[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 794 Introduced in Senate (IS)]







110th CONGRESS
  1st Session
                                 S. 794

   To amend titles XIX and XXI of the Social Security Act to provide 
  States with the option to expand or add coverage of pregnant women 
under the Medicaid and State children's health insurance programs, and 
                          for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 7, 2007

  Mrs. Lincoln (for herself, Mr. Lugar, Mr. Bingaman, and Ms. Snowe) 
introduced the following bill; which was read twice and referred to the 
                          Committee on Finance

_______________________________________________________________________

                                 A BILL


 
   To amend titles XIX and XXI of the Social Security Act to provide 
  States with the option to expand or add coverage of pregnant women 
under the Medicaid and State children's health insurance programs, and 
                          for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Prevent Prematurity and Improve 
Child Health Act of 2007''.

SEC. 2. STATE OPTION TO EXPAND OR ADD COVERAGE OF CERTAIN PREGNANT 
              WOMEN UNDER MEDICAID AND SCHIP.

    (a) Medicaid.--
            (1) Authority to expand coverage.--Section 1902(l)(2)(A)(i) 
        of the Social Security Act (42 U.S.C. 1396a(l)(2)(A)(i)) is 
        amended by inserting ``(or such higher percentage as the State 
        may elect for purposes of expenditures for medical assistance 
        for pregnant women described in section 1905(u)(4)(A))'' after 
        ``185 percent''.
            (2) Enhanced matching funds available if certain conditions 
        met.--Section 1905 of the Social Security Act (42 U.S.C. 1396d) 
        is amended--
                    (A) in the fourth sentence of subsection (b), by 
                striking ``or subsection (u)(3)'' and inserting ``, 
                (u)(3), or (u)(4)''; and
                    (B) in subsection (u)--
                            (i) by redesignating paragraph (4) as 
                        paragraph (5); and
                            (ii) by inserting after paragraph (3) the 
                        following new paragraph:
    ``(4) For purposes of the fourth sentence of subsection (b) and 
section 2105(a), the expenditures described in this paragraph are the 
following:
            ``(A) Certain pregnant women.--If the conditions described 
        in subparagraph (B) are met, expenditures for medical 
        assistance for pregnant women described in subsection (n) or in 
        section 1902(l)(1)(A) in a family the income of which exceeds 
        185 percent of the poverty line, but does not exceed the income 
        eligibility level established under title XXI for a targeted 
        low-income child.
            ``(B) Conditions.--The conditions described in this 
        subparagraph are the following:
                    ``(i) The State plans under this title and title 
                XXI do not provide coverage for pregnant women 
                described in subparagraph (A) with higher family income 
                without covering such pregnant women with a lower 
                family income.
                    ``(ii) The State does not apply an effective income 
                level for pregnant women that is lower than the 
                effective income level (expressed as a percent of the 
                poverty line and considering applicable income 
                disregards) specified under the State plan under 
                subsection (a)(10)(A)(i)(III) or (l)(2)(A) of section 
                1902, on January 1, 2008, to be eligible for medical 
                assistance as a pregnant woman.
            ``(C) Definition of poverty line.--In this subsection, the 
        term `poverty line' has the meaning given such term in section 
        2110(c)(5).''.
            (3) Payment from title xxi allotment for medicaid expansion 
        costs; elimination of counting medicaid child presumptive 
        eligibility costs against title xxi allotment.--Section 
        2105(a)(1) of the Social Security Act (42 U.S.C. 1397ee(a)(1)) 
        is amended--
                    (A) in the matter preceding subparagraph (A), by 
                striking ``(or, in the case of expenditures described 
                in subparagraph (B), the Federal medical assistance 
                percentage (as defined in the first sentence of section 
                1905(b)))''; and
                    (B) by striking subparagraph (B) and inserting the 
                following new subparagraph:
                    ``(B) for the provision of medical assistance that 
                is attributable to expenditures described in section 
                1905(u)(4)(A);''.
    (b) SCHIP.--
            (1) Coverage.--Title XXI of the Social Security Act (42 
        U.S.C. 1397aa et seq.) is amended by adding at the end the 
        following new section:

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

    ``(a) Optional Coverage.--Notwithstanding any other provision of 
this title, a State may provide for coverage, through an amendment to 
its State child health plan under section 2102, of pregnancy-related 
assistance for targeted low-income pregnant women in accordance with 
this section, but only if--
            ``(1) the State has established an income eligibility level 
        for pregnant women under subsection (a)(10)(A)(i)(III) or 
        (l)(2)(A) of section 1902 that is at least 185 percent of the 
        income official poverty line; and
            ``(2) the State meets the conditions described in section 
        1905(u)(4)(B).
    ``(b) Definitions.--For purposes of this title:
            ``(1) Pregnancy-related assistance.--The term `pregnancy-
        related assistance' has the meaning given the term `child 
        health assistance' in section 2110(a) as if any reference to 
        targeted low-income children were a reference to targeted low-
        income pregnant women.
            ``(2) Targeted low-income pregnant woman.--The term 
        `targeted low-income pregnant woman' means a woman--
                    ``(A) during pregnancy and through the end of the 
                month in which the 60-day period (beginning on the last 
                day of her pregnancy) ends;
                    ``(B) whose family income exceeds the effective 
                income level (expressed as a percent of the poverty 
                line and considering applicable income disregards) 
                specified under subsection (a)(10)(A)(i)(III) or 
                (l)(2)(A) of section 1902, on January 1, 2008, to be 
                eligible for medical assistance as a pregnant woman 
                under title XIX but does not exceed the income 
                eligibility level established under the State child 
                health plan under this title for a targeted low-income 
                child; and
                    ``(C) who satisfies the requirements of paragraphs 
                (1)(A), (1)(C), (2), and (3) of section 2110(b) in the 
                same manner as a child applying for child health 
                assistance would have to satisfy such requirements.
    ``(c) References to Terms and Special Rules.--In the case of, and 
with respect to, a State providing for coverage of pregnancy-related 
assistance to targeted low-income pregnant women under subsection (a), 
the following special rules apply:
            ``(1) Any reference in this title (other than in subsection 
        (b)) to a targeted low-income child is deemed to include a 
        reference to a targeted low-income pregnant woman.
            ``(2) Any such reference to child health assistance with 
        respect to such women is deemed a reference to pregnancy-
        related assistance.
            ``(3) Any such reference to a child is deemed a reference 
        to a woman during pregnancy and the period described in 
        subsection (b)(2)(A).
            ``(4) In applying section 2102(b)(3)(B), any reference to 
        children found through screening to be eligible for medical 
        assistance under the State Medicaid plan under title XIX is 
        deemed a reference to pregnant women.
            ``(5) There shall be no exclusion of benefits for services 
        described in subsection (b)(1) based on any preexisting 
        condition and no waiting period (including any waiting period 
        imposed to carry out section 2102(b)(3)(C)) shall apply.
            ``(6) In applying section 2103(e)(3)(B) in the case of a 
        pregnant woman provided coverage under this section, the 
        limitation on total annual aggregate cost sharing shall be 
        applied to such pregnant woman.
            ``(7) The reference in section 2107(e)(1)(D) to section 
        1920A (relating to presumptive eligibility for children) is 
        deemed a reference to section 1920 (relating to presumptive 
        eligibility for pregnant women).
    ``(d) Automatic Enrollment for Children Born to Women Receiving 
Pregnancy-Related Assistance.--If a child is born to a targeted low-
income pregnant woman who was receiving pregnancy-related assistance 
under this section on the date of the child's birth, the child shall be 
deemed to have applied for child health assistance under the State 
child health plan and to have been found eligible for such assistance 
under such plan or to have applied for medical assistance under title 
XIX and to have been found eligible for such assistance under such 
title, as appropriate, on the date of such birth and to remain eligible 
for such assistance until the child attains 1 year of age. During the 
period in which a child is deemed under the preceding sentence to be 
eligible for child health or medical assistance, the child health or 
medical assistance eligibility identification number of the mother 
shall also serve as the identification number of the child, and all 
claims shall be submitted and paid under such number (unless the State 
issues a separate identification number for the child before such 
period expires).''.
            (2) Additional allotments for providing coverage of 
        pregnant women.--
                    (A) In general.--Section 2104 of the Social 
                Security Act (42 U.S.C. 1397dd) is amended by adding at 
                the end the following new subsection:
    ``(h) Additional Allotments for Providing Coverage of Pregnant 
Women.--
            ``(1) Appropriation; total allotment.--For the purpose of 
        providing additional allotments to States under this title, 
        there is appropriated, out of any money in the Treasury not 
        otherwise appropriated, for each of fiscal years 2008 through 
        2012, $200,000,000.
            ``(2) State and territorial allotments.--In addition to the 
        allotments provided under subsections (b) and (c), subject to 
        paragraphs (3) and (4), of the amount available for the 
        additional allotments under paragraph (1) for a fiscal year, 
        the Secretary shall allot to each State with a State child 
        health plan approved under this title--
                    ``(A) in the case of such a State other than a 
                commonwealth or territory described in subparagraph 
                (B), the same proportion as the proportion of the 
                State's allotment under subsection (b) (determined 
                without regard to subsection (f)) to the total amount 
                of the allotments under subsection (b) for such States 
                eligible for an allotment under this paragraph for such 
                fiscal year; and
                    ``(B) in the case of a commonwealth or territory 
                described in subsection (c)(3), the same proportion as 
                the proportion of the commonwealth's or territory's 
                allotment under subsection (c) (determined without 
                regard to subsection (f)) to the total amount of the 
                allotments under subsection (c) for commonwealths and 
                territories eligible for an allotment under this 
                paragraph for such fiscal year.
            ``(3) Use of additional allotment.--Additional allotments 
        provided under this subsection are not available for amounts 
        expended before October 1, 2007. Such amounts are available for 
        amounts expended on or after such date for child health 
        assistance for targeted low-income children, as well as for 
        pregnancy-related assistance for targeted low-income pregnant 
        women.
            ``(4) No payments unless election to expand coverage of 
        pregnant women.--No payments may be made to a State under this 
        title from an allotment provided under this subsection unless 
        the State provides pregnancy-related assistance for targeted 
        low-income pregnant women under this title, or provides medical 
        assistance for pregnant women under title XIX, whose family 
        income exceeds the effective income level applicable under 
        subsection (a)(10)(A)(i)(III) or (l)(2)(A) of section 1902 to a 
        family of the size involved on January 1, 2008.''.
                    (B) Conforming amendments.--Section 2104 of the 
                Social Security Act (42 U.S.C. 1397dd) is amended--
                            (i) in subsection (a), in the matter 
                        preceding paragraph (1), by striking 
                        ``subsection (d)'' and inserting ``subsections 
                        (d) and (h)'';
                            (ii) in subsection (b)(1), by striking 
                        ``subsection (d)'' and inserting ``subsections 
                        (d) and (h)''; and
                            (iii) in subsection (c)(1), by striking 
                        ``subsection (d),'' and inserting ``subsections 
                        (d) and (h)''.
            (3) Additional conforming amendments.--
                    (A) No cost sharing for pregnancy-related 
                benefits.--Section 2103(e)(2) of the Social Security 
                Act (42 U.S.C. 1397cc(e)(2)) is amended--
                            (i) in the heading, by inserting ``or 
                        pregnancy-related services'' after ``preventive 
                        services''; and
                            (ii) by inserting before the period at the 
                        end the following: ``or for pregnancy-related 
                        services''.
                    (B) No waiting period.--Section 2102(b)(1)(B) of 
                the Social Security Act (42 U.S.C. 1397bb(b)(1)(B)) is 
                amended--
                            (i) in clause (i), by striking ``, and'' at 
                        the end and inserting a semicolon;
                            (ii) in clause (ii), by striking the period 
                        at the end and inserting ``; and''; and
                            (iii) by adding at the end the following 
                        new clause:
                            ``(iii) may not apply a waiting period 
                        (including a waiting period to carry out 
                        paragraph (3)(C)) in the case of a targeted 
                        low-income pregnant woman.''.
    (c) Authority for States That Provide Medicaid or SCHIP Coverage 
for Pregnant Women With Income Above 185 Percent of the Poverty Line To 
Use Portion of SCHIP Funds for Medicaid Expenditures.--Section 2105(g) 
of the Social Security Act (42 U.S.C. 1397ee(g)) is amended--
            (1) in the subsection heading, by inserting ``and Certain 
        Pregnancy Coverage Expansion States'' after ``Qualifying 
        States'';
            (2) by adding at the end the following:
            ``(4) Special authority for certain pregnancy coverage 
        expansion states.--
                    ``(A) In general.--In the case of a State that, as 
                of the date of enactment of the Prevent Prematurity and 
                Improve Child Health Act of 2007, has an income 
                eligibility standard under title XIX or this title 
                (under section 1902(a)(10)(A) or under a statewide 
                waiver in effect under section 1115 with respect to 
                title XIX or this title) that is at least 185 percent 
                of the poverty line with respect to pregnant women, the 
                State may elect to use not more than 20 percent of any 
                allotment under section 2104 for any fiscal year 
                (insofar as it is available under any subsection of 
                such section) for payments under title XIX in 
                accordance with subparagraph (B), instead of for 
                expenditures under this title.
                    ``(B) Payments to states.--
                            ``(i) In general.--In the case of a State 
                        described in subparagraph (A) that has elected 
                        the option described in that subparagraph, 
                        subject to the availability of funds under such 
                        subparagraph and, if applicable, paragraph 
                        (1)(A), with respect to the State, the 
                        Secretary shall pay the State an amount each 
                        quarter equal to the additional amount that 
                        would have been paid to the State under title 
                        XIX with respect to expenditures described in 
                        clause (ii) if the enhanced FMAP (as determined 
                        under subsection (b)) had been substituted for 
                        the Federal medical assistance percentage (as 
                        defined in section 1905(b)).
                            ``(ii) Expenditures described.--For 
                        purposes of this subparagraph, the expenditures 
                        described in this clause are expenditures, made 
                        after the date of the enactment of this 
                        paragraph and during the period in which funds 
                        are available to the State for use under 
                        subparagraph (A), for medical assistance under 
                        title XIX for pregnant women whose family 
                        income is at least 185 percent of the poverty 
                        line.
                            ``(iii) No impact on determination of 
                        budget neutrality for waivers.--In the case of 
                        a State described in subparagraph (A) that uses 
                        amounts paid under this paragraph for 
                        expenditures described in clause (ii) that are 
                        incurred under a waiver approved for the State, 
                        any budget neutrality determinations with 
                        respect to such waiver shall be determined 
                        without regard to such amounts paid.''; and
            (3) in paragraph (3), by striking ``and (2)'' and inserting 
        ``(2), and (4)''.
    (d) Other Amendments to Medicaid.--
            (1) Eligibility of a newborn.--Section 1902(e)(4) of the 
        Social Security Act (42 U.S.C. 1396a(e)(4)) is amended in the 
        first sentence by striking ``so long as the child is a member 
        of the woman's household and the woman remains (or would remain 
        if pregnant) eligible for such assistance''.
            (2) Application of qualified entities to presumptive 
        eligibility for pregnant women under medicaid.--Section 1920(b) 
        of the Social Security Act (42 U.S.C. 1396r-1(b)) is amended by 
        adding after paragraph (2) the following flush sentence:
``The term `qualified provider' includes a qualified entity as defined 
in section 1920A(b)(3).''.
    (e) Effective Date.--The amendments made by this section apply to 
items and services furnished on or after October 1, 2007, without 
regard to whether regulations implementing such amendments have been 
promulgated.

SEC. 3. OPTIONAL COVERAGE OF LEGAL IMMIGRANTS UNDER THE MEDICAID 
              PROGRAM AND SCHIP.

    (a) Medicaid Program.--Section 1903(v) of the Social Security Act 
(42 U.S.C. 1396b(v)) is amended--
            (1) in paragraph (1), by striking ``paragraph (2)'' and 
        inserting ``paragraphs (2) and (4)''; and
            (2) by adding at the end the following new paragraph:
    ``(4)(A) A State may elect (in a plan amendment under this title) 
to provide medical assistance under this title for aliens who are 
lawfully residing in the United States (including battered aliens 
described in section 431(c) of the Personal Responsibility and Work 
Opportunity Reconciliation Act of 1996) and who are otherwise eligible 
for such assistance, within any of the following eligibility 
categories:
            ``(i) Pregnant women.--Women during pregnancy (and during 
        the 60-day period beginning on the last day of the pregnancy).
            ``(ii) Children.--Children (as defined under such plan), 
        including optional targeted low-income children described in 
        section 1905(u)(2)(B).
    ``(B)(i) In the case of a State that has elected to provide medical 
assistance to a category of aliens under subparagraph (A), no debt 
shall accrue under an affidavit of support against any sponsor of such 
an alien on the basis of provision of assistance to such category and 
the cost of such assistance shall not be considered as an unreimbursed 
cost.
    ``(ii) The provisions of sections 401(a), 402(b), 403, and 421 of 
the Personal Responsibility and Work Opportunity Reconciliation Act of 
1996 shall not apply to a State that makes an election under 
subparagraph (A).''.
    (b) Title XXI.--Section 2107(e)(1) of the Social Security Act (42 
U.S.C. 1397gg(e)(1)) is amended by adding at the end the following new 
subparagraph:
                    ``(E) Section 1903(v)(4) (relating to optional 
                coverage of permanent resident alien pregnant women and 
                children), but only with respect to an eligibility 
                category under this title, if the same eligibility 
                category has been elected under such section for 
                purposes of title XIX.''.
    (c) Effective Date.--The amendments made by this section take 
effect on October 1, 2007, and apply to medical assistance and child 
health assistance furnished on or after such date.

SEC. 4. PROMOTING CESSATION OF TOBACCO USE UNDER THE MEDICAID PROGRAM.

    (a) Dropping Exception From Medicaid Prescription Drug Coverage for 
Tobacco Cessation Medications.--Section 1927(d)(2) of the Social 
Security Act (42 U.S.C. 1396r-8(d)(2)) is amended--
            (1) by striking subparagraph (E);
            (2) by redesignating subparagraphs (F) through (J) as 
        subparagraphs (E) through (I), respectively; and
            (3) in subparagraph (F) (as redesignated by paragraph (2)), 
        by inserting before the period at the end the following: ``, 
        except agents approved by the Food and Drug Administration for 
        purposes of promoting, and when used to promote, tobacco 
        cessation''.
    (b) Requiring Coverage of Tobacco Cessation Counseling Services for 
Pregnant Women.--Section 1905 of the Social Security Act (42 U.S.C. 
1396d(a)(4)) is amended--
            (1) in subsection (a)(4)--
                    (A) by striking ``and'' before ``(C)''; and
                    (B) by inserting before the semicolon at the end 
                the following new subparagraph: ``; and (D) counseling 
                for cessation of tobacco use (as defined in subsection 
                (y)) for pregnant women''; and
            (2) by adding at the end the following:
    ``(y)(1) For purposes of this title, the term `counseling for 
cessation of tobacco use' means therapy and counseling for cessation of 
tobacco use for pregnant women who use tobacco products or who are 
being treated for tobacco use that is furnished--
            ``(A) by or under the supervision of a physician; or
            ``(B) by any other health care professional who--
                    ``(i) is legally authorized to furnish such 
                services under State law (or the State regulatory 
                mechanism provided by State law) of the State in which 
                the services are furnished; and
                    ``(ii) is authorized to receive payment for other 
                services under this title or is designated by the 
                Secretary for this purpose.
    ``(2) Subject to paragraph (3), such term is limited to--
            ``(A) therapy and counseling services recommended in 
        `Treating Tobacco Use and Dependence: A Clinical Practice 
        Guideline', published by the Public Health Service in June 
        2000, or any subsequent modification of such Guideline; and
            ``(B) such other therapy and counseling services that the 
        Secretary recognizes to be effective.
    ``(3) Such term shall not include coverage for drugs or biologicals 
that are not otherwise covered under this title.''.
    (c) Removal of Cost Sharing for Tobacco Cessation Counseling 
Services for Pregnant Women.--
            (1) General cost sharing limitations.--Section 1916 of the 
        Social Security Act (42 U.S.C. 1396o) is amended in each of 
        subsections (a)(2)(B) and (b)(2)(B) by inserting ``, and 
        counseling for cessation of tobacco use (as defined in section 
        1905(y))'' after ``complicate the pregnancy''.
            (2) Application to alternative cost sharing.--Section 
        1916A(b)(3)(B)(iii) of such Act (42 U.S.C. 1396o-
        1(b)(3)(B)(iii)) is amended by inserting ``, and counseling for 
        cessation of tobacco use by pregnant women (as defined in 
        section 1905(y))'' after ``complicate the pregnancy''.
    (d) Effective Date.--The amendments made by this section shall 
apply to services furnished on or after the date that is 1 year after 
the date of enactment of this Act.

SEC. 5. STATE OPTION TO PROVIDE FAMILY PLANNING SERVICES AND SUPPLIES 
              TO INDIVIDUALS WITH INCOMES THAT DO NOT EXCEED A STATE'S 
              INCOME ELIGIBILITY LEVEL FOR MEDICAL ASSISTANCE.

    (a) In General.--Title XIX of the Social Security Act (42 U.S.C. 
1396 et seq.) is amended--
            (1) by redesignating section 1939 as section 1940; and
            (2) by inserting after section 1938 the following new 
        section:

    ``state option to provide family planning services and supplies

    ``Sec. 1939.  (a) In General.--Subject to subsections (b) and (c), 
a State may elect (through a State plan amendment) to make medical 
assistance described in section 1905(a)(4)(C) available to any 
individual whose family income does not exceed the greater of--
            ``(1) 185 percent of the income official poverty line (as 
        defined by the Office of Management and Budget, and revised 
        annually in accordance with section 673(2) of the Omnibus 
        Budget Reconciliation Act of 1981) applicable to a family of 
        the size involved; or
            ``(2) the eligibility income level (expressed as a 
        percentage of such poverty line) that has been specified under 
        a waiver authorized by the Secretary or under section 
        1902(r)(2)), on October 1, 2007, for an individual to be 
        eligible for medical assistance under the State plan.
    ``(b) Comparability.--Medical assistance described in section 
1905(a)(4)(C) that is made available under a State plan amendment under 
subsection (a) shall--
            ``(1) not be less in amount, duration, or scope than the 
        medical assistance described in that section that is made 
        available to any other individual under the State plan; and
            ``(2) be provided in accordance with the restrictions on 
        deductions, cost sharing, or similar charges imposed under 
        section 1916(a)(2)(D).
    ``(c) Option To Extend Coverage During a Post-Eligibility Period.--
            ``(1) Initial period.--A State plan amendment made under 
        subsection (a) may provide that any individual who was 
        receiving medical assistance described in section 1905(a)(4)(C) 
        as a result of such amendment, and who becomes ineligible for 
        such assistance because of hours of, or income from, 
        employment, may remain eligible for such medical assistance 
        through the end of the 6-month period that begins on the first 
        day the individual becomes so ineligible.
            ``(2) Additional extension.--A State plan amendment made 
        under subsection (a) may provide that any individual who has 
        received medical assistance described in section 1905(a)(4)(C) 
        during the entire 6-month period described in paragraph (1) may 
        be extended coverage for such assistance for a succeeding 6-
        month period.''.
    (b) Effective Date.--The amendments made by subsection (a) apply to 
medical assistance provided on and after October 1, 2007.

SEC. 6. STATE OPTION TO EXTEND THE POSTPARTUM PERIOD FOR PROVISION OF 
              FAMILY PLANNING SERVICES AND SUPPLIES.

    (a) In General.--Section 1902(e)(5) of the Social Security Act (42 
U.S.C. 1396a(e)(5)) is amended--
            (1) by striking ``eligible under the plan, as though'' and 
        inserting ``eligible under the plan--
            ``(A) as though'';
            (2) by striking the period and inserting ``; and''; and
            (3) by adding at the end the following new subparagraph:
            ``(B) for medical assistance described in section 
        1905(a)(4)(C) for so long as the family income of such woman 
        does not exceed the maximum income level established by the 
        State for the woman to be eligible for medical assistance under 
        the State plan (as a result of pregnancy or otherwise).''.
    (b) Effective Date.--The amendments made by subsection (a) apply to 
medical assistance provided on and after October 1, 2007.

SEC. 7. STATE OPTION TO PROVIDE SUPPLEMENTAL SCHIP COVERAGE TO CHILDREN 
              WHO HAVE OTHER HEALTH COVERAGE.

    (a) In General.--
            (1) SCHIP.--
                    (A) State option to provide supplemental 
                coverage.--Section 2110(b) of the Social Security Act 
                (42 U.S.C. 1397jj(b)) is amended--
                            (i) in paragraph (1)(C), by inserting ``, 
                        subject to paragraph (5),'' after ``under title 
                        XIX or''; and
                            (ii) by adding at the end the following:
            ``(5) State option to provide supplemental coverage.--
                    ``(A) In general.--A State may waive the 
                requirement of paragraph (1)(C) that a targeted low-
                income child may not be covered under a group health 
                plan or under health insurance coverage if the State 
                satisfies the conditions described in subsection 
                (c)(9). The State may waive such requirement in order 
                to provide--
                            ``(i) services for children with special 
                        health care needs (as defined for purposes of 
                        title V); or
                            ``(ii) all services.
                    ``(B) Authority to limit income eligibility.--In 
                waiving such requirement, a State may limit the 
                application of the waiver to children whose family 
                income does not exceed a level specified by the State, 
                so long as the level so specified does not exceed the 
                maximum income level otherwise established for other 
                children under the State child health plan.''.
                    (B) Conditions described.--Section 2105(c) of the 
                Social Security Act (42 U.S.C. 1397ee(c)) is amended by 
                adding at the end the following:
            ``(9) Conditions for provision of supplemental coverage.--
        For purposes of section 2110(b)(5), the conditions described in 
        this paragraph are the following:
                    ``(A) Income eligibility.--The State child health 
                plan (whether implemented under title XIX or this 
                title)--
                            ``(i) has the highest income eligibility 
                        standard permitted under this title on January 
                        1, 2008;
                            ``(ii) subject to subparagraph (B), does 
                        not limit the acceptance of applications for 
                        children; and
                            ``(iii) provides benefits to all children 
                        in the State who apply for and meet eligibility 
                        standards.
                    ``(B) No waiting list imposed.--With respect to 
                children whose family income is at or below 200 percent 
                of the poverty line, the State does not impose any 
                numerical limitation, waiting list, or similar 
                limitation on the eligibility of such children for 
                child health assistance under such State plan.
                    ``(C) No more favorable treatment.--The State child 
                health plan may not provide more favorable coverage of 
                dental services to the children covered under section 
                2110(b)(5) than to children otherwise covered under 
                this title.''.
                    (C) State option to waive waiting period.--Section 
                2102(b)(1)(B) of the Social Security Act (42 U.S.C. 
                1397bb(b)(1)(B)), as amended by section 2(b)(3)(B), is 
                amended--
                            (i) in clause (ii), by striking ``and'' at 
                        the end;
                            (ii) in clause (iii), by striking the 
                        period at the end and inserting ``; and''; and
                            (iii) by adding at the end the following 
                        new clause:
                            ``(iv) at State option, may not apply a 
                        waiting period in the case of a child described 
                        in section 2110(b)(5), if the State satisfies 
                        the requirements of section 2105(c)(9).''.
            (2) Application of enhanced match under medicaid.--Section 
        1905 of the Social Security Act (42 U.S.C. 1396d), as amended 
        by section 2(a)(2), is amended--
                    (A) in subsection (b), in the fourth sentence, by 
                striking ``or (u)(4)'' and inserting ``(u)(4), or 
                (u)(5)''; and
                    (B) in subsection (u)--
                            (i) by redesignating paragraph (5) as 
                        paragraph (6); and
                            (ii) by inserting after paragraph (4) the 
                        following:
            ``(5) For purposes of subsection (b), the expenditures 
        described in this paragraph are expenditures for items and 
        services for children described in section 2110(b)(5), but only 
        in the case of a State that satisfies the requirements of 
        section 2105(c)(8).''.
            (3) Application of secondary payor provisions.--Section 
        2107(e)(1) of the Social Security Act (42 U.S.C. 1397gg(e)(1)), 
        as amended by section 3(b), is amended by adding at the end the 
        following:
                    ``(F) Section 1902(a)(25) (relating to coordination 
                of benefits and secondary payor provisions) with 
                respect to children covered under a waiver described in 
                section 2110(b)(5).''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
take effect on January 1, 2008, and shall apply to child health 
assistance and medical assistance provided on or after that date.

SEC. 8. DEMONSTRATION PROJECT FOR COVERAGE OF TELEMEDICINE SERVICES 
              UNDER MEDICAID.

    (a) Definitions.--
            (1) Applicable individual.--The term ``applicable 
        individual'' means an individual who--
                    (A) is eligible for benefits under a State plan 
                under title XIX of the Social Security Act (42 U.S.C. 
                1396 et seq.);
                    (B) is a pregnant woman;
                    (C) is at risk of complications in pregnancy or 
                preterm birth; and
                    (D) resides in a rural area.
            (2) Medicaid.--The term ``Medicaid'' means the program 
        established under title XIX of the Social Security Act (42 
        U.S.C. 1396 et seq.).
            (3) Rural area.--The term ``rural area'' means an area not 
        within a Metropolitan Statistical Area (as defined by the 
        Office of Management and Budget).
            (4) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (5) State.--The term ``State'' has the meaning given such 
        term for purposes of title XIX of the Social Security Act (42 
        U.S.C. 1396 et seq.).
            (6) Telemedicine services.--The term ``telemedicine 
        services'' means the provision of health care consultations and 
        diagnoses by an off-site specialist using equipment that allows 
        the specialist to be connected to a local provider and a 
        patient in real time during a patient visit.
    (b) Establishment.--
            (1) In general.--The Secretary shall establish a 
        demonstration program (in this section referred to as the 
        ``program'') to provide payments to States for the cost of 
        providing telemedicine services for the treatment of applicable 
        individuals.
            (2) Sites.--
                    (A) In general.--The demonstration shall be 
                conducted at not less than 3 and not more than 5 sites.
                    (B) Composition.--Each site shall be composed of a 
                single rural area.
            (3) Duration.--The demonstration shall be conducted for a 
        period of 3 years.
    (c) Use of Funds.--Funds provided to a State under the program 
shall be used to reimburse local providers and off-site specialists for 
the cost of providing telemedicine services for the treatment of 
applicable individuals.
    (d) Evaluations and Reports.--
            (1) Initial evaluation and report.--Not later than 24 
        months after the date of enactment of this Act, the Secretary 
        shall provide to Congress an interim report on the 
        demonstration containing an evaluation of the impact of the 
        demonstration on health outcomes and cost-effectiveness.
            (2) Final report.--Not later than 6 months after the 
        completion of the program under this section, the Secretary 
        shall submit to Congress a report on such program, together 
        with recommendations for such legislation and administrative 
        action as the Secretary determines to be appropriate.
    (e) Prohibition.--Amounts paid to a State under the program shall 
not be used for purposes of claiming a Federal matching payment under 
section 1903(a) of the Social Security Act (42 U.S.C. 1396b(a)).
    (f) Limitation on Payment Amounts.--In no case may the aggregate 
amount paid by the Secretary to States under the program exceed 
$15,000,000.
    (g) Waiver.--The Secretary shall waive compliance with such 
requirements of the Medicaid program to the extent and for the period 
the Secretary finds necessary to conduct the program.

SEC. 9. PEDIATRIC AND PERINATAL QUALITY MEASURES.

    (a) Pediatric and Perinatal Quality Measures.--
            (1) In general.--The Secretary of Health and Human Services 
        (in this section referred to as the ``Secretary'') shall 
        develop and disseminate a national set of core pediatric and 
        perinatal quality measures.
            (2) Consultation and collaboration.--
                    (A) Collaboration.--In developing and disseminating 
                such quality measures, the Secretary shall collaborate 
                with--
                            (i) the Director of the Agency for 
                        Healthcare Research and Quality; and
                            (ii) other appropriate entities, 
                        including--
                                    (I) a national organization that 
                                exists for the purpose of achieving 
                                consensus among health care providers, 
                                payers, and consumers on 
                                recommendations of measures of quality; 
                                and
                                    (II) health professional 
                                certification boards.
                    (B) Consultation.--In developing and disseminating 
                such quality measures, the Secretary shall consult 
                with--
                            (i) health professionals; and
                            (ii) consumer groups.
            (3) Appropriation.--There are appropriated $50,000,000 to 
        the Agency for Healthcare Research and Quality for each of 
        fiscal years 2009, 2010, and 2011, to carry out this 
        subsection.
    (b) Collection and Reporting of State Data.--
            (1) In general.--The Secretary shall collect data regarding 
        the extent to which States use pediatric and perinatal 
        inpatient and outpatient quality measures on an ongoing basis.
            (2) Report.--The Secretary shall report to Congress and 
        make publicly available the data collected under paragraph (1) 
        on an annual basis.
    (c) Requirement Under State Plan.--
            (1) Medicaid.--Section 1902(a) of the Social Security Act 
        (42 U.S.C. 1396a) is amended--
                    (A) in paragraph (69), by striking ``and'';
                    (B) in paragraph (70), by striking the period at 
                the end and inserting ``; and''; and
                    (C) by inserting after paragraph (70) the following 
                new paragraph:
            ``(71) provide that the State shall cooperate with the 
        Secretary in the collection of data under section 9(b)(1) of 
        the Prevent Prematurity and Improve Child Health Act of 
        2007.''.
            (2) SCHIP.--Section 2107(e)(1) of the Social Security Act 
        (42 U.S.C. 1397gg(e)(1)) is amended by adding at the end the 
        following new subparagraph:
                    ``(E) Section 1902(a)(71) (relating to collection 
                of data).''.
    (d) Payments to States for Implementation of Quality Measures.--
            (1) Medicaid.--Section 1903(a)(3) of the Social Security 
        Act (42 U.S.C. 1396b(a)(3)) is amended--
                    (A) in subparagraph (D), by striking ``and'';
                    (B) in subparagraph (E)(ii), by striking ``plus'' 
                and inserting ``and''; and
                    (C) by adding at the end the following new 
                subparagraph:
                    ``(F) an amount equal to the enhanced FMAP (as 
                defined in section 2105(b)) of the sums expended during 
                the quarter which are attributable to the costs of 
                complying with section 1902(a)(71); plus''.
            (2) SCHIP.--Section 2105(a)(1)(D) of the Social Security 
        Act (42 U.S.C. 1397ee(a)(1)(D)) is amended--
                    (A) in clause (iii), by striking ``and'';
                    (B) by redesignating clause (iv) as clause (v); and
                    (C) by inserting after clause (iii) the following 
                new clause:
                            ``(iv) for expenditures attributable to the 
                        costs of complying with section 2107(e)(1)(E); 
                        and''.
                                 <all>