1.Incentives to increase use of
HIV screening tests under the Medicaid program
(a)Higher Federal
matching percentage for routine HIV screening servicesSection 1903 of the Social Security Act (42
U.S.C. 1396b) is amended—
(1)in subsection
(a)—
(A)by redesignating
paragraph (7) as paragraph (8); and
(B)by inserting after
paragraph (6) the following new paragraph:
(7)an amount equal to 90 percent of the sums
expended during such quarter which are attributable to the costs of providing
routine HIV screening services (as defined in subsection (aa)(1)) if the
conditions described in subsection (aa)(2) are met; plus
; and
(2)by adding at the end the following new
subsection:
(aa)Routine HIV
screening services
(1)For purposes of this section, the term routine HIV
screening services means the following:
(A)An HIV screening
test (and, if such test is positive, a confirmatory HIV test), including the
interpretation of such tests, that is provided as part of medical care in any
health care setting (other than an inpatient hospital setting) for an
individual who—
(i)is
at least 13, but not more than 64, years of age;
(ii)is not known to the health care provider
(directly, through information provided by the individual, or through access to
an electronic medical record) previously ever to have had a positive test for
HIV or, subject to paragraph (3), within the previous 6 months to have had any
test for HIV; and
(iii)has been informed that such a test will be
administered and has not objected to such a test.
(B)Informing an
individual so tested of the results of the tests at the time of such
examination.
(C)In the case of
such an individual who tests positive for HIV on the screening and confirmatory
tests, post-test counseling concerning HIV at the time, and as part of, such
examination.
(2)For purposes of subsection (a)(7), the
conditions of this paragraph, with respect to routine HIV screening services,
are that—
(A)the payment amount
for such services under this title is reasonable and closely approximates the
payment amount for such services under part B of title XVIII;
(B)no cost-sharing is
imposed under this title for the provision of such services; and
(C)in the case of a
State for which a political subdivision is required to contribute towards the
non-Federal share of expenditures for routine HIV screening services, the
increase in the Federal share applicable under subsection (a)(5) to such
services is first applied to reduce the contribution (but not below zero)
required by such political subdivision.
(3)The
limitation under paragraph (1)(A)(ii) with respect to having a test for HIV
within the previous 6 months shall not apply to an individual if the individual
indicates that, because of the individual’s possible exposure to HIV during the
intervening period, the individual is at increased risk of acquiring HIV since
such previous
test.
.
(b)
(1)Subparagraphs (E)
and (F) of section 1919(h)(2) of such Act (42 U.S.C. 1396r(h)(2)) are each
amended by striking 1903(a)(7)
and inserting
1903(a)(8)
.
(2)Paragraphs (1) and
(2) of section 1931(h) of such Act (42 U.S.C. 1396u–1(h)) are each amended by
striking 1903(a)(7)
and inserting
1903(a)(8)
.
(3)Section 1938(d)(4)
of such Act (42 U.S.C. 1396u–8(d)(4)) is amended by striking
1903(a)(7)
and inserting 1903(a)(8)
.
(4)Section 1940(j) of
such Act (42 U.S.C. 1396w(j)) is amended by striking paragraph
(7)
and inserting paragraph (8)
.
(c)The amendments made by
subsection (a) shall apply to services furnished on or after the date of the
enactment of this Act.
(d)Not later 2 years after the date of the
enactment of this Act, the Secretary of Health and Human Services shall submit
a report to Congress on barriers that exist for Medicaid beneficiaries to
access routine HIV screening services (as defined in section 1903(aa) of the
Social Security Act, as added by subsection (a)(2)). Such report shall include
recommendations on how to reduce such barriers to access such services.