[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 1446 Introduced in Senate (IS)]

111th CONGRESS
  1st Session
                                S. 1446

To amend title XIX of the Social Security Act to provide incentives for 
    increased use of HIV screening tests under the Medicaid program.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 14, 2009

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

_______________________________________________________________________

                                 A BILL


 
To amend title XIX of the Social Security Act to provide incentives for 
    increased use of HIV screening tests under the Medicaid program.

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

SECTION 1. INCENTIVES TO INCREASE USE OF HIV SCREENING TESTS UNDER THE 
              MEDICAID PROGRAM.

    (a) Higher Federal Matching Percentage for Routine HIV Screening 
Services.--Section 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) In general.--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) Conditions.--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) Exception.--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) Conforming Amendments.--
            (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) Effective Date.--The amendments made by subsection (a) shall 
apply to services furnished on or after the date of the enactment of 
this Act.
    (d) Report.--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.
                                 <all>