a State
other than a commonwealth or territory described in subparagraph (B), the same
proportion as the proportion of the State’s allotment under subsection (b)
(determined without regard to subsection (f)) to the total amount of the
allotments under subsection (b) for such States eligible for an allotment under
this paragraph for such fiscal year; and
(B)
in the case of a
commonwealth or territory described in subsection (c)(3), the same proportion
as the proportion of the commonwealth’s or territory’s allotment under
subsection (c) (determined without regard to subsection (f)) to the total
amount of the allotments under subsection (c) for commonwealths and territories
eligible for an allotment under this paragraph for such fiscal year.
(3)
Use of additional allotment
Additional allotments
provided under this subsection are not available for amounts expended before
October 1, 2005. Such amounts are available for amounts expended on or after
such date for child health assistance for targeted low-income children, as well
as for pregnancy-related assistance for targeted low-income pregnant
women.
(4)
No payments unless election to expand coverage of pregnant
women
No payments may be made to
a State under this title from an allotment provided under this subsection
unless the State provides pregnancy-related assistance for targeted low-income
pregnant women under this title, or provides medical assistance for pregnant
women under title XIX, whose family income exceeds the effective income level
applicable under subsection (a)(10)(A)(i)(III) or (l)(2)(A) of section 1902 to
a family of the size involved as of January 1, 2005.
.
(B)
Section 2104 of the
Social Security Act (42 U.S.C. 1397dd)
is amended—
(i)
in subsection (a), in the
matter preceding paragraph (1), by inserting subject to subsection
(d),
after under this section,
;
(ii)
in subsection (b)(1), by
inserting and subsection (d)
after Subject to paragraph
(4)
; and
(iii)
in subsection (c)(1), by
inserting subject to subsection (d),
after for a fiscal
year,
.
(3)
Additional conforming amendments
(A)
No cost-sharing for pregnancy-related benefits
Section 2103(e)(2) of the
Social Security Act (42 U.S.C.
1397cc(e)(2)) is amended—
(i)
in the heading, by inserting
or pregnancy-related
services
after
preventive
services
; and
(ii)
by inserting before the
period at the end the following: or for pregnancy-related
services
.
(B)
Section 2102(b)(1)(B) (42
U.S.C. 1397bb(b)(1)(B)) is amended—
(i)
in clause (i), by striking
, and
at the end and inserting a semicolon;
(ii)
in clause (ii), by striking
the period at the end and inserting ; and
; and
(iii)
by adding at the end the
following new clause:
(iii)
may not apply a waiting
period (including a waiting period to carry out paragraph (3)(C)) in the case
of a targeted low-income pregnant woman.
.
(c)
Authority for States that provide medicaid or SCHIP coverage
for pregnant women with income above 185 percent of the poverty line to use
portion of SCHIP funds for medicaid expenditures
Section 2105(g) of the
Social Security Act (42 U.S.C.
1397ee(g)) is amended—
(1)
in the subsection heading, by
inserting
and Certain
Pregnancy Coverage Expansion States
after
Qualifying
States
;
(2)
by adding at the end the
following:
(4)
Special authority for certain pregnancy coverage expansion
states
(A)
In the case of a State
that, as of the date of enactment of the Prevent Prematurity and Improve Child
Health Act of 2005, has an income eligibility standard under title XIX or this
title (under section 1902(a)(10)(A) or under a statewide waiver in effect under
section 1115 with respect to title XIX or this title) that is at least 185
percent of the poverty line with respect to pregnant women, the State may elect
to use not more than 20 percent of any allotment under section 2104 for any
fiscal year (insofar as it is available under any subsection of such section)
for payments under title XIX in accordance with subparagraph (B), instead of
for expenditures under this title.
(B)
(i)
In the case of a State
described in subparagraph (A) that has elected the option described in that
subparagraph, subject to the availability of funds under such subparagraph and,
if applicable, paragraph (1)(A), with respect to the State, the Secretary shall
pay the State an amount each quarter equal to the additional amount that would
have been paid to the State under title XIX with respect to expenditures
described in clause (ii) if the enhanced FMAP (as determined under subsection
(b)) had been substituted for the Federal medical assistance percentage (as
defined in section 1905(b)).
(ii)
For purposes of this
subparagraph, the expenditures described in this clause are expenditures, made
after the date of the enactment of this paragraph and during the period in
which funds are available to the State for use under subparagraph (A), for
medical assistance under title XIX for pregnant women whose family income is at
least 185 percent of the poverty line.
(iii)
No impact on determination of budget neutrality for
waivers
In the case of a State
described in subparagraph (A) that uses amounts paid under this paragraph for
expenditures described in clause (ii) that are incurred under a waiver approved
for the State, any budget neutrality determinations with respect to such waiver
shall be determined without regard to such amounts paid.
; and
(3)
in paragraph (3), by striking
and (2)
and inserting (2), and (4)
.
(d)
Other amendments to medicaid
(1)
Section 1902(e)(4) of the
Social Security Act (42 U.S.C.
1396a(e)(4)) is amended in the first sentence by striking so long as the
child is a member of the woman’s household and the woman remains (or would
remain if pregnant) eligible for such assistance
.
(2)
Application of qualified entities to presumptive eligibility
for pregnant women under medicaid
Section 1920(b) of the
Social Security Act (42 U.S.C.
1396r–1(b)) is amended by adding after paragraph (2) the following flush
sentence:
The term
qualified provider
includes a qualified entity as defined in
section 1920A(b)(3)..
(e)
The amendments made by this
section apply to items and services furnished on or after October 1, 2005,
without regard to whether regulations implementing such amendments have been
promulgated.
3.
Optional coverage of legal immigrants under the medicaid
program and SCHIP
(a)
Section 1903(v) of the
Social Security Act (42 U.S.C.
1396b(v)) is amended—
(1)
in paragraph (1), by striking
paragraph (2)
and inserting paragraphs (2) and
(4)
; and
(2)
by adding at the end the
following new paragraph:
(4)
(A)
A State may elect (in a
plan amendment under this title) to provide medical assistance under this title
for aliens who are lawfully residing in the United States (including battered
aliens described in section 431(c) of the Personal Responsibility and Work
Opportunity Reconciliation Act of 1996) and who are otherwise eligible for such
assistance, within any of the following eligibility categories:
(i)
Women during pregnancy (and
during the 60-day period beginning on the last day of the pregnancy).
(ii)
Children (as defined under
such plan), including optional targeted low-income children described in
section 1905(u)(2)(B).
(B)
(i)
In the case of a State that
has elected to provide medical assistance to a category of aliens under
subparagraph (A), no debt shall accrue under an affidavit of support against
any sponsor of such an alien on the basis of provision of assistance to such
category and the cost of such assistance shall not be considered as an
unreimbursed cost.
(ii)
The provisions of sections
401(a), 402(b), 403, and 421 of the Personal Responsibility and Work
Opportunity Reconciliation Act of 1996 shall not apply to a State that makes an
election under subparagraph (A).
.
(b)
Section 2107(e)(1) of the
Social Security Act (42 U.S.C.
1397gg(e)(1)) is amended by adding at the end the following new
subparagraph:
(E)
Section 1903(v)(4)
(relating to optional coverage of permanent resident alien pregnant women and
children), but only with respect to an eligibility category under this title,
if the same eligibility category has been elected under such section for
purposes of title XIX.
.
(c)
The amendments made by this
section take effect on October 1, 2005, and apply to medical assistance and
child health assistance furnished on or after such date.
4.
Promoting cessation of tobacco use under the medicaid
program
(a)
Dropping exception from medicaid prescription drug coverage for
tobacco cessation medications
Section 1927(d)(2) of the
Social Security Act (42 U.S.C.
1396r–8(d)(2)) is amended—
(1)
by striking subparagraph
(E);
(2)
by redesignating
subparagraphs (F) through (J) as subparagraphs (E) through (I), respectively;
and
(3)
in subparagraph (F) (as
redesignated by paragraph (2)), by inserting before the period at the end the
following: , except agents approved by the Food and Drug Administration
for purposes of promoting, and when used to promote, tobacco
cessation
.
(b)
Requiring coverage of tobacco cessation counseling services for
pregnant women
Section 1905 of the
Social Security Act (42 U.S.C.
1396d(a)(4)) is amended—
(1)
in subsection (a)(4)—
(A)
by striking
and
before (C)
; and
(B)
by inserting before the
semicolon at the end the following new subparagraph: ; and (D)
counseling for cessation of tobacco use (as defined in subsection (y)) for
pregnant women
; and
(2)
by adding at the end the
following:
(y)
(1)
For purposes of this title,
the term counseling for cessation of tobacco use means therapy and
counseling for cessation of tobacco use for pregnant women who use tobacco
products or who are being treated for tobacco use that is furnished—
(A)
by or under the supervision
of a physician; or
(B)
by any other health care
professional who—
(i)
is legally authorized to
furnish such services under State law (or the State regulatory mechanism
provided by State law) of the State in which the services are furnished;
and
(ii)
is authorized to receive
payment for other services under this title or is designated by the Secretary
for this purpose.
(2)
Subject to paragraph (3),
such term is limited to—
(A)
therapy and counseling
services recommended in Treating Tobacco Use and Dependence: A Clinical
Practice Guideline
, published by the Public Health Service in June
2000, or any subsequent modification of such Guideline; and
(B)
such other therapy and
counseling services that the Secretary recognizes to be effective.
(3)
Such term shall not include
coverage for drugs or biologicals that are not otherwise covered under this
title.
.
(c)
Removal of Cost-Sharing for tobacco cessation counseling
services for pregnant women
Section 1916 of the
Social Security Act (42 U.S.C. 1396o)
is amended in each of subsections (a)(2)(B) and (b)(2)(B) by inserting ,
and counseling for cessation of tobacco use (as defined in section
1905(y))
after complicate the pregnancy
.
(d)
The amendments made by this
section shall apply to services furnished on or after the date that is 1 year
after the date of enactment of this Act.
5.
Promoting cessation of tobacco use under the maternal and child
health services block grant program
(a)
Quality maternal and child health services include tobacco
cessation counseling and medications
(1)
Section 501 of the
Social Security Act (42 U.S.C. 701) is
amended by adding at the end the following new subsection:
(c)
For purposes of this title,
counseling for cessation of tobacco use (as defined in section 1905(y)), drugs
and biologicals used to promote smoking cessation, and the inclusion of
antitobacco messages in health promotion counseling shall be considered to be
part of quality maternal and child health services.
.
(2)
The amendment made by
paragraph (1) shall take effect on the date that is 1 year after the date of
enactment of this Act.
(b)
Evaluation of national core performance measures
(1)
The Administrator of the
Health Resources and Services Administration shall assess the current national
core performance measures and national core outcome measures utilized under the
Maternal and Child Health Block Grant under title V of the
Social Security Act (42 U.S.C. 701 et
seq.) for purposes of expanding such measures to include some of the known
causes of low birth weight and prematurity, including the percentage of infants
born to pregnant women who smoked during pregnancy.
(2)
Not later than 1 year after
the date of enactment of this Act, the Administrator of the Health Resources
and Services Administration shall submit to the appropriate committees of
Congress a report concerning the results of the evaluation conducted under
paragraph (1).
6.
State option to provide family planning services and supplies
to individuals with incomes that do not exceed a State’s income eligibility
level for medical assistance
(a)
Title XIX of the
Social Security Act (42 U.S.C. 1396 et
seq.) is amended—
(1)
by redesignating section 1936
as section 1937; and
(2)
by inserting after section
1935 the following new section:
1935.
State option to provide family planning services and
supplies(a)
Subject to subsections (b)
and (c), a State may elect (through a State plan amendment) to make medical
assistance described in section 1905(a)(4)(C) available to any individual whose
family income does not exceed the greater of—
(1)
185 percent of the income
official poverty line (as defined by the Office of Management and Budget, and
revised annually in accordance with section 673(2) of the Omnibus Budget
Reconciliation Act of 1981) applicable to a family of the size involved;
or
(2)
the eligibility income
level (expressed as a percentage of such poverty line) that has been specified
under a waiver authorized by the Secretary or under section 1902(r)(2)), as of
October 1, 2005, for an individual to be eligible for medical assistance under
the State plan.
(b)
Medical assistance
described in section 1905(a)(4)(C) that is made available under a State plan
amendment under subsection (a) shall—
(1)
not be less in amount,
duration, or scope than the medical assistance described in that section that
is made available to any other individual under the State plan; and
(2)
be provided in accordance
with the restrictions on deductions, cost sharing, or similar charges imposed
under section 1916(a)(2)(D).
(c)
Option To extend coverage during a Post-Eligibility
period
(1)
A State plan amendment made
under subsection (a) may provide that any individual who was receiving medical
assistance described in section 1905(a)(4)(C) as a result of such amendment,
and who becomes ineligible for such assistance because of hours of, or income
from, employment, may remain eligible for such medical assistance through the
end of the 6-month period that begins on the first day the individual becomes
so ineligible.
(2)
A State plan amendment made
under subsection (a) may provide that any individual who has received medical
assistance described in section 1905(a)(4)(C) during the entire 6-month period
described in paragraph (1) may be extended coverage for such assistance for a
succeeding 6-month period.
.
(b)
The amendments made by
subsection (a) apply to medical assistance provided on and after October 1,
2005.
7.
State option to extend the postpartum period for provision of
family planning services and supplies
(a)
Section 1902(e)(5) of the
Social Security Act (42 U.S.C.
1396a(e)(5)) is amended—
(1)
by striking eligible
under the plan, as though
and inserting
eligible under the
plan—
(A)
as though
;
(2)
by striking the period and
inserting ; and
; and
(3)
by adding at the end the
following new subparagraph:
(B)
for medical assistance
described in section 1905(a)(4)(C) for so long as the family income of such
woman does not exceed the maximum income level established by the State for the
woman to be eligible for medical assistance under the State plan (as a result
of pregnancy or otherwise).
.
(b)
The amendments made by
subsection (a) apply to medical assistance provided on and after October 1,
2005.
8.
State option to provide wrap-around SCHIP coverage to children
who have other health coverage
(a)
(1)
(A)
State option to provide wrap-around coverage
Section 2110(b) of the
Social Security Act (42 U.S.C.
1397jj(b)) is amended—
(i)
in paragraph (1)(C), by
inserting , subject to paragraph (5),
after under title
XIX or
; and
(ii)
by adding at the end the
following:
(5)
State option to provide wrap-around coverage
(A)
A State may waive the
requirement of paragraph (1)(C) that a targeted low-income child may not be
covered under a group health plan or under health insurance coverage if the
State satisfies the conditions described in subsection (c)(8). The State may
waive such requirement in order to provide—
(i)
services for a child with
special health care needs; or
(ii)
all services.
(B)
Authority to limit income eligibility
In waiving such
requirement, a State may limit the application of the waiver to children whose
family income does not exceed a level specified by the State, so long as the
level so specified does not exceed the maximum income level otherwise
established for other children under the State child health plan.
.
(B)
Section 2105(c) of the
Social Security Act (42 U.S.C.
1397ee(c)) is amended by adding at the end the following:
(8)
Conditions for provision of wrap-around coverage
For purposes of section
2110(b)(5), the conditions described in this paragraph are the
following:
(A)
The State child health plan
(whether implemented under title XIX or this title)—
(i)
has the highest income
eligibility standard permitted under this title as of January 1, 2005;
(ii)
subject to subparagraph
(B), does not limit the acceptance of applications for children; and
(iii)
provides benefits to all
children in the State who apply for and meet eligibility standards.
(B)
With respect to children
whose family income is at or below 200 percent of the poverty line, the State
does not impose any numerical limitation, waiting list, or similar limitation
on the eligibility of such children for child health assistance under such
State plan.
(C)
No more favorable treatment
The State child health plan
may not provide more favorable coverage of dental services to the children
covered under section 2110(b)(5) than to children otherwise covered under this
title.
.
(C)
State option to waive waiting period
Section 2102(b)(1)(B) of the
Social Security Act (42 U.S.C.
1397bb(b)(1)(B)), as amended by section 2(b)(3)(B), is amended—
(i)
in clause (ii), by striking
, and
at the end and inserting a semicolon;
(ii)
in clause (iii), by striking
the period at the end and inserting ; and
; and
(iii)
by adding at the end the
following new clause:
(iv)
at State option, may not
apply a waiting period in the case of a child described in section 2110(b)(5),
if the State satisfies the requirements of section 2105(c)(8).
.
(2)
Application of enhanced match under medicaid
Section 1905 of the
Social Security Act (42 U.S.C. 1396d),
as amended by section 2(a)(2), is amended—
(A)
in subsection (b), in the
fourth sentence, by striking or (u)(4)
and inserting
(u)(4), or (u)(5)
; and
(B)
in subsection (u)—
(i)
by redesignating paragraph
(5) as paragraph (6); and
(ii)
by inserting after paragraph
(4) the following:
(5)
For purposes of subsection
(b), the expenditures described in this paragraph are expenditures for items
and services for children described in section 2110(b)(5), but only in the case
of a State that satisfies the requirements of section 2105(c)(8).
.
(3)
Application of secondary payor provisions
Section 2107(e)(1) of the
Social Security Act (42 U.S.C.
1397gg(e)(1)), as amended by section 3(b), is amended by adding at the end the
following:
(F)
Section 1902(a)(25)
(relating to coordination of benefits and secondary payor provisions) with
respect to children covered under a waiver described in section
2110(b)(5).
.
(b)
The amendments made by
subsection (a) shall take effect on January 1, 2005, and shall apply to child
health assistance and medical assistance provided on or after that date.