[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 1364 Introduced in Senate (IS)]







110th CONGRESS
  1st Session
                                S. 1364

 To amend titles XIX and XXI of the Social Security Act to extend the 
   State Children's Health Insurance Program (SCHIP) and streamline 
      enrollment under SCHIP and Medicaid, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 10, 2007

  Mr. Durbin introduced the following bill; which was read twice and 
                  referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
 To amend titles XIX and XXI of the Social Security Act to extend the 
   State Children's Health Insurance Program (SCHIP) and streamline 
      enrollment under SCHIP and Medicaid, 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; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Healthy Kids Act 
of 2007''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
                      TITLE I--EXTENSION OF SCHIP

Sec. 101. Extension of SCHIP program; increase in allotments to take 
                            into account growth in child population and 
                            health care costs.
Sec. 102. 2-year initial availability of SCHIP allotments.
Sec. 103. Redistribution of unused allotments to address State funding 
                            shortfalls.
    TITLE II--STATE OPTIONS FOR INCREASING COVERAGE OF CHILDREN AND 
                PREGNANT WOMEN UNDER MEDICAID AND SCHIP

Sec. 201. Bonus payments for States that implement administrative 
                            policies to streamline enrollment process.
Sec. 202. State option to provide for ``express lane'' and simplified 
                            determinations of a child's financial 
                            eligibility for medical assistance under 
                            Medicaid or child health assistance under 
                            SCHIP.
Sec. 203. Information technology connections to improve health coverage 
                            determinations.
Sec. 204. State option to expand or add coverage of certain pregnant 
                            women under Medicaid and SCHIP.
Sec. 205. Optional coverage of legal immigrants under Medicaid and 
                            SCHIP.
Sec. 206. Authorizing adjustment of SCHIP allotment due to increased 
                            outreach.
Sec. 207. Model of Interstate coordinated enrollment and coverage 
                            process.
Sec. 208. Authority for qualifying States to use portion of SCHIP 
                            allotment for any fiscal year for certain 
                            Medicaid expenditures.
Sec. 209. Application of Medicaid outreach procedures to all pregnant 
                            women and children.
Sec. 210. No impact on section 1115 waivers.
Sec. 211. Elimination of counting Medicaid child presumptive 
                            eligibility costs against title XXI 
                            allotment.
Sec. 212. Prohibiting limitations on enrollment.
         TITLE III--ELIMINATION OF CERTAIN BARRIERS TO COVERAGE

Sec. 301. State option to require certain individuals to present 
                            satisfactory documentary evidence of proof 
                            of citizenship or nationality for purposes 
                            of eligibility for Medicaid.
Sec. 302. Increased Federal matching rate for language services 
                            provided under Medicaid or SCHIP.
 TITLE IV--GRANTS TO PROMOTE INNOVATIVE OUTREACH AND ENROLLMENT UNDER 
                           MEDICAID AND SCHIP

Sec. 401. Grants to promote innovative outreach and enrollment under 
                            Medicaid and SCHIP.
            TITLE V--IMPROVING THE QUALITY OF PEDIATRIC CARE

Sec. 501. Requiring coverage of EPSDT services, including dental 
                            services, State option to provide 
                            supplemental coverage of dental services.
Sec. 502. Pediatric quality and performance measures program.
Sec. 503. Grants to States for demonstration projects transforming 
                            delivery of pediatric care.
Sec. 504. Report by the comptroller general on design and 
                            implementation of a demonstration project 
                            evaluating existing quality and performance 
                            measures for children's inpatient hospital 
                            services.
Sec. 505. Medical home demonstration project.
Sec. 506. Disease prevention and treatment demonstration projects for 
                            ethnic and racial minority children.
           TITLE VI--COMMISSION ON CHILDREN'S HEALTH COVERAGE

Sec. 601. Commission on Children's Health Coverage.

                      TITLE I--EXTENSION OF SCHIP

SEC. 101. EXTENSION OF SCHIP PROGRAM; INCREASE IN ALLOTMENTS TO TAKE 
              INTO ACCOUNT GROWTH IN CHILD POPULATION AND HEALTH CARE 
              COSTS.

    (a) In General.--Section 2104 of the Social Security Act (42 U.S.C. 
1397dd) is amended--
            (1) in subsection (a)--
                    (A) by striking ``and'' at the end of paragraph 
                (9);
                    (B) by striking the period at the end of paragraph 
                (10) and inserting ``; and''; and
                    (C) by adding at the end the following new 
                paragraph:
            ``(11) for each fiscal year 2008 and each subsequent fiscal 
        year, $7,500,000,000 multiplied by the population and cost 
        inflation factor for that fiscal year, as determined under 
        subsection (i).''; and
            (2) by adding at the end the following new subsection:
    ``(i) Population and Cost Inflation Factor.--For purposes of 
subsection (a)(11), the population and cost inflation factor for a 
fiscal year is equal to the product of the following:
            ``(1) Child population growth factor.--One plus the 
        percentage increase in the population of children under 20 
        years of age in the United States from July 1, 2007, to July 1 
        during the fiscal year involved, as projected by the Secretary 
        based on the most recent published estimates of the Bureau of 
        the Census before the beginning of the fiscal year involved.
            ``(2) Per capita health care growth factor.--One plus the 
        percentage increase in the projected per capita amount of 
        National Health Expenditures from fiscal year 2007 to the 
        fiscal year involved, as most recently published by the 
        Secretary before the beginning of the fiscal year involved.''.
    (b) Additional Allotments to Territories.--Section 2104(c)(4)(B) of 
such Act (42 U.S.C. 1397dd(c)(4)(B)) is amended by striking ``and 
$40,000,000 for fiscal year 2007'' and inserting ``$40,000,000 for 
fiscal year 2007, and for each of fiscal years 2008 through 2017, the 
amount appropriated under this subparagraph for the preceding fiscal 
year increased by the population and cost inflation factor for that 
fiscal year, as determined under subsection (i)''.

SEC. 102. 2-YEAR INITIAL AVAILABILITY OF SCHIP ALLOTMENTS.

    Section 2104(e) of the Social Security Act (42 U.S.C. 1397dd(e)) is 
amended to read as follows:
    ``(e) Availability of Amounts Allotted.--
            ``(1) In general.--Except as provided in paragraphs (2) and 
        (3), amounts allotted to a State pursuant to this section--
                    ``(A) for each of fiscal years 1998 through 2007, 
                shall remain available for expenditure by the State 
                through the end of the second succeeding fiscal year; 
                and
                    ``(B) for fiscal year 2008 and each fiscal year 
                thereafter, shall remain available for expenditure by 
                the State through the end of the succeeding fiscal 
                year.
            ``(2) Availability of amounts reallotted.--Subject to 
        paragraph (3), amounts reallotted to a State under subsection 
        (f) shall be available for expenditure by the State through the 
        end of the fiscal year in which they are reallotted.
            ``(3) Permanent availability of unused funds.--Reallotted 
        funds that are not used by the end of the fiscal year described 
        in paragraph (2) shall be subject to reallotment under 
        subsection (f) in subsequent fiscal years subject to such 
        paragraph and shall remain available for subsequent reallotment 
        until expended.''.

SEC. 103. REDISTRIBUTION OF UNUSED ALLOTMENTS TO ADDRESS STATE FUNDING 
              SHORTFALLS.

    Section 2104(f) of the Social Security Act (42 U.S.C. 1397dd(f)) is 
amended--
            (1) by striking ``The Secretary'' and inserting the 
        following:
            ``(1) In general.--The Secretary'';
            (2) by striking ``States that have fully expended the 
        amount of their allotments under this section'' and inserting 
        ``States that the Secretary determines with respect to the 
        fiscal year for which unused allotments are available for 
        redistribution under this subsection, are shortfall States 
        described in paragraph (2) for such fiscal year''; and
            (3) by adding at the end the following new paragraph:
            ``(2) Shortfall states described.--
                    ``(A) In general.--For purposes of paragraph (1), 
                with respect to a fiscal year, a shortfall State 
                described in this subparagraph is a State with a State 
                child health plan approved under this title for which 
                the Secretary estimates on the basis of the most recent 
                data available to the Secretary, that the projected 
                expenditures under such plan for the State for the 
                fiscal year will exceed the sum of--
                            ``(i) the amount of the State's allotments 
                        for any preceding fiscal years that remain 
                        available for expenditure and that will not be 
                        expended by the end of the immediately 
                        preceding fiscal year; and
                            ``(ii) the amount of the State's allotment 
                        for the fiscal year (taking into account any 
                        increase made in such allotment under section 
                        2104(j), as added by section 205(a) of the 
                        Healthy Kids Act of 2007).
                    ``(B) Proration rule.--If the amounts available for 
                redistribution under paragraph (1) for a fiscal year 
                are less than the total amounts of the estimated 
                shortfalls determined for the year under subparagraph 
                (A), the amount to be reallotted under such paragraph 
                for each shortfall State shall be reduced 
                proportionally.
                    ``(C) Retrospective adjustment.--The Secretary may 
                adjust the estimates and determinations made under 
                paragraph (1) and this paragraph with respect to a 
                fiscal year as necessary on the basis of the amounts 
                reported by States not later than November 30 of the 
                succeeding fiscal year, as approved by the 
                Secretary.''.

    TITLE II--STATE OPTIONS FOR INCREASING COVERAGE OF CHILDREN AND 
                PREGNANT WOMEN UNDER MEDICAID AND SCHIP

SEC. 201. BONUS PAYMENTS FOR STATES THAT IMPLEMENT ADMINISTRATIVE 
              POLICIES TO STREAMLINE ENROLLMENT PROCESS.

    (a) Bonus in FMAP and Enhanced FMAP for Application of Streamline 
Enrollment Procedures Under Medicaid and SCHIP.--Section 2102 of the 
Social Security Act (42 U.S.C. 1397bb) is amended by adding at the end 
the following new subsection:
    ``(d) Streamline Enrollment Procedures.--
            ``(1) Increase in federal matching rate.--
                    ``(A) In general.--In the case of a State that 
                meets the conditions described in subparagraph (B) 
                (relating to agreeing to implement administrative 
                enrollment policies under this title and title XIX) for 
                a fiscal year, the Federal medical assistance 
                percentage (for purposes of title XIX only) and the 
                enhanced FMAP (for purposes of this title, but 
                determined without regard to the application of this 
                subsection to the Federal medical assistance percentage 
                under title XIX) otherwise computed for such fiscal 
                year as applied to medical assistance for children and 
                child health assistance, respectively, shall be 
                increased by such number of percentage points as the 
                Secretary determines is necessary to provide an 
                incentive for the State to satisfy the conditions 
                described in subparagraph (B) (but not to exceed such 
                number of percentage points that would result in a 
                Federal medical assistance percentage or enhanced FMAP 
                for the State that would exceed 83 or 85 percent, 
                respectively).
                    ``(B) Agreeing to remove enrollment and access 
                barriers.--The conditions described in this 
                subparagraph, for a State for a fiscal year are that 
                the State agrees to do the following:
                            ``(i) Presumptive eligibility for 
                        children.--The State agrees--
                                    ``(I) to provide presumptive 
                                eligibility for children under this 
                                title and title XIX in accordance with 
                                section 1920A; and
                                    ``(II) to treat any items or 
                                services that are provided to an 
                                uncovered child (as defined in section 
                                2110(c)(8)) who is determined 
                                ineligible for medical assistance under 
                                title XIX as child health assistance 
                                for purposes of paying a provider of 
                                such items or services, so long as such 
                                items or services would be considered 
                                child health assistance for a targeted 
                                low-income child under this title.
                            ``(ii) 12-month continuous eligibility.--
                        The State agrees to provide that eligibility of 
                        children for assistance under this title and 
                        title XIX shall not be regularly redetermined 
                        more often than once every year.
                            ``(iii) Automatic renewal.--The State 
                        agrees to provide for the automatic renewal of 
                        the eligibility of children for assistance 
                        under this title and under title XIX if the 
                        child's family does not report any changes to 
                        family income or other relevant circumstances, 
                        subject to verification of information from 
                        databases available to the State for such 
                        purpose.
                            ``(iv) Elimination of asset test.--The 
                        State has amended its plans under this title 
                        and title XIX so that no asset or resource test 
                        is applied for eligibility under this title or 
                        title XIX with respect to children.
                            ``(v) Administrative verification of 
                        income.--The State agrees to permit the family 
                        of a child applying for child health assistance 
                        under this title or medical assistance under 
                        title XIX to declare and certify, by signature 
                        under penalty of perjury, the family income for 
                        purposes of collecting financial eligibility 
                        information.''.
    (b) Conforming Medicaid Amendments.--
            (1) In general.--Section 1905(b) of the Social Security Act 
        (42 U.S.C. 1396d(b)) is amended by inserting ``and section 
        2102(d)(1)'' after ``section 1933(d)''.
            (2) Increase in medicaid cap for territories.--Section 
        1108(g) of such Act (42 U.S.C. 1308(g)) is amended--
                    (A) in paragraph (2), by striking ``paragraph (3)'' 
                and inserting ``paragraphs (3) and (4)''; and
                    (B) by adding at the end the following new 
                paragraph:
            ``(4) Disregard of increased expenditures directly 
        attributable to increase in fmap for application of streamlined 
        enrollment procedures.--The limitation of paragraph (2) shall 
        not apply to payment under title XIX to a territory insofar as 
        such payment is attributable to an increase in the Federal 
        medical assistance percentage under subparagraph (A) of section 
        2102(d)(1).''.
    (c) Effective Date.--The amendments made by this section shall 
apply beginning with fiscal year 2007.

SEC. 202. STATE OPTION TO PROVIDE FOR ``EXPRESS LANE'' AND SIMPLIFIED 
              DETERMINATIONS OF A CHILD'S FINANCIAL ELIGIBILITY FOR 
              MEDICAL ASSISTANCE UNDER MEDICAID OR CHILD HEALTH 
              ASSISTANCE UNDER SCHIP.

    (a) Medicaid.--Section 1902(e) of the Social Security Act (42 
U.S.C. 1396a(e)) is amended by adding at the end the following:
    ``(13)(A) At the option of the State, the plan may provide that 
eligibility requirements (including such requirements applicable to 
redeterminations or renewals of eligibility) for medical assistance 
relating to income, assets (or resources), or citizenship status are 
met for a child who is under an age specified by the State (not to 
exceed 21 years of age) by using a determination made within a 
reasonable period (as determined by the State) before its use for this 
purpose, of the child's family or household income, or if applicable 
for purposes of determining eligibility under this title or title XXI, 
assets or resources, or citizenship status, respectively, 
(notwithstanding any other provision of law, including sections 
1902(a)(46)(B), 1903(x), and 1137(d)), by a Federal or State agency, or 
a public or private entity making such determination on behalf of such 
agency, specified by the plan, including an agency administering the 
State program funded under part A of title IV, the Food Stamp Act of 
1977, the Richard B. Russell National School Lunch Act, or the Child 
Nutrition Act of 1966, notwithstanding any differences in budget unit, 
disregard, deeming, or other methodology, but only if--
            ``(i) the agency has fiscal liabilities or responsibilities 
        affected by such determination; and
            ``(ii) the agency or entity notifies the child's family--
                    ``(I) of the information which shall be disclosed 
                in accordance with this subparagraph;
                    ``(II) that the information disclosed will be used 
                solely for purposes of determining eligibility for 
                medical assistance under this title or for child health 
                assistance under title XXI; and
                    ``(III) that interagency agreements limit the use 
                of such information to that purpose; and
            ``(iii) the requirements of section 1939 are satisfied.
    ``(B) Nothing in this paragraph shall be construed to relieve a 
State of the obligation to determine, on another basis, eligibility for 
medical assistance under this title or for child health assistance 
under title XXI if a child is determined ineligible for such assistance 
on the basis of information furnished pursuant to this paragraph.
    ``(C) If a State applies the eligibility process described in 
subparagraph (A) to individuals eligible under this title and to 
individuals eligible under title XXI, the State may, at its option, 
implement its duties under subparagraphs (A) and (B) of section 
2102(b)(3) using either or both of the following approaches:
            ``(i) The State may--
                    ``(I) establish a threshold percentage of the 
                Federal poverty level (that shall exceed the income 
                eligibility level applicable for a population of 
                individuals under this title by 30 percentage points 
                (as a fraction of the Federal poverty level) or such 
                other higher number of percentage points as the State 
                determines reflects the typical application of income 
                methodologies by the non-health program and the State 
                plan under this title); and
                    ``(II) provide that, with respect to any individual 
                within such population whom a non-health agency 
                determines has income that does not exceed such 
                threshold percentage for such population, such 
                individual is eligible for medical assistance under 
                this title (regardless of whether such individual would 
                otherwise be determined to be eligible to receive such 
                assistance).
        In exercising the approach under this clause, a State shall 
        inform families whose children are enrolled in a State child 
        health plan under title XXI based on having family income above 
        the threshold described in subclause (I) that they may qualify 
        for medical assistance under this title and, at their option, 
        can seek a regular eligibility determination for such 
        assistance for their child.
            ``(ii) Regardless of whether a State otherwise provides for 
        presumptive eligibility under section 1920A, a State may 
        provide presumptive eligibility under this title, consistent 
        with subsection (e) of section 1920A, to a child who, based on 
        a determination by a non-health agency, would qualify for child 
        health assistance under a State child health plan under title 
        XXI. During such presumptive eligibility period, the State may 
        determine the child's eligibility for medical assistance under 
        this title, pursuant to subparagraph (A) of section 2102(b)(3), 
        based on telephone contact with family members, access to data 
        available in electronic or paper form, and other means of 
        gathering information that are less burdensome to the family 
        than completing an application form on behalf of the child. The 
        procedures described in the previous sentence may be used 
        regardless of whether the State uses similar procedures under 
        other circumstances for purposes of determining eligibility for 
        medical assistance under this title.
    ``(D) At the option of a State, the eligibility process described 
in subparagraph (A) may apply to an individual who is not a child.
    ``(E)(i) At the option of a State, an individual determined to be 
eligible for medical assistance or child health assistance pursuant to 
subparagraph (A), (C), or (D) or other procedures through which 
eligibility is determined based on data obtained from sources other 
than the individual may receive medical assistance under this title if 
such individual (or, in the case of an individual under age 19 (or if 
the State elects the option under subparagraph (A), age 20 or 21) who 
is not authorized to consent to medical care, the individual's parent, 
guardian, or other caretaker relative) has acknowledged notice of such 
determination and has consented to such eligibility determination. The 
State (at its option) may waive any otherwise applicable requirements 
for signatures by or on behalf of an individual who has so consented.
    ``(ii) In the case of an individual enrolled pursuant to clause 
(i), the State shall inform the individual (or, in the case of an 
individual under age 19 (or if the State elects the option under 
subparagraph (A), age 20 or 21), the individual's parent, guardian, or 
other caretaker relative) about the significance of such enrollment, 
including appropriate methods to access covered services.
    ``(F) For purposes of this paragraph--
            ``(i) the term `non-health agency' means an agency or 
        entity described in subparagraph (A); and
            ``(ii) the term `non-health benefits' means the benefits or 
        assistance provided by a non-health agency.''.
    (b) SCHIP.--Section 2107(e)(1) of such Act (42 U.S.C. 1397gg(e)(1)) 
is amended by redesignating subparagraphs (B) through (E) as 
subparagraphs (C) through (F) and by inserting after subparagraph (B) 
the following new subparagraph:
                    ``(C) Section 1902(e)(13) (relating to the State 
                option to base a determination of a child's eligibility 
                for assistance on determinations made by a program 
                providing nutrition or other public assistance (except 
                that the State option under subparagraph (D) of such 
                section shall apply under this title only if an 
                individual is pregnant)).''.
    (c) Presumptive Eligibility.--Section 1920A of such Act (42 U.S.C. 
1396r-1a) is amended--
            (1) in subsection (b)(3)(A)(i), is amended by striking ``or 
        (IV)'' and inserting ``(IV) is an agency or entity described in 
        section 1902(e)(13)(A), or (V)''; and
            (2) by adding at the end the following:
    ``(e) In the case of a State with a child health plan under title 
XXI that provides for presumptive eligibility under such plan for 
children, the State shall make a reasonable effort to place each 
presumptively eligible child in the program under this title or title 
XXI for which the child appears most likely to qualify. During the 
child's period of presumptive eligibility, the State shall receive 
Federal matching funds under section 1903 or section 2105, depending on 
the program in which the child has been placed. If at the conclusion of 
such period, the child is found to qualify for, and is enrolled in, the 
program established under this title or title XXI when the child was 
enrolled in the program under the other such title during such period, 
the State's receipt of Federal matching funds shall be adjusted both 
retroactively and prospectively so that Federal matching funds are 
provided, both during and following such period of presumptive 
eligibility, based on the program in which the child is enrolled.''.
    (d) Signature Requirements.--Section 1902(a) of such Act (42 U.S.C. 
1396a(a)) is amended by adding at the end the following: 
``Notwithstanding any other provision of law, a signature under penalty 
of perjury shall not be required on an application form for medical 
assistance as to any element of eligibility for which eligibility is 
based on information received from a source other than applicant, 
rather than on representations from the applicant. Notwithstanding any 
other provision of law, any signature requirement for an application 
for medical assistance may be satisfied through an electronic 
signature, as defined in section 1710(1) of the Government Paperwork 
Elimination Act (44 U.S.C. 3504 note).''.

SEC. 203. INFORMATION TECHNOLOGY CONNECTIONS TO IMPROVE HEALTH COVERAGE 
              DETERMINATIONS.

    (a) Enhanced Federal Funding for Improvements Related to 
Implementation of Certain Model Outreach and Enrollment Practices.--
            (1) In general.--Section 1903(a)(3)(A) of the Social 
        Security Act (42 U.S.C. 1396b(a)(3)(A)) is amended--
                    (A) by striking ``and'' at the end of clause (i); 
                and
                    (B) by adding at the end the following new clause:
                    ``(iii) 75 percent of so much of the sums expended 
                during such quarter as are attributable to the design, 
                development, or installation of such mechanized claims 
                processing and information retrieval systems and the 
                implementation of administrative systems and processes 
                (including modification of eligibility computer systems 
                to permit the exchange of electronic information with 
                other Federal or State programs) as the Secretary 
                determines are directly related to the implementation 
                of a model outreach and enrollment practice described 
                in subparagraph (B), (C), (D), (E), or (F) of section 
                1905(y)(3), and''.
            (2) Conforming amendment to ensure availability for 
        territories.--Section 1108(g) of such Act (42 U.S.C. 1308(g)), 
        as amended by section 201(b)(2)(B), is amended--
                    (A) in paragraph (2), by striking ``and (4)'' and 
                inserting ``, (4), and (5)''; and
                    (B) by adding at the end the following new 
                paragraph:
            ``(5) Additional increase for certain expenditures.--With 
        respect to fiscal year 2008 and each fiscal year thereafter, if 
        Puerto Rico, the Virgin Islands, Guam, the Northern Mariana 
        Islands, or American Samoa qualify for a payment under section 
        1903(a)(3)(A)(iii) for a calendar quarter of such fiscal year, 
        the additional Federal financial participation under such 
        section shall not be counted towards the limitation on 
        expenditures under title XIX for such commonwealth or territory 
        otherwise determined under subsection (f) and this subsection 
        for such fiscal year.''.
    (b) Authorization of Information Disclosure.--
            (1) In general.--Title XIX of such Act (42 U.S.C. 1396 et 
        seq.) is amended--
                    (A) by redesignating section 1939 as section 1940; 
                and
                    (B) by inserting after section 1938 the following:

            ``authorization to receive pertinent information

    ``Sec. 1939.  (a) In General.--Notwithstanding any other provision 
of law, a Federal or State agency or private entity in possession of 
the sources of data potentially pertinent to eligibility determinations 
under this title or title XXI (including eligibility files maintained 
by programs described in section 1902(e)(13)(A), information described 
in paragraph (2) or (3) of section 1137(a), vital records information 
about births in any State, and information described in sections 453(i) 
and 1902(a)(25)(I)) is authorized to convey such data or information to 
a State agency administering a State plan under this title or title 
XXI, if--
            ``(1) such data or information are used only to establish 
        or verify eligibility or provide coverage under this title or 
        title XXI; and
            ``(2) an interagency or other agreement, consistent with 
        standards developed by the Secretary, prevents the unauthorized 
        use, disclosure, or modification of such data and otherwise 
        meets applicable Federal requirements safeguarding privacy and 
        data security.
    ``(b) Requirements for Conveyance.--Data or information may be 
conveyed pursuant to this section only if the following requirements 
are met:
            ``(1) The individual whose circumstances are described in 
        the data or information (or such individual's parent, guardian, 
        caretaker relative, or authorized representative) has either 
        provided advance consent to disclosure or has not objected to 
        disclosure after receiving advance notice of disclosure and a 
        reasonable opportunity to object.
            ``(2) Such data or information are used solely for the 
        purposes of--
                    ``(A) identifying individuals who are eligible or 
                potentially eligible for assistance under this title or 
                title XXI and enrolling such individuals in the State 
                plans established under such titles; and
                    ``(B) verifying the eligibility of individuals for 
                assistance under the State plans established under this 
                title or title XXI.
            ``(3) An interagency or other agreement, consistent with 
        standards developed by the Secretary--
                    ``(A) prevents the unauthorized use, disclosure, or 
                modification of such data and otherwise meets 
                applicable Federal requirements safeguarding privacy 
                and data security; and
                    ``(B) requires the State agencies administering the 
                State plans established under this title and title XXI 
                to use the data and information obtained under this 
                section to seek to enroll individuals in such plans.
    ``(c) Criminal Penalty.--A person described in the subsection (a) 
who publishes, divulges, discloses, or makes known in any manner, or to 
any extent not authorized by Federal law, any information obtained 
under this section shall be fined not more than $1,000 or imprisoned 
not more than 1 year, or both for each such unauthorized activity.
    ``(d) Rule of Construction.--The limitations and requirements that 
apply to disclosure pursuant to this section shall not be construed to 
prohibit the conveyance or disclosure of data or information otherwise 
permitted under Federal law (without regard to this section).''.
            (2) Conforming amendment to assure access to national new 
        hires database.--Section 453(i)(1) of such Act (42 U.S.C. 
        653(i)(1)) is amended by striking ``and programs funded under 
        part A'' and inserting ``, programs funded under part A, and 
        State plans approved under title XIX or XXI''.
            (3) Conforming amendment to provide schip programs with 
        access to national income data.--Section 6103(l)(7)(D)(ii) of 
        the Internal Revenue Code of 1986 is amended by inserting ``or 
        title XXI'' after ``title XIX''.
            (4) Conforming amendment to provide access to data about 
        enrollment in insurance for purposes of evaluating applications 
        and for schip.--Section 1902(a)(25)(I)(i) of the Social 
        Security Act (42 U.S.C. 1396a(a)(25)(I)(i)) is amended--
                    (A) by inserting ``(and, at State option, 
                individuals who are potentially eligible or who 
                apply)'' after ``with respect to individuals who are 
                eligible''; and
                    (B) by inserting ``under this title (and, at State 
                option, child health assistance under title XXI)'' 
                after ``the State plan''.

SEC. 204. STATE OPTION TO EXPAND OR ADD COVERAGE OF CERTAIN PREGNANT 
              WOMEN UNDER MEDICAID AND SCHIP.

    (a) Medicaid.--
            (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 such 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) Certain pregnant women.--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) Conditions.--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) specified under the State plan under 
                subsection (a)(10)(A)(i)(III) or (l)(2)(A) of section 
                1902, on the date of enactment of this paragraph 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.--Section 2105(a)(1) of such Act (42 U.S.C. 
        1397ee(a)(1)), as amended by section 211, is amended by 
        striking subparagraph (B) and inserting the following new 
        subparagraph:
                    ``(B) for the portion of the payments made for 
                expenditures described in section 1905(u)(4)(A) that 
                represents the additional amount paid for such 
                expenditures as a result of the enhanced FMAP being 
                substituted for the Federal medical assistance 
                percentage of such expenditures;''.
    (b) CHIP.--
            (1) Coverage.--Title XXI of such Act(42 U.S.C. 1397aa et 
        seq.) is amended by adding at the end the following new 
        section:

``SEC. 2111. OPTIONAL COVERAGE OF TARGETED LOW-INCOME PREGNANT WOMEN.

    ``(a) Optional Coverage.--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) Definitions.--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.
            ``(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) 
                specified under subsection (a)(10)(A)(i)(III) or 
                (l)(2)(A) of section 1902, on January 1, 2008, 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) 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.
            ``(7) The reference in section 2107(e)(1)(F) 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 conforming amendments.--
                    (A) No cost sharing for pregnancy-related 
                benefits.--Section 2103(e)(2) (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) No waiting period.--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) Other Amendments to Medicaid.--
            (1) Eligibility of a newborn.--Section 1902(e)(4) (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) 
        (42 U.S.C. 1396r-1(b)) is amended by adding after paragraph (2) 
        the following new flush sentence:
``The term `qualified provider' includes a qualified entity as defined 
in section 1920A(b)(3).''.

SEC. 205. OPTIONAL COVERAGE OF LEGAL IMMIGRANTS UNDER MEDICAID AND 
              SCHIP.

    (a) Medicaid Program.--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, notwithstanding 
sections 401(a), 402(b), 403, and 421 of the Personal Responsibility 
and Work Opportunity Reconciliation Act of 1996, for aliens who are 
lawfully residing in the United States (including battered aliens 
described in section 431(c) of such Act) and who are otherwise eligible 
for such assistance, within either or both of the following eligibility 
categories:
            ``(i) Pregnant women.--Women during pregnancy (and during 
        the 60-day period beginning on the last day of the pregnancy).
            ``(ii) Children.--Individuals under 21 years of age, 
        including optional targeted low-income children described in 
        section 1905(u)(2)(B).
    ``(B) 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.''.
    (b) SCHIP.--Section 2107(e)(1) of such Act (42 U.S.C. 
1397gg(e)(1)), as amended by section 202(b), is amended by 
redesignating subparagraphs (D) and (E) as subparagraph (E) and (F), 
respectively, and by inserting after subparagraph (C) the following new 
subparagraph:
                    ``(D) Section 1903(v)(4) (relating to optional 
                coverage of categories of lawfully residing immigrant 
                children), but only if the State has elected to apply 
                such section to the category of children under title 
                XIX.''.
    (c) Effective Date.--The amendments made by this section take 
effect on October 1, 2007, and apply to medical assistance and child 
health assistance furnished on or after such date.
    (d) Construction.--Nothing in this section shall be construed as 
affecting eligibility of aliens who are not lawfully residing in the 
United States to benefits under the Medicaid program under title XIX of 
the Social Security Act or under the State children's health insurance 
program (SCHIP) under title XXI of such Act.

SEC. 206. AUTHORIZING ADJUSTMENT OF SCHIP ALLOTMENT DUE TO INCREASED 
              OUTREACH.

    (a) In General.--Section 2104 of the Social Security Act (42 U.S.C. 
1397dd), as amended by section 101, is further amended by adding at the 
end the following new subsection:
    ``(j) Authorizing Allotment Adjustment Due to Increased Outreach.--
            ``(1) In general.--Notwithstanding the previous provisions 
        of this section, if the Secretary determines that--
                    ``(A) a State has an increase in the average number 
                of children enrolled under its State child health plan 
                in a fiscal year that exceeds the enrollment of 
                children projected under paragraph (2) for the State 
                for such fiscal year, and
                    ``(B) the total Federal expenditures under the 
                State child health plan (or waiver) under this title 
                exceeds the amount of the allotment made available to 
                the State for the fiscal year,
        the Secretary shall increase the allotment under this section 
        for the State for the fiscal year by the amount specified in 
        paragraph (3). There are hereby appropriated, out of any money 
        in the Treasury not otherwise appropriated, such sums as may be 
        necessary to provide for such increase in allotment.
            ``(2) Projected enrollment of children.--The projected 
        enrollment of children for a State under this paragraph for a 
        fiscal year is equal to the average number of children enrolled 
        under the State child health plan in fiscal year 2007 
        increased, for each subsequent fiscal year through the fiscal 
        year involved, by a factor equal to the population growth of 
        children in the State for such fiscal year, as projected by the 
        Secretary before the beginning of the fiscal year involved.
            ``(3) Amount of allotment increase.--
                    ``(A) In general.--Subject to subparagraph (B), the 
                amount of the allotment increase under this subsection 
                for a State for a fiscal year shall be an amount equal 
                to the product of--
                            ``(i) the number by which the average 
                        number of children enrolled under the State 
                        child health plan in the fiscal year exceeds 
                        the enrollment of children projected under 
                        paragraph (2) for such State for such fiscal 
                        year; and
                            ``(ii) the per capita expenditures for 
                        children under the State child health plan for 
                        the previous year, increased by the average 
                        annual rate of increase (for the three previous 
                        fiscal years) in the amount of such per capita 
                        expenditures.
                The amount of the allotment increase under this 
                subsection shall not be subject to administrative or 
                judicial review.
                    ``(B) Limitation.--
                            ``(i) In general.--Subject to clause (ii), 
                        in no case shall the sum of the allotment 
                        increases for all States under this subsection 
                        for a fiscal year exceed an amount equal to 20 
                        percent of the total Federal payments to all of 
                        the States otherwise made under this title for 
                        the fiscal year. If such sum exceeds such 
                        amount, subject to clause (ii), the allotment 
                        increase for each State under this subsection 
                        for the fiscal year shall be reduced in a pro 
                        rata manner in order that such sum does not 
                        exceed such amount.
                            ``(ii) Congressional approval of additional 
                        amounts.--If the Secretary estimates that the 
                        allotment increases that should be provided 
                        under this subsection, but for clause (i), 
                        would exceed the limitation established under 
                        such clause, the Secretary shall submit to 
                        Congress a request for supplemental 
                        appropriations for the purpose of meeting such 
                        shortfall.
            ``(4) Clarification.--An adjustment in an allotment shall 
        not be made under this subsection due to excess State 
        expenditures resulting from a growth in per capita costs, 
        increased reimbursement to providers, or other factors not 
        directly related to outreach to eligible, but previously 
        unenrolled children.''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
take effect beginning with allotments for fiscal year 2008.

SEC. 207. MODEL OF INTERSTATE COORDINATED ENROLLMENT AND COVERAGE 
              PROCESS.

    In order to assure continuity of coverage of low-income children 
under the Medicaid program and the State Children's Health Insurance 
Program (SCHIP), the Secretary of Health and Human Services, in 
consultation with State Medicaid and SCHIP directors, shall develop and 
disseminate a model process for the coordination of the enrollment and 
coverage under such programs of children who, because of migration of 
families, emergency evacuations, educational needs, or otherwise, 
frequently change their State of residency or otherwise are temporarily 
present outside of the State of their residency.

SEC. 208. AUTHORITY FOR QUALIFYING STATES TO USE PORTION OF SCHIP 
              ALLOTMENT FOR ANY FISCAL YEAR FOR CERTAIN MEDICAID 
              EXPENDITURES.

    Section 2105(g)(1)(A) of the Social Security Act (42 U.S.C. 
1397ee(g)(1)(A)), as amended by section 201(b) of the National 
Institutes of Health Reform Act of 2006 (Public Law 109-482) is amended 
by striking ``fiscal year 1998, 1999, 2000, 2001, 2004, 2005, 2006, or 
2007'' and inserting ``a fiscal year''.

SEC. 209. APPLICATION OF MEDICAID OUTREACH PROCEDURES TO ALL PREGNANT 
              WOMEN AND CHILDREN.

    (a) In General.--Section 1902(a)(55) of the Social Security Act (42 
U.S.C. 1396a(a)(55)) is amended by striking ``individuals for medical 
assistance under subsection (a)(10)(A)(i)(IV), (a)(10)(A)(i)(VI), 
(a)(10)(A)(i)(VII), or (a)(10)(A)(ii)(IX)'' and inserting ``child and 
pregnant women for medical assistance (including under clauses (i)(IV), 
(i)(VI), (i)(VII), and (ii)(IX) of paragraph (10)(A))''.
    (b) Effective Date.--
            (1) In general.--
            (2) Exception for state legislation.--In the case of a 
        State plan under title XIX of the Social Security Act, which 
        the Secretary of Health and Human Services determines requires 
        State legislation in order for the plan to meet the additional 
        requirements imposed by the amendment made by subsection (a), 
        the State plan shall not be regarded as failing to comply with 
        the requirements of such Act 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 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 the session shall be 
        considered to be a separate regular session of the State 
        legislature.

SEC. 210. NO IMPACT ON SECTION 1115 WAIVERS.

    Nothing in this Act shall be construed to affect State flexibility 
on eligibility and waivers approved by the Federal government under 
section 1115 of the Social Security Act (42 U.S.C. 1315).

SEC. 211. 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--
            (1) 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
            (2) by amending subparagraph (B) to read as follows:
                    ``(B) [reserved]''.

SEC. 212. PROHIBITING LIMITATIONS ON ENROLLMENT.

    (a) In General.--Section 2102(b)(3)(B) of the Social Security Act 
(42 U.S.C. 1397bb(b)(3)(B)) is amended--
            (1) by striking ``and'' at the end of clause (i);
            (2) by striking the period at the end of clause (ii) and 
        inserting ``; and''; and
            (3) by adding at the end the following new clause:
                            ``(iii) shall not impose, with respect to 
                        enrollment of targeted low-income children 
                        under the State child health plan, any 
                        enrollment cap or other numerical limitation on 
                        enrollment, any waiting list, any procedures 
                        designed to delay the consideration of 
                        applications for enrollment, or similar 
                        limitation with respect to enrollment.''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply to State child health plans as of October 1, 2007.

         TITLE III--ELIMINATION OF CERTAIN BARRIERS TO COVERAGE

SEC. 301. STATE OPTION TO REQUIRE CERTAIN INDIVIDUALS TO PRESENT 
              SATISFACTORY DOCUMENTARY EVIDENCE OF PROOF OF CITIZENSHIP 
              OR NATIONALITY FOR PURPOSES OF ELIGIBILITY FOR MEDICAID.

    (a) In General.--Section 1902(a)(46) of the Social Security Act (42 
U.S.C. 1396a(a)(46)) is amended--
            (1) by inserting ``(A)'' after ``(46)'';
            (2) by adding ``and'' after the semicolon; and
            (3) by adding at the end the following new subparagraph:
            ``(B) at the option of the State and subject to section 
        1903(x), require that, with respect to an individual (other 
        than an individual described in section 1903(x)(1)) who 
        declares to be a citizen or national of the United States for 
        purposes of establishing initial eligibility for medical 
        assistance under this title (or, at State option, for purposes 
        of renewing or redetermining such eligibility to the extent 
        that such satisfactory documentary evidence of citizenship or 
        nationality has not yet been presented), there is presented 
        satisfactory documentary evidence of citizenship or nationality 
        of the individual (using criteria determined by the State, 
        which shall be no more restrictive than the criteria used by 
        the Social Security Administration to determine citizenship, 
        and which shall accept as such evidence a document issued by a 
        federally recognized Indian tribe evidencing membership or 
        enrollment in, or affiliation with, such tribe (such as a 
        tribal enrollment card or certificate of degree of Indian 
        blood, and, with respect to those federally recognized Indian 
        tribes located within States having an international border 
        whose membership includes individuals who are not citizens of 
        the United States, such other forms of documentation (including 
        tribal documentation, if appropriate) that the Secretary, after 
        consulting with such tribes, determines to be satisfactory 
        documentary evidence of citizenship or nationality for purposes 
        of satisfying the requirement of this subparagraph));''.
    (b) Limitation on Waiver Authority.--Notwithstanding any provision 
of section 1115 of the Social Security Act (42 U.S.C. 1315), or any 
other provision of law, the Secretary may not waive the requirements of 
section 1902(a)(46)(B) of such Act (42 U.S.C. 1396a(a)(46)(B)) with 
respect to a State.
    (c) Conforming Amendments.--Section 1903 of such Act (42 U.S.C. 
1396b) is amended--
            (1) in subsection (i)--
                    (A) in paragraph (20), by adding ``or'' after the 
                semicolon;
                    (B) in paragraph (21), by striking ``; or'' and 
                inserting a period; and
                    (C) by striking paragraph (22); and
            (2) in subsection (x) (as amended by section 405(c)(1)(A) 
        of division B of the Tax Relief and Health Care Act of 2006 
        (Public Law 109-432))--
                    (A) by striking paragraphs (1) and (3);
                    (B) by redesignating paragraph (2) as paragraph 
                (1);
                    (C) in paragraph (1), as so redesignated, by 
                striking ``paragraph (1)'' and inserting ``section 
                1902(a)(46)(B)''; and
                    (D) by adding at the end the following new 
                paragraphs:
    ``(2) In the case of an individual declaring to be a citizen or 
national of the United States with respect to whom a State requires the 
presentation of satisfactory documentary evidence of citizenship or 
nationality under section 1902(a)(46)(B), the individual shall be 
provided at least the reasonable opportunity to present satisfactory 
documentary evidence of citizenship or nationality under this 
subsection as is provided under clauses (i) and (ii) of section 
1137(d)(4)(A) to an individual for the submittal to the State of 
evidence indicating a satisfactory immigration status.
    ``(3)(A) In addition to the criteria established by the State for 
purposes of section 1902(a)(46)(B), a State shall deem presentation of 
the following documents to be `satisfactory documentary evidence of 
citizenship or nationality' (and shall not favor presentation of 1 type 
of document described over another):
            ``(i) Any document described in subparagraph (B).
            ``(ii) Any document described in subparagraph (C) when 
        presented with any document described in subparagraph (D).
            ``(iii) Any document described in subparagraph (E) if the 
        requirements of that subparagraph are met.
    ``(B) The following are documents described in this subparagraph:
            ``(i) A United States passport.
            ``(ii) Form N-550 or N-570 (Certificate of Naturalization).
            ``(iii) Form N-560 or N-561 (Certificate of United States 
        Citizenship).
            ``(iv) A valid State-issued driver's license or other 
        identity document described in section 274A(b)(1)(D) of the 
        Immigration and Nationality Act, but only if the State issuing 
        the license or such document requires proof of United States 
        citizenship before issuance of such license or document or 
        obtains a social security number from the applicant and 
        verifies before certification that such number is valid and 
        assigned to the applicant who is a citizen.
            ``(v) Such other document as the Secretary may specify, by 
        regulation, that provides proof of United States citizenship or 
        nationality and that provides a reliable means of documentation 
        of personal identity.
    ``(C) The following are documents described in this subparagraph:
            ``(i) A certificate of birth in the United States.
            ``(ii) Form FS-545 or Form DS-1350 (Certification of Birth 
        Abroad).
            ``(iii) Form I-197 (United States Citizen Identification 
        Card).
            ``(iv) Form FS-240 (Report of Birth Abroad of a Citizen of 
        the United States).
            ``(v) Such other document (not described in subparagraph 
        (B)(iv)) as the Secretary may specify that provides proof of 
        United States citizenship or nationality.
    ``(D) The following are documents described in this subparagraph:
            ``(i) Any identity document described in section 
        274A(b)(1)(D) of the Immigration and Nationality Act.
            ``(ii) Any other documentation of personal identity of such 
        other type as the Secretary finds, by regulation, provides a 
        reliable means of identification.
    ``(E) A document described in this subparagraph is an affidavit of 
citizenship or identity, or both, which need not be notarized or 
witnessed, but only if the individual has been unable to acquire other 
satisfactory documentary evidence within the reasonable opportunity 
period established by the State, despite a good faith effort to do so. 
An individual shall be deemed unable to acquire such documentary 
evidence--
            ``(i) if there is good reason to believe that such 
        documentary evidence does not exist;
            ``(ii) if, after a timely request for such documentary 
        evidence, it has not been received by the State or the 
        individual within the reasonable opportunity period established 
        by the State;
            ``(iii) if such documentary evidence cannot be acquired at 
        a nominal cost to the individual; or
            ``(iv) in such additional situations as the Secretary may 
        describe.
    ``(F)(i) A reference in this paragraph to a form includes a 
reference to any successor form.
    ``(ii) Any legible copy of a form described in this paragraph shall 
be accepted as if it were the original of such form.''.
    (d) Clarification of Rules for Children Born in the United States 
to Mothers Eligible for Medicaid.--Section 1903(x) of such Act (42 
U.S.C. 1396b(x)), as amended by subsection (c)(2), is amended--
            (1) in paragraph (1)--
                    (A) in subparagraph (C), by striking ``or'' at the 
                end;
                    (B) by redesignating subparagraph (D) as 
                subparagraph (E); and
                    (C) by inserting after subparagraph (C) the 
                following new subparagraph:
            ``(D) pursuant to the application of section 1902(e)(4) 
        (and, in the case of an individual who is eligible for medical 
        assistance on such basis, the individual shall be deemed to 
        have provided satisfactory documentary evidence of citizenship 
        or nationality and shall not be required to provide further 
        documentary evidence on any date that occurs during or after 
        the period in which the individual is eligible for medical 
        assistance on such basis); or''; and
            (2) by adding at the end the following new paragraph:
    ``(4) Nothing in subparagraph (A) or (B) of section 1902(a)(46), 
the preceding paragraphs of this subsection, or the Deficit Reduction 
Act of 2005, including section 6036 of such Act, shall be construed as 
changing the requirement of section 1902(e)(4) that a child born in the 
United States to an alien mother for whom medical assistance for the 
delivery of such child is available as treatment of an emergency 
medical condition pursuant to subsection (v) shall be deemed eligible 
for medical assistance during the first year of such child's life.''.
    (e) Effective Date.--
            (1) Retroactive application.--The amendments made by this 
        section shall take effect as if included in the enactment of 
        the Deficit Reduction Act of 2005 (Public Law 109-171; 120 
        Stat. 4).
            (2) Restoration of eligibility.--In the case of an 
        individual who, during the period that began on July 1, 2006, 
        and ends on the date of enactment of this Act, was determined 
        to be ineligible for medical assistance under a State Medicaid 
        program solely as a result of the application of subsections 
        (i)(22) and (x) of section 1903 of the Social Security Act (as 
        in effect during such period), but who would have been 
        determined eligible for such assistance if such subsections, as 
        amended by this section, had applied to the individual, a State 
        may deem the individual to be eligible for such assistance as 
        of the date that the individual was determined to be ineligible 
        for such medical assistance on such basis.

SEC. 302. INCREASED FEDERAL MATCHING RATE FOR LANGUAGE SERVICES 
              PROVIDED UNDER MEDICAID OR SCHIP.

    (a) In General.--Section 1903(a)(3) of the Social Security Act (42 
U.S.C. 1396b(a)(3)) is amended--
            (1) in subparagraph (E)(ii), by striking ``plus'' at the 
        end; and
            (2) by adding at the end the following:
            ``(3) 85 percent of the sums expended with respect to costs 
        incurred during such quarter as are attributable to the 
        provision of language services on behalf of individuals with 
        limited English proficiency who apply for or receive medical 
        assistance under the State plan (including any provisions of 
        the plan implemented pursuant to any waiver authority of the 
        Secretary) or child health assistance under title XXI; plus''.
    (b) Effective Date.--The amendments made by subsection (a) take 
effect on October 1, 2007, and apply to language services provided on 
or after that date.

 TITLE IV--GRANTS TO PROMOTE INNOVATIVE OUTREACH AND ENROLLMENT UNDER 
                           MEDICAID AND SCHIP

SEC. 401. GRANTS TO PROMOTE INNOVATIVE OUTREACH AND ENROLLMENT UNDER 
              MEDICAID AND SCHIP.

    Title XXI of the Social Security Act (42 U.S.C. 1397aa et seq.), as 
amended by section 204(b), is amended by adding at the end the 
following:

``SEC. 2112. EXPANDED OUTREACH AND ENROLLMENT ACTIVITIES.

    ``(a) Grants To Conduct Innovative Outreach and Enrollment 
Efforts.--
            ``(1) In general.--The Secretary shall award grants to 
        eligible entities to--
                    ``(A) conduct innovative outreach and enrollment 
                efforts that are designed to increase the enrollment 
                and participation of eligible children under this title 
                and title XIX; and
                    ``(B) promote understanding of the importance of 
                health insurance coverage for prenatal care and 
                children.
            ``(2) Performance bonuses.--The Secretary may reserve a 
        portion of the funds appropriated under subsection (g) for a 
        fiscal year for the purpose of awarding performance bonuses 
        during the succeeding fiscal year to eligible entities that 
        meet enrollment goals or other criteria established by the 
        Secretary.
    ``(b) Priority for Award of Grants.--
            ``(1) In general.--In making grants under subsection 
        (a)(1), the Secretary shall give priority to--
                    ``(A) eligible entities that propose to target 
                geographic areas with high rates of--
                            ``(i) eligible but unenrolled children, 
                        including such children who reside in rural 
                        areas; or
                            ``(ii) racial and ethnic minorities and 
                        health disparity populations, including those 
                        proposals that address cultural and linguistic 
                        barriers to enrollment; and
                    ``(B) eligible entities that plan to engage in 
                outreach efforts with respect to individuals described 
                in subparagraph (A) and that are--
                            ``(i) Federal health safety net 
                        organizations; or
                            ``(ii) faith-based organizations or 
                        consortia.
            ``(2) 10 percent set aside for outreach to indian 
        children.--An amount equal to 10 percent of the funds 
        appropriated under subsection (g) for a fiscal year shall be 
        used by the Secretary to award grants to Indian Health Service 
        providers and urban Indian organizations receiving funds under 
        title V of the Indian Health Care Improvement Act (25 U.S.C. 
        1651 et seq.) for outreach to, and enrollment of, children who 
        are Indians.
    ``(c) Application.--An eligible entity that desires to receive a 
grant under subsection (a)(1) shall submit an application to the 
Secretary in such form and manner, and containing such information, as 
the Secretary may decide. Such application shall include--
            ``(1) quality and outcomes performance measures to evaluate 
        the effectiveness of activities funded by a grant awarded under 
        this section to ensure that the activities are meeting their 
        goals; and
            ``(2) an assurance that the entity shall--
                    ``(A) conduct an assessment of the effectiveness of 
                such activities against such performance measures; and
                    ``(B) cooperate with the collection and reporting 
                of enrollment data and other information determined as 
                a result of conducting such assessments to the 
                Secretary, in such form and manner as the Secretary 
                shall require.
    ``(d) Dissemination of Enrollment Data and Information Determined 
From Effectiveness Assessments; Annual Report.--The Secretary shall--
            ``(1) disseminate to eligible entities and make publicly 
        available the enrollment data and information collected and 
        reported in accordance with subsection (c)(2)(B); and
            ``(2) submit an annual report to Congress on the outreach 
        activities funded by grants awarded under this section.
    ``(e) Supplement, Not Supplant.--Federal funds awarded under this 
section shall be used to supplement, not supplant, non-Federal funds 
that are otherwise available for activities funded under this section.
    ``(f) Definitions.--In this section:
            ``(1) Eligible entity.--The term `eligible entity' means 
        any of the following:
                    ``(A) A State or local government.
                    ``(B) A Federal health safety net organization.
                    ``(C) A national, local, or community-based public 
                or nonprofit private organization, including 
                organizations that use community health workers or 
                community-based doula programs.
                    ``(D) A faith-based organization or consortia, to 
                the extent that a grant awarded to such an entity is 
                consistent with the requirements of section 1955 of the 
                Public Health Service Act (42 U.S.C. 300x-65) relating 
                to a grant award to non-governmental entities.
                    ``(E) An elementary or secondary school.
            ``(2) Federal health safety net organization.--The term 
        `Federal health safety net organization' means--
                    ``(A) an Indian tribe, tribal organization, or an 
                urban Indian organization receiving funds under title V 
                of the Indian Health Care Improvement Act (25 U.S.C. 
                1651 et seq.), or an Indian Health Service provider;
                    ``(B) a Federally-qualified health center (as 
                defined in section 1905(l)(2)(B));
                    ``(C) a hospital defined as a disproportionate 
                share hospital for purposes of section 1923;
                    ``(D) a covered entity described in section 
                340B(a)(4) of the Public Health Service Act (42 U.S.C. 
                256b(a)(4)); and
                    ``(E) any other entity or a consortium that serves 
                children under a federally-funded program, including 
                the special supplemental nutrition program for women, 
                infants, and children (WIC) established under section 
                17 of the Child Nutrition Act of 1966 (42 U.S.C. 1786), 
                the head start and early head start programs under the 
                Head Start Act (42 U.S.C. 9801 et seq.), the school 
                lunch program established under the Richard B. Russell 
                National School Lunch Act, and an elementary or 
                secondary school.
            ``(3) Indians; indian tribe; tribal organization; urban 
        indian organization.--The terms `Indian', `Indian tribe', 
        `tribal organization', and `urban Indian organization' have the 
        meanings given such terms in section 4 of the Indian Health 
        Care Improvement Act (25 U.S.C. 1603).
    ``(g) Appropriation.--There is appropriated, out of any money in 
the Treasury not otherwise appropriated, $50,000,000 for each of fiscal 
years 2008 through 2012 for the purpose of awarding grants under this 
section. Amounts appropriated and paid under the authority of this 
section shall be in addition to amounts appropriated under section 2104 
and paid to States in accordance with section 2105, including with 
respect to expenditures for outreach activities in accordance with 
subsection (a)(1)(D)(iii) of such section.''.

            TITLE V--IMPROVING THE QUALITY OF PEDIATRIC CARE

SEC. 501. REQUIRING COVERAGE OF EPSDT SERVICES, INCLUDING DENTAL 
              SERVICES; STATE OPTION TO PROVIDE SUPPLEMENTAL COVERAGE 
              OF DENTAL SERVICES.

    (a) Additional Required Services.--
            (1) Required coverage of epsdt services, including dental 
        services.--Section 2103(c) of the Social Security Act (42 
        U.S.C. 1397cc(c)) is amended--
                    (A) by redesignating paragraph (5) as paragraph 
                (6); and
                    (B) by inserting after paragraph (4), the 
                following:
            ``(5) Other required services.--The child health assistance 
        provided to a targeted low-income child shall include coverage 
        of early and periodic screening, diagnostic, and treatment 
        services described in subsections (a)(4)(B) and (r) of section 
        1905 and provided in accordance with section 1903(a)(43) 
        (including dental services that are necessary to prevent 
        disease and promote oral health, restore oral structures to 
        health and function, and treat emergency conditions).''.
            (2) State child health plan requirement.--Section 
        2102(a)(7)(B) of such Act (42 U.S.C. 1397bb(c)(2)) is amended 
        by inserting ``and services described in section 2103(c)(5)'' 
        after ``emergency services''.
            (3) Conforming amendment.--Section 2103(a) of such Act (42 
        U.S.C. 1397cc(a)) is amended, in the matter preceding paragraph 
        (1), by striking ``subsection (c)(5)'' and inserting 
        ``paragraphs (5) and (6) of subsection (c)''.
    (b) State Option To Provide Supplemental Coverage of Dental 
Services Under SCHIP to Children With Other Health Coverage.--
            (1) In general.--Section 2110(b) of the Social Security Act 
        (42 U.S.C. 1397jj(b)) is amended--
                    (A) in paragraph (1)(C), by inserting ``, subject 
                to paragraph (5),'' after ``under title XIX or''; and
                    (B) by adding at the end the following:
            ``(5) State option to provide supplemental coverage of 
        dental services to children with other health coverage.--
                    ``(A) In general.--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 in order to 
                provide dental services that are not covered, or are 
                only partially covered, under such plan or coverage. 
                Nothing in subsection (c)(5) of section 2103 shall be 
                construed as prohibiting a State from limiting the 
                supplemental coverage of dental services provided in 
                accordance with this paragraph and nothing in paragraph 
                (2) or (3) of subsection (e) of such section shall be 
                construed as prohibiting a State from imposing 
                premiums, deductibles, cost-sharing, or similar charges 
                for such coverage without regard to the requirements of 
                either such paragraph.
                    ``(B) 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, which may not exceed the 
                maximum income level otherwise established for other 
                children under the State child health plan.
                    ``(C) Continued application of duty to prevent 
                substitution of existing coverage.--Nothing in this 
                paragraph shall be construed as modifying the 
                application of section 2102(b)(3)(C) to a State.''.
            (2) Application of enhanced match under medicaid.--Section 
        1905 of such Act (42 U.S.C. 1396d) is amended--
                    (A) in subsection (b), in the fourth sentence, by 
                striking ``subsection (u)(3)'' and inserting ``(u)(3), 
                or (u)(4)''; and
                    (B) in subsection (u), by redesignating paragraph 
                (4) as paragraph (5) and by inserting after paragraph 
                (3) the following:
    ``(4) For purposes of subsection (b), the expenditures described in 
this paragraph are expenditures for supplemental coverage of dental 
services for children described in section 2110(b)(5).''.
            (3) Application of secondary payor provisions.--Section 
        2107(e)(1) of such Act (42 U.S.C. 1397gg(e)(1)) is amended--
                    (A) by redesignating subparagraphs (B) through (D) 
                as subparagraphs (C) through (E), respectively; and
                    (B) by inserting after subparagraph (A) the 
                following new subparagraph:
                    ``(B) Section 1902(a)(25) (relating to coordination 
                of benefits and secondary payor provisions) with 
                respect to children provided supplemental coverage of 
                dental services under a waiver described in section 
                2110(b)(5).''.

SEC. 502. PEDIATRIC QUALITY AND PERFORMANCE MEASURES PROGRAM.

    Title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) is 
amended--
            (1) by redesignating section 1939 as section 1941; and
            (2) by inserting after section 1938 the following:

          ``pediatric quality and performance measures program

    ``Sec. 1939.  (a) Establishment.--The Secretary, acting through the 
Administrator of the Centers for Medicare & Medicaid Services and in 
consultation with the Director of the Agency for Healthcare Research 
and Quality, shall establish a program to encourage and support the 
development of new and emerging quality and performance measures for 
providers of pediatric care through the activities described in 
subsection (c). In establishing the program, gaps in existing evidence-
based measures and priority areas for advancement shall be identified.
    ``(b) Purpose.--The purpose of the program is to ensure that--
            ``(1) evidence-based pediatric quality and performance 
        measures are developed; and
            ``(2) such measures are available for States, other 
        purchasers of pediatric health care services, health care 
        providers, and consumers to use.
    ``(c) Program Activities.--
            ``(1) Identifying quality and performance measures for 
        providers of pediatric services and opportunities for new 
        measures.--Not later than 3 months after the date of enactment 
        of this section, the Secretary shall identify quality and 
        performance measures for providers of pediatric services and 
        opportunities for the development of new measures, taking into 
        consideration existing evidence-based measures. In conducting 
        this review, the Secretary shall--
                    ``(A) ensure the inclusion of at least 1 measure 
                related to children's dental and oral health; and
                    ``(B) convene and consult with representatives of--
                            ``(i) States;
                            ``(ii) pediatric hospitals, pediatricians, 
                        and other pediatric health professionals;
                            ``(iii) national organizations 
                        representing--
                                    ``(I) consumers of children's 
                                health care; and
                                    ``(II) purchasers of children's 
                                health care;
                            ``(iv) experts in pediatric quality and 
                        performance measurement; and
                            ``(v) a voluntary consensus standards 
                        setting organization and other organizations 
                        involved in the advancement of consensus on 
                        evidence-based measures of health care.
            ``(2) Developing, validating, and testing new measures.--
        The Secretary shall award grants or contracts to eligible 
        entities (as defined in subsection (d)(1)) for the development, 
        validation, and testing of new and emerging quality and 
        performance measures, including at least 1 measure related to 
        children's dental and oral health, for providers of pediatric 
        services. Such measures shall--
                    ``(A) provide consumers and purchasers (including 
                States and beneficiaries under the program under this 
                title and title XXI) with information about provider 
                performance and quality; and
                    ``(B) assist health care providers in improving the 
                quality of the items and services they provide and 
                their performance with respect to the provision of such 
                items and services.
            ``(3) Achieving consensus on evidence-based measures.--The 
        Secretary shall award grants or contracts to eligible consensus 
        entities (as defined in subsection (d)(2)) for the development 
        of consensus on evidence-based measures for pediatric care, 
        including at least 1 measure related to children's dental and 
        oral health, that have broad acceptability in the health care 
        industry.
    ``(d) Eligible Entities.--
            ``(1) Development, validation, and testing.--For purposes 
        of paragraph (2) of subsection (c), the term `eligible entity' 
        means--
                    ``(A) organizations with demonstrated expertise and 
                capacity in the development and evaluation of pediatric 
                quality and performance measures;
                    ``(B) an organization or association of health care 
                providers with demonstrated experience in working with 
                accrediting organizations in developing pediatric 
                quality and performance measures; and
                    ``(C) a collaboration of national pediatric 
                organizations working to improve pediatric quality and 
                performance measures.
            ``(2) Achievement of consensus.--For purposes of paragraph 
        (3) of such subsection, the term `eligible consensus entity' 
        means an organization, including a voluntary consensus 
        standards setting organization involved in the advancement of 
        consensus on evidence-based measures of health care.
    ``(e) Ongoing Authority To Update and Adjust Pediatric Measures.--
The Secretary may update and adjust measures developed and advanced 
under the program under this section in accordance with--
            ``(1) any changes that a voluntary consensus standards 
        setting organization determines should be made with respect to 
        such measures; or
            ``(2) new evidence indicating the need for changes with 
        respect to such measures.
    ``(f) Addition of Pediatric Consumer Assessment Measures to CAHPS 
Hospital Survey Conducted by AHRQ.--The Director of the Agency for 
Healthcare Research and Quality shall ensure that consumer assessment 
measures for hospital services for children are added to the Consumer 
Assessment of Healthcare Providers and Systems (CAHPS) Hospital survey 
conducted by such Agency.
    ``(g) Appropriation.--There are authorized to be appropriated and 
there are appropriated, for the purpose of carrying out this section, 
$10,000,000, for each of fiscal years 2008 through 2012, to remain 
available until expended.''.

SEC. 503. GRANTS TO STATES FOR DEMONSTRATION PROJECTS TRANSFORMING 
              DELIVERY OF PEDIATRIC CARE.

    Title XIX of the Social Security Act (42 U.S.C. 1396 et seq.), as 
amended by section 502, is amended by inserting after section 1939 the 
following:

``grants to states for demonstration projects transforming delivery of 
                             pediatric care

    ``Sec. 1940.  (a) Establishment.--The Secretary, acting through the 
Administrator of the Centers for Medicare & Medicaid Services, shall 
establish demonstration projects, including demonstration projects in 
each of the 4 categories described in subsection (d), to award grants 
to States to improve the delivery of health care services provided to 
children under this title and title XXI.
    ``(b) Duration.--The demonstration projects shall be conducted for 
a period of 4 years.
    ``(c) Eligibility.--A State shall not be eligible to receive a 
grant under this section unless the State has demonstrated experience 
or commitment to the concept of transformation in the delivery of 
pediatric care.
    ``(d) Categories of Projects.--The following categories of projects 
are described in this subsection:
            ``(1) Health information technology systems.--Projects for 
        developing health information technology systems, including 
        technology acquisition, electronic health record development, 
        data standards development, and software development, for 
        pediatric hospital and physician services and other community-
        based services; implementing model systems; and evaluating 
        their impact on the quality, safety, and costs of care.
            ``(2) Disease management.--Projects for providing provider-
        based care disease management for children with chronic 
        conditions (including physical, developmental, behavioral, and 
        psychological conditions), demonstrating the effectiveness of 
        provider-based management models in promoting better care, 
        reducing adverse health outcomes, and preventing avoidable 
        hospitalizations.
            ``(3) Evidence-based quality improvements.--Projects for 
        implementing evidence-based approaches to improving efficiency, 
        safety, and effectiveness in the delivery of hospital care for 
        children across hospital services, evaluating the translation 
        of successful models of such evidence-based approaches to other 
        institutions, and the impact of such changes on the quality, 
        safety, and costs of care.
            ``(4) Quality and performance measures for providers of 
        children's health care services.--Projects to pilot test 
        evidence-based pediatric quality and performance measures for 
        inpatient hospital services, physician services, or services of 
        other health professionals, determining the reliability, 
        feasibility, and validity of such measures, and evaluating 
        their potential impact on improving the quality and delivery of 
        children's health care. To the extent feasible, such measures 
        shall have been approved by consensus standards setting 
        organizations.
    ``(e) Uniform Metrics.--The Secretary shall establish uniform 
metrics (adjusted, as appropriate, for patient acuity), collect data, 
and conduct evaluations with respect to each demonstration project 
category described in subsection (d). In establishing such metrics, 
collecting such data, and conducting such evaluations, the Secretary 
shall consult with--
            ``(1) experts in each such demonstration project category;
            ``(2) participating States;
            ``(3) national pediatric provider organizations;
            ``(4) health care consumers; and
            ``(5) such other entities or individuals with relevant 
        expertise as the Secretary determines appropriate.
    ``(f) Evaluation and Report.--The Secretary shall evaluate the 
demonstration projects conducted under this section and submit a report 
to Congress not later than 3 months before the completion of each 
demonstration project that includes the findings of the evaluation and 
recommendations with respect to--
            ``(1) expansion of the demonstration project to additional 
        States and sites; and
            ``(2) the broader implementation of approaches identified 
        as being successful in advancing quality and performance in the 
        delivery of medical assistance provided to children under this 
        title and title XXI.
    ``(g) Waiver.--The Secretary may waive the requirements of this 
title and title XXI to the extent necessary to carry out the 
demonstration projects under this section.
    ``(h) Amounts Paid to a State.--Amounts paid to a State under this 
section--
            ``(1) shall be in addition to Federal payments made to the 
        State under section 1903(a);
            ``(2) shall not be used for the State share of any 
        expenditures claimed for payment under such section; and
            ``(3) shall be used only for expenditures of the State for 
        participating in the demonstration projects, or for 
        expenditures of providers in participating in the demonstration 
        projects, including--
                    ``(A) administrative costs of States and 
                participating providers (such as costs associated with 
                the design and evaluation of, and data collection 
                under, the demonstration projects); and
                    ``(B) such other expenditures that are not 
                otherwise eligible for reimbursement under this title 
                or title XXI as the Secretary may determine 
                appropriate.
    ``(i) Appropriation.--There are authorized to be appropriated and 
there are appropriated, for the purpose of carrying out this section, 
to remain available until expended $10,000,000 for each of fiscal years 
2008 through 2012.''.

SEC. 504. REPORT BY THE COMPTROLLER GENERAL ON DESIGN AND 
              IMPLEMENTATION OF A DEMONSTRATION PROJECT EVALUATING 
              EXISTING QUALITY AND PERFORMANCE MEASURES FOR CHILDREN'S 
              INPATIENT HOSPITAL SERVICES.

    (a) In General.--Not later than 12 months after the date of 
enactment of this Act, the Comptroller General of the United States (in 
this section referred to as the ``Comptroller General'') shall submit a 
report to Congress containing recommendations for the design and 
implementation of a demonstration project to evaluate the suitability 
of existing quality and performance measures for children's inpatient 
hospital services for public reporting, differentiating quality, 
identifying best practices, and providing a basis for payment rewards.
    (b) Development of Recommendations.--In developing the 
recommendations submitted under subsection (a), the Comptroller General 
shall accomplish the following:
            (1) Consider which agency within the Department of Health 
        and Human Services should have primary responsibility and 
        oversight for such a demonstration project.
            (2) Determine a sufficient number of participating 
        hospitals and volume of children's cases, given existing 
        measures that might be chosen for evaluation under such a 
        demonstration project.
            (3) Determine the number of States and variety of 
        geographic locations that may be required to conduct such a 
        demonstration project.
            (4) Describe alternatives for administering and directing 
        funding for such a demonstration project, taking into 
        consideration the potential involvement of multiple States, 
        State plans under title XIX of the Social Security Act (42 
        U.S.C. 1396 et seq.), and State child health plans under title 
        XXI of such Act (42 U.S.C. 1397aa et seq.). Such description 
        shall be included in the recommendations submitted under 
        subsection (a).
            (5) Determine requirements for consistency in measures, 
        metrics, and risk adjustment for such a demonstration project, 
        across hospitals and across State lines.
            (6) Consider the infrastructure requirements involved in 
        public reporting of quality and performance measures for 
        children's inpatient hospital services at the national and 
        State levels, including the requirements involved with respect 
        to maintaining such measures and data.
            (7) Estimate the cost of undertaking such a demonstration 
        project.
    (c) Suggestion of Existing Measures for Evaluation Under the 
Demonstration Project.--
            (1) In general.--The report submitted under subsection (a) 
        shall include suggestions for existing measures to be evaluated 
        under the demonstration project recommended in such report, 
        including, to the extent feasible, measures with respect to--
                    (A) high volume pediatric inpatient conditions;
                    (B) high cost pediatric inpatient services;
                    (C) pediatric conditions with predicted high 
                morbidities; and
                    (D) pediatric cases at high risk of patient safety 
                failures.
            (2) Suggested measures.--The measures suggested under 
        paragraph (1) shall be measures representing process, 
        structure, patient outcomes, or patient and family experience--
                    (A) that are evidence-based;
                    (B) that are feasible to collect and report;
                    (C) that include a mechanism for risk adjustment 
                when necessary; and
                    (D) for which there is a consensus within the 
                pediatric hospital community or a consensus determined 
                by a voluntary consensus standards setting organization 
                involved in the advancement of evidence-based measures 
                of health care.
            (3) Consultation.--In determining the existing measures 
        suggested under paragraph (1), the Comptroller General shall 
        consult with representatives of the following:
                    (A) National associations of pediatric hospitals 
                and pediatric health professionals.
                    (B) Experts in pediatric quality and performance 
                measurement.
                    (C) Voluntary consensus standards setting 
                organizations and other organizations involved in the 
                advancement of consensus on evidence-based measures.
                    (D) The Department of Health and Human Services, 
                States, and other purchasers of health care items and 
                services.

SEC. 505. MEDICAL HOME DEMONSTRATION PROJECT.

    (a) Establishment.--
            (1) In general.--The Secretary of Health and Human Services 
        (in this section referred to as the ``Secretary'') shall 
        establish a medical home demonstration project (in this section 
        referred to as the ``project'') under titles XIX and XXI of the 
        Social Security Act (42 U.S.C. 1396 et seq.; 1397aa et seq.) to 
        redesign the health care delivery system by providing targeted, 
        accessible, continuous, coordinated, and family-centered care 
        to eligible individuals.
            (2) Eligible individuals defined.--In this section, the 
        term ``eligible individual'' means an individual who--
                    (A) is receiving child health assistance under a 
                State child health plan implemented under title XXI of 
                the Social Security Act (42 U.S.C. 1397aa et seq.), 
                title XIX of such Act (42 U.S.C. 1396 et seq.), or both 
                such titles; and
                    (B) is a member of a high need population (as 
                determined by the Secretary).
            (3) Project goals.--The project shall be designed in order 
        to determine whether, and if so, the extent to which, medical 
        homes accomplish the following:
                    (A) Increase--
                            (i) cost efficiencies of health care 
                        delivery;
                            (ii) access to appropriate health care 
                        services;
                            (iii) patient satisfaction;
                            (iv) school attendance; and
                            (v) the quality of health care services 
                        provided, as determined based on measures of 
                        quality the Secretary determines are broadly 
                        accepted in the health care community.
                    (B) Decrease--
                            (i) inappropriate emergency room 
                        utilization; and
                            (ii) duplication of health care services 
                        provided.
                    (C) Provide appropriate--
                            (i) preventive care; and
                            (ii) referrals to multidisciplinary 
                        services.
    (b) Project Design.--
            (1) Duration.--The project shall be conducted for a 5 year 
        period.
            (2) Sites.--
                    (A) In general.--The project shall be conducted in 
                8 States on a State-wide basis.
                    (B) Application.--A State seeking to participate in 
                the project shall submit an application to the 
                Secretary at such time, in such manner, and containing 
                such information as the Secretary may require.
            (3) Conduct of project.--
                    (A) Agreements with academic institutions.--A 
                participating State may enter into an agreement with an 
                academic institution in order to have the institution 
                conduct the project, provide technical assistance and 
                monitoring, and to participate in the evaluation of the 
                project under subsection (e)(1).
                    (B) Choice of participating physician practices.--
                            (i) In general.--A participating State 
                        shall establish procedures for physician 
                        practices to participate in the project by 
                        providing coordinated care to eligible 
                        individuals. Such participation shall be on a 
                        voluntary basis.
                            (ii) Standards for participating physician 
                        practices.--The procedures established under 
                        clause (i) shall encourage physician practices 
                        participating in the project to demonstrate 
                        that they have--
                                    (I) identified care coordinators, 
                                family resource guides, family 
                                advisors, and a family advisory 
                                committee;
                                    (II) developed care plans for 
                                eligible individuals; and
                                    (III) taken such other actions as 
                                the State determines appropriate in 
                                order to provide coordinated care to 
                                eligible individuals.
    (c) Project Requirements.--Each participating State shall establish 
procedures in order to ensure that the following requirements are met:
            (1) Each eligible individual in the State who is enrolled 
        in the project is provided a medical home with access to 
        appropriate medical care.
            (2) Each medical home in the State that is participating in 
        the project--
                    (A) provides for physician-directed care 
                coordination;
                    (B) uses health information technology (including 
                patient registry systems, clinical decision support 
                tools, remote monitoring, and electronic medical record 
                systems);
                    (C) communicates with physician practices 
                participating in the project, eligible individuals 
                receiving health care through the medical home, and 
                other health care providers (as appropriate) with 
                respect to health matters, including through electronic 
                mail and telephone consultations;
                    (D) makes arrangements with teams of other health 
                professionals, including care coordinators, and 
                facilitates linkages to community resources to extend 
                access to the full spectrum of health care services 
                that eligible individuals require;
                    (E) establishes networks with community practices, 
                hospitals, and community health care providers to 
                facilitate the exchange of ideas and resources in order 
                to improve project outcomes; and
                    (F) acts as a facilitator in order to ensure that 
                eligible individuals enrolled in the medical home under 
                the project receive high-quality care at the 
                appropriate time and place in a cost-effective manner.
            (3) The State provides payment (in accordance with 
        subsection (d)) and appropriate support for physician-directed 
        care coordination services provided to eligible individuals 
        under the project.
    (d) Payment.--
            (1) In general.--The Secretary shall establish a structure 
        for payments to participating States for the cost of services 
        provided under the project. Such structure shall provide 
        payments based on the performance of medical homes located in 
        the State in achieving quality and efficiency goals (as defined 
        by the Secretary).
            (2) Payments for health information technology.--
                    (A) In general.--The Secretary shall establish a 
                prospective, bundled, and risk adjusted structural 
                practice payment to cover health information technology 
                expenses incurred by medical homes under the project.
                    (B) In general.--Such payments shall take into 
                account any expenses the medical home incurs in order 
                to acquire and utilize health information technology, 
                such as clinical decision support tools, patient 
                registries, and electronic medical records.
            (3) Payments for physician work outside of office visits.--
        The Secretary shall establish a prospective, bundled, and risk 
        adjusted structural care coordination payment that represents 
        the value of physician work provided to eligible individuals 
        under the project that is done outside of any office visits.
    (e) Evaluation and Report.--
            (1) Evaluation.--The Secretary, in consultation with 
        appropriate pediatric medical associations, shall evaluate the 
        project in order to determine the effectiveness of medical 
        homes in terms of quality improvement, patient and provider 
        satisfaction, and the improvement of health outcomes.
            (2) Report.--Not later than 12 months after completion of 
        the project, the Secretary shall submit to Congress a report on 
        the project containing the results of the evaluation conducted 
        under paragraph (1), together with recommendations for such 
        legislation and administrative action as the Secretary 
        determines to be appropriate.
    (f) Funding.--
            (1) In general.--There are authorized to be appropriated, 
        such sums as may be necessary to carry out this section.
            (2) Prohibition.--Amounts paid to a State under the project 
        shall not be used for purposes of claiming a Federal matching 
        payment under section 1903(a) or 2105(a) of the Social Security 
        Act (42 U.S.C. 1396b(a); 1397ee(a)).
    (g) Waiver.--The Secretary shall waive compliance with such 
requirements of titles XIX and XXI of the Social Security Act (42 
U.S.C. 1396 et seq.; 1397aa et seq.) to the extent and for the period 
the Secretary finds necessary to conduct the project.

SEC. 506. DISEASE PREVENTION AND TREATMENT DEMONSTRATION PROJECTS FOR 
              ETHNIC AND RACIAL MINORITY CHILDREN.

    (a) Definitions.--In this section:
            (1) Child.--The term ``child'' has the meaning given such 
        term in section 2110(c)(1) of the Social Security Act (42 
        U.S.C. 1397jj(c)(1)).
            (2) Medicaid.--The term ``Medicaid'' means the program 
        established under title XIX of the Social Security Act (42 
        U.S.C. 1396 et seq.).
            (3) Projects.--The term ``projects'' means the 
        demonstration projects established under subsection (b)(1).
            (4) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (5) SCHIP.--The term ``SCHIP'' means the State Children's 
        Health Insurance Program established under title XXI of the 
        Social Security Act (42 U.S.C. 1397aa et seq.).
            (6) Target individual.--
                    (A) In general.--The term ``target individual'' 
                means a child--
                            (i) who is a member of a racial and ethnic 
                        minority group; and
                            (ii) who is enrolled in a State Medicaid 
                        program or a State child health plan under 
                        SCHIP.
                    (B) Racial and ethnic minority group.--The term 
                ``racial and ethnic minority group'' has the meaning 
                given such term in section 1707(g)(1) of the Public 
                Health Service Act (42 U.S.C. 300u-6(1)).
    (b) Demonstration Projects.--
            (1) Establishment.--The Secretary shall establish 
        demonstration projects for the purpose of developing models and 
        evaluating methods that--
                    (A) improve the quality of medical assistance and 
                child health assistance provided to target individuals 
                under Medicaid and SCHIP in order to reduce disparities 
                in the provision of health care services;
                    (B) improve clinical outcomes, satisfaction, 
                quality of life, and the appropriate use of services 
                covered and referral patterns under Medicaid and SCHIP 
                among target individuals;
                    (C) eliminate disparities in the rate of preventive 
                measures, such as well child visits and immunizations, 
                among target individuals; and
                    (D) promote collaboration with community-based 
                organizations to ensure cultural competency of health 
                care professionals and linguistic access for persons 
                with limited English proficiency.
            (2) Design.--
                    (A) Initial design.--Not later than 1 year after 
                the date of enactment of this Act, the Secretary 
                shall--
                            (i) evaluate best practices in the private 
                        sector, community programs, and academic 
                        research with respect to methods for reducing 
                        health care disparities among target 
                        individuals; and
                            (ii) design the projects based on such 
                        evaluation.
                    (B) Number and project areas.--
                            (i) In general.--Not later than 2 years 
                        after the date of enactment of this Act, the 
                        Secretary shall implement not less than 9 
                        projects, including the following:
                                    (I) Two projects for each of the 4 
                                following racial and ethnic minority 
                                groups:
                                            (aa) American Indians, 
                                        including Alaskan Natives, 
                                        Eskimos, and Aleuts.
                                            (bb) Asian Americans and 
                                        Pacific Islanders.
                                            (cc) Blacks.
                                            (dd) Hispanics (as defined 
                                        in section 1707(g)(2) of the 
                                        Public Health Service Act (42 
                                        U.S.C. 300u-6(g)(2)).
                                    (II) One project within Puerto 
                                Rico.
                            (ii) Subpopulations.--The 2 projects 
                        implemented for the groups described in clause 
                        (i)(I) shall each target different ethnic 
                        subpopulations within such groups.
                            (iii) Rural and inner-city areas.--Not less 
                        than 1 of the projects implemented under clause 
                        (i)(I) shall be conducted in a rural area and 
                        not less than 1 of such projects shall be 
                        conducted in an inner-city area.
    (c) Reports to Congress.--
            (1) In general.--Not later than 2 years after the date on 
        which the Secretary initially implements the projects, and 
        biannually thereafter for the duration of the projects, the 
        Secretary shall submit to Congress a report on the projects.
            (2) Contents of report.--Each report submitted under 
        paragraph (1) shall include the following:
                    (A) A description of the projects.
                    (B) An evaluation of--
                            (i) the cost and benefits of the projects, 
                        including whether the projects have reduced 
                        expenditures under Medicaid and SCHIP;
                            (ii) the quality of the health care 
                        services provided to target individuals under 
                        the projects, including whether the projects 
                        have reduced racial and ethnic health 
                        disparities in the quality of health care 
                        services provided to such individuals;
                            (iii) beneficiary and health care provider 
                        satisfaction under the projects; and
                            (iv) whether, based on the factors 
                        evaluated under clauses (i) through (iii), the 
                        projects should be continued or conducted on an 
                        expanded basis.
                    (C) Any other information with respect to the 
                projects the Secretary determines appropriate.
            (3) Expansion of projects; implementation of results.--If 
        the initial report submitted under paragraph (1) includes an 
        evaluation under paragraph (2)(B)(iv) that the projects 
        initially established under subsection (b)(1) should be 
        continued or conducted on an expanded basis, the Secretary--
                    (A) shall continue to conduct such projects; and
                    (B) may conduct such additional projects as the 
                Secretary determines appropriate.
    (d) Funding for Projects.--
            (1) In general.--There are authorized to be appropriated, 
        such sums as may be necessary to carry out projects under this 
        section.
            (2) Prohibition.--Amounts paid to a State or territory 
        under the projects shall not be used for purposes of claiming a 
        Federal matching payment under section 1903(a) or 2105(a) of 
        the Social Security Act (42 U.S.C. 1396b(a); 1397ee(a)).
    (e) Waiver.--The Secretary shall waive compliance with such 
requirements of titles XIX and XXI of the Social Security Act (42 
U.S.C. 1396 et seq.; 1397aa et seq.) to the extent and for the period 
the Secretary finds necessary to conduct the projects.

           TITLE VI--COMMISSION ON CHILDREN'S HEALTH COVERAGE

SEC. 601. COMMISSION ON CHILDREN'S HEALTH COVERAGE.

    (a) Establishment of Commission.--
            (1) Establishment.--There is established a commission to be 
        known as the ``Commission on Children's Health Coverage'' 
        (referred to in this section as the ``Commission'').
            (2) Membership.--
                    (A) In general.--The Committee shall be composed of 
                10 members with academic training and practical 
                experience in--
                            (i) the areas of--
                                    (I) child health and development;
                                    (II) maternal health and 
                                development;
                                    (III) pediatric care;
                                    (IV) health care financing;
                                    (V) community-based participatory 
                                research;
                                    (VI) public health;
                                    (VII) data collection, analysis, 
                                and reporting; and
                                    (VIII) health and health care 
                                disparities; and
                            (ii) such other areas as the Secretary of 
                        Health and Human Services (in this section 
                        referred to as the ``Secretary'') determines 
                        appropriate.
                    (B) Selection.--The Secretary shall appoint members 
                of the Committee. No candidate for appointment on the 
                Committee shall be asked to provide non-relevant 
                information, such as voting record, political party 
                affiliation, or position on particular policies.
            (3) Term; vacancies.--
                    (A) Term.--A member shall be appointed for the life 
                of the Commission.
                    (B) Vacancies.--A vacancy on the Commission--
                            (i) shall not affect the powers of the 
                        Commission; and
                            (ii) shall be filled in the same manner as 
                        the original appointment was made.
            (4) Meetings.--The Commission shall meet at the call of the 
        Chairperson.
            (5) Quorum.--A majority of the members of the Commission 
        shall constitute a quorum, but a lesser number of members may 
        hold hearings.
            (6) Chairperson and vice chairperson.--The Commission shall 
        select a Chairperson from among the members of the Commission.
    (b) Duties.--
            (1) Study.--The Commission shall conduct a study of all 
        matters relating to children's health coverage.
            (2) Recommendations.--The Commission shall develop 
        recommendations on policy improvements at the State and 
        national levels, and in the private sector, with respect to 
        children's health coverage.
            (3) Report.--
                    (A) Annual reports.--During the 2 year period 
                beginning on the date of enactment of this Act, the 
                Commission shall submit to the President and Congress 
                annual reports evaluating the status of children's 
                health coverage, together with recommendations for such 
                legislation and administrative administrative actions 
                as the Commission determines would result in 
                improvements in such health coverage at the State and 
                national levels, and in the private sector.
                    (B) Final report.--Not later than 3 years after 
                such date of enactment, the Commission shall submit to 
                the President and Congress a report that contains the 
                recommendations of the Commission for such legislation 
                and administrative actions as the Commission determines 
                would result in comprehensive health coverage of all 
                children in the United States.
    (c) Powers.--
            (1) Hearings.--The Commission may hold such hearings, meet 
        and act at such times and places, take such testimony, and 
        receive such evidence as the Commission considers advisable to 
        carry out this Act.
            (2) Information from federal agencies.--
                    (A) In general.--The Commission may secure directly 
                from a Federal agency such information as the 
                Commission considers necessary to carry out this Act.
                    (B) Provision of information.--On request of the 
                Chairperson of the Commission, the head of the agency 
                shall provide the information to the Commission.
            (3) Postal services.--The Commission may use the United 
        States mails in the same manner and under the same conditions 
        as other agencies of the Federal Government.
            (4) Gifts.--The Commission may accept, use, and dispose of 
        gifts or donations of services or property.
    (d) Commission Personnel Matters.--
            (1) Compensation of members.--
                    (A) Non-federal employees.--A member of the 
                Commission who is not an officer or employee of the 
                Federal Government shall be compensated at a rate equal 
                to the daily equivalent of the annual rate of basic pay 
                prescribed for level IV of the Executive Schedule under 
                section 5315 of title 5, United States Code, for each 
                day (including travel time) during which the member is 
                engaged in the performance of the duties of the 
                Commission.
                    (B) Federal employees.--A member of the Commission 
                who is an officer or employee of the Federal Government 
                shall serve without compensation in addition to the 
                compensation received for the services of the member as 
                an officer or employee of the Federal Government.
            (2) Travel expenses.--A member of the Commission shall be 
        allowed travel expenses, including per diem in lieu of 
        subsistence, at rates authorized for an employee of an agency 
        under subchapter I of chapter 57 of title 5, United States 
        Code, while away from the home or regular place of business of 
        the member in the performance of the duties of the Commission.
            (3) Staff.--
                    (A) In general.--The Chairperson of the Commission 
                may, without regard to the civil service laws 
                (including regulations), appoint and terminate an 
                executive director and such other additional personnel 
                as are necessary to enable the Commission to perform 
                the duties of the Commission.
                    (B) Confirmation of executive director.--The 
                employment of an executive director shall be subject to 
                confirmation by the Commission.
                    (C) Compensation.--
                            (i) In general.--Except as provided in 
                        subparagraph (B), the Chairperson of the 
                        Commission may fix the compensation of the 
                        executive director and other personnel without 
                        regard to the provisions of chapter 51 and 
                        subchapter III of chapter 53 of title 5, United 
                        States Code, relating to classification of 
                        positions and General Schedule pay rates.
                            (ii) Maximum rate of pay.--The rate of pay 
                        for the executive director and other personnel 
                        shall not exceed the rate payable for level V 
                        of the Executive Schedule under section 5316 of 
                        title 5, United States Code.
            (4) Detail of federal government employees.--
                    (A) In general.--An employee of the Federal 
                Government may be detailed to the Commission without 
                reimbursement.
                    (B) Civil service status.--The detail of the 
                employee shall be without interruption or loss of civil 
                service status or privilege.
            (5) Procurement of temporary and intermittent services.--
        The Chairperson of the Commission may procure temporary and 
        intermittent services in accordance with section 3109(b) of 
        title 5, United States Code, at rates for individuals that do 
        not exceed the daily equivalent of the annual rate of basic pay 
        prescribed for level V of the Executive Schedule under section 
        5316 of that title.
    (e) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as are necessary to carry out this section.
    (f) Termination of Commission.--The Commission shall terminate 90 
days after the date on which the Commission submits the final report of 
the Commission under subsection (b)(3)(B).
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