[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7141 Introduced in House (IH)]

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118th CONGRESS
  2d Session
                                H. R. 7141

To amend titles XIX and XXI of the Social Security Act and title XXVII 
 of the Public Health Service Act to require no-cost coverage of human 
                            milk fortifier.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 30, 2024

    Mr. McGarvey (for himself, Ms. DeLauro, and Mr. Krishnamoorthi) 
 introduced the following bill; which was referred to the Committee on 
                          Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
To amend titles XIX and XXI of the Social Security Act and title XXVII 
 of the Public Health Service Act to require no-cost coverage of human 
                            milk fortifier.

    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 ``Supporting Premature Infant 
Nutrition Act of 2024''.

SEC. 2. REQUIRING NO-COST COVERAGE OF HUMAN MILK FORTIFIER.

    (a) Coverage Under Medicaid.--
            (1) Mandatory coverage.--
                    (A) In general.--Section 1902(a)(10)(A) of the 
                Social Security Act (42 U.S.C. 1396a(a)(10)(A)) is 
                amended by striking ``and (30)'' and inserting ``(30), 
                and (31)''.
                    (B) Medically needy.--Section 1902(a)(10)(C)(iv) of 
                the Social Security Act (42 U.S.C. 1396a(a)(10)(C)(iv)) 
                is amended by striking ``and (17)'' and inserting 
                ``(17), and (31)''.
                    (C) Alternative benefit plans.--Section 1937(b) of 
                the Social Security Act (42 U.S.C. 1396u-7(b)) is 
                amended by adding at the end the following new 
                paragraph:
            ``(9) Human milk fortifier.--Notwithstanding the previous 
        provisions of this section, a State may not provide for medical 
        assistance through enrollment of an individual with benchmark 
        coverage or benchmark-equivalent coverage under this section 
        unless, beginning on January 1, 2025, such coverage includes 
        (and does not impose any deduction, cost sharing, or similar 
        charge for) human milk fortifier described in section 
        1905(a)(31).''.
            (2) Inclusion as medical assistance.--Section 1905 of the 
        Social Security Act (42 U.S.C. 1396d) is amended--
                    (A) in subsection (a)--
                            (i) in paragraph (30), by striking ``and'' 
                        at the end;
                            (ii) by redesignating paragraph (31) as 
                        paragraph (32); and
                            (iii) by inserting after paragraph (30) the 
                        following new paragraph:
            ``(31) beginning January 1, 2025, human milk fortifier (as 
        described in subsection (jj)); and''; and
                    (B) by adding at the end the following new 
                subsection:
    ``(jj) Human Milk Fortifier.--
            ``(1) In general.--For purposes of subsection (a)(31), the 
        term `human milk fortifier' means a donor human milk-derived 
        product that is furnished to an infant under 1 year of age if a 
        specified professional determines that such donor human milk-
        derived product is medically necessary for the infant because--
                    ``(A) the infant's gestational age at birth was 34 
                weeks or less;
                    ``(B) the infant--
                            ``(i) had a birth weight of less than 1800 
                        grams; or
                            ``(ii) has a body weight below healthy 
                        levels, as determined by the specified 
                        professional; or
                    ``(C) the infant has a congenital or acquired 
                condition and such donor human milk-derived product 
                will--
                            ``(i) improve such condition; or
                            ``(ii) aid in the recovery of the infant 
                        with respect to such condition.
            ``(2) Definitions.--For purposes of this subsection, the 
        following definitions apply:
                    ``(A) Donor human milk-derived product.--The term 
                `donor human milk-derived product' means a specialty 
                nutritional product made from donor human milk wherein 
                the donor human milk has been concentrated or one or 
                more components have been removed.
                    ``(B) Specified professional.--The term `specified 
                professional' means a physician, nurse practitioner, 
                physician's assistant, registered dietician, or other 
                licensed professional authorized by State statute to 
                make the determination described in paragraph (1).''.
            (3) Prohibition of cost sharing.--
                    (A) In general.--Section 1916 of the Social 
                Security Act (42 U.S.C. 1396o) is amended--
                            (i) in subsection (a)(2)--
                                    (I) in subparagraph (I), by 
                                striking at the end ``or'';
                                    (II) in subparagraph (J), by 
                                striking at the end ``; and'' and 
                                inserting ``, or''; and
                                    (III) by adding at the end the 
                                following new subparagraph:
                    ``(K) beginning January 1, 2025, human milk 
                fortifier (as described in section 1905(a)(31)); and''; 
                and
                            (ii) in subsection (b)(2)--
                                    (I) in subparagraph (I), by 
                                striking at the end ``or'';
                                    (II) in subparagraph (J), by 
                                striking at the end ``; and'' and 
                                inserting ``, or''; and
                                    (III) by adding at the end the 
                                following new subparagraph:
                    ``(K) beginning January 1, 2025, human milk 
                fortifier (as described in section 1905(a)(31)); and''.
                    (B) Application to alternative cost sharing.--
                Section 1916A(b)(3)(B) of the Social Security Act (42 
                U.S.C. 1396o-1(b)(3)(B)) is amended by adding at the 
                end the following new clause:
                            ``(xv) Beginning January 1, 2025, human 
                        milk fortifier (as described in section 
                        1905(a)(31)).''.
    (b) Coverage Under the Children's Health Insurance Plan.--
            (1) In general.--Section 2103 of the Social Security Act 
        (42 U.S.C. 1397cc) is amended--
                    (A) in subsection (a), by striking ``and (8)'' and 
                inserting ``, (8), and (13)''; and
                    (B) in subsection (c), by adding at the end the 
                following new paragraph:
            ``(13) Required coverage of human milk fortifier.--The 
        child health assistance provided to a targeted low-income child 
        shall include coverage of human milk fortifier (as described in 
        section 1905(a)(31)).''.
            (2) Prohibition of cost sharing.--Section 2103(e)(2) of the 
        Social Security Act (42 U.S.C. 1397cc(e)(2)) is amended--
                    (A) in the paragraph heading, by inserting ``human 
                milk fortifier,'' before ``or pregnancy-related 
                assistance''; and
                    (B) by inserting ``human milk fortifier described 
                in section 1905(a)(31),'' before ``or for pregnancy-
                related assistance''.
            (3) Effective date.--
                    (A) In general.--Subject to subparagraph (B), the 
                amendments made by this subsection shall apply with 
                respect to child health assistance furnished on or 
                after January 1, 2025.
                    (B) Exception if state legislation required.--In 
                the case of a State child health plan for child health 
                assistance under title XXI of the Social Security Act 
                which the Secretary of Health and Human Services 
                determines requires State legislation (other than 
                legislation appropriating funds) in order for the plan 
                to meet the additional requirement imposed by the 
                amendments made by this subsection, the State child 
                health plan shall not be regarded as failing to comply 
                with the requirements of such title solely on the basis 
                of its failure to meet this additional requirement 
                before the first day of the first calendar quarter 
                beginning after the close of the first regular session 
                of the State legislature that begins after the date of 
                the enactment of this Act. For purposes of the previous 
                sentence, in the case of a State that has a 2-year 
                legislative session, each year of such session shall be 
                deemed to be a separate regular session of the State 
                legislature.
    (c) Coverage Under Group Health Plans and Group and Individual 
Health Insurance.--
            (1) In general.--Subpart II of part A of title XXVII of the 
        Public Health Service Act (42 U.S.C. 300gg-11 et seq.) is 
        amended by adding at the end the following new section:

``SEC. 2730. NO-COST COVERAGE OF HUMAN MILK FORTIFIER.

    ``A group health plan, and a health insurance issuer offering group 
or individual health insurance coverage, shall provide coverage for, 
and shall not impose any cost sharing requirements for, human milk 
fortifier (as described in section 1905(a)(jj) of the Social Security 
Act).''.
            (2) Effective date.--The amendments made by this subsection 
        shall apply to plan years beginning on or after January 1, 
        2025.
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