[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7233 Reported in House (RH)]

<DOC>





                                                 Union Calendar No. 285
117th CONGRESS
  2d Session
                                H. R. 7233

                          [Report No. 117-374]

     To amend title XIX of the Social Security Act to provide for 
   requirements under Medicaid State plans for health screenings and 
referrals for certain eligible juveniles in public institutions; and to 
 require the Secretary of Health and Human Services to issue clear and 
 specific guidance under the Medicaid and Children's Health Insurance 
  programs to improve the delivery of health care services, including 
mental health services, in elementary and secondary schools and school-
                         based health centers.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 28, 2022

Mr. Hudson (for himself and Ms. Kuster) introduced the following bill; 
       which was referred to the Committee on Energy and Commerce

                             June 16, 2022

  Additional sponsors: Mrs. Hinson, Mrs. Hayes, Ms. Houlahan, and Mr. 
                                 Trone

                             June 16, 2022

Reported with amendments, committed to the Committee of the Whole House 
          on the State of the Union, and ordered to be printed
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]
 [For text of introduced bill, see copy of bill as introduced on March 
                               28, 2022]


_______________________________________________________________________

                                 A BILL


 
     To amend title XIX of the Social Security Act to provide for 
   requirements under Medicaid State plans for health screenings and 
referrals for certain eligible juveniles in public institutions; and to 
 require the Secretary of Health and Human Services to issue clear and 
 specific guidance under the Medicaid and Children's Health Insurance 
  programs to improve the delivery of health care services, including 
mental health services, in elementary and secondary schools and school-
                         based health centers.


 


    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 ``Keeping Incarceration Discharges 
Streamlined for Children and Accommodating Resources in Education Act'' 
or the ``KIDS CARE Act''.

SEC. 2. MEDICAID AND CHIP REQUIREMENTS FOR HEALTH SCREENINGS AND 
              REFERRALS FOR ELIGIBLE JUVENILES IN PUBLIC INSTITUTIONS.

    (a) Medicaid State Plan Requirement.--Section 1902 of the Social 
Security Act (42 U.S.C. 1396a) is amended--
            (1) in subsection (a)(84)--
                    (A) in subparagraph (B), by striking ``and'' at the 
                end;
                    (B) in subparagraph (C), by adding ``and'' at the 
                end; and
                    (C) by adding at the end the following new 
                subparagraph:
                    ``(D) beginning October 1, 2023, in the case of 
                individuals who are eligible juveniles described in 
                subsection (nn)(2), are scheduled to be released from 
                placement in a public institution following 
                adjudication, and who the State determines pursuant to 
                subparagraph (B) or (C), as applicable, meet the 
                eligibility requirements for medical assistance under 
                the State plan, the State shall have in place a plan to 
                ensure, and in accordance with such plan, provide--
                            ``(i) for, prior to the release of such an 
                        eligible juvenile from such public institution 
                        (or not later than one week after release from 
                        the public institution), and in coordination 
                        with such institution--
                                    ``(I) any screening described in 
                                section 1905(r) for which such eligible 
                                juvenile qualifies based on the 
                                intervals established pursuant to such 
                                section;
                                    ``(II) any screening which such 
                                eligible juvenile did not receive in 
                                accordance with such intervals due to 
                                the incarceration of such eligible 
                                juvenile; and
                                    ``(III) a behavioral health or 
                                mental health screening that is a 
                                screening service described under 
                                section 1905(r)(1), if such screening 
                                was not otherwise conducted pursuant to 
                                this clause;
                            ``(ii) for, not later than the latter of 
                        the date on which such eligible juvenile is 
                        released from such institution, or the date on 
                        which the screenings pursuant to clause (i) for 
                        such eligible juvenile are conducted, referrals 
                        for such eligible juvenile to the appropriate 
                        services, including necessary health care, 
                        diagnostic services, treatment, and other 
                        measures described in section 1905(a), giving 
                        preference to providers of such services who 
                        are located in the geographic region of the 
                        home or residence of such eligible juvenile 
                        when available, based on such screenings; and
                            ``(iii) for, following the release of such 
                        eligible juvenile from such institution, and 
                        the completion of the screenings conducted 
                        pursuant to clause (i), not less than 30 days 
                        of targeted case management services furnished 
                        by a provider in the geographic region of the 
                        home or residence of such eligible juvenile.''; 
                        and
            (2) in subsection (nn)(3), by striking ``(30)'' and 
        inserting ``(31)''.
    (b) Clarification of Federal Financial Participation.--The 
subdivision (A) of section 1905(a) of the Social Security Act (42 
U.S.C. 1396d(a)) following paragraph (31) of such section is amended by 
striking ``(except as a patient in a medical institution)'' and 
inserting ``(except in the case of eligible juveniles described in 
section 1902(a)(84)(D), and individuals as a patient in a medical 
institution)''.
    (c) CHIP Requirement.--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:
                    ``(U) Section 1902(a)(84)(D) (relating to eligible 
                juveniles scheduled to be released from placement in a 
                public institution following adjudication).''.

SEC. 3. GUIDANCE ON REDUCING ADMINISTRATIVE BARRIERS TO PROVIDING 
              HEALTH CARE SERVICES IN SCHOOLS.

    (a) In General.--Not later than 180 days after the date of 
enactment of this Act, the Secretary of Health and Human Services shall 
issue guidance to State Medicaid agencies, elementary and secondary 
schools, and school-based health centers on reducing administrative 
barriers to such schools and centers furnishing medical assistance and 
obtaining payment for such assistance under titles XIX and XXI of the 
Social Security Act (42 U.S.C. 1396 et seq., 1397aa et seq.).
    (b) Contents of Guidance.--The guidance issued pursuant to 
subsection (a) shall--
            (1) include proposed revisions to the May 2003 Medicaid 
        School-Based Administrative Claiming Guide, the 1997 Medicaid 
        and Schools Technical Assistance Guide, and other guidance in 
        effect on the date of enactment of this Act;
            (2) provide information on payment under titles XIX and XXI 
        of the Social Security Act (42 U.S.C. 1396 et seq., 1397aa et 
        seq.) for the provision of medical assistance, including such 
        assistance provided in accordance with an individualized 
        education program or under the ``free care'' policy described 
        in the State Medicaid Director letter on payment for services 
        issued on December 15, 2014 (#14-006);
            (3) take into account reasons why small and rural local 
        education agencies may not provide medical assistance, and 
        consider approaches to encourage such agencies to provide such 
        assistance; and
            (4) include best practices and examples of methods that 
        State Medicaid agencies and local education agencies have used 
        to pay for, and increase the availability of, medical 
        assistance.
    (c) Definitions.--In this Act:
            (1) Individualized education program.--The term 
        ``individualized education program'' has the meaning given such 
        term in section 602(14) of the Individuals with Disabilities 
        Education Act (20 U.S.C. 1401(14)).
            (2) School-based health center.--The term ``school-based 
        health center'' has the meaning given such term in section 
        2110(c)(9) of the Social Security Act (42 U.S.C. 1397jj(c)(9)).

SEC. 4. GUIDANCE TO STATES ON SUPPORTING MENTAL, EMOTIONAL, AND 
              BEHAVIORAL HEALTH SERVICES, AND ON THE AVAILABILITY OF 
              TELEHEALTH UNDER MEDICAID.

    Not later than January 1, 2024, the Secretary of Health and Human 
Services shall issue guidance to States on how to expand the provision 
of mental, emotional, and behavioral health services covered under 
State plans (or waivers of such plans) under title XIX of the Social 
Security Act (42 U.S.C. 1396 et seq.), including a description of best 
practices for--
            (1) effective programs for the provision of such services;
            (2) provision of such services to underserved communities;
            (3) flexibilities for children's hospitals and other 
        providers to expand access to such services while ensuring high 
        quality and safety; and
            (4) recruitment and retention of providers of such 
        services.

SEC. 5. ENSURING CHILDREN RECEIVE TIMELY ACCESS TO CARE.

    (a) Guidance to States on Flexibilities to Ensure Provider Capacity 
to Provide Pediatric Mental, Emotional, and Behavioral Crisis Care.--
Not later than July 1, 2024, the Secretary of Health and Human Services 
shall provide guidance to States on existing flexibilities under State 
plans (or waivers of such plans) under title XIX of the Social Security 
Act (42 U.S.C. 1396 et seq.) to support children in crisis or in need 
of intensive mental, emotional, or behavioral health services.
    (b) Ensuring Consistent Review and State Implementation of Early 
and Periodic Screening, Diagnostic, and Treatment Services.--Section 
1905(r) of the Social Security Act (42 U.S.C. 1396d(r)) is amended by 
adding at the end the following: ``Not later than January 1, 2025, and 
not later than each January 1 thereafter, the Secretary shall review 
implementation of the requirements of this subsection by States, 
including such requirements relating to services provided by a managed 
care entity, identify and disseminate best practices for ensuring 
comprehensive coverage of services, identify gaps and deficiencies in 
meeting Federal requirements, and provide guidance to States on 
addressing identified gaps and disparities and meeting Federal coverage 
requirements in order to ensure children have access to behavioral 
health services.''.

SEC. 6. STRATEGIES TO INCREASE ACCESS TO TELEHEALTH UNDER MEDICAID AND 
              CHILDREN'S HEALTH INSURANCE PROGRAM.

    Not later than 1 year after the date of the enactment of this Act, 
and not less frequently than once every five years thereafter, the 
Secretary of Health and Human Services shall update guidance issued by 
the Centers for Medicare & Medicaid Services to States, the State 
Medicaid & CHIP Telehealth Toolkit, to clarify strategies to overcome 
existing barriers and increase access to telehealth services under the 
Medicaid program under title XIX of the Social Security Act (42 U.S.C. 
1396 et seq.) and the Children's Health Insurance Program under title 
XXI of such Act (42 U.S.C. 1397aa et seq.). Such updated guidance shall 
include examples of and promising practices regarding--
            (1) telehealth delivery of covered services;
            (2) recommended voluntary billing codes, modifiers, and 
        place-of-service designations for telehealth and other virtual 
        health care services;
            (3) the simplification or alignment (including through 
        reciprocity) of provider licensing, credentialing, and 
        enrollment protocols with respect to telehealth across States, 
        State Medicaid plans under such title XIX, and Medicaid managed 
        care organizations, including during national public health 
        emergencies;
            (4) strategies States can use to integrate telehealth and 
        other virtual health care services into value-based health care 
        models; and
            (5) waivers under the Medicaid program to test expanded 
        access to telehealth, including during the emergency period 
        described in section 1135(g)(1)(B) of the Social Security Act 
        (42 U.S.C. 1320b-5(g)(1)(B)).

SEC. 7. REMOVAL OF INMATE LIMITATIONS ON BENEFITS UNDER MEDICAID.

    (a) In General.--The subdivision (A) of section 1905(a) of the 
Social Security Act (42 U.S.C. 1396d(a)) following paragraph (31) of 
such section, as amended by section 2(b), is further amended by 
striking ``and individuals as a patient in a medical institution'' and 
inserting ``individuals as a patient in a medical institution, or, at 
the option of the State, for an individual who is a juvenile, while 
such individual is an inmate of a public institution pending 
disposition of charges''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
take effect on the first day of the first calendar quarter that begins 
after the date that is 18 months after the date of enactment of this 
Act and shall apply to items and services furnished for periods 
beginning on or after such date.
            Amend the title so as to read: ``A bill to amend titles XIX 
        and XXI of the Social Security Act to provide for requirements 
        under Medicaid State plans for health screenings and referrals 
        for certain eligible juveniles in public institutions; to 
        require the Secretary of Health and Human Services to issue and 
        update guidance under the Medicaid and Children's Health 
        Insurance Programs to improving access to, and the delivery of, 
        timely health care services, including mental and behavioral 
        health services; and for other purposes.''.
                                                 Union Calendar No. 285

117th CONGRESS

  2d Session

                               H. R. 7233

                          [Report No. 117-374]

_______________________________________________________________________

                                 A BILL

     To amend title XIX of the Social Security Act to provide for 
   requirements under Medicaid State plans for health screenings and 
referrals for certain eligible juveniles in public institutions; and to 
 require the Secretary of Health and Human Services to issue clear and 
 specific guidance under the Medicaid and Children's Health Insurance 
  programs to improve the delivery of health care services, including 
mental health services, in elementary and secondary schools and school-
                         based health centers.

_______________________________________________________________________

                             June 16, 2022

Reported with amendments, committed to the Committee of the Whole House 
          on the State of the Union, and ordered to be printed