1.Short title; amendments to
Social Security Act; references; table of contents
(a)This Act may be cited
as the Children's Health Insurance
Program Reauthorization Act of 2007
.
(b)Amendments to
social security actExcept as otherwise specifically provided,
whenever in this Act an amendment is expressed in terms of an amendment to or
repeal of a section or other provision, the reference shall be considered to be
made to that section or other provision of the Social Security Act.
(c)References to
Medicaid; CHIP; SecretaryIn this Act:
(1)The
term CHIP means the State Children's Health Insurance Program
established under title XXI of the Social Security Act (42 U.S.C. 1397aa et
seq.).
(2)The
term Medicaid means the program for medical assistance established
under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.).
(3)The
term Secretary means the Secretary of Health and Human
Services.
(d)The table of contents for this Act is as follows:
Sec. 1. Short title; amendments to Social
Security Act; references; table of contents.
TITLE I—Financing of CHIP
Sec. 101. Extension of CHIP.
Sec. 102. Allotments for the 50 States and
the District of Columbia.
Sec. 103. One-time
appropriation.
Sec. 104. Improving funding for the
territories under CHIP and Medicaid.
Sec. 105. Incentive bonuses for
States.
Sec. 106. Phase-out of coverage for
nonpregnant childless adults under CHIP; conditions for coverage of
parents.
Sec. 107. State option to cover low-income pregnant women under
CHIP through a State plan amendment.
Sec. 108. CHIP Contingency fund.
Sec. 109. Two-year availability of allotments; expenditures
counted against oldest allotments.
Sec. 110. Limitation on matching rate for States that propose
to cover children with effective family income that exceeds 300 percent of the
poverty line.
Sec. 111. Option for qualifying States to receive the enhanced
portion of the CHIP matching rate for Medicaid coverage of certain
children.
TITLE II—Outreach and Enrollment
Sec. 201. Grants for outreach and enrollment.
Sec. 202. Increased outreach and enrollment of
Indians.
Sec. 203. Demonstration project to permit
States to rely on findings by an Express Lane agency to determine components of
a child’s eligibility for Medicaid or CHIP.
Sec. 204. Authorization of certain information disclosures to
simplify health coverage determinations.
TITLE III—Reducing Barriers to Enrollment
Sec. 301. Verification of declaration of citizenship or
nationality for purposes of eligibility for Medicaid and CHIP.
Sec. 302. Reducing administrative barriers to
enrollment.
TITLE IV—Reducing Barriers to Providing Premium
Assistance
Subtitle A—Additional State option for providing premium
assistance
Sec. 401. Additional State option for providing premium
assistance.
Sec. 402. Outreach, education, and enrollment
assistance.
Subtitle B—Coordinating Premium Assistance With Private
Coverage
Sec. 411. Special enrollment period under group health plans in
case of termination of Medicaid or CHIP coverage or eligibility for assistance
in purchase of employment-based coverage; coordination of coverage.
TITLE V—Strengthening Quality of Care and Health Outcomes of
Children
Sec. 501. Child health quality improvement activities for
children enrolled in Medicaid or CHIP.
Sec. 502. Improved information regarding access to coverage
under CHIP.
Sec. 503. Application of certain managed care quality
safeguards to CHIP.
TITLE VI—Miscellaneous
Sec. 601. Technical correction regarding current State
authority under Medicaid.
Sec. 602. Payment error rate measurement
(PERM
).
Sec. 603. Elimination of counting medicaid child presumptive
eligibility costs against title XXI allotment.
Sec. 604. Improving data
collection.
Sec. 605. Deficit Reduction Act technical
corrections.
Sec. 606. Elimination of confusing program
references.
Sec. 607. Mental health parity in CHIP plans.
Sec. 608. Dental health grants.
Sec. 609. Application of prospective payment system for
services provided by Federally-qualified health centers and rural health
clinics.
TITLE VII—Revenue Provisions
Sec. 701. Increase in excise tax rate on
tobacco products.
Sec. 702. Administrative improvements.
Sec. 703. Time for payment of corporate estimated
taxes.
TITLE VIII—Effective date
Sec. 801. Effective date.
<enum>I</enum><header>Financing of
CHIP</header>
<section id="id7B45673E0E744939936E1E0089C49811"><enum>101.</enum><header>Extension of
CHIP</header><text display-inline="no-display-inline">Section 2104(a) (42
U.S.C. 1397dd(a)) is amended—</text>
<paragraph id="idE929C93C28344B3D836B0FD490E04A65"><enum>(1)</enum><text>in paragraph (9),
by striking <quote>and</quote> at the end;</text>
</paragraph><paragraph id="idEB53EC32205B4646BADF08BA9942B19B"><enum>(2)</enum><text>in paragraph
(10), by striking the period at the end and inserting a semicolon; and</text>
</paragraph><paragraph id="id4E2F29945DFF489F83D21D9EF586AE4E"><enum>(3)</enum><text>by adding at the
end the following new paragraphs:</text>
<quoted-block display-inline="no-display-inline" id="id44B97AACD64D4BE18A248AF20E421042" style="OLC">
<paragraph id="idAB8077840C35417A8E0445D6ECA6426D"><enum>(11)</enum><text>for fiscal year
2008, $9,125,000,000;</text>
</paragraph><paragraph id="id0AF00CC1D3F64425829A7B87FBCAD5A4"><enum>(12)</enum><text>for fiscal year
2009, $10,675,000,000;</text>
</paragraph><paragraph id="idC1CBB1110E494486B86D5CCF0A748C1B"><enum>(13)</enum><text>for fiscal year
2010, $11,850,000,000;</text>
</paragraph><paragraph id="id7E711B4A7A354ED1BD7885437603E76F"><enum>(14)</enum><text>for fiscal year
2011, $13,750,000,000; and</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id39DA07F9DAA1406EB98F57937EA6B65C"><enum>(15)</enum><text>for fiscal year
2012, for purposes of making 2 semi-annual allotments—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="idEF6F602C20AD43FE8665F6F0120D4E27"><enum>(A)</enum><text>$1,750,000,000
for the period beginning on October 1, 2011, and ending on March 31, 2012,
and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id9D2AC487BBD74D8E8AD22A4D5C7174FE"><enum>(B)</enum><text>$1,750,000,000
for the period beginning on April 1, 2012, and ending on September 30,
2012.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section id="idD9FDFB6C34D14EE58E6F73402E015B06" section-type="subsequent-section"><enum>102.</enum><header>Allotments for the
50 States and the District of Columbia</header>
<subsection id="id3A601AD7B7CB47768FDCD2D95CF66678"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Section 2104 (42
U.S.C. 1397dd) is amended by adding at the end the following new
subsection:</text>
<quoted-block display-inline="no-display-inline" id="idB27EEA0745B64DC09E98B2E03FA78B8B" style="OLC">
<subsection id="idE72AF09C651348C7AB72088A40CE4DE9"><enum>(i)</enum><header>Determination
of allotments for the 50 states and the district of columbia for fiscal years
2008 through 2012</header>
<paragraph id="id60C124497C544C96B24CD87AD564BB02"><enum>(1)</enum><header>Computation of
allotment</header>
<subparagraph id="idEA2FC048E941461C9DCDBD94B96A3EE8"><enum>(A)</enum><header>In
general</header><text>Subject to the succeeding paragraphs of this subsection,
the Secretary shall for each of fiscal years 2008 through 2012 allot to each
subsection (b) State from the available national allotment an amount equal to
110 percent of—</text>
<clause id="idBE71ED8D948F4B42AFD0BFD8CCA4A304"><enum>(i)</enum><text>in the case of
fiscal year 2008, the highest of the amounts determined under paragraph
(2);</text>
</clause><clause id="id05F3921C60EC4D9193799771587DAEB8"><enum>(ii)</enum><text>in the case of
each of fiscal years 2009 through 2011, the Federal share of the expenditures
determined under subparagraph (B) for the fiscal year; and</text>
</clause><clause id="idEBB360A68AB44205BEA1B5C24AC9708A"><enum>(iii)</enum><text>beginning with
fiscal year 2012, subject to subparagraph (E), each semi-annual allotment
determined under subparagraph (D).</text>
</clause></subparagraph><subparagraph id="idC04006C2FFBF45B783682405FE72FC07"><enum>(B)</enum><header>Projected state
expenditures for the fiscal year</header><text>For purposes of subparagraphs
(A)(ii) and (D), the expenditures determined under this subparagraph for a
fiscal year are the projected expenditures under the State child health plan
for the fiscal year (as certified by the State and submitted to the Secretary
by not later than August 31 of the preceding fiscal year).</text>
</subparagraph><subparagraph id="idD55A39F9459942B6BEC914F345329F3D"><enum>(C)</enum><header>Available
national allotment</header><text>For purposes of this subsection, the term
<term>available national allotment</term> means, with respect to any fiscal
year, the amount available for allotment under subsection (a) for the fiscal
year, reduced by the amount of the allotments made for the fiscal year under
subsection (c). Subject to paragraph (3)(B), the available national allotment
with respect to the amount available under subsection (a)(15)(A) for fiscal
year 2012 shall be increased by the amount of the appropriation for the period
beginning on October 1 and ending on March 31 of such fiscal year under section
103 of the <short-title>Children's Health Insurance
Program Reauthorization Act of 2007</short-title>.</text>
</subparagraph><subparagraph id="idC75222B01FAB4576959EB95BA2D33210"><enum>(D)</enum><header>Semi-annual
allotments</header><text>For purposes of subparagraph (A)(iii), the semi-annual
allotments determined under this paragraph with respect to a fiscal year are as
follows:</text>
<clause id="idEE014EC8DCD84C2EB07F814FFB3C9975"><enum>(i)</enum><text>For the period
beginning on October 1 and ending on March 31 of the fiscal year, the Federal
share of the portion of the expenditures determined under subparagraph (B) for
the fiscal year which are allocable to such period.</text>
</clause><clause id="idA80E5A2CC28346C18BAA3E514B4EB455"><enum>(ii)</enum><text>For the period
beginning on April 1 and ending on September 30 of the fiscal year, the Federal
share of the portion of the expenditures determined under subparagraph (B) for
the fiscal year which are allocable to such period.</text>
</clause></subparagraph><subparagraph commented="no" id="id1B54C7FEECA24FC88897FCC773B56095"><enum>(E)</enum><header>Availability</header><text>Each
semi-annual allotment made under subparagraph (A)(iii) shall remain available
for expenditure under this title for periods after the period specified in
subparagraph (D) for purposes of determining the allotment in the same manner
as the allotment would have been available for expenditure if made for an
entire fiscal year.</text>
</subparagraph></paragraph><paragraph id="idF7B08F9B14B6449099D5F187C641C43E"><enum>(2)</enum><header>Special rule
for fiscal year 2008</header>
<subparagraph id="idD5EF064411414EE9AAFF9D0252EA4232"><enum>(A)</enum><header>In
general</header><text>For purposes of paragraph (1)(A)(i), the amounts
determined under this paragraph for fiscal year 2008 are as follows:</text>
<clause id="id69A9825215154F44A4593E47B190F76F"><enum>(i)</enum><text>The total Federal
payments to the State under this title for fiscal year 2007, multiplied by the
annual adjustment determined under subparagraph (B) for fiscal year
2008.</text>
</clause><clause id="id07780CC53CEF4DCAA68E59A2142BC55E"><enum>(ii)</enum><text>The Federal
share of the amount allotted to the State for fiscal year 2007 under subsection
(b), multiplied by the annual adjustment determined under subparagraph (B) for
fiscal year 2008.</text>
</clause><clause commented="no" display-inline="no-display-inline" id="idDC0EA212DD4348F39F22EEFF9375D23F"><enum>(iii)</enum><text display-inline="yes-display-inline">Only in the case of—</text>
<subclause commented="no" display-inline="no-display-inline" id="id5B6933E97204472D8E660DB2A58477AD"><enum>(I)</enum><text display-inline="yes-display-inline">a State that received a payment,
redistribution, or allotment under any of paragraphs (1), (2), or (4) of
subsection (h), the amount of the projected total Federal payments to the State
under this title for fiscal year 2007, as determined on the basis of the
November 2006 estimates certified by the State to the Secretary;</text>
</subclause><subclause commented="no" display-inline="no-display-inline" id="idAD03FFAB4EDF440886AA3C5E7ABAF533"><enum>(II)</enum><text display-inline="yes-display-inline">a State whose projected total Federal
payments to the State under this title for fiscal year 2007, as determined on
the basis of the May 2006 estimates certified by the State to the Secretary,
were at least $95,000,000 but not more than $96,000,000 higher than the
projected total Federal payments to the State under this title for fiscal year
2007 on the basis of the November 2006 estimates, the amount of the projected
total Federal payments to the State under this title for fiscal year 2007 on
the basis of the May 2006 estimates; or</text>
</subclause><subclause commented="no" display-inline="no-display-inline" id="idC4736AF224034DEB8716658EAD4202D7"><enum>(III)</enum><text>a State whose
projected total Federal payments under this title for fiscal year 2007, as
determined on the basis of the November 2006 estimates certified by the State
to the Secretary, exceeded all amounts available to the State for expenditure
for fiscal year 2007 (including any amounts paid, allotted, or redistributed to
the State in prior fiscal years), the amount of the projected total Federal
payments to the State under this title for fiscal year 2007, as determined on
the basis of the November 2006 estimates certified by the State to the
Secretary,</text>
</subclause><continuation-text continuation-text-level="clause">multiplied by
the annual adjustment determined under subparagraph (B) for fiscal year
2008.</continuation-text></clause><clause id="id20BB1DB2CE5C49708F9F0768EDA8D6C3"><enum>(iv)</enum><text>The projected
total Federal payments to the State under this title for fiscal year 2008, as
determined on the basis of the August 2007 projections certified by the State
to the Secretary by not later than September 30, 2007.</text>
</clause></subparagraph><subparagraph id="idD9CEF1FC13E743C8A1BEFD571AF0C84F"><enum>(B)</enum><header>Annual
adjustment for health care cost growth and child population
growth</header><text>The annual adjustment determined under this subparagraph
for a fiscal year with respect to a State is equal to the product of the
amounts determined under clauses (i) and (ii):</text>
<clause id="id850026132BF44938A96E0F703BBDE983"><enum>(i)</enum><header>Per capita
health care growth</header><text>1 plus the percentage increase (if any) in the
projected nominal per capita amount of National Health Expenditures for the
calendar year that begins during the fiscal year involved over the preceding
calendar year, as most recently published by the Secretary.</text>
</clause><clause id="idF05ED9F6F34E4A129EBBA18DFD0DA474"><enum>(ii)</enum><header>Child
population growth</header><text>1.01 plus the percentage change in the
population of children under 19 years of age in the State from July 1 of the
fiscal year preceding the fiscal year involved to July 1 of the fiscal year
involved, as determined by the Secretary based on the most timely and accurate
published estimates of the Bureau of the Census.</text>
</clause></subparagraph><subparagraph id="idAFC681B2A5BC4618AD736270A9432D14"><enum>(C)</enum><header>Definition</header><text>For
purposes of subparagraph (B), the term <term>fiscal year involved</term> means
the fiscal year for which an allotment under this subsection is being
determined.</text>
</subparagraph><subparagraph id="idC1EBE9EA065A4BDF967621098DE0FFAC"><enum>(D)</enum><header>Proration
rule</header><text>If, after the application of this paragraph without regard
to this subparagraph, the sum of the State allotments determined under this
paragraph for fiscal year 2008 exceeds the available national allotment for
fiscal year 2008, the Secretary shall reduce each such allotment on a
proportional basis.</text>
</subparagraph></paragraph><paragraph id="idB5D706E91C234462A1AF512D53CCEC8A"><enum>(3)</enum><header>Alternative
allotments for fiscal years 2009 through 2012</header>
<subparagraph id="id8B107CBA34C64CBFB6DA5C7E8AAB27C4"><enum>(A)</enum><header>In
general</header><text>If the sum of the State allotments determined under
paragraph (1)(A)(ii) for any of fiscal years 2009 through 2011 exceeds the
available national allotment for the fiscal year, the Secretary shall allot to
each subsection (b) State from the available national allotment for the fiscal
year an amount equal to the product of—</text>
<clause id="id06C00971A31D46CE880895BCEDE9F3F4"><enum>(i)</enum><text>the available
national allotment for the fiscal year; and</text>
</clause><clause id="id1907C1D0ECE449CC88DFFF25FC167032"><enum>(ii)</enum><text>the percentage
equal to the sum of the State allotment factors for the fiscal year determined
under paragraph (4) with respect to the State.</text>
</clause></subparagraph><subparagraph id="id88440C01F13145B3804DC9EE0D38B58E"><enum>(B)</enum><header>Special rules
beginning in fiscal year 2012</header><text>Beginning in fiscal year
2012—</text>
<clause id="id80BE4D84A7174BBDBA6657B45CAF03E8"><enum>(i)</enum><text>this paragraph
shall be applied separately with respect to each of the periods described in
clauses (i) and (ii) of paragraph (1)(D) and the available national allotment
for each such period shall be the amount appropriated for such period (rather
than the amount appropriated for the entire fiscal year), reduced by the amount
of the allotments made for the fiscal year under subsection (c) for each such
period, and</text>
</clause><clause id="idF60979CF23B44316B2CD7316AA7B2557"><enum>(ii)</enum><text>if—</text>
<subclause id="id5D3E7D3B9F464B648AD8895A54BCFD08"><enum>(I)</enum><text>the sum of the
State allotments determined under paragraph (1)(A)(iii) for either such period
exceeds the amount of such available national allotment for such period, the
Secretary shall make the allotment for each State for such period in the same
manner as under subparagraph (A), and</text>
</subclause><subclause id="idCAE80A14BF9F48B6BFBA46BA5677BE7F"><enum>(II)</enum><text>the amount of
such available national allotment for either such period exceeds the sum of the
State allotments determined under paragraph (1)(A)(iii) for such period, the
Secretary shall increase the allotment for each State for such period by the
amount that bears the same ratio to such excess as the State's allotment
determined under paragraph (1)(A)(iii) for such period (without regard to this
subparagraph) bears to the sum of such allotments for all States.</text>
</subclause></clause></subparagraph></paragraph><paragraph id="id426AF25EB3934772872142756F9D554F"><enum>(4)</enum><header>Weighted
factors</header>
<subparagraph id="id805E8FB5EC8E45A18606DF32FF81A5AC"><enum>(A)</enum><header>Factors
described</header><text>For purposes of paragraph (3), the factors described in
this subparagraph are the following:</text>
<clause id="idE1D6A5261390402A9DAAF42F71C81B00"><enum>(i)</enum><header>Projected state
expenditures for the fiscal year</header><text>The ratio of the projected
expenditures under the State child health plan for the fiscal year (as
certified by the State to the Secretary by not later than August 31 of the
preceding fiscal year) to the sum of the projected expenditures under all such
plans for all subsection (b) States for the fiscal year, multiplied by the
applicable percentage weight assigned under subparagraph (B).</text>
</clause><clause id="id7B8FD7F911BA44C086F7F35C1D0A7BA5"><enum>(ii)</enum><header>Number of
low-income children in the State</header><text>The ratio of the number of
low-income children in the State, as determined on the basis of the most timely
and accurate published estimates of the Bureau of the Census, to the sum of the
number of low-income children so determined for all subsection (b) States for
such fiscal year, multiplied by the applicable percentage weight assigned under
subparagraph (B).</text>
</clause><clause id="id2BBBB9F530144B0D90BDAFD6FC39197B"><enum>(iii)</enum><header>Projected
state expenditures for the preceding fiscal year</header><text>The ratio of the
projected expenditures under the State child health plan for the preceding
fiscal year (as determined on the basis of the projections certified by the
State to the Secretary for November of the fiscal year), to the sum of the
projected expenditures under all such plans for all subsection (b) States for
such preceding fiscal year (as so determined), multiplied by the applicable
percentage weight assigned under subparagraph (B).</text>
</clause><clause id="id529C365FB5344B09BB6B02B72239BCC7"><enum>(iv)</enum><header>Actual state
expenditures for the second preceding fiscal year</header><text>The ratio of
the actual expenditures under the State child health plan for the second
preceding fiscal year, as determined by the Secretary on the basis of
expenditure data reported by States on CMS Form 64 or CMS Form 21, to such sum
of the actual expenditures under all such plans for all subsection (b) States
for such second preceding fiscal year, multiplied by the applicable percentage
weight assigned under subparagraph (B).</text>
</clause></subparagraph><subparagraph id="id3AC0EB57779E48DE931EB0780B205C16"><enum>(B)</enum><header>Assignment of
weights</header><text>For each of fiscal years 2009 through 2012, the
applicable weights assigned under this subparagraph are the following:</text>
<clause id="id8D25BDFE17CC4CF685DD7E048780EB67"><enum>(i)</enum><text>With respect to
the factor described in subparagraph (A)(i), a weight of 75 percent for each
such fiscal year.</text>
</clause><clause id="id722826F91945404E8089865C98308152"><enum>(ii)</enum><text>With respect to
the factor described in subparagraph (A)(ii), a weight of 12½ percent for each
such fiscal year.</text>
</clause><clause id="id4D1206DA77BF44B685AE8A6C57196020"><enum>(iii)</enum><text>With respect to
the factor described in subparagraph (A)(iii), a weight of 7½ percent for each
such fiscal year.</text>
</clause><clause id="id6BCDC6FDEBF747F68E72D3DE7A6C9695"><enum>(iv)</enum><text>With respect to
the factor described in subparagraph (A)(iv), a weight of 5 percent for each
such fiscal year.</text>
</clause></subparagraph></paragraph><paragraph id="id37EC11B9310F4CFEAA2960D2B48C6DB2"><enum>(5)</enum><header>Demonstration
of need for increased allotment based on projected state expenditures exceeding
10 percent of the preceding fiscal year allotment</header>
<subparagraph id="id69DF41ACC12744818444F4426BA0017B"><enum>(A)</enum><header>In
general</header><text>If the projected expenditures under the State child
health plan described in paragraph (1)(B) for any of fiscal years 2009 through
2012 are at least 10 percent more than the allotment determined for the State
for the preceding fiscal year (determined without regard to paragraph (2)(D) or
paragraph (3)), and, during the preceding fiscal year, the State did not
receive approval for a State plan amendment or waiver to expand coverage under
the State child health plan or did not receive a CHIP contingency fund payment
under subsection (k)—</text>
<clause id="id9E9108DD7C0C42DA9EEE0719AA25D874"><enum>(i)</enum><text>the State shall
submit to the Secretary, by not later than August 31 of the preceding fiscal
year, information relating to the factors that contributed to the need for the
increase in the State's allotment for the fiscal year, as well as any other
additional information that the Secretary may require for the State to
demonstrate the need for the increase in the State's allotment for the fiscal
year;</text>
</clause><clause id="id7B135E8B066443AD8D3AD9BF28C81265"><enum>(ii)</enum><text>the Secretary
shall—</text>
<subclause id="id44083CEBD23D4F38A4146BE0BEE3EE59"><enum>(I)</enum><text>review the
information submitted under clause (i);</text>
</subclause><subclause id="idDA3BEF2EF1F0479085DD5FCDD93A9E08"><enum>(II)</enum><text>notify the State
in writing within 60 days after receipt of the information that—</text>
<item id="idF6BA8809BF51402D9D3FA121CB10BB14"><enum>(aa)</enum><text>the projected
expenditures under the State child health plan are approved or disapproved (and
if disapproved, the reasons for disapproval); or</text>
</item><item id="id3339844DB3B04E1D9246621C0AD72B6D"><enum>(bb)</enum><text>specified
additional information is needed; and</text>
</item></subclause><subclause id="id8122826870184CBDBBC49384B7435F4C"><enum>(III)</enum><text>if the
Secretary disapproved the projected expenditures or determined additional
information is needed, provide the State with a reasonable opportunity to
submit additional information to demonstrate the need for the increase in the
State's allotment for the fiscal year.</text>
</subclause></clause></subparagraph><subparagraph id="idCA25C975D86944949EB4DA79CBE8ABCB"><enum>(B)</enum><header>Provisional and
final allotment</header><text>In the case of a State described in subparagraph
(A) for which the Secretary has not determined by September 30 of a fiscal year
whether the State has demonstrated the need for the increase in the State's
allotment for the succeeding fiscal year, the Secretary shall provide the State
with a provisional allotment for the fiscal year equal to 110 percent of the
allotment determined for the State under this subsection for the preceding
fiscal year (determined without regard to paragraph (2)(D) or paragraph (3)),
and may, not later than November 30 of the fiscal year, adjust the State's
allotment (and the allotments of other subsection (b) States), as necessary
(and, if applicable, subject to paragraph (3)), on the basis of information
submitted by the State in accordance with subparagraph (A).</text>
</subparagraph></paragraph><paragraph id="idD086F3A2B2E4403994A7E53480DA7E5B"><enum>(6)</enum><header>Special
rules</header>
<subparagraph id="id32EE5690A0764685871459B114628D99"><enum>(A)</enum><header>Deadline and
data for determining fiscal year 2008 allotments</header><text>In computing the
amounts under paragraph (2)(A) and subsection (c)(5)(A) that determine the
allotments to subsection (b) States and territories for fiscal year 2008, the
Secretary shall use the most recent data available to the Secretary before the
start of that fiscal year. The Secretary may adjust such amounts and
allotments, as necessary, on the basis of the expenditure data for the prior
year reported by States on CMS Form 64 or CMS Form 21 not later than November
30, 2007, but in no case shall the Secretary adjust the allotments provided
under paragraph (2)(A) or subsection (c)(5)(A) for fiscal year 2008 after
December 31, 2007.</text>
</subparagraph><subparagraph id="id87EE770CDFDF43738A1B09BB5F59E136"><enum>(B)</enum><header>Inclusion of
certain expenditures</header>
<clause id="id35C79BF5C9DA4B8EAC3ED4FD00B407D0"><enum>(i)</enum><header>Projected
expenditures of qualifying states</header><text>Payments made or projected to
be made to a qualifying State described in paragraph (2) of section 2105(g) for
expenditures described in paragraph (1)(B)(ii) or (4)(B) of that section shall
be included for purposes of determining the projected expenditures described in
paragraph (1)(B) with respect to the allotments determined for each of fiscal
years 2009 through 2012 and for purposes of determining the amounts described
in clauses (i) and (iv) of paragraph (2)(A) with respect to the allotments
determined for fiscal year 2008.</text>
</clause><clause id="id855CFCBC364A447B90957D53BFDC461A"><enum>(ii)</enum><header>Projected
expenditures under block grant set-asides for nonpregnant childless adults and
parents</header><text>Payments projected to be made to a State under subsection
(a) or (b) of section 2111 shall be included for purposes of determining the
projected expenditures described in paragraph (1)(B) with respect to the
allotments determined for each of fiscal years 2009 through 2012 (to the extent
such payments are permitted under such section), including for purposes of
allocating such expenditures for purposes of clauses (i) and (ii) of paragraph
(1)(D).</text>
</clause></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id3B0B5ECF6C55414AA2311DE0127C8735"><enum>(7)</enum><header display-inline="yes-display-inline">Subsection
(<enum-in-header>b</enum-in-header>) State</header><text display-inline="yes-display-inline">In this paragraph, the term
<term>subsection (b) State</term> means 1 of the 50 States or the District of
Columbia.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="id04A96FC80DC04124BFB062E8071249B9"><enum>(b)</enum><header>Conforming
amendments</header><text>Section 2104 (42 U.S.C. 1397dd) is amended—</text>
<paragraph id="idF97A41BA839445CCBE2F80044F981BE7"><enum>(1)</enum><text>in subsection
(a), by striking <quote>subsection (d)</quote> and inserting <quote>subsections
(d), (h), and (i)</quote>;</text>
</paragraph><paragraph id="id0AF7E6C58668480FAE4A71A4488A095C"><enum>(2)</enum><text>in subsection
(b)(1), by striking <quote>subsection (d)</quote> and inserting
<quote>subsections (d), (h), and (i)</quote>; and</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="idFB2203AAA87A4C53BC0C4A378E5FBFF3"><enum>(3)</enum><text>in subsection
(c)(1), by striking <quote>subsection (d)</quote> and inserting
<quote>subsections (d), (h), and (i)</quote>.</text>
</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="id86491ACF62C043D184D10851FE285D84"><enum>103.</enum><header>One-time
appropriation</header><text display-inline="no-display-inline">There is
appropriated to the Secretary, out of any money in the Treasury not otherwise
appropriated, $12,500,000,000 to accompany the allotment made for the period
beginning on October 1, 2011, and ending on March 31, 2012, under section
2104(a)(15)(A) of the Social Security Act (42 U.S.C. 1397dd(a)(15)(A)) (as
added by section 101), to remain available until expended. Such amount shall be
used to provide allotments to States under subsections (c)(5) and (i) of
section 2104 of the Social Security Act (42 U.S.C. 1397dd) for the first 6
months of fiscal year 2012 in the same manner as allotments are provided under
subsection (a)(15)(A) of such section and subject to the same terms and
conditions as apply to the allotments provided from such subsection
(a)(15)(A).</text>
</section><section commented="no" display-inline="no-display-inline" id="id4CDEB45FA7BD4686A4BBA81182E8E2A6"><enum>104.</enum><header>Improving
funding for the territories under CHIP and Medicaid</header>
<subsection commented="no" display-inline="no-display-inline" id="id4D3C57327A2A42C98530186ABD9FA4E1"><enum>(a)</enum><header>Update of CHIP
allotments</header><text>Section 2104(c) (42 U.S.C. 1397dd(c)) is
amended—</text>
<paragraph commented="no" display-inline="no-display-inline" id="id4014B33A0D20403F9272EE7AE8623CAC"><enum>(1)</enum><text>in paragraph (1),
by inserting <quote>and paragraphs (5) and (6)</quote> after <quote>and
(i)</quote>; and</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id29853A2ABBC34B8589084AAA48DA8DE6"><enum>(2)</enum><text>by adding at the
end the following new paragraphs:</text>
<quoted-block display-inline="no-display-inline" id="id0D30EE9E66EA474987F5A7C16AF7EC06" style="OLC">
<paragraph commented="no" display-inline="no-display-inline" id="id43D33BBF6B154941A8743EC31E7B7A95"><enum>(5)</enum><header>Annual
allotments for territories beginning with fiscal year 2008</header><text>Of the
total allotment amount appropriated under subsection (a) for a fiscal year
beginning with fiscal year 2008, the Secretary shall allot to each of the
commonwealths and territories described in paragraph (3) the following:</text>
<subparagraph id="id8C7F0CC94FE54FCF9F54DAEF992963A2"><enum>(A)</enum><header>Fiscal year
2008</header><text>For fiscal year 2008, the highest amount of Federal payments
to the commonwealth or territory under this title for any fiscal year occurring
during the period of fiscal years 1998 through 2007, multiplied by the annual
adjustment determined under subsection (i)(2)(B) for fiscal year 2008, except
that clause (ii) thereof shall be applied by substituting <quote>the United
States</quote> for <quote>the State</quote>.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id6949185F8711402B96DAD324FBE419F2"><enum>(B)</enum><header>Fiscal years
2009 through 2012</header>
<clause commented="no" display-inline="no-display-inline" id="id0312D84F15584A9A8D495F9FC2D7E535"><enum>(i)</enum><header>In
general</header><text>For each of fiscal years 2009 through 2012, except as
provided in clause (ii), the amount determined under this paragraph for the
preceding fiscal year multiplied by the annual adjustment determined under
subsection (i)(2)(B) for the fiscal year, except that clause (ii) thereof shall
be applied by substituting <quote>the United States</quote> for <quote>the
State</quote>.</text>
</clause><clause commented="no" display-inline="no-display-inline" id="id1C8B2DCE96DE4A3D97EC9C75D63F5CAA"><enum>(ii)</enum><header>Special rule
for fiscal year 2012</header><text>In the case of fiscal year 2012—</text>
<subclause commented="no" display-inline="no-display-inline" id="idDF380848DDFD4819830D4E7B6FFE8C63"><enum>(I)</enum><text>89 percent of the
amount allocated to the commonwealth or territory for such fiscal year (without
regard to this subclause) shall be allocated for the period beginning on
October 1, 2011, and ending on March 31, 2012, and</text>
</subclause><subclause id="id7E323A5A09304AAF841F2119A135B2EB"><enum>(II)</enum><text>11 percent of
such amount shall be allocated for the period beginning on April 1, 2012, and
ending on September 30,
2012.</text>
</subclause></clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id6EBF17661D42494396EF2374762B928E"><enum>(b)</enum><header>Removal of
federal matching payments for data reporting systems from the overall limit on
payments to territories under title XIX</header><text>Section 1108(g) (42
U.S.C. 1308(g)) is amended by adding at the end the following new
paragraph:</text>
<quoted-block display-inline="no-display-inline" id="idEE0414EFB6054FC0BD69AD4F35939593" style="OLC">
<paragraph id="id802D6A2CA1B04D7D88529A3DA7694E3C"><enum>(4)</enum><header>Exclusion of
certain expenditures from payment limits</header><text>With respect to fiscal
years beginning with fiscal year 2008, if Puerto Rico, the Virgin Islands,
Guam, the Northern Mariana Islands, or American Samoa qualify for a payment
under subparagraph (A)(i), (B), or (F) of section 1903(a)(3) for a calendar
quarter of such fiscal year, the payment shall not be taken into account in
applying subsection (f) (as increased in accordance with paragraphs (1), (2),
and (3) of this subsection) to such commonwealth or territory for such fiscal
year.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection commented="no" display-inline="no-display-inline" id="id69851CD1E23F498882A6F4B39A1C5342"><enum>(c)</enum><header>GAO study and
report</header><text>Not later than September 30, 2009, the Comptroller General
of the United States shall submit a report to the appropriate committees of
Congress regarding Federal funding under Medicaid and CHIP for Puerto Rico, the
United States Virgin Islands, Guam, American Samoa, and the Northern Mariana
Islands. The report shall include the following:</text>
<paragraph commented="no" display-inline="no-display-inline" id="id427B059E3C9A4A5E9DA349E7CAC48465"><enum>(1)</enum><text>An analysis of
all relevant factors with respect to—</text>
<subparagraph id="id020EEE279442498AAA095ADE2C6AB17D"><enum>(A)</enum><text>eligible Medicaid
and CHIP populations in such commonwealths and territories;</text>
</subparagraph><subparagraph id="idDDE3EE7FF7EB41129AA161DA66B06408"><enum>(B)</enum><text>historical and
projected spending needs of such commonwealths and territories and the ability
of capped funding streams to respond to those spending needs;</text>
</subparagraph><subparagraph id="idBEDFC50B4CC64A2E99B01578B6439A17"><enum>(C)</enum><text>the extent to
which Federal poverty guidelines are used by such commonwealths and territories
to determine Medicaid and CHIP eligibility; and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id5A7219E2365E48DDB137A81C049A0BFE"><enum>(D)</enum><text>the extent to
which such commonwealths and territories participate in data collection and
reporting related to Medicaid and CHIP, including an analysis of territory
participation in the Current Population Survey versus the American Community
Survey.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id31773A5687624534BCC1D3C9E6EF4BFF"><enum>(2)</enum><text>Recommendations
for improving Federal funding under Medicaid and CHIP for such commonwealths
and territories.</text>
</paragraph></subsection></section><section id="idE9F59D0975D142ABB60A2CA2EA1634D2"><enum>105.</enum><header>Incentive
bonuses for States</header>
<subsection id="idA0A41DD207F24E00904D6279921B302E"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Section 2104 (42
U.S.C. 1397dd), as amended by section 102, is amended by adding at the end the
following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="idA0DB52FDF5344590AB014D82E018918F" style="OLC">
<subsection id="id49413805DF2745528D58D2AD9B7813BA"><enum>(j)</enum><header>Incentive
bonuses</header>
<paragraph id="idE7DCE02951DF4678815D88C4BFABF512"><enum>(1)</enum><header>Establishment
of incentive pool from unobligated national allotment and unexpended state
allotments</header>
<subparagraph id="id5F5C8F3C196347B2B75E96D8302A739F"><enum>(A)</enum><header>In
general</header><text>There is hereby established in the Treasury of the United
States a fund which shall be known as the <quote>CHIP Incentive Bonuses
Pool</quote> (in this subsection referred to as the <quote>Incentive
Pool</quote>). Amounts in the Incentive Pool are authorized to be appropriated
for payments under this subsection and shall remain available until
expended.</text>
</subparagraph><subparagraph id="idA1FFA0D94D814417A058C7D961657FC4"><enum>(B)</enum><header>Deposits
through initial appropriation and transfers of funds</header>
<clause id="idF51F6BF9C6E24173B42DEE7378103BE2"><enum>(i)</enum><header>Initial
appropriation</header><text>There is appropriated to the Incentive Pool, out of
any money in the Treasury not otherwise appropriated, $3,000,000,000 for fiscal
year 2008.</text>
</clause><clause id="id8939453D08C14DE7BC7FE1724C4A80A0"><enum>(ii)</enum><header>Transfers</header><text>Notwithstanding
any other provision of law, the following amounts are hereby appropriated or
transferred to, deposited in, and made available for expenditure from the
Incentive Pool on the following dates:</text>
<subclause id="idB799338F40454874B987E13ACEB221B1"><enum>(I)</enum><header>Unexpended
fiscal year 2006 and 2007 allotments</header><text>On December 31, 2007, the
sum for all States of the excess (if any) for each State of—</text>
<item id="id5B895555E007491AB960C5C99EE57BD4"><enum>(aa)</enum><text>the aggregate
allotments provided for the State under subsection (b) or (c) for fiscal years
2006 and 2007 that are not expended by September 30, 2007, over</text>
</item><item id="idBDC548A0116D48099A00EA825ED39926"><enum>(bb)</enum><text>an
amount equal to 50 percent of the allotment provided for the State under
subsection (c) or (i) for fiscal year 2008 (as determined in accordance with
subsection (i)(6)).</text>
</item></subclause><subclause id="idAB857A1C13D74A3BB499BFBFB370F240"><enum>(II)</enum><header>Unobligated
national allotment</header>
<item id="idE0BA04B73EDB4CA380B7A591CA7CCA96"><enum>(aa)</enum><header>Fiscal years
2008 through 2011</header><text>On December 31 of fiscal year 2008, and on
December 31 of each succeeding fiscal year through fiscal year 2011, the
portion, if any, of the amount appropriated under subsection (a) for such
fiscal year that is unobligated for allotment to a State under subsection (c)
or (i) for such fiscal year or set aside under subsection (a)(3) or (b)(2) of
section 2111 for such fiscal year.</text>
</item><item id="idD4BAF8B4FD5449BCB54FF58B1BCDED93"><enum>(bb)</enum><header>First half of
fiscal year 2012</header><text>On December 31 of fiscal year 2012, the portion,
if any, of the sum of the amounts appropriated under subsection (a)(15)(A) and
under section 103 of the <short-title>Children's Health
Insurance Program Reauthorization Act of 2007</short-title> for the period
beginning on October 1, 2011, and ending on March 31, 2012, that is unobligated
for allotment to a State under subsection (c) or (i) for such fiscal year or
set aside under subsection (b)(2) of section 2111 for such fiscal year.</text>
</item><item id="id8056A8944BE84BC0B682D3A38CE8046D"><enum>(cc)</enum><header>Second half of
fiscal year 2012</header><text>On June 30 of fiscal year 2012, the portion, if
any, of the amount appropriated under subsection (a)(15)(B) for the period
beginning on April 1, 2012, and ending on September 30, 2012, that is
unobligated for allotment to a State under subsection (c) or (i) for such
fiscal year or set aside under subsection (b)(2) of section 2111 for such
fiscal year.</text>
</item></subclause><subclause id="id260BA97C888343D5A75E286807C23551"><enum>(III)</enum><header>Percentage of
state allotments that are unexpended by the end of the first year of
availability beginning with the fiscal year 2009 allotments</header><text>On
October 1 of each of fiscal years 2009 through 2012, the sum for all States for
such fiscal year (the <term>current fiscal year</term>) of the excess (if any)
for each State of—</text>
<item id="id4E1D69B1BACC425FB6B332B8AAB45AF3"><enum>(aa)</enum><text>the allotment
made for the State under subsection (b), (c), or (i) for the fiscal year
preceding the current fiscal year (reduced by any amounts set aside under
section 2111(a)(3)) that is not expended by the end of such preceding fiscal
year, over</text>
</item><item id="idD7B7671A25904E979780E257E947FC81"><enum>(bb)</enum><text>an
amount equal to the applicable percentage (for the fiscal year) of the
allotment made for the State under subsection (b), (c), or (i) (as so reduced)
for such preceding fiscal year.</text>
</item><continuation-text continuation-text-level="subclause">For
purposes of item (bb), the applicable percentage is 20 percent for fiscal year
2009, and 10 percent for each of fiscal years 2010, 2011, and 2012.</continuation-text></subclause><subclause id="idE875DD1B493F4909A39F3314FBBF9E65"><enum>(IV)</enum><header>Remainder of
state allotments that are unexpended by the end of the period of availability
beginning with the fiscal year 2006 allotments</header><text>On October 1 of
each of fiscal years 2009 through 2012, the total amount of allotments made to
States under subsection (b), (c), or (i) for the second preceding fiscal year
(third preceding fiscal year in the case of the fiscal year 2006 allotments)
and remaining after the application of subclause (III) that are not expended by
September 30 of the preceding fiscal year.</text>
</subclause><subclause id="id1F8D1E5284D741C19C23E9ABF0ED5AE3"><enum>(V)</enum><header>Unexpended
transitional coverage block grant for nonpregnant childless
adults</header><text>On October 1, 2009, any amounts set aside under section
2111(a)(3) that are not expended by September 30, 2009.</text>
</subclause><subclause id="idECD7D2D838344AF8BB372B6141FB6974"><enum>(VI)</enum><header> Excess CHIP
contingency funds</header>
<item id="idB09E10E83ABE4BFCBC9D19698077CB85"><enum>(aa)</enum><header>Amounts in
excess of the aggregate cap</header><text>On October 1 of each of fiscal years
2010 through 2012, any amount in excess of the aggregate cap applicable to the
CHIP Contingency Fund for the fiscal year under subsection (k)(2)(B).</text>
</item><item id="idCB5C4D57BF5A4C6680737FD0D7621DFE"><enum>(bb)</enum><header>Unexpended
CHIP contingency fund payments</header><text>On October 1 of each of fiscal
years 2010 through 2012, any portion of a CHIP Contingency Fund payment made to
a State that remains unexpended at the end of the period for which the payment
is available for expenditure under subsection (e)(3).</text>
</item></subclause><subclause id="idC9620A86E1194CDC9A83D057816CDBC9"><enum>(VII)</enum><header>Extension of
availability for portion of unexpended state allotments</header><text>The
portion of the allotment made to a State for a fiscal year that is not
transferred to the Incentive Pool under subclause (I) or (III) shall remain
available for expenditure by the State only during the fiscal year in which
such transfer occurs, in accordance with subclause (IV) and subsection
(e)(4).</text>
</subclause></clause></subparagraph><subparagraph id="idAA3536BD84854E7DBC7E771D1F65AAE3"><enum>(C)</enum><header>Investment of
fund</header><text>The Secretary of the Treasury shall invest, in interest
bearing securities of the United States, such currently available portions of
the Incentive Pool as are not immediately required for payments from the Pool.
The income derived from these investments constitutes a part of the Incentive
Pool.</text>
</subparagraph></paragraph><paragraph id="id6D2E7D8D59F14CF2AF7E256C87D80F42"><enum>(2)</enum><header>Payments to
states increasing enrollment</header>
<subparagraph id="id1E2A6B40EDFF4F99A510413BFF836AEE"><enum>(A)</enum><header>In
general</header><text>Subject to paragraph (3)(D), with respect to each of
fiscal years 2009 through 2012, the Secretary shall make payments to States
from the Incentive Pool determined under subparagraph (B).</text>
</subparagraph><subparagraph id="id8B11C3BF3198439D81314D1E9265B863"><enum>(B)</enum><header>Determination
of payments</header><text>If, for any coverage period ending in a fiscal year
ending after September 30, 2008, the average monthly enrollment of children in
the State plan under title XIX exceeds the baseline monthly average for such
period, the payment made for the fiscal year shall be equal to the applicable
amount determined under subparagraph (C).</text>
</subparagraph><subparagraph id="id22C53E41AA454921A12F7BBAE6568D67"><enum>(C)</enum><header>Applicable
amount</header><text>For purposes of subparagraph (B), the applicable amount is
the product determined in accordance with the following:</text>
<clause id="idE6A5E3545C7440BCA33782A9F4727DB9"><enum>(i)</enum><text>If such excess
with respect to the number of individuals who are enrolled in the State plan
under title XIX does not exceed 2 percent, the product of $75 and the number of
such individuals included in such excess.</text>
</clause><clause id="id0076408185E0441CBB25C38E1D6BFC02"><enum>(ii)</enum><text>If such excess
with respect to the number of individuals who are enrolled in the State plan
under title XIX exceeds 2, but does not exceed 5 percent, the product of $300
and the number of such individuals included in such excess, less the amount of
such excess calculated in clause (i).</text>
</clause><clause id="idD3210E67CF454D6780DB7C793C8FB417"><enum>(iii)</enum><text>If such excess
with respect to the number of individuals who are enrolled in the State plan
under title XIX exceeds 5 percent, the product of $625 and the number of such
individuals included in such excess, less the sum of the amount of such excess
calculated in clauses (i) and (ii).</text>
</clause></subparagraph><subparagraph id="id23DAD8671EB646448EB70980A1C0CA4D"><enum>(D)</enum><header>Indexing of
dollar amounts</header><text>For each coverage period ending in a fiscal year
ending after September 30, 2009, the dollar amounts specified in subparagraph
(C) shall be increased by the percentage increase (if any) in the projected
nominal per capita amount of National Health Expenditures for the calendar year
beginning on January 1 of the coverage period over the preceding coverage
period, as most recently published by the Secretary before the beginning of the
coverage period involved.</text>
</subparagraph></paragraph><paragraph id="id1EF27BCC965142A49A45E8ECF280798C"><enum>(3)</enum><header>Rules relating
to enrollment increases</header><text>For purposes of paragraph (2)(B)—</text>
<subparagraph id="idA507B7ADA5C4465FB97B35A927B64BCC"><enum>(A)</enum><header>Baseline
monthly average</header><text>Except as provided in subparagraph (C), the
baseline monthly average for any fiscal year for a State is equal to—</text>
<clause id="id3E3934F2856546FEA35230783BA14E15"><enum>(i)</enum><text>the baseline
monthly average for the preceding fiscal year; multiplied by</text>
</clause><clause id="id66E8EB0799B64358971A8500C7398FEB"><enum>(ii)</enum><text>the sum of 1
plus the sum of—</text>
<subclause id="id0026A8CB7BD14EABBB906F218042C156"><enum>(I)</enum><text>0.01; and</text>
</subclause><subclause id="idDF1DD70D9FB74C9BAE9630B4C9611546"><enum>(II)</enum><text>the percentage
increase in the population of low-income children in the State from the
preceding fiscal year to the fiscal year involved, as determined by the
Secretary based on the most timely and accurate published estimates of the
Bureau of the Census before the beginning of the fiscal year involved.</text>
</subclause></clause></subparagraph><subparagraph id="id2A8355B203A447D294B5CD7FB3DBE847"><enum>(B)</enum><header>Coverage
period</header><text>Except as provided in subparagraph (C), the coverage
period for any fiscal year consists of the last 2 quarters of the preceding
fiscal year and the first 2 quarters of the fiscal year.</text>
</subparagraph><subparagraph id="idFDF62983C7474F5EA05099BEC20D9DD8"><enum>(C)</enum><header>Special rules
for fiscal year 2009</header><text>With respect to fiscal year 2009—</text>
<clause id="id1A930A6D51BD4649AB557CC9A21F1BDF"><enum>(i)</enum><text>the coverage
period for that fiscal year shall be based on the first 2 quarters of fiscal
year 2009; and</text>
</clause><clause id="idBA3B55C10DE847EEA666DA5A1B671DB1"><enum>(ii)</enum><text>the baseline
monthly average shall be—</text>
<subclause id="idAFD7A09A690D4A8A8B856B4587F9F918"><enum>(I)</enum><text>the average
monthly enrollment of low-income children enrolled in the State's plan under
title XIX for the first 2 quarters of fiscal year 2007 (as determined over a
6-month period on the basis of the most recent information reported through the
Medicaid Statistical Information System (MSIS)); multiplied by</text>
</subclause><subclause id="id1BCFF39988F245569C59BF0AB36848FD"><enum>(II)</enum><text>the sum of 1
plus the sum of—</text>
<item id="id8B6FE956706E48F3A0933479E882DF74"><enum>(aa)</enum><text>0.02; and</text>
</item><item id="id88C459FAE8DD40FEA8C8866E31FDE91E"><enum>(bb)</enum><text>the percentage
increase in the population of low-income children in the State from fiscal year
2007 to fiscal year 2009, as determined by the Secretary based on the most
timely and accurate published estimates of the Bureau of the Census before the
beginning of the fiscal year involved.</text>
</item></subclause></clause></subparagraph><subparagraph id="id1C166E0154394F6B84244D7DA7C91929"><enum>(D)</enum><header>Additional
requirement for eligibility for payment</header><text>For purposes of
subparagraphs (B) and (C), the average monthly enrollment shall be determined
without regard to children who do not meet the income eligibility criteria in
effect on July 19, 2007, for enrollment under the State plan under title XIX or
under a waiver of such plan.</text>
</subparagraph></paragraph><paragraph id="id654FDFB86ACA4E81A41B1687B01AC3BE"><enum>(4)</enum><header>Time of
payment</header><text>Payments under paragraph (2) for any fiscal year shall be
made during the last quarter of such year.</text>
</paragraph><paragraph commented="no" id="idBEACC0FFE1D643179645994A29D2CB76"><enum>(5)</enum><header>Use of
payments</header><text>Payments made to a State from the Incentive Pool shall
be used for any purpose that the State determines is likely to reduce the
percentage of low-income children in the State without health insurance.</text>
</paragraph><paragraph id="idD0A76E4CDC4B43EB9AF5D7BECDA37331"><enum>(6)</enum><header>Proration
rule</header><text>If the amount available for payment from the Incentive Pool
is less than the total amount of payments to be made for such fiscal year, the
Secretary shall reduce the payments described in paragraph (2) on a
proportional basis.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="idEB1D521D1BCF40F3B85607849C13964F"><enum>(7)</enum><header display-inline="yes-display-inline">References</header><text display-inline="yes-display-inline">With respect to a State plan under title
XIX, any references to a child in this subsection shall include a reference to
any individual provided medical assistance under the plan who has not attained
age 19 (or, if a State has so elected under such State plan, age 20 or
21).</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="idD8BBEB756187444BA8010D08AEFA3095"><enum>(b)</enum><header>Redistribution
of unexpended fiscal year 2005 allotments</header><text>Notwithstanding section
2104(f) of the Social Security Act (42 U.S.C. 1397dd(f)), with respect to
fiscal year 2008, the Secretary shall provide for a redistribution under such
section from the allotments for fiscal year 2005 under subsection (b) and (c)
of such section that are not expended by the end of fiscal year 2007, to each
State described in clause (iii) of section 2104(i)(2)(A) of the Social Security
Act, as added by section 102(a), of an amount that bears the same ratio to such
unexpended fiscal year 2005 allotments as the ratio of the fiscal year 2007
allotment determined for each such State under subsection (b) of section 2104
of such Act for fiscal year 2007 (without regard to any amounts paid, allotted,
or redistributed to the State under section 2104 for any preceding fiscal year)
bears to the total amount of the fiscal year 2007 allotments for all such
States (as so determined).</text>
</subsection><subsection id="id51D2724C6D5440D7998B4A98F7D9E139"><enum>(c)</enum><header>Conforming
amendment eliminating rules for redistribution of unexpended allotments for
fiscal years after 2005</header><text>Effective January 1, 2008, section
2104(f) (42 U.S.C. 1397dd(f)) is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="idDEEBFA491A7F49B3A38E75EBABE0F986" style="OLC">
<subsection id="id8C4A665CB1F6442C807C51598E719D40"><enum>(f)</enum><header>Unallocated
portion of national allotment and unused allotments</header><text>For
provisions relating to the distribution of portions of the unallocated national
allotment under subsection (a) for fiscal years beginning with fiscal year
2008, and unexpended allotments for fiscal years beginning with fiscal year
2006, see subsection
(j).</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="idAA05C14B88314CFB8CE0091260E20ACF"><enum>(d)</enum><header>Additional
funding for the Secretary To improve timeliness of data reporting and analysis
for purposes of determining enrollment increases under Medicaid and
CHIP</header>
<paragraph id="id1B8AD0FFF2394D148F251201FDB40AAC"><enum>(1)</enum><header>Appropriation</header><text>There
is appropriated, out of any money in the Treasury not otherwise appropriated,
$5,000,000 to the Secretary for fiscal year 2008 for the purpose of improving
the timeliness of the data reported and analyzed from the Medicaid Statistical
Information System (MSIS) for purposes of carrying out section 2104(j)(2)(B) of
the Social Security Act (as added by subsection (a)) and to provide guidance to
States with respect to any new reporting requirements related to such
improvements. Amounts appropriated under this paragraph shall remain available
until expended.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="idEC20EC237F6C43609B876C05D4951218"><enum>(2)</enum><header>Requirements</header><text>The
improvements made by the Secretary under paragraph (1) shall be designed and
implemented (including with respect to any necessary guidance for States) so
that, beginning no later than October 1, 2008, data regarding the enrollment of
low-income children (as defined in section 2110(c)(4) of the Social Security
Act (42 U.S.C. 1397jj(c)(4)) of a State enrolled in the State plan under
Medicaid or the State child health plan under CHIP with respect to a fiscal
year shall be collected and analyzed by the Secretary within 6 months of
submission.</text>
</paragraph></subsection></section><section id="id7AA6910B8CC84F0689A24747A6526613"><enum>106.</enum><header>Phase-out of
coverage for nonpregnant childless adults under CHIP; conditions for coverage
of parents</header>
<subsection id="idE101618102F64FE29CEA6B03609C2729"><enum>(a)</enum><header>Phase-out
rules</header>
<paragraph id="id22E33209443343BFBC7FEC82FF10031E"><enum>(1)</enum><header>In
general</header><text>Title XXI (42 U.S.C. 1397aa et seq.) is amended by adding
at the end the following new section:</text>
<quoted-block display-inline="no-display-inline" id="id3FE8B9093E464CEBBEDC331A51A47C72" style="OLC">
<section id="id653B26427A6F43478124D05244711EDB"><enum>2111.</enum><header>Phase-out of
coverage for nonpregnant childless adults; conditions for coverage of
parents</header>
<subsection id="idA4955606E1A4457884844E49FC97FA86"><enum>(a)</enum><header>Termination of
coverage for nonpregnant childless adults</header>
<paragraph id="id43A77F9041D843D5B06CFD84D0CE4A62"><enum>(1)</enum><header>No new CHIP
waivers; automatic extensions at state option through fiscal year
2008</header><text>Notwithstanding section 1115 or any other provision of this
title, except as provided in this subsection—</text>
<subparagraph id="id15578B10546F4BB78924FCCCEC51EB4A"><enum>(A)</enum><text>the Secretary
shall not on or after the date of the enactment of the
<short-title>Children's Health Insurance Program
Reauthorization Act of 2007</short-title>, approve or renew a waiver,
experimental, pilot, or demonstration project that would allow funds made
available under this title to be used to provide child health assistance or
other health benefits coverage to a nonpregnant childless adult; and</text>
</subparagraph><subparagraph id="id56AE96A758D744AB851EE2625F530EB3"><enum>(B)</enum><text>notwithstanding
the terms and conditions of an applicable existing waiver, the provisions of
paragraphs (2) and (3) shall apply for purposes of any fiscal year beginning on
or after October 1, 2008, in determining the period to which the waiver
applies, the individuals eligible to be covered by the waiver, and the amount
of the Federal payment under this title.</text>
</subparagraph></paragraph><paragraph id="idE19C21498F044724B8B2FFA95F161A49"><enum>(2)</enum><header>Termination of
CHIP coverage under applicable existing waivers at the end of fiscal year
2008</header>
<subparagraph id="id9A168FA207B340D6ACF0C0CEC5DA0B02"><enum>(A)</enum><header>In
general</header><text>No funds shall be available under this title for child
health assistance or other health benefits coverage that is provided to a
nonpregnant childless adult under an applicable existing waiver after September
30, 2008.</text>
</subparagraph><subparagraph id="idBE327F927F984DB6AB1DE1E37B110710"><enum>(B)</enum><header>Extension upon
State request</header><text>If an applicable existing waiver described in
subparagraph (A) would otherwise expire before October 1, 2008, and the State
requests an extension of such waiver, the Secretary shall grant such an
extension, but only through September 30, 2008.</text>
</subparagraph><subparagraph id="id7382693614534BE083248212B541AD96"><enum>(C)</enum><header>Application of
enhanced FMAP</header><text>The enhanced FMAP determined under section 2105(b)
shall apply to expenditures under an applicable existing waiver for the
provision of child health assistance or other health benefits coverage to a
nonpregnant childless adult during fiscal year 2008.</text>
</subparagraph></paragraph><paragraph id="id5812A8B5E5DD4392AA34E698F305FCD3"><enum>(3)</enum><header>Optional 1-year
transitional coverage block grant funded from state
allotment</header><text>Subject to paragraph (4)(B), each State for which
coverage under an applicable existing waiver is terminated under paragraph
(2)(A) may elect to provide nonpregnant childless adults who were provided
child health assistance or health benefits coverage under the applicable
existing waiver at any time during fiscal year 2008 with such assistance or
coverage during fiscal year 2009, as if the authority to provide such
assistance or coverage under an applicable existing waiver was extended through
that fiscal year, but subject to the following terms and conditions:</text>
<subparagraph id="id8F34B0AF48434FDEAD1C94DCD465C3F4"><enum>(A)</enum><header>Block grant set
aside from state allotment</header><text>The Secretary shall set aside for the
State an amount equal to the Federal share of the State's projected
expenditures under the applicable existing waiver for providing child health
assistance or health benefits coverage to all nonpregnant childless adults
under such waiver for fiscal year 2008 (as certified by the State and submitted
to the Secretary by not later than August 31, 2008, and without regard to
whether any such individual lost coverage during fiscal year 2008 and was later
provided child health assistance or other health benefits coverage under the
waiver in that fiscal year), increased by the annual adjustment for fiscal year
2009 determined under section 2104(i)(2)(B)(i). The Secretary may adjust the
amount set aside under the preceding sentence, as necessary, on the basis of
the expenditure data for fiscal year 2008 reported by States on CMS Form 64 or
CMS Form 21 not later than November 30, 2008, but in no case shall the
Secretary adjust such amount after December 31, 2008.</text>
</subparagraph><subparagraph id="id8937FAF4DD7D4B1DA1717137E89F202A"><enum>(B)</enum><header>No coverage for
nonpregnant childless adults who were not covered during fiscal year
2008</header>
<clause id="id0C304F15CA9045BE8BF6E6DB954FC2B1"><enum>(i)</enum><header>FMAP applied to
expenditures</header><text>The Secretary shall pay the State for each quarter
of fiscal year 2009, from the amount set aside under subparagraph (A), an
amount equal to the Federal medical assistance percentage (as determined under
section 1905(b) without regard to clause (4) of such section) of expenditures
in the quarter for providing child health assistance or other health benefits
coverage to a nonpregnant childless adult but only if such adult was enrolled
in the State program under this title during fiscal year 2008 (without regard
to whether the individual lost coverage during fiscal year 2008 and was
reenrolled in that fiscal year or in fiscal year 2009).</text>
</clause><clause id="id7DAD3CEF60424F39B325E6AAEEEE7E0A"><enum>(ii)</enum><header>Federal
payments limited to amount of block grant set-aside</header><text>No payments
shall be made to a State for expenditures described in this subparagraph after
the total amount set aside under subparagraph (A) for fiscal year 2009 has been
paid to the State.</text>
</clause></subparagraph></paragraph><paragraph id="idDCBFFECDC9F145C0A811B192BF8ACA53"><enum>(4)</enum><header>State option to
apply for medicaid waiver to continue coverage for nonpregnant childless
adults</header>
<subparagraph id="id3385C35716174E4E9B6A0D06AB42B3D0"><enum>(A)</enum><header>In
general</header><text>Each State for which coverage under an applicable
existing waiver is terminated under paragraph (2)(A) may submit, not later than
June 30, 2009, an application to the Secretary for a waiver under section 1115
of the State plan under title XIX to provide medical assistance to a
nonpregnant childless adult whose coverage is so terminated (in this subsection
referred to as a <quote>Medicaid nonpregnant childless adults
waiver</quote>).</text>
</subparagraph><subparagraph id="id433A721B2837464D9729457DCDE8308A"><enum>(B)</enum><header>Deadline for
approval</header><text>The Secretary shall make a decision to approve or deny
an application for a Medicaid nonpregnant childless adults waiver submitted
under subparagraph (A) within 90 days of the date of the submission of the
application. If no decision has been made by the Secretary as of September 30,
2009, on the application of a State for a Medicaid nonpregnant childless adults
waiver that was submitted to the Secretary by June 30, 2009, the application
shall be deemed approved.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idECF7924066B74AAB9CE9094390171702"><enum>(C)</enum><header display-inline="yes-display-inline">Standard for budget
neutrality</header><text display-inline="yes-display-inline">The budget
neutrality requirement applicable with respect to expenditures for medical
assistance under a Medicaid nonpregnant childless adults waiver shall—</text>
<clause commented="no" display-inline="no-display-inline" id="idB4256EC4B9D5471F8CFF37FA479235DD"><enum>(i)</enum><text display-inline="yes-display-inline">in the case of fiscal year 2010, allow
expenditures for medical assistance under title XIX for all such adults to not
exceed the total amount of payments made to the State under paragraph (3)(B)
for fiscal year 2009, increased by the percentage increase (if any) in the
projected nominal per capita amount of National Health Expenditures for
calendar year 2010 over calendar year 2009, as most recently published by the
Secretary; and</text>
</clause><clause commented="no" display-inline="no-display-inline" id="idE9A46F3F32594F9497CC602CE331BF11"><enum>(ii)</enum><text display-inline="yes-display-inline">in the case of any succeeding fiscal year,
allow such expenditures to not exceed the amount in effect under this
subparagraph for the preceding fiscal year, increased by the percentage
increase (if any) in the projected nominal per capita amount of National Health
Expenditures for the calendar year that begins during the fiscal year involved
over the preceding calendar year, as most recently published by the
Secretary.</text>
</clause></subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="idB3F285B13D1F43799A01E3F6D5CA660B"><enum>(b)</enum><header>Rules and
conditions for coverage of parents of targeted low-income children</header>
<paragraph id="idC433443ACD3A4B30B9F8E9FE2C4513E4"><enum>(1)</enum><header>Two-year
transition period; automatic extension at state option through fiscal year
2009</header>
<subparagraph id="id7E974CBD49D94C14B78EBACAD8A99986"><enum>(A)</enum><header>No new CHIP
waivers</header><text>Notwithstanding section 1115 or any other provision of
this title, except as provided in this subsection—</text>
<clause id="idDE4352BBAA6C496187FE6951F1E8130B"><enum>(i)</enum><text>the Secretary
shall not on or after the date of the enactment of the
<short-title>Children's Health Insurance Program
Reauthorization Act of 2007</short-title> approve or renew a waiver,
experimental, pilot, or demonstration project that would allow funds made
available under this title to be used to provide child health assistance or
other health benefits coverage to a parent of a targeted low-income child;
and</text>
</clause><clause id="id1D5265B87D85444597DCE0E2FBF7ADDF"><enum>(ii)</enum><text>notwithstanding
the terms and conditions of an applicable existing waiver, the provisions of
paragraphs (2) and (3) shall apply for purposes of any fiscal year beginning on
or after October 1, 2009, in determining the period to which the waiver
applies, the individuals eligible to be covered by the waiver, and the amount
of the Federal payment under this title.</text>
</clause></subparagraph><subparagraph id="id89AE80E171FE403C91727BC7650367AA"><enum>(B)</enum><header>Extension upon
State request</header><text>If an applicable existing waiver described in
subparagraph (A) would otherwise expire before October 1, 2009, and the State
requests an extension of such waiver, the Secretary shall grant such an
extension, but only, subject to paragraph (2)(A), through September 30,
2009.</text>
</subparagraph><subparagraph id="idC40288ACEA514030A8920D030975901B"><enum>(C)</enum><header>Application of
enhanced FMAP</header><text>The enhanced FMAP determined under section 2105(b)
shall apply to expenditures under an applicable existing waiver for the
provision of child health assistance or other health benefits coverage to a
parent of a targeted low-income child during fiscal years 2008 and 2009.</text>
</subparagraph></paragraph><paragraph id="id89948C7DBD5042DAAB41E2A8307DBE43"><enum>(2)</enum><header>Rules for
fiscal years 2010 through 2012</header>
<subparagraph id="id1245137D99404FCB93D84553449693A9"><enum>(A)</enum><header>Payments for
coverage limited to block grant funded from state allotment</header><text>Any
State that provides child health assistance or health benefits coverage under
an applicable existing waiver for a parent of a targeted low-income child may
elect to continue to provide such assistance or coverage through fiscal year
2010, 2011, or 2012, subject to the same terms and conditions that applied
under the applicable existing waiver, unless otherwise modified in subparagraph
(B).</text>
</subparagraph><subparagraph id="id09A642E379854010A515AC00C70DC8D1"><enum>(B)</enum><header>Terms and
conditions</header>
<clause id="id8CE4382588C04072835937CA65BC6109"><enum>(i)</enum><header>Block grant set
aside from state allotment</header><text>If the State makes an election under
subparagraph (A), the Secretary shall set aside for the State for each such
fiscal year an amount equal to the Federal share of 110 percent of the State's
projected expenditures under the applicable existing waiver for providing child
health assistance or health benefits coverage to all parents of targeted
low-income children enrolled under such waiver for the fiscal year (as
certified by the State and submitted to the Secretary by not later than August
31 of the preceding fiscal year). In the case of fiscal year 2012, the set
aside for any State shall be computed separately for each period described in
clauses (i) and (ii) of subsection (i))(1)(D) and any increase or reduction in
the allotment for either such period under subsection (i)(3)(B)(ii) shall be
allocated on a pro rata basis to such set aside.</text>
</clause><clause id="id945328375BCB4085B1ABFED87FB0B9B5"><enum>(ii)</enum><header>Payments from
block grant</header><text>The Secretary shall pay the State from the amount set
aside under clause (i) for the fiscal year, an amount for each quarter of such
fiscal year equal to the applicable percentage determined under clause (iii) or
(iv) for expenditures in the quarter for providing child health assistance or
other health benefits coverage to a parent of a targeted low-income
child.</text>
</clause><clause id="id966E1B4D8DE24AB8B7FDEDEE3C6F4192"><enum>(iii)</enum><header>Enhanced FMAP
only in fiscal year 2010 for States with significant child outreach or that
achieve child coverage benchmarks; FMAP for any other states</header><text>For
purposes of clause (ii), the applicable percentage for any quarter of fiscal
year 2010 is equal to—</text>
<subclause id="idC4F24DF35C494F61BED6539160A0E9C6"><enum>(I)</enum><text>the enhanced FMAP
determined under section 2105(b) in the case of a State that meets the outreach
or coverage benchmarks described in any of subparagraphs (A), (B), or (C) of
paragraph (3) for fiscal year 2009; or</text>
</subclause><subclause id="idFD522EED882A4E82B187B814ABFB8CF5"><enum>(II)</enum><text>the Federal
medical assistance percentage (as determined under section 1905(b) without
regard to clause (4) of such section) in the case of any other State.</text>
</subclause></clause><clause id="id5D74A94CB09444089D2EF9A98968791A"><enum>(iv)</enum><header>Amount of
Federal matching payment in 2011 or 2012</header><text>For purposes of clause
(ii), the applicable percentage for any quarter of fiscal year 2011 or 2012 is
equal to—</text>
<subclause id="idE0F1013B61C748B389F33B2E4412B18A"><enum>(I)</enum><text>the REMAP
percentage if the State met either of the coverage benchmarks described in
subparagraph (B) or (C) of paragraph (3) for the preceding fiscal year;
or</text>
</subclause><subclause id="id540421B7A1384774B6541CC0FF840439"><enum>(II)</enum><text>the Federal
medical assistance percentage (as so determined) in the case of any State to
which subclause (I) does not apply.</text>
</subclause><continuation-text continuation-text-level="clause">For purposes
of subclause (I), the REMAP percentage is the percentage which is the sum of
such Federal medical assistance percentage and a number of percentage points
equal to one-half of the difference between such Federal medical assistance
percentage and such enhanced FMAP.</continuation-text></clause><clause id="idD448D15A0E934A66B16F2ABBDAF1AF83"><enum>(v)</enum><header>No federal
payments other than from block grant set aside</header><text>No payments shall
be made to a State for expenditures described in clause (ii) after the total
amount set aside under clause (i) for a fiscal year has been paid to the
State.</text>
</clause><clause id="id63A68ED2BE4844C3AA1FE808710D04C8"><enum>(vi)</enum><header>No increase in
income eligibility level for parents</header><text>No payments shall be made to
a State from the amount set aside under clause (i) for a fiscal year for
expenditures for providing child health assistance or health benefits coverage
to a parent of a targeted low-income child whose family income exceeds the
income eligibility level applied under the applicable existing waiver to
parents of targeted low-income children on the date of enactment of the
<short-title>Children's Health Insurance Program
Reauthorization Act of 2007</short-title>.</text>
</clause></subparagraph></paragraph><paragraph id="idA5E44C7CECD9483D855BC04B0E8D7AEB"><enum>(3)</enum><header>Outreach or
coverage benchmarks</header><text>For purposes of paragraph (2), the outreach
or coverage benchmarks described in this paragraph are as follows:</text>
<subparagraph id="idA74F7756A9954631A094EA5D867302D5"><enum>(A)</enum><header>Significant
child outreach campaign</header><text>The State—</text>
<clause id="idBE1583DF4AE04751A62538A6F0C529E3"><enum>(i)</enum><text>was awarded a
grant under section 2113 for fiscal year 2009;</text>
</clause><clause id="idAC884839D64B4938BACDAEDF9586AB76"><enum>(ii)</enum><text>implemented 1 or
more of the process measures described in section 2104(j)(3)(A)(i) for such
fiscal year; or</text>
</clause><clause id="id5608A5676BEB40A8BA88D94592E8F9A8"><enum>(iii)</enum><text>has submitted a
specific plan for outreach for such fiscal year.</text>
</clause></subparagraph><subparagraph id="id1EC93ACE82C348419B5360A2EFF84F9F"><enum>(B)</enum><header>High-performing
state</header><text>The State, on the basis of the most timely and accurate
published estimates of the Bureau of the Census, ranks in the lowest
<fraction>1/3</fraction> of States in terms of the State's percentage of
low-income children without health insurance.</text>
</subparagraph><subparagraph id="idA886EEC1562A4F91A26D5EF8631FD1A6"><enum>(C)</enum><header>State
increasing enrollment of low-income children</header><text>The State qualified
for a payment from the Incentive Fund under paragraph (2)(C) of section 2104(j)
for the most recent coverage period applicable under such section.</text>
</subparagraph></paragraph><paragraph id="id9C261C33B23445C484644753F9BF3685"><enum>(4)</enum><header>Rules of
construction</header><text>Nothing in this subsection shall be construed as
prohibiting a State from submitting an application to the Secretary for a
waiver under section 1115 of the State plan under title XIX to provide medical
assistance to a parent of a targeted low-income child that was provided child
health assistance or health benefits coverage under an applicable existing
waiver.</text>
</paragraph></subsection><subsection id="id27517EA34490403895741EAD49EF095B"><enum>(c)</enum><header>Applicable
existing waiver</header><text>For purposes of this section—</text>
<paragraph id="idF3A9FDEDD5E148C7AFD50D9ACF59C686"><enum>(1)</enum><header>In
general</header><text>The term <term>applicable existing waiver</term> means a
waiver, experimental, pilot, or demonstration project under section 1115,
grandfathered under section 6102(c)(3) of the Deficit Reduction Act of 2005, or
otherwise conducted under authority that—</text>
<subparagraph id="id84ADE9E543394E07BDBFC81A8C36596B"><enum>(A)</enum><text>would allow funds
made available under this title to be used to provide child health assistance
or other health benefits coverage to—</text>
<clause id="idBF7F6EE220444923AC753D15B348AAAA"><enum>(i)</enum><text>a
parent of a targeted low-income child;</text>
</clause><clause id="id830367E0DE984A2D857C103FAA3DCB74"><enum>(ii)</enum><text>a nonpregnant
childless adult; or</text>
</clause><clause id="idB30050FCCFFF410D9C91D50ABB6AE0C2"><enum>(iii)</enum><text>individuals
described in both clauses (i) and (ii); and</text>
</clause></subparagraph><subparagraph id="id5B22CDA8A0EF4B1A8860FC4481E24D76"><enum>(B)</enum><text>was in effect
during fiscal year 2007.</text>
</subparagraph></paragraph><paragraph id="idA32AB048FBDF45D486E7A6FBD72A455C"><enum>(2)</enum><header>Definitions</header>
<subparagraph id="idF86F75AC6E7C48D8BB334518CEBEFFE5"><enum>(A)</enum><header>Parent</header><text>The
term <term>parent</term> includes a caretaker relative (as such term is used in
carrying out section 1931) and a legal guardian.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id5F804488A82E450C8907400E758CFAF3"><enum>(B)</enum><header>Nonpregnant
childless adult</header><text>The term <term>nonpregnant childless adult</term>
has the meaning given such term by section
2107(f).</text>
</subparagraph></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="idED4BB7C994C34D14B4DAC78D49FD67C0"><enum>(2)</enum><header>Conforming
amendments</header>
<subparagraph id="idC1120E3B4ACC4397997CC3C0081E047B"><enum>(A)</enum><text>Section 2107(f)
(42 U.S.C. 1397gg(f)) is amended—</text>
<clause id="id9BFCF85584CB429DA0EDE0BB3FFE8643"><enum>(i)</enum><text display-inline="yes-display-inline">by striking <quote>, the Secretary</quote>
and inserting “:</text>
<quoted-block display-inline="no-display-inline" id="idD2C13B1F511A43408509EA3CC18065CD" style="OLC">
<paragraph id="id7E2E9C91FE9444C5B23118D2CCBB05E3"><enum>(1)</enum><text>The
Secretary</text>
</paragraph><after-quoted-block>;
</after-quoted-block></quoted-block>
</clause><clause id="id58579D6584ED409885F040D90513A7F3"><enum>(ii)</enum><text>in
the first sentence, by inserting <quote>or a parent (as defined in section
2111(c)(2)(A)), who is not pregnant, of a targeted low-income child</quote>
before the period;</text>
</clause><clause id="id23366F3B83CA4B54871FA75ABD2A9E4D"><enum>(iii)</enum><text>by striking the
second sentence; and</text>
</clause><clause id="id1A08198EADEC4D838A2BE287A7D27593"><enum>(iv)</enum><text>by
adding at the end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="idCAEBA54FACA845A4AD2AAEDE5DEA4A4D" style="OLC">
<paragraph id="idD6251E043A1946829196BD11D1DA572E"><enum>(2)</enum><text>The Secretary may
not approve, extend, renew, or amend a waiver, experimental, pilot, or
demonstration project with respect to a State after the date of enactment of
the <short-title>Children's Health Insurance Program
Reauthorization Act of 2007</short-title> that would waive or modify the
requirements of section
2111.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</clause></subparagraph><subparagraph id="id61E4624354AF46B8BFB282CFFB0792A1"><enum>(B)</enum><text>Section 6102(c)
of the Deficit Reduction Act of 2005 (Public Law 109–171; 120 Stat. 131) is
amended by striking <quote>Nothing</quote> and inserting <quote>Subject to
section 2111 of the Social Security Act, as added by section 106(a)(1) of the
<short-title>Children's Health Insurance Program
Reauthorization Act of 2007</short-title>, nothing</quote>.</text>
</subparagraph></paragraph></subsection><subsection id="id29481A152A6D4AD8B8D43240AADA5DB3"><enum>(b)</enum><header>GAO study and
report</header>
<paragraph id="idB26881E5ED9A45C6B97A1A386AF4B100"><enum>(1)</enum><header>In
general</header><text>The Comptroller General of the United States shall
conduct a study of whether—</text>
<subparagraph id="id2792913A59244B70AFC4363DFE5884A0"><enum>(A)</enum><text>the coverage of a
parent, a caretaker relative (as such term is used in carrying out section
1931), or a legal guardian of a targeted low-income child under a State health
plan under title XXI of the Social Security Act increases the enrollment of, or
the quality of care for, children, and</text>
</subparagraph><subparagraph id="id72C9BB839C9147BFBE9DF35F3B9CC020"><enum>(B)</enum><text>such parents,
relatives, and legal guardians who enroll in such a plan are more likely to
enroll their children in such a plan or in a State plan under title XIX of such
Act.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idE5826C819DBA4695AD9A1CF64D036B53"><enum>(2)</enum><header>Report</header><text>Not
later than 2 years after the date of the enactment of this Act, the Comptroller
General shall report the results of the study to the appropriate committees of
Congress, including recommendations (if any) for changes in legislation.</text>
</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="ID7AEFC9E3E0CD4207A936CB2C8F9284AF" section-type="subsequent-section"><enum>107.</enum><header>State option to
cover low-income pregnant women under CHIP through a state plan
amendment</header>
<subsection commented="no" display-inline="no-display-inline" id="id3E1EFC25CCEF456487F610FCDEAF0538"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Title XXI (42 U.S.C.
1397aa et seq.), as amended by section 106(a), is amended by adding at the end
the following new section:</text>
<quoted-block act-name="Social Security Act" display-inline="no-display-inline" id="id80C9C23E97C6491CB6ACE91FC657DF6E" style="OLC">
<section commented="no" display-inline="no-display-inline" id="id916062011C804F84858F26C62E398177" section-type="subsequent-section"><enum>2112.</enum><header>Optional coverage
of targeted low-income pregnant women through a state plan amendment</header>
<subsection commented="no" display-inline="no-display-inline" id="idFAF7A1A8698046849C13D90CBA939DE4"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Subject to the
succeeding provisions of this section, a State may elect through an amendment
to its State child health plan under section 2102 to provide pregnancy-related
assistance under such plan for targeted low-income pregnant women.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="id679809CB3D2E4715887ACFA37384D745"><enum>(b)</enum><header>Conditions</header><text>A
State may only elect the option under subsection (a) if the following
conditions are satisfied:</text>
<paragraph commented="no" display-inline="no-display-inline" id="id45E88B536E4041E4898287A9A8CD58CA"><enum>(1)</enum><header>Medicaid income
eligibility level for pregnant women of at least 185 percent of
poverty</header><text display-inline="yes-display-inline">The State has
established an income eligibility level for pregnant women under subsection
(a)(10)(A)(i)(III), (a)(10)(A)(i)(IV), or (l)(1)(A) of section 1902 that is at
least 185 percent of the income official poverty line.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id674AAF23CA5A47819B06C53AEE8DFA48"><enum>(2)</enum><header>No CHIP income
eligibility level for pregnant women lower than the State's Medicaid
level</header><text display-inline="yes-display-inline">The State does not
apply an effective income level for pregnant women under the State plan
amendment that is lower than 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), (a)(10)(A)(i)(IV), or (l)(1)(A) of section
1902, on the date of enactment of this paragraph to be eligible for medical
assistance as a pregnant woman.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id9A8C7996FB024125A8B70A1BBAA99938"><enum>(3)</enum><header>No coverage for
higher income pregnant women without covering lower income pregnant
women</header><text display-inline="yes-display-inline">The State does not
provide coverage for pregnant women with higher family income without covering
pregnant women with a lower family income.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id463FA54BF0554310917C7F4A14BE27EC"><enum>(4)</enum><header>Application of
requirements for coverage of targeted low-income children</header><text display-inline="yes-display-inline">The State provides pregnancy-related
assistance for targeted low-income pregnant women in the same manner, and
subject to the same requirements, as the State provides child health assistance
for targeted low-income children under the State child health plan, and in
addition to providing child health assistance for such women.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id54EE3D6E6D4F4D41AFC12F63DA124CCD"><enum>(5)</enum><header>No preexisting
condition exclusion or waiting period</header><text display-inline="yes-display-inline">The State does not apply any exclusion of
benefits for pregnancy-related assistance based on any preexisting condition or
any waiting period (including any waiting period imposed to carry out section
2102(b)(3)(C)) for receipt of such assistance.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="idC7D23D29C71B4C1C9F6CFB1DCA54FC77"><enum>(6)</enum><header>Application of
cost-sharing protection</header><text display-inline="yes-display-inline">The
State provides pregnancy-related assistance to a targeted low-income woman
consistent with the cost-sharing protections under section 2103(e) and applies
the limitation on total annual aggregate cost sharing imposed under paragraph
(3)(B) of such section to the family of such a woman.</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id0E5EC3B645E449358A044B90946E4060"><enum>(c)</enum><header>Option To
provide presumptive eligibility</header><text display-inline="yes-display-inline">A State that elects the option under
subsection (a) and satisfies the conditions described in subsection (b) may
elect to apply section 1920 (relating to presumptive eligibility for pregnant
women) to the State child health plan in the same manner as such section
applies to the State plan under title XIX.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="id9C552ADC68DF42389C6EA80884998E43"><enum>(d)</enum><header>Definitions</header><text display-inline="yes-display-inline">For purposes of this section:</text>
<paragraph commented="no" display-inline="no-display-inline" id="idCA213481006D40E195E3A87F9A18DF1B"><enum>(1)</enum><header>Pregnancy-related
assistance</header><text display-inline="yes-display-inline">The term
<term>pregnancy-related assistance</term> has the meaning given the term
<term>child health assistance</term> in section 2110(a) and includes any
medical assistance that the State would provide for a pregnant woman under the
State plan under title XIX during pregnancy and the period described in
paragraph (2)(A).</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id3591A4F5005F47B4AC19C9C6CAC8A656"><enum>(2)</enum><header>Targeted
low-income pregnant woman</header><text display-inline="yes-display-inline">The
term <term>targeted low-income pregnant woman</term> means a woman—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="id6E5E3E5D050D49D1B97BC75741940908"><enum>(A)</enum><text display-inline="yes-display-inline">during pregnancy and through the end of the
month in which the 60-day period (beginning on the last day of her pregnancy)
ends;</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idA0A5C4B4261E444094190FC2DA995AB1"><enum>(B)</enum><text display-inline="yes-display-inline">whose family income does not exceed the
income eligibility level established under the State child health plan under
this title for a targeted low-income child; and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id3687C353213A485087365056C31B090B"><enum>(C)</enum><text display-inline="yes-display-inline">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.</text>
</subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="idC82C2E04C4DB465494770536EAD0239E"><enum>(e)</enum><header>Automatic
enrollment for children born to women receiving pregnancy-related
assistance</header><text display-inline="yes-display-inline">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).</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="id7794149671C741B9A7A20697837E79DD"><enum>(f)</enum><header>States
providing assistance through other options</header>
<paragraph commented="no" display-inline="no-display-inline" id="id971D339B87684F708D42B09E887F9325"><enum>(1)</enum><header>Continuation of
other options for providing assistance</header><text display-inline="yes-display-inline">The option to provide assistance in
accordance with the preceding subsections of this section shall not limit any
other option for a State to provide—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="id05F539B0A4964069BB2B77C81A6C0EB0"><enum>(A)</enum><text display-inline="yes-display-inline">child health assistance through the
application of sections 457.10, 457.350(b)(2), 457.622(c)(5), and 457.626(a)(3)
of title 42, Code of Federal Regulations (as in effect after the final rule
adopted by the Secretary and set forth at 67 Fed. Reg. 61956–61974 (October 2,
2002)), or</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id7F04A6F52D264345BB75C8E0C9E0B1E8"><enum>(B)</enum><text display-inline="yes-display-inline">pregnancy-related services through the
application of any waiver authority (as in effect on June 1, 2007).</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id3A8F6BAAD50443EF97F3F210868DC391"><enum>(2)</enum><header>Clarification
of authority to provide postpartum services</header><text display-inline="yes-display-inline">Any State that provides child health
assistance under any authority described in paragraph (1) may continue to
provide such assistance, as well as postpartum services, through the end of the
month in which the 60-day period (beginning on the last day of the pregnancy)
ends, in the same manner as such assistance and postpartum services would be
provided if provided under the State plan under title XIX, but only if the
mother would otherwise satisfy the eligibility requirements that apply under
the State child health plan (other than with respect to age) during such
period.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id6C8744F9C28D4A8184FA900705B9C344"><enum>(3)</enum><header>No
inference</header><text>Nothing in this subsection shall be construed—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="id80D08039078740B0838ABE5618422A34"><enum>(A)</enum><text>to infer
congressional intent regarding the legality or illegality of the content of the
sections specified in paragraph (1)(A); or</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id57AB2F8579B647EA8677651F6BEFA65D"><enum>(B)</enum><text>to modify the
authority to provide pregnancy-related services under a waiver specified in
paragraph
(1)(B).</text>
</subparagraph></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection commented="no" display-inline="no-display-inline" id="id7AD8923056924711852D29305ABB7F0F"><enum>(b)</enum><header>Additional
conforming amendments</header>
<paragraph commented="no" display-inline="no-display-inline" id="id0903513E52B143C99DF07FC671083EF3"><enum>(1)</enum><header>No cost sharing
for pregnancy-related benefits</header><text display-inline="yes-display-inline">Section 2103(e)(2) (42 U.S.C. 1397cc(e)(2))
is amended—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="id41C0328A3E524321855CED4A2AFAB461"><enum>(A)</enum><text display-inline="yes-display-inline">in the heading, by inserting
<quote><header-in-text level="paragraph" style="OLC">or pregnancy-related
assistance</header-in-text></quote> after <quote><header-in-text level="paragraph" style="OLC">preventive services</header-in-text></quote>;
and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id0C834BFF7C2F450DA28701BA4919EA9B"><enum>(B)</enum><text display-inline="yes-display-inline">by inserting before the period at the end
the following: <quote>or for pregnancy-related assistance</quote>.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idBFD248641B1F4E76BF7DC32E215341CD"><enum>(2)</enum><header>No waiting
period</header><text display-inline="yes-display-inline">Section 2102(b)(1)(B)
(42 U.S.C. 1397bb(b)(1)(B)) is amended—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="id345FA56A0F524DC4A3BEB13A9B6A5C3D"><enum>(A)</enum><text display-inline="yes-display-inline">in clause (i), by striking <quote>,
and</quote> at the end and inserting a semicolon;</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idB601F464B081403DB63DC6E169D2BE43"><enum>(B)</enum><text display-inline="yes-display-inline">in clause (ii), by striking the period at
the end and inserting <quote>; and</quote>; and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id4AA3E105D3C24F368E1FC405A701E4F4"><enum>(C)</enum><text display-inline="yes-display-inline">by adding at the end the following new
clause:</text>
<quoted-block display-inline="no-display-inline" id="idBBD1CF8386664A52A9770A072A635670" style="OLC">
<clause commented="no" display-inline="no-display-inline" id="idB7AC9FA89ABE4E1BA9B4D64F2D7E281C"><enum>(iii)</enum><text display-inline="yes-display-inline">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 provided pregnancy-related assistance under section
2112.</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph></subsection></section><section id="id97079E30CEEA4F45942F630AC8EFF1F0"><enum>108.</enum><header>CHIP
Contingency fund</header><text display-inline="no-display-inline">Section 2104
(42 U.S.C. 1397dd), as amended by section 105, is amended by adding at the end
the following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="id1BEAF7E6B6DB4D7EB4C45B2654316DA7" style="OLC">
<subsection id="id702CCD785EFE4D749CDDC7AA7B4D08D5"><enum>(k)</enum><header>CHIP
contingency fund</header>
<paragraph id="ID8744AD9F85C74147867D91F265CFA641"><enum>(1)</enum><header>Establishment</header><text>There
is hereby established in the Treasury of the United States a fund which shall
be known as the <quote>CHIP Contingency Fund</quote> (in this subsection
referred to as the <quote>Fund</quote>). Amounts in the Fund are authorized to
be appropriated for payments under this subsection.</text>
</paragraph><paragraph id="IDCBB8AF64BFA44D5CBC924875AA7EB021"><enum>(2)</enum><header>Deposits into
fund</header>
<subparagraph id="id1722B97A96B742C49720E726999883C7"><enum>(A)</enum><header>Initial and
subsequent appropriations</header><text>Subject to subparagraphs (B) and (E),
out of any money in the Treasury of the United States not otherwise
appropriated, there are appropriated to the Fund—</text>
<clause id="idE681777A55E74B9D864DB46EFC9D7FB9"><enum>(i)</enum><text>for fiscal year
2009, an amount equal to 12.5 percent of the available national allotment under
subsection (i)(1)(C) for the fiscal year; and</text>
</clause><clause id="idD43290D8018B4ABF8F80C09A898511C4"><enum>(ii)</enum><text>for each of
fiscal years 2010 through 2012, such sums as are necessary for making payments
to eligible States for such fiscal year, but not in excess of the aggregate cap
described in subparagraph (B).</text>
</clause></subparagraph><subparagraph id="idE16FEAC347F14C06B1B2698E29E84483"><enum>(B)</enum><header>Aggregate
cap</header><text>Subject to subparagraph (E), the total amount available for
payment from the Fund for each of fiscal years 2009 through 2012 (taking into
account deposits made under subparagraph (C)), shall not exceed 12.5 percent of
the available national allotment under subsection (i)(1)(C) for the fiscal
year.</text>
</subparagraph><subparagraph id="id5875BB16328D49938F257B6B102D143D"><enum>(C)</enum><header>Investment of
fund</header><text>The Secretary of the Treasury shall invest, in interest
bearing securities of the United States, such currently available portions of
the Fund as are not immediately required for payments from the Fund. The income
derived from these investments constitutes a part of the Fund.</text>
</subparagraph><subparagraph id="id7B377B3FE8BC489A936244A942F8FE8C"><enum>(D)</enum><header>Transfer of
excess funds to the incentive fund</header><text>The Secretary of the Treasury
shall transfer to, and deposit in, the CHIP Incentive Bonuses Pool established
under subsection (j) any amounts in excess of the aggregate cap described in
subparagraph (B) for a fiscal year.</text>
</subparagraph><subparagraph id="idA269343466054A5E8E5087F68956C9C6"><enum>(E)</enum><header>Special rules
for amounts set aside for parents and childless adults</header><text>For
purposes of subparagraphs (A) and (B)—</text>
<clause id="idACEBE331091F454283845A6827C248D5"><enum>(i)</enum><text>the available
national allotment under subsection (i)(1)(C) shall be reduced by any amount
set aside under section 2111(a)(3) for block grant payments for transitional
coverage for childless adults; and</text>
</clause><clause id="id7CC8DA3083AA4EF4A803478ACE92F6D6"><enum>(ii)</enum><text>the Secretary
shall establish a separate account in the Fund for the portion of any amount
appropriated to the Fund for any fiscal year which is allocable to the portion
of the available national allotment under subsection (i)(1)(C) which is set
aside for the fiscal year under section 2111(b)(2)(B)(i) for coverage of
parents of low-income children.</text>
</clause><continuation-text continuation-text-level="subparagraph">The
Secretary shall include in the account established under clause (ii) any income
derived under subparagraph (C) which is allocable to amounts in such
account.</continuation-text></subparagraph></paragraph><paragraph id="IDBA3C446D3BD8432B9787E3CD8EA9FFC6"><enum>(3)</enum><header>CHIP
contingency fund payments</header>
<subparagraph id="ID9F9F1EC23B5A4380A8F54414B97BBFDB"><enum>(A)</enum><header>Payments</header>
<clause id="id86491B405F604D0CBF32C29F54B3B3A3"><enum>(i)</enum><header>In
general</header><text>Subject to clauses (ii) and (iii) and the succeeding
subparagraphs of this paragraph, the Secretary shall pay from the Fund to a
State that is an eligible State for a month of a fiscal year a CHIP contingency
fund payment equal to the Federal share of the shortfall determined under
subparagraph (D). In the case of an eligible State under subparagraph (D)(i),
the Secretary shall not make the payment under this subparagraph until the
State makes, and submits to the Secretary, a projection of the amount of the
shortfall.</text>
</clause><clause id="idC4358638076544CBAB3F111FA241CBD5"><enum>(ii)</enum><header>Separate
determinations of shortfalls</header><text>The Secretary shall separately
compute the shortfall under subparagraph (D) for expenditures for eligible
individuals other than nonpregnant childless adults and parents with respect to
whom amounts are set aside under section 2111, for expenditures for such
childless adults, and for expenditures for such parents.</text>
</clause><clause id="idD62F54FB9E134CEDA747299E1BD78705"><enum>(iii)</enum><header>Payments</header>
<subclause id="idBEC617470027458EBF50DA261634BAB3"><enum>(I)</enum><header>Nonpregnant
childless adults</header><text>No payments shall be made from the Fund for
nonpregnant childless adults with respect to whom amounts are set aside under
section 2111(a)(3).</text>
</subclause><subclause id="idEB1FD54A75324E3B83264981799AE242"><enum>(II)</enum><header>Parents</header><text>Any
payments with respect to any shortfall for parents who are paid from amounts
set aside under section 2111(b)(2)(B)(i) shall be made only from the account
established under paragraph (2)(E)(ii) and not from any other amounts in the
Fund. No other payments may be made from such account.</text>
</subclause></clause><clause id="idA5DCF7989BDB473DBBBE24DCCDB34E3D"><enum>(iv)</enum><header>Special
rules</header><text>Subparagraphs (B) and (C) shall be applied separately with
respect to shortfalls described in clause (ii).</text>
</clause></subparagraph><subparagraph id="idFB54FDEADDEE4419AB506347113B226D"><enum>(B)</enum><header>Use of
funds</header><text>Amounts paid to an eligible State from the Fund shall be
used only to eliminate the Federal share of a shortfall in the State's
allotment under subsection (i) for a fiscal year.</text>
</subparagraph><subparagraph id="id40FE2D18A35C4F1F817925881470FA8B"><enum>(C)</enum><header>Proration
rule</header><text>If the amounts available for payment from the Fund for a
fiscal year are less than the total amount of payments determined under
subparagraph (A) for the fiscal year, the amount to be paid under such
subparagraph to each eligible State shall be reduced proportionally.</text>
</subparagraph><subparagraph id="IDDA241D0F8A1D4345AAF49D55AEF55BBD"><enum>(D)</enum><header>Eligible
State</header>
<clause id="id1812B3AE46604BE7815BA19CD6E39B8C"><enum>(i)</enum><header>In
general</header><text>A State is an eligible State for a month if the State is
a subsection (b) State (as defined in subsection (i)(7)), the State requests
access to the Fund for the month, and it is described in clause (ii) or
(iii).</text>
</clause><clause id="idCA6F56C4EEEA4F3D88A47EEAFD2B94BA"><enum>(ii)</enum><header>Shortfall of
federal allotment funding of not more than 5 percent</header><text>The
Secretary estimates, on the basis of the most recent data available to the
Secretary or requested from the State by the Secretary, that the State's
allotment for the fiscal year is at least 95 percent, but less than 100
percent, of the projected expenditures under the State child health plan for
the State for the fiscal year determined under subsection (i) (without regard
to incentive bonuses or payments for which the State is eligible for under
subsection (j)(2) for the fiscal year).</text>
</clause><clause id="idBECBF29DBEF44DD3BC6D41A1A20BA074"><enum>(iii)</enum><header>Shortfall of
federal allotment funding of more than 5 percent caused by specific
events</header><text>The Secretary estimates, on the basis of the most recent
data available to the Secretary or requested from the State by the Secretary,
that the State's allotment for the fiscal year is less than 95 percent of the
projected expenditures under the State child health plan for the State for the
fiscal year determined under subsection (i) (without regard to incentive
bonuses or payments for which the State is eligible for under subsection (j)(2)
for the fiscal year) and that such shortfall is attributable to 1 or more of
the following events:</text>
<subclause id="id598941B4DEF546329737CB6C81203607"><enum>(I)</enum><header>Stafford Act or
public health emergency</header><text>The State has—</text>
<item id="id1C1074A1F2004537BFAE769CD627B4EF"><enum>(aa)</enum><text>1
or more parishes or counties for which a major disaster has been declared in
accordance with section 401 of the Robert T. Stafford Disaster Relief and
Emergency Assistance Act (42 U.S.C. 5170) and which the President has
determined warrants individual and public assistance from the Federal
Government under such Act; or</text>
</item><item id="idDE89B89486A548D48BDD32320E3B4CAD"><enum>(bb)</enum><text>a
public health emergency declared by the Secretary under section 319 of the
Public Health Service Act.</text>
</item></subclause><subclause id="idB89981D267DA4CF2858653C0EC239854"><enum>(II)</enum><header>State economic
downturn</header><text>The State unemployment rate is at least 5.5 percent
during any 13-consecutive week period during the fiscal year and such rate is
at least 120 percent of the State unemployment rate for the same period as
averaged over the last 3 fiscal years.</text>
</subclause><subclause id="id4D5DD814564648FAA56D4766BDFFDFB9"><enum>(III)</enum><header> Event
resulting in rise in percentage of low-income children without health
insurance</header><text>The State experienced a recent event that resulted in
an increase in the percentage of low-income children in the State without
health insurance (as determined on the basis of the most timely and accurate
published estimates of the Bureau of the Census) that was outside the control
of the State and warrants granting the State access to the Fund (as determined
by the Secretary).</text>
</subclause></clause></subparagraph><subparagraph commented="no" id="idD8202695201046C1923DD49FA8A17FBE"><enum>(E)</enum><header>Payments made
to all eligible states on a monthly basis; authority for pro rata
payments</header><text>The Secretary shall make monthly payments from the Fund
to all States that are determined to be eligible States with respect to a
month. If the sum of the payments to be made from the Fund for a month exceed
the amount in the Fund, the Secretary shall reduce each such payment on a
proportional basis.</text>
</subparagraph><subparagraph id="IDA77F995DB1FB44A4AA5C4D02BFD5E67D"><enum>(F)</enum><header>Payments
limited to fiscal year of eligibility determination unless new eligibility
basis determined</header><text>No State shall receive a CHIP contingency fund
payment under this section for a month beginning after September 30 of the
fiscal year in which the State is determined to be an eligible State under this
subsection, except that in the case of an event described in subclause (I) or
(III) of subparagraph (D)(iii) that occurred after July 1 of the fiscal year,
any such payment with respect to such event shall remain available until
September 30 of the subsequent fiscal year. Nothing in the preceding sentence
shall be construed as prohibiting a State from being determined to be an
eligible State under this subsection for any fiscal year occurring after a
fiscal year in which such a determination is made.</text>
</subparagraph><subparagraph id="id9DA5C5F751314872B15A714E0F97143B"><enum>(G)</enum><header>Exemption from
determination of percentage of allotment retained after first year of
availability</header><text>In no event shall payments made to a State under
this subsection be treated as part of the allotment determined for a State for
a fiscal year under subsection (i) for purposes of subsection
(j)(1)(B)(ii)(III).</text>
</subparagraph><subparagraph id="id149F006311F64DCBA96AF490AA770987"><enum>(H)</enum><header>Application of
allotment reporting rules</header><text>Rules applicable to States for purposes
of receiving payments from an allotment determined under subsection (c) or (i)
shall apply in the same manner to an eligible State for purposes of receiving a
CHIP contingency fund payment under this subsection.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="IDE0790ED5ED2A4B4094A5E099E8A194A9"><enum>(4)</enum><header>Annual
reports</header><text>The Secretary shall annually report to the Congress on
the amounts in the Fund, the specific events that caused States to apply for
payments from the Fund, and the payments made from the
Fund.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="idB370F8B8ADC04D76994ACB8045252ECC"><enum>109.</enum><header>Two-year
availability of allotments; expenditures counted against oldest
allotments</header><text display-inline="no-display-inline">Section 2104(e) (42
U.S.C. 1397dd(e)) is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="id9AA638E14F2F4A96841C0B7BE3FA95D3" style="OLC">
<subsection id="id8B8801E8E3934B908773DD0A817E27F6"><enum>(e)</enum><header>Availability of
amounts allotted</header>
<paragraph id="idBC799FE96BEE4267A4B1DA90102B13D8"><enum>(1)</enum><header>In
general</header><text>Except as provided in subsection (j)(1)(B)(ii)(III),
amounts allotted to a State pursuant to this section—</text>
<subparagraph id="idC9CB50F9B1414394A5854B2CE9A639EE"><enum>(A)</enum><text>for each of
fiscal years 1998 through 2006, shall remain available for expenditure by the
State through the end of the second succeeding fiscal year; and</text>
</subparagraph><subparagraph id="idFBCE03547A2A45A1B49E10E3B2EB9F8D"><enum>(B)</enum><text>for each of
fiscal years 2007 through 2012, shall remain available for expenditure by the
State only through the end of the succeeding fiscal year for which such amounts
are allotted.</text>
</subparagraph></paragraph><paragraph id="idC01FC9ABFA3E47FAA783C75BCE383161"><enum>(2)</enum><header>Incentive
bonuses</header><text>Incentive bonuses paid to a State under subsection (j)(2)
for a fiscal year shall remain available for expenditure by the State without
limitation.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id57A9AA3D14C84B38BF061E173DE60D96"><enum>(3)</enum><header>CHIP
Contingency Fund payments</header><text>Except as provided in paragraph (3)(F)
of subsection (k), CHIP Contingency Fund payments made to a State under such
subsection for a month of a fiscal year shall remain available for expenditure
by the State through the end of the fiscal year.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="idCCC5EEFB44D94153B3683947A5ED4350"><enum>(4)</enum><header>Rule for
counting expenditures against CHIP contingency Fund payments, fiscal year
allotments, and incentive bonuses</header>
<subparagraph commented="no" display-inline="no-display-inline" id="idFF0A9F4898AA43859F8C3782F702D094"><enum>(A)</enum><header>In
general</header><text>Expenditures under the State child health plan made on or
after October 1, 2007, shall be counted against—</text>
<clause commented="no" display-inline="no-display-inline" id="id7CE8F1153B564F31959D6AD4E8510C3F"><enum>(i)</enum><text>first, any CHIP
Contingency Fund payment made to the State under subsection (k) for the
earliest month of the earliest fiscal year for which the payment remains
available for expenditure; and</text>
</clause><clause commented="no" display-inline="no-display-inline" id="idFEC170DBA440443196DFF003E61A6A63"><enum>(ii)</enum><text>second, amounts
allotted to the State for the earliest fiscal year for which amounts remain
available for expenditure.</text>
</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idF5251DC7122B4F8BAA50D6EE7B577726"><enum>(B)</enum><header>Incentive
bonuses</header><text>A State may elect, but is not required, to count
expenditures under the State child health plan against any incentive bonuses
paid to the State under subsection (j)(2) for a fiscal year.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id266E1E5FD11E4F4D9E8CB6CB9E147BCC"><enum>(C)</enum><header>Block grant
set-asides</header><text>Expenditures for coverage of—</text>
<clause commented="no" display-inline="no-display-inline" id="id34719D8F7B8D44BD9FC3CCAC95C7A976"><enum>(i)</enum><text>nonpregnant
childless adults for fiscal year 2009 shall be counted only against the amount
set aside for such coverage under section 2111(a)(3); and</text>
</clause><clause commented="no" display-inline="no-display-inline" id="idEB83FC0E5DFD41ACA71D1488711EB9D5"><enum>(ii)</enum><text>parents of
targeted low-income children for each of fiscal years 2010 through 2012, shall
be counted only against the amount set aside for such coverage under section
2111(b)(2)(B)(i).</text>
</clause></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section commented="no" id="id875B5E0DD7F346E5B0846C1959E048EF"><enum>110.</enum><header>Limitation on
matching rate for States that propose to cover children with effective family
income that exceeds 300 percent of the poverty line</header>
<subsection commented="no" id="idF617B50098634B6DBA9815B7A6EE0DE7"><enum>(a)</enum><header>FMAP applied to
expenditures</header><text display-inline="yes-display-inline">Section 2105(c)
(42 U.S.C. 1397ee(c)) is amended by adding at the end the following new
paragraph:</text>
<quoted-block display-inline="no-display-inline" id="idFB38D2BBEF804A3E8FC0EDFC52F7941E" style="OLC">
<paragraph commented="no" id="H05972A3C55F84FDC9F4E00C91F410984"><enum>(8)</enum><header>Limitation on
matching rate for expenditures for child health assistance provided to children
whose effective family income exceeds 300 percent of the poverty line</header>
<subparagraph commented="no" id="HA4E4260251CF4D07A016C244005F915B"><enum>(A)</enum><header>FMAP applied to
expenditures</header><text display-inline="yes-display-inline">Except as
provided in subparagraph (B), for fiscal years beginning with fiscal year 2008,
the Federal medical assistance percentage (as determined under section 1905(b)
without regard to clause (4) of such section) shall be substituted for the
enhanced FMAP under subsection (a)(1) with respect to any expenditures for
providing child health assistance or health benefits coverage for a targeted
low-income child whose effective family income would exceed 300 percent of the
poverty line but for the application of a general exclusion of a block of
income that is not determined by type of expense or type of income.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id590140B9FE6F4841B25F7102B2AED7A2"><enum>(B)</enum><header display-inline="yes-display-inline">Exception</header><text display-inline="yes-display-inline">Subparagraph (A) shall not apply to any
State that, on the date of enactment of the <short-title>Children's Health Insurance Program Reauthorization Act of
2007</short-title>, has an approved State plan amendment or waiver to provide,
or has enacted a State law to submit a State plan amendment to provide,
expenditures described in such subparagraph under the State child health
plan.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection commented="no" display-inline="no-display-inline" id="id41C62319911B45BDAECEC8DA15E22627"><enum>(b)</enum><header>Conforming
amendment</header><text>Section 2105(a)(1) ( 42 U.S.C. 1397dd(a)(1)) is
amended, in the matter preceding subparagraph (A), by inserting <quote>or
subsection (c)(8)</quote> after <quote>subparagraph (B)</quote>.</text>
</subsection></section><section id="idB3025F48F9804F6BAF0BED3CEEE77AC6"><enum>111.</enum><header>Option for
qualifying states to receive the enhanced portion of the CHIP matching rate for
Medicaid coverage of certain children</header><text display-inline="no-display-inline">Section 2105(g) (42 U.S.C. 1397ee(g)) is
amended—</text>
<paragraph id="id92808B92AFE54F3D94F8B59FDDCF3C3F"><enum>(1)</enum><text display-inline="yes-display-inline">in paragraph (1)(A), by inserting
<quote>subject to paragraph (4),</quote> after <quote>Notwithstanding any other
provision of law,</quote>; and</text>
</paragraph><paragraph id="id5CD0C8E20C814F0D9F242909DEB73B1C"><enum>(2)</enum><text>by adding at the
end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="idD16DB6BB49444DB29152DCE36B48FCDA" style="OLC">
<paragraph commented="no" display-inline="no-display-inline" id="id6C19075F86114B9B9B08916A7DCD5591"><enum>(4)</enum><header>Option for
allotments for fiscal years 2008 through 2012</header>
<subparagraph commented="no" display-inline="no-display-inline" id="id94A67150BC394411A37243800F35B8CB"><enum>(A)</enum><header>Payment of
enhanced portion of matching rate for certain expenditures</header><text>In the
case of expenditures described in subparagraph (B), a qualifying State (as
defined in paragraph (2)) may elect to be paid from the State's allotment made
under section 2104 for any of fiscal years 2008 through 2012 (insofar as the
allotment is available to the State under subsections (e) and (i) of such
section) an amount each quarter equal to the additional amount that would have
been paid to the State under title XIX with respect to such expenditures if the
enhanced FMAP (as determined under subsection (b)) had been substituted for the
Federal medical assistance percentage (as defined in section 1905(b)).</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idA955EAA55F094DFEB91FBC6BA7689BF0"><enum>(B)</enum><header>Expenditures
described</header><text>For purposes of subparagraph (A), the expenditures
described in this subparagraph are expenditures made after the date of the
enactment of this paragraph and during the period in which funds are available
to the qualifying State for use under subparagraph (A), for the provision of
medical assistance to individuals residing in the State who are eligible for
medical assistance under the State plan under title XIX or under a waiver of
such plan and who have not attained age 19 (or, if a State has so elected under
the State plan under title XIX, age 20 or 21), and whose family income equals
or exceeds 133 percent of the poverty line but does not exceed the Medicaid
applicable income
level.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><enum>II</enum><header>Outreach and
Enrollment</header>
<section id="id6F7836C5C34B42AF9FD218C730D5864D"><enum>201.</enum><header>Grants for
outreach and enrollment</header>
<subsection id="id248ED27589F9401C9895D6EE2C76BB4F"><enum>(a)</enum><header>Grants</header><text>Title
XXI (42 U.S.C. 1397aa et seq.), as amended by section 107, is amended by adding
at the end the following:</text>
<quoted-block act-name="Social Security Act" id="IDAFEDF086D88441D687EC648AE624E951" style="OLC">
<section id="ID9B8762DFDBCE434D834292D0476B26A8"><enum>2113.</enum><header>Grants to
improve outreach and enrollment</header>
<subsection id="ID74E6740521D04EE3A08143CBDF440682"><enum>(a)</enum><header>Outreach and
enrollment grants; national campaign</header>
<paragraph id="id0B06C0CEF99844DBA8249CA4CAC54B1E"><enum>(1)</enum><header>In
general</header><text>From the amounts appropriated under subsection (g),
subject to paragraph (2), the Secretary shall award grants to eligible entities
during the period of fiscal years 2008 through 2012 to conduct outreach and
enrollment efforts that are designed to increase the enrollment and
participation of eligible children under this title and title XIX.</text>
</paragraph><paragraph commented="no" id="IDD95F96AFCF194191ABD22B68BC9D7629"><enum>(2)</enum><header>Ten percent set
aside for national enrollment campaign</header><text>An amount equal to 10
percent of such amounts shall be used by the Secretary for expenditures during
such period to carry out a national enrollment campaign in accordance with
subsection (h).</text>
</paragraph></subsection><subsection id="ID500754BA2E4141558DBE3DA2AC9C5EA4"><enum>(b)</enum><header>Priority for
Award of Grants</header>
<paragraph id="ID5E7658359EA54D5E8CA14296E12CFEED"><enum>(1)</enum><header>In
general</header><text>In awarding grants under subsection (a), the Secretary
shall give priority to eligible entities that—</text>
<subparagraph id="idAD69168CE51E4468898A514AE498A4FB"><enum>(A)</enum><text>propose to target
geographic areas with high rates of—</text>
<clause id="IDC6F18D5CA27440A583198F4EF3C0B90B"><enum>(i)</enum><text>eligible but
unenrolled children, including such children who reside in rural areas;
or</text>
</clause><clause id="ID689651E029F14D579E846597C7ECC992"><enum>(ii)</enum><text>racial and
ethnic minorities and health disparity populations, including those proposals
that address cultural and linguistic barriers to enrollment; and</text>
</clause></subparagraph><subparagraph id="id5EBB5079478143299A6077955CD5B799"><enum>(B)</enum><text>submit the most
demonstrable evidence required under paragraphs (1) and (2) of subsection
(c).</text>
</subparagraph></paragraph><paragraph id="ID013F71F54AC14F88ACDCC674E2DFB063"><enum>(2)</enum><header>Ten percent set
aside for outreach to indian children</header><text>An amount equal to 10
percent of the funds appropriated under subsection (g) 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
<act-name parsable-cite="IHCIA">Indian Health Care Improvement Act</act-name>
(25 U.S.C. 1651 et seq.) for outreach to, and enrollment of, children who are
Indians.</text>
</paragraph></subsection><subsection id="ID8D49B4319989410EA77D23FEDC1DE5E1"><enum>(c)</enum><header>Application</header><text>An
eligible entity that desires to receive a grant under subsection (a) 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—</text>
<paragraph id="id58F1D383F4034AFB90CB45D2ADDAE73B"><enum>(1)</enum><text>evidence
demonstrating that the entity includes members who have access to, and
credibility with, ethnic or low-income populations in the communities in which
activities funded under the grant are to be conducted;</text>
</paragraph><paragraph id="idC2FB1C8BF4C940B9A11015FBFC60EFA9"><enum>(2)</enum><text>evidence
demonstrating that the entity has the ability to address barriers to
enrollment, such as lack of awareness of eligibility, stigma concerns and
punitive fears associated with receipt of benefits, and other cultural barriers
to applying for and receiving child health assistance or medical
assistance;</text>
</paragraph><paragraph id="ID322107602DC14E26AA0F8C075F4FD120"><enum>(3)</enum><text>specific quality
or outcomes performance measures to evaluate the effectiveness of activities
funded by a grant awarded under this section; and</text>
</paragraph><paragraph id="ID322E7B7F0905433F8110697211139779"><enum>(4)</enum><text>an assurance that
the eligible entity shall—</text>
<subparagraph id="ID8D74FA2A93F549039BB8E4406AAA4F9B"><enum>(A)</enum><text>conduct an
assessment of the effectiveness of such activities against the performance
measures;</text>
</subparagraph><subparagraph id="ID4CCBDFE3F32C49A49F6E87112927EC3B"><enum>(B)</enum><text>cooperate with
the collection and reporting of enrollment data and other information in order
for the Secretary to conduct such assessments; and</text>
</subparagraph><subparagraph id="idA2CB6BABFD7D46A3AEE601E26D7D5A67"><enum>(C)</enum><text>in the case of an
eligible entity that is not the State, provide the State with enrollment data
and other information as necessary for the State to make necessary projections
of eligible children and pregnant women.</text>
</subparagraph></paragraph></subsection><subsection id="ID2F16099A1FE844CCA9B5243753F9C61F"><enum>(d)</enum><header>Dissemination
of Enrollment Data and Information Determined From Effectiveness Assessments;
Annual Report</header><text>The Secretary shall—</text>
<paragraph id="IDE9FCFEDDA1C140EE853BD96CD34DFF35"><enum>(1)</enum><text>make publicly
available the enrollment data and information collected and reported in
accordance with subsection (c)(4)(B); and</text>
</paragraph><paragraph id="IDC9915E7981624FC2A1507B8DD6826F6A"><enum>(2)</enum><text>submit an annual
report to Congress on the outreach and enrollment activities conducted with
funds appropriated under this section.</text>
</paragraph></subsection><subsection id="ID06DF24AF0AD14A7EA4A1C61EFAA1E594"><enum>(e)</enum><header>Maintenance of
effort for states awarded grants; no state match required</header><text>In the
case of a State that is awarded a grant under this section—</text>
<paragraph id="id965FD29E6BB240D890072B072AE84A5E"><enum>(1)</enum><text>the State share
of funds expended for outreach and enrollment activities under the State child
health plan shall not be less than the State share of such funds expended in
the fiscal year preceding the first fiscal year for which the grant is awarded;
and</text>
</paragraph><paragraph commented="no" id="id8D42D65CDB594AD098E85CCA660C580B"><enum>(2)</enum><text>no State matching
funds shall be required for the State to receive a grant under this
section.</text>
</paragraph></subsection><subsection id="idC49F6B61C4DE451DB278F0FAC5167E37"><enum>(f)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="id3BFF774C4F704493BAA22EDEC26DE59C"><enum>(1)</enum><header>Eligible
entity</header><text>The term <term>eligible entity</term> means any of the
following:</text>
<subparagraph id="idF9A27209698041A293756BE10DF4CE69"><enum>(A)</enum><text>A State with an
approved child health plan under this title.</text>
</subparagraph><subparagraph id="idF55E440439894F4FBD3788DACA33F7B9"><enum>(B)</enum><text>A local
government.</text>
</subparagraph><subparagraph id="idAE90581CDB904CE1B7941C173153D690"><enum>(C)</enum><text>An Indian tribe
or tribal consortium, a tribal organization, an urban Indian organization
receiving funds under title V of the <act-name parsable-cite="IHCIA">Indian
Health Care Improvement Act</act-name> (25 U.S.C. 1651 et seq.), or an Indian
Health Service provider.</text>
</subparagraph><subparagraph id="idFAE44AA9C34A49FF95BD24E76256841D"><enum>(D)</enum><text>A Federal health
safety net organization.</text>
</subparagraph><subparagraph id="idC3454C0686C14BE3B96B69C5148BFE60"><enum>(E)</enum><text>A national,
State, local, or community-based public or nonprofit private organization,
including organizations that use community health workers or community-based
doula programs.</text>
</subparagraph><subparagraph id="id2F4E990CEAC04F9F8F22FD0C88B19973"><enum>(F)</enum><text>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
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C.
300x–65) relating to a grant award to nongovernmental entities.</text>
</subparagraph><subparagraph id="idE3F5688E385642339B9D2B5F1539E2A2"><enum>(G)</enum><text>An elementary or
secondary school.</text>
</subparagraph></paragraph><paragraph id="id10EF62CD88B647AFBC3BD4093D1525A3"><enum>(2)</enum><header>Federal health
safety net organization</header><text>The term <term>Federal health safety net
organization</term> means—</text>
<subparagraph id="idC8884EC67A7D489B85C6E7512B0F4886"><enum>(A)</enum><text>a
Federally-qualified health center (as defined in section 1905(l)(2)(B));</text>
</subparagraph><subparagraph id="id852F6BEE19DC42BBAFB8D088356E8846"><enum>(B)</enum><text>a hospital
defined as a disproportionate share hospital for purposes of section
1923;</text>
</subparagraph><subparagraph id="idB6D27CE5D3204541AD0972683F718BB4"><enum>(C)</enum><text>a covered entity
described in section 340B(a)(4) of the <act-name parsable-cite="PHSA">Public
Health Service Act</act-name> (42 U.S.C. 256b(a)(4)); and</text>
</subparagraph><subparagraph id="idAACD56DCE29D400C938E5A1A78E8D516"><enum>(D)</enum><text>any other entity
or 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 <act-name parsable-cite="CNA66">Child
Nutrition Act of 1966</act-name> (42 U.S.C. 1786), the Head Start and Early
Head Start programs under the <act-name parsable-cite="HSA">Head Start
Act</act-name> (42 U.S.C. 9801 et seq.), the school lunch program established
under the Richard B. Russell <act-name parsable-cite="NSLA">National School
Lunch Act</act-name>, and an elementary or secondary school.</text>
</subparagraph></paragraph><paragraph id="idFDBB3CFBB2B9442982EA1D2418D9EDC8"><enum>(3)</enum><header>Indians; indian
tribe; tribal organization; urban indian organization</header><text>The terms
<term>Indian</term>, <term>Indian tribe</term>, <term>tribal
organization</term>, and <term>urban Indian organization</term> have the
meanings given such terms in section 4 of the <act-name parsable-cite="IHCIA">Indian Health Care Improvement Act</act-name> (25 U.S.C.
1603).</text>
</paragraph><paragraph id="idF95BC21A585E46F1955749DCAEE96C68"><enum>(4)</enum><header>Community
health worker</header><text>The term <term>community health worker</term> means
an individual who promotes health or nutrition within the community in which
the individual resides—</text>
<subparagraph id="ID1713875CD4AD458EA66CCD420B02AE57"><enum>(A)</enum><text>by serving as a
liaison between communities and health care agencies;</text>
</subparagraph><subparagraph id="ID59C265546AB8461E9C6F5D5CBC221E6F"><enum>(B)</enum><text>by providing
guidance and social assistance to community residents;</text>
</subparagraph><subparagraph id="IDF7832A9BEAD2494AAA1EB41423460AEE"><enum>(C)</enum><text>by enhancing
community residents’ ability to effectively communicate with health care
providers;</text>
</subparagraph><subparagraph id="ID82965F09BBD140469CBEF0FEA4C1E7BF"><enum>(D)</enum><text>by providing
culturally and linguistically appropriate health or nutrition education;</text>
</subparagraph><subparagraph id="ID379DF57E5E964B57B75339A92D710CD5"><enum>(E)</enum><text>by advocating for
individual and community health or nutrition needs; and</text>
</subparagraph><subparagraph id="IDA425067F10564454B831B04C791F8D2A"><enum>(F)</enum><text>by providing
referral and followup services.</text>
</subparagraph></paragraph></subsection><subsection id="IDF2678CBB138B406B9B78F628E54D0EA7"><enum>(g)</enum><header>Appropriation</header><text>There
is appropriated, out of any money in the Treasury not otherwise appropriated,
$100,000,000 for the period of fiscal years 2008 through 2012, to remain
available until expended, 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 subsections (a)(1)(D)(iii) and
(c)(2)(C) of that section.</text>
</subsection><subsection commented="no" id="IDFC3C25AFC4D44483867C7EEB5837BD6D"><enum>(h)</enum><header>National
Enrollment Campaign</header><text>From the amounts made available under
subsection (a)(2), the Secretary shall develop and implement a national
enrollment campaign to improve the enrollment of underserved child populations
in the programs established under this title and title XIX. Such campaign may
include—</text>
<paragraph commented="no" id="IDB4853B34BC5946CBA2DBF8FB5BE6B78B"><enum>(1)</enum><text>the establishment
of partnerships with the Secretary of Education and the Secretary of
Agriculture to develop national campaigns to link the eligibility and
enrollment systems for the assistance programs each Secretary administers that
often serve the same children;</text>
</paragraph><paragraph commented="no" id="IDF40B75B529544213B1B75B8A95EAB3DD"><enum>(2)</enum><text>the integration
of information about the programs established under this title and title XIX in
public health awareness campaigns administered by the Secretary;</text>
</paragraph><paragraph commented="no" id="ID1A601FFDD636458E949F0E5B5B311698"><enum>(3)</enum><text>increased
financial and technical support for enrollment hotlines maintained by the
Secretary to ensure that all States participate in such hotlines;</text>
</paragraph><paragraph commented="no" id="ID1E7C953E3FDD4F7F80768AE39BB05380"><enum>(4)</enum><text>the establishment
of joint public awareness outreach initiatives with the Secretary of Education
and the Secretary of Labor regarding the importance of health insurance to
building strong communities and the economy;</text>
</paragraph><paragraph commented="no" id="IDE52EDDF903924B47B1F25B0C9E38CB2B"><enum>(5)</enum><text>the development
of special outreach materials for Native Americans or for individuals with
limited English proficiency; and</text>
</paragraph><paragraph commented="no" id="ID80D6BECF6737415B9C9E2EDF6AD96CD8"><enum>(6)</enum><text>such other
outreach initiatives as the Secretary determines would increase public
awareness of the programs under this title and title
XIX.</text>
</paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection commented="no" id="idBBCBDED506F0431AA36A605A44D1A339"><enum>(b)</enum><header>Enhanced
administrative funding for translation or interpretation services under
CHIP</header><text>Section 2105(a)(1) (42 U.S.C. 1397ee(a)(1)), as amended by
section 603, is amended—</text>
<paragraph commented="no" id="idDBCBEEB4B77246EFA11E0147855C6168"><enum>(1)</enum><text>in the matter
preceding subparagraph (A), by inserting <quote>(or, in the case of
expenditures described in subparagraph (D)(iv), the higher of 75 percent or the
sum of the enhanced FMAP plus 5 percentage points)</quote> after
<quote>enhanced FMAP</quote>; and</text>
</paragraph><paragraph commented="no" id="id7DAC1EF779BC4B81AD627844C1F23B5B"><enum>(2)</enum><text>in subparagraph
(D)—</text>
<subparagraph commented="no" id="idADC9881644F04F529FDA9893102F2B0E"><enum>(A)</enum><text>in clause (iii),
by striking <quote>and</quote> at the end;</text>
</subparagraph><subparagraph commented="no" id="idFB496A03AFB848C193F5BA86D395E4CE"><enum>(B)</enum><text>by redesignating
clause (iv) as clause (v); and</text>
</subparagraph><subparagraph commented="no" id="id5912558E2BA94F64A814E77C0447D2E8"><enum>(C)</enum><text>by inserting
after clause (iii) the following new clause:</text>
<quoted-block display-inline="no-display-inline" id="idF258C46547684CA7BF542090CC0EEF1B" style="OLC">
<clause commented="no" id="id8786E13973CB49E8BF5777124832E8DD"><enum>(iv)</enum><text>for translation
or interpretation services in connection with the enrollment and use of
services under this title by individuals for whom English is not their primary
language (as found necessary by the Secretary for the proper and efficient
administration of the State plan);
and</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph></subsection><subsection id="id8EE2DDEFDD1A4E1B8B400971E56ED9D6"><enum>(c)</enum><header>Nonapplication
of administrative expenditures cap</header><text>Section 2105(c)(2) (42 U.S.C.
1397ee(c)(2)) is amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="id602D81BA2ADB4C5C907B78343364EF4D" style="OLC">
<subparagraph id="id2A6921FC83384A0B95BA4D51C5E903ED"><enum>(C)</enum><header>Nonapplication
to certain expenditures</header><text>The limitation under subparagraph (A)
shall not apply with respect to the following expenditures:</text>
<clause commented="no" display-inline="no-display-inline" id="id0AF7DA3077A64AD180A420BF9F653875"><enum>(i)</enum><header>Expenditures
funded under section 2113</header><text>Expenditures for outreach and
enrollment activities funded under a grant awarded to the State under section
2113.</text>
</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section><section id="id14A29D88609840F59946C22202011A68"><enum>202.</enum><header> Increased
outreach and enrollment of Indians</header>
<subsection id="idE2FCE19605D446CA8A0904E1C86FF33C"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Section 1139 (42
U.S.C. 1320b–9) is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="id8A56984BB635456D84CC4A2FCD9D2569" style="OLC">
<section id="idAC1190391E394AC090901D5D78E9434C"><enum>1139.</enum><header>Improved
access to, and delivery of, health care for Indians under titles XIX and
XXI</header>
<subsection id="ID0387765797B3490294664639DA393AB9"><enum>(a)</enum><header>Agreements with
States for Medicaid and CHIP outreach On or near reservations To increase the
enrollment of Indians in those programs</header>
<paragraph id="IDDBDF604B58994E6DBFB9830129B818B7"><enum>(1)</enum><header>In
general</header><text>In order to improve the access of Indians residing on or
near a reservation to obtain benefits under the Medicaid and State children's
health insurance programs established under titles XIX and XXI, the Secretary
shall encourage the State to take steps to provide for enrollment on or near
the reservation. Such steps may include outreach efforts such as the
outstationing of eligibility workers, entering into agreements with the Indian
Health Service, Indian Tribes, Tribal Organizations, and Urban Indian
Organizations to provide outreach, education regarding eligibility and
benefits, enrollment, and translation services when such services are
appropriate.</text>
</paragraph><paragraph id="ID95753AF28151453897A6CFFBD5489392"><enum>(2)</enum><header>Construction</header><text>Nothing
in paragraph (1) shall be construed as affecting arrangements entered into
between States and the Indian Health Service, Indian Tribes, Tribal
Organizations, or Urban Indian Organizations for such Service, Tribes, or
Organizations to conduct administrative activities under such titles.</text>
</paragraph></subsection><subsection id="IDEEFE78A752A64D0A950065190544A7EF"><enum>(b)</enum><header>Requirement To
facilitate cooperation</header><text>The Secretary, acting through the Centers
for Medicare & Medicaid Services, shall take such steps as are necessary to
facilitate cooperation with, and agreements between, States and the Indian
Health Service, Indian Tribes, Tribal Organizations, or Urban Indian
Organizations with respect to the provision of health care items and services
to Indians under the programs established under title XIX or XXI.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="idE34F545BB86548DB83AB8664B4F1DFA0"><enum>(c)</enum><header>Definition of
Indian; Indian Tribe; Indian Health Program; Tribal Organization; Urban Indian
Organization</header><text>In this section, the terms <term>Indian</term>,
<term>Indian Tribe</term>, <term>Indian Health Program</term>, <term>Tribal
Organization</term>, and <term>Urban Indian Organization</term> have the
meanings given those terms in section 4 of the Indian Health Care Improvement
Act.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection commented="no" id="id6845A624F6154465A4C3838E2B33B4F4"><enum>(b)</enum><header>Nonapplication
of 10 percent limit on outreach and certain other
expenditures</header><text>Section 2105(c)(2)(C) (42 U.S.C. 1397ee(c)(2)(C)),
as added by section 201(c), is amended by adding at the end the following new
clause:</text>
<quoted-block display-inline="no-display-inline" id="idA69B21C080C243209B0AD1CD42DDDDA1" style="OLC">
<clause commented="no" id="id261A6AA6A61441E39690BC660F71B9A3"><enum>(ii)</enum><header>Expenditures
to increase outreach to, and the enrollment of, Indian children under this
title and title XIX</header><text>Expenditures for outreach activities to
families of Indian children likely to be eligible for child health assistance
under the plan or medical assistance under the State plan under title XIX (or
under a waiver of such plan), to inform such families of the availability of,
and to assist them in enrolling their children in, such plans, including such
activities conducted under grants, contracts, or agreements entered into under
section
1139(a).</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section><section id="IDC053CC243F0145F485A5A082301BC772"><enum>203.</enum><header>Demonstration
program to permit States to rely on findings by an Express Lane agency to
determine components of a child’s eligibility for Medicaid or CHIP</header>
<subsection id="ID20ADE4FFD65C48BA8B3ACA5FB8AE4C80"><enum>(a)</enum><header>Requirement To
Conduct Demonstration program</header>
<paragraph id="IDF6AB5D4DF92F44A894054AD30E0866FE"><enum>(1)</enum><header>In
general</header><text>The Secretary shall establish a 3–year demonstration
program under which up to 10 States shall be authorized to rely on a finding
made within the preceding 12 months by an Express Lane agency to determine
whether a child has met 1 or more of the eligibility requirements, such as
income, assets or resources, citizenship status, or other criteria, necessary
to determine the child's initial eligibility, eligibility redetermination, or
renewal of eligibility, for medical assistance under the State Medicaid plan or
child health assistance under the State CHIP plan. A State selected to
participate in the demonstration program—</text>
<subparagraph id="id1A2BF0E6F9B146D49590EF5FAB81A993"><enum>(A)</enum><text>shall not be
required to direct a child (or a child’s family) to submit information or
documentation previously submitted by the child or family to an Express Lane
agency that the State relies on for its Medicaid or CHIP eligibility
determination; and</text>
</subparagraph><subparagraph id="id7C2B58C36D834BBFABCAB6520393D4CF"><enum>(B)</enum><text>may rely on
information from an Express Lane agency when evaluating a child’s eligibility
for medical assistance under the State Medicaid plan or child health assistance
under the State CHIP plan without a separate, independent confirmation of the
information at the time of enrollment, redetermination, or renewal.</text>
</subparagraph></paragraph><paragraph id="id439DD41444454DAFA1A3BFFC8F736981"><enum>(2)</enum><header>Payments to
states</header><text>From the amount appropriated under paragraph (1) of
subsection (f), after the application of paragraph (2) of that subsection, the
Secretary shall pay the States selected to participate in the demonstration
program such sums as the Secretary shall determine for expenditures made by the
State for systems upgrades and implementation of the demonstration program. In
no event shall a payment be made to a State from the amount appropriated under
subsection (f) for any expenditures incurred for providing medical assistance
or child health assistance to a child enrolled in the State Medicaid plan or
the State CHIP plan through reliance on a finding made by an Express Lane
agency.</text>
</paragraph></subsection><subsection id="id3BB93BBA2F5F472FBDE112530F3AE73C"><enum>(b)</enum><header>Requirements;
options for application</header>
<paragraph id="id778236D2D3FB4C70BBC109C4D681C215"><enum>(1)</enum><header>State
requirements</header><text>A State selected to participate in the demonstration
program established under this section may rely on a finding of an Express Lane
agency only if the following conditions are met:</text>
<subparagraph id="IDb5b8b89c3a604fe39deee2050d36e09a"><enum>(A)</enum><header>Requirement to
determine eligibility using regular procedures if child is first found
ineligible</header><text>If reliance on a finding from an Express Lane agency
results in a child not being found eligible for the State Medicaid plan or the
State CHIP plan, the State would be required to determine eligibility under
such plan using its regular procedures.</text>
</subparagraph><subparagraph id="ID5cc419ab626744d9af466ca0a2723023"><enum>(B)</enum><header>Notice</header><text>The
State shall inform the families (especially those whose children are enrolled
in the State CHIP plan) that they may qualify for lower premium payments or
more comprehensive health coverage under the State Medicaid plan if the
family’s income were directly evaluated for an eligibility determination by the
State Medicaid agency, and that, at the family’s option, the family may seek an
eligibility determination by the State Medicaid agency.</text>
</subparagraph><subparagraph id="ID5e8adf8adb9649258a19809c5c9135aa"><enum>(C)</enum><header>Compliance with
Department of Homeland Security procedures</header><text>The State may rely on
an Express Lane agency finding that a child is a qualified alien as long as the
Express Lane agency complies with guidance and regulatory procedures issued by
the Secretary of Homeland Security for eligibility determinations of qualified
aliens (as defined in subsections (b) and (c) of section 431 of the Personal
Responsibility and Work Opportunity Reconciliation Act of 1996 (8 U.S.C.
1641)).</text>
</subparagraph><subparagraph id="idC2A6BD814A10447385D88559C867B0E2"><enum>(D)</enum><header>Verification of
citizenship or nationality status</header><text>The State shall satisfy the
requirements of section 1902(a)(46)(B) or 2105(c)(9) of the Social Security
Act, as applicable (and as added by section 301 of this Act) for verifications
of citizenship or nationality status.</text>
</subparagraph><subparagraph id="id15BFA67156E94DBD8D17DF8407ED8F69"><enum>(E)</enum><header>Coding;
application to enrollment error rates</header>
<clause id="idCA0E1D1389A54373ABEBC512F0E0A040"><enum>(i)</enum><header>In
general</header><text>The State agrees to—</text>
<subclause id="id36CA5884C824446E89FC028F9738ABE9"><enum>(I)</enum><text>assign such codes
as the Secretary shall require to the children who are enrolled in the State
Medicaid plan or the State CHIP plan through reliance on a finding made by an
Express Lane agency for the duration of the State's participation in the
demonstration program;</text>
</subclause><subclause id="idF0373950FBB14902B1192E083EFB2108"><enum>(II)</enum><text>annually provide
the Secretary with a statistically valid sample (that is approved by Secretary)
of the children enrolled in such plans through reliance on such a finding by
conducting a full Medicaid eligibility review of the children identified for
such sample for purposes of determining an eligibility error rate with respect
to the enrollment of such children;</text>
</subclause><subclause id="id51C59F8D47BE4F68A2A7A1004A40443E"><enum>(III)</enum><text>submit the
error rate determined under subclause (II) to the Secretary;</text>
</subclause><subclause id="idA64529E6D2D5416285E67B427F13D8BB"><enum>(IV)</enum><text>if such error
rate exceeds 3 percent for either of the first 2 fiscal years in which the
State participates in the demonstration program, demonstrate to the
satisfaction of the Secretary the specific corrective actions implemented by
the State to improve upon such error rate; and</text>
</subclause><subclause id="id09C9D24566E747CBABA12BF460E008F5"><enum>(V)</enum><text>if such error
rate exceeds 3 percent for any fiscal year in which the State participates in
the demonstration program, a reduction in the amount otherwise payable to the
State under section 1903(a) of the Social Security Act (42 Secretary 1396b(a))
for quarters for that fiscal year, equal to the total amount of erroneous
excess payments determined for the fiscal year only with respect to the
children included in the sample for the fiscal year that are in excess of a 3
percent error rate with respect to such children.</text>
</subclause></clause><clause id="id9719100BE12E41C783BF5DB6D0776405"><enum>(ii)</enum><header>No punitive
action based on error rate</header><text>The Secretary shall not apply the
error rate derived from the sample under clause (i) to the entire population of
children enrolled in the State Medicaid plan or the State CHIP plan through
reliance on a finding made by an Express Lane agency, or to the population of
children enrolled in such plans on the basis of the State's regular procedures
for determining eligibility, or penalize the State on the basis of such error
rate in any manner other than the reduction of payments provided for under
clause (i)(V).</text>
</clause><clause id="idF08C7DB9FD234C3FA0937677D4AF3FAE"><enum>(iii)</enum><header>Rule of
construction</header><text>Nothing in this section shall be construed as
relieving a State that participates in the demonstration program established
under this section from being subject to a penalty under section 1903(u) of the
Social Security Act (42 U.S.C. 1396b(u)) for payments made under the State
Medicaid plan with respect to ineligible individuals and families that are
determined to exceed the error rate permitted under that section (as determined
without regard to the error rate determined under clause (i)(II)).</text>
</clause></subparagraph></paragraph><paragraph id="id820B78C72E324C68A296602FAF40A652"><enum>(2)</enum><header>State options
for application</header><text>A State selected to participate in the
demonstration program may elect to apply any of the following:</text>
<subparagraph id="ID64cc0f2690434e5f9a06150bdbe181cb"><enum>(A)</enum><header>Satisfaction of
CHIP screen and enroll requirements</header><text>If the State relies on a
finding of an Express Lane agency for purposes of determining eligibility under
the State CHIP plan, the State may meet the screen and enroll requirements
imposed under subparagraphs (A) and (B) of section 2102(b)(3) of the Social
Security Act (42 U.S.C. 1397bb(b)(3)) by using any of the following:</text>
<clause id="id2450C87DB1AE459F903CBB8E3F8A357E"><enum>(i)</enum><text>Establishing a
threshold percentage of the poverty line that is 30 percentage points (or such
other higher number of percentage points) as the State determines reflects the
income methodologies of the program administered by the Express Lane Agency and
the State Medicaid plan.</text>
</clause><clause id="idFB493717B41A4B7EA9BBF8CF76C9ED92"><enum>(ii)</enum><text>Providing that a
child satisfies all income requirements for eligibility under the State
Medicaid plan.</text>
</clause><clause id="idAD4EA3EB6F064DA7B8DE7667A480FAC2"><enum>(iii)</enum><text>Providing that
a child has a family income that exceeds the Medicaid applicable income
level.</text>
</clause></subparagraph><subparagraph id="idB48CE4D4266F42008C71C2967392F94A"><enum>(B)</enum><header>Presumptive
eligibility</header><text>The State may provide for presumptive eligibility
under the State CHIP plan for a child who, based on an eligibility
determination of an income finding from an Express Lane agency, would qualify
for child health assistance under the State CHIP plan. During the period of
presumptive eligibility, the State may determine the child’s eligibility for
child health assistance under the State CHIP plan based on telephone contact
with family members, access to data available in electronic or paper format, or
other means that minimize to the maximum extent feasible the burden on the
family.</text>
</subparagraph><subparagraph id="id12F290E82B6547E79E7B9AEB5F2D441B"><enum>(C)</enum><header>Automatic
enrollment</header>
<clause id="id583528EA7DF94E059251C985E08085C5"><enum>(i)</enum><header>In
general</header><text>The State may initiate and determine eligibility for
medical assistance under the State Medicaid plan or for child health assistance
under the State CHIP plan without a program application from, or on behalf of,
the child based on data obtained from sources other than the child (or the
child’s family), but a child can only be automatically enrolled in the State
Medicaid plan or the State CHIP plan if the child or the family affirmatively
consents to being enrolled through affirmation and signature on an Express Lane
agency application.</text>
</clause><clause id="id6D818694C11E4F16A29FB4DA74235509"><enum>(ii)</enum><header>Information
requirement</header><text>A State that elects the option under clause (i) shall
have procedures in place to inform the child or the child's family of the
services that will be covered under the State Medicaid plan or the State CHIP
plan (as applicable), appropriate methods for using such services, premium or
other cost sharing charges (if any) that apply, medical support obligations
created by the enrollment (if applicable), and the actions the child or the
child's family must take to maintain enrollment and renew coverage.</text>
</clause><clause id="id323FF6EBC7B540B68E49983A6A43E269"><enum>(iii)</enum><header>Option to
waive signatures</header><text>The State may waive any signature requirements
for enrollment for a child who consents to, or on whose behalf consent is
provided for, enrollment in the State Medicaid plan or the State CHIP
plan.</text>
</clause></subparagraph></paragraph><paragraph id="id14407C1D507547F8B1872D0BF8940383"><enum>(3)</enum><header>Signature
requirements</header><text>In the case of a State selected to participate in
the demonstration program—</text>
<subparagraph id="id890B6A191CE74455A525A5B02292BB97"><enum>(A)</enum><text>no signature
under penalty of perjury shall be required on an application form for medical
assistance under the State Medicaid plan or child health assistance under the
State CHIP plan to attest to any element of the application for which
eligibility is based on information received from an Express Lane agency or a
source other than an applicant; and</text>
</subparagraph><subparagraph id="idF12FEB28CECD4AE2968F9A9F4B95253A"><enum>(B)</enum><text>any signature
requirement for determination of an application for medical assistance under
the State Medicaid plan or child health assistance under the State CHIP plan
may be satisfied through an electronic signature.</text>
</subparagraph></paragraph><paragraph id="id86DE9E4F34A34970A7747BF638D6D9C3"><enum>(4)</enum><header>Rules of
construction</header><text>Nothing in this subsection shall be construed
to—</text>
<subparagraph id="id72C15E42F85D41BAA3E71C720521CEBF"><enum>(A)</enum><text>relieve a State
of the obligation under section 1902(a)(5) of the Social Security Act (42
U.S.C. 1396a(a)(5)) to determine eligibility for medical assistance under the
State Medicaid plan; or</text>
</subparagraph><subparagraph id="id37A2DE50A40246B097F183C769ECA557"><enum>(B)</enum><text>prohibit any
State options otherwise permitted under Federal law (without regard to this
paragraph or the demonstration program established under this section) that are
intended to increase the enrollment of eligible children for medical assistance
under the State Medicaid plan or child health assistance under the State CHIP
plan, including options related to outreach, enrollment, applications, or the
determination or redetermination of eligibility.</text>
</subparagraph></paragraph></subsection><subsection id="id43AE78BE8D154A3BAF1C3BE9EF8B4AE1"><enum>(c)</enum><header>Limited waiver
of other applicable requirements</header>
<paragraph id="id1E5FC27E6AA64F4E8AC403C7A2C70199"><enum>(1)</enum><header>Social Security
Act</header><text>The Secretary shall waive only such requirements of the
Social Security Act as the Secretary determines are necessary to carry out the
demonstration program established under this section.</text>
</paragraph><paragraph id="id12F77022771A498CBC7DD15BF5161AC8"><enum>(2)</enum><header>Authorization
for participating States to receive certain data directly relevant to
determining eligibility and correct amount of assistance</header><text>For
provisions relating to the authority of States participating in the
demonstration program to receive certain data directly, see section
204(c).</text>
</paragraph></subsection><subsection id="ID312BE9222663445A82EBC488E46174E9"><enum>(d)</enum><header>Evaluation and
Report</header>
<paragraph id="ID21FA4D9DAD014D9AB4E4424172D67416"><enum>(1)</enum><header>Evaluation</header><text>The
Secretary shall conduct, by grant, contract, or interagency agreement, a
comprehensive, independent evaluation of the demonstration program established
under this section. Such evaluation shall include an analysis of the
effectiveness of the program, and shall include—</text>
<subparagraph id="id2E5A66AC0A8844599E85D085D68CAF74"><enum>(A)</enum><text>obtaining a
statistically valid sample of the children who were enrolled in the State
Medicaid plan or the State CHIP plan through reliance on a finding made by an
Express Lane agency and determining the percentage of children who were
erroneously enrolled in such plans;</text>
</subparagraph><subparagraph id="idC7832223C76546ED935D635B77378B6A"><enum>(B)</enum><text>determining
whether enrolling children in such plans through reliance on a finding made by
an Express Lane agency improves the ability of a State to identify and enroll
low-income, uninsured children who are eligible but not enrolled in such
plans;</text>
</subparagraph><subparagraph id="id6E6CF4FB549C4D73BA8E24577BEF2054"><enum>(C)</enum><text>evaluating the
administrative costs or savings related to identifying and enrolling children
in such plans through reliance on such findings, and the extent to which such
costs differ from the costs that the State otherwise would have incurred to
identify and enroll low-income, uninsured children who are eligible but not
enrolled in such plans; and</text>
</subparagraph><subparagraph id="id252EC8D347F14D43A6D93D277D70CD15"><enum>(D)</enum><text>any
recommendations for legislative or administrative changes that would improve
the effectiveness of enrolling children in such plans through reliance on such
findings.</text>
</subparagraph></paragraph><paragraph id="IDA46091492D2B446EB5BC76D6038F1419"><enum>(2)</enum><header>Report to
congress</header><text>Not later than September 30, 2012, the Secretary shall
submit a report to Congress on the results of the evaluation of the
demonstration program established under this section.</text>
</paragraph></subsection><subsection id="idF390933797D8406EB2E8B46B91F04CDF"><enum>(e)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="id109732D99BED44D58266A3652F098F91"><enum>(1)</enum><header>Child;
children</header><text>With respect to a State selected to participate in the
demonstration program established under this section, the terms
<term>child</term> and <term>children</term> have the meanings given such terms
for purposes of the State plans under titles XIX and XXI of the Social Security
Act.</text>
</paragraph><paragraph id="id972F39B992804E32BC6466920089889B"><enum>(2)</enum><header>Express lane
agency</header>
<subparagraph id="id4E683BBDD70A4F4DA7AB845284E1BEAF"><enum>(A)</enum><header>In
general</header><text>The term <term>Express Lane agency</term> means a public
agency that—</text>
<clause id="id99D31E120BDD47CABBB6E351530B5D5E"><enum>(i)</enum><text>is
determined by the State Medicaid agency or the State CHIP agency (as
applicable) to be capable of making the determinations of 1 or more eligibility
requirements described in subsection (a)(1);</text>
</clause><clause id="id5C3B9667511B4BF2B828BA26E2E12C2A"><enum>(ii)</enum><text>is
identified in the State Medicaid plan or the State CHIP plan; and</text>
</clause><clause id="idDAAEC21213D54332A4363C051AED37BA"><enum>(iii)</enum><text>notifies the
child's family—</text>
<subclause id="id8F26F75EA9604D549F9D43B7686F0C25"><enum>(I)</enum><text>of the
information which shall be disclosed in accordance with this section;</text>
</subclause><subclause id="idEAD6DDE506FC408585978E53CA137892"><enum>(II)</enum><text>that the
information disclosed will be used solely for purposes of determining
eligibility for medical assistance under the State Medicaid plan or for child
health assistance under the State CHIP plan; and</text>
</subclause><subclause id="id8ECFD1E2F135445699C37C50139D5582"><enum>(III)</enum><text>that the family
may elect to not have the information disclosed for such purposes; and</text>
</subclause></clause><clause id="idD337781790C0456F9CA193D1B66C00D1"><enum>(iv)</enum><text>enters into, or
is subject to, an interagency agreement to limit the disclosure and use of the
information disclosed.</text>
</clause></subparagraph><subparagraph id="id6816AA71065943919DFA424550F63D84"><enum>(B)</enum><header>Inclusion of
specific public agencies</header><text>Such term includes the following:</text>
<clause id="id6528BC8709BC4CB091B17CAB98499CA1"><enum>(i)</enum><text>A
public agency that determines eligibility for assistance under any of the
following:</text>
<subclause id="idF545779C12D842C69331315721143A90"><enum>(I)</enum><text>The temporary
assistance for needy families program funded under part A of title IV of the
Social Security Act (42 U.S.C. 601 et seq.).</text>
</subclause><subclause id="idE50FA2058CF04BA680C23364E6E00E70"><enum>(II)</enum><text>A State program
funded under part D of title IV of such Act (42 U.S.C. 651 et seq.).</text>
</subclause><subclause commented="no" id="id664D966D751F4BC79B7D19E67FFA9A1D"><enum>(III)</enum><text>The State
Medicaid plan.</text>
</subclause><subclause id="id07F20BC9548F4A0D8CC06AE6F2EBC880"><enum>(IV)</enum><text>The State CHIP
plan.</text>
</subclause><subclause id="idD1074DCD0BE640589CE08DFE31DC7AE0"><enum>(V)</enum><text>The Food Stamp
Act of 1977 (7 U.S.C. 2011 et seq.).</text>
</subclause><subclause id="idACCD8F1B84E34D55B14B20A692E405E8"><enum>(VI)</enum><text>The Head Start
Act (42 U.S.C. 9801 et seq.).</text>
</subclause><subclause id="id02F3919CF91140F0A5183B87CD1D55EB"><enum>(VII)</enum><text>The Richard B.
Russell National School Lunch Act (42 U.S.C. 1751 et seq.).</text>
</subclause><subclause id="id8AEF9559F4E2421D8730D8CD70D07141"><enum>(VIII)</enum><text>The Child
Nutrition Act of 1966 (42 U.S.C. 1771 et seq.).</text>
</subclause><subclause id="idDA1CEEBE62E24A2896DDA9E5482D10EB"><enum>(IX)</enum><text>The Child Care
and Development Block Grant Act of 1990 (42 U.S.C. 9858 et seq.).</text>
</subclause><subclause id="id6EC99E26997F4357A1E8D6DB8CAD167C"><enum>(X)</enum><text>The Stewart B.
McKinney Homeless Assistance Act (42 U.S.C. 11301 et seq.).</text>
</subclause><subclause id="id6E9A38AC3138476AAD63DA2909573F05"><enum>(XI)</enum><text>The United
States Housing Act of 1937 (42 U.S.C. 1437 et seq.).</text>
</subclause><subclause id="id8626433489A145C2BD25E7D424CCE5A4"><enum>(XII)</enum><text>The Native
American Housing Assistance and Self-Determination Act of 1996 (25 U.S.C. 4101
et seq.).</text>
</subclause></clause><clause id="idCB59C9D7C18C401FBBB7D868E0F74871"><enum>(ii)</enum><text>A
State-specified governmental agency that has fiscal liability or legal
responsibility for the accuracy of the eligibility determination findings
relied on by the State.</text>
</clause><clause id="id997474F420AD4E85A60481DE19669F87"><enum>(iii)</enum><text>A
public agency that is subject to an interagency agreement limiting the
disclosure and use of the information disclosed for purposes of determining
eligibility under the State Medicaid plan or the State CHIP plan.</text>
</clause></subparagraph><subparagraph id="id87C0BDAF11764160B22CAC2FDECED8BF"><enum>(C)</enum><header>Exclusions</header><text>Such
term does not include an agency that determines eligibility for a program
established under the Social Services Block Grant established under title XX of
the Social Security Act (42 U.S.C. 1397 et seq.) or a private, for-profit
organization.</text>
</subparagraph><subparagraph id="idBE2B13678B5646F4989840DBBA485451"><enum>(D)</enum><header>Rules of
construction</header><text>Nothing in this paragraph shall be construed
as—</text>
<clause id="id17701094BBEA4D3782AF29FDE61394D7"><enum>(i)</enum><text>affecting the
authority of a State Medicaid agency to enter into contracts with nonprofit and
for-profit agencies to administer the Medicaid application process;</text>
</clause><clause id="idA285A086F03348868EFB6248B9E354A5"><enum>(ii)</enum><text>exempting a
State Medicaid agency from complying with the requirements of section
1902(a)(4) of the Social Security Act (relating to merit-based personnel
standards for employees of the State Medicaid agency and safeguards against
conflicts of interest); or</text>
</clause><clause id="idADE84F66BB98467FAF9CF6B6B9E1AC21"><enum>(iii)</enum><text>authorizing a
State Medicaid agency that participates in the demonstration program
established under this section to use the Express Lane option to avoid
complying with such requirements for purposes of making eligibility
determinations under the State Medicaid plan.</text>
</clause></subparagraph></paragraph><paragraph id="id0D92FCB992D94AECA9B97D069BDFCF14"><enum>(3)</enum><header>Medicaid
applicable income level</header><text>With respect to a State, the term
<term>Medicaid applicable income level</term> has the meaning given that term
for purposes of such State under section 2110(b)(4) of the Social Security Act
(42 U.S.C. 1397jj(4)).</text>
</paragraph><paragraph id="idE4317C1ED4784B58824995A7652E9B83"><enum>(4)</enum><header>Poverty
line</header><text>The term <term>poverty line</term> has the meaning given
that term in section 2110(c)(5) of the Social Security Act (42 U.S.C.
1397jj(c)(5)).</text>
</paragraph><paragraph id="id7C5CA961FD0547B4996A17A8B4C0AE1C"><enum>(5)</enum><header>State</header><text>The
term <term>State</term> means 1 of the 50 States or the District of
Columbia.</text>
</paragraph><paragraph id="idADD3D22094864A3C9D32F28199DE3810"><enum>(6)</enum><header>State CHIP
agency</header><text>The term <term>State CHIP agency</term> means the State
agency responsible for administering the State CHIP plan.</text>
</paragraph><paragraph id="id20776BFDDF7A4737BB60F725124CBB93"><enum>(7)</enum><header>State CHIP
plan</header><text>The term <term>State CHIP plan</term> means the State child
health plan established under title XXI of the Social Security Act (42 U.S.C.
1397aa et seq.), and includes any waiver of such plan.</text>
</paragraph><paragraph id="idDE987220998A4CC5BA4C1F45FD042019"><enum>(8)</enum><header>State Medicaid
agency</header><text>The term <term>State Medicaid agency</term> means the
State agency responsible for administering the State Medicaid plan.</text>
</paragraph><paragraph id="id0A630D1141D34CC1BD420F23CAA06927"><enum>(9)</enum><header>State Medicaid
plan</header><text>The term <term>State Medicaid plan</term> means the State
plan established under title XIX of the Social Security Act (42 U.S.C. 1396 et
seq.), and includes any waiver of such plan.</text>
</paragraph></subsection><subsection id="ID2EA7B840DDD14027B96CF8C460635BF8"><enum>(f)</enum><header>Appropriation</header>
<paragraph id="IDCD5EC65DC6A345099CF3B2554BC73B93"><enum>(1)</enum><header>Operational
funds</header><text>Out of any funds in the Treasury not otherwise
appropriated, there is appropriated to the Secretary to carry out the
demonstration program established under this section, $49,000,000 for the
period of fiscal years 2008 through 2012.</text>
</paragraph><paragraph id="id8A10156FFB4D4DF08CD2DFB898E6DF00"><enum>(2)</enum><header>Evaluation
funds</header><text>$5,000,000 of the funds appropriated under paragraph (1)
shall be used to conduct the evaluation required under subsection (d).</text>
</paragraph><paragraph id="ID07D331F90A3B44E7A8F26EE5DAF8613A"><enum>(3)</enum><header>Budget
authority</header><text>Paragraph (1) constitutes budget authority in advance
of appropriations Act and represents the obligation of the Federal Government
to provide for the payment to States selected to participate in the
demonstration program established under this section of the amounts provided
under such paragraph (after the application of paragraph (2)).</text>
</paragraph></subsection></section><section commented="no" id="HF1D34352DF724C108316825200579400"><enum>204.</enum><header>Authorization
of certain information disclosures to simplify health coverage
determinations</header>
<subsection commented="no" id="id6CD87F91B0C541DFA3DE063C3E7867E2"><enum>(a)</enum><header>Authorization
of information disclosure</header><text>Title XIX (42 U.S.C. 1396 et seq.) is
amended—</text>
<paragraph commented="no" id="id65EF73E9768D42119C01F0F6E97FCEF3"><enum>(1)</enum><text>by redesignating
section 1939 as section 1940; and</text>
</paragraph><paragraph commented="no" id="idDA872A494B564D13BDD170999A579875"><enum>(2)</enum><text>by inserting
after section 1938 the following new section:</text>
<quoted-block display-inline="no-display-inline" id="id70BD1BAE8B684202973089E41D9680DB" style="traditional">
<section commented="no" id="idB0A392D4CF3642BF850AA1159E6C4284"><enum>1939.</enum><header>Authorization to receive pertinent
information</header><subsection commented="no" display-inline="yes-display-inline" id="id20C0AF4417AE4C2091732500E874BA85"><enum>(a)</enum><header>In
general</header><text>Notwithstanding any other provision of law, a Federal or
State agency or private entity in possession of the sources of data directly
relevant to eligibility determinations under this title (including eligibility
files, 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 the State agency administering the State plan under this title,
but only if such conveyance meets the requirements of subsection (b).</text>
</subsection><subsection commented="no" id="id27DF357E64F043609E3B2B391D3778F8"><enum>(b)</enum><header>Requirements
for conveyance</header><text>Data or information may be conveyed pursuant to
this section only if the following requirements are met:</text>
<paragraph commented="no" id="id1D069EE98BC94FF6AB5A5A1EFBFA5DBA"><enum>(1)</enum><text>The child whose
circumstances are described in the data or information (or such child’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.</text>
</paragraph><paragraph commented="no" id="id798CAEDABD8C40E6A28AF45536720C41"><enum>(2)</enum><text>Such data or
information are used solely for the purposes of—</text>
<subparagraph commented="no" id="id6D01208B36094C739E6649F07AA6FFDE"><enum>(A)</enum><text>identifying
children who are eligible or potentially eligible for medical assistance under
this title and enrolling (or attempting to enroll) such children in the State
plan; and</text>
</subparagraph><subparagraph commented="no" id="idFF4F62386F88479198FD784261232AD3"><enum>(B)</enum><text>verifying the
eligibility of children for medical assistance under the State plan.</text>
</subparagraph></paragraph><paragraph commented="no" id="id53B1C62E113F46C2A08E39F9179D065E"><enum>(3)</enum><text>An interagency or
other agreement, consistent with standards developed by the Secretary—</text>
<subparagraph commented="no" id="idCC082C2F25BD42EF96C25CCD2BC0E989"><enum>(A)</enum><text>prevents the
unauthorized use, disclosure, or modification of such data and otherwise meets
applicable Federal requirements for safeguarding privacy and data security;
and</text>
</subparagraph><subparagraph commented="no" id="idD0B048E034BD420BBBFC096DBDC6806E"><enum>(B)</enum><text>requires the
State agency administering the State plan to use the data and information
obtained under this section to seek to enroll children in the plan.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="id02FC823E47124378826CE7BF603E56C5"><enum>(c)</enum><header>Criminal
penalty</header><text>A person described in 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.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="id77B8676F4F1E474FA3B19441CF6E1BF9"><enum>(d)</enum><header>Rule of
construction</header><text>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).</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" id="idB7D50609B2AB46CFB48A4C5C4166581C"><enum>(b)</enum><header>Conforming
amendment to title XXI</header><text>Section 2107(e)(1) (42 U.S.C.
1397gg(e)(1)) is amended by adding at the end the following new
subparagraph:</text>
<quoted-block act-name="Social" id="id48ECD8DC86B540AE9F641A052E1D0D8F">
<subparagraph commented="no" id="idB93A48901B5B4D3F941D5E1FFC39482E"><enum>(E)</enum><text>Section 1939
(relating to authorization to receive data directly relevant to eligibility
determinations).</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="id6824C2EDC2C441168391B823D4D7A016"><enum>(c)</enum><header>Authorization
for States participating in the Express Lane demonstration program To receive
certain data directly relevant To determining eligibility and correct amount of
assistance</header><text>Only in the case of a State selected to participate in
the Express Lane demonstration program established under section 203, the
Secretary shall enter into such agreements as are necessary to permit such a
State to receive data directly relevant to eligibility determinations and
determining the correct amount of benefits under the State CHIP plan or the
State Medicaid plan (as such terms are defined in paragraphs (7) and (9)
section 203(e)) from the following:</text>
<paragraph id="id2B894795D38546799BBD455BC030B195"><enum>(1)</enum><text>The National
Directory of New Hires established under section 453(i) of the Social Security
Act (42 U.S.C. 653(i)).</text>
</paragraph><paragraph id="id3A8B200B8CEE4664BBDDBF4820B3E5DB"><enum>(2)</enum><text>The National
Income Data collected by the Commissioner of Social Security from information
described in subparagraphs (A) and (B) of section 6103(l)(7) of the Internal
Revenue Code of 1986, in accordance with the requirements of that
section.</text>
</paragraph><paragraph id="idD566B8E438AF44C39041DCB3714F1910"><enum>(3)</enum><text>Data regarding
enrollment in insurance that may help to facilitate outreach and enrollment
under the State Medicaid plan, the State CHIP plan, and such other programs as
the Secretary may specify.</text>
</paragraph></subsection></section><enum>III</enum><header>Reducing
Barriers to Enrollment</header>
<section id="idB7CE8662A8034780AFDBF0889CE32E09"><enum>301.</enum><header>Verification
of declaration of citizenship or nationality for purposes of eligibility for
Medicaid and CHIP</header>
<subsection id="id10F916C1DF7F400495EE3E21DB74F418"><enum>(a)</enum><header>State option To
verify declaration of citizenship or nationality for purposes of eligibility
for Medicaid through verification of name and social security number</header>
<paragraph id="id1274F12F1BBE4E1CA7C3D87E3745A950"><enum>(1)</enum><header>Alternative to
documentation requirement</header>
<subparagraph id="id7266F938946C46858414ADA44CE84D8C"><enum>(A)</enum><header>In
general</header><text>Section 1902 (42 U.S.C. 1396a) is amended—</text>
<clause id="id7E9D14B5D17C4A86BE433F934AFAE9F3"><enum>(i)</enum><text>in
subsection (a)(46)—</text>
<subclause id="id3E742D0EEE9941A1BD3E7BF1D3DB861B"><enum>(I)</enum><text>by inserting
<quote>(A)</quote> after <quote>(46)</quote>;</text>
</subclause><subclause id="idC55A42D2602E440F8E5E5DC1CF42721D"><enum>(II)</enum><text>by adding
<quote>and</quote> after the semicolon; and</text>
</subclause><subclause id="id8D3EA228C39944A8B0102B5DE9809E1B"><enum>(III)</enum><text>by adding at
the end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="id312BED5E5CA34CF69CC810EE64273E95" style="OLC">
<subparagraph id="id8FA8EAA40BDF4646BCFFF473A9B98606" indent="up1"><enum>(B)</enum><text>provide, with respect to an individual
declaring to be a citizen or national of the United States for purposes of
establishing eligibility under this title, that the State shall satisfy the
requirements of—</text>
<clause id="id83BBC8D4F10D4D5BB9799EC4DA7876BB"><enum>(i)</enum><text>section 1903(x); or</text>
</clause><clause id="id45F0266BA78E43BB9B29C7BD1C1AB79F"><enum>(ii)</enum><text>subsection
(dd);</text>
</clause></subparagraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</subclause></clause><clause id="idA7D0B8C458954136B9889D772AA9C2E6"><enum>(ii)</enum><text>by
adding at the end the following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="id484E236B382C4DD08FC29F15DD13DC67" style="OLC">
<subsection id="id6062C7773FCF439886D16848340CE406"><enum>(dd)</enum><paragraph commented="no" display-inline="yes-display-inline" id="idFC9003BA5CB743DDA49F417D6FA134A5"><enum>(1)</enum><text>For purposes of section
1902(a)(46)(B)(ii), the requirements of this subsection with respect to an
individual declaring to be a citizen or national of the United States for
purposes of establishing eligibility under this title, are, in lieu of
requiring the individual to present satisfactory documentary evidence of
citizenship or nationality under section 1903(x) (if the individual is not
described in paragraph (2) of that section), as follows:</text>
<subparagraph id="idD6E17AD908D4449F875EA13DF25B0D4C" indent="up1"><enum>(A)</enum><text>The State submits the name and social
security number of the individual to the Commissioner of Social Security as
part of the plan established under paragraph (2).</text>
</subparagraph><subparagraph id="idD54D6A71D40443809A14C2B2DAB33A08" indent="up1"><enum>(B)</enum><text>If the State receives notice from the
Commissioner of Social Security that the name or social security number of the
individual is invalid, the State—</text>
<clause id="id95BAD8094C2D4B26B0E810DED33336E2"><enum>(i)</enum><text>notifies the individual of such
fact;</text>
</clause><clause id="id06F2E770614540FAA9BFD51FE5725408"><enum>(ii)</enum><text>provides the individual with an
opportunity to cure the invalid determination with the Commissioner of Social
Security, followed by a period of 90 days from the date on which the notice
required under clause (i) is received by the individual to present satisfactory
documentary evidence of citizenship or nationality (as defined in section
1903(x)(3)); and</text>
</clause><clause id="id166F2D26437442F484394F1B9A9CA001"><enum>(iii)</enum><text>disenrolls the individual from
the State plan under this title within 30 days after the end of such 90-day
period if no such documentary evidence is presented.</text>
</clause></subparagraph></paragraph><paragraph id="id4F1A08D331894F4385D518D43485823E" indent="up1"><enum>(2)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="id18A80B3FEB1442059AA94328AA25E53C"><enum>(A)</enum><text>Each State electing to
satisfy the requirements of this subsection for purposes of section
1902(a)(46)(B) shall establish a program under which the State submits each
month to the Commissioner of Social Security for verification the name and
social security number of each individual enrolled in the State plan under this
title that month who has attained the age of 1 before the date of the
enrollment.</text>
</subparagraph><subparagraph id="id0F335F2E443044D0AC72BF375CFCC686" indent="up1"><enum>(B)</enum><text>In establishing the State program
under this paragraph, the State may enter into an agreement with the
Commissioner of Social Security to provide for the electronic submission and
verification of the name and social security number of an individual before the
individual is enrolled in the State plan.</text>
</subparagraph></paragraph><paragraph id="idD6EB6B2B7A42490AA4B88ACCB9C8FBA0" indent="up1"><enum>(3)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="idDE553D6666174D2CB274E465D2ACF11B"><enum>(A)</enum><text>The State agency
implementing the plan approved under this title shall, at such times and in
such form as the Secretary may specify, provide information on the percentage
each month that the invalid names and numbers submitted bears to the total
submitted for verification.</text>
</subparagraph><subparagraph id="idD23D9C7C451B4A66A1D22C87F14DC50E" indent="up1"><enum>(B)</enum><text>If, for any fiscal year, the average
monthly percentage determined under subparagraph (A) is greater than 7
percent—</text>
<clause id="id97E86C8DE40A40AC8765C9152081FF05"><enum>(i)</enum><text>the State shall develop and adopt a
corrective plan to review its procedures for verifying the identities of
individuals seeking to enroll in the State plan under this title and to
identify and implement changes in such procedures to improve their accuracy;
and</text>
</clause><clause id="id5A94CD2A85FC49AB81DD787A60F6FB47"><enum>(ii)</enum><text>pay to the Secretary an amount equal
to the amount which bears the same ratio to the total payments under the State
plan for the fiscal year for providing medical assistance to individuals who
provided invalid information as the number of individuals with invalid
information in excess of 7 percent of such total submitted bears to the total
number of individuals with invalid information.</text>
</clause></subparagraph><subparagraph id="id24BDD9B193504257B27ED08BA04568D7" indent="up1"><enum>(C)</enum><text>The Secretary may waive, in certain
limited cases, all or part of the payment under subparagraph (B)(ii) if the
State is unable to reach the allowable error rate despite a good faith effort
by such State.</text>
</subparagraph><subparagraph id="id52D7BEA70718434482FCBCEE5EA1F2FF" indent="up1"><enum>(D)</enum><text>This paragraph shall not apply to a
State for a fiscal year if there is an agreement described in paragraph (2)(B)
in effect as of the close of the fiscal year.</text>
</subparagraph></paragraph><paragraph id="id8A987E664E92490F8E28162522A8B06B" indent="up1"><enum>(4)</enum><text>Nothing in this subsection shall
affect the rights of any individual under this title to appeal any
disenrollment from a State
plan.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</clause></subparagraph><subparagraph id="idFB0CC94B56EF4BEDA1EFB86F29372816"><enum>(B)</enum><header>Costs of
implementing and maintaining system</header><text>Section 1903(a)(3) (42 U.S.C.
1396b(a)(3)) is amended—</text>
<clause id="id20A4B5701F834BCF9D0C35B7426481B0"><enum>(i)</enum><text>by
striking <quote>plus</quote> at the end of subparagraph (E) and inserting
<quote>and</quote>, and</text>
</clause><clause id="idA8A00CEDC66B42FEAAEDD449037177C5"><enum>(ii)</enum><text>by
adding at the end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="idC686D6B07CBD41C089B44EC3D9008C19" style="OLC">
<subparagraph id="idC4811BBC996E4BC5B36F86D2AFCCEB13"><enum>(F)</enum><clause commented="no" display-inline="yes-display-inline" id="id4379EC1257064E499F2C21DD3E41082F"><enum>(i)</enum><text>90 percent of the sums
expended during the quarter as are attributable to the design, development, or
installation of such mechanized verification and information retrieval systems
as the Secretary determines are necessary to implement section 1902(dd)
(including a system described in paragraph (2)(B) thereof), and</text>
</clause><clause commented="no" display-inline="no-display-inline" id="id0439A331CE9F45979A0C5AF08CD45D5C" indent="up1"><enum>(ii)</enum><text>75 percent of the sums expended
during the quarter as are attributable to the operation of systems to which
clause (i) applies,
plus</text>
</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</clause></subparagraph></paragraph><paragraph id="idACEFEADD962B48A991435CEF37AF9E8F"><enum>(2)</enum><header>Limitation on
waiver authority</header><text>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.</text>
</paragraph><paragraph id="idFB52F9AA635F4CA1926C97BD694007D9"><enum>(3)</enum><header>Conforming
amendments</header><text>Section 1903 (42 U.S.C. 1396b) is amended—</text>
<subparagraph id="id491503A5039F450BBBDB61C0B3C95E5A"><enum>(A)</enum><text>in subsection
(i)(22), by striking <quote>subsection (x)</quote> and inserting <quote>section
1902(a)(46)(B)</quote>; and</text>
</subparagraph><subparagraph id="id218AF314B88B40279599BC00C36260C5"><enum>(B)</enum><text>in subsection
(x)(1), by striking <quote>subsection (i)(22)</quote> and inserting
<quote>section 1902(a)(46)(B)(i)</quote>.</text>
</subparagraph></paragraph></subsection><subsection id="id7D81A2C329BC45379C69A4AE6DFDB66A"><enum>(b)</enum><header>Clarification
of requirements relating to presentation of satisfactory documentary evidence
of citizenship or nationality</header>
<paragraph id="id73F4618C591949DC93164264269EEB00"><enum>(1)</enum><header>Acceptance of
documentary evidence issued by a federally recognized Indian
tribe</header><text>Section 1903(x)(3)(B) (42 U.S.C. 1396b(x)(3)(B)) is
amended—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="idCD876F8047FB450AABC8E8402BF9F270"><enum>(A)</enum><text>by redesignating
clause (v) as clause (vi); and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idBE16EC74CD5B49F184334E30BF8D2A9F"><enum>(B)</enum><text>by inserting
after clause (iv), the following new clause:</text>
<quoted-block display-inline="no-display-inline" id="id17B9FF673F324852ADF1759391A09B82" style="OLC">
<clause commented="no" display-inline="no-display-inline" id="id615E25B41713411D8F4A75B6F24E7E0D" indent="up2"><enum>(v)</enum><subclause commented="no" display-inline="yes-display-inline" id="id27952B0AB6EF401BAF01F8E47F6A009F"><enum>(I)</enum><text>Except as provided in
subclause (II), 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).</text>
</subclause><subclause commented="no" display-inline="no-display-inline" id="id89656CBFDF034E17B354F34D563DA5EF" indent="up1"><enum>(II)</enum><text>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, the Secretary shall, after consulting with such tribes, issue
regulations authorizing the presentation of such other forms of documentation
(including tribal documentation, if appropriate) that the Secretary determines
to be satisfactory documentary evidence of citizenship or nationality for
purposes of satisfying the requirement of this
subsection.</text>
</subclause></clause><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id68BEAC07FA4745E18B1184B93DCFC8A1"><enum>(2)</enum><header>Requirement to
provide reasonable opportunity to present satisfactory documentary
evidence</header><text>Section 1903(x) (42 U.S.C. 1396b(x)) is amended by
adding at the end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="id484A6C18D79B442AB9B3EF2AA7582F6E" style="OLC">
<paragraph commented="no" display-inline="no-display-inline" id="ID998E5A231C83480CA923B3E232CF1EFB" indent="up1"><enum>(4)</enum><text>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)(i), 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.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="idCFBCEFA2069943738889A51B06DDD956"><enum>(3)</enum><header>Children born
in the United States to mothers eligible for Medicaid</header>
<subparagraph id="idA0DFFC44C81F456F9805878833A16D08"><enum>(A)</enum><header>Clarification
of rules</header><text display-inline="yes-display-inline">Section 1903(x) (42
U.S.C. 1396b(x)), as amended by paragraph (2), is amended—</text>
<clause id="id0A1B688DB90B439382DC9D7818E70A2D"><enum>(i)</enum><text>in
paragraph (2)—</text>
<subclause id="id97B56112FD494C11ADC5B8E0842FD9A1"><enum>(I)</enum><text>in subparagraph
(C), by striking <quote>or</quote> at the end;</text>
</subclause><subclause id="id51C7C1AFDA944D8CBC5D2EC69762378E"><enum>(II)</enum><text>by redesignating
subparagraph (D) as subparagraph (E); and</text>
</subclause><subclause id="id70B5D69E21124A889F49E7B6F8A11FE0"><enum>(III)</enum><text>by inserting
after subparagraph (C) the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="idBEC75EF939DA4E2086143BBE9D6A45AE" style="OLC">
<subparagraph id="id0D3BDA6493054FCBB1F257C247D4DFE8" indent="up1"><enum>(D)</enum><text>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</text>
</subparagraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</subclause></clause><clause id="idED735FB86DC94629A77665B357313BBB"><enum>(ii)</enum><text display-inline="yes-display-inline">by adding at the end the following new
paragraph:</text>
<quoted-block display-inline="no-display-inline" id="id8973D8BC7CFE46F188AB6750135F9537" style="OLC">
<paragraph id="idF1261AE0183B422185CB312BEA5F2205" indent="up1"><enum>(5)</enum><text>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.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</clause></subparagraph><subparagraph id="id9D79C9CB849B427A86A5A18245DB0C84"><enum>(B)</enum><header>State
requirement to issue separate identification number</header><text>Section
1902(e)(4) (42 U.S.C. 1396a(e)(4)) is amended by adding at the end the
following new sentence: <quote>Notwithstanding the preceding sentence, in the
case of a child who is born in the United States to an alien mother for whom
medical assistance for the delivery of the child is made available pursuant to
section 1903(v), the State immediately shall issue a separate identification
number for the child upon notification by the facility at which such delivery
occurred of the child's birth.</quote>.</text>
</subparagraph></paragraph><paragraph id="idB4675DB88C0144E59D0F8563F86B4902"><enum>(4)</enum><header>Technical
amendments</header><text>Section 1903(x)(2) (42 U.S.C. 1396b(x)) is
amended—</text>
<subparagraph id="idB7B62FEA4B824295BF8D79666094E57A"><enum>(A)</enum><text>in subparagraph
(B)—</text>
<clause id="id3956C6F2C84C47B89AFD8944C32C9C64"><enum>(i)</enum><text>by
realigning the left margin of the matter preceding clause (i) 2 ems to the
left; and</text>
</clause><clause id="idCED53440AE4445C788E00376AFD97F6A"><enum>(ii)</enum><text>by
realigning the left margins of clauses (i) and (ii), respectively, 2 ems to the
left; and</text>
</clause></subparagraph><subparagraph id="id3FDB2AD7534D4F708FD42C95D0456D98"><enum>(B)</enum><text>in subparagraph
(C)—</text>
<clause id="id9B4950427F02459ABF6E5DDE6953A4F5"><enum>(i)</enum><text>by
realigning the left margin of the matter preceding clause (i) 2 ems to the
left; and</text>
</clause><clause id="idD331FCED70114889B59D1A3F83D3EF70"><enum>(ii)</enum><text>by
realigning the left margins of clauses (i) and (ii), respectively, 2 ems to the
left.</text>
</clause></subparagraph></paragraph></subsection><subsection id="id4477FA56B2344BF1845AE0E57689EB23"><enum>(c)</enum><header>Application of
documentation system to CHIP</header>
<paragraph commented="no" id="id778DFA2CDD634C879B574B8127603274"><enum>(1)</enum><header>In
general</header><text>Section 2105(c) (42 U.S.C. 1397ee(c)), as amended by
section 110(a), is amended by adding at the end the following new
paragraph:</text>
<quoted-block display-inline="no-display-inline" id="idC4455549E73D42AC82E134C65A61A936" style="OLC">
<paragraph commented="no" id="idF0ADB75B16634E34BE0333AACE1C4167"><enum>(9)</enum><header>Citizenship
documentation requirements</header>
<subparagraph commented="no" id="id88DF62C7B09F4FBAA4D60803DFC6BD2E"><enum>(A)</enum><header>In
general</header><text>No payment may be made under this section with respect to
an individual who has, or is, declared to be a citizen or national of the
United States for purposes of establishing eligibility under this title unless
the State meets the requirements of section 1902(a)(46)(B) with respect to the
individual.</text>
</subparagraph><subparagraph commented="no" id="id556326DBD14D4334B4FBFA7B19C1C808"><enum>(B)</enum><header>Enhanced
payments</header><text>Notwithstanding subsection (b), the enhanced FMAP with
respect to payments under subsection (a) for expenditures described in clause
(i) or (ii) of section 1903(a)(3)(F) necessary to comply with subparagraph (A)
shall in no event be less than 90 percent and 75 percent,
respectively.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="id7A06ED8AE81042BBB287B4AF2690C0BD"><enum>(2)</enum><header>Nonapplication
of administrative expenditures cap</header><text>Section 2105(c)(2)(C) (42
U.S.C. 1397ee(c)(2)(C)), as amended by section 202(b), is amended by adding at
the end the following:</text>
<quoted-block display-inline="no-display-inline" id="id02D96317187D4389BCEB516AB5E4239D" style="OLC">
<clause id="id00342E570AE84429AB924BF20EB207EB"><enum>(iii)</enum><header>Expenditures
to comply with citizenship or nationality verification
requirements</header><text>Expenditures necessary for the State to comply with
paragraph
(9)(A).</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="id0E9EFDD4EAE5458696FC88A05B88D4FC"><enum>(d)</enum><header>Effective
date</header>
<paragraph id="id41BB388571F249519E7939A0C87C2442"><enum>(1)</enum><header>In
general</header><text>The amendments made by this section shall take effect on
October 1, 2008.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="idD906E6D0B0E94BC3821E007B3F17EA1D"><enum>(2)</enum><header>Restoration of
eligibility</header><text>In the case of an individual who, during the period
that began on July 1, 2006, and ends on October 1, 2008, was determined to be
ineligible for medical assistance under a State Medicaid plan, including any
waiver of such plan, 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 subsection (b), 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.</text>
</paragraph><paragraph id="idC64C7A7F87CB468D8774495BAD207365"><enum>(3)</enum><header>Special
transition rule for indians</header><text>During the period that begins on July
1, 2006, and ends on the effective date of final regulations issued under
subclause (II) of section 1903(x)(3)(B)(v) of the Social Security Act (42
U.S.C. 1396b(x)(3)(B)(v)) (as added by subsection (b)(1)(B)), an individual who
is a member of a federally-recognized Indian tribe described in subclause (II)
of that section who presents a document described in subclause (I) of such
section that is issued by such Indian tribe, shall be deemed to have presented
satisfactory evidence of citizenship or nationality for purposes of satisfying
the requirement of subsection (x) of section 1903 of such Act.</text>
</paragraph></subsection></section><section id="idB5E2F9C94F8F40BF896F24E30CB16D18"><enum>302.</enum><header>Reducing
administrative barriers to enrollment</header><text display-inline="no-display-inline">Section 2102(b) (42 U.S.C. 1397bb(b)) is
amended—</text>
<paragraph id="id064D951AA988475BA9F1FE09E731040B"><enum>(1)</enum><text>by redesignating
paragraph (4) as paragraph (5); and</text>
</paragraph><paragraph id="id61C167AF16BC4F00B3774F98D5F2D3D5"><enum>(2)</enum><text>by inserting
after paragraph (3) the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="id5D3E5D26B0624496A1DC84454F02D477" style="OLC">
<paragraph id="id51082C32E6334AF08A3CA3372D88E004"><enum>(4)</enum><header>Reduction of
administrative barriers to enrollment</header>
<subparagraph id="id27E7A529A4DB4DD4A05C1354F327FD70"><enum>(A)</enum><header>In
general</header><text>Subject to subparagraph (B), the plan shall include a
description of the procedures used to reduce administrative barriers to the
enrollment of children and pregnant women who are eligible for medical
assistance under title XIX or for child health assistance or health benefits
coverage under this title. Such procedures shall be established and revised as
often as the State determines appropriate to take into account the most recent
information available to the State identifying such barriers.</text>
</subparagraph><subparagraph id="idE36839871C7E4C9386282C6013EDDC3C"><enum>(B)</enum><header>Deemed
compliance if joint application and renewal process that permits application
other than in person</header><text>A State shall be deemed to comply with
subparagraph (A) if the State's application and renewal forms and supplemental
forms (if any) and information verification process is the same for purposes of
establishing and renewing eligibility for children and pregnant women for
medical assistance under title XIX and child health assistance under this
title, and such process does not require an application to be made in person or
a face-to-face
interview.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><enum>IV</enum><header>Reducing
barriers to providing premium assistance</header>
<subtitle id="idF73580D6828040FFB07861A2AE741EDE"><enum>A</enum><header>Additional State
option for providing premium assistance</header>
<section id="id9BE24CAB567144E9A8349CB6FB0F630D"><enum>401.</enum><header>Additional
State option for providing premium assistance</header>
<subsection id="id2F063077176D4E59916307AF78B1D22E"><enum>(a)</enum><header>In
general</header><text>Section 2105(c) (42 U.S.C. 1397ee(c)), as amended by
section 301(c), is amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="idBB3957B24D2045D2A6A4424CAE6FFC56" style="OLC">
<paragraph id="idF58EEE6DB8964C26A3117FEA8ACE3BE4"><enum>(10)</enum><header>State option
to offer premium assistance</header>
<subparagraph id="id066856B4034C4F69B51AB4E7C2DEE7A0"><enum>(A)</enum><header>In
general</header><text>Subject to the succeeding provisions of this paragraph, a
State may elect to offer a premium assistance subsidy (as defined in
subparagraph (C)) for qualified employer-sponsored coverage (as defined in
subparagraph (B)) to all targeted low-income children who are eligible for
child health assistance under the plan and have access to such coverage in
accordance with the requirements of this paragraph.</text>
</subparagraph><subparagraph id="id6851158ED2AD44B591E0D6814027C820"><enum>(B)</enum><header>Qualified
employer-sponsored coverage</header>
<clause id="idA4387A08ADE14DBCA4635C529EE06DCD"><enum>(i)</enum><header>In
general</header><text>Subject to clauses (ii) and (iii), in this paragraph, the
term <term>qualified employer-sponsored coverage</term> means a group health
plan or health insurance coverage offered through an employer—</text>
<subclause id="id8075CD7EB3B24132873AC888296DAC09"><enum>(I)</enum><text>that qualifies as
creditable coverage as a group health plan under section 2701(c)(1) of the
Public Health Service Act;</text>
</subclause><subclause id="id2622EF642D794E9D8B05F7B11020CA49"><enum>(II)</enum><text>for which the
employer contribution toward any premium for such coverage is at least 40
percent; and</text>
</subclause><subclause id="id05CC4C9D921E408799944FE7FF45FFF3"><enum>(III)</enum><text>to all
individuals in a manner that would be considered a nondiscriminatory
eligibility classification for purposes of paragraph (3)(A)(ii) of section
105(h) of the Internal Revenue Code of 1986 (but determined without regard to
clause (i) of subparagraph (B) of such paragraph).</text>
</subclause></clause><clause id="id24FEFA5D9F5844CB886CE6B11A3686CC"><enum>(ii)</enum><header>Exception</header><text>Such
term does not include coverage consisting of—</text>
<subclause id="id0B2B1EC407B647C285BE64739A882B6D"><enum>(I)</enum><text>benefits provided
under a health flexible spending arrangement (as defined in section 106(c)(2)
of the Internal Revenue Code of 1986); or</text>
</subclause><subclause id="id240D0E3D3A2947B5B39F17AB2C66980F"><enum>(II)</enum><text>a high
deductible health plan (as defined in section 223(c)(2) of such Code) purchased
in conjunction with a health savings account (as defined under section 223(d)
of such Code).</text>
</subclause></clause><clause id="idC64A138F2F58418EB7F04EB9003EFC83"><enum>(iii)</enum><header>Cost-effectiveness
alternative to required employer contribution</header><text>A group health plan
or health insurance coverage offered through an employer that would be
considered qualified employer-sponsored coverage but for the application of
clause (i)(II) may be deemed to satisfy the requirement of such clause if
either of the following applies:</text>
<subclause commented="no" display-inline="no-display-inline" id="id26CA0257AB4147DB9373C417E232491C"><enum>(I)</enum><header display-inline="yes-display-inline">Application of child-based or family-based
test</header><text display-inline="yes-display-inline">The State establishes to
the satisfaction of the Secretary that the cost of such coverage is less than
the expenditures that the State would have made to enroll the child or the
family (as applicable) in the State child health plan.</text>
</subclause><subclause id="idD4F417D311104975B532932EC3DC2996"><enum>(II)</enum><header>Aggregate
program operational costs do not exceed the cost of providing coverage under
the state child health plan</header><text>If subclause (I) does not apply, the
State establishes to the satisfaction of the Secretary that the aggregate
amount of expenditures by the State for the purchase of all such coverage for
targeted low-income children under the State child health plan (including
administrative expenditures) does not exceed the aggregate amount of
expenditures that the State would have made for providing coverage under the
State child health plan for all such children.</text>
</subclause></clause></subparagraph><subparagraph id="id699B4358EFB9422CB929CAFD4159942A"><enum>(C)</enum><header>Premium
assistance subsidy</header>
<clause id="idC31DF8B1980D4CDF9502A09D284A2301"><enum>(i)</enum><header>In
general</header><text>In this paragraph, the term <term>premium assistance
subsidy</term> means, with respect to a targeted low-income child, the amount
equal to the difference between the employee contribution required for
enrollment only of the employee under qualified employer-sponsored coverage and
the employee contribution required for enrollment of the employee and the child
in such coverage, less any applicable premium cost-sharing applied under the
State child health plan (subject to the limitations imposed under section
2103(e), including the requirement to count the total amount of the employee
contribution required for enrollment of the employee and the child in such
coverage toward the annual aggregate cost-sharing limit applied under paragraph
(3)(B) of such section).</text>
</clause><clause id="idAFFE11F5345A4A7886CF648792F6700E"><enum>(ii)</enum><header>State payment
option</header><text>A State may provide a premium assistance subsidy either as
reimbursement to an employee for out-of-pocket expenditures or, subject to
clause (iii), directly to the employee's employer.</text>
</clause><clause id="idD83001457A874C3AAAA7AD407EBC21F6"><enum>(iii)</enum><header>Employer
opt-out</header><text>An employer may notify a State that it elects to opt-out
of being directly paid a premium assistance subsidy on behalf of an employee.
In the event of such a notification, an employer shall withhold the total
amount of the employee contribution required for enrollment of the employee and
the child in the qualified employer-sponsored coverage and the State shall pay
the premium assistance subsidy directly to the employee.</text>
</clause><clause id="id0E4F55C6B85E40979B7FFFC7E8B52B8E"><enum>(iv)</enum><header>Treatment as
child health assistance</header><text>Expenditures for the provision of premium
assistance subsidies shall be considered child health assistance described in
paragraph (1)(C) of subsection (a) for purposes of making payments under that
subsection.</text>
</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id1521EA9D1AAF48069B86E5B247DA5DCE"><enum>(D)</enum><header display-inline="yes-display-inline">Application of secondary payor
rules</header><text>The State shall be a secondary payor for any items or
services provided under the qualified employer-sponsored coverage for which the
State provides child health assistance under the State child health
plan.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id3F1E0AF523474CA388A306E40FECD5F7"><enum>(E)</enum><header>Requirement to
provide supplemental coverage for benefits and cost-sharing protection provided
under the state child health plan</header>
<clause commented="no" display-inline="no-display-inline" id="id25607DB113934C3E92086BB0F3DD681D"><enum>(i)</enum><header>In
general</header><text>Notwithstanding section 2110(b)(1)(C), the State shall
provide for each targeted low-income child enrolled in qualified
employer-sponsored coverage, supplemental coverage consisting of—</text>
<subclause id="id97CD6A059DA044BAA907CBB026FBEABF"><enum>(I)</enum><text>items or services
that are not covered, or are only partially covered, under the qualified
employer-sponsored coverage; and</text>
</subclause><subclause id="id7CDDEF51E0FA44D9A1C8A52D4A12831E"><enum>(II)</enum><text>cost-sharing
protection consistent with section 2103(e).</text>
</subclause></clause><clause id="id7154A677529B4D92A579D989474B2441"><enum>(ii)</enum><header>Record keeping
requirements</header><text>For purposes of carrying out clause (i), a State may
elect to directly pay out-of-pocket expenditures for cost-sharing imposed under
the qualified employer-sponsored coverage and collect or not collect all or any
portion of such expenditures from the parent of the child.</text>
</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id076F80C41F8C49A9B2248D70DBD558B6"><enum>(F)</enum><header>Application of
waiting period imposed under the State</header><text>Any waiting period imposed
under the State child health plan prior to the provision of child health
assistance to a targeted low-income child under the State plan shall apply to
the same extent to the provision of a premium assistance subsidy for the child
under this paragraph.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id276EA0EF70F041989583030C0A559207"><enum>(G)</enum><header>Opt-out
permitted for any month</header><text>A State shall establish a process for
permitting the parent of a targeted low-income child receiving a premium
assistance subsidy to disenroll the child from the qualified employer-sponsored
coverage and enroll the child in, and receive child health assistance under,
the State child health plan, effective on the first day of any month for which
the child is eligible for such assistance and in a manner that ensures
continuity of coverage for the child.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idDD94D8B8563F4409B1B93E57E90E2250"><enum>(H)</enum><header>Application to
parents</header><text>If a State provides child health assistance or health
benefits coverage to parents of a targeted low-income child in accordance with
section 2111(b), the State may elect to offer a premium assistance subsidy to a
parent of a targeted low-income child who is eligible for such a subsidy under
this paragraph in the same manner as the State offers such a subsidy for the
enrollment of the child in qualified employer-sponsored coverage, except
that—</text>
<clause commented="no" display-inline="no-display-inline" id="id3E6FE013789640818A259A73B2A504E1"><enum>(i)</enum><text>the amount of the
premium assistance subsidy shall be increased to take into account the cost of
the enrollment of the parent in the qualified employer-sponsored coverage or,
at the option of the State if the State determines it cost-effective, the cost
of the enrollment of the child's family in such coverage; and</text>
</clause><clause commented="no" display-inline="no-display-inline" id="id3FC2617A068146C989A5D497B394C1B6"><enum>(ii)</enum><text>any reference in
this paragraph to a child is deemed to include a reference to the parent or, if
applicable under clause (i), the family of the child.</text>
</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idBC2D706DA4D747FB8309A20988652019"><enum>(I)</enum><header>Additional
State option for providing premium assistance</header>
<clause commented="no" display-inline="no-display-inline" id="id588E4FD287E649F2B96FB303E9FCCF5E"><enum>(i)</enum><header>In
general</header><text>A State may establish an employer-family premium
assistance purchasing pool for employers with less than 250 employees who have
at least 1 employee who is a pregnant woman eligible for assistance under the
State child health plan (including through the application of an option
described in section 2112(f)) or a member of a family with at least 1 targeted
low-income child and to provide a premium assistance subsidy under this
paragraph for enrollment in coverage made available through such pool.</text>
</clause><clause commented="no" display-inline="no-display-inline" id="id4059D8EBEE504A06B8549E13A1669DC1"><enum>(ii)</enum><header>Access to
choice of coverage</header><text>A State that elects the option under clause
(i) shall identify and offer access to not less than 2 private health plans
that are health benefits coverage that is equivalent to the benefits coverage
in a benchmark benefit package described in section 2103(b) or
benchmark-equivalent coverage that meets the requirements of section 2103(a)(2)
for employees described in clause (i).</text>
</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id528942BE5BE14975B8BE0598BB1FF9CB"><enum>(J)</enum><header>No effect on
previously approved premium assistance programs</header><text>Nothing in this
paragraph shall be construed as limiting the authority of a State to offer
premium assistance under section 1906, a waiver described in paragraph (2)(B)
or (3), a waiver approved under section 1115, or other authority in effect
prior to the date of enactment of the <short-title>Children's Health Insurance Program Reauthorization Act of
2007</short-title>.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idF89C7EC336C3431DA0F9DE6720D78FFD"><enum>(K)</enum><header>Notice of
availability</header><text>If a State elects to provide premium assistance
subsidies in accordance with this paragraph, the State shall—</text>
<clause commented="no" display-inline="no-display-inline" id="id4DFDA10FE3894E679048F7A69C46F087"><enum>(i)</enum><text>include on any
application or enrollment form for child health assistance a notice of the
availability of premium assistance subsidies for the enrollment of targeted
low-income children in qualified employer-sponsored coverage;</text>
</clause><clause commented="no" display-inline="no-display-inline" id="id38AAC7BE5497462981C029B2A91BA4E0"><enum>(ii)</enum><text>provide, as part
of the application and enrollment process under the State child health plan,
information describing the availability of such subsidies and how to elect to
obtain such a subsidy; and</text>
</clause><clause commented="no" display-inline="no-display-inline" id="id1EB9C48F45B54AA19176A582926A9AD7"><enum>(iii)</enum><text>establish such
other procedures as the State determines necessary to ensure that parents are
fully informed of the choices for receiving child health assistance under the
State child health plan or through the receipt of premium assistance
subsidies.</text>
</clause></subparagraph><subparagraph id="id3A2A1EFBF29C4EAC97753240BC538B11"><enum>(L)</enum><header>Application to
qualified employer-sponsored benchmark coverage</header><text>If a group health
plan or health insurance coverage offered through an employer is certified by
an actuary as health benefits coverage that is equivalent to the benefits
coverage in a benchmark benefit package described in section 2103(b) or
benchmark-equivalent coverage that meets the requirements of section
2103(a)(2), the State may provide premium assistance subsidies for enrollment
of targeted low-income children in such group health plan or health insurance
coverage in the same manner as such subsidies are provided under this paragraph
for enrollment in qualified employer-sponsored coverage, but without regard to
the requirement to provide supplemental coverage for benefits and cost-sharing
protection provided under the State child health plan under subparagraph
(E).</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="id692C4D70497C4AD0895476E1EAE743F7"><enum>(b)</enum><header>Application to
Medicaid</header><text>Section 1906 (42 U.S.C. 1396e) is amended by inserting
after subsection (c) the following:</text>
<quoted-block display-inline="no-display-inline" id="id4D21081C801E4727806CAC5FBC0EE922" style="OLC">
<subsection id="id28A318BE237141D29CDF88E97CB79DC4"><enum>(d)</enum><text>A State may elect
to offer a premium assistance subsidy (as defined in section 2105(c)(10)(C))
for qualified employer-sponsored coverage (as defined in section
2105(c)(10)(B)) to a child who is eligible for medical assistance under the
State plan under this title, to the parent of such a child, and to a pregnant
woman, in the same manner as such a subsidy for such coverage may be offered
under a State child health plan under title XXI in accordance with section
2105(c)(10) (except that subparagraph (E)(i)(II) of such section shall be
applied by substituting <quote>1916 or, if applicable, 1916A</quote> for
<quote>2103(e)</quote>).</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection commented="no" display-inline="no-display-inline" id="idECCB9D8385094259A59865E6FCB79DFB"><enum>(c)</enum><header>GAO study and
report</header><text display-inline="yes-display-inline">Not later than January
1, 2009, the Comptroller General of the United States shall study cost and
coverage issues relating to any State premium assistance programs for which
Federal matching payments are made under title XIX or XXI of the Social
Security Act, including under waiver authority, and shall submit a report to
the appropriate committees of Congress on the results of such study.</text>
</subsection></section><section id="id97BDEE3EA37B4453A9D40DECE4484663"><enum>402.</enum><header>Outreach,
education, and enrollment assistance</header>
<subsection id="id474730FEE5D24ACDA7236D53AD00E278"><enum>(a)</enum><header>Requirement To
include description of outreach, education, and enrollment efforts related to
premium assistance subsidies in state child health plan</header><text display-inline="yes-display-inline">Section 2102(c) (42 U.S.C. 1397bb(c)) is
amended by adding at the end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="id26B2C4FAE8C9425BA98244095615F413" style="OLC">
<paragraph id="idB2E5472DC68743B4BBB184FBD4413A0F"><enum>(3)</enum><header>Premium
assistance subsidies</header><text>Outreach, education, and enrollment
assistance for families of children likely to be eligible for premium
assistance subsidies under the State child health plan in accordance with
paragraphs (2)(B), (3), or (10) of section 2105(c), or a waiver approved under
section 1115, to inform such families of the availability of, and to assist
them in enrolling their children in, such subsidies, and for employers likely
to provide coverage that is eligible for such subsidies, including the
specific, significant resources the State intends to apply to educate employers
about the availability of premium assistance subsidies under the State child
health
plan.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="idD12CD853284B4FE38DAB8FF844CB4747"><enum>(b)</enum><header>Nonapplication
of 10 percent limit on outreach and certain other
expenditures</header><text>Section 2105(c)(2)(C) (42 U.S.C. 1397ee(c)(2)(C)),
as amended by section 301(c)(2), is amended by adding at the end the following
new clause:</text>
<quoted-block display-inline="no-display-inline" id="idEA5BA8ACE639495F9205C12A7422AC9C" style="OLC">
<clause id="id2B01962D3337425BBE0EAE402528EADF"><enum>(iv)</enum><header>Expenditures
for outreach to increase the enrollment of children under this title and title
XIX through premium assistance subsidies</header><text>Expenditures for
outreach activities to families of children likely to be eligible for premium
assistance subsidies in accordance with paragraphs (2)(B), (3), or (10), or a
waiver approved under section 1115, to inform such families of the availability
of, and to assist them in enrolling their children in, such subsidies, and to
employers likely to provide qualified employer-sponsored coverage (as defined
in subparagraph (B) of such
paragraph).</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section></subtitle><subtitle id="id009EB83EEB64468FB9ADF68B6A93FA63"><enum>B</enum><header>Coordinating
Premium Assistance With Private Coverage</header>
<section id="id8D6B77C073594904BD0DC00327061906"><enum>411.</enum><header>Special
enrollment period under group health plans in case of termination of Medicaid
or CHIP coverage or eligibility for assistance in purchase of employment-based
coverage; coordination of coverage</header>
<subsection id="idBFAA81371BF24DC1AFFB7554EECDAE47"><enum>(a)</enum><header>Amendments to
Internal Revenue Code of 1986</header><text>Section 9801(f) of the Internal
Revenue Code of 1986 (relating to special enrollment periods) is amended by
adding at the end the following new paragraph:</text>
<quoted-block act-name="" id="idD9971B3AD92441ECAF28EEDB39CE25C4" style="OLC">
<paragraph id="id438182684FE64D53A129FBD7B66B2AA7"><enum>(3)</enum><header>Special rules
relating to Medicaid and CHIP</header>
<subparagraph id="idED41F82F2FF445B89C5BD3CF373BC7BF"><enum>(A)</enum><header>In
general</header><text display-inline="yes-display-inline">A group health plan
shall permit an employee who is eligible, but not enrolled, for coverage under
the terms of the plan (or a dependent of such an employee if the dependent is
eligible, but not enrolled, for coverage under such terms) to enroll for
coverage under the terms of the plan if either of the following conditions is
met:</text>
<clause id="idE3CEFC66F1934DBA8F4FAE3CDEA30E5F"><enum>(i)</enum><header>Termination of
Medicaid or CHIP coverage</header><text>The employee or dependent is covered
under a Medicaid plan under title XIX of the Social Security Act or under a
State child health plan under title XXI of such Act and coverage of the
employee or dependent under such a plan is terminated as a result of loss of
eligibility for such coverage and the employee requests coverage under the
group health plan not later than 60 days after the date of termination of such
coverage.</text>
</clause><clause id="idF5B67460B07C49819C7055A9148C89CD"><enum>(ii)</enum><header>Eligibility
for employment assistance under Medicaid or CHIP</header><text>The employee or
dependent becomes eligible for assistance, with respect to coverage under the
group health plan under such Medicaid plan or State child health plan
(including under any waiver or demonstration project conducted under or in
relation to such a plan), if the employee requests coverage under the group
health plan not later than 60 days after the date the employee or dependent is
determined to be eligible for such assistance.</text>
</clause></subparagraph><subparagraph id="id55DAEA2F6218460088CA8F2415222DC3"><enum>(B)</enum><header>Employee
outreach and disclosure</header>
<clause id="idD5445EB42918461BB03914A29681D14C"><enum>(i)</enum><header>Outreach to
employees regarding availability of Medicaid and CHIP coverage</header>
<subclause id="idC4385A72358D43309CFB869BC5E6DBC1"><enum>(I)</enum><header>In
general</header><text display-inline="yes-display-inline">Each employer that
maintains a group health plan in a State that provides medical assistance under
a State Medicaid plan under title XIX of the Social Security Act, or child
health assistance under a State child health plan under title XXI of such Act,
in the form of premium assistance for the purchase of coverage under a group
health plan, shall provide to each employee a written notice informing the
employee of potential opportunities then currently available in the State in
which the employee resides for premium assistance under such plans for health
coverage of the employee or the employee's dependents. For purposes of
compliance with this clause, the employer may use any State-specific model
notice issued by the Secretary of Labor or the Secretary of Health and Human
Services in accordance with section 701(f)(3)(B) of the Employee Retirement
Income Security Act of 1974 (29 U.S.C. 1181(f)(3)(B)).</text>
</subclause><subclause id="idD29B8B12D46E434FBD68EB74FF573A5B"><enum>(II)</enum><header>Option to
provide concurrent with provision of summary plan description</header><text>An
employer may provide the model notice applicable to the State in which an
employee resides concurrent with the furnishing of the summary plan description
as provided in section 104(b) of the Employee Retirement Income Security Act of
1974 (29 U.S.C. 1024).</text>
</subclause></clause><clause commented="no" display-inline="no-display-inline" id="id975C2D38B80447028AFA66B3D317D2F5"><enum>(ii)</enum><header>Disclosure
about group health plan benefits to States for Medicaid and CHIP eligible
individuals</header><text>In the case of a participant or beneficiary of a
group health plan who is covered under a Medicaid plan of a State under title
XIX of the Social Security Act or under a State child health plan under title
XXI of such Act, the plan administrator of the group health plan shall disclose
to the State, upon request, information about the benefits available under the
group health plan in sufficient specificity, as determined under regulations of
the Secretary of Health and Human Services in consultation with the Secretary
that require use of the model coverage coordination disclosure form developed
under section 411(b)(2)(C) of the <short-title>Children's
Health Insurance Program Reauthorization Act of 2007</short-title>, so as to
permit the State to make a determination (under paragraph (2)(B), (3), or (10)
of section 2105(c) of the Social Security Act or otherwise) concerning the
cost-effectiveness of the State providing medical or child health assistance
through premium assistance for the purchase of coverage under such group health
plan and in order for the State to provide supplemental benefits required under
paragraph (10)(E) of such section or other
authority.</text>
</clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="idCC25D594CF9A48DEA3DDD8EE0CFE368B"><enum>(b)</enum><header>Conforming
amendments</header>
<paragraph id="idE2994190CF064A3A8F345577E52A3C2F"><enum>(1)</enum><header>Amendments to
Employee Retirement Income Security Act</header>
<subparagraph id="idBBB13C654FBD45D1A352B709CB2EE02B"><enum>(A)</enum><header>In
general</header><text>Section 701(f) of the Employee Retirement Income Security
Act of 1974 (29 U.S.C. 1181(f)) is amended by adding at the end the following
new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="idE829B3718BFA48AB8D01D42BC493F952" style="OLC">
<paragraph id="id51CFB5D2B79F4550AFAE211F5FB67A76"><enum>(3)</enum><header>Special rules
for application in case of Medicaid and CHIP</header>
<subparagraph id="id3AD4AD3BB897496A8BAEA1F685CF11FE"><enum>(A)</enum><header>In
general</header><text display-inline="yes-display-inline">A group health plan,
and a health insurance issuer offering group health insurance coverage in
connection with a group health plan, shall permit an employee who is eligible,
but not enrolled, for coverage under the terms of the plan (or a dependent of
such an employee if the dependent is eligible, but not enrolled, for coverage
under such terms) to enroll for coverage under the terms of the plan if either
of the following conditions is met:</text>
<clause id="idC57CC652879D4137BF46D561632F27ED"><enum>(i)</enum><header>Termination of
Medicaid or CHIP coverage</header><text>The employee or dependent is covered
under a Medicaid plan under title XIX of the Social Security Act or under a
State child health plan under title XXI of such Act and coverage of the
employee or dependent under such a plan is terminated as a result of loss of
eligibility for such coverage and the employee requests coverage under the
group health plan (or health insurance coverage) not later than 60 days after
the date of termination of such coverage.</text>
</clause><clause id="idBA7D94A2E48E4EAFA6A4A69C456D678A"><enum>(ii)</enum><header>Eligibility
for employment assistance under Medicaid or CHIP</header><text>The employee or
dependent becomes eligible for assistance, with respect to coverage under the
group health plan or health insurance coverage, under such Medicaid plan or
State child health plan (including under any waiver or demonstration project
conducted under or in relation to such a plan), if the employee requests
coverage under the group health plan or health insurance coverage not later
than 60 days after the date the employee or dependent is determined to be
eligible for such
assistance.</text>
</clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
<quoted-block display-inline="no-display-inline" id="idF586376DAE5D473F8E70F6B7B2E42CF6" style="OLC">
<subparagraph id="id0CD3375255224825AD698AF76CA89A04"><enum>(B)</enum><header>Coordination
with Medicaid and CHIP</header>
<clause id="idB36B423945D049B5885A7CC8CF9E24EA"><enum>(i)</enum><header>Outreach to
employees regarding availability of Medicaid and CHIP coverage</header>
<subclause id="idCBF66B429B1846F4AFD29456197FCD46"><enum>(I)</enum><header>In
general</header><text display-inline="yes-display-inline">Each employer that
maintains a group health plan in a State that provides medical assistance under
a State Medicaid plan under title XIX of the Social Security Act, or child
health assistance under a State child health plan under title XXI of such Act,
in the form of premium assistance for the purchase of coverage under a group
health plan, shall provide to each employee a written notice informing the
employee of potential opportunities then currently available in the State in
which the employee resides for premium assistance under such plans for health
coverage of the employee or the employee's dependents.</text>
</subclause><subclause id="id6844B7CD02C442F58DF39D3AA94ECBDC"><enum>(II)</enum><header>Model
notice</header><text>Not later than 1 year after the date of enactment of the
<short-title>Children's Health Insurance Program
Reauthorization Act of 2007</short-title>, the Secretary and the Secretary of
Health and Human Services, in consultation with Directors of State Medicaid
agencies under title XIX of the Social Security Act and Directors of State CHIP
agencies under title XXI of such Act, shall jointly develop national and
State-specific model notices for purposes of subparagraph (A). The Secretary
shall provide employers with such model notices so as to enable employers to
timely comply with the requirements of subparagraph (A). Such model notices
shall include information regarding how an employee may contact the State in
which the employee resides for additional information regarding potential
opportunities for such premium assistance, including how to apply for such
assistance.</text>
</subclause><subclause id="idD02CA0994A9047BA9E8C29F7F44AF08A"><enum>(III)</enum><header>Option to
provide concurrent with provision of summary plan description</header><text>An
employer may provide the model notice applicable to the State in which an
employee resides concurrent with the furnishing of the summary plan description
as provided in section 104(b).</text>
</subclause></clause><clause commented="no" display-inline="no-display-inline" id="id624C1837DA074B72A249503C787C6DD4"><enum>(ii)</enum><header>Disclosure
about group health plan benefits to States for Medicaid and CHIP eligible
individuals</header><text>In the case of a participant or beneficiary of a
group health plan who is covered under a Medicaid plan of a State under title
XIX of the Social Security Act or under a State child health plan under title
XXI of such Act, the plan administrator of the group health plan shall disclose
to the State, upon request, information about the benefits available under the
group health plan in sufficient specificity, as determined under regulations of
the Secretary of Health and Human Services in consultation with the Secretary
that require use of the model coverage coordination disclosure form developed
under section 411(b)(2)(C) of the <short-title>Children's
Health Insurance Program Reauthorization Act of 2007</short-title>, so as to
permit the State to make a determination (under paragraph (2)(B), (3), or (10)
of section 2105(c) of the Social Security Act or otherwise) concerning the
cost-effectiveness of the State providing medical or child health assistance
through premium assistance for the purchase of coverage under such group health
plan and in order for the State to provide supplemental benefits required under
paragraph (10)(E) of such section or other
authority.</text>
</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="id0BF92F668ADA42B4A90CF7217DB010B4"><enum>(B)</enum><header>Conforming
amendment</header><text>Section 102(b) of the Employee Retirement Income
Security Act of 1974 (29 U.S.C. 1022(b)) is amended—</text>
<clause id="id219AA5A643004870974575CE102D7E0D"><enum>(i)</enum><text>by
striking <quote>and the remedies</quote> and inserting <quote>, the
remedies</quote>; and</text>
</clause><clause commented="no" display-inline="no-display-inline" id="id63D2D4CAD85E41A7A3CAB3E43791F6F5"><enum>(ii)</enum><text>by inserting
before the period the following: <quote>, and if the employer so elects for
purposes of complying with section 701(f)(3)(B)(i), the model notice applicable
to the State in which the participants and beneficiaries reside</quote>.</text>
</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idE5A11AD00A1B473AB4D5DFC8CBF89C31"><enum>(C)</enum><header>Working Group
to develop model coverage coordination disclosure form</header>
<clause id="idAC4E548557204C9CABB97FFD727242A0"><enum>(i)</enum><header>Medicaid, CHIP,
and Employer-Sponsored Coverage Coordination working group</header>
<subclause id="id7803AA52CF944BDCA455B5DEE94C271B"><enum>(I)</enum><header>In
general</header><text>Not later than 60 days after the date of enactment of
this Act, the Secretary of Health and Human Services and the Secretary of Labor
shall jointly establish a Medicaid, CHIP, and Employer-Sponsored Coverage
Coordination Working Group (in this subparagraph referred to as the
<quote>Working Group</quote>). The purpose of the Working Group shall be to
develop the model coverage coordination disclosure form described in subclause
(II) and to identify the impediments to the effective coordination of coverage
available to families that include employees of employers that maintain group
health plans and members who are eligible for medical assistance under title
XIX of the Social Security Act or child health assistance or other health
benefits coverage under title XXI of such Act.</text>
</subclause><subclause commented="no" display-inline="no-display-inline" id="id1EEDDA6CA91E47CFAB4E3F4C2909795C"><enum>(II)</enum><header>Model coverage
coordination disclosure form described</header><text>The model form described
in this subclause is a form for plan administrators of group health plans to
complete for purposes of permitting a State to determine the availability and
cost-effectiveness of the coverage available under such plans to employees who
have family members who are eligible for premium assistance offered under a
State plan under title XIX or XXI of such Act and to allow for coordination of
coverage for enrollees of such plans. Such form shall provide the following
information in addition to such other information as the Working Group
determines appropriate:</text>
<item commented="no" display-inline="no-display-inline" id="idF85C90814D964B0F884A11D9A7BD0F8E"><enum>(aa)</enum><text>A determination
of whether the employee is eligible for coverage under the group health
plan.</text>
</item><item commented="no" display-inline="no-display-inline" id="id38690D10D8FA4D89A09B5B5351590A7B"><enum>(bb)</enum><text>The name and
contract information of the plan administrator of the group health plan.</text>
</item><item commented="no" display-inline="no-display-inline" id="id6C2F6296F6A1422E8A94F24DA27FDDD1"><enum>(cc)</enum><text>The benefits
offered under the plan.</text>
</item><item commented="no" display-inline="no-display-inline" id="id91017BBFE9BB40248F08582AF8FE655F"><enum>(dd)</enum><text>The premiums and
cost-sharing required under the plan.</text>
</item><item commented="no" display-inline="no-display-inline" id="idC158F33480E24DBEBD4434AE251F9088"><enum>(ee)</enum><text>Any other
information relevant to coverage under the plan.</text>
</item></subclause></clause><clause id="id37316E472FD5416BA1E798E6E7363A71"><enum>(ii)</enum><header>Membership</header><text>The
Working Group shall consist of not more than 30 members and shall be composed
of representatives of—</text>
<subclause id="idAEADFF849E88443F98BA99CE897E44F8"><enum>(I)</enum><text>the Department of
Labor;</text>
</subclause><subclause id="idF5317348C1274FFFB5A7724615F057CE"><enum>(II)</enum><text>the Department
of Health and Human Services;</text>
</subclause><subclause id="idA8E831CF7DC54278ADA718814472CF39"><enum>(III)</enum><text>State directors
of the Medicaid program under title XIX of the <act-name parsable-cite="SSA">Social Security Act</act-name>;</text>
</subclause><subclause id="idDCA7A3551CA64467BB2286480F340286"><enum>(IV)</enum><text>State directors
of the State Children's Health Insurance Program under title XXI of the
<act-name parsable-cite="SSA">Social Security Act</act-name>;</text>
</subclause><subclause id="idE20EE2526F4D4E6ABA199C98F1956CFD"><enum>(V)</enum><text>employers,
including owners of small businesses and their trade or industry
representatives and certified human resource and payroll professionals;</text>
</subclause><subclause id="id52B07C65E4BA46BDAF156821A2D695D2"><enum>(VI)</enum><text>plan
administrators and plan sponsors of group health plans (as defined in section
607(1) of the Employee Retirement Income Security Act of 1974); and</text>
</subclause><subclause id="id0CC10021F51049DF96F811FA451B5FB5"><enum>(VII)</enum><text>children and
other beneficiaries of medical assistance under title XIX of the Social
Security Act or child health assistance or other health benefits coverage under
title XXI of such Act.</text>
</subclause></clause><clause id="idE58F8217114D49EFB5CE714D6B995ED9"><enum>(iii)</enum><header>Compensation</header><text>The
members of the Working Group shall serve without compensation.</text>
</clause><clause commented="no" display-inline="no-display-inline" id="id597948FFC61E40E59F5613FD495C2A89"><enum>(iv)</enum><header>Administrative
support</header><text>The Department of Health and Human Services and the
Department of Labor shall jointly provide appropriate administrative support to
the Working Group, including technical assistance. The Working Group may use
the services and facilities of either such Department, with or without
reimbursement, as jointly determined by such Departments.</text>
</clause><clause id="idFD62A2C3DBC44A3BACD44DBC3BE56A5D"><enum>(v)</enum><header>Report</header>
<subclause id="id7E69ABA384E545159206DCD3E90F6E00"><enum>(I)</enum><header>Report by
working group to the secretaries</header><text>Not later than 18 months after
the date of the enactment of this Act, the Working Group shall submit to the
Secretary of Labor and the Secretary of Health and Human Services the model
form described in clause (i)(II) along with a report containing recommendations
for appropriate measures to address the impediments to the effective
coordination of coverage between group health plans and the State plans under
titles XIX and XXI of the Social Security Act.</text>
</subclause><subclause id="idB6336F8A41C647D98CBF331610B70C2B"><enum>(II)</enum><header>Report by
secretaries to the congress</header><text>Not later than 2 months after receipt
of the report pursuant to subclause (I), the Secretaries shall jointly submit a
report to each House of the Congress regarding the recommendations contained in
the report under such subclause.</text>
</subclause></clause><clause commented="no" display-inline="no-display-inline" id="idA99AF9BF4104471CB242BA842E12640C"><enum>(vi)</enum><header>Termination</header><text>The
Working Group shall terminate 30 days after the date of the issuance of its
report under clause (v).</text>
</clause></subparagraph><subparagraph id="id79605A9982C0463C96F93A72EFB3F16F"><enum>(D)</enum><header>Effective
dates</header><text>The Secretary of Labor and the Secretary of Health and
Human Services shall develop the initial model notices under section
701(f)(3)(B)(i)(II) of the Employee Retirement Income Security Act of 1974, and
the Secretary of Labor shall provide such notices to employers, not later than
the date that is 1 year after the date of enactment of this Act, and each
employer shall provide the initial annual notices to such employer’s employees
beginning with the first plan year that begins after the date on which such
initial model notices are first issued. The model coverage coordination
disclosure form developed under subparagraph (C) shall apply with respect to
requests made by States beginning with the first plan year that begins after
the date on which such model coverage coordination disclosure form is first
issued.</text>
</subparagraph><subparagraph id="idD6D9A7CF1E994AECABC307B822FF3181"><enum>(E)</enum><header>Enforcement</header><text>Section
502 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1132) is
amended—</text>
<clause id="id1F619A6C04E44CEABB07A494B1DDE828"><enum>(i)</enum><text>in
subsection (a)(6), by striking <quote>or (8)</quote> and inserting <quote>(8),
or (9)</quote>; and</text>
</clause><clause id="id9ADC908AC2D64137A50177E34DD2E13E"><enum>(ii)</enum><text>in
subsection (c), by redesignating paragraph (9) as paragraph (10), and by
inserting after paragraph (8) the following:</text>
<quoted-block display-inline="no-display-inline" id="idA3AB61B82D964623A94D486C643EFEB5" style="traditional">
<paragraph id="id489ABDDEB3A2478AB4BDDD8C9FD3595D" indent="up1"><enum>(9)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="id663BBB7004694F06908BEB057CF5F637"><enum>(A)</enum><text>The Secretary may
assess a civil penalty against any employer of up to $100 a day from the date
of the employer’s failure to meet the notice requirement of section
701(f)(3)(B)(i)(I). For purposes of this subparagraph, each violation with
respect to any single employee shall be treated as a separate violation.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id99C3719752CA4A6CB920979123CFA370" indent="up1"><enum>(B)</enum><text>The Secretary may assess a civil
penalty against any plan administrator of up to $100 a day from the date of the
plan administrator’s failure to timely provide to any State the information
required to be disclosed under section 701(f)(3)(B)(ii). For purposes of this
subparagraph, each violation with respect to any single participant or
beneficiary shall be treated as a separate
violation.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</clause></subparagraph></paragraph></subsection></section></subtitle><enum>V</enum><header>Strengthening
Quality of Care and Health Outcomes of Children</header>
<section id="id17A3ACEFD4E743089C1051A9011C3C76"><enum>501.</enum><header>Child health
quality improvement activities for children enrolled in Medicaid or
CHIP</header>
<subsection id="idEECEBEED70D24B1AAF9572AF07D69129"><enum>(a)</enum><header>Development of
child health quality measures for children enrolled in medicaid or
chip</header><text>Title XI (42 U.S.C. 1301 et seq.) is amended by inserting
after section 1139 the following new section:</text>
<quoted-block display-inline="no-display-inline" id="idBD5F3668A4E0487295B2CD68BEA1E076" style="OLC">
<section id="id61A4F86280CF4CADAEE9E9FFC13770D1"><enum>1139A.</enum><header>Child health
quality measures</header>
<subsection id="id2BF66DD2EB2F430E8C1C441BA9E0C873"><enum>(a)</enum><header>Development of
an initial core set of health care quality measures for children enrolled in
medicaid or chip</header>
<paragraph id="id43471CFE7F07442E88228C8E6B210D55"><enum>(1)</enum><header>In
general</header><text>Not later than January 1, 2009, the Secretary shall
identify and publish for general comment an initial, recommended core set of
child health quality measures for use by State programs administered under
titles XIX and XXI, health insurance issuers and managed care entities that
enter into contracts with such programs, and providers of items and services
under such programs.</text>
</paragraph><paragraph id="idC38AAABFA053452587F8E89BFE8A2263"><enum>(2)</enum><header>Identification
of initial core measures</header><text>In consultation with the individuals and
entities described in subsection (b)(3), the Secretary shall identify existing
quality of care measures for children that are in use under public and
privately sponsored health care coverage arrangements, or that are part of
reporting systems that measure both the presence and duration of health
insurance coverage over time.</text>
</paragraph><paragraph id="idE5B5BD0DB9D9496381341E95D5D0CB3D"><enum>(3)</enum><header>Recommendations
and dissemination</header><text>Based on such existing and identified measures,
the Secretary shall publish an initial core set of child health quality
measures that includes (but is not limited to) the following:</text>
<subparagraph id="idB05DB68E30CA46B2B522E36650514BFB"><enum>(A)</enum><text>The duration of
children’s health insurance coverage over a 12-month time period.</text>
</subparagraph><subparagraph id="id9D24469BC3BE4D5A852D9732F05ABA7E"><enum>(B)</enum><text>The availability
of a full range of—</text>
<clause id="idDCE3085ADE93470EB48FF57D481528C6"><enum>(i)</enum><text>preventive
services, treatments, and services for acute conditions, including services to
promote healthy birth and prevent and treat premature birth; and</text>
</clause><clause id="id634E5B5A5CEF4BE69A3ED35329A27DAC"><enum>(ii)</enum><text>treatments to
correct or ameliorate the effects of chronic physical and mental conditions in
infants, young children, school-age children, and adolescents.</text>
</clause></subparagraph><subparagraph id="id1C5FDE0912A94E1BAF9310860B0AD10E"><enum>(C)</enum><text>The availability
of care in a range of ambulatory and inpatient health care settings in which
such care is furnished.</text>
</subparagraph><subparagraph id="idB353FBD7F2BE4033967FF9B1EC2852CC"><enum>(D)</enum><text>The types of
measures that, taken together, can be used to estimate the overall national
quality of health care for children and to perform comparative analyses of
pediatric health care quality and racial, ethnic, and socioeconomic disparities
in child health and health care for children.</text>
</subparagraph></paragraph><paragraph id="id29F6236C1DA24E5A945B595857901611"><enum>(4)</enum><header>Encourage
voluntary and standardized reporting</header><text>Not later than 2 years after
the date of enactment of the <short-title>Children's
Health Insurance Program Reauthorization Act of 2007</short-title>, the
Secretary, in consultation with States, shall develop a standardized format for
reporting information and procedures and approaches that encourage States to
use the initial core measurement set to voluntarily report information
regarding the quality of pediatric health care under titles XIX and XXI.</text>
</paragraph><paragraph id="idB44DF44DB8A84DA1B39D7107EDBB9A9D"><enum>(5)</enum><header>Adoption of
best practices in implementing quality programs</header><text>The Secretary
shall disseminate information to States regarding best practices among States
with respect to measuring and reporting on the quality of health care for
children, and shall facilitate the adoption of such best practices. In
developing best practices approaches, the Secretary shall give particular
attention to State measurement techniques that ensure the timeliness and
accuracy of provider reporting, encourage provider reporting compliance,
encourage successful quality improvement strategies, and improve efficiency in
data collection using health information technology.</text>
</paragraph><paragraph id="idA2EE4969F1E04D6689E6D7A9C1CAD54B"><enum>(6)</enum><header>Reports to
congress</header><text>Not later than January 1, 2010, and every 3 years
thereafter, the Secretary shall report to Congress on—</text>
<subparagraph id="idAFC651FBE236461EAC0A17F2A2A52319"><enum>(A)</enum><text>the status of the
Secretary's efforts to improve—</text>
<clause id="idEF3358D722064DC49429F05D168ABF98"><enum>(i)</enum><text>quality related
to the duration and stability of health insurance coverage for children under
titles XIX and XXI;</text>
</clause><clause id="id3AF8A7B3C209420999772F04ADD498C2"><enum>(ii)</enum><text>the quality of
children's health care under such titles, including preventive health services,
health care for acute conditions, chronic health care, and health services to
ameliorate the effects of physical and mental conditions and to aid in growth
and development of infants, young children, school-age children, and
adolescents with special health care needs; and</text>
</clause><clause id="id151E1B3A09984567B70EB9F667A11D40"><enum>(iii)</enum><text>the quality of
children’s health care under such titles across the domains of quality,
including clinical quality, health care safety, family experience with health
care, health care in the most integrated setting, and elimination of racial,
ethnic, and socioeconomic disparities in health and health care;</text>
</clause></subparagraph><subparagraph id="id9A31ED28B08D4383BC3EDD1F44E44DEA"><enum>(B)</enum><text>the status of
voluntary reporting by States under titles XIX and XXI, utilizing the initial
core quality measurement set; and</text>
</subparagraph><subparagraph commented="no" id="idAA291BA0EC54415E80D4E4F665B6DA59"><enum>(C)</enum><text>any
recommendations for legislative changes needed to improve the quality of care
provided to children under titles XIX and XXI, including recommendations for
quality reporting by States.</text>
</subparagraph></paragraph><paragraph id="id757DBEB63D0F463BACABCA8E5050C344"><enum>(7)</enum><header>Technical
assistance</header><text>The Secretary shall provide technical assistance to
States to assist them in adopting and utilizing core child health quality
measures in administering the State plans under titles XIX and XXI.</text>
</paragraph><paragraph id="idA39333BF17C448689BE6AD219AC73426"><enum>(8)</enum><header>Definition of
core set</header><text>In this section, the term <term>core set</term> means a
group of valid, reliable, and evidence-based quality measures that, taken
together—</text>
<subparagraph id="id12303A560C5541DF986BC318DE851456"><enum>(A)</enum><text>provide
information regarding the quality of health coverage and health care for
children;</text>
</subparagraph><subparagraph id="idB94AC2B1392B469B9F2F0BB8ADC89A67"><enum>(B)</enum><text>address the needs
of children throughout the developmental age span; and</text>
</subparagraph><subparagraph id="id8881184C969D41D18EAF08183F225A52"><enum>(C)</enum><text>allow purchasers,
families, and health care providers to understand the quality of care in
relation to the preventive needs of children, treatments aimed at managing and
resolving acute conditions, and diagnostic and treatment services whose purpose
is to correct or ameliorate physical, mental, or developmental conditions that
could, if untreated or poorly treated, become chronic.</text>
</subparagraph></paragraph></subsection><subsection id="idC4D4B1AB7E6442A09CE408BF41D4A98F"><enum>(b)</enum><header>Advancing and
improving pediatric quality measures</header>
<paragraph id="id95A42F15AE304566B9C5810339845B60"><enum>(1)</enum><header>Establishment
of pediatric quality measures program</header><text>Not later than January 1,
2010, the Secretary shall establish a pediatric quality measures program
to—</text>
<subparagraph id="id3EBB4AD3457D4524A76712977B031DE4"><enum>(A)</enum><text>improve and
strengthen the initial core child health care quality measures established by
the Secretary under subsection (a);</text>
</subparagraph><subparagraph id="id2D05E3EBBABF4C26BFC72E68184F5E3F"><enum>(B)</enum><text>expand on
existing pediatric quality measures used by public and private health care
purchasers and advance the development of such new and emerging quality
measures; and</text>
</subparagraph><subparagraph id="id7EA028F215B044CBA31301050666EA76"><enum>(C)</enum><text>increase the
portfolio of evidence-based, consensus pediatric quality measures available to
public and private purchasers of children's health care services, providers,
and consumers.</text>
</subparagraph></paragraph><paragraph id="id9FD4BB9FF77D43B1B89A7D0E86324742"><enum>(2)</enum><header>Evidence-based
measures</header><text>The measures developed under the pediatric quality
measures program shall, at a minimum, be—</text>
<subparagraph id="id50F7B955A20644089B5DBF2A91D0D1FA"><enum>(A)</enum><text>evidence-based
and, where appropriate, risk adjusted;</text>
</subparagraph><subparagraph id="id22DAD5D084804CAFBB8F7959449B8379"><enum>(B)</enum><text>designed to
identify and eliminate racial and ethnic disparities in child health and the
provision of health care;</text>
</subparagraph><subparagraph id="id788E1F24F251415B875AC548C76E5AA4"><enum>(C)</enum><text>designed to
ensure that the data required for such measures is collected and reported in a
standard format that permits comparison of quality and data at a State, plan,
and provider level;</text>
</subparagraph><subparagraph id="id14275AD4CB4A41FD8F0E7739508F64FC"><enum>(D)</enum><text>periodically
updated; and</text>
</subparagraph><subparagraph id="id0A175EE7999042B086CC7F6D65693A19"><enum>(E)</enum><text>responsive to the
child health needs, services, and domains of health care quality described in
clauses (i), (ii), and (iii) of subsection (a)(6)(A).</text>
</subparagraph></paragraph><paragraph id="idF02BFE6775024138B7FAB89649CD113B"><enum>(3)</enum><header>Process for
pediatric quality measures program</header><text>In identifying gaps in
existing pediatric quality measures and establishing priorities for development
and advancement of such measures, the Secretary shall consult with—</text>
<subparagraph id="id261BF6CC2D1C4F8591C7FCA93B842B4C"><enum>(A)</enum><text>States;</text>
</subparagraph><subparagraph id="id051DC44F3523469D93F336DE4CFD39FD"><enum>(B)</enum><text>pediatricians,
children's hospitals, and other primary and specialized pediatric health care
professionals (including members of the allied health professions) who
specialize in the care and treatment of children, particularly children with
special physical, mental, and developmental health care needs;</text>
</subparagraph><subparagraph id="id06B58656049B4E4099F198CCED23F83F"><enum>(C)</enum><text>dental
professionals, including pediatric dental professionals;</text>
</subparagraph><subparagraph id="id5689EB250FCC4F3B8A744CA3ABCE25C8"><enum>(D)</enum><text>health care
providers that furnish primary health care to children and families who live in
urban and rural medically underserved communities or who are members of
distinct population sub-groups at heightened risk for poor health
outcomes;</text>
</subparagraph><subparagraph id="idCDA2199F724D429FA175542260D9E899"><enum>(E)</enum><text>national
organizations representing consumers and purchasers of children’s health
care;</text>
</subparagraph><subparagraph id="id75A238A135B2430699307B45434488AA"><enum>(F)</enum><text>national
organizations and individuals with expertise in pediatric health quality
measurement; and</text>
</subparagraph><subparagraph id="id276BCCDF54294F24ADF9D0B4714C9DEA"><enum>(G)</enum><text>voluntary
consensus standards setting organizations and other organizations involved in
the advancement of evidence-based measures of health care.</text>
</subparagraph></paragraph><paragraph id="idDF8F435447034E8FAD6A53AF2F0C1B31"><enum>(4)</enum><header>Developing,
validating, and testing a portfolio of pediatric quality
measures</header><text>As part of the program to advance pediatric quality
measures, the Secretary shall—</text>
<subparagraph id="id79D0627319CB4E48A2A73F5E5BDB4E8F"><enum>(A)</enum><text>award grants and
contracts for the development, testing, and validation of new, emerging, and
innovative evidence-based measures for children’s health care services across
the domains of quality described in clauses (i),(ii), and (iii) of subsection
(a)(6)(A); and</text>
</subparagraph><subparagraph id="id26771A8389F24965B63DA39BD6057FEB"><enum>(B)</enum><text>award grants and
contracts for—</text>
<clause id="idA16D9B5D585A4BD7AFFA1065B1C5121D"><enum>(i)</enum><text>the development
of consensus on evidence-based measures for children’s health care
services;</text>
</clause><clause id="idB1ACE3A93EEE4FE08DDF7AE51FFD226D"><enum>(ii)</enum><text>the
dissemination of such measures to public and private purchasers of health care
for children; and</text>
</clause><clause id="id0E561F3AA22645E6BB2E68E631CA62F3"><enum>(iii)</enum><text>the updating of
such measures as necessary.</text>
</clause></subparagraph></paragraph><paragraph id="id0E0AF91C847947AE96615B73D8898E88"><enum>(5)</enum><header>Revising,
strengthening, and improving initial core measures</header><text>Beginning no
later than January 1, 2012, and annually thereafter, the Secretary shall
publish recommended changes to the core measures described in subsection (a)
that shall reflect the testing, validation, and consensus process for the
development of pediatric quality measures described in subsection paragraphs
(1) through (4).</text>
</paragraph><paragraph id="id3D0AB50B36FA4D9E9E82507D4CC12679"><enum>(6)</enum><header>Definition of
pediatric quality measure</header><text>In this subsection, the term
<term>pediatric quality measure</term> means a measurement of clinical care
that is capable of being examined through the collection and analysis of
relevant information, that is developed in order to assess 1 or more aspects of
pediatric health care quality in various institutional and ambulatory health
care settings, including the structure of the clinical care system, the process
of care, the outcome of care, or patient experiences in care.</text>
</paragraph></subsection><subsection id="id8ED02171B8244F2AA04154E71A09CEA4"><enum>(c)</enum><header>Annual state
reports regarding state-specific quality of care measures applied under
medicaid or chip</header>
<paragraph id="idE833919D81274C12964A1C9AADBE831A"><enum>(1)</enum><header>Annual state
reports</header><text>Each State with a State plan approved under title XIX or
a State child health plan approved under title XXI shall annually report to the
Secretary on the—</text>
<subparagraph id="id2B4E118669744957BF2E7CC55B60B462"><enum>(A)</enum><text>State-specific
child health quality measures applied by the States under such plans, including
measures described in subparagraphs (A) and (B) of subsection (a)(6);
and</text>
</subparagraph><subparagraph id="idA44DA9D9C2D44D548FA00E00C7EFD687"><enum>(B)</enum><text>State-specific
information on the quality of health care furnished to children under such
plans, including information collected through external quality reviews of
managed care organizations under section 1932 of the Social Security Act (42
U.S.C. 1396u–4) and benchmark plans under sections 1937 and 2103 of such Act
(42 U.S.C. 1396u–7, 1397cc).</text>
</subparagraph></paragraph><paragraph id="id7C56B915A76141788FC948FDC5E382F1"><enum>(2)</enum><header>Publication</header><text>Not
later than September 30, 2009, and annually thereafter, the Secretary shall
collect, analyze, and make publicly available the information reported by
States under paragraph (1).</text>
</paragraph></subsection><subsection id="id3E7BFB39E9FA40DEB4F866947D9892F3"><enum>(d)</enum><header>Demonstration
projects for improving the quality of children's health care and the use of
health information technology</header>
<paragraph id="id664DA87CB7BA461EB9F4FFDB1B740D78"><enum>(1)</enum><header>In
general</header><text>During the period of fiscal years 2008 through 2012, the
Secretary shall award not more than 10 grants to States and child health
providers to conduct demonstration projects to evaluate promising ideas for
improving the quality of children's health care provided under title XIX or
XXI, including projects to—</text>
<subparagraph id="idAB45D29179754155BF6506CF026ACAA7"><enum>(A)</enum><text>experiment with,
and evaluate the use of, new measures of the quality of children's health care
under such titles (including testing the validity and suitability for reporting
of such measures);</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idE05CB90EC7134DA386DD14903D3A7535"><enum>(B)</enum><text>promote the use
of health information technology in care delivery for children under such
titles;</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idF8B8BEC737004B51BC51FDA6AF2B10BB"><enum>(C)</enum><text>evaluate
provider-based models which improve the delivery of children's health care
services under such titles, including care management for children with chronic
conditions and the use of evidence-based approaches to improve the
effectiveness, safety, and efficiency of health care services for children;
or</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id6E838A676BCD495DAE4DCF3A4665BEB2"><enum>(D)</enum><text>demonstrate the
impact of the model electronic health record format for children developed and
disseminated under subsection (f) on improving pediatric health, including the
effects of chronic childhood health conditions, and pediatric health care
quality as well as reducing health care costs.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id41FEA231821540B6A6BBCC74318343B1"><enum>(2)</enum><header>Requirements</header><text>In
awarding grants under this subsection, the Secretary shall ensure that—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="id3867339DD4E04A8BAD7240968C6EA718"><enum>(A)</enum><text>only 1
demonstration project funded under a grant awarded under this subsection shall
be conducted in a State; and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id080BB6EA528A46E2B1520215F4D5E64E"><enum>(B)</enum><text>demonstration
projects funded under grants awarded under this subsection shall be conducted
evenly between States with large urban areas and States with large rural
areas.</text>
</subparagraph></paragraph><paragraph id="id503CB2E7AB8A49649233A4AF150005D6"><enum>(3)</enum><header>Authority for
multistate projects</header><text>A demonstration project conducted with a
grant awarded under this subsection may be conducted on a multistate basis, as
needed.</text>
</paragraph><paragraph id="id05F85B247068485B8B51A1427CA0A739"><enum>(4)</enum><header>Funding</header><text>$20,000,000
of the amount appropriated under subsection (i) for a fiscal year shall be used
to carry out this subsection.</text>
</paragraph></subsection><subsection id="id5E68C4FDBD024B93A3392E63E278D893"><enum>(e)</enum><header>Childhood
obesity demonstration project</header>
<paragraph id="id000CD3EFC7F249FDA6F2B99CCEFD684D"><enum>(1)</enum><header>Authority To
conduct demonstration</header><text>The Secretary, in consultation with the
Administrator of the Centers for Medicare & Medicaid Services, shall
conduct a demonstration project to develop a comprehensive and systematic model
for reducing childhood obesity by awarding grants to eligible entities to carry
out such project. Such model shall—</text>
<subparagraph id="idF7193B9584864E8A9E0BC4F38011F170"><enum>(A)</enum><text>identify, through
self-assessment, behavioral risk factors for obesity among children;</text>
</subparagraph><subparagraph id="id1A0CFA09AF0B49D4B665DB4FD7F9C1B4"><enum>(B)</enum><text>identify, through
self-assessment, needed clinical preventive and screening benefits among those
children identified as target individuals on the basis of such risk
factors;</text>
</subparagraph><subparagraph id="id2DA8BED75BC64FB0BEEA3D234308B09E"><enum>(C)</enum><text>provide ongoing
support to such target individuals and their families to reduce risk factors
and promote the appropriate use of preventive and screening benefits;
and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id83EF7BD8487E438399BEFA9C2F3AABF6"><enum>(D)</enum><text>be designed to
improve health outcomes, satisfaction, quality of life, and appropriate use of
items and services for which medical assistance is available under title XIX or
child health assistance is available under title XXI among such target
individuals.</text>
</subparagraph></paragraph><paragraph id="id7601458D0C504310B42CC25CF9933734"><enum>(2)</enum><header>Eligibility
entities</header><text>For purposes of this subsection, an eligible entity is
any of the following:</text>
<subparagraph id="idB881A75B8FF84F1F82692FC6551FDE08"><enum>(A)</enum><text>A city, county,
or Indian tribe.</text>
</subparagraph><subparagraph id="id9D40A658F9C74F96A695EB41858690DE"><enum>(B)</enum><text>A local or tribal
educational agency.</text>
</subparagraph><subparagraph id="id46582DF480DF4E63B27B19784ED184DE"><enum>(C)</enum><text>An accredited
university, college, or community college.</text>
</subparagraph><subparagraph id="id4B473F94C47F4C04B6C8D52CFC4EFAE2"><enum>(D)</enum><text>A
Federally-qualified health center.</text>
</subparagraph><subparagraph id="id373A254398D74164B8B7BE728DC4E8D5"><enum>(E)</enum><text>A local health
department.</text>
</subparagraph><subparagraph id="id9A9EA243355F408FB89416AADB6D97F0"><enum>(F)</enum><text>A health care
provider.</text>
</subparagraph><subparagraph id="id2DC977B4DD8244448795D4608012CFB0"><enum>(G)</enum><text>A community-based
organization.</text>
</subparagraph><subparagraph id="idAD9049145345454499BD7437E36DEF72"><enum>(H)</enum><text>Any other entity
determined appropriate by the Secretary, including a consortia or partnership
of entities described in any of subparagraphs (A) through (G).</text>
</subparagraph></paragraph><paragraph id="id8390F9195D114EE082E700AA103B851F"><enum>(3)</enum><header>Use of
funds</header><text>An eligible entity awarded a grant under this subsection
shall use the funds made available under the grant to—</text>
<subparagraph id="idC8D9330462844141947DC36F70AE93A8"><enum>(A)</enum><text>carry out
community-based activities related to reducing childhood obesity, including
by—</text>
<clause id="id663C11F53E9D4A5F822A5E1E9D718E9D"><enum>(i)</enum><text>forming
partnerships with entities, including schools and other facilities providing
recreational services, to establish programs for after school and weekend
community activities that are designed to reduce childhood obesity;</text>
</clause><clause id="idC758B071544642ED8E98406D5CE23E37"><enum>(ii)</enum><text>forming
partnerships with daycare facilities to establish programs that promote healthy
eating behaviors and physical activity; and</text>
</clause><clause id="idD5D3CA4D20C540B481188E33613AAE0C"><enum>(iii)</enum><text>developing and
evaluating community educational activities targeting good nutrition and
promoting healthy eating behaviors;</text>
</clause></subparagraph><subparagraph id="id14E61C463F0F46A0AC378D5618737602"><enum>(B)</enum><text>carry out
age-appropriate school-based activities that are designed to reduce childhood
obesity, including by—</text>
<clause id="id44E0AF97ECEA4DA1BDB74940FF5DA2F2"><enum>(i)</enum><text>developing and
testing educational curricula and intervention programs designed to promote
healthy eating behaviors and habits in youth, which may include—</text>
<subclause id="id311FA2FC87FD40889999A9B2CF358449"><enum>(I)</enum><text>after hours
physical activity programs; and</text>
</subclause><subclause id="idAA36D766108047BCA25076F71F086445"><enum>(II)</enum><text>science-based
interventions with multiple components to prevent eating disorders including
nutritional content, understanding and responding to hunger and satiety,
positive body image development, positive self-esteem development, and learning
life skills (such as stress management, communication skills, problemsolving
and decisionmaking skills), as well as consideration of cultural and
developmental issues, and the role of family, school, and community;</text>
</subclause></clause><clause id="idE397FFAB76B54E6B83AC51559D17B41E"><enum>(ii)</enum><text>providing
education and training to educational professionals regarding how to promote a
healthy lifestyle and a healthy school environment for children;</text>
</clause><clause id="id82D30253AA9540F88491348F36D6FE26"><enum>(iii)</enum><text>planning and
implementing a healthy lifestyle curriculum or program with an emphasis on
healthy eating behaviors and physical activity; and</text>
</clause><clause id="idAC6D5CCA6F734CC784AAB6925D547588"><enum>(iv)</enum><text>planning and
implementing healthy lifestyle classes or programs for parents or guardians,
with an emphasis on healthy eating behaviors and physical activity for
children;</text>
</clause></subparagraph><subparagraph id="id8AB7EE05FCF6419BAA60AF7E1AF0BFC1"><enum>(C)</enum><text>carry out
educational, counseling, promotional, and training activities through the local
health care delivery systems including by—</text>
<clause id="id35705F5763DF4E48B13FD137F99AD7CA"><enum>(i)</enum><text>promoting healthy
eating behaviors and physical activity services to treat or prevent eating
disorders, being overweight, and obesity;</text>
</clause><clause id="idFB4D0DD303D44D0DB9A36BA609709BB9"><enum>(ii)</enum><text>providing
patient education and counseling to increase physical activity and promote
healthy eating behaviors;</text>
</clause><clause id="id6A8C50D5159C41EBB969370985EB14B9"><enum>(iii)</enum><text>training health
professionals on how to identify and treat obese and overweight individuals
which may include nutrition and physical activity counseling; and</text>
</clause><clause id="id77C9CAC4472A4AE3AC8530A0C7986AF7"><enum>(iv)</enum><text>providing
community education by a health professional on good nutrition and physical
activity to develop a better understanding of the relationship between diet,
physical activity, and eating disorders, obesity, or being overweight;
and</text>
</clause></subparagraph><subparagraph id="id033D0BDFB67D4CFB8D27A631391C9C17"><enum>(D)</enum><text>provide, through
qualified health professionals, training and supervision for community health
workers to—</text>
<clause id="id55FA2ABE46F14528B561062C9C7DE958"><enum>(i)</enum><text>educate families
regarding the relationship between nutrition, eating habits, physical activity,
and obesity;</text>
</clause><clause id="id9840215D9E4944698579233B595BB04A"><enum>(ii)</enum><text>educate families
about effective strategies to improve nutrition, establish healthy eating
patterns, and establish appropriate levels of physical activity; and</text>
</clause><clause id="id76420E233B0945C295ABF23AF75ACE4B"><enum>(iii)</enum><text>educate and
guide parents regarding the ability to model and communicate positive health
behaviors.</text>
</clause></subparagraph></paragraph><paragraph id="id3BD2FCC676A843048A2122039515D6EF"><enum>(4)</enum><header>Priority</header><text>In
awarding grants under paragraph (1), the Secretary shall give priority to
awarding grants to eligible entities—</text>
<subparagraph id="id7C17DE42FBCB494ABBA65F3F135D84F8"><enum>(A)</enum><text>that demonstrate
that they have previously applied successfully for funds to carry out
activities that seek to promote individual and community health and to prevent
the incidence of chronic disease and that can cite published and peer-reviewed
research demonstrating that the activities that the entities propose to carry
out with funds made available under the grant are effective;</text>
</subparagraph><subparagraph id="id92E1CBC2D3C7421DB648CE17E96A603C"><enum>(B)</enum><text>that will carry
out programs or activities that seek to accomplish a goal or goals set by the
State in the Healthy People 2010 plan of the State;</text>
</subparagraph><subparagraph id="idF475B52D824E459FB461D9F054368B59"><enum>(C)</enum><text>that provide
non-Federal contributions, either in cash or in-kind, to the costs of funding
activities under the grants;</text>
</subparagraph><subparagraph id="id736B7E112CE24AFD9A36086EA78446EC"><enum>(D)</enum><text>that develop
comprehensive plans that include a strategy for extending program activities
developed under grants in the years following the fiscal years for which they
receive grants under this subsection;</text>
</subparagraph><subparagraph id="idDC6A4A5361EA46CDBF76DDCF80A2395E"><enum>(E)</enum><text>located in
communities that are medically underserved, as determined by the
Secretary;</text>
</subparagraph><subparagraph id="id83E6CEF2236A416D840D7521DA9B3413"><enum>(F)</enum><text>located in areas
in which the average poverty rate is at least 150 percent or higher of the
average poverty rate in the State involved, as determined by the Secretary;
and</text>
</subparagraph><subparagraph id="idC43AE77D82474D53885208D5721791CD"><enum>(G)</enum><text>that submit plans
that exhibit multisectoral, cooperative conduct that includes the involvement
of a broad range of stakeholders, including—</text>
<clause id="idBA32D051E47F4BC3A22D794694790D5E"><enum>(i)</enum><text>community-based
organizations;</text>
</clause><clause id="idE68E443C87FA4DDAB5F32B5C2E697A0F"><enum>(ii)</enum><text>local
governments;</text>
</clause><clause id="id4486DBDF5F574FD68EA98664215C5F24"><enum>(iii)</enum><text>local
educational agencies;</text>
</clause><clause id="id27DA5F06F2BA4F0F80D4035AA1BBD0EA"><enum>(iv)</enum><text>the private
sector;</text>
</clause><clause id="idD7696BB4CDD74683812C46163122B2AA"><enum>(v)</enum><text>State or local
departments of health;</text>
</clause><clause id="idCF01620387274C59B97063BECD3A90FA"><enum>(vi)</enum><text>accredited
colleges, universities, and community colleges;</text>
</clause><clause id="idB03B990E43054C1EBF1C3302B4ED87C8"><enum>(vii)</enum><text>health care
providers;</text>
</clause><clause id="id7AB5EDA9F81B41D2AB4C454011CDD049"><enum>(viii)</enum><text>State and
local departments of transportation and city planning; and</text>
</clause><clause id="id41B96756CE494FC49251FA4A55A3606E"><enum>(ix)</enum><text>other entities
determined appropriate by the Secretary.</text>
</clause></subparagraph></paragraph><paragraph id="idDF002C751659481F9C2BF0D1EF256E5E"><enum>(5)</enum><header>Program
design</header>
<subparagraph id="id3223914175DF497E9CEE7F223E0C700D"><enum>(A)</enum><header>Initial
design</header><text>Not later than 1 year after the date of enactment of the
<short-title>Children's Health Insurance Program
Reauthorization Act of 2007</short-title>, the Secretary shall design the
demonstration project. The demonstration should draw upon promising, innovative
models and incentives to reduce behavioral risk factors. The Administrator of
the Centers for Medicare & Medicaid Services shall consult with the
Director of the Centers for Disease Control and Prevention, the Director of the
Office of Minority Health, the heads of other agencies in the Department of
Health and Human Services, and such professional organizations, as the
Secretary determines to be appropriate, on the design, conduct, and evaluation
of the demonstration.</text>
</subparagraph><subparagraph id="idBAC34E1FBB1C42BF9AC862E7992D7570"><enum>(B)</enum><header>Number and
project areas</header><text>Not later than 2 years after the date of enactment
of the <short-title>Children's Health Insurance Program
Reauthorization Act of 2007</short-title>, the Secretary shall award 1 grant
that is specifically designed to determine whether programs similar to programs
to be conducted by other grantees under this subsection should be implemented
with respect to the general population of children who are eligible for child
health assistance under State child health plans under title XXI in order to
reduce the incidence of childhood obesity among such population.</text>
</subparagraph></paragraph><paragraph id="idEA3958EDA2EF4DF2923AE806E94FCE3E"><enum>(6)</enum><header>Report to
congress</header><text>Not later than 3 years after the date the Secretary
implements the demonstration project under this subsection, the Secretary shall
submit to Congress a report that describes the project, evaluates the
effectiveness and cost effectiveness of the project, evaluates the beneficiary
satisfaction under the project, and includes any such other information as the
Secretary determines to be appropriate.</text>
</paragraph><paragraph id="id13B4A0FFCF9E425992C37912148F48D7"><enum>(7)</enum><header>Definitions</header><text>In
this subsection:</text>
<subparagraph id="id801EDED160884E7E9931DD8866015FE9"><enum>(A)</enum><header>Federally-qualified
health center</header><text>The term <term>Federally-qualified health
center</term> has the meaning given that term in section 1905(l)(2)(B).</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id71CE261D49D6426E9BB9478452BBA064"><enum>(B)</enum><header>Indian
tribe</header><text>The term <term>Indian tribe</term> has the meaning given
that term in section 4 of the Indian Health Care Improvement Act (25 U.S.C.
1603).</text>
</subparagraph><subparagraph id="id5FC4013701B84662A259B701664F1305"><enum>(C)</enum><header>Self-assessment</header><text>The
term <term>self-assessment</term> means a form that—</text>
<clause id="idB63A21EC8C804CC18BA7782499888907"><enum>(i)</enum><text>includes
questions regarding—</text>
<subclause id="id48877BFA402849D0A42B0EB9406C2636"><enum>(I)</enum><text>behavioral risk
factors;</text>
</subclause><subclause id="id37D5C05E98A94171A8054DC5570F2E7A"><enum>(II)</enum><text>needed
preventive and screening services; and</text>
</subclause><subclause id="id047B13E6C311476AB8F10811D51D3E8C"><enum>(III)</enum><text>target
individuals' preferences for receiving follow-up information;</text>
</subclause></clause><clause id="id3CCFEF02C84546C49C4364F75D06CAF7"><enum>(ii)</enum><text>is assessed
using such computer generated assessment programs; and</text>
</clause><clause id="idBA34AE1B4253430393E9CDF73AFBD1F7"><enum>(iii)</enum><text>allows for the
provision of such ongoing support to the individual as the Secretary determines
appropriate.</text>
</clause></subparagraph><subparagraph id="id073D196577E54947BFBB15496733319E"><enum>(D)</enum><header>Ongoing
support</header><text>The term <term>ongoing support</term> means—</text>
<clause id="id9919DFFCA2A64AF28582DCCC88CE6F3C"><enum>(i)</enum><text>to provide any
target individual with information, feedback, health coaching, and
recommendations regarding—</text>
<subclause id="id2ED93BE0D3DB4FF5A3EF886B1CB600C3"><enum>(I)</enum><text>the results of a
self-assessment given to the individual;</text>
</subclause><subclause id="id44D8A12AC2D24EB09DA4D56F2453BD1C"><enum>(II)</enum><text>behavior
modification based on the self-assessment; and</text>
</subclause><subclause id="id282AC376398B4B759FCB40D1D495E654"><enum>(III)</enum><text>any need for
clinical preventive and screening services or treatment including medical
nutrition therapy;</text>
</subclause></clause><clause id="id7306FCCA00BB46FCA4874421778CB3A7"><enum>(ii)</enum><text>to provide any
target individual with referrals to community resources and programs available
to assist the target individual in reducing health risks; and</text>
</clause><clause id="id9FB14A1282B5478C86C046ACF22B69F5"><enum>(iii)</enum><text>to provide the
information described in clause (i) to a health care provider, if designated by
the target individual to receive such information.</text>
</clause></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idE4BB0615B8DD44E896BCFA289E8AC337"><enum>(8)</enum><header>Authorization
of appropriations</header><text>There is authorized to be appropriated to carry
out this subsection, $25,000,000 for the period of fiscal years 2008 through
2012.</text>
</paragraph></subsection><subsection id="id62B8E80192654572824473B17CD86E05"><enum>(f)</enum><header>Development of
model electronic health record format for children enrolled in Medicaid or
CHIP</header>
<paragraph id="idFA4CB95407E449D8BF19A0EA8EBE19BE"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">Not later than
January 1, 2009, the Secretary shall establish a program to encourage the
development and dissemination of a model electronic health record format for
children enrolled in the State plan under title XIX or the State child health
plan under title XXI that is—</text>
<subparagraph id="idB1EB51125D0C44F1955D1F70EC761142"><enum>(A)</enum><text display-inline="yes-display-inline">subject to State laws, accessible to
parents, caregivers, and other consumers for the sole purpose of demonstrating
compliance with school or leisure activity requirements, such as appropriate
immunizations or physicals;</text>
</subparagraph><subparagraph id="id0C360C99D7E5453AAC04E80278B2D17A"><enum>(B)</enum><text display-inline="yes-display-inline">designed to allow interoperable exchanges
that conform with Federal and State privacy and security requirements;</text>
</subparagraph><subparagraph id="id1A2F0287F93B48D2954DF83CFA5ACC65"><enum>(C)</enum><text>structured in a
manner that permits parents and caregivers to view and understand the extent to
which the care their children receive is clinically appropriate and of high
quality; and</text>
</subparagraph><subparagraph id="idCC1E8C71FA694CF395F0422574DA8C9C"><enum>(D)</enum><text>capable of being
incorporated into, and otherwise compatible with, other standards developed for
electronic health records.</text>
</subparagraph></paragraph><paragraph id="id65D3FAA88FE74008BAADE8F4BCDF30DA"><enum>(2)</enum><header>Funding</header><text>$5,000,000
of the amount appropriated under subsection (i) for a fiscal year shall be used
to carry out this subsection.</text>
</paragraph></subsection><subsection id="id5BA17FF7F9334FBDA43DA4E251CC5D7B"><enum>(g)</enum><header>Study of
pediatric health and health care quality measures</header>
<paragraph id="id0F4FC5078A3E4F90AB14ECE84F7B15F6"><enum>(1)</enum><header>In
general</header><text>Not later than July 1, 2009, the Institute of Medicine
shall study and report to Congress on the extent and quality of efforts to
measure child health status and the quality of health care for children across
the age span and in relation to preventive care, treatments for acute
conditions, and treatments aimed at ameliorating or correcting physical,
mental, and developmental conditions in children. In conducting such study and
preparing such report, the Institute of Medicine shall—</text>
<subparagraph id="idA3D9F7DF96794A20A3163EEDAA9E76D9"><enum>(A)</enum><text>consider all of
the major national population-based reporting systems sponsored by the Federal
Government that are currently in place, including reporting requirements under
Federal grant programs and national population surveys and estimates conducted
directly by the Federal Government;</text>
</subparagraph><subparagraph id="id4E31F34D7BAE472F85479880305B67B8"><enum>(B)</enum><text>identify the
information regarding child health and health care quality that each system is
designed to capture and generate, the study and reporting periods covered by
each system, and the extent to which the information so generated is made
widely available through publication;</text>
</subparagraph><subparagraph id="idCB347F695E3949B68FBF57D9C9F465BA"><enum>(C)</enum><text>identify gaps in
knowledge related to children’s health status, health disparities among
subgroups of children, the effects of social conditions on children’s health
status and use and effectiveness of health care, and the relationship between
child health status and family income, family stability and preservation, and
children’s school readiness and educational achievement and attainment;
and</text>
</subparagraph><subparagraph id="id44FFD03DDF2B4539810288428E8E57AF"><enum>(D)</enum><text>make
recommendations regarding improving and strengthening the timeliness, quality,
and public transparency and accessibility of information about child health and
health care quality.</text>
</subparagraph></paragraph><paragraph id="id4678E694340948DBA074DFFBB97F7D6E"><enum>(2)</enum><header>Funding</header><text>Up
to $1,000,000 of the amount appropriated under subsection (i) for a fiscal year
shall be used to carry out this subsection.</text>
</paragraph></subsection><subsection id="id753834668532442B95D69E02528097EB"><enum>(h)</enum><header>Rule of
construction</header><text>Notwithstanding any other provision in this section,
no evidence based quality measure developed, published, or used as a basis of
measurement or reporting under this section may be used to establish an
irrebuttable presumption regarding either the medical necessity of care or the
maximum permissible coverage for any individual child who is eligible for and
receiving medical assistance under title XIX or child health assistance under
title XXI .</text>
</subsection><subsection id="id5162D5B90B324F83BFA37E1A171F4899"><enum>(i)</enum><header>Appropriation</header><text>Out
of any funds in the Treasury not otherwise appropriated, there is appropriated
for each of fiscal years 2008 through 2012, $45,000,000 for the purpose of
carrying out this section (other than subsection (e)). Funds appropriated under
this subsection shall remain available until
expended.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection commented="no" id="id4E48F195F93D46DCB9ED5FF523450152"><enum>(b)</enum><header>Increased
matching rate for collecting and reporting on child health
measures</header><text display-inline="yes-display-inline">Section
1903(a)(3)(A) (42 U.S.C. 1396b(a)(3)(A)), is amended—</text>
<paragraph commented="no" id="idE0DAAEC2C19644C1942C7DEF10DD8D7A"><enum>(1)</enum><text>by striking
<quote>and</quote> at the end of clause (i); and</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id0832E2BFF7C549F5A68132B75EBD6EDB"><enum>(2)</enum><text>by adding at the
end the following new clause:</text>
<quoted-block display-inline="no-display-inline" id="idDFBD377C851741059DD0605C1C47CBB2" style="OLC">
<clause commented="no" display-inline="no-display-inline" id="idD2C084E024EB4C98B5BF2A8F1FFC11CE" indent="up1"><enum>(iii)</enum><text>an amount equal to the Federal
medical assistance percentage (as defined in section 1905(b)) of so much of the
sums expended during such quarter (as found necessary by the Secretary for the
proper and efficient administration of the State plan) as are attributable to
such developments or modifications of systems of the type described in clause
(i) as are necessary for the efficient collection and reporting on child health
measures;
and</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section><section commented="no" id="idA78626037EB144239527DE7B81E4ECDB"><enum>502.</enum><header>Improved
information regarding access to coverage under CHIP</header>
<subsection commented="no" id="idD670058A5C1E4C9690B66FEC0938A221"><enum>(a)</enum><header>Inclusion of
process and access measures in annual state reports</header><text display-inline="yes-display-inline">Section 2108 (42 U.S.C. 1397hh) is
amended—</text>
<paragraph commented="no" id="id1D5626C2055B49648A638C2AFC5F1277"><enum>(1)</enum><text>in subsection
(a), in the matter preceding paragraph (1), by striking <quote>The
State</quote> and inserting <quote>Subject to subsection (e), the
State</quote>; and</text>
</paragraph><paragraph commented="no" id="id8395DB0A6BC744F880A80D0DF989D6A1"><enum>(2)</enum><text>by adding at the
end the following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="id5E5C93D12AFF468C970478D9FB81A212" style="OLC">
<subsection commented="no" id="id9D1194D0361F45A09EC1A6720832CC0A"><enum>(e)</enum><header>Information
required for inclusion in state annual report</header><text>The State shall
include the following information in the annual report required under
subsection (a):</text>
<paragraph commented="no" id="id97C62663D9DA4D4B8561C6F533B1D091"><enum>(1)</enum><text>Eligibility
criteria, enrollment, and retention data (including data with respect to
continuity of coverage or duration of benefits).</text>
</paragraph><paragraph commented="no" id="id3DE0AABF42A044C0A386EA52A1F1D561"><enum>(2)</enum><text>Data regarding
the extent to which the State uses process measures with respect to determining
the eligibility of children under the State child health plan, including
measures such as 12-month continuous eligibility, self-declaration of income
for applications or renewals, or presumptive eligibility.</text>
</paragraph><paragraph commented="no" id="id237368AA7FA44FCB9F1199DADB89A645"><enum>(3)</enum><text>Data regarding
denials of eligibility and redeterminations of eligibility.</text>
</paragraph><paragraph commented="no" id="id5509CB8D7BF94BC48CB6F593B93C7B7E"><enum>(4)</enum><text>Data regarding
access to primary and specialty services, access to networks of care, and care
coordination provided under the State child health plan, using quality care and
consumer satisfaction measures included in the Consumer Assessment of
Healthcare Providers and Systems (CAHPS) survey.</text>
</paragraph><paragraph commented="no" id="id4863ACA7FBF24C30A4B5EAEDC04DA810"><enum>(5)</enum><text>If the State
provides child health assistance in the form of premium assistance for the
purchase of coverage under a group health plan, data regarding the provision of
such assistance, including the extent to which employer-sponsored health
insurance coverage is available for children eligible for child health
assistance under the State child health plan, the range of the monthly amount
of such assistance provided on behalf of a child or family, the number of
children or families provided such assistance on a monthly basis, the income of
the children or families provided such assistance, the benefits and
cost-sharing protection provided under the State child health plan to
supplement the coverage purchased with such premium assistance, the effective
strategies the State engages in to reduce any administrative barriers to the
provision of such assistance, and, the effects, if any, of the provision of
such assistance on preventing the coverage provided under the State child
health plan from substituting for coverage provided under employer-sponsored
health insurance offered in the State.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id8453BDED21F14AAA8A10E26011E6F2A6"><enum>(6)</enum><text display-inline="yes-display-inline">To the extent applicable, a description of
any State activities that are designed to reduce the number of uncovered
children in the State, including through a State health insurance connector
program or support for innovative private health coverage
initiatives.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" id="id7F40943B6C544E418AEBE1637B2B14B2"><enum>(b)</enum><header>GAO study and
report on access to primary and speciality services</header>
<paragraph commented="no" id="id73EA913D42574723B5DF0B6FDDFD41A7"><enum>(1)</enum><header>In
general</header><text>The Comptroller General of the United States shall
conduct a study of children’s access to primary and specialty services under
Medicaid and CHIP, including—</text>
<subparagraph commented="no" id="id5A8CCB0BA10F45F288ECC14826481F91"><enum>(A)</enum><text>the extent to
which providers are willing to treat children eligible for such
programs;</text>
</subparagraph><subparagraph commented="no" id="id569983B5259F4CC782BF21F62AE2A33F"><enum>(B)</enum><text>information on
such children's access to networks of care;</text>
</subparagraph><subparagraph commented="no" id="id9620117697964D50851C04741308DC60"><enum>(C)</enum><text>geographic
availability of primary and specialty services under such programs;</text>
</subparagraph><subparagraph commented="no" id="idF476E2FFF8074F2F8236CA5B12DE0784"><enum>(D)</enum><text>the extent to
which care coordination is provided for children’s care under Medicaid and
CHIP; and</text>
</subparagraph><subparagraph commented="no" id="idDDF69858178345C6A4C4CF985F3214B4"><enum>(E)</enum><text>as appropriate,
information on the degree of availability of services for children under such
programs.</text>
</subparagraph></paragraph><paragraph commented="no" id="id0A5911610C99408DB15472D43E620976"><enum>(2)</enum><header>Report</header><text>Not
later than 2 years after the date of enactment of this Act, the Comptroller
General shall submit a report to the appropriate committees of Congress on the
study conducted under paragraph (1) that includes recommendations for such
Federal and State legislative and administrative changes as the Comptroller
General determines are necessary to address any barriers to access to
children's care under Medicaid and CHIP that may exist.</text>
</paragraph></subsection></section><section commented="no" id="id0A31971A168746EEB0FF43C903752EB6"><enum>503.</enum><header>Application of
certain managed care quality safeguards to CHIP</header><text display-inline="no-display-inline">Section 2107(e)(1) (42 U.S.C. 1397gg(e)(1)),
as amended by section 204(b), is amended by redesignating subparagraph (E) (as
added by such section) as subparagraph (F) and by inserting after subparagraph
(D) the following new subparagraph:</text>
<quoted-block id="id2321E101E9A04ADFA202693F598141BE">
<subparagraph commented="no" id="idAC1331BD87294D79AF5537077180ECEA"><enum>(E)</enum><text>Subsections
(a)(4), (a)(5), (b), (c), (d), and (e) of section 1932 (relating to
requirements for managed
care).</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</section><enum>VI</enum><header>Miscellaneous</header>
<section id="id82F1C100DEEF4EB8B370892B2ABA3B6D"><enum>601.</enum><header>Technical
correction regarding current State authority under Medicaid</header>
<subsection id="idFDEACBF5DA3B4BD2BFE31FA1E0CE4F7A"><enum>(a)</enum><header>In
general</header><text>Only with respect to expenditures for medical assistance
under a State Medicaid plan, including any waiver of such plan, for fiscal
years 2007 and 2008, a State may elect, notwithstanding the fourth sentence of
subsection (b) of section 1905 of the Social Security Act (42 U.S.C. 1396d) or
subsection (u) of such section—</text>
<paragraph id="idF4A177D0E0944CE8BF88812A6837CB5E"><enum>(1)</enum><text>to cover
individuals described in section 1902(a)(10)(A)(ii)(IX) of the Social Security
Act and, at its option, to apply less restrictive methodologies to such
individuals under section 1902(r)(2) of such Act or 1931(b)(2)(C) of such Act
and thereby receive Federal financial participation for medical assistance for
such individuals under title XIX of the Social Security Act; or</text>
</paragraph><paragraph id="idDEBB816115A44B968908CFCA8E93074D"><enum>(2)</enum><text>to receive
Federal financial participation for expenditures for medical assistance under
title XIX of such Act for children described in paragraph (2)(B) or (3) of
section 1905(u) of such Act based on the Federal medical assistance percentage,
as otherwise determined based on the first and third sentences of subsection
(b) of section 1905 of the Social Security Act, rather than on the basis of an
enhanced FMAP (as defined in section 2105(b) of such Act).</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id781E5230156747189A637C3CE8A84AC3"><enum>(b)</enum><header>Repeal</header><text>Effective
October 1, 2008, subsection (a) is repealed.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="id81930F061E5B4BC9A3F262CF5804D832"><enum>(c)</enum><header>Hold
harmless</header><text>No State that elects the option described in subsection
(a) shall be treated as not having been authorized to make such election and to
receive Federal financial participation for expenditures for medical assistance
described in that subsection for fiscal years 2007 and 2008 as a result of the
repeal of the subsection under subsection (b).</text>
</subsection></section><section commented="no" display-inline="no-display-inline" id="id3AD6D1EA68224D81AD0CCBA7B79B3CC0"><enum>602.</enum><header>Payment error
rate measurement (<quote>PERM</quote>)</header>
<subsection commented="no" display-inline="no-display-inline" id="idA9E73D5CBAAE460A8D157D0C697A8B05"><enum>(a)</enum><header>Expenditures
related to compliance with requirements</header>
<paragraph commented="no" display-inline="no-display-inline" id="id788EAB3CE8F44FE7A5CD76AA6EE213CB"><enum>(1)</enum><header>Enhanced
payments</header><text>Section 2105(c) (42 U.S.C. 1397ee(c)), as amended by
section 401(a), is amended by adding at the end the following new
paragraph:</text>
<quoted-block display-inline="no-display-inline" id="idB8B93297857A47D0845EF2787AA2AFC0" style="OLC">
<paragraph commented="no" display-inline="no-display-inline" id="idB5B7CED00A5D42ACA3BA83DB385407BB"><enum>(11)</enum><header display-inline="yes-display-inline">Enhanced payments</header><text display-inline="yes-display-inline">Notwithstanding subsection (b), the
enhanced FMAP with respect to payments under subsection (a) for expenditures
related to the administration of the payment error rate measurement (PERM)
requirements applicable to the State child health plan in accordance with the
Improper Payments Information Act of 2002 and parts 431 and 457 of title 42,
Code of Federal Regulations (or any related or successor guidance or
regulations) shall in no event be less than 90
percent.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph commented="no" id="id1DFC0BF33D824ABA9D8E5366906E43B9"><enum>(2)</enum><header>Exclusion of
from cap on administrative expenditures</header><text display-inline="yes-display-inline">Section 2105(c)(2)(C) (42 U.S.C.
1397ee(c)(2)C)), as amended by section 402(b), is amended by adding at the end
the following:</text>
<quoted-block display-inline="no-display-inline" id="id864ACF44E57F47969EF2D15D8B5AA3E5" style="OLC">
<clause commented="no" id="id4DBA7653A11D4AB7954F422D1FE8587B"><enum>(v)</enum><header>Payment error
rate measurement (PERM) expenditures</header><text>Expenditures related to the
administration of the payment error rate measurement (PERM) requirements
applicable to the State child health plan in accordance with the Improper
Payments Information Act of 2002 and parts 431 and 457 of title 42, Code of
Federal Regulations (or any related or successor guidance or
regulations).</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" id="idE7FAA9FA522D45F8A5FECE64B128B660"><enum>(b)</enum><header>Final rule
required To be in effect for all states</header><text>Notwithstanding parts 431
and 457 of title 42, Code of Federal Regulations (as in effect on the date of
enactment of this Act), the Secretary shall not calculate or publish any
national or State-specific error rate based on the application of the payment
error rate measurement (in this section referred to as <quote>PERM</quote>)
requirements to CHIP until after the date that is 6 months after the date on
which a final rule implementing such requirements in accordance with the
requirements of subsection (c) is in effect for all States. Any calculation of
a national error rate or a State specific error rate after such final rule in
effect for all States may only be inclusive of errors, as defined in such final
rule or in guidance issued within a reasonable time frame after the effective
date for such final rule that includes detailed guidance for the specific
methodology for error determinations.</text>
</subsection><subsection commented="no" id="id7DF4DEED76D14F288F211AA1E11B6DC3"><enum>(c)</enum><header>Requirements
for final rule</header><text>For purposes of subsection (b), the requirements
of this subsection are that the final rule implementing the PERM requirements
shall include—</text>
<paragraph id="idD1A4A3F532E94045BCD0FA578BFE2B22"><enum>(1)</enum><text>clearly defined
criteria for errors for both States and providers;</text>
</paragraph><paragraph id="id024F2C7693174428852A940B35B8BADE"><enum>(2)</enum><text>a clearly defined
process for appealing error determinations by review contractors; and</text>
</paragraph><paragraph id="id6C8F13E784684A47953FE6A9385501EC"><enum>(3)</enum><text>clearly defined
responsibilities and deadlines for States in implementing any corrective action
plans.</text>
</paragraph></subsection><subsection id="idA291A970C9514AA5BCEE5E4DDCBF326E"><enum>(d)</enum><header>Option for
application of data for certain states under the interim final rule</header>
<paragraph id="id94C344EEA3F846A08D0A699B1C698369"><enum>(1)</enum><header>Option for
states in first application cycle</header><text>After the final rule
implementing the PERM requirements in accordance with the requirements of
subsection (c) is in effect for all States, a State for which the PERM
requirements were first in effect under an interim final rule for fiscal year
2007 may elect to accept any payment error rate determined in whole or in part
for the State on the basis of data for that fiscal year or may elect to not
have any payment error rate determined on the basis of such data and, instead,
shall be treated as if fiscal year 2010 were the first fiscal year for which
the PERM requirements apply to the State.</text>
</paragraph><paragraph id="idA989DE307925471C8E636F5C8EAB16BE"><enum>(2)</enum><header>Option for
states in second application cycle</header><text>If such final rule is not in
effect for all States by July 1, 2008, a State for which the PERM requirements
were first in effect under an interim final rule for fiscal year 2008 may elect
to accept any payment error rate determined in whole or in part for the State
on the basis of data for that fiscal year or may elect to not have any payment
error rate determined on the basis of such data and, instead, shall be treated
as if fiscal year 2011 were the first fiscal year for which the PERM
requirements apply to the State.</text>
</paragraph></subsection><subsection id="id1556E87039CA4BC59C27D80BEF37C9BB"><enum>(e)</enum><header>Harmonization
of MEQC and PERM</header>
<paragraph id="id451CE4FA8F804F47BB3E2AB5043465C5"><enum>(1)</enum><header>Reduction of
redundancies</header><text>The Secretary shall review the Medicaid Eligibility
Quality Control (in this subsection referred to as the <quote>MEQC</quote>)
requirements with the PERM requirements and coordinate consistent
implementation of both sets of requirements, while reducing
redundancies.</text>
</paragraph><paragraph id="id93B4B3D187CB4014A7A2917DD977F42A"><enum>(2)</enum><header>State option to
apply perm data</header><text>A State may elect, for purposes of determining
the erroneous excess payments for medical assistance ratio applicable to the
State for a fiscal year under section 1903(u) of the Social Security Act (42
U.S.C. 1396b(u)) to substitute data resulting from the application of the PERM
requirements to the State after the final rule implementing such requirements
is in effect for all States for data obtained from the application of the MEQC
requirements to the State with respect to a fiscal year.</text>
</paragraph></subsection><subsection commented="no" id="id8D3E0389BB6945F0851499942DE21E05"><enum>(f)</enum><header>Identification
of improved state-specific sample sizes</header><text>The Secretary shall
establish State-specific sample sizes for application of the PERM requirements
with respect to State child health plans for fiscal years beginning with fiscal
year 2009, on the basis of such information as the Secretary determines
appropriate. In establishing such sample sizes, the Secretary shall, to the
greatest extent practicable—</text>
<paragraph commented="no" display-inline="no-display-inline" id="idFB86D9DA978D425EA14D4AF5F4701C39"><enum>(1)</enum><text>minimize the
administrative cost burden on States under Medicaid and CHIP; and</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id6418907CE8BB46B7B52A9CE6FBDB7A33"><enum>(2)</enum><text>maintain State
flexibility to manage such programs.</text>
</paragraph></subsection></section><section id="HFB7D3CB389654BF790CB01DBECA15DC0"><enum>603.</enum><header>Elimination of
counting medicaid child presumptive eligibility costs against title XXI
allotment</header><text display-inline="no-display-inline">Section 2105(a)(1)
(42 U.S.C. 1397ee(a)(1)) is amended—</text>
<paragraph id="H42E218EA39F4440C934119A2D0E494CC"><enum>(1)</enum><text>in the matter
preceding subparagraph (A), by striking <quote>(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)))</quote>; and</text>
</paragraph><paragraph id="H65F2DB9B50494E9BA41C93E5AFAD16E6"><enum>(2)</enum><text>by striking
subparagraph (B) and inserting the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H0C804DA341D44B229E49CA04BCB000BD" style="OLC">
<subparagraph commented="no" display-inline="no-display-inline" id="H234F91C3D2974FCEB6EF7CF9CA4E8EA1"><enum>(B)</enum><text>[reserved]</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section commented="no" display-inline="no-display-inline" id="id109113B6C9F84F47BDEED6A09EE4BBD1"><enum>604.</enum><header>Improving data
collection</header>
<subsection commented="no" display-inline="no-display-inline" id="idCF84C3EFCE5E423397B1F3F2B6F92B6F"><enum>(a)</enum><header>Increased
appropriation</header><text display-inline="yes-display-inline">Section
2109(b)(2) (42 U.S.C. 1397ii(b)(2)) is amended by striking <quote>$10,000,000
for fiscal year 2000</quote> and inserting <quote>$20,000,000 for fiscal year
2008</quote>.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="idAF2EE97FD02D4474A6DC047120630FD4"><enum>(b)</enum><header>Use of
additional funds</header><text>Section 2109(b) (42 U.S.C. 1397ii(b)), as
amended by subsection (a), is amended—</text>
<paragraph commented="no" display-inline="no-display-inline" id="id0CEC5A627EE6435884748D72CCA1B7C1"><enum>(1)</enum><text>by redesignating
paragraph (2) as paragraph (4); and</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id2FA061C0D52C4B18852543F647690F0F"><enum>(2)</enum><text>by inserting
after paragraph (1), the following new paragraphs:</text>
<quoted-block display-inline="no-display-inline" id="id249B6A4C39A44F71AA1B890559A6D4C3" style="OLC">
<paragraph commented="no" display-inline="no-display-inline" id="idDC34764EB29D47E3B8B0CEB23228B678"><enum>(2)</enum><header>Additional
requirements</header><text>In addition to making the adjustments required to
produce the data described in paragraph (1), with respect to data collection
occurring for fiscal years beginning with fiscal year 2008, in appropriate
consultation with the Secretary of Health and Human Services, the Secretary of
Commerce shall do the following:</text>
<subparagraph id="ID1cec5bfb809b410a91f6e1139dd7ad0f"><enum>(A)</enum><text>Make appropriate
adjustments to the Current Population Survey to develop more accurate
State-specific estimates of the number of children enrolled in health coverage
under title XIX or this title.</text>
</subparagraph><subparagraph id="ID8442595fe69249cb97f21b4cda3cc620"><enum>(B)</enum><text>Make appropriate
adjustments to the Current Population Survey to improve the survey estimates
used to compile the State-specific and national number of low-income children
without health insurance for purposes of determining allotments under
subsections (c) and (i) of section 2104 and making payments to States from the
CHIP Incentive Bonuses Pool established under subsection (j) of such section,
the CHIP Contingency Fund established under subsection (k) of such section,
and, to the extent applicable to a State, from the block grant set aside under
section 2112(b)(2)(A)(i) for each of fiscal years 2010 through 2012.</text>
</subparagraph><subparagraph id="IDaa1b75824a37400c8ef430dbdb0fbd4d"><enum>(C)</enum><text>Include health
insurance survey information in the American Community Survey related to
children.</text>
</subparagraph><subparagraph id="ID1559318d61da4f008fb30d4ce8823e36"><enum>(D)</enum><text>Assess whether
American Community Survey estimates, once such survey data are first available,
produce more reliable estimates than the Current Population Survey with respect
to the purposes described in subparagraph (B).</text>
</subparagraph><subparagraph id="ID1a2cf2c1ea7e46438d92f5feea9f0485"><enum>(E)</enum><text>On the basis of
the assessment required under subparagraph (D), recommend to the Secretary of
Health and Human Services whether American Community Survey estimates should be
used in lieu of, or in some combination with, Current Population Survey
estimates for the purposes described in subparagraph (B).</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id18F4FFBE0D134E44BF9CAA0E9745853B"><enum>(F)</enum><text>Continue making
the adjustments described in the last sentence of paragraph (1) with respect to
expansion of the sample size used in State sampling units, the number of
sampling units in a State, and using an appropriate verification
element.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idDE138FF5EB90478A99E60B05F181AA22"><enum>(3)</enum><header>Authority for
the Secretary of Health and Human Services to transition to the use of all, or
some combination of, ACS estimates upon recommendation of the secretary of
commerce</header><text>If, on the basis of the assessment required under
paragraph (2)(D), the Secretary of Commerce recommends to the Secretary of
Health and Human Services that American Community Survey estimates should be
used in lieu of, or in some combination with, Current Population Survey
estimates for the purposes described in paragraph (2)(B), the Secretary of
Health and Human Services may provide for a period during which the Secretary
may transition from carrying out such purposes through the use of Current
Population Survey estimates to the use of American Community Survey estimates
(in lieu of, or in combination with the Current Population Survey estimates, as
recommended), provided that any such transition is implemented in a manner that
is designed to avoid adverse impacts upon States with approved State child
health plans under this
title.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section><section id="IDBD48B1E817F148568F2417B8C94DC8EE"><enum>605.</enum><header>Deficit
Reduction Act technical corrections</header>
<subsection id="ID266ACEFC27AF4519B4F012C4D344626F"><enum>(a)</enum><header>Determination
of Medicaid patient days for DSH computation</header>
<paragraph id="IDA13EB2698C154C1DB6A29AA1DBC684B2"><enum>(1)</enum><header>In
general</header><text>Section 5002 of the Deficit Reduction Act of 2005 (Public
Law 109–171, 120 Stat. 31) is amended by adding at the end the following new
subsection:</text>
<quoted-block id="IDA35FFB86C24443409B8F23793F3C6584" style="OLC">
<subsection id="IDC53CC6B806CF4566A6F7C150B9C63E5F"><enum>(c)</enum><header>Determination
of medicaid patient days for discharges occurring On or after the date of
enactment of this subsection</header><text>For discharges occurring on or after
the date of enactment of this subsection, in determining under section
1886(d)(5)(F)(vi)(II) of the <act-name parsable-cite="SSA">Social Security
Act</act-name> (42 U.S.C. 1395ww(d)(5)(F)(vi)(II)) the number of the hospital’s
patient days for the applicable cost reporting period which consist of patients
who (for such days) were eligible for medical assistance under a State plan
approved under title XIX, the Secretary shall include patient days of patients
who are eligible to receive inpatient hospital benefits under a demonstration
project approved under title XI and shall not include patient days under such a
project if the patient is not eligible to receive inpatient hospital benefits
under the
project.</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="IDE1620BE6CD5A44209B6AC9372AB91D06"><enum>(2)</enum><header>Conforming
amendment</header><text>The last sentence of section 1886(d)(5)(F)(vi) of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C.
1395ww(d)(5)(F)(vi)), as added by section 5002(a) of the Deficit Reduction Act
of 2005 (Public Law 109–171), is amended by striking <quote>In determining
under subclause (II)</quote> and inserting <quote>Subject to section 5002(c) of
the Deficit Reduction Act of 2005, in determining under subclause
(II)</quote>.</text>
</paragraph><paragraph id="IDDBBF34C295C541CCA3F3873B7804A9AD"><enum>(3)</enum><header>Effective
date</header><text>The amendments made by this subsection shall take effect on
the date of enactment of this Act.</text>
</paragraph></subsection><subsection id="IDECD33E8E45F244A4AE8E3AB13119C9BB"><enum>(b)</enum><header>State
Flexibility in Benefit Packages</header>
<paragraph id="ID76EE57F8FC6B462BA91C4536900A4F44"><enum>(1)</enum><header>Clarification
of requirement to provide epsdt services for all children in benchmark benefit
packages</header><text>Section 1937(a)(1) (42 U.S.C. 1396u–7(a)(1)), as
inserted by section 6044(a) of the Deficit Reduction Act of 2005 (Public Law
109–171, 120 Stat. 88), is amended—</text>
<subparagraph id="IDD74C816A223D477A841DD2F2E7D10D86"><enum>(A)</enum><text>in subparagraph
(A)—</text>
<clause id="ID079A33283B6B466D9081E4CB1A494128"><enum>(i)</enum><text>in
the matter before clause (i), by striking <quote>enrollment in coverage that
provides</quote> and inserting <quote>coverage that</quote>;</text>
</clause><clause id="IDAD51E3307EEC4974AF1F51C00A4E1FBF"><enum>(ii)</enum><text>in
clause (i), by inserting <quote>provides</quote> after <quote>(i)</quote>;
and</text>
</clause><clause id="ID65AB48F0479943028B2DB6CF1ADE7407"><enum>(iii)</enum><text>by striking
clause (ii) and inserting the following:</text>
<quoted-block id="ID8D8F8EE042184CEEAC03A892CA15AFF3" style="OLC">
<clause id="IDE8E291DFFE2F41478A7078965DDF92E3"><enum>(ii)</enum><text>for any
individual described in section 1905(a)(4)(B) who is eligible under the State
plan in accordance with paragraphs (10) and (17) of section 1902(a), consists
of the items and services described in section 1905(a)(4)(B) (relating to early
and periodic screening, diagnostic, and treatment services defined in section
1905(r)) and provided in accordance with the requirements of section
1902(a)(43).</text>
</clause><after-quoted-block>;</after-quoted-block></quoted-block>
</clause></subparagraph><subparagraph id="ID1BFC156DDA5049E5BA071FE0E6FC338A"><enum>(B)</enum><text>in subparagraph
(C)—</text>
<clause id="IDF99F34E03FC748D7833B93C696776BC2"><enum>(i)</enum><text>in
the heading, by striking <quote><header-in-text level="subparagraph" style="OLC">wrap-around</header-in-text></quote> and inserting
<quote><header-in-text level="subparagraph" style="OLC">additional</header-in-text></quote>; and</text>
</clause><clause id="IDE256BA64745E495091D14658154314E9"><enum>(ii)</enum><text>by
striking <quote>wrap-around or</quote>; and</text>
</clause></subparagraph><subparagraph id="ID8773C19CA97A49C3960B46E04F285752"><enum>(C)</enum><text>by adding at the
end the following new subparagraph:</text>
<quoted-block id="ID59020AA976C74DFE9F21CDA06B474DE2" style="OLC">
<subparagraph id="ID38C52BA101DC4F4F93BAA7B3402567D1"><enum>(E)</enum><header>Rule of
construction</header><text>Nothing in this paragraph shall be construed
as—</text>
<clause id="id19AC0B308903497A801A707930A583D6"><enum>(i)</enum><text>requiring a State
to offer all or any of the items and services required by subparagraph (A)(ii)
through an issuer of benchmark coverage described in subsection (b)(1) or
benchmark equivalent coverage described in subsection (b)(2); or</text>
</clause><clause id="id13D0BD3740B74903BB8C8E0FC4011BBA"><enum>(ii)</enum><text>preventing a
State from offering all or any of the items and services required by
subparagraph (A)(ii) through an issuer of benchmark coverage described in
subsection (b)(1) or benchmark equivalent coverage described in subsection
(b)(2).</text>
</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="IDB07E860C91A046BA94EA909F7790A38D"><enum>(2)</enum><header>Correction of
reference to children in foster care receiving child welfare
services</header><text>Section 1937(a)(2)(B)(viii) (42 U.S.C.
1396u–7(a)(2)(B)(viii), as inserted by section 6044(a) of the Deficit Reduction
Act of 2005, is amended by striking <quote>aid or assistance is made available
under part B of title IV to children in foster care and individuals</quote> and
inserting <quote>child welfare services are made available under part B of
title IV on the basis of being a child in foster care or</quote>.</text>
</paragraph><paragraph id="id752582D5EDA74BC0A55692DA921144A6"><enum>(3)</enum><header>Transparency</header><text>Section
1937 (42 U.S.C. 1396u–7), as inserted by section 6044(a) of the Deficit
Reduction Act of 2005, is amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="id398DC7BCA12F43ECABB757F8AA72B2D1" style="OLC">
<subsection id="idD47E1EDFD25849B1A9AB589DBFA57CF3"><enum>(c)</enum><header>Publication of
provisions affected</header><text>Not later than 30 days after the date the
Secretary approves a State plan amendment to provide benchmark benefits in
accordance with subsections (a) and (b), the Secretary shall publish in the
Federal Register and on the Internet website of the Centers for Medicare &
Medicaid Services, a list of the provisions of this title that the Secretary
has determined do not apply in order to enable the State to carry out such plan
amendment and the reason for each such
determination.</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="ID1204ECD29CFD48D69BB4B165E47C054D"><enum>(4)</enum><header>Effective
date</header><text>The amendments made by this subsection shall take effect as
if included in the amendment made by section 6044(a) of the Deficit Reduction
Act of 2005.</text>
</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="id0BB3397544924B7E846283813CA89A58" section-type="subsequent-section"><enum>606.</enum><header display-inline="yes-display-inline">Elimination of confusing program
references</header><text display-inline="no-display-inline">Section 704 of the
Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999, as
enacted into law by division B of Public Law 106–113 (113 Stat. 1501A–402) is
repealed.</text>
</section><section commented="no" display-inline="no-display-inline" id="id543F9EBE260A408495CA2A5929D04C64" section-type="subsequent-section"><enum>607.</enum><header>Mental health parity
in CHIP plans</header>
<subsection id="id6A0CF148366C40A0BB957CF94D442DD8"><enum>(a)</enum><header>Assurance of
parity</header><text>Section 2103(c) (42 U.S.C. 1397cc(c)) is amended—</text>
<paragraph id="idE8776343A7684BE68F52D6A141B6FC56"><enum>(1)</enum><text>by redesignating
paragraph (5) as paragraph (6); and</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id58508027258C424AA16CE7A6454B7A33"><enum>(2)</enum><text>by inserting
after paragraph (4), the following:</text>
<quoted-block display-inline="no-display-inline" id="id5A9F73DB64CC4745B680F071C92F04E5" style="OLC">
<paragraph commented="no" display-inline="no-display-inline" id="idB64C6AC9F96B4C6C832022A86B4EE7CD"><enum>(5)</enum><header>Mental health
services parity</header>
<subparagraph commented="no" display-inline="no-display-inline" id="id2459673981EA49C99F180CD8730FDEAB"><enum>(A)</enum><header>In
general</header><text>In the case of a State child health plan that provides
both medical and surgical benefits and mental health or substance abuse
benefits, such plan shall ensure that the financial requirements and treatment
limitations applicable to such mental health or substance abuse benefits are no
more restrictive than the financial requirements and treatment limitations
applied to substantially all medical and surgical benefits covered by the
plan.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id359E849D36CC43FAA22E86EEFCB93383"><enum>(B)</enum><header>Deemed
compliance</header><text>To the extent that a State child health plan includes
coverage with respect to an individual described in section 1905(a)(4)(B) and
covered under the State plan under section 1902(a)(10)(A) of the services
described in section 1905(a)(4)(B) (relating to early and periodic screening,
diagnostic, and treatment services defined in section 1905(r)) and provided in
accordance with section 1902(a)(43), such plan shall be deemed to satisfy the
requirements of subparagraph
(A).</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id912D360F01DD4CA08FB96797FAEF9315"><enum>(b)</enum><header display-inline="yes-display-inline">Conforming amendments</header><text display-inline="yes-display-inline">Section 2103 (42 U.S.C. 1397cc) is
amended—</text>
<paragraph commented="no" display-inline="no-display-inline" id="id5A586349CCA0406B922335517049F58F"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (a), in the matter preceding
paragraph (1), by striking <quote>subsection (c)(5)</quote> and inserting
<quote>paragraphs (5) and (6) of subsection (c)</quote>; and</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="idF9429A7F4E474731B7DC2FD7BD4FFAC5"><enum>(2)</enum><text>in subsection
(c)(2), by striking subparagraph (B) and redesignating subparagraphs (C) and
(D) as subparagraphs (B) and (C), respectively.</text>
</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="idFCEB0375D3CC4650B0DFEBB607BEAE9A"><enum>608.</enum><header>Dental health
grants</header><text display-inline="no-display-inline">Title XXI (42 U.S.C.
1397aa et seq.), as amended by section 201, is amended by adding at the end the
following:</text>
<quoted-block display-inline="no-display-inline" id="idA6AF2849E5DC443ABD9F033477017B7E" style="OLC">
<section id="id24E9228E9C644180AFCD6EC68834BAB7"><enum>2114.</enum><header>Dental health
grants</header>
<subsection commented="no" id="id9D5EE5B866194EC3B1ECFCA4F9ED6BDF"><enum>(a)</enum><header>Authority To
award grants</header>
<paragraph commented="no" id="idB172F753768C4B5693CA63818B0FCF7B"><enum>(1)</enum><header>In
general</header><text>From the amount appropriated under subsection (e), the
Secretary shall award grants from amounts to eligible States for the purpose of
carrying out programs and activities that are designed to improve the
availability of dental services and strengthen dental coverage for targeted
low-income children enrolled in State child health plans.</text>
</paragraph><paragraph id="id2C668D7DE46C4B7C8943281221C5D790"><enum>(2)</enum><header>Eligible
state</header><text>In this section, the term <term>eligible State</term> means
a State with an approved State child health plan under this title that submits
an application under subsection (b) that is approved by Secretary.</text>
</paragraph></subsection><subsection id="id36958E7B1A5A4BB28890A8A3252EF1D5"><enum>(b)</enum><header>Application</header><text>An
eligible State that desires to receive a grant under this paragraph shall
submit an application to the Secretary in such form and manner, and containing
such information, as the Secretary may require. Such application shall
include—</text>
<paragraph id="id8219DF7941A24E67AC0FEEE0E471ADCD"><enum>(1)</enum><text>a detailed
description of the programs and activities proposed to be conducted with funds
awarded under the grant;</text>
</paragraph><paragraph commented="no" id="id0778AB67E81D49DCA808489B9E2268D3"><enum>(2)</enum><text>quality and
outcomes performance measures to evaluate the effectiveness of such activities;
and</text>
</paragraph><paragraph commented="no" id="idBEBA1C1CA28C4A52AE5345ED77A293D4"><enum>(3)</enum><text>an assurance that
the State shall—</text>
<subparagraph commented="no" id="id1A4AD52654BF4700920FF8598EF80DFD"><enum>(A)</enum><text>conduct an
assessment of the effectiveness of such activities against such performance
measures; and</text>
</subparagraph><subparagraph commented="no" id="id7C4E470B57B849F98ACF1BEBBDA586A8"><enum>(B)</enum><text>cooperate with
the collection and reporting of 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.</text>
</subparagraph></paragraph></subsection><subsection id="id7F351F8CDD834A59A3FEF41D5ACD2890"><enum>(c)</enum><header>Maintenance of
effort for states awarded grants; no state match required</header><text>In the
case of a State that is awarded a grant under this section—</text>
<paragraph id="idB711D8E8A3A5473F939C9CC0633D82E1"><enum>(1)</enum><text>the State share
of funds expended for dental services under the State child health plan shall
not be less than the State share of such funds expended in the fiscal year
preceding the first fiscal year for which the grant is awarded; and</text>
</paragraph><paragraph commented="no" id="id5B538B2842684EDD9B8F44673BB10AF3"><enum>(2)</enum><text>no State matching
funds shall be required for the State to receive a grant under this
section.</text>
</paragraph></subsection><subsection id="id511232E857DF4C4C9E7FEB741B0443CA"><enum>(d)</enum><header>Annual
report</header><text>The Secretary shall submit an annual report to the
appropriate committees of Congress regarding the grants awarded under this
section that includes—</text>
<paragraph id="idC7FF94ECB3844899AF84C4FA2795795B"><enum>(1)</enum><text>State specific
descriptions of the programs and activities conducted with funds awarded under
such grants; and</text>
</paragraph><paragraph id="idEE2E8CBC47674DD980FCBC609676FD3E"><enum>(2)</enum><text>information
regarding the assessments required of States under subsection (b)(3).</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id80BA1D02F24547DEA4269A3D04367822"><enum>(e)</enum><header display-inline="yes-display-inline">Appropriation</header><text display-inline="yes-display-inline">Out of any funds in the Treasury not
otherwise appropriated, there is appropriated, $200,000,000 for the period of
fiscal years 2008 through 2012, to remain available until expended, for the
purpose of awarding grants to States 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.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="id3513B3B76B764424974BDD9C7C16D768"><enum>609.</enum><header>Application of
prospective payment system for services provided by Federally-qualified health
centers and rural health clinics</header>
<subsection id="id6C67AD1918BB4B2F81445B6D39A5C820"><enum>(a)</enum><header>Application of
prospective payment system</header>
<paragraph id="idD33F674C14CF46B2923FE53CB3FE8B53"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">Section 2107(e)(1)
(42 U.S.C. 1397gg(e)(1)), as amended by sections 204(b) and 503, is amended by
inserting after subparagraph (A) the following new subparagraph (and
redesignating the succeeding subparagraphs accordingly):</text>
<quoted-block display-inline="no-display-inline" id="H85FF2975EF9643EABA00B07F7AE2CB7" style="OLC">
<subparagraph id="H772A04E6382544ADBF4CAB00CD41FAC9"><enum>(B)</enum><text>Section 1902(bb)
(relating to payment for services provided by Federally-qualified health
centers and rural health
clinics).</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HA21A0E8708124D349B074CFEE911E7C9"><enum>(2)</enum><header>Effective
date</header><text>The amendment made by paragraph (1) shall apply to services
provided on or after October 1, 2008.</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="idE7C3B02C7583421289F85EC51991A0B9"><enum>(b)</enum><header display-inline="yes-display-inline">Transition grants</header>
<paragraph commented="no" display-inline="no-display-inline" id="idD3ED5595B1D14513ADDB60229BBE8833"><enum>(1)</enum><header>Appropriation</header><text display-inline="yes-display-inline">Out of any funds in the Treasury not
otherwise appropriated, there is appropriated to the Secretary for fiscal year
2008, $5,000,000, to remain available until expended, for the purpose of
awarding grants to States with State child health plans under CHIP that are
operated separately from the State Medicaid plan under title XIX of the Social
Security Act (including any waiver of such plan), or in combination with the
State Medicaid plan, for expenditures related to transitioning to compliance
with the requirement of section 2107(e)(1)(B) of the Social Security Act (as
added by subsection (a)) to apply the prospective payment system established
under section 1902(bb) of the such Act (42 U.S.C. 1396a(bb)) to services
provided by Federally-qualified health centers and rural health clinics.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id53461F6F92DA414F8EBCF06ACD1EAA95"><enum>(2)</enum><header>Monitoring and
report</header><text display-inline="yes-display-inline">The Secretary shall
monitor the impact of the application of such prospective payment system on the
States described in paragraph (1) and, not later than October 1, 2010, shall
report to Congress on any effect on access to benefits, provider payment rates,
or scope of benefits offered by such States as a result of the application of
such payment system.</text>
</paragraph></subsection></section><enum>VII</enum><header>Revenue
Provisions</header>
<section id="ID8A6FF5CE94B647E1800FE97D358CF4DA"><enum>701.</enum><header>Increase in
excise tax rate on tobacco products</header>
<subsection id="IDB1321248B5964F1EAACBF68B60E3ADF7"><enum>(a)</enum><header>Cigars</header><text>Section
5701(a) of the Internal Revenue Code of 1986 is amended—</text>
<paragraph id="ID47D2EF6781324682AB6348F36EC3F6BA"><enum>(1)</enum><text>by striking
<quote>$1.828 cents per thousand ($1.594 cents per thousand on cigars removed
during 2000 or 2001)</quote> in paragraph (1) and inserting <quote>$50.00 per
thousand</quote>,</text>
</paragraph><paragraph id="ID1561A78A0EDF474A92EB47E855016072"><enum>(2)</enum><text>by striking
<quote>20.719 percent (18.063 percent on cigars removed during 2000 or
2001)</quote> in paragraph (2) and inserting <quote>53.13 percent</quote>,
and</text>
</paragraph><paragraph id="ID43728F442BAA423496F9139564F8733A"><enum>(3)</enum><text>by striking
<quote>$48.75 per thousand ($42.50 per thousand on cigars removed during 2000
or 2001)</quote> in paragraph (2) and inserting <quote>$10.00 per
cigar</quote>.</text>
</paragraph></subsection><subsection id="ID9924BE0C120C42EA8F8FBEBCD7537D57"><enum>(b)</enum><header>Cigarettes</header><text>Section
5701(b) of such Code is amended—</text>
<paragraph id="IDB64A0C065EDC4B47A3BFD3327F0E3EB7"><enum>(1)</enum><text>by striking
<quote>$19.50 per thousand ($17 per thousand on cigarettes removed during 2000
or 2001)</quote> in paragraph (1) and inserting <quote>$50.00 per
thousand</quote>, and</text>
</paragraph><paragraph id="ID2CDEC4D8B71946DAA440B14FF9080709"><enum>(2)</enum><text>by striking
<quote>$40.95 per thousand ($35.70 per thousand on cigarettes removed during
2000 or 2001)</quote> in paragraph (2) and inserting <quote>$104.9999 cents per
thousand</quote>.</text>
</paragraph></subsection><subsection id="ID5BD9B528C6674576B94EA559A0397BCE"><enum>(c)</enum><header>Cigarette
Papers</header><text>Section 5701(c) of such Code is amended by striking
<quote>1.22 cents (1.06 cents on cigarette papers removed during 2000 or
2001)</quote> and inserting <quote>3.13 cents</quote>.</text>
</subsection><subsection id="IDA5BF2DA6CAE74BEC9E4E65EC41B62FF2"><enum>(d)</enum><header>Cigarette
Tubes</header><text>Section 5701(d) of such Code is amended by striking
<quote>2.44 cents (2.13 cents on cigarette tubes removed during 2000 or
2001)</quote> and inserting <quote>6.26 cents</quote>.</text>
</subsection><subsection id="IDBDB31D1D918D418EB6ABD1C70FB8FF38"><enum>(e)</enum><header>Smokeless
Tobacco</header><text>Section 5701(e) of such Code is amended—</text>
<paragraph id="IDB308F3BCEE7C4CBA99FB8659F4AD92AB"><enum>(1)</enum><text>by striking
<quote>58.5 cents (51 cents on snuff removed during 2000 or 2001)</quote> in
paragraph (1) and inserting <quote>$1.50</quote>, and</text>
</paragraph><paragraph id="IDD64C649EFA5042BA93FC96A6C9EE9F90"><enum>(2)</enum><text>by striking
<quote>19.5 cents (17 cents on chewing tobacco removed during 2000 or
2001)</quote> in paragraph (2) and inserting <quote>50 cents</quote>.</text>
</paragraph></subsection><subsection id="IDEC923E1CC5A64EDBB46E0BF131FB8FE5"><enum>(f)</enum><header>Pipe
Tobacco</header><text>Section 5701(f) of such Code is amended by striking
<quote>$1.0969 cents (95.67 cents on pipe tobacco removed during 2000 or
2001)</quote> and inserting <quote>$2.8126 cents</quote>.</text>
</subsection><subsection id="IDD6270F3C3153418AA0F798C6293D0236"><enum>(g)</enum><header>Roll-Your-Own
Tobacco</header><text>Section 5701(g) of such Code is amended by striking
<quote>$1.0969 cents (95.67 cents on roll-your-own tobacco removed during 2000
or 2001)</quote> and inserting <quote>$8.8889 cents</quote>.</text>
</subsection><subsection id="id1F970A441EA8431FB933E820F465F48B"><enum>(h)</enum><header>Floor Stocks
Taxes</header>
<paragraph id="id109A2112CDC54495BA1217070F2D06DA"><enum>(1)</enum><header>Imposition of
tax</header><text>On tobacco products and cigarette papers and tubes
manufactured in or imported into the United States which are removed before
January 1, 2008, and held on such date for sale by any person, there is hereby
imposed a tax in an amount equal to the excess of—</text>
<subparagraph id="idD5279A866A954523875BEF10CDDE63A2"><enum>(A)</enum><text>the tax which
would be imposed under section 5701 of the Internal Revenue Code of 1986 on the
article if the article had been removed on such date, over</text>
</subparagraph><subparagraph id="idD19783AFDF234EDFA017ED34F7AB3913"><enum>(B)</enum><text>the prior tax (if
any) imposed under section 5701 of such Code on such article.</text>
</subparagraph></paragraph><paragraph id="idEF0C4AB9904142FF9CDA3B05CA937D28"><enum>(2)</enum><header>Credit against
tax</header><text>Each person shall be allowed as a credit against the taxes
imposed by paragraph (1) an amount equal to $500. Such credit shall not exceed
the amount of taxes imposed by paragraph (1) on January 1, 2008, for which such
person is liable.</text>
</paragraph><paragraph id="idC9F4A567AAEB48AB80FC5B6A1D90247E"><enum>(3)</enum><header>Liability for
tax and method of payment</header>
<subparagraph id="idEB07B27E3DB64C98B28343EF1DD573A3"><enum>(A)</enum><header>Liability for
tax</header><text>A person holding tobacco products, cigarette papers, or
cigarette tubes on January 1, 2008, to which any tax imposed by paragraph (1)
applies shall be liable for such tax.</text>
</subparagraph><subparagraph id="idFFF5339E99D845D6919C361C3C5BAF79"><enum>(B)</enum><header>Method of
payment</header><text>The tax imposed by paragraph (1) shall be paid in such
manner as the Secretary shall prescribe by regulations.</text>
</subparagraph><subparagraph id="id95909B9BF9E5467E8C8EBEEF9EB367FE"><enum>(C)</enum><header>Time for
payment</header><text>The tax imposed by paragraph (1) shall be paid on or
before April 1, 2008.</text>
</subparagraph></paragraph><paragraph id="idF8EF4F7419954BCE96BB6E303E28B25D"><enum>(4)</enum><header>Articles in
foreign trade zones</header><text>Notwithstanding the Act of June 18, 1934
(commonly known as the Foreign Trade Zone Act, 48 Stat. 998, 19 U.S.C. 81a et
seq.) or any other provision of law, any article which is located in a foreign
trade zone on January 1, 2008, shall be subject to the tax imposed by paragraph
(1) if—</text>
<subparagraph id="id08575C89F8444ED1B7322D26C3EB8307"><enum>(A)</enum><text>internal revenue
taxes have been determined, or customs duties liquidated, with respect to such
article before such date pursuant to a request made under the 1st proviso of
section 3(a) of such Act, or</text>
</subparagraph><subparagraph id="id1644E8F077EA4ABE91019BDB3B115230"><enum>(B)</enum><text>such article is
held on such date under the supervision of an officer of the United States
Customs and Border Protection of the Department of Homeland Security pursuant
to the 2d proviso of such section 3(a).</text>
</subparagraph></paragraph><paragraph id="id3B6734D6494F4A3C8AB0717F14FD5687"><enum>(5)</enum><header>Definitions</header><text>For
purposes of this subsection—</text>
<subparagraph id="id78D811A0040B43A5BD540317FD4538FE"><enum>(A)</enum><header>In
general</header><text>Any term used in this subsection which is also used in
section 5702 of the Internal Revenue Code of 1986 shall have the same meaning
as such term has in such section.</text>
</subparagraph><subparagraph id="idA9AEFD930732439D8AA28E611EF8B1B1"><enum>(B)</enum><header>Secretary</header><text>The
term <term>Secretary</term> means the Secretary of the Treasury or the
Secretary’s delegate.</text>
</subparagraph></paragraph><paragraph id="id4ED3CBC06E0A4E9197204A5B6C998182"><enum>(6)</enum><header>Controlled
groups</header><text>Rules similar to the rules of section 5061(e)(3) of such
Code shall apply for purposes of this subsection.</text>
</paragraph><paragraph id="idAA4C17DCCB84427484F8237B95D86759"><enum>(7)</enum><header>Other laws
applicable</header><text>All provisions of law, including penalties, applicable
with respect to the taxes imposed by section 5701 of such Code shall, insofar
as applicable and not inconsistent with the provisions of this subsection,
apply to the floor stocks taxes imposed by paragraph (1), to the same extent as
if such taxes were imposed by such section 5701. The Secretary may treat any
person who bore the ultimate burden of the tax imposed by paragraph (1) as the
person to whom a credit or refund under such provisions may be allowed or
made.</text>
</paragraph></subsection><subsection id="idB6ACCE23BE394777A4E2E9932AF95ED5"><enum>(i)</enum><header>Effective
Date</header><text>The amendments made by this section shall apply to articles
removed (as defined in section 5702(j) of the Internal Revenue Code of 1986)
after December 31, 2007.</text>
</subsection></section><section id="idE6C86ADDFD7E4179B60BFE9BD7542052"><enum>702.</enum><header>Administrative
improvements</header>
<subsection id="idD3FCFE4175004267A5DD5F990D5CBD45"><enum>(a)</enum><header>Permit, report,
and record requirements for manufacturers and importers of processed
tobacco</header>
<paragraph id="id0DEC1905E7FE4B049E016D01A05625EC"><enum>(1)</enum><header>Permits</header>
<subparagraph id="id2A2440B8692A4BF2A8462B2C30CF158D"><enum>(A)</enum><header>Application</header><text>Section
5712 of the Internal Revenue Code of 1986 is amended by inserting <quote>or
processed tobacco</quote> after <quote>tobacco products</quote>.</text>
</subparagraph><subparagraph id="id2376C06F17C64090A4CCB63B541F0927"><enum>(B)</enum><header>Issuance</header><text>Section
5713(a) of such Code is amended by inserting <quote>or processed
tobacco</quote> after <quote>tobacco products</quote>.</text>
</subparagraph></paragraph><paragraph id="id3C1CD85D7ED5471C98A2BE0599E1E098"><enum>(2)</enum><header>Inventories and
reports</header>
<subparagraph id="idE73F5BD1B3344DCCA256B857F0ECA8B3"><enum>(A)</enum><header>Inventories</header><text>Section
5721 of such Code is amended by inserting <quote>, processed tobacco,</quote>
after <quote>tobacco products</quote>.</text>
</subparagraph><subparagraph id="id6D30650B1EC448A6B41AAD1C8EB5C462"><enum>(B)</enum><header>Reports</header><text>Section
5722 of such Code is amended by inserting <quote>, processed tobacco,</quote>
after <quote>tobacco products</quote>.</text>
</subparagraph></paragraph><paragraph id="idD00077D53AC1417C9DA726C4AF14089A"><enum>(3)</enum><header>Records</header><text>Section
5741 of such Code is amended by inserting <quote>, processed tobacco,</quote>
after <quote>tobacco products</quote>.</text>
</paragraph><paragraph id="idF4BE5C7D481249BDA4A2BA02AAE2EA8C"><enum>(4)</enum><header>Manufacturer of
processed tobacco</header><text>Section 5702 of such Code is amended by adding
at the end the following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="idEBF854DEDF394467A7B94DBB74F0D8A7" style="OLC">
<subsection id="id301840FCFCE9474C97DAB10CEC6C4033"><enum>(p)</enum><header>Manufacturer of
processed tobacco</header>
<paragraph id="id653E706665AF4935AB09FE9BA652C776"><enum>(1)</enum><header>In
general</header><text>The term <term>manufacturer of processed tobacco</term>
means any person who processes any tobacco other than tobacco products.</text>
</paragraph><paragraph id="id00230C2783B24041AF12220344AE6668"><enum>(2)</enum><header>Processed
tobacco</header><text>The processing of tobacco shall not include the farming
or growing of tobacco or the handling of tobacco solely for sale, shipment, or
delivery to a manufacturer of tobacco products or processed
tobacco.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="idD33757C7B9134236AF0470587B80A7FA"><enum>(5)</enum><header>Conforming
amendment</header><text>Section 5702(k) of such Code is amended by inserting
<quote>, or any processed tobacco,</quote> after <quote>nontaxpaid tobacco
products or cigarette papers or tubes</quote>.</text>
</paragraph><paragraph id="id1C54A0C285654EFCB8EF92C5BB124352"><enum>(6)</enum><header>Effective
date</header><text>The amendments made by this subsection shall take effect on
January 1, 2008.</text>
</paragraph></subsection><subsection id="id8B1FFEDE028F435D87850DA42872BFB4"><enum>(b)</enum><header>Basis for
denial, suspension, or revocation of permits</header>
<paragraph id="id6F1470A2A9054CE5947A966694C2B602"><enum>(1)</enum><header>Denial</header><text>Paragraph
(3) of section 5712 of such Code is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="id5140CA49814246CBAB27106B5D5D2AA8" style="OLC">
<paragraph id="idEBA9F3E84135496A9B6EBA54908F8A7D"><enum>(3)</enum><text>such person
(including, in the case of a corporation, any officer, director, or principal
stockholder and, in the case of a partnership, a partner)—</text>
<subparagraph id="id1CD264DA93524813A5C4926880BF7BA0"><enum>(A)</enum><text>is, by reason of
his business experience, financial standing, or trade connections or by reason
of previous or current legal proceedings involving a felony violation of any
other provision of Federal criminal law relating to tobacco products, cigarette
paper, or cigarette tubes, not likely to maintain operations in compliance with
this chapter,</text>
</subparagraph><subparagraph id="id1CEF4A19986B4141BED0C91EA7FBFEAE"><enum>(B)</enum><text>has been
convicted of a felony violation of any provision of Federal or State criminal
law relating to tobacco products, cigarette paper, or cigarette tubes,
or</text>
</subparagraph><subparagraph id="idAA445D2D4F654FA9BABA9453A14F819F"><enum>(C)</enum><text>has failed to
disclose any material information required or made any material false statement
in the application
therefor.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="id9B005FD1A170482CB83DBA70D5D1CCC1"><enum>(2)</enum><header>Suspension or
revocation</header><text>Subsection (b) of section 5713 of such Code is amended
to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="idB8326F23C64049E39F418C777D783D3C" style="OLC">
<subsection id="idA74AA5085276498884DB776A90EF36A8"><enum>(b)</enum><header>Suspension or
revocation</header>
<paragraph id="idA50E7C6BDB9748C284AD2B66FE75F5F5"><enum>(1)</enum><header>Show cause
hearing</header><text>If the Secretary has reason to believe that any person
holding a permit—</text>
<subparagraph id="idA599CDBAFC1E45C696AEEC46096D247B"><enum>(A)</enum><text>has not in good
faith complied with this chapter, or with any other provision of this title
involving intent to defraud,</text>
</subparagraph><subparagraph id="idBE5886AEB5DE444583D8ECA8AD91DBC2"><enum>(B)</enum><text>has violated the
conditions of such permit,</text>
</subparagraph><subparagraph id="id37C022E788C04847B5894DD49EADA90E"><enum>(C)</enum><text>has failed to
disclose any material information required or made any material false statement
in the application for such permit,</text>
</subparagraph><subparagraph id="idFCD22B3E1CC9468390218576D6FFBF90"><enum>(D)</enum><text>has failed to
maintain his premises in such manner as to protect the revenue,</text>
</subparagraph><subparagraph id="id251168EE15F145C796FB60931CC6CA51"><enum>(E)</enum><text>is, by reason of
previous or current legal proceedings involving a felony violation of any other
provision of Federal criminal law relating to tobacco products, cigarette
paper, or cigarette tubes, not likely to maintain operations in compliance with
this chapter, or</text>
</subparagraph><subparagraph id="idE4B2712D41F846A2B0F86649FE2E7D71"><enum>(F)</enum><text>has been
convicted of a felony violation of any provision of Federal or State criminal
law relating to tobacco products, cigarette paper, or cigarette tubes,</text>
</subparagraph><continuation-text continuation-text-level="paragraph">the
Secretary shall issue an order, stating the facts charged, citing such person
to show cause why his permit should not be suspended or revoked.</continuation-text></paragraph><paragraph id="id8A9DC0929F7E4CF5A28A84A19A54DC59"><enum>(2)</enum><header>Action
following hearing</header><text>If, after hearing, the Secretary finds that
such person has not shown cause why his permit should not be suspended or
revoked, such permit shall be suspended for such period as the Secretary deems
proper or shall be
revoked.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="id3BD22C34456C488AB163007196F09A9F"><enum>(c)</enum><header>Application of
Internal Revenue Code statute of limitations for alcohol and tobacco excise
taxes</header><text>Section 514(a) of the Tariff Act of 1930 (19 U.S.C.
1514(a)) is amended by striking <quote>and section 520 (relating to
refunds)</quote> and inserting <quote>section 520 (relating to refunds), and
section 6501 of the Internal Revenue Code of 1986 (but only with respect to
taxes imposed under chapters 51 and 52 of such Code)</quote>.</text>
</subsection><subsection id="idB8A60CC353894908918C9B938515EB70"><enum>(d)</enum><header>Expansion of
definition of roll-your-own tobacco</header>
<paragraph id="idFC659A5AA4B348BF8FA6207D2FFE760F"><enum>(1)</enum><header>In
general</header><text>Section 5702(o) of the Internal Revenue Code of 1986 is
amended by inserting <quote>or cigars, or for use as wrappers thereof</quote>
before the period at the end.</text>
</paragraph><paragraph id="id9BAF9F6F828D442084BCF9955B9F945E"><enum>(2)</enum><header>Effective
date</header><text>The amendment made by this subsection shall apply to
articles removed (as defined in section 5702(j) of the Internal Revenue Code of
1986) after December 31, 2007.</text>
</paragraph></subsection><subsection id="idDF274158F28B47EC8448B06ECDBCDEC9"><enum>(e)</enum><header>Time of tax for
unlawfully manufactured tobacco products</header><text>Section 5703(b)(2) of
such Code is amended by adding at the end the following new
subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="id1E292D1D319B46589308749063051584" style="OLC">
<subparagraph id="idFAB7F272565A418C9C41DF6A5C52C736"><enum>(F)</enum><header>Special rule
for unlawfully manufactured tobacco products</header><text>In the case of any
tobacco products, cigarette paper, or cigarette tubes produced in the United
States at any place other than the premises of a manufacturer of tobacco
products, cigarette paper, or cigarette tubes that has filed the bond and
obtained the permit required under this chapter, tax shall be due and payable
immediately upon
manufacture.</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section><section commented="no" display-inline="no-display-inline" id="HDED547A87DA54BFBBD8292C9C8F94B67" section-type="subsequent-section"><enum>703.</enum><header display-inline="yes-display-inline">Time for payment of corporate estimated
taxes</header><text display-inline="no-display-inline">Subparagraph (B) of
section 401(1) of the Tax Increase Prevention and Reconciliation Act of 2005 is
amended by striking <quote>114.50 percent</quote> and inserting <quote>113.25
percent</quote>.</text>
</section><enum>VIII</enum><header>Effective
date</header>
<section commented="no" display-inline="no-display-inline" id="H69B55E93F3B14039B37773A5E0310560" section-type="subsequent-section"><enum>801.</enum><header>Effective
date</header>
<subsection commented="no" display-inline="no-display-inline" id="id8BF24E25D9C4403287D6150664B487C0"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Unless otherwise
provided in this Act, subject to subsection (b), the amendments made by this
Act shall take effect on October 1, 2007, and shall apply to child health
assistance and medical assistance provided on or after that date without regard
to whether or not final regulations to carry out such amendments have been
promulgated by such date.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="id9ADB880CBD594EB6B6F134031E2A88BB"><enum>(b)</enum><header display-inline="yes-display-inline">Exception for State
legislation</header><text display-inline="yes-display-inline">In the case of a
State plan under title XIX or XXI of the Social Security Act, which the
Secretary determines requires State legislation in order for the plan to meet
the additional requirements imposed by an amendment made by this Act, 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 preceding 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.</text>
</subsection></section>
July 27 (legislative
day, July 26), 2007
Read twice and placed on the calendar