[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7432 Introduced in House (IH)]

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118th CONGRESS
  2d Session
                                H. R. 7432

To amend title XIX of the Social Security Act to enable State Medicaid 
 programs to provide comprehensive, coordinated care through a health 
             home to individuals with sickle cell disease.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 23, 2024

  Mr. Burgess (for himself and Mr. Davis of Illinois) introduced the 
   following bill; which was referred to the Committee on Energy and 
                                Commerce

_______________________________________________________________________

                                 A BILL


 
To amend title XIX of the Social Security Act to enable State Medicaid 
 programs to provide comprehensive, coordinated care through a health 
             home to individuals with sickle cell disease.

    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 ``Sickle Cell Disease Comprehensive 
Care Act''.

SEC. 2. ENABLING STATE MEDICAID PROGRAMS TO PROVIDE CARE THROUGH HEALTH 
              HOMES TO INDIVIDUALS WITH SICKLE CELL DISEASE.

    Section 1945 of the Social Security Act (42 U.S.C. 1396w-4) is 
amended--
            (1) in subsection (a), by inserting ``(and, beginning 
        January 1, 2025, to eligible individuals with sickle cell 
        disease (as described under subsection (c)(5)))'' after 
        ``chronic conditions''; and
            (2) in subsection (c)--
                    (A) in paragraph (1), by inserting ``and each 
                eligible individual with sickle cell disease'' after 
                ``chronic conditions''; and
                    (B) by adding at the end the following new 
                paragraph:
            ``(5) Special rule relating to sickle cell disease health 
        homes.--
                    ``(A) In general.--Beginning January 1, 2025, the 
                Secretary may approve a State plan amendment under this 
                section that is designed to provide health home 
                services primarily to eligible individuals with sickle 
                cell disease (in this section referred to as a `sickle 
                cell disease-focused State plan amendment').
                    ``(B) Report requirements.--In the case of a State 
                with a sickle cell disease-focused State plan 
                amendment, such State shall, at the end of the first 8 
                fiscal year quarters that such State plan amendment is 
                in effect, submit to the Secretary a report on the 
                following, with respect to eligible individuals with 
                sickle cell disease provided health home services under 
                such State plan amendment:
                            ``(i) The quality of health care provided 
                        to such individuals, with a focus on outcomes 
                        relevant to the recovery of each such 
                        individual.
                            ``(ii) The access of such individuals to 
                        health care.
                            ``(iii) The total expenditures of such 
                        individuals for health care.
                For purposes of this subparagraph, the Secretary shall 
                specify all applicable measures for determining 
                quality, access, and expenditures.
                    ``(C) Best practices.--Not later than June 30, 
                2025, the Secretary shall make publicly available on 
                the internet website of the Centers for Medicare & 
                Medicaid Services best practices for designing and 
                implementing a sickle cell disease-focused State plan 
                amendment, based on clinical practice guidelines for 
                sickle cell diseases developed by medical specialty 
                societies and in consultation with sickle cell disease 
                providers and patient advocacy organizations.
                    ``(D) Definitions.--For purposes of this section:
                            ``(i) Eligible individual with sickle cell 
                        disease.--The term `eligible individual with 
                        sickle cell disease' means, with respect to a 
                        State, an individual who satisfies all of the 
                        following:
                                    ``(I) The individual is eligible 
                                for medical assistance under the State 
                                plan or under a waiver of such plan.
                                    ``(II) The individual has sickle 
                                cell disease.
                                    ``(III) The individual may or may 
                                not have previously received health 
                                home services under any other State 
                                plan amendment approved for the State 
                                under this section by the Secretary.
                            ``(ii) Sickle cell disease.--The term 
                        `sickle cell disease' means an inherited blood 
                        disorder affecting red blood cells that occurs 
                        when an individual has inherited a sickle cell 
                        gene from each parent, as identified by a 
                        newborn screening or other genetic test.''; and
            (3) in subsection (h)--
                    (A) in paragraph (4)(A)--
                            (i) by striking the period at the end and 
                        inserting ``; and'';
                            (ii) by striking ``means comprehensive'' 
                        and inserting ``means--
                            ``(i) with respect to eligible individuals 
                        with chronic conditions, comprehensive''; and
                            (iii) by adding at the end the following 
                        new clause:
                            ``(ii) in the case of a State that provides 
                        for dental services and vision services (as 
                        defined by such State), with respect to 
                        eligible individuals with sickle cell disease, 
                        the services described in clause (i), dental 
                        services, and vision services.''; and
                    (B) in paragraph (5), by inserting ``or a health 
                home for eligible individuals with sickle cell 
                disease'' after ``chronic conditions''.
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