1.This Act may be cited as the
Medicaid–SCHIP Dental Benefits
Improvement Act of 2009
.
2.
(a)
(1)Section 2103 of the Social Security Act (42 U.S.C.
1397cc) is amended—
(A)in subsection
(a)—
(i)in
the matter before paragraph (1), by striking subsection (c)(5)
and inserting paragraphs (5) and (6) of subsection (c)
;
and
(ii)in
paragraph(I),
by inserting at least
after that is
; and
(B)in subsection
(c)—
(i)by
redesignating paragraph (5) as paragraph (6); and
(ii)by
inserting after paragraph (4), the following:
(5)
(A)The child health assistance provided to a targeted
low-income child shall include coverage of dental services necessary to prevent
disease and promote oral health, restore oral structures to health and
function, and treat emergency conditions.
(B)Permitting use of
dental benchmark plans by certain statesA State may elect to
meet the requirement of subparagraph (A) through dental coverage that is
equivalent to a benchmark dental benefit package described in subparagraph
(C).
(C)Benchmark dental
benefit packagesThe benchmark dental benefit packages are as
follows:
(i)FEHBP children’s
dental coverageA dental benefits plan under chapter 89A of title
5, United States Code, that has been selected most frequently by employees
seeking dependent coverage, among such plans that provide such dependent
coverage, in either of the previous 2 plan years.
(ii)State employee
dependent dental coverageA dental benefits plan that is offered
and generally available to State employees in the State involved and that has
been selected most frequently by employees seeking dependent coverage, among
such plans that provide such dependent coverage, in either of the previous 2
plan years.
(iii)Coverage
offered through commercial dental planA dental benefits plan
that has the largest insured commercial, non-medicaid enrollment of dependent
covered lives of such plans that is offered in the State
involved.
.
(2)Section 2102(a)(7)(B) of such Act (42 U.S.C.
1397bb(c)(2)) is amended by inserting and services described in section
2103(c)(5)
after emergency services
.
(3)The amendments made by paragraph (1) shall apply to coverage
of items and services furnished on or after October 1, 2009.
(b)Dental education
for parents of newbornsThe Secretary of Health and Human
Services shall develop and implement, through entities that fund or provide
perinatal care services to targeted low-income children under a State child
health plan under title XXI of the Social Security Act, a program to deliver
oral health educational materials that inform new parents about risks for, and
prevention of, early childhood caries and the need for a dental visit within
their newborn's first year of life.
(c)Provision of
dental services through FQHCs
(1)Section
1902(a) of such Act (42 U.S.C. 1396a(a)) is amended—
(A)by striking
and
at the end of paragraph (70);
(B)by striking the
period at the end of paragraph (71) and inserting ; and
;
and
(C)by inserting after
paragraph (71) the following new paragraph:
(72)provide that the
State will not prevent a Federally-qualified health center from entering into
contractual relationships with private practice dental providers in the
provision of Federally-qualified health center
services.
.
(2)Section
2107(e)(1) of such Act (42 U.S.C. 1397g(e)(1)) is amended by redesignating
subparagraphs (B) through (D) as subparagraphs (C) through (E), respectively,
and by inserting after subparagraph (A) the following new subparagraph:
(B)Section 1902(a)(72)
(relating to limiting FQHC contracting for provision of dental
services).
.
(3)The amendments made by this subsection shall take effect on
January 1, 2009.
(d)Reporting
information on dental health
(1)Section
1902(a)(43)(D)(iii) of such Act (42 U.S.C. 1396a(a)(43)(D)(iii)) is amended by
inserting and other information relating to the provision of dental
services to such children described in section 2108(e)
after
receiving dental services,
.
(2)Section
2108 of such Act (42 U.S.C. 1397hh) is amended by adding at the end the
following new subsection:
(e)Information on
dental care for children
(1)Each annual report under subsection (a) shall include the
following information with respect to care and services described in section
1905(r)(3) provided to targeted low-income children enrolled in the State child
health plan under this title at any time during the year involved:
(A)The number of
enrolled children by age grouping used for reporting purposes under section
1902(a)(43).
(B)For children
within each such age grouping, information of the type contained in questions
12(a)–(c) of CMS Form 416 (that consists of the number of enrolled targeted low
income children who receive any, preventive, or restorative dental care under
the State plan).
(C)For the age
grouping that includes children 8 years of age, the number of such children who
have received a protective sealant on at least one permanent molar
tooth.
(2)Inclusion of
information on enrollees in managed care plansThe information
under paragraph (1) shall include information on children who are enrolled in
managed care plans and other private health plans and contracts with such plans
under this title shall provide for the reporting of such information by such
plans to the
State.
.
(3)The amendments made by this subsection shall be effective
for annual reports submitted for years beginning after date of
enactment.
(e)Improved
accessibility of dental provider information to enrollees under medicaid and
chipThe Secretary of Health and Human Services shall—
(1)work with States, pediatric dentists, and
other dental providers (including providers that are, or are affiliated with, a
school of dentistry) to include, not later than 6 months after the date of the
enactment of this Act, on the Insure Kids Now website
(http://www.insurekidsnow.gov/) and hotline (1–877–KIDS–NOW) (or on any
successor websites or hotlines) a current and accurate list of all such
dentists and providers within each State that provide dental services to
children enrolled in the State plan (or waiver) under Medicaid or the State
child health plan (or waiver) under title XXI of the Social Security Act, and
shall ensure that such list is updated at least quarterly; and
(2)work with States
to include, not later than 6 months after the date of the enactment of this
Act, a description of the dental services provided under each State plan (or
waiver) under Medicaid and each State child health plan (or waiver) under title
XXI of the Social Security Act on such Insure Kids Now website, and shall
ensure that such list is updated at least annually.
(f)
(1)The
Comptroller General of the United States shall provide for a study that
examines—
(A)access to dental
services by children in underserved areas;
(B)children’s access
to oral health care, including preventive and restorative services, under
Medicaid and the State Children’s Health Insurance Program, including—
(i)the
extent to which dental providers are willing to treat children eligible for
such programs;
(ii)information on
such children's access to networks of care, including such networks that serve
special needs children; and
(iii)geographic
availability of oral health care, including preventive and restorative
services, under such programs; and
(C)the feasibility
and appropriateness of using qualified mid-level dental health providers, in
coordination with dentists, to improve access for children to oral health
services and public health overall.
(2)Not
later than 18 months after the date of the enactment of this Act, the
Comptroller General shall submit to Congress a report on the study conducted
under paragraph (1). The report shall include recommendations for such Federal
and State legislative and administrative changes as the Comptroller General
determines are necessary to address any barriers to access to oral health care,
including preventive and restorative services, under Medicaid and the State
Children’s Health Insurance Program that may exist.
3.Child health
quality improvement activities for children enrolled in Medicaid or
CHIP
(a)Development of
Child Health Quality Measures for Children Enrolled in Medicaid or
ChipTitle XI of the Social Security Act (42 U.S.C. 1301 et seq.)
is amended by inserting after section 1139 the following new section:
1139A.Child health
quality measures
(a)Development of
an Initial Core Set of Health Care Quality Measures for Children Enrolled in
Medicaid or Chip
(1)Not later than January 1, 2010, 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.
(2)Identification
of initial core measuresIn 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.
(3)Recommendations
and disseminationBased 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:
(A)The duration of
children’s health insurance coverage over a 12-month time period.
(B)The availability
and effectiveness of a full range of—
(i)preventive
services, treatments, and services for acute conditions, including services to
promote healthy birth, prevent and treat premature birth, and detect the
presence or risk of physical or mental conditions that could adversely affect
growth and development; and
(ii)treatments to correct or ameliorate the
effects of physical and mental conditions, including chronic conditions, and,
with respect to dental care, conditions requiring the restoration of teeth,
relief of pain and infection, and maintenance of dental health, in infants,
young children, school-age children, and adolescents.
(C)The availability
of care in a range of ambulatory and inpatient health care settings in which
such care is furnished.
(D)The types of
measures that, taken together, can be used to estimate the overall national
quality of health care for children, including children with special needs, and
to perform comparative analyses of pediatric health care quality and racial,
ethnic, and socioeconomic disparities in child health and health care for
children.
(4)Encourage
voluntary and standardized reportingNot later than 2 years after
the date of enactment of this section, 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.
(5)Adoption of best
practices in implementing quality programsThe 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.
(6)Not later than January 1, 2011, and every 3 years
thereafter, the Secretary shall report to Congress on—
(A)the status of the
Secretary’s efforts to improve—
(i)quality related to
the duration and stability of health insurance coverage for children under
titles XIX and XXI;
(ii)the quality of
children’s health care under such titles, including preventive health services,
dental 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
(iii)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;
(B)the status of
voluntary reporting by States under titles XIX and XXI, utilizing the initial
core quality measurement set; and
(C)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.
(7)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.
(8)In this section, the term core set means a
group of valid, reliable, and evidence-based quality measures that, taken
together—
(A)provide
information regarding the quality of health coverage and health care for
children;
(B)address the needs
of children throughout the developmental age span; and
(C)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.
(b)Advancing and
Improving Pediatric Quality Measures
(1)Establishment of
pediatric quality measures programNot later than January 1,
2011, the Secretary shall establish a pediatric quality measures program
to—
(A)improve and
strengthen the initial core child health care quality measures established by
the Secretary under subsection (a);
(B)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
(C)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.
(2)The measures developed under the pediatric quality
measures program shall, at a minimum, be—
(A)evidence-based
and, where appropriate, risk adjusted;
(B)designed to
identify and eliminate racial and ethnic disparities in child health and the
provision of health care;
(C)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;
(D)periodically
updated; and
(E)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).
(3)Process for
pediatric quality measures programIn identifying gaps in
existing pediatric quality measures and establishing priorities for development
and advancement of such measures, the Secretary shall consult with—
(A)States;
(B)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;
(C)dental
professionals, including pediatric dental professionals;
(D)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;
(E)national
organizations representing children, including children with disabilities and
children with chronic conditions;
(F)national
organizations representing consumers and purchasers of children’s health
care;
(G)national
organizations and individuals with expertise in pediatric health quality
measurement; and
(H)voluntary consensus
standards setting organizations and other organizations involved in the
advancement of evidence-based measures of health care.
(4)Developing,
validating, and testing a portfolio of pediatric quality
measuresAs part of the program to advance pediatric quality
measures, the Secretary shall—
(A)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
(B)award grants and
contracts for—
(i)the development of
consensus on evidence-based measures for children’s health care
services;
(ii)the dissemination
of such measures to public and private purchasers of health care for children;
and
(iii)the updating of
such measures as necessary.
(5)Revising,
strengthening, and improving initial core measuresBeginning no
later than January 1, 2013, 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).
(6)Definition of
pediatric quality measureIn this subsection, the term
pediatric quality measure 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.
(7)Nothing
in this section shall be construed as supporting the restriction of coverage,
under title XIX or XXI or otherwise, to only those services that are
evidence-based.
(c)Annual State
Reports Regarding State-Specific Quality of Care Measures Applied Under
Medicaid or Chip
(1)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—
(A)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
(B)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).
(2)Not
later than September 30, 2010, and annually thereafter, the Secretary shall
collect, analyze, and make publicly available the information reported by
States under paragraph (1).
(d)Demonstration
Projects for Improving the Quality of Children’s Health Care and the Use of
Health Information Technology
(1)During the period of fiscal years 2009 through 2013, 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—
(A)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);
(B)promote the use of
health information technology in care delivery for children under such
titles;
(C)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
(D)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.
(2)In
awarding grants under this subsection, the Secretary shall ensure that—
(A)only 1
demonstration project funded under a grant awarded under this subsection shall
be conducted in a State; and
(B)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.
(3)Authority for
multistate projectsA demonstration project conducted with a
grant awarded under this subsection may be conducted on a multistate basis, as
needed.
(4)$20,000,000
of the amount appropriated under subsection (i) for a fiscal year shall be used
to carry out this subsection.
(e)Childhood
Obesity Demonstration Project
(1)Authority to
conduct demonstrationThe 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—
(A)identify, through
self-assessment, behavioral risk factors for obesity among children;
(B)identify, through
self-assessment, needed clinical preventive and screening benefits among those
children identified as target individuals on the basis of such risk
factors;
(C)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
(D)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.
(2)For purposes of this subsection, an eligible entity is
any of the following:
(A)A city, county, or
Indian tribe.
(B)A local or tribal
educational agency.
(C)An accredited
university, college, or community college.
(D)A
Federally-qualified health center.
(E)A local health
department.
(F)A health care
provider.
(G)A community-based
organization.
(H)Any other entity
determined appropriate by the Secretary, including a consortia or partnership
of entities described in any of subparagraphs (A) through (G).
(3)An eligible entity awarded a grant under this subsection
shall use the funds made available under the grant to—
(A)carry out
community-based activities related to reducing childhood obesity, including
by—
(i)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;
(ii)forming
partnerships with daycare facilities to establish programs that promote healthy
eating behaviors and physical activity; and
(iii)developing and
evaluating community educational activities targeting good nutrition and
promoting healthy eating behaviors;
(B)carry out
age-appropriate school-based activities that are designed to reduce childhood
obesity, including by—
(i)developing and
testing educational curricula and intervention programs designed to promote
healthy eating behaviors and habits in youth, which may include—
(I)after hours
physical activity programs; and
(II)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;
(ii)providing
education and training to educational professionals regarding how to promote a
healthy lifestyle and a healthy school environment for children;
(iii)planning and
implementing a healthy lifestyle curriculum or program with an emphasis on
healthy eating behaviors and physical activity; and
(iv)planning and
implementing healthy lifestyle classes or programs for parents or guardians,
with an emphasis on healthy eating behaviors and physical activity for
children;
(C)carry out
educational, counseling, promotional, and training activities through the local
health care delivery systems including by—
(i)promoting healthy
eating behaviors and physical activity services to treat or prevent eating
disorders, being overweight, and obesity;
(ii)providing patient
education and counseling to increase physical activity and promote healthy
eating behaviors;
(iii)training health
professionals on how to identify and treat obese and overweight individuals
which may include nutrition and physical activity counseling; and
(iv)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
(D)provide, through
qualified health professionals, training and supervision for community health
workers to—
(i)educate families
regarding the relationship between nutrition, eating habits, physical activity,
and obesity;
(ii)educate families
about effective strategies to improve nutrition, establish healthy eating
patterns, and establish appropriate levels of physical activity; and
(iii)educate and
guide parents regarding the ability to model and communicate positive health
behaviors.
(4)In
awarding grants under paragraph (1), the Secretary shall give priority to
awarding grants to eligible entities—
(A)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;
(B)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;
(C)that provide
non-Federal contributions, either in cash or in-kind, to the costs of funding
activities under the grants;
(D)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;
(E)located in
communities that are medically underserved, as determined by the
Secretary;
(F)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
(G)that submit plans
that exhibit multisectoral, cooperative conduct that includes the involvement
of a broad range of stakeholders, including—
(i)community-based
organizations;
(ii)local
governments;
(iii)local
educational agencies;
(iv)the private
sector;
(v)State or local
departments of health;
(vi)accredited
colleges, universities, and community colleges;
(vii)health care
providers;
(viii)State and local
departments of transportation and city planning; and
(ix)other entities
determined appropriate by the Secretary.
(5)
(A)Not later than 1 year after the date of enactment of this
section, 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.
(B)Not later than 2 years after the date of enactment
of this section, 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.
(6)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.
(7)In
this subsection:
(A)Federally-qualified
health centerThe term Federally-qualified health
center has the meaning given that term in section 1905(l)(2)(B).
(B)The term Indian tribe has the meaning given
that term in section 4 of the Indian Health
Care Improvement Act (25 U.S.C. 1603).
(C)The
term self-assessment means a form that—
(i)includes questions
regarding—
(I)behavioral risk
factors;
(II)needed preventive
and screening services; and
(III)target
individuals’ preferences for receiving follow-up information;
(ii)is assessed using
such computer generated assessment programs; and
(iii)allows for the
provision of such ongoing support to the individual as the Secretary determines
appropriate.
(D)The term ongoing support means—
(i)to
provide any target individual with information, feedback, health coaching, and
recommendations regarding—
(I)the results of a
self-assessment given to the individual;
(II)behavior
modification based on the self-assessment; and
(III)any need for
clinical preventive and screening services or treatment including medical
nutrition therapy;
(ii)to provide any
target individual with referrals to community resources and programs available
to assist the target individual in reducing health risks; and
(iii)to provide the
information described in clause (i) to a health care provider, if designated by
the target individual to receive such information.
(8)Authorization of
appropriationsThere is authorized to be appropriated to carry
out this subsection, $25,000,000 for the period of fiscal years 2009 through
2013.
(f)Development of
Model Electronic Health Record Format for Children Enrolled in Medicaid or
CHIP
(1)Not later than January 1, 2010, 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—
(A)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;
(B)designed to allow
interoperable exchanges that conform with Federal and State privacy and
security requirements;
(C)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
(D)capable of being
incorporated into, and otherwise compatible with, other standards developed for
electronic health records.
(2)$5,000,000
of the amount appropriated under subsection (i) for a fiscal year shall be used
to carry out this subsection.
(g)Study of
Pediatric Health and Health Care Quality Measures
(1)Not later than July 1, 2010, 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—
(A)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;
(B)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;
(C)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
(D)make
recommendations regarding improving and strengthening the timeliness, quality,
and public transparency and accessibility of information about child health and
health care quality.
(2)Up
to $1,000,000 of the amount appropriated under subsection (i) for a fiscal year
shall be used to carry out this subsection.
(h)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.
(i)Out
of any funds in the Treasury not otherwise appropriated, there is appropriated
for each of fiscal years 2009 through 2013, $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.
.
(b)Increased
Matching Rate for Collecting and Reporting on Child Health
MeasuresSection 1903(a)(3)(A) of such Act (42 U.S.C.
1396b(a)(3)(A)), is amended—
(1)by striking
and
at the end of clause (i); and
(2)by adding at the
end the following new clause:
(iii)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
.