Children's Health Insurance Program Reauthorization Act of 2009
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HR 2 — Children's Health Insurance Program Reauthorization Act of 2009
Last action — Became Public Law No: 111-3.
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✓Introduced
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✓In Committee
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✓Passed House
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✓Passed Senate
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✓To Executive
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6Enacted
This bill has been enacted into law. Introduced January 13, 2009. Enacted.
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Summary
Children's Health Insurance Program Reauthorization Act of 2009 - (Sec. 3) Makes the amendments made by this Act effective on April 1, 2009, regardless of whether final regulations have been promulgated to carry them out.Allows certain state plans under titles XIX (Medicaid) or XXI (State Children's Health Insurance Program) (SCHIP, referred to in this Act as CHIP) of the Social Security Act (SSA) that require state legislation to meet additional requirements imposed by this Act additional time to make required plan changes.Provides for coordination of CHIP funding for FY2009.Title I: Financing - Subtitle A: Funding - (Sec. 101) Amends SSA title XXI to reauthorize the CHIP program through FY2013 at increased levels. (Sec. 102) Provides for the determination of allotments for the 50 states, the District of Columbia, and the commonwealths and territories for FY2009-FY2013.(Sec. 103) Establishes in the Treasury the Child Enrollment Contingency Fund for payments to a state to eliminate its shortfall (the amount by which its available federal CHIP allotments are not adequate to cover its CHIP expenditures).(Sec. 104) Directs the Secretary of Health and Human Services to make a performance bonus payment to states to offset additional Medicaid and CHIP child enrollment costs resulting from enrollment and retention efforts. Limits the use of such payments to reducing the number of low-income children who do not have health insurance coverage in the state. Makes appropriations for FY2009 for such payments. Requires certain funds transfers to cover FY2009-FY2013. (Sec. 105) Reduces the availability of allotments for FY2009 and each ensuing fiscal year from three to two years.(Sec. 106) Amends SSA title XXI to require redistribution of unused allotments to states with funding shortfalls for fiscal years beginning with FY2007.Revises requirements for the redistribution of unused allotments for FY2006.(Sec. 107) Allows qualifying states the option to receive the enhanced portion of the CHIP matching rate for Medicaid coverage of certain children.Repeals the March 31, 2009, termination date of (thus making permanent) the authority for a state to use certain funds to pay for medical assistance to individuals under age 19 whose family income exceeds 150% of the poverty line.(Sec. 108) Makes a one-time appropriation of additional funds to the Secretary of Health and Human Services for FY2013.(Sec. 109) Revises funding requirements for the territories under CHIP and Medicaid for FY2009-FY2013.Removes federal matching payments for data reporting systems from the overall limit on payments to Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa.Directs the Comptroller General to report to the appropriate congressional committees on federal funding under Medicaid and CHIP for such territories.Subtitle B: Focus on Low-Income Children and Pregnant Women - (Sec. 111) Gives states the option to cover targeted low-income pregnant women under CHIP through a state plan amendment if certain conditions are met, including that the state has established an income eligibility level of at least 185% of the federal poverty line for pregnant women under Medicaid. Sets the minimum income eligibility level for children under age 19 at 200% of the poverty line applicable to a family of the size involved. Provides for automatic enrollment for children born to women receiving pregnancy-related assistance.(Sec. 112) Provides for phase-out of CHIP coverage for nonpregnant childless adults, leaving states an option to apply for a Medicaid waiver to continue coverage for such adults. Requires extension of an expiring waiver at state request, but only through calendar 2009 and only for childless adults who were covered through that year. Prescribes terms and conditions for coverage of parents of targeted low-income children.Directs the Comptroller General to study and report to Congress on whether: (1) the coverage of a parent, a caretaker relative, or a legal guardian of a targeted low-income child under a state CHIP health plan increases the enrollment of, or the quality of care for, children; and (2) such parents, relatives, and legal guardians who enroll in such a plan are more likely to enroll their children in such a plan or in a state Medicaid plan.(Sec. 113) Eliminates counting Medicaid child presumptive eligibility costs against CHIP allotment.(Sec. 114) Limits the matching rate for states that propose to cover children with effective family income that exceeds 300% of the poverty line. Exempts from this denial (grandfathers) any state that already has an approved state plan amendment or waiver to provide such expenditures. (Sec. 115) Allows the Secretary, at state option, to provide the state with the federal medical assistance percentage determined for the state for Medicaid with respect to certain expenditures or otherwise made to provide medical assistance under Medicaid to a child who could be covered by the state under CHIP.Allows a state to cover: (1) certain individuals and thereby receive federal financial participation for medical assistance for them under Medicaid; or (2) receive such federal financial participation for children made eligible as a result of an income or resource eligibility level expansion.Title II: Outreach and Enrollment - Subtitle A: Outreach and Enrollment Activities - (Sec. 201) Amends SSA title XXI to direct the Secretary to award grants during FY2009-FY2013 for outreach and enrollment efforts to increase the enrollment and participation of eligible children under CHIP and Medicaid.Makes appropriations for FY2009-FY2013. Directs the Secretary to develop and implement a national enrollment campaign to improve the enrollment of underserved child populations in CHIP and Medicaid programs.Allows payments under CHIP and Medicaid for translation or interpreting services in connection with the enrollment of, retention of, and use of services by, individuals for whom English is not their primary language.(Sec. 202) Amends SSA title XI to provide for increased outreach and enrollment of Indians in CHIP and Medicaid.Waives the 10% cap on CHIP payments for outreach with respect to any expenditures for outreach activities to families of Indian children likely to be eligible for child health assistance under the state Medicaid plan or related waivers.(Sec. 203) Authorizes a state plan under the Medicaid and CHIP programs to rely on findings from an Express Lane agency to conduct simplified eligibility determinations.Amends SSA title XIX to authorize a federal or state agency or private entity in possession of the sources of data directly relevant for Medicaid eligibility determination (including eligibility files maintained by an Express Lane agency) to convey such information to the state Medicaid agency, if such conveyance meets specified requirements. Prescribes civil and criminal penalties for improper disclosure of such information.Directs the Secretary to enter into agreements necessary to permit a state that elects the Express Lane option to receive data directly relevant to determining eligibility and the correct amount of benefits under CHIP or Medicaid from: (1) the National Directory of New Hires; and (2) data regarding enrollment in insurance that may help to facilitate outreach and enrollment under the state Medicaid and CHIP plans and such other programs as the Secretary may specify.Subtitle B: Reducing Barriers to Enrollment - (Sec. 211) Gives states the option, as an alternative to the current documentation requirement, to verify a declaration of U.S. citizenship or nationality for purposes of Medicaid or CHIP eligibility through verification of a name and Social Security number with the Commissioner of Social Security. Prescribes a procedure for investigating any inconsistency between the name and number presented and the name and number in the records maintained by the Commissioner.Applies such documentation requirements to CHIP.Makes appropriations to the Commissioner of Social Security to carry out such responsibilities.(Sec. 212) Requires state child health insurance plans to describe procedures used to reduce administrative barriers to enrollment of children and eligible pregnant women under Medicaid or CHIP.(Sec. 213) Requires the Secretary, in order to assure continuity of coverage, to develop a model process for the coordination of the enrollment, retention, and coverage under Medicaid and CHIP of children who frequently change their state of residency or otherwise are temporarily located outside of their state of residency.(Sec. 214) Permits states to waive certain restrictions which result in a five-year delay for coverage of necessary health services for children and women residing lawfully in the United States under the Medicaid program and CHIP.Title III: Reducing Barriers to Providing Premium Assistance - Subtitle A: Additional State Option for Providing Premium Assistance - (Sec. 301) Gives states the option to provide a premium assistance subsidy for qualified employer-sponsored coverage to all targeted low-income children eligible for CHIP who have access to such coverage, if the child (or the child's parent) voluntarily elects to receive such a subsidy. Allows employers to opt-out of being paid the subsidy directly, in which event the state shall pay the employee.Amends SSA title XIX to allow a state to elect to offer a similar voluntary premium assistance subsidy for qualified employer-sponsored coverage to all individuals under age 19 entitled to Medicaid.Directs the Comptroller General to study and report to Congress on cost and coverage issues relating to any state premium assistance programs for which federal Medicaid and CHIP matching payments are made.(Sec. 302) Requires state CHIP plans to describe procedures in place to provide outreach, education, and enrollment assistance for families of children likely to be eligible for premium assistance subsidies under CHIP.Waives the 10% cap on CHIP payments for outreach activities to families of children likely to be eligible for premium assistance payments under the state child health plan or related waivers.Subtitle B: Coordinating Premium Assistance With Private Coverage - (Sec. 311) Amends the Internal Revenue Code to require a group health plan to permit an employee who is eligible, but not enrolled, for coverage under the plan to enroll if either of the following conditions are met: (1) the employee or dependent covered under Medicaid or CHIP has coverage terminated as a result of loss of eligibility, and the employee requests coverage under the group health plan within 60 days after such termination; or (2) the employee or dependent becomes eligible for Medicaid or CHIP assistance if the employee requests coverage within 60 days after the eligibility determination date.Directs the Secretary and the Secretary of Labor jointly to establish a Medicaid, CHIP, and Employer-Sponsored Coverage Coordination Working Group to: (1) develop the model coverage disclosure form; and (2) identify impediments to the effective coordination of coverage available to families.Title IV: Strengthening Quality of Care And Health Outcomes of Children - (Sec. 401) Amends SSA title XI to direct the Secretary to identify and publish for general comment an initial, recommended core set of child health quality measures for use by state Medicaid and CHIP programs, health insurance issuers and managed care entities that contract with such programs, and item and service providers. Directs the Secretary to identify existing quality of care measures for children that are: (1) in use under public and privately sponsored health care arrangements; or (2) part of reporting systems that measure both the presence and duration of health insurance coverage over time.Directs the Secretary to establish a pediatric quality measures program to improve and strengthen such initial core child health care quality measures.Directs the Secretary to award: (1) grants and contracts for the development, testing, and validation of new, emerging, and innovative evidence-based measures for children's health care services; and (2) up to 10 grants to states and child health providers for demonstration projects to evaluate promising ideas for improving the quality of children's health care and the use of health information technology. Specifies funding.Directs the Secretary to conduct a childhood obesity demonstration project. Authorizes appropriations for FY2008-FY2012.Directs the Secretary to establish a program to encourage the development and dissemination of a model electronic health record format for children enrolled in a state Medicaid or CHIP plan.Requires the Institute of Medicine to study and report to Congress on pediatric health and health care quality measures.Makes FY2009-FY2013 appropriations to carry out this section. Increases the matching rate for collecting and reporting on child health measures.(Sec. 402) Specifies the information each state must cover in its annual CHIP report to the Secretary, including eligibility criteria, enrollment, and retention data.Requires the Comptroller General to study and report to the appropriate congressional committees on children's access to primary and specialty services under Medicaid and CHIP.(Sec. 403) Requires a state child health plan to provide for application of certain managed care quality safeguards to CHIP coverage, state agencies, enrollment brokers, managed care entities, and managed care organizations in the same manner such safeguards are applied under the Medicaid program.Title V: Improving Access to Benefits - (Sec. 501) Requires the child health assistance provided to a targeted low-income child to include coverage of dental services necessary to prevent disease and promote oral health, restore oral structures to health and function, and treat emergency conditions.Gives states with a separate CHIP program the option to provide dental-only supplemental coverage for any child enrolled in a group health plan or employer-offered health insurance coverage who would otherwise satisfy the requirements for a targeted low-income child under a state child health plan. Allows a state child health plan, at state option, to waive a waiting period for a child provided dental-only supplemental coverage. Requires the Secretary to develop, through entities that fund or provide prenatal care services to targeted low-income children under CHIP, 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.Directs the Secretary to work with states, pediatric dentists, and other dental providers to include on the Insure Kids Now website (http://www.insurekidsnow.gov/) and hotline (1-877-KIDS-NOW) a current and accurate list, updated quarterly, 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 CHIP, together (on the website) with a description of the services.Directs the Comptroller General to study and report to Congress on children's access to dental services in underserved areas and to oral health care. (Sec. 502) Provides for the parity of mental health services in CHIP plans with all covered medical and surgical benefits.(Sec. 503) Applies the prospective payment system (PPS) to services provided by federally-qualified health centers (FQHCs) and rural health clinics.(Sec. 504) Requires a state child health plan to afford individuals enrolled under it a grace period of at least 30 days from beginning of a new coverage period to make premium payments before the individual's coverage under the plan may be terminated.(Sec. 505) Provides that nothing in SSA title XXI shall be construed as limiting a state's ability to provide child health assistance for covered items and services that are furnished through school-based health centers.(Sec. 506) Establishes the Medicaid and CHIP Payment and Access Commission (MACPAC) to: (1) review policies of Medicaid and CHIP affecting children's access to covered items and services; and (2) report and make recommendations to Congress concerning them. Authorizes appropriations. Title VI: Program Integrity and Other Miscellaneous Provisions - Subtitle A: Program Integrity and Data Collection - (Sec. 601) Applies a minimum FMAP of 90% to expenditures related to administration of payment error rate measurement (PERM) requirements applicable to CHIP.Waives the 10% cap on CHIP administrative costs for all expenditures related to the administration of PERM requirements.Prohibits the Secretary from calculating or publishing any national or state-specific error rate based on the application of PERM requirements to CHIP until after a final rule implementing such requirements is in effect for all states. Specifies requirements for any calculation of a national error rate or a state specific error rate after such a final rule is in effect for all states.Requires the final rule implementing the PERM requirements to include: (1) clearly defined criteria for errors for both states and providers; (2) a clearly defined process for appealing error determinations by review contractors or specified agency and personnel; and (3) clearly defined responsibilities and deadlines for states in implementing any corrective action plans.Directs the Secretary to review the Medicaid Eligibility Quality Control (MEQC) requirements with PERM requirements and coordinate consistent implementation of both sets of requirements, while reducing redundancies.Prescribes requirements for a state option to substitute data resulting from the application of the PERM requirements to the state for data obtained from the application of MEQC requirements to the state, and vice versa, for specified purposes.Directs the Secretary to establish state-specific sample sizes for application of the PERM requirements with respect to state child health plans beginning with FY2009.(Sec. 602) Appropriates increased amounts for FY2009 for data collection regarding low-income children without health insurance coverage.Requires the Secretary of Commerce, among other things, to make appropriate adjustments to the Current Population Survey (CPA) to: (1) develop more accurate state-specific estimates of the number of children enrolled under Medicaid; and (2) include health insurance survey information in the American Community Survey (ACS) related to children.Authorizes the Secretary to transition to the use of all, or some combination of, ACS estimates, instead of the CPS, if the Secretary of Commerce so recommends.(Sec. 603) Directs the Secretary, directly or through contracts or interagency agreements, to conduct an independent subsequent evaluation of 10 states with approved child health plans. Makes FY2009 appropriations for such evaluation.(Sec. 604) Revises requirements for audits of state CHIP programs. Declares that the Comptroller General (as well as the Secretary and the Office of Inspector General), for evaluation and audit purposes, shall have access to any books, accounts, and other documents related to the expenditure of federal CHIP funds that are in state or local government, grantee, or contractor possession, custody, or control.(Sec. 605) Declares that: (1) nothing in this Act allows federal payment for individuals who are not lawfully residing in the United States; and (2) SSA titles XI, XIX (Medicaid), and XXI (CHIP) provide for the disallowance of federal financial participation for erroneous expenditures under Medicaid and under CHIP, respectively.Subtitle B: Miscellaneous Health Provisions - (Sec. 611) Amends the Deficit Reduction Act of 2005 to make a technical amendment to the requirement to provide early and periodic screening, diagnostic, and treatment (EPSDT) services for all children in benchmark benefit packages.(Sec. 612) Amends the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 to repeal the requirement that the Secretary refer to CHIP as SCHIP or the state children's health insurance program. (Sec. 613) Prohibits the Secretary from approving any new health opportunity account demonstration programs.(Sec. 614) Provides that, only for purposes of computing the FMAP for a state for a fiscal year, beginning with FY2006, and applying it under Medicaid, any significantly disproportionate employer pension or insurance fund contribution shall be disregarded in computing the state's per capita income, but shall not be disregarded in computing the per capita income for the continental United States (and Alaska) and Hawaii.Prohibits any state from having its FMAP reduced as a result of the application of this section.Directs the Secretary to report to Congress on: (1) the problems presented by the current treatment of pension and insurance fund contributions in the use of Bureau of Economic Affairs calculations for the FMAP and for Medicaid; and (2) possible alternative methodologies to mitigate such problems.(Sec. 615) Provides that nothing in the prohibition on use of voluntary contributions, and the limitation on use of provider-specific taxes to obtain federal financial participation under Medicaid, shall be construed by the Secretary as prohibiting a state's use of funds as the nonfederal share of Medicaid expenditures where such funds are transferred from or certified by a publicly-owned regional medical center located in another state, so long as the Secretary determines that such use is proper and in the interest of the Medicaid program.(Sec. 616) Amends SSA title XIX, as amended by the Medicare Improvements for Patients and Providers Act of 2008, to extend the Medicaid disproportionate share hospital (DSH) allotments for Hawaii and Tennessee. (Sec. 617) Directs the Comptroller General to report to Congress on the extent to which state payment rates for Medicaid managed care organizations under Medicaid are actuarially sound.Subtitle C: Other Provisions - (Sec. 621) Establishes a task force to conduct a nationwide campaign of education and outreach for small business concerns regarding the availability of coverage for children through private insurance options, the Medicaid program, and CHIP.(Sec. 622) Expresses the sense of the Senate that it: (1) recognizes the necessity to improve affordability and access to health insurance for all Americans; (2) acknowledges the value of building upon the existing private health insurance market; and (3) affirms its intent to enact legislation this year that, with appropriate consumer protections, improves access to affordable and meaningful health insurance coverage for employees of small business and individuals.Title VII: Revenue Provisions - (Sec. 701) Amends the Internal Revenue Code to increase excise tax rates on cigars, cigarettes, cigarette papers and tubes, smokeless tobacco, pipe tobacco, and roll-your-own tobacco. Imposes a tax on floor stocks of tobacco products (other than certain cigars and cigarette papers and tubes), reduced by a $500 tax credit. Requires payment of such floor stock taxes on or before August 1, 2009. Extends the floor stock tax to articles located in a foreign trade zone on any tax increase date.(Sec. 702) Applies administrative tax law provisions relating to permits, inventories, reporting, and recordkeeping to manufacturers and importers of processed tobacco (i.e., any tobacco other than tobacco products).Expands the authority of the Secretary of the Treasury to deny, suspend, or revoke permits for manufacturing or importing tobacco products.Revises the definition of "roll-your-own tobacco" to include cigars or cigar wrappers.Amends the Tariff Act of 1930 to apply limitation periods for assessment of tax under the Internal Revenue Code to alcohol and tobacco excise taxes. Imposes an immediate excise tax on any tobacco products, cigarette paper, or tubes produced in the United States at any place other than the premises of a lawful manufacturer of such products. (Sec. 703) Directs the Secretary of the Treasury to study and report to Congress on: (1) the magnitude of tobacco smuggling in the United States; and (2) any recommendations for the most effective steps to reduce it.(Sec. 704) Amends the Tax Increase Prevention and Reconciliation Act of 2005 to increase by 0.5% the amount of any required installment of corporate estimated tax otherwise due in July, August, or September 2013.
Bill Text
What changed in the latest version
4132 added · 4886 removedPlain-language change summary
The updated version of the bill clarifies definitions related to the Children's Health Insurance Program (CHIP) and the Secretary of Health and Human Services, ensuring consistent terminology throughout. Notably, the reference to Medicaid was removed, which means the text will no longer include Medicaid-related definitions in this context. This change could streamline the focus on CHIP specifically within the bill.
[111th[Congressional CongressBills Public111th LawCongress] 3] [From the U.S.
Government PublishingPrinting Office] [DOCID:[H.R.
f:publ003.111]2 [[PageEnrolled 7]]Bill CHILDREN'S(ENR)] HEALTHH.R.2 INSURANCEOne PROGRAMHundred REAUTHORIZATIONEleventh ACTCongress OFof 2009the [[PageUnited 123States STAT.of America AT THE FIRST SESSION Begun and held at the City of Washington on Tuesday, the sixth day of January, two thousand and nine An Act To amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes.
8]]Be Publicit Lawenacted 111-3by 111ththe CongressSenate Anand ActHouse Toof amendRepresentatives title XXI of the SocialUnited SecurityStates Actof toAmerica extendin andCongress improveassembled, theSECTION Children's1. Health Insurance Program, and for other purposes.
<<NOTE:
Feb.
4, 2009 - [H.R.
2]>> Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, <<NOTE:
Children's Health Insurance Program Reauthorization Act of 2009.>> SECTION 1.
(a) <<NOTE:Short Title.--This Act may be cited as the ``Children's Health Insurance Program Reauthorization Act of 2009''.
42 USC 1305 note.>> Short Title.--This Act may be cited as the ``Children's Health Insurance Program Reauthorization Act of 2009''.
(c) <<NOTE:References to CHIP;
42 USC 1396 note.>> References to CHIP;
[[PageSec. 123 STAT.
9]] Sec.
[[PageSec. 123 STAT.
10]] Sec.
<<NOTE:PURPOSE.
42 USC 1396 note.>> PURPOSE.
<<NOTE:GENERAL EFFECTIVE DATE;
42 USC 1396 note.>> GENERAL EFFECTIVE DATE;
(d) Reliance on Law.--With respect to amendments made by this Act (other than title VII) that become effective as of a date-- [[Page(1) 123such STAT.amendments are effective as of such date whether or not regulations implementing such amendments have been issued;
11]] (1) such amendments are effective as of such date whether or not regulations implementing such amendments have been issued;
``(m) Allotments for Fiscal Years 2009 Through 2013.-- ``(1) For fiscal year 2009.-- ``(A) For the 50 states and the district of columbia.--Subjectcolumbia.-- Subject to the succeeding provisions of this paragraph and paragraph (4), the Secretary shall allot for fiscal year 2009 from the amount made available under subsection (a)(12), to each of the 50 States and the District of Columbia 110 percent of the highest of the following amounts for such State or District:
[[Page``(ii) 123The STAT.amount allotted to the State for fiscal year under subsection (b), multiplied by the allotment increase factor determined under paragraph (5) for fiscal year 2009.
12]]``(iii) ``(ii) The amountprojected allottedtotal Federal payments to the State under this title for fiscal year 20082009, underas subsectiondetermined (b),on multipliedthe basis of the February 2009 projections certified by the allotmentState increaseto factorthe determinedSecretary underby paragraphnot (5)later forthan fiscalMarch year31, 2009.
``(iii)``(B) <<NOTE:For the commonwealths and territories.--Subject to the succeeding provisions of this paragraph and paragraph (4), the Secretary shall allot for fiscal year 2009 from the amount made available under subsection (a)(12) to each of the commonwealths and territories described in subsection (c)(3) an amount equal to the highest amount of Federal payments to the commonwealth or territory under this title for any fiscal year occurring during the period of fiscal years 1999 through 2008, multiplied by the allotment increase factor determined under paragraph (5) for fiscal year 2009, except that subparagraph (B) thereof shall be applied by substituting `the United States' for `the State'.
Certification.
Deadline.>> The projected total Federal payments to the State under this title for fiscal year 2009, as determined on the basis of the February 2009 projections certified by the State to the Secretary by not later than March 31, 2009.
``(B) For the commonwealths and territories.-- <<NOTE:
Applicability.>> Subject to the succeeding provisions of this paragraph and paragraph (4), the Secretary shall allot for fiscal year 2009 from the amount made available under subsection (a)(12) to each of the commonwealths and territories described in subsection (c)(3) an amount equal to the highest amount of Federal payments to the commonwealth or territory under this title for any fiscal year occurring during the period of fiscal years 1999 through 2008, multiplied by the allotment increase factor determined under paragraph (5) for fiscal year 2009, except that subparagraph (B) thereof shall be applied by substituting `the United States' for `the State'.
[[Page``(iii) 123Growth STAT.factor update for fiscal year 2012.--For fiscal year 2012, the allotment of the State is equal to the sum of-- ``(I) the amount of the State allotment under clause (ii) for fiscal year 2011;
13]] ``(iii) Growth factor update for fiscal year 2012.--For fiscal year 2012, the allotment of the State is equal to the sum of-- ``(I) the amount of the State allotment under clause (ii) for fiscal year 2011;
``(3) For fiscal year 2013.-- ``(A) First half.--Subject to paragraphs (4) and (6), from the amount made available under subparagraph (A) of paragraph (16) of subsection (a) for the semi-semi-annual annual period described in such paragraph, increased by the amount of the appropriation for such period under section 108 of the Children's Health Insurance Program Reauthorization Act of 2009, the Secretary shall compute a State allotment for each State (including the District of Columbia and each commonwealth and territory) for such semi-annual period in an amount equal to the first half ratio (described in subparagraph (D)) of the amount described in subparagraph (C).
``(B) Second half.--Subject to paragraphs (4) and (6), from the amount made available under subparagraph (B) of paragraph (16) of subsection (a) for the semi-semi-annual annual period described in such paragraph, the Secretary shall compute a State allotment for each State (including the District of Columbia and each commonwealth and territory) for such semi-annual period in an amount equal to the amount made available under such subparagraph, multiplied by the ratio of-- ``(i) the amount of the allotment to such State under subparagraph (A);
``(C) Full year amount based on rebased amount.--The amount described in this subparagraph for a State is equal to the Federal payments to the State that are attributable to (and countable towards) the total amount of allotments available under this section to the State in fiscal year 2012 (including payments made to the State under subsection (n) for fiscal year 2012 as well as amounts redistributed to the State in fiscal year 2012), multiplied by the allotment increase factor under paragraph (5) for fiscal year 2013.
and [[Page``(II) 123the STAT.amount made available under subsection (a)(16)(B).
14]]``(4) ``(II)Proration rule.--If, after the amountapplication madeof this subsection without regard to this paragraph, the sum of the allotments determined under paragraph (1), (2), or (3) for a fiscal year (or, in the case of fiscal year 2013, for a semi-annual period in such fiscal year) exceeds the amount available under subsection (a)(16)(B).(a) for such fiscal year or period, the Secretary shall reduce each allotment for any State under such paragraph for such fiscal year or period on a proportional basis.
``(4) Proration rule.--If, after the application of this subsection without regard to this paragraph, the sum of the allotments determined under paragraph (1), (2), or (3) for a fiscal year (or, in the case of fiscal year 2013, for a semi- annual period in such fiscal year) exceeds the amount available under subsection (a) for such fiscal year or period, the Secretary shall reduce each allotment for any State under such paragraph for such fiscal year or period on a proportional basis.
``(6) Increase in allotment to account for approved program expansions.--In the case of one of the 50 States or the District of Columbia that-- ``(A) has submitted to the Secretary, and has approved by the Secretary, a State plan amendment or waiver request relating to an expansion of eligibility for children or benefits under this title that becomes effective for a fiscal year (beginning with fiscal year 2010 and ending with fiscal year 2013);
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and ``(B) has submitted to the Secretary, before the August 31 preceding the beginning of the fiscal year, a request for an expansion allotment adjustment under this paragraph for such fiscal year that specifies-- ``(i) <<NOTE:the additional expenditures that are attributable to the eligibility or benefit expansion provided under the amendment or waiver described in subparagraph (A), as certified by the State and submitted to the Secretary by not later than August 31 preceding the beginning of the fiscal year;
Certification.
Deadline.>> the additional expenditures that are attributable to the eligibility or benefit expansion provided under the amendment or waiver described in subparagraph (A), as certified by the State and submitted to the Secretary by not later than August 31 preceding the beginning of the fiscal year;
A State or District may only obtain an increase under this paragraph for an allotment for fiscal year 2010 or fiscal year 2012.
``(7) Availability of amounts for semi-annual periods in fiscal year 2013.--Each semi-annual allotment made under [[Pageparagraph 123(3) STAT.for a period in fiscal year 2013 shall remain available for expenditure under this title for periods after the end of such fiscal year in the same manner as if the allotment had been made available for the entire fiscal year.''.
15]] paragraph (3) for a period in fiscal year 2013 shall remain available for expenditure under this title for periods after the end of such fiscal year in the same manner as if the allotment had been made available for the entire fiscal year.''.
``(2) Deposits into fund.-- ``(A) Initial and subsequent appropriations.--appropriations.--Subject Subject to subparagraphs (B) and (D), out of any money in the Treasury of the United States not otherwise appropriated, there are appropriated to the Fund-- ``(i) for fiscal year 2009, an amount equal to 20 percent of the amount made available under paragraph (12) of subsection (a) for the fiscal year;
and ``(ii) for each of fiscal years 2010 through 2012 (and for each of the semi-annual allotment periods for fiscal year 2013), such sums as are necessary for making payments to eligible States for such fiscal year or period, but not in excess of the aggregate cap described in subparagraph (B).
``(B) Aggregate cap.--The total amount available for payment from the Fund for each of fiscal years 2010 through 2012 (and for each of the semi-annual allotment periods for fiscal year 2013), taking into account deposits made under subparagraph (C), shall not exceed 20 percent of the amount made available under subsection (a) for the fiscal year or period.
``(3) Child enrollment contingency fund payments.-- ``(A) In general.--If a State's expenditures under this title in fiscal year 2009, fiscal year 2010, fiscal year 2011, fiscal year 2012, or a semi-annual allotment period for fiscal year 2013, exceed the total amount of allotments available under this section to the State in the fiscal year or period (determined without regard to any redistribution [[Pageit 123receives STAT.under subsection (f) that is available for expenditure during such fiscal year or period, but including any carryover from a previous fiscal year) and if the average monthly unduplicated number of children enrolled under the State plan under this title (including children receiving health care coverage through funds under this title pursuant to a waiver under section 1115) during such fiscal year or period exceeds its target average number of such enrollees (as determined under subparagraph (B)) for that fiscal year or period, subject to subparagraph (D), the Secretary shall pay to the State from the Fund an amount equal to the product of-- ``(i) the amount by which such average monthly caseload exceeds such target number of enrollees;
16]] it receives under subsection (f) that is available for expenditure during such fiscal year or period, but including any carryover from a previous fiscal year) and if the average monthly unduplicated number of children enrolled under the State plan under this title (including children receiving health care coverage through funds under this title pursuant to a waiver under section 1115) during such fiscal year or period exceeds its target average number of such enrollees (as determined under subparagraph (B)) for that fiscal year or period, subject to subparagraph (D), the Secretary shall pay to the State from the Fund an amount equal to the product of-- ``(i) the amount by which such average monthly caseload exceeds such target number of enrollees;
or ``(ii) for a subsequent fiscal year (or semi-semi-annual annual period occurring in a fiscal year) is equal to the target average number of child enrollees for the State for the previous fiscal year increased by the child population growth factor described in subsection (m)(5)(B) for the State for the prior fiscal year.
or ``(ii) for a subsequent fiscal year (or semi-semi-annual annual period occurring in a fiscal year) is equal to the projected per capita expenditures under such plan for the previous fiscal year (as determined under clause (i) or this clause) increased by the annual percentage increase in the projected per capita amount of National [[PageHealth 123Expenditures STAT.(as estimated by the Secretary) for the year in which such subsequent fiscal year ends.
17]] Health Expenditures (as estimated by the Secretary) for the year in which such subsequent fiscal year ends.
reconciliation.--reconciliation.--Payment <<NOTE:under this paragraph for a fiscal year or period shall be made before the end of the fiscal year or period based upon the most recent data for expenditures and enrollment and the provisions of subsection (e) of section 2105 shall apply to payments under this subsection in the same manner as they apply to payments under such section.
Applicability.>> Payment under this paragraph for a fiscal year or period shall be made before the end of the fiscal year or period based upon the most recent data for expenditures and enrollment and the provisions of subsection (e) of section 2105 shall apply to payments under this subsection in the same manner as they apply to payments under such section.
``(3) Performance bonus payment to offset additional medicaid and chip child enrollment costs resulting from enrollment and retention efforts.-- ``(A) In general.--In addition to the payments made under paragraph (1), for each fiscal year (beginning with fiscal year 2009 and ending with fiscal year 2013), the Secretary shall pay from amounts made available under subparagraph (E), to each State that meets the condition under paragraph (4) for the fiscal year, an amount equal to the amount described in subparagraph (B) for the State and fiscal year.
<<NOTE:The payment under this paragraph shall be made, to a State for a fiscal year, as a single payment not later than the last day of the first calendar quarter of the following fiscal year.
Deadline.>> The payment under this paragraph shall be made, to a State for a fiscal year, as a single payment not later than the last day of the first calendar quarter of the following fiscal year.
``(i) First tier above baseline medicaid enrollees.--An amount equal to the number of first [[Pagetier 123above STAT.baseline child enrollees (as determined under subparagraph (C)(i)) under title XIX for the State and fiscal year, multiplied by 15 percent of the projected per capita State Medicaid expenditures (as determined under subparagraph (D)) for the State and fiscal year under title XIX.
18]]``(ii) Second tier above baseline medicaid enrollees.-- An amount equal to the number of second tier above baseline child enrollees (as determined under subparagraph (C)(i))(C)(ii)) under title XIX for the State and fiscal year, multiplied by 1562.5 percent of the projected per capita State Medicaid expenditures (as determined under subparagraph (D)) for the State and fiscal year under title XIX.
``(ii) Second tier above baseline medicaid enrollees.--An amount equal to the number of second tier above baseline child enrollees (as determined under subparagraph (C)(ii)) under title XIX for the State and fiscal year, multiplied by 62.5 percent of the projected per capita State Medicaid expenditures (as determined under subparagraph (D)) for the State and fiscal year under title XIX.
baseline number of child enrollees.--enrollees.--For For purposes of this paragraph:
``(iii) Baseline number of child enrollees.--enrollees.--Subject Subject to subparagraph (H), the baseline number of child enrollees for a State under title XIX-- ``(I) for fiscal year 2009 is equal to the monthly average unduplicated number of qualifying children enrolled in the State plan under title XIX during fiscal year 2007 increased by the population growth for children in that State from 2007 to 2008 (as estimated by the Bureau of the Census) plus 4 percentage points, and further increased [[Pageby 123the STAT.population growth for children in that State from 2008 to 2009 (as estimated by the Bureau of the Census) plus 4 percentage points;
19]] by the population growth for children in that State from 2008 to 2009 (as estimated by the Bureau of the Census) plus 4 percentage points;
``(D) Projected per capita state medicaid expenditures.--Forexpenditures.-- For purposes of subparagraph (B), the projected per capita State Medicaid expenditures for a State and fiscal year under title XIX is equal to the average per capita expenditures (including both State and Federal financial participation) for children under the State plan under such title, including under waivers but not including such children eligible for assistance by virtue of the receipt of benefits under title XVI, for the most recent fiscal year for which actual data are available (as determined by the Secretary), increased (for each subsequent fiscal year up to and including the fiscal year involved) by the annual percentage increase in per capita amount of National Health Expenditures (as estimated by the Secretary) for the calendar year in which the respective subsequent fiscal year ends and multiplied by a State matching percentage equal to 100 percent minus the Federal medical assistance percentage (as defined in section 1905(b)) for the fiscal year involved.
``(E) Amounts available for payments.-- ``(i) Initial appropriation.--Out of any money in the Treasury not otherwise appropriated, there are appropriated $3,225,000,000 for fiscal year 2009 for making payments under this paragraph, to be available until expended.
``(ii) Transfers.--Notwithstanding any other provision of this title, the following amounts shall also [[Pagebe 123available, STAT.without fiscal year limitation, for making payments under this paragraph:
20]]``(I) beUnobligated available,national withoutallotment.-- ``(aa) Fiscal years 2009 through 2012.--As of December 31 of fiscal year limitation,2009, and as of December of each succeeding fiscal year through fiscal year 2012, the portion, if any, of the amount appropriated under subsection (a) for makingsuch paymentsfiscal year that is unobligated for allotment to a State under thissubsection paragraph:(m) for such fiscal year or set aside under subsection (a)(3) or (b)(2) of section for such fiscal year.
``(I)``(bb) UnobligatedFirst nationalhalf allotment.--of ``(aa)fiscal Fiscalyear years2013.--As 2009 through 2012.--As of December 31 of fiscal year 2009,2013, andthe asportion, if any, of Decemberthe 31sum of eachthe succeedingamounts fiscalappropriated yearunder throughsubsection fiscal(a)(16)(A) yearand 2012,under section 108 of the portion,Children's ifHealth any,Insurance Reauthorization Act of for the amountperiod appropriatedbeginning underon subsectionOctober (a)1, for2012, suchand fiscalending yearon March 31, 2013, that is unobligated for allotment to a State under subsection (m) for such fiscal year or set aside under subsection (a)(3) or (b)(2) of section 2111 for such fiscal year.
``(bb)``(cc) FirstSecond half of fiscal year 2013.--As of DecemberJune 3130 of fiscal year 2013, the portion, if any, of the sumamount of the amounts appropriated under subsection (a)(16)(A)(a)(16)(B) and under section 108 of the Children's Health Insurance Reauthorization Act of 2009 for the period beginning on OctoberApril 1, 2012,2013, and ending on MarchSeptember 31,30, 2013, that is unobligated for allotment to a State under subsection (m) for such fiscal year or set aside under subsection (b)(2) of section 2111 for such fiscal year.
``(cc)``(II) SecondUnexpended halfallotments ofnot fiscalused yearfor 2013.--Asredistribution.--As of JuneNovember 3015 of each of fiscal yearyears 2010 through 2013, the portion,total ifamount any, of theallotments amountmade appropriatedto States under subsectionsection (a)(16)(B)2104 for the periodsecond beginningpreceding onfiscal Aprilyear 1,(third 2013,preceding andfiscal endingyear onin Septemberthe 30,case 2013,of thatthe isfiscal unobligatedyear for2006, allotment2007, toand a2008 Stateallotments) underthat subsectionis (m)not forexpended suchor fiscalredistributed yearunder orsection set2104(f) asideduring underthe subsectionperiod (b)(2)in ofwhich sectionsuch forallotments suchare fiscalavailable year.for obligation.
``(II) Unexpended allotments not used for redistribution.--As of November of each of fiscal years 2010 through 2013, the total amount of allotments made to States under section 2104 for the second preceding fiscal year (third preceding fiscal year in the case of the fiscal year 2006, 2007, and 2008 allotments) that is not expended or redistributed under section 2104(f) during the period in which such allotments are available for obligation.
``(iii) Proportional reduction.--If the sum of the amounts otherwise payable under this paragraph for [[Pagea 123fiscal STAT.year exceeds the amount available for the fiscal year under this subparagraph, the amount to be paid under this paragraph to each State shall be reduced proportionally.
21]] a fiscal year exceeds the amount available for the fiscal year under this subparagraph, the amount to be paid under this paragraph to each State shall be reduced proportionally.
``(4) Enrollment and retention provisions for children.--For purposes of paragraph (3)(A), a State meets the condition of this paragraph for a fiscal year if it is implementing at least 5 of the following enrollment and retention provisions (treating each subparagraph as a separate enrollment and retention provision) throughout the entire fiscal year:
``(A) Continuous eligibility.--The State has elected the option of continuous eligibility for a full 12 months [[Pagefor 123all STAT.children described in section 1902(e)(12) under title XIX under years of age, as well as applying such policy under its State child health plan under this title.
22]] for all children described in section 1902(e)(12) under title XIX under 19 years of age, as well as applying such policy under its State child health plan under this title.
``(ii) Satisfaction through demonstrated use of ex parte process.--A State shall be treated as satisfying the requirement of clause (i) if renewal of eligibility of children under title XIX or this title is determined without any requirement for an in-person interview, unless sufficient information is not in the State's possession and cannot be acquired from other [[Pagesources 123(including STAT.other State agencies) without the participation of the applicant or the applicant's parent or caretaker relative.
23]] sources (including other State agencies) without the participation of the applicant or the applicant's parent or caretaker relative.
``(2) Shortfall states described.-- ``(A) In general.--For purposes of paragraph (1), with respect to a fiscal year, a shortfall State described in this subparagraph is a State with a State child health plan approved under this title for which the Secretary estimates on the basis of the most recent data available to the Secretary, that the projected expenditures under such plan for the State for the fiscal year will exceed the sum of-- ``(i) the amount of the State's allotments for any preceding fiscal years that remains available for [[Pageexpenditure 123and STAT.that will not be expended by the end of the immediately preceding fiscal year;
24]] expenditure and that will not be expended by the end of the immediately preceding fiscal year;
``(C) Retrospective adjustment.--adjustment.--The <<NOTE:Secretary may adjust the estimates and determinations made under paragraph (1) and this paragraph with respect to a fiscal year as necessary on the basis of the amounts reported by States not later than November 30 of the succeeding fiscal year, as approved by the Secretary.''.
Deadline.>>(2) TheEffective Secretarydate.--The mayamendments adjust the estimates and determinations made underby paragraph (1) andshall thisapply paragraph with respect to aredistribution fiscal year as necessary on the basis of theallotments amountsmade reportedfor byfiscal Statesyear not2007 laterand thansubsequent November 30 of the succeeding fiscal year,years. as approved by the Secretary.''.
(2) <<NOTE:
42 USC 1397dd note.>> Effective date.--The amendments made by paragraph (1) shall apply to redistribution of allotments made for fiscal year 2007 and subsequent fiscal years.
``(4) Option for allotments for fiscal years 2009 through 2013.-- ``(A) Payment of enhanced portion of matching rate for certain expenditures.--In the case of expenditures described in subparagraph (B), a qualifying State (as defined in paragraph (2)) may elect to be paid from the State's allotment made under section 2104 for any of fiscal years 2009 through 2013 (insofar as the allotment is available to the State under subsections (e) and (m) of such section) an amount each quarter equal to the additional amount that would have been paid to the State under title XIX with respect to such expenditures if the enhanced FMAP (as determined under subsection (b)) had [[Pagebeen 123substituted STAT.for the Federal medical assistance percentage (as defined in section 1905(b)).
25]] been substituted for the Federal medical assistance percentage (as defined in section 1905(b)).
(b) Repeal of Limitation on Availability of Fiscal Year 2009 Allotments.--Paragraph (2) of section 201(b) of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (Public Law 110-173) <<NOTE:is repealed.
42 USC 1397ee note.>> is repealed.
``(4) Exclusion of certain expenditures from payment limits.--Withlimits.-- With respect to fiscal years beginning with fiscal year 2009, if Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa qualify for a payment under subparagraph (A)(i), (B), or (F) of section 1903(a)(3) for a calendar quarter of such fiscal year, the payment shall not be taken into account in applying subsection (f) (as increased in accordance with paragraphs (1), (2), and (3) of this subsection) to such commonwealth or territory for such fiscal year.''.
[[PageSubtitle 123B--Focus STAT.on Low-Income Children and Pregnant Women SEC.
26]] Subtitle B--Focus on Low-Income Children and Pregnant Women SEC.
<<NOTE:OPTIONAL COVERAGE OF TARGETED LOW-INCOME PREGNANT WOMEN THROUGH A STATE PLAN AMENDMENT.
42 USC 1397ll note.>> OPTIONAL COVERAGE OF TARGETED LOW-INCOME PREGNANT WOMEN THROUGH A STATE PLAN AMENDMENT.
``(1) Minimum income eligibility levels for pregnant women and children.--The State has established an income eligibility level-- ``(A) for pregnant women under subsection (a)(10)(A)(i)(III), (a)(10)(A)(i)(IV), or (l)(1)(A) of section 1902 that is at least 185 percent (or such higher percent as the State has in effect with regard to pregnant women under this title) of the poverty line applicable to a family of the size involved, but in no case lower than the percent in effect under any such subsection as of July 1, 2008;
``(4) Application of requirements for coverage of targeted low-incomelow- income children.--The State provides pregnancy-related assistance for targeted low-income pregnant women in the same manner, and subject to the same requirements, as the State provides child health assistance for targeted low-income children under the State child health plan, and in addition to providing child health assistance for such women.
``(5) No preexisting condition exclusion or waiting period.--Theperiod.-- The State does not apply any exclusion of benefits [[Pagefor 123pregnancy- STAT.related assistance based on any preexisting condition or any waiting period (including any waiting period imposed to carry out section 2102(b)(3)(C)) for receipt of such assistance.
27]] for pregnancy-related assistance based on any preexisting condition or any waiting period (including any waiting period imposed to carry out section 2102(b)(3)(C)) for receipt of such assistance.
During the period in which a child is deemed under the preceding sentence to be eligible for child health or medical assistance, the child health or medical assistance eligibility identification number of the mother shall also [[Pageserve 123as STAT.the identification number of the child, and all claims shall be submitted and paid under such number (unless the State issues a separate identification number for the child before such period expires).
28]]``(f) serveStates asProviding theAssistance identificationThrough numberOther Options.-- ``(1) Continuation of other options for providing assistance.-- The option to provide assistance in accordance with the child,preceding andsubsections allof claimsthis section shall benot submittedlimit andany paidother underoption suchfor numbera (unlessState to provide-- ``(A) child health assistance through the Stateapplication issuesof asections separate457.10, identification457.350(b)(2), number457.622(c)(5), forand 457.626(a)(3) of title 42, Code of Federal Regulations (as in effect after the childfinal beforerule suchadopted periodby expires).the Secretary and set forth at 67 Fed.
``(f) States Providing Assistance Through Other Options.-- ``(1) Continuation of other options for providing assistance.--The option to provide assistance in accordance with the preceding subsections of this section shall not limit any other option for a State to provide-- ``(A) child health assistance through the application of sections 457.10, 457.350(b)(2), 457.622(c)(5), and 457.626(a)(3) of title 42, Code of Federal Regulations (as in effect after the final rule adopted by the Secretary and set forth at 67 Fed.
or ``(B) to modify the authority to provide pregnancy-pregnancy-related related services under a waiver specified in paragraph (1)(B).''.
1397cc(e)(2)) is amended-- (A) in the heading, by inserting ``or``<SUP>or pregnancy- related assistance'' after ``preventive``<SUP>preventive services'';
``(iii) may not apply a waiting period (including a waiting period to carry out paragraph (3)(C)) in the case of a targeted low-income pregnant woman provided pregnancy-relatedpregnancy- related assistance under section 2112.''.
[[PageSEC. 123 STAT.
29]] SEC.
<<NOTE:PHASE-OUT OF COVERAGE FOR NONPREGNANT CHILDLESS ADULTS;
42 USC 1397kk.>> PHASE-OUT OF COVERAGE FOR NONPREGNANT CHILDLESS ADULTS;
and ``(B) <<NOTE:notwithstanding the terms and conditions of an applicable existing waiver, the provisions of paragraph (2) shall apply for purposes of any period beginning on or after January 1, 2010, in determining the period to which the waiver applies, the individuals eligible to be covered by the waiver, and the amount of the Federal payment under this title.
Applicability.>> notwithstanding the terms and conditions of an applicable existing waiver, the provisions of paragraph (2) shall apply for purposes of any period beginning on or after January 1, 2010, in determining the period to which the waiver applies, the individuals eligible to be covered by the waiver, and the amount of the Federal payment under this title.
``(B) Extension upon state request.--request.--If <<NOTE:an applicable existing waiver described in subparagraph (A) would otherwise expire before January 1, 2010, notwithstanding the requirements of subsections (e) and (f) of section 1115, a State may submit, not later than September 30, 2009, a request to the Secretary for an extension of the waiver.
Deadline.>> If an applicable existing waiver described in subparagraph (A) would otherwise expire before January 1, 2010, notwithstanding the requirements of subsections (e) and (f) of section 1115, a State may submit, not later than September 30, 2009, a request to the Secretary for an extension of the waiver.
``(3) State option to apply for medicaid waiver to continue coverage for nonpregnant childless adults.-- ``(A) In general.--general.--Each <<NOTE:State for which coverage under an applicable existing waiver is terminated under paragraph (2)(A) may submit, not later than September 30, 2009, an application to the Secretary for a waiver under section 1115 of the State plan under title XIX to provide medical assistance to a nonpregnant childless adult whose coverage is so terminated (in this subsection referred to as a `Medicaid nonpregnant childless adults waiver').
Deadline.>> Each State for which coverage under an applicable existing waiver is terminated under paragraph (2)(A) may submit, not later than September 30, [[Page 123 STAT.
30]] 2009, an application to the Secretary for a waiver under section 1115 of the State plan under title XIX to provide medical assistance to a nonpregnant childless adult whose coverage is so terminated (in this subsection referred to as a `Medicaid nonpregnant childless adults waiver').
automatic extension at state option through fiscal year 2011.-- ``(A) No new chip waivers.--Notwithstanding section 1115 or any other provision of this title, except as provided in this subsection-- ``(i) the Secretary shall not on or after the date of the enactment of the Children's Health Insurance Program Reauthorization Act of 2009 approve or renew a waiver, experimental, pilot, or demonstration project that would allow funds made available under this title to be used to provide child health assistance or other health benefits coverage to a parent of a targeted low-income child;
and ``(ii) <<NOTE:notwithstanding the terms and conditions of an applicable existing waiver, the provisions of paragraphs (2) and (3) shall apply for purposes of any fiscal year beginning on or after October 1, 2011, in determining the period to which the waiver applies, the individuals eligible to be covered by the waiver, and the amount of the Federal payment under this title.
Applicability.``(B) Extension upon state request.--If an applicable existing waiver described in subparagraph (A) would otherwise expire before October 1, 2011, and the State requests an extension of such waiver, the Secretary shall grant such an extension, but only, subject to paragraph (2)(A), through September 30, 2011.
Effective date.>> notwithstanding the terms and conditions of an applicable existing waiver, the provisions of paragraphs (2) and (3) shall apply for purposes of any fiscal year beginning on or after October 1, 2011, in determining the period to which the waiver applies, the individuals eligible to be covered by the waiver, and the amount of the Federal payment under this title.
[[Page 123 STAT.
31]] ``(B) Extension upon state request.--If an applicable existing waiver described in subparagraph (A) would otherwise expire before October 1, 2011, and the State requests an extension of such waiver, the Secretary shall grant such an extension, but only, subject to paragraph (2)(A), through September 30, 2011.
``(2) Rules for fiscal years 2012 through 2013.-- ``(A) Payments for coverage limited to block grant funded from state allotment.--Any State that provides child health assistance or health benefits coverage under an applicable existing waiver for a parent of a targeted low-income child may elect to continue to provide such assistance or coverage through fiscal year 2012 or 2013, subject to the same terms and conditions that applied under the applicable existing waiver, unless otherwise modified in subparagraph (B).
``(B) Terms and conditions.-- ``(i) Block grant set aside from state allotment.--allotment.--If <<NOTE:the State makes an election under subparagraph (A), the Secretary shall set aside for the State for each such fiscal year an amount equal to the Federal share of 110 percent of the State's projected expenditures under the applicable existing waiver for providing child health assistance or health benefits coverage to all parents of targeted low-income children enrolled under such waiver for the fiscal year (as certified by the State and submitted to the Secretary by not later than August 31 of the preceding fiscal year).
Certification.
Deadline.>> If the State makes an election under subparagraph (A), the Secretary shall set aside for the State for each such fiscal year an amount equal to the Federal share of 110 percent of the State's projected expenditures under the applicable existing waiver for providing child health assistance or health benefits coverage to all parents of targeted low-income children enrolled under such waiver for the fiscal year (as certified by the State and submitted to the Secretary by not later than August 31 of the preceding fiscal year).
fmap for any other states.--For purposes of clause (ii), the applicable percentage for any quarter of fiscal year 2012 is equal to-- ``(I) the enhanced FMAP determined under section 2105(b) in the case of a State that meets [[Pagethe 123outreach STAT.or coverage benchmarks described in any of subparagraph (A), (B), or (C) of paragraph (3) for fiscal year 2011;
32]] the outreach or coverage benchmarks described in any of subparagraph (A), (B), or (C) of paragraph (3) for fiscal year 2011;
``(vi) No increase in income eligibility level for parents.--No payments shall be made to a State from the amount set aside under clause (i) for a fiscal year for expenditures for providing child health assistance or health benefits coverage to a parent of a targeted low-incomelow- income child whose family income exceeds the income eligibility level applied under the applicable existing waiver to parents of targeted low-income children on the date of enactment of the Children's Health Insurance Program Reauthorization Act of 2009.
``(B) High-performing state.--The State, on the basis of the most timely and accurate published estimates of the Bureau of the Census, ranks in the lowest \1/3\ of States [[Pagein 123terms STAT.of the State's percentage of low-income children without health insurance.
33]]``(C) inState termsincreasing enrollment of low-income children.-- The State qualified for a performance bonus payment under section 2105(a)(3)(B) for the State'smost percentagerecent offiscal low-incomeyear childrenapplicable withoutunder healthsuch insurance.section.
``(C) State increasing enrollment of low-income children.--The State qualified for a performance bonus payment under section 2105(a)(3)(B) for the most recent fiscal year applicable under such section.
(B) Section 6102(c) of the Deficit Reduction Act of 2005 (Public Law 109-171;
131) <<NOTE:is amended by striking ``Nothing'' and inserting ``Subject to section 2111 of the Social Security Act, as added by section 112 of the Children's Health Insurance Program Reauthorization Act of 2009, nothing''.
42(b) USCGAO 1397ggStudy note.>>and isReport.-- amended(1) byIn strikinggeneral.--The ``Nothing''Comptroller andGeneral insertingof ``Subjectthe toUnited States shall conduct a study of whether-- (A) the coverage of a parent, a caretaker relative (as such term is used in carrying out section 21111931), or a legal guardian of a targeted low-income child under a State health plan under title XXI of the Social Security Act,Act asincreases addedthe byenrollment sectionof, 112or the quality of thecare Children'sfor, Healthchildren, Insuranceand Program(B) Reauthorizationsuch Actparents, relatives, and legal guardians who enroll in such a plan are more likely to enroll their children in such a plan or in a State plan under title XIX of 2009,such nothing''.Act.
[[Page 123 STAT.
34]] (b) GAO Study and Report.-- (1) In general.--The Comptroller General of the United States shall conduct a study of whether-- (A) the coverage of a parent, a caretaker relative (as such term is used in carrying out section 1931), or a legal guardian of a targeted low-income child under a State health plan under title XXI of the Social Security Act increases the enrollment of, or the quality of care for, children, and (B) such parents, relatives, and legal guardians who enroll in such a plan are more likely to enroll their children in such a plan or in a State plan under title XIX of such Act.
``(8) Limitation on matching rate for expenditures for child health assistance provided to children whose effective family income exceeds 300 percent of the poverty line.-- ``(A) FMAP applied to expenditures.--Except as provided in subparagraph (B), for fiscal years beginning with fiscal year 2009, the Federal medical assistance percentage [[Page(as 123determined STAT.under section 1905(b) without regard to clause (4) of such section) shall be substituted for the enhanced FMAP under subsection (a)(1) with respect to any expenditures for providing child health assistance or health benefits coverage for a targeted low-income child whose effective family income would exceed 300 percent of the poverty line but for the application of a general exclusion of a block of income that is not determined by type of expense or type of income.
35]] (as determined under section 1905(b) without regard to clause (4) of such section) shall be substituted for the enhanced FMAP under subsection (a)(1) with respect to any expenditures for providing child health assistance or health benefits coverage for a targeted low-income child whose effective family income would exceed 300 percent of the poverty line but for the application of a general exclusion of a block of income that is not determined by type of expense or type of income.
(b) <<NOTE:Rule of Construction.--Nothing in the amendments made by this section shall be construed as-- (1) changing any income eligibility level for children under title XXI of the Social Security Act;
42 USC 1397ee note.>> Rule of Construction.--Nothing in the amendments made by this section shall be construed as-- (1) changing any income eligibility level for children under title XXI of the Social Security Act;
<<NOTE:STATE AUTHORITY UNDER MEDICAID.
42 USC 1396d note.>> STATE AUTHORITY UNDER MEDICAID.
<<NOTE:GRANTS TO IMPROVE OUTREACH AND ENROLLMENT.
42 USC 1397mm.>> GRANTS TO IMPROVE OUTREACH AND ENROLLMENT.
National Campaign.-- ``(1) In general.--From the amounts appropriated under subsection (g), subject to paragraph (2), the Secretary shall award grants to eligible entities during the period of fiscal years 2009 through 2013 to conduct outreach and enrollment [[Pageefforts 123that STAT.are designed to increase the enrollment and participation of eligible children under this title and title XIX.
36]]``(2) effortsTen thatpercent areset designedaside for national enrollment campaign.-- An amount equal to increase10 percent of such amounts shall be used by the enrollmentSecretary andfor participationexpenditures ofduring eligiblesuch childrenperiod underto thiscarry titleout anda titlenational XIX.enrollment campaign in accordance with subsection (h).
``(2) Ten percent set aside for national enrollment campaign.--An amount equal to 10 percent of such amounts shall be used by the Secretary for expenditures during such period to carry out a national enrollment campaign in accordance with subsection (h).
``(2) Ten percent set aside for outreach to indian children.--Anchildren.-- An amount equal to 10 percent of the funds appropriated under subsection (g) shall be used by the Secretary to award grants to Indian Health Service providers and urban Indian organizations receiving funds under title V of the Indian Health Care Improvement Act (25 U.S.C.
Such application shall include-- ``(1) evidence demonstrating that the entity includes members who have access to, and credibility with, ethnic or low-low-income income populations in the communities in which activities funded under the grant are to be conducted;
Annual Report.--The Secretary shall-- [[Page``(1) 123make STAT.publicly available the enrollment data and information collected and reported in accordance with subsection (c)(4)(B);
37]] ``(1) make publicly available the enrollment data and information collected and reported in accordance with subsection (c)(4)(B);
9801 et seq.), the school lunch program [[Pageestablished 123under STAT.the Richard B.
38]] established under the Richard B.
[[Page(b) 123Enhanced STAT.Administrative Funding for Translation or Interpretation Services Under CHIP and Medicaid.-- (1) CHIP.--Section 2105(a)(1) (42 U.S.C.
39]] (b) Enhanced Administrative Funding for Translation or Interpretation Services Under CHIP and Medicaid.-- (1) CHIP.--Section 2105(a)(1) (42 U.S.C.
Such steps may include outreach efforts such as the outstationing of eligibility workers, entering [[Pageinto 123agreements STAT.with the Indian Health Service, Indian Tribes, Tribal Organizations, and Urban Indian Organizations to provide outreach, education regarding eligibility and benefits, enrollment, and translation services when such services are appropriate.
40]] into agreements with the Indian Health Service, Indian Tribes, Tribal Organizations, and Urban Indian Organizations to provide outreach, education regarding eligibility and benefits, enrollment, and translation services when such services are appropriate.
``(13) Express Lane Option.-- ``(A) In general.-- ``(i) Option to use a finding from an express lane agency.--At the option of the State, the State plan may provide that in determining eligibility under this title for a child (as defined in subparagraph (G)), the State may rely on a finding made within a reasonable period (as determined by the State) from an Express Lane agency [[Page(as 123defined STAT.in subparagraph (F)) when it determines whether a child satisfies one or more components of eligibility for medical assistance under this title.
41]] (as defined in subparagraph (F)) when it determines whether a child satisfies one or more components of eligibility for medical assistance under this title.
``(ii) Option to apply to renewals and redeterminations.--Theredeterminations.-- The State may apply the provisions of this paragraph when conducting initial determinations of eligibility, redeterminations of eligibility, or both, as described in the State plan.
``(C) Options for satisfying the screen and enroll requirement.-- ``(i) In general.--With respect to a child whose eligibility for medical assistance under this title or for child health assistance under title XXI has been evaluated by [[Pagea 123State STAT.agency using an income finding from an Express Lane agency, a State may carry out its duties under subparagraphs (A) and (B) of section 2102(b)(3) (relating to screen and enroll) in accordance with either clause (ii) or clause (iii).
42]] a State agency using an income finding from an Express Lane agency, a State may carry out its duties under subparagraphs (A) and (B) of section 2102(b)(3) (relating to screen and enroll) in accordance with either clause (ii) or clause (iii).
[[Page``(II) 123Determination STAT.of eligibility.--During such temporary enrollment period, the State shall determine the child's eligibility for child health assistance under title XXI or for medical assistance under this title in accordance with this clause.
43]] ``(II) Determination of eligibility.--During such temporary enrollment period, the State shall determine the child's eligibility for child health assistance under title XXI or for medical assistance under this title in accordance with this clause.
``(IV) Requirement for simplified determination.--determination.--In <<NOTE:making such a determination, the State shall use procedures that, to the maximum feasible extent, reduce the burden imposed on the individual of such determination.
Procedures.>> In making such a determination, the State shall use procedures that, to the maximum feasible extent, reduce the burden imposed on the individual of such determination.
application to enrollment error rates.-- ``(i) In general.--For purposes of subparagraph (A)(iv), the requirement of this subparagraph for a State is that the State agrees to-- ``(I) assign such codes as the Secretary shall require to the children who are enrolled in the State [[PageMedicaid 123plan STAT.or the State CHIP plan through reliance on a finding made by an Express Lane agency for the duration of the State's election under this paragraph;
44]]``(II) Medicaidannually planprovide orthe Secretary with a statistically valid sample (that is approved by Secretary) of the Statechildren CHIPenrolled planin such plans through reliance on such a finding made by anconducting Expressa Lanefull agencyMedicaid foreligibility review of the durationchildren identified for such sample for purposes of determining an eligibility error rate (as described in clause (iv)) with respect to the State'senrollment electionof undersuch thischildren paragraph;(and shall not include such children in any data or samples used for purposes of complying with a Medicaid Eligibility Quality Control (MEQC) review or a payment error rate measurement (PERM) requirement);
``(II)``(III) <<NOTE:submit the error rate determined under subclause (II) to the Secretary;
Deadline.
Statistics.>> annually provide the Secretary with a statistically valid sample (that is approved by Secretary) of the children enrolled in such plans through reliance on such a finding by conducting a full Medicaid eligibility review of the children identified for such sample for purposes of determining an eligibility error rate (as described in clause (iv)) with respect to the enrollment of such children (and shall not include such children in any data or samples used for purposes of complying with a Medicaid Eligibility Quality Control (MEQC) review or a payment error rate measurement (PERM) requirement);
``(III) <<NOTE:
Submission.>> submit the error rate determined under subclause (II) to the Secretary;
``(iv) Error rate defined.--In this subparagraph, the term `error rate' means the rate of erroneous excess payments for medical assistance (as defined in section 1903(u)(1)(D)) for the period involved, except that such payments shall be limited to individuals for which eligibility determinations are made under this paragraph and [[Pageexcept 123that STAT.in applying this paragraph under title XXI, there shall be substituted for references to provisions of this title corresponding provisions within title XXI.
45]] except that in applying this paragraph under title XXI, there shall be substituted for references to provisions of this title corresponding provisions within title XXI.
``(ee) The Food and Nutrition Act of 2008 (7 U.S.C.
2011 et seq.).
``(ff) The Head Start Act (42 U.S.C.
``(ff) The Head Start Act (42 U.S.C.
9801 et seq.).
1751 et seq.).
``(hh) The Child Nutrition Act of 1966 (42 U.S.C.
``(hh) The Child Nutrition Act of (42 U.S.C.
1771 et seq.).
``(ll) The Native American Housing Assistance and Self-Determination Act of 1996 (25 U.S.C.
[[Page``(III) 123A STAT.public agency that is subject to an interagency agreement limiting the disclosure and use of the information disclosed for purposes of determining eligibility under the State Medicaid plan or the State CHIP plan.
46]] ``(III) A public agency that is subject to an interagency agreement limiting the disclosure and use of the information disclosed for purposes of determining eligibility under the State Medicaid plan or the State CHIP plan.
``(I) State.--The term `State' means 1 of the 50 States or the District of Columbia.
(b) Evaluation and Report.-- [[Page(1) 123Evaluation.--The STAT.Secretary shall conduct, by grant, contract, or interagency agreement, a comprehensive, independent evaluation of the option provided under the amendments made by subsection (a).
47]]Such (1)evaluation <<NOTE:shall include an analysis of the effectiveness of the option, and shall include-- (A) obtaining a statistically valid sample of the children who were enrolled in the State Medicaid plan or the State CHIP plan through reliance on a finding made by an Express Lane agency and determining the percentage of children who were erroneously enrolled in such plans;
Grants.(B) determining whether enrolling children in such plans through reliance on a finding made by an Express Lane agency improves the ability of a State to identify and enroll low- income, uninsured children who are eligible but not enrolled in such plans;
Contracts.>> Evaluation.--The Secretary shall conduct, by grant, contract, or interagency agreement, a comprehensive, independent evaluation of the option provided under the amendments made by subsection (a).
Such evaluation shall include an analysis of the effectiveness of the option, and shall include-- (A) <<NOTE:
Statistics.>> obtaining a statistically valid sample of the children who were enrolled in the State Medicaid plan or the State CHIP plan through reliance on a finding made by an Express Lane agency and determining the percentage of children who were erroneously enrolled in such plans;
(B) determining whether enrolling children in such plans through reliance on a finding made by an Express Lane agency improves the ability of a State to identify and enroll low-income, uninsured children who are eligible but not enrolled in such plans;
and (D) <<NOTE:any recommendations for legislative or administrative changes that would improve the effectiveness of enrolling children in such plans through reliance on such findings.
Recommen- dations.>> any recommendations for legislative or administrative changes that would improve the effectiveness of enrolling children in such plans through reliance on such findings.
(3) Funding.-- (A) In general.--Out of any funds in the Treasury not otherwise appropriated, there is appropriated to the Secretary to carry out the evaluation under this subsection $5,000,000 for the period of fiscal years 2009 through 2012.
(d) Authorization of Information Disclosure.-- [[Page(1) 123In STAT.general.--Title XIX is amended by adding at the end the following new section:
48]] (1) In general.--Title XIX is amended by adding at the end the following new section:
<<NOTE:AUTHORIZATION TO RECEIVE RELEVANT INFORMATION.
42 USC 1396w-2 note.>> AUTHORIZATION TO RECEIVE RELEVANT INFORMATION.
<<NOTE:The provisions of section 1128A (other than subsections (a) and (b) and the second sentence of subsection (f)) shall apply to a civil money penalty under this paragraph in the same manner as such provisions apply to a penalty or proceeding under section 1128A(a).
Applicability.>>``(2) TheCriminal provisionspenalty.--A ofprivate sectionentity 1128Adescribed (otherin thanthe subsectionssubsection (a) andthat (b)willfully andpublishes, thediscloses, secondor sentencemakes ofknown subsectionin (f))any shallmanner, applyor to aany civilextent moneynot penaltyauthorized by Federal law, any information obtained under this paragraphsection inshall thebe samefined mannernot asmore suchthan provisions$10,000 applyor toimprisoned anot penaltymore than 1 year, or proceedingboth, underfor sectioneach 1128A(a).such unauthorized publication or disclosure.
``(2) Criminal penalty.--A private entity described in the subsection (a) that willfully publishes, discloses, or makes known in any manner, or to any extent not authorized by Federal law, any information obtained under this section shall [[Page 123 STAT.
49]] be fined not more than $10,000 or imprisoned not more than 1 year, or both, for each such unauthorized publication or disclosure.
(e) <<NOTE:Authorization for States Electing Express Lane Option To Receive Certain Data Directly Relevant To Determining Eligibility and Correct Amount of Assistance.--The Secretary shall enter into such agreements as are necessary to permit a State that elects the Express Lane option under section 1902(e)(13) of the Social Security Act to receive data directly relevant to eligibility determinations and determining the correct amount of benefits under a State child health plan under CHIP or a State plan under Medicaid from the following:
42 USC 1396w-2 note.>> Authorization for States Electing Express Lane Option To Receive Certain Data Directly Relevant To Determining Eligibility and Correct Amount of Assistance.-- <<NOTE:
Contracts.>> The Secretary shall enter into such agreements as are necessary to permit a State that elects the Express Lane option under section 1902(e)(13) of the Social Security Act to receive data directly relevant to eligibility determinations and determining the correct amount of benefits under a State child health plan under CHIP or a State plan under Medicaid from the following:
(f) Effective Date.--Date.--The <<NOTE:amendments made by this section are effective on the date of the enactment of this Act.
42 USC 1396a note.>> The amendments made by this section are effective on the date of the enactment of this Act.
1396a), as amended by section 203(c), is amended-- (i) in subsection (a)(46)-- [[Page(I) 123by STAT.inserting ``(A)'' after ``(46)'';
50]] (I) by inserting ``(A)'' after ``(46)'';
``(A) <<NOTE:The State submits the name and social security number of the individual to the Commissioner of Social Security as part of the program established under paragraph (2).
Submission.>> The State submits the name and social security number of the individual to the Commissioner of Social Security as part of the program established under paragraph (2).
and ``(ii) in the case such inconsistency is not resolved under clause (i), the State-- ``(I) <<NOTE:notifies the individual of such fact;
Notification.>>``(II) notifiesprovides the individual with a period of 90 days from the date on which the notice required under subclause (I) is received by the individual to either present satisfactory documentary evidence of citizenship or nationality (as defined in section 1903(x)(3)) or resolve the inconsistency with the Commissioner of Social Security (and continues to provide the individual with medical assistance during such fact;90-day period);
``(II)and <<NOTE:``(III) disenrolls the individual from the State plan under this title within 30 days after the end of such 90- day period if no such documentary evidence is presented or if such inconsistency is not resolved.
Time``(2)(A) period.>>Each providesState theelecting individualto withsatisfy athe periodrequirements of 90this dayssubsection fromfor thepurposes dateof onsection which1902(a)(46)(B) theshall noticeestablish requireda program under subclausewhich (I)the isState receivedsubmits byat theleast individualmonthly to eitherthe presentCommissioner satisfactoryof documentarySocial evidenceSecurity for comparison of citizenshipthe orname nationalityand (associal definedsecurity innumber, sectionof 1903(x)(3))each orindividual resolvenewly enrolled in the inconsistencyState withplan theunder Commissionerthis oftitle Socialthat Securitymonth (andwho continuesis not described in section 1903(x)(2) and who declares to providebe thea individualUnited States citizen or national, with medicalinformation assistancein duringrecords suchmaintained 90-by daythe period);Commissioner.
and ``(III) <<NOTE:
Deadline.>> disenrolls the individual from the State plan under this title within 30 days after the end of such 90-day period if no such documentary evidence is presented or if such inconsistency is not resolved.
``(2)(A) <<NOTE:
Submission.
Deadline.>> Each State electing to satisfy the requirements of this subsection for purposes of section 1902(a)(46)(B) shall establish a program under which the State submits at least monthly to the Commissioner of Social Security for comparison of the name [[Page 123 STAT.
51]] and social security number, of each individual newly enrolled in the State plan under this title that month who is not described in section 1903(x)(2) and who declares to be a United States citizen or national, with information in records maintained by the Commissioner.
``(B) If, for any fiscal year, the average monthly percentage determined under subparagraph (A) is greater than 3 percent-- ``(i) <<NOTE:the State shall develop and adopt a corrective plan to review its procedures for verifying the identities of individuals seeking to enroll in the State plan under this title and to identify and implement changes in such procedures to improve their accuracy;
Plan.and ``(ii) pay to the Secretary an amount equal to the amount which bears the same ratio to the total payments under the State plan for the fiscal year for providing medical assistance to individuals who provided inconsistent information as the number of individuals with inconsistent information in excess of 3 percent of such total submitted bears to the total number of individuals with inconsistent information.
Procedures.>>``(C) theThe StateSecretary shallmay developwaive, andin adoptcertain alimited correctivecases, planall toor reviewpart itsof procedures for verifying the identitiespayment ofunder individualssubparagraph seeking(B)(ii) toif enroll in the State planis underunable thisto titlereach andthe toallowable identifyerror andrate implementdespite changesa ingood suchfaith procedureseffort toby improvesuch theirState. accuracy;
and ``(ii) pay to the Secretary an amount equal to the amount which bears the same ratio to the total payments under the [[Page 123 STAT.
52]] State plan for the fiscal year for providing medical assistance to individuals who provided inconsistent information as the number of individuals with inconsistent information in excess of percent of such total submitted bears to the total number of individuals with inconsistent information.
``(C) <<NOTE:
Waiver authority.>> The Secretary may waive, in certain limited cases, all or part of the payment under subparagraph (B)(ii) if the State is unable to reach the allowable error rate despite a good faith effort by such State.
(B) Costs of implementing and maintaining system.--system.--Section Section 1903(a)(3) (42 U.S.C.
(2) <<NOTE:Limitation on waiver authority.--Notwithstanding any provision of section 1115 of the Social Security Act (42 U.S.C.
42 USC 1396a note.>> Limitation on waiver authority.--Notwithstanding any provision of section 1115 of the Social Security Act (42 U.S.C.
and [[Page(B) 123by STAT.inserting after clause (iv), the following new clause:
53]] (B) by inserting after clause (iv), the following new clause:
``(II) <<NOTE:With respect to those federally recognized Indian tribes located within States having an international border whose membership includes individuals who are not citizens of the United States, the Secretary shall, after consulting with such tribes, issue regulations authorizing the presentation of such other forms of documentation (including tribal documentation, if appropriate) that the Secretary determines to be satisfactory documentary evidence of citizenship or nationality for purposes of satisfying the requirement of this subsection.''.
Regulations.>> With respect to those federally recognized Indian tribes located within States having an international border whose membership includes individuals who are not citizens of the United States, the Secretary shall, after consulting with such tribes, issue regulations authorizing the presentation of such other forms of documentation (including tribal documentation, if appropriate) that the Secretary determines to be satisfactory documentary evidence of citizenship or nationality for purposes of satisfying the requirement of this subsection.''.
``(5) Nothing in subparagraph (A) or (B) of section 1902(a)(46), the preceding paragraphs of this subsection, or the Deficit Reduction Act of 2005, including section 6036 of such Act, shall be construed as changing the requirement of section 1902(e)(4) that a child born in the United States to an alien mother for whom medical assistance for the delivery of such child is available as treatment [[Pageof 123an STAT.emergency medical condition pursuant to subsection (v) shall be deemed eligible for medical assistance during the first year of such child's life.''.
54]] of an emergency medical condition pursuant to subsection (v) shall be deemed eligible for medical assistance during the first year of such child's life.''.
(2) Nonapplication of administrative expenditures cap.--cap.--Section Section 2105(c)(2)(C) (42 U.S.C.
``(ii) Expenditures to comply with citizenship or nationality verification requirements.--requirements.--Expenditures Expenditures necessary for the State to comply with paragraph (9)(A).''.
(d) <<NOTE:Effective Date.-- (1) In general.-- (A) In general.--Except as provided in subparagraph (B), the amendments made by this section shall take effect on January 1, 2010.
42(B) USCTechnical 1396aamendments.--The note.>>amendments Effectivemade Date.--by-- (1)(i) Inparagraphs general.--(1), (A)(2), Inand general.--Except(3) of subsection (b) shall take effect as providedif included in subparagraphthe (B),enactment theof amendmentssection made6036 byof thisthe sectionDeficit shallReduction takeAct effectof on2005 January(Public 1,Law 2010.109-171;
[[Page 123 STAT.
55]] (B) Technical amendments.--The amendments made by-- (i) paragraphs (1), (2), and (3) of subsection (b) shall take effect as if included in the enactment of section 6036 of the Deficit Reduction Act of 2005 (Public Law 109-171;
(2) Restoration of eligibility.--eligibility.--In <<NOTE:the case of an individual who, during the period that began on July 1, 2006, and ends on October 1, 2009, was determined to be ineligible for medical assistance under a State Medicaid plan, including any waiver of such plan, solely as a result of the application of subsections (i)(22) and (x) of section 1903 of the Social Security Act (as in effect during such period), but who would have been determined eligible for such assistance if such subsections, as amended by subsection (b), had applied to the individual, a State may deem the individual to be eligible for such assistance as of the date that the individual was determined to be ineligible for such medical assistance on such basis.
Time(3) period.>>Special Intransition therule casefor ofindians.--During an individual who, during the period that beganbegins on July 1, 2006, and ends on Octoberthe 1,effective 2009,date wasof determinedfinal toregulations beissued ineligible for medical assistance under asubclause State(II) Medicaid plan, including any waiver of such plan, solely as a result of the application of subsections (i)(22) and (x) of section 19031903(x)(3)(B)(v) of the Social Security Act (as(42 inU.S.C. effect during such period), but who would have been determined eligible for such assistance if such subsections, as amended by subsection (b), had applied to the individual, a State may deem the individual to be eligible for such assistance as of the date that the individual was determined to be ineligible for such medical assistance on such basis.
(3) Special transition rule for indians.-- <<NOTE:
Time period.>> During the period that begins on July 1, 2006, and ends on the effective date of final regulations issued under subclause (II) of section 1903(x)(3)(B)(v) of the Social Security Act (42 U.S.C.
``(4) Reduction of administrative barriers to enrollment.-- ``(A) <<NOTE:In general.--Subject to subparagraph (B), the plan shall include a description of the procedures used to reduce administrative barriers to the enrollment of children and pregnant women who are eligible for medical assistance under title XIX or for child health assistance or health benefits coverage under this title.
Plan.
Procedures.>> In general.-- Subject to subparagraph (B), the plan shall include a description of the procedures used to reduce administrative barriers to the enrollment of children and pregnant women who are eligible for medical assistance under title XIX or for child health assistance or health benefits coverage under this title.
``(B) Deemed compliance if joint application and renewal process that permits application other than in person.--A State shall be deemed to comply with subparagraph (A) if the State's application and renewal [[Pageforms 123and STAT.supplemental forms (if any) and information verification process is the same for purposes of establishing and renewing eligibility for children and pregnant women for medical assistance under title XIX and child health assistance under this title, and such process does not require an application to be made in person or a face-to-face interview.''.
56]] forms and supplemental forms (if any) and information verification process is the same for purposes of establishing and renewing eligibility for children and pregnant women for medical assistance under title XIX and child health assistance under this title, and such process does not require an application to be made in person or a face-to-face interview.''.
<<NOTE:MODEL OF INTERSTATE COORDINATED ENROLLMENT AND COVERAGE PROCESS.
42(a) USCIn 1396General.--In note.>>order MODELto OFassure INTERSTATEcontinuity COORDINATEDof ENROLLMENTcoverage ANDof COVERAGElow- PROCESS.income children under the Medicaid program and the State Children's Health Insurance Program (CHIP), not later than 18 months after the date of the enactment of this Act, the Secretary of Health and Human Services, in consultation with State Medicaid and CHIP directors and organizations representing program beneficiaries, shall develop a model process for the coordination of the enrollment, retention, and coverage under such programs of children who, because of migration of families, emergency evacuations, natural or other disasters, public health emergencies, educational needs, or otherwise, frequently change their State of residency or otherwise are temporarily located outside of the State of their residency.
(a) In General.-- <<NOTE:
Deadline.>> In order to assure continuity of coverage of low-income children under the Medicaid program and the State Children's Health Insurance Program (CHIP), not later than 18 months after the date of the enactment of this Act, the Secretary of Health and Human Services, in consultation with State Medicaid and CHIP directors and organizations representing program beneficiaries, shall develop a model process for the coordination of the enrollment, retention, and coverage under such programs of children who, because of migration of families, emergency evacuations, natural or other disasters, public health emergencies, educational needs, or otherwise, frequently change their State of residency or otherwise are temporarily located outside of the State of their residency.
[[Page``(C) 123As STAT.part of the State's ongoing eligibility redetermination requirements and procedures for an individual provided medical assistance as a result of an election by the State under subparagraph (A), a State shall verify that the individual continues to lawfully reside in the United States using the documentation presented to the State by the individual on initial enrollment.
57]] ``(C) <<NOTE:
Verification.>> As part of the State's ongoing eligibility redetermination requirements and procedures for an individual provided medical assistance as a result of an election by the State under subparagraph (A), a State shall verify that the individual continues to lawfully reside in the United States using the documentation presented to the State by the individual on initial enrollment.
No subsidy shall be provided to a targeted low-incomelow- income child under this paragraph unless the child (or the child's parent) voluntarily elects to receive such a subsidy.
``(B) Qualified employer-sponsored coverage.-- ``(i) In general.--Subject to clause (ii), in this paragraph, the term `qualified employer-employer-sponsored sponsored coverage' means a group health plan or health insurance coverage offered through an employer-- [[Page``(I) 123that STAT.qualifies as creditable coverage as a group health plan under section 2701(c)(1) of the Public Health Service Act;
58]] ``(I) that qualifies as creditable coverage as a group health plan under section 2701(c)(1) of the Public Health Service Act;
and ``(III) that is offered to all individuals in a manner that would be considered a nondiscriminatory eligibility classification for purposes of paragraph (3)(A)(ii) of section 105(h) of the Internal Revenue Code of 1986 (but determined without regard to clause (i) of subparagraph (B) of such paragraph).
``(C) Premium assistance subsidy.-- ``(i) In general.--In this paragraph, the term `premium assistance subsidy' means, with respect to a targeted low-incomelow- income child, the amount equal to the difference between the employee contribution required for enrollment only of the employee under qualified employer-sponsored coverage and the employee contribution required for enrollment of the employee and the child in such coverage, less any applicable premium cost-cost-sharing sharing applied under the State child health plan (subject to the limitations imposed under section 2103(e), including the requirement to count the total amount of the employee contribution required for enrollment of the employee and the child in such coverage toward the annual aggregate cost-cost-sharing sharing limit applied under paragraph (3)(B) of such section).
``(iv) Treatment as child health assistance.-- Expenditures for the provision of premium assistance subsidies shall be considered child health assistance [[Pagedescribed 123in STAT.paragraph (1)(C) of subsection (a) for purposes of making payments under that subsection.
59]] described in paragraph (1)(C) of subsection (a) for purposes of making payments under that subsection.
``(G) Opt-out permitted for any month.--month.--A <<NOTE:State shall establish a process for permitting the parent of a targeted low-income child receiving a premium assistance subsidy to disenroll the child from the qualified employer-sponsored coverage and enroll the child in, and receive child health assistance under, the State child health plan, effective on the first day of any month for which the child is eligible for such assistance and in a manner that ensures continuity of coverage for the child.
Procedures.>>``(H) AApplication to parents.--If a State shallprovides establishchild ahealth processassistance foror permittinghealth thebenefits parentcoverage to parents of a targeted low-income child receivingin accordance with section 2111(b), the State may elect to offer a premium assistance subsidy to disenrolla theparent of a targeted low-income child fromwho theis qualifiedeligible employer-sponsoredfor coveragesuch anda enrollsubsidy under this paragraph in the childsame in,manner andas receivethe childState healthoffers assistancesuch under,a subsidy for the Stateenrollment of the child healthin plan,qualified effectiveemployer-sponsored oncoverage, theexcept firstthat-- day``(i) the amount of anythe monthpremium forassistance whichsubsidy shall be increased to take into account the childcost isof eligiblethe forenrollment suchof assistancethe andparent in athe mannerqualified thatemployer- ensuressponsored continuitycoverage or, at the option of coveragethe forState if the child.State determines it cost-effective, the cost of the enrollment of the child's family in such coverage;
``(H)and Application``(ii) toany parents.--Ifreference a State provides child health assistance or health benefits coverage to parents of a targeted low-income child in accordancethis withparagraph section 2111(b), the State may elect to offer a premium assistance subsidy to a parent of a targeted low-income child who is eligibledeemed forto suchinclude a subsidyreference under this paragraph in the same manner as the State offers such a subsidy for the enrollment of the child in qualified employer-sponsored coverage, except that-- ``(i) the amount of the premium assistance subsidy shall be increased to take into account the cost of the enrollment of the parent in the qualified employer-sponsored coverage or, at the option of the State if theapplicable Stateunder determinesclause it(i), cost-effective, the costfamily of the enrollmentchild. of the child's family in such coverage;
``(I) Additional state option for providing premium assistance.-- ``(i) In general.--A State may establish an employer- family premium assistance purchasing pool for employers with less than 250 employees who have at least 1 employee who is a pregnant woman eligible for assistance under the State child health plan (including through the application of an option described in section 2112(f)) or a member of a family with at least 1 targeted low-income child and [[Pageto 123provide STAT.a premium assistance subsidy under this paragraph for enrollment in coverage made available through such pool.
60]] ``(ii) any reference in this paragraph to a child is deemed to include a reference to the parent or, if applicable under clause (i), the family of the child.
``(I) Additional state option for providing premium assistance.-- ``(i) In general.--A State may establish an employer-family premium assistance purchasing pool for employers with less than 250 employees who have at least 1 employee who is a pregnant woman eligible for assistance under the State child health plan (including through the application of an option described in section 2112(f)) or a member of a family with at least 1 targeted low- income child and to provide a premium assistance subsidy under this paragraph for enrollment in coverage made available through such pool.
``(J) No effect on premium assistance waiver programs.--Nothingprograms.-- Nothing in this paragraph shall be construed as limiting the authority of a State to offer premium assistance under section 1906 or 1906A, a waiver described in paragraph (2)(B) or (3), a waiver approved under section 1115, or other authority in effect prior to the date of enactment of the Children's Health Insurance Program Reauthorization Act of 2009.
and ``(iii) <<NOTE:establish such other procedures as the State determines necessary to ensure that parents are fully informed of the choices for receiving child health assistance under the State child health plan or through the receipt of premium assistance subsidies.
Procedures.>>``(L) establishApplication suchto otherqualified proceduresemployer-sponsored benchmark coverage.--If a group health plan or health insurance coverage offered through an employer is certified by an actuary as thehealth Statebenefits determinescoverage necessarythat is equivalent to ensurethe thatbenefits parentscoverage arein fullya informedbenchmark benefit package described in section 2103(b) or benchmark-equivalent coverage that meets the requirements of section 2103(a)(2), the choicesState may provide premium assistance subsidies for receivingenrollment childof healthtargeted assistancelow- underincome thechildren Statein childsuch group health plan or throughhealth insurance coverage in the receiptsame ofmanner premiumas assistancesuch subsidies.subsidies are provided under this paragraph for enrollment in qualified employer- sponsored coverage, but without regard to the requirement to provide supplemental coverage for benefits and cost-sharing protection provided under the State child health plan under subparagraph (E).
[[Page``(M) 123Satisfaction STAT.of cost-effectiveness test.--Premium assistance subsidies for qualified employer-sponsored coverage offered under this paragraph shall be deemed to meet the requirement of subparagraph (A) of paragraph (3).
61]]``(N) ``(L)Coordination Applicationwith tomedicaid.--In qualifiedthe employer-sponsoredcase benchmarkof coverage.--If a grouptargeted healthlow-income planchild orwho healthreceives insurancechild coveragehealth offeredassistance through ana employerState isplan certifiedunder bytitle anXIX actuaryand aswho healthvoluntarily benefitselects coverage that is equivalent to thereceive benefits coverage in a benchmarkpremium benefitassistance packagesubsidy describedunder inthis sectionsection, 2103(b) or benchmark-equivalent coverage that meets the requirementsprovisions of section 2103(a)(2),1906A theshall Stateapply mayand provideshall premiumsupersede assistanceany subsidiesother forprovisions enrollment of targeted low-income children in such group health plan or health insurance coverage in the same manner as such subsidies are provided under this paragraph forthat enrollmentare ininconsistent qualifiedwith employer-sponsoredsuch coverage,section.''. but without regard to the requirement to provide supplemental coverage for benefits and cost-sharing protection provided under the State child health plan under subparagraph (E).
``(M) Satisfaction of cost-effectiveness test.-- Premium assistance subsidies for qualified employer- sponsored coverage offered under this paragraph shall be deemed to meet the requirement of subparagraph (A) of paragraph (3).
``(N) <<NOTE:
Applicability.>> Coordination with medicaid.--In the case of a targeted low-income child who receives child health assistance through a State plan under title XIX and who voluntarily elects to receive a premium assistance subsidy under this section, the provisions of section 1906A shall apply and shall supersede any other provisions of this paragraph that are inconsistent with such section.''.
1397ee(c)(3)(A)) is amended by striking ``relative to'' and all that follows through the comma and inserting ``relative to ``(i) the amount of expenditures under the State child health plan, including administrative expenditures, that the State would have made to provide comparable coverage of the targeted low-low-income income child involved or the family involved (as applicable);
(B) <<NOTE:Nonapplication to previously approved coverage.--The amendment made by subparagraph (A) shall not apply to coverage the purchase of which has been approved by the Secretary under section 2105(c)(3) of the Social Security Act prior to the date of enactment of this Act.
42 USC 1397ee note.>> Nonapplication to previously approved coverage.--The amendment made by subparagraph (A) shall not apply to coverage the purchase of which has been approved by the Secretary under section 2105(c)(3) of the Social Security Act prior to the date of enactment of this Act.
<<NOTE:(a) In General.--A State may elect to offer a premium assistance subsidy (as defined in subsection (c)) for qualified employer-sponsored coverage (as defined in subsection (b)) to all individuals under age 19 who are entitled to medical assistance under this title (and to the parent of such an individual) who have access to such coverage if the State meets the requirements of this section.
42 USC 1396e-1.>> (a) In General.--A State may elect to offer a premium assistance subsidy (as defined in subsection (c)) for qualified employer-sponsored coverage (as defined in subsection (b)) to [[Page 123 STAT.
62]] all individuals under age 19 who are entitled to medical assistance under this title (and to the parent of such an individual) who have access to such coverage if the State meets the requirements of this section.
``(3) Opt-out permitted for any month.--month.--A <<NOTE:State shall establish a process for permitting the parent of an individual under age 19 receiving a premium assistance subsidy to disenroll the individual from the qualified employer-sponsored coverage.
Procedures.>> A State shall establish a process for permitting the parent of an individual under age 19 receiving a premium assistance subsidy to [[Page 123 STAT.
63]] disenroll the individual from the qualified employer-sponsored coverage.
``(iii) Expenditures for outreach to increase the enrollment of children under this title and title xix through premium assistance subsidies.--subsidies.--Expenditures Expenditures for outreach activities to families of children likely to be eligible for premium assistance subsidies in accordance with paragraph (2)(B), (3), or (10), or a waiver approved under section 1115, to inform such families of the availability of, and to assist them in enrolling their children in, such subsidies, and to [[Pageemployers 123likely STAT.to provide qualified employer-sponsored coverage (as defined in subparagraph (B) of such paragraph), but not to exceed an amount equal to 1.25 percent of the maximum amount permitted to be expended under subparagraph (A) for items described in subsection (a)(1)(D).''.
64]] employers likely to provide qualified employer- sponsored coverage (as defined in subparagraph (B) of such paragraph), but not to exceed an amount equal to 1.25 percent of the maximum amount permitted to be expended under subparagraph (A) for items described in subsection (a)(1)(D).''.
(a) Amendments to Internal Revenue Code of 1986.--Section 9801(f) of the Internal Revenue Code of 1986 <<NOTE:(relating to special enrollment periods) is amended by adding at the end the following new paragraph:
26``(3) USCSpecial 9801.>>rules (relatingrelating to specialmedicaid enrollmentand periods)chip.-- ``(A) In general.--A group health plan shall permit an employee who is amendedeligible, bybut addingnot atenrolled, for coverage under the endterms of the plan (or a dependent of such an employee if the dependent is eligible, but not enrolled, for coverage under such terms) to enroll for coverage under the terms of the plan if either of the following newconditions paragraph:is met:
``(3) Special rules relating to medicaid and chip.-- ``(A) <<NOTE:
Deadlines.>> In general.--A group health plan shall permit an employee who is eligible, but not enrolled, for coverage under the terms of the plan (or a dependent of such an employee if the dependent is eligible, but not enrolled, for coverage under such terms) to enroll for coverage under the terms of the plan if either of the following conditions is met:
``(B) Employee outreach and disclosure.-- ``(i) Outreach to employees regarding availability of medicaid and chip coverage.-- ``(I) In general.--general.--Each <<NOTE:employer that maintains a group health plan in a State that provides medical assistance under a State Medicaid plan under title XIX of the Social Security Act, or child health assistance under a State child health plan under title XXI of such Act, in the form of premium assistance for the purchase of coverage under a group health plan, shall provide to each employee a written notice informing the employee of potential opportunities then currently available in the State in which the employee resides for premium assistance under such plans for health coverage of the employee or the employee's dependents.
Notification.>>For Eachpurposes employerof thatcompliance maintainswith athis groupclause, healththe planemployer inmay ause Stateany thatState-specific providesmodel medicalnotice assistancedeveloped underin aaccordance Statewith Medicaidsection plan701(f)(3)(B)(i)(II) under title XIX of the SocialEmployee SecurityRetirement Act,Income orSecurity childAct health assistance under a State child health plan under title XXI of such1974 Act,(29 inU.S.C. the form of premium [[Page 123 STAT.
65]] assistance for the purchase of coverage under a group health plan, shall provide to each employee a written notice informing the employee of potential opportunities then currently available in the State in which the employee resides for premium assistance under such plans for health coverage of the employee or the employee's dependents.
For purposes of compliance with this clause, the employer may use any State- specific model notice developed in accordance with section 701(f)(3)(B)(i)(II) of the Employee Retirement Income Security Act of 1974 (29 U.S.C.
[[Page``(3) 123Special STAT.rules for application in case of medicaid and chip.-- ``(A) In general.--A group health plan, and a health insurance issuer offering group health insurance coverage in connection with a group health plan, shall permit an employee who is eligible, but not enrolled, for coverage under the terms of the plan (or a dependent of such an employee if the dependent is eligible, but not enrolled, for coverage under such terms) to enroll for coverage under the terms of the plan if either of the following conditions is met:
66]]``(i) ``(3)Termination Specialof rulesmedicaid foror applicationchip incoverage.--The caseemployee or dependent is covered under a Medicaid plan under title XIX of medicaidthe Social Security Act or under a State child health plan under title XXI of such Act and chip.--coverage ``(A)of <<NOTE:the employee or dependent under such a plan is terminated as a result of loss of eligibility for such coverage and the employee requests coverage under the group health plan (or health insurance coverage) not later than days after the date of termination of such coverage.
Deadlines.>> In general.--A group health plan, and a health insurance issuer offering group health insurance coverage in connection with a group health plan, shall permit an employee who is eligible, but not enrolled, for coverage under the terms of the plan (or a dependent of such an employee if the dependent is eligible, but not enrolled, for coverage under such terms) to enroll for coverage under the terms of the plan if either of the following conditions is met:
``(i) Termination of medicaid or chip coverage.--The employee or dependent is covered under a Medicaid plan under title XIX of the Social Security Act or under a State child health plan under title XXI of such Act and coverage of the employee or dependent under such a plan is terminated as a result of loss of eligibility for such coverage and the employee requests coverage under the group health plan (or health insurance coverage) not later than 60 days after the date of termination of such coverage.
``(B) Coordination with medicaid and chip.-- ``(i) Outreach to employees regarding availability of medicaid and chip coverage.-- ``(I) In general.--general.--Each <<NOTE:employer that maintains a group health plan in a State that provides medical assistance under a State Medicaid plan under title XIX of the Social Security Act, or child health assistance under a State child health plan under title XXI of such Act, in the form of premium assistance for the purchase of coverage under a group health plan, shall provide to each employee a written notice informing the employee of potential opportunities then currently available in the State in which the employee resides for premium assistance under such plans for health coverage of the employee or the employee's dependents.
Notification.>>``(II) EachModel employernotice.--Not thatlater maintainsthan a1 groupyear healthafter planthe indate aof Stateenactment thatof providesthe medicalChildren's assistanceHealth underInsurance aProgram StateReauthorization MedicaidAct planof under2009, titlethe XIXSecretary ofand the SocialSecretary Securityof Act,Health orand childHuman healthServices, assistancein underconsultation awith StateDirectors childof healthState planMedicaid agencies under title XXIXIX of such Act, in the formSocial ofSecurity premiumAct assistanceand forDirectors theof purchaseState ofCHIP coverageagencies under atitle groupXXI health plan, shall provide to each employee a written notice informing the employee of potentialsuch opportunitiesAct, thenshall currentlyjointly availabledevelop innational theand StateState-specific inmodel whichnotices the employee resides for premiumpurposes assistance under such plans for health coverage of thesubparagraph employee(A). or the employee's dependents.
``(II) Model notice.-- <<NOTE:
Deadline.>> Not later than 1 year after the date of enactment of the Children's Health Insurance Program Reauthorization Act of 2009, the Secretary and the Secretary of Health and Human Services, in consultation with Directors of State Medicaid agencies under title XIX of the Social Security Act and Directors of State CHIP agencies under title XXI of such Act, shall jointly develop national and State- specific model [[Page 123 STAT.
67]] notices for purposes of subparagraph (A).
[[Page(C) 123Working STAT.group to develop model coverage coordination disclosure form.-- (i) Medicaid, chip, and employer-sponsored coverage coordination working group.-- (I) In general.--Not later than 60 days after the date of enactment of this Act, the Secretary of Health and Human Services and the Secretary of Labor shall jointly establish a Medicaid, CHIP, and Employer- Sponsored Coverage Coordination Working Group (in this subparagraph referred to as the ``Working Group'').
68]] (C) <<NOTE:
29 USC 1181 note.>> Working group to develop model coverage coordination disclosure form.-- (i) Medicaid, chip, and employer-sponsored coverage coordination working group.-- (I) In general.-- <<NOTE:
Deadline.
Establishment.>> Not later than 60 days after the date of enactment of this Act, the Secretary of Health and Human Services and the Secretary of Labor shall jointly establish a Medicaid, CHIP, and Employer-Sponsored Coverage Coordination Working Group (in this subparagraph referred to as the ``Working Group'').
(dd) The premiums and cost-cost-sharing sharing required under the plan.
[[Page(V) 123employers, STAT.including owners of small businesses and their trade or industry representatives and certified human resource and payroll professionals;
69]] (V) employers, including owners of small businesses and their trade or industry representatives and certified human resource and payroll professionals;
(v) Report.-- (I) Report by working group to the secretaries.--Notsecretaries.-- Not later than 18 months after the date of the enactment of this Act, the Working Group shall submit to the Secretary of Labor and the Secretary of Health and Human Services the model form described in clause (i)(II) along with a report containing recommendations for appropriate measures to address the impediments to the effective coordination of coverage between group health plans and the State plans under titles XIX and XXI of the Social Security Act.
(D) Effective dates.--dates.--The <<NOTE:Secretary of Labor and the Secretary of Health and Human Services shall develop the initial model notices under section 701(f)(3)(B)(i)(II) of the Employee Retirement Income Security Act of 1974, and the Secretary of Labor shall provide such notices to employers, not later than the date that is 1 year after the date of enactment of this Act, and each employer shall provide the initial annual notices to such employer's employees beginning with the first plan year that begins after the date on which such initial model notices are first issued.
Notification.The model coverage coordination disclosure form developed under subparagraph (C) shall apply with respect to requests made by States beginning with the first plan year that begins after the date on which such model coverage coordination disclosure form is first issued.
Deadline.
29 USC 1181 note.>> The Secretary of Labor and the Secretary of Health and Human Services shall develop the initial model notices under section 701(f)(3)(B)(i)(II) of the Employee Retirement Income Security Act of 1974, and the Secretary of Labor shall provide such notices to employers, not later than the date that is 1 year after the date of enactment of this Act, and each employer shall provide the initial annual notices to such employer's employees beginning with the first plan year that begins after the date on which such initial model notices are first issued.
<<NOTE:
Applicability.>> The model coverage coordination disclosure form developed under subparagraph (C) shall apply with respect to requests made by States beginning with the [[Page 123 STAT.
70]] first plan year that begins after the date on which such model coverage coordination disclosure form is first issued.
``(3) Special rules for application in case of medicaid and chip.-- ``(A) <<NOTE:In general.--A group health plan, and a health insurance issuer offering group health insurance coverage in connection with a group health plan, shall permit an employee who is eligible, but not enrolled, for coverage under the terms of the plan (or a dependent of such an employee if the dependent is eligible, but not enrolled, for coverage under such terms) to enroll for coverage under the terms of the plan if either of the following conditions is met:
Deadlines.>>``(i) InTermination general.--Aof groupmedicaid healthor plan,chip andcoverage.--The aemployee healthor insurancedependent issueris offeringcovered groupunder healtha insuranceMedicaid coverageplan inunder connectiontitle withXIX aof groupthe healthSocial plan,Security shallAct permitor anunder employeea whoState ischild eligible,health butplan notunder enrolled,title forXXI coverageof undersuch theAct termsand coverage of the planemployee (oror a dependent ofunder such ana employeeplan ifis theterminated dependentas isa eligible,result butof notloss enrolled,of eligibility for coverage under such terms)coverage toand enrollthe foremployee requests coverage under the termsgroup ofhealth the plan if(or eitherhealth ofinsurance coverage) not later than days after the followingdate conditionsof istermination met:of such coverage.
``(i) Termination of medicaid or chip coverage.--The employee or dependent is covered under a Medicaid plan under title XIX of the Social Security Act or under a State child health plan under title XXI of such Act and coverage of the employee or dependent under such a plan is terminated as a result of loss of eligibility for such coverage and the employee requests coverage under the group health plan (or health insurance coverage) not later than 60 days after the date of termination of such coverage.
[[Page``(B) 123Coordination STAT.with medicaid and chip.-- ``(i) Outreach to employees regarding availability of medicaid and chip coverage.-- ``(I) In general.--Each employer that maintains a group health plan in a State that provides medical assistance under a State Medicaid plan under title XIX of the Social Security Act, or child health assistance under a State child health plan under title XXI of such Act, in the form of premium assistance for the purchase of coverage under a group health plan, shall provide to each employee a written notice informing the employee of potential opportunities then currently available in the State in which the employee resides for premium assistance under such plans for health coverage of the employee or the employee's dependents.
71]] ``(B) Coordination with medicaid and chip.-- ``(i) Outreach to employees regarding availability of medicaid and chip coverage.-- ``(I) In general.-- <<NOTE:
Notification.>> Each employer that maintains a group health plan in a State that provides medical assistance under a State Medicaid plan under title XIX of the Social Security Act, or child health assistance under a State child health plan under title XXI of such Act, in the form of premium assistance for the purchase of coverage under a group health plan, shall provide to each employee a written notice informing the employee of potential opportunities then currently available in the State in which the employee resides for premium assistance under such plans for health coverage of the employee or the employee's dependents.
``(ii) Disclosure about group health plan benefits to states for medicaid and chip eligible individuals.--In the case of an enrollee in a group health plan who is covered under a Medicaid plan of a State under title XIX of the Social Security Act or under a State child health plan under title XXI of such Act, the plan administrator of the group health plan shall disclose to the State, upon request, information about the benefits available under the group health plan in sufficient specificity, as determined under regulations of the Secretary of Health and Human Services in consultation with the Secretary that require use of the model coverage coordination disclosure form developed under section 311(b)(1)(C) of the Children's Health Insurance Reauthorization Act of 2009, so as to permit the State to make a determination (under paragraph (2)(B), (3), or (10) of section 2105(c) of the Social Security Act or otherwise) concerning the cost-effectivenesscost- effectiveness of the State providing medical or child health assistance through premium assistance for the purchase of coverage under such group health plan and in order for the State to provide [[Pagesupplemental 123benefits STAT.required under paragraph (10)(E) of such section or other authority.''.
72]] supplemental benefits required under paragraph (10)(E) of such section or other authority.''.
<<NOTE:CHILD HEALTH QUALITY MEASURES.
42``(a) USCDevelopment 13206-9a.>>of CHILDan HEALTHInitial QUALITYCore MEASURES.Set of Health Care Quality Measures for Children Enrolled in Medicaid or Chip.-- ``(1) In general.--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.
``(a) Development of an Initial Core Set of Health Care Quality Measures for Children Enrolled in Medicaid or Chip.-- ``(1) In general.-- <<NOTE:
Deadline.
Publication.>> 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.
``(3) <<NOTE:Recommendations and dissemination.--Based 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:
Publication.>> Recommendations and dissemination.--Based 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:
``(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 [[Pagecare 123quality STAT.and racial, ethnic, and socioeconomic disparities in child health and health care for children.
73]]``(4) careEncourage qualityvoluntary and racial,standardized ethnic,reporting.--Not andlater socioeconomicthan disparities2 years after the date of enactment of the Children's Health Insurance Program Reauthorization Act of 2009, the Secretary, in childconsultation healthwith 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 forunder children.titles XIX and XXI.
``(4) Encourage voluntary and standardized reporting.-- <<NOTE:
Procedures.>> Not later than 2 years after the date of enactment of the Children's Health Insurance Program Reauthorization Act of 2009, 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.
``(8) Definition of core set.--In this section, the term `core set' means a group of valid, reliable, and evidence-based quality measures that, taken together-- [[Page``(A) 123provide STAT.information regarding the quality of health coverage and health care for children;
74]] ``(A) provide information regarding the quality of health coverage and health care for children;
``(b) Advancing and Improving Pediatric Quality Measures.-- ``(1) Establishment of pediatric quality measures program.--program.--Not <<NOTE: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);
Deadline.>> Not 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);
[[Page``(D) 123health STAT.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;
75]] ``(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;
``(5) Revising, strengthening, and improving initial core measures.--measures.--Beginning <<NOTE: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).
Deadlines.
Publication.>> Beginning 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).
``(c) Annual State Reports Regarding State-Specific Quality of Care Measures Applied Under Medicaid or Chip.-- ``(1) Annual state reports.--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-- [[Page``(A) 123State-specific STAT.child health quality measures applied by the States under such plans, including measures described in subparagraphs (A) and (B) of subsection (a)(6);
76]] ``(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);
``(2) Publication.--Publication.--Not <<NOTE: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).
Deadlines.>>``(d) NotDemonstration laterProjects thanfor SeptemberImproving 30,the 2010,Quality of Children's Health Care and annuallythe thereafter,Use of Health Information Technology.-- ``(1) In general.--During the period of fiscal years 2009 through 2013, the Secretary shall collect,award analyze,not more than 10 grants to States and makechild publiclyhealth availableproviders to conduct demonstration projects to evaluate promising ideas for improving the informationquality reportedof bychildren's Stateshealth care provided under paragraphtitle (1).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);
``(d) Demonstration Projects for Improving the Quality of Children's Health Care and the Use of Health Information Technology.-- ``(1) In general.-- <<NOTE:
Time period.
Grants.>> 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);
[[Page``(e) 123Childhood STAT.Obesity Demonstration Project.-- ``(1) Authority to conduct demonstration.--The 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.
77]] ``(e) Childhood Obesity Demonstration Project.-- ``(1) Authority to conduct demonstration.--The 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.
``(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-- [[Page``(I) 123after STAT.hours physical activity programs;
78]] ``(I) after hours physical activity programs;
``(4) Priority.--In awarding grants under paragraph (1), the Secretary shall give priority to awarding grants to eligible entities-- [[Page``(A) 123that STAT.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;
79]] ``(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;
``(5) <<NOTE:Program design.-- ``(A) Initial design.--Not later than 1 year after the date of enactment of the Children's Health Insurance Program Reauthorization Act of 2009, the Secretary shall design the demonstration project.
Deadlines.>> Program design.-- ``(A) Initial design.--Not later than 1 year after the date of enactment of the Children's Health Insurance Program Reauthorization Act of 2009, the Secretary shall design the demonstration project.
``(B) Number and project areas.--areas.--Not <<NOTE:later than 2 years after the date of enactment of the Children's Health Insurance Program Reauthorization Act of 2009, the Secretary shall award 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.
Grants.>> Not later than 2 years after the date of enactment of the Children's Health Insurance Program Reauthorization Act of 2009, the Secretary shall award 1 grant that is specifically designed [[Page 123 STAT.
80]] 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.
``(D) Ongoing support.--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-self-assessment assessment given to the individual;
``(II) behavior modification based on the self-assessment;self- assessment;
[[Page``(f) 123Development STAT.of Model Electronic Health Record Format for Children Enrolled in Medicaid or CHIP.-- ``(1) In general.--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;
81]] ``(f) Development of Model Electronic Health Record Format for Children Enrolled in Medicaid or CHIP.-- ``(1) In general.-- <<NOTE:
Deadline.>> 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;
``(g) Study of Pediatric Health and Health Care Quality Measures.-- ``(1) In general.--general.--Not <<NOTE: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.
Deadline.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;
Reports.>> 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;
and [[Page``(D) 123make STAT.recommendations regarding improving and strengthening the timeliness, quality, and public transparency and accessibility of information about child health and health care quality.
82]] ``(D) <<NOTE:
Recommen- dations.>> make recommendations regarding improving and strengthening the timeliness, quality, and public transparency and accessibility of information about child health and health care quality.
``(i) Appropriation.--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)).
``(2) Data regarding the extent to which the State uses process measures with respect to determining the eligibility of children under the State child health plan, including measures such as 12-month12- month continuous eligibility, self-declaration of income for applications or renewals, or presumptive eligibility.
[[Page``(4) 123Data STAT.regarding access to primary and specialty services, access to networks of care, and care coordination provided under the State child health plan, using quality care and consumer satisfaction measures included in the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey.
83]] ``(4) Data regarding access to primary and specialty services, access to networks of care, and care coordination provided under the State child health plan, using quality care and consumer satisfaction measures included in the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey.
(b) <<NOTE:Standardized Reporting Format.-- (1) In general.--Not later than 1 year after the date of enactment of this Act, the Secretary shall specify a standardized format for States to use for reporting the information required under section 2108(e) of the Social Security Act, as added by subsection (a)(2).
42 USC 1397hh note.>> Standardized Reporting Format.-- (1) In general.--Not later than 1 year after the date of enactment of this Act, the Secretary shall specify a standardized format for States to use for reporting the information required under section 2108(e) of the Social Security Act, as added by subsection (a)(2).
(2) Requirements.--The improvements made by the Secretary under paragraph (1) shall be designed and implemented (including with respect to any necessary guidance for States [[Pageto 123report STAT.such information in a complete and expeditious manner) so that, beginning no later than October 1, 2009, data regarding the enrollment of low-income children (as defined in section 2110(c)(4) of the Social Security Act (42 U.S.C.
84]] to report such information in a complete and expeditious manner) so that, beginning no later than October 1, 2009, data regarding the enrollment of low-income children (as defined in section 2110(c)(4) of the Social Security Act (42 U.S.C.
(a) In General.--Section 2103(f) of Social Security Act <<NOTE:(42 U.S.C.
42 USC 1397cc.>> (42 U.S.C.
``(3) Compliance with managed care requirements.--The State child health plan shall provide for the application of subsections (a)(4), (a)(5), (b), (c), (d), and (e) of section 1932 (relating to requirements for managed care) to coverage, State agencies, enrollment brokers, managed care entities, and managed care organizations under this title in the same manner as such subsections apply to coverage and such entities and organizations under title XIX.''.
(b) <<NOTE:Effective Date.--The amendment made by subsection (a) shall apply to contract years for health plans beginning on or after July 1, 2009.
42 USC 1397cc note.>> Effective Date.--The amendment made by subsection (a) shall apply to contract years for health plans beginning on or after July 1, 2009.
(a) Coverage.-- [[Page(1) 123In STAT.general.--Section 2103 (42 U.S.C.
85]] (1) In general.--Section 2103 (42 U.S.C.
(3) <<NOTE:Effective date.--The amendments made by paragraphs (1) and (2) shall apply to coverage of items and services furnished on or after October 1, 2009.
42 USC 1397bb note.>> Effective date.--The amendments made by paragraphs (1) and (2) shall apply to coverage of items and services furnished on or after October 1, 2009.
[[Page``(5) 123Option STAT.for states with a separate chip program to provide dental-only supplemental coverage.-- ``(A) In general.--Subject to subparagraphs (B) and (C), in the case of any child who is enrolled in a group health plan or health insurance coverage offered through an employer who would, but for the application of paragraph (1)(C), satisfy the requirements for being a targeted low-income child under a State child health plan that is implemented under this title, a State may waive the application of such paragraph to the child in order to provide-- ``(i) dental coverage consistent with the requirements of subsection (c)(5) of section 2103;
86]] ``(5) Option for states with a separate chip program to provide dental-only supplemental coverage.-- ``(A) In general.--Subject to subparagraphs (B) and (C), in the case of any child who is enrolled in a group health plan or health insurance coverage offered through an employer who would, but for the application of paragraph (1)(C), satisfy the requirements for being a targeted low-income child under a State child health plan that is implemented under this title, a State may waive the application of such paragraph to the child in order to provide-- ``(i) dental coverage consistent with the requirements of subsection (c)(5) of section 2103;
[[Page(c) 123Dental STAT.Education for Parents of Newborns.--The Secretary 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.
87]] (c) <<NOTE:
42 USC 247d-9.>> Dental Education for Parents of Newborns.--The Secretary 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.
(2) CHIP.--Section 2107(e)(1) <<NOTE:(42 U.S.C.
42 USC 1397gg note.>> (42 U.S.C.
(3) <<NOTE:Effective date.--The amendments made by this subsection shall take effect on January 1, 2009.
42 USC 1396a note.>> Effective date.--The amendments made by this subsection shall take effect on January 1, 2009.
``(e) Information on Dental Care for Children.-- ``(1) In general.--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-incomelow- income children enrolled in the State child health plan under this title at any time during the year involved:
``(2) Inclusion of information on enrollees in managed care plans.--The information under paragraph (1) shall include information on children who are enrolled in managed care plans and other private health plans and contracts with [[Pagesuch 123plans STAT.under this title shall provide for the reporting of such information by such plans to the State.''.
88]](3) suchEffective plansdate.--The underamendments made by this titlesubsection shall providebe effective for theannual reportingreports ofsubmitted suchfor informationyears bybeginning suchafter plansdate toof theenactment. State.''.
(3)(f) <<NOTE:Improved Accessibility of Dental Provider Information to Enrollees Under Medicaid and CHIP.--The Secretary 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 CHIP, and shall ensure that such list is updated at least quarterly;
42 USC 1396a note.>> Effective date.--The amendments made by this subsection shall be effective for annual reports submitted for years beginning after date of enactment.
(f) <<NOTE:
Deadlines.
42 USC 1396 note.>> Improved Accessibility of Dental Provider Information to Enrollees Under Medicaid and CHIP.--The Secretary 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 CHIP, and shall ensure that such list is updated at least quarterly;
(g) Inclusion of Status of Efforts To Improve Dental Care in Reports on the Quality of Children's Health Care Under Medicaid and CHIP.--CHIP.--Section Section 1139A(a), as added by section 401(a), is amended-- (1) in paragraph (3)(B)(ii), by inserting ``and, with respect to dental care, conditions requiring the restoration of teeth, relief of pain and infection, and maintenance of dental health'' after ``chronic conditions'';
(2) Report.--Not later than 18 months year after the date of the enactment of this Act, the Comptroller General shall submit to Congress a report on the study conducted under [[Pageparagraph 123(1). STAT.
89]] paragraph (1).
(2) <<NOTE:Effective date.--The amendment made by paragraph (1) shall apply to services provided on or after October 1, 2009.
42(b) USCTransition 1397ggGrants.-- note.>>(1) EffectiveAppropriation.--Out date.--Theof amendmentany madefunds byin paragraphthe (1)Treasury shallnot applyotherwise appropriated, there is appropriated to servicesthe providedSecretary onfor fiscal year 2009, $5,000,000, to remain available until expended, for the purpose of awarding grants to States with State child health plans under CHIP that are operated separately from the State Medicaid plan under title XIX of the Social Security Act (including any waiver of such plan), or afterin Octobercombination 1,with 2009.the State Medicaid plan, for expenditures related to transitioning to compliance with the requirement of section 2107(e)(1)(D) of the Social Security Act (as added by subsection (a)) to apply the prospective payment system established under section 1902(bb) of the such Act (42 U.S.C.
(b) Transition Grants.-- (1) Appropriation.--Out of any funds in the Treasury not otherwise appropriated, there is appropriated to the Secretary for fiscal year 2009, $5,000,000, to remain available [[Page 123 STAT.
90]] until expended, for the purpose of awarding grants to States with State child health plans under CHIP that are operated separately from the State Medicaid plan under title XIX of the Social Security Act (including any waiver of such plan), or in combination with the State Medicaid plan, for expenditures related to transitioning to compliance with the requirement of section 2107(e)(1)(D) of the Social Security Act (as added by subsection (a)) to apply the prospective payment system established under section 1902(bb) of the such Act (42 U.S.C.
(b) <<NOTE:Effective Date.--The amendment made by subsection (a) shall apply to new coverage periods beginning on or after the date of the enactment of this Act.
42 USC 1397cc note.>> Effective Date.--The amendment made by subsection (a) shall apply to new coverage periods beginning on or after the date of the enactment of this Act.
[[Page``(9) 123School-based STAT.health center.-- ``(A) In general.--The term `school-based health center' means a health clinic that-- ``(i) is located in or near a school facility of a school district or board or of an Indian tribe or tribal organization;
91]] ``(9) School-based health center.-- ``(A) In general.--The term `school-based health center' means a health clinic that-- ``(i) is located in or near a school facility of a school district or board or of an Indian tribe or tribal organization;
<<NOTE:(a) Establishment.--There is hereby established the Medicaid and CHIP Payment and Access Commission (in this section referred to as `MACPAC').
42 USC 1396.>> (a) Establishment.--There is hereby established the Medicaid and CHIP Payment and Access Commission (in this section referred to as `MACPAC').
[[Page``(2) 123Specific STAT.topics to be reviewed.--Specifically, MACPAC shall review and assess the following:
92]] ``(2) Specific topics to be reviewed.--Specifically, MACPAC shall review and assess the following:
[[Page``(8) 123Voting STAT.and reporting requirements.--With respect to each recommendation contained in a report submitted under paragraph (1), each member of MACPAC shall vote on the recommendation, and MACPAC shall include, by member, the results of that vote in the report containing the recommendation.
93]] ``(8) Voting and reporting requirements.--With respect to each recommendation contained in a report submitted under paragraph (1), each member of MACPAC shall vote on the recommendation, and MACPAC shall include, by member, the results of that vote in the report containing the recommendation.
``(c) Membership.-- ``(1) Number and appointment.--MACPAC shall be composed of 17 members appointed by the Comptroller General of the United States.
``(B) Vacancies.--Any member appointed to fill a vacancy occurring before the expiration of the term for which the member's predecessor was appointed shall be [[Pageappointed 123only STAT.for the remainder of that term.
94]] appointed only for the remainder of that term.
[[Page``(e) 123Powers.-- STAT.``(1) Obtaining official data.--MACPAC may secure directly from any department or agency of the United States information necessary to enable it to carry out this section.
95]] ``(e) Powers.-- ``(1) Obtaining official data.--MACPAC may secure directly from any department or agency of the United States information necessary to enable it to carry out this section.
(b) <<NOTE:Deadline for Initial Appointments.--Not later than January 1, 2010, the Comptroller General of the United States shall appoint the initial members of the Medicaid and CHIP Payment and Access Commission established under section 1900 of the Social Security Act (as added by subsection (a)).
42(c) USCAnnual 1396Report note.>>on DeadlineMedicaid.--Not for Initial Appointments.-- Not later than January 1, 2010, and annually thereafter, the ComptrollerSecretary, Generalin consultation with the Secretary of the UnitedTreasury, Statesthe shallSecretary appointof Labor, and the initialStates members(as defined for purposes of Medicaid), shall submit an annual report to Congress on the Medicaidfinancial andstatus CHIPof, Paymentenrollment in, and Accessspending Commissiontrends establishedfor, underMedicaid sectionfor 1900the offiscal theyear Socialending Securityon ActSeptember (as30 addedof bythe subsectionpreceding (a)).year.
(c)TITLE <<NOTE:VI--PROGRAM INTEGRITY AND OTHER MISCELLANEOUS PROVISIONS Subtitle A--Program Integrity and Data Collection SEC.
42 USC 1396 note.>> Annual Report on Medicaid.--Not later than January 1, 2010, and annually thereafter, the Secretary, in consultation with the Secretary of the Treasury, the Secretary of Labor, and the States (as defined for purposes of Medicaid), shall submit an annual report to Congress on the financial status of, enrollment in, and spending trends for, Medicaid for the fiscal year ending on September 30 of the preceding year.
[[Page 123 STAT.
96]] TITLE VI--PROGRAM INTEGRITY AND OTHER MISCELLANEOUS PROVISIONS Subtitle A--Program Integrity and Data Collection SEC.
(b) <<NOTE:Final Rule Required To Be in Effect for All States.-- Notwithstanding parts 431 and 457 of title 42, Code of Federal Regulations (as in effect on the date of enactment of this Act), the Secretary shall not calculate or publish any national or State-specific error rate based on the application of the payment error rate measurement (in this section referred to as ``PERM'') requirements to CHIP until after the date that is 6 months after the date on which a new final rule (in this section referred to as the ``new final rule'') promulgated after the date of the enactment of this Act and implementing such requirements in accordance with the requirements of subsection (c) is in effect for all States.
42 USC 1397ee note.>> Final Rule Required To Be in Effect for All States.--Notwithstanding parts 431 and 457 of title 42, Code of Federal Regulations (as in effect on the date of enactment of this Act), the Secretary shall not calculate or publish any national or State-specific error rate based on the application of the payment error rate measurement (in this section referred to as ``PERM'') requirements to CHIP until after the date that is 6 months after the date on which a new final rule (in this section referred to as the ``new final rule'') promulgated after the date of the enactment of this Act and implementing such requirements in accordance with the requirements of subsection (c) is in effect for all States.
(c) Requirements for New Final Rule.--For purposes of subsection (b), the requirements of this subsection are that the new final rule implementing the PERM requirements shall-- (1) include-- [[Page(A) 123clearly STAT.defined criteria for errors for both States and providers;
97]] (A) clearly defined criteria for errors for both States and providers;
and (2) provide that the payment error rate determined for a State shall not take into account payment errors resulting from the State's verification of an applicant's self-declaration or self-certificationself- certification of eligibility for, and the correct amount of, medical assistance or child health assistance, if the State process for verifying an applicant's self-declaration or self-self-certification certification satisfies the requirements for such process applicable under regulations promulgated by the Secretary or otherwise approved by the Secretary.
1396b(u)) for data required for purposes of PERM requirements, but only if the State [[PageMEQC 123reviews STAT.are based on a broad, representative sample of Medicaid applicants or enrollees in the States.
98]] MEQC reviews are based on a broad, representative sample of Medicaid applicants or enrollees in the States.
``(A) Make appropriate adjustments to the Current Population Survey to develop more accurate State-State-specific specific estimates of the number of children enrolled in health coverage under title XIX or this title.
[[Page``(F) 123Continue STAT.making the adjustments described in the last sentence of paragraph (1) with respect to expansion of the sample size used in State sampling units, the number of sampling units in a State, and using an appropriate verification element.
99]] ``(F) Continue making the adjustments described in the last sentence of paragraph (1) with respect to expansion of the sample size used in State sampling units, the number of sampling units in a State, and using an appropriate verification element.
``(5) Subsequent evaluation using updated information.-- ``(A) <<NOTE:In general.--The Secretary, directly or through contracts or interagency agreements, shall conduct an independent subsequent evaluation of 10 States with approved child health plans.
Contracts.>>``(B) InSelection general.--Theof Secretary,states directlyand ormatters throughincluded.--Paragraphs contracts(2) orand interagency(3) agreements, shall conductapply anto independentsuch subsequent evaluation ofin 10the Statessame withmanner approvedas childsuch healthprovisions plans.apply to the evaluation conducted under paragraph (1).
``(B) <<NOTE:
Applicability.>> Selection of states and matters included.--Paragraphs (2) and (3) shall apply to such subsequent evaluation in the same manner as such provisions apply to the evaluation conducted under paragraph (1).
``(d) Access to Records for IG and GAO Audits and Evaluations.--For the purpose of evaluating and auditing the program established under this title, or title XIX, the Secretary, the Office of Inspector General, and the Comptroller General shall have access [[Pageto 123any STAT.books, accounts, records, correspondence, and other documents that are related to the expenditure of Federal funds under this title and that are in the possession, custody, or control of States receiving Federal funds under this title or political subdivisions thereof, or any grantee or contractor of such States or political subdivisions.''.
100]] to any books, accounts, records, correspondence, and other documents that are related to the expenditure of Federal funds under this title and that are in the possession, custody, or control of States receiving Federal funds under this title or political subdivisions thereof, or any grantee or contractor of such States or political subdivisions.''.
<<NOTE:NO FEDERAL FUNDING FOR ILLEGAL ALIENS;
42 USC 1396 note.>> NO FEDERAL FUNDING FOR ILLEGAL ALIENS;
(2) in subparagraph (C)-- (A) in the heading, by striking ``<SUP>wrap-``<SUP>wrap-around'' around</SUP>'' and inserting ``<SUP>additional</SUP>'';``<SUP>additional'';
``(E) Rule of construction.--Nothing in this paragraph shall be construed as-- ``(i) requiring a State to offer all or any of the items and services required by subparagraph (A)(ii) through an issuer of benchmark coverage described [[Pagein 123subsection STAT.(b)(1) or benchmark equivalent coverage described in subsection (b)(2);
101]] in subsection (b)(1) or benchmark equivalent coverage described in subsection (b)(2);
``(c) <<NOTE:Publication of Provisions Affected.--With respect to a State plan amendment to provide benchmark benefits in accordance with subsections (a) and (b) that is approved by the Secretary, the Secretary shall publish on the Internet website of the Centers for Medicare & Medicaid Services, a list of the provisions of this title that the Secretary has determined do not apply in order to enable the State to carry out the plan amendment and the reason for each such determination on the date such approval is made, and shall publish such list in the Federal Register and not later than 30 days after such date of approval.''.
Web(d) site.Effective Date.--The amendments made by subsections (a), (b), and (c) of this section shall take effect as if included in the amendment made by section 6044(a) of the Deficit Reduction Act of 2005.
Federal Register, publication.
Deadline.>> Publication of Provisions Affected.--With respect to a State plan amendment to provide benchmark benefits in accordance with subsections (a) and (b) that is approved by the Secretary, the Secretary shall publish on the Internet website of the Centers for Medicare & Medicaid Services, a list of the provisions of this title that the Secretary has determined do not apply in order to enable the State to carry out the plan amendment and the reason for each such determination on the date such approval is made, and shall publish such list in the Federal Register and not later than 30 days after such date of approval.''.
(d) <<NOTE:
42 USC 1396u-7 note.>> Effective Date.--The amendments made by subsections (a), (b), and (c) of this section shall take effect as if included in the amendment made by section 6044(a) of the Deficit Reduction Act of 2005.
1501A-402) <<NOTE:is repealed.
42 USC 1397aa note.>> is repealed.
<<NOTE:PROHIBITING INITIATION OF NEW HEALTH OPPORTUNITY ACCOUNT DEMONSTRATION PROGRAMS.
42 USC 1396u-8 note.>> PROHIBITING INITIATION OF NEW HEALTH OPPORTUNITY ACCOUNT DEMONSTRATION PROGRAMS.
<<NOTE:ADJUSTMENT IN COMPUTATION OF MEDICAID FMAP TO DISREGARD AN EXTRAORDINARY EMPLOYER PENSION CONTRIBUTION.
42(a) USCIn 1396dGeneral.--Only note.>>for ADJUSTMENTpurposes INof COMPUTATIONcomputing OFthe MEDICAIDFMAP (as defined in subsection (e)) for a State for a fiscal year (beginning with fiscal year 2006) and applying the FMAP TOunder DISREGARDtitle ANXIX EXTRAORDINARYof EMPLOYERthe PENSIONSocial CONTRIBUTION.Security Act, any significantly disproportionate employer pension or insurance fund contribution described in subsection (b) shall be disregarded in computing the per capita income of such State, but shall not be disregarded in computing the per capita income for the continental United States (and Alaska) and Hawaii.
(a) In General.--Only for purposes of computing the FMAP (as defined in subsection (e)) for a State for a fiscal year (beginning with fiscal year 2006) and applying the FMAP under title XIX of the Social Security Act, any significantly disproportionate [[Page 123 STAT.
102]] employer pension or insurance fund contribution described in subsection (b) shall be disregarded in computing the per capita income of such State, but shall not be disregarded in computing the per capita income for the continental United States (and Alaska) and Hawaii.
<<NOTE:CLARIFICATION TREATMENT OF REGIONAL MEDICAL CENTER.
42 USC 1396b note.>> CLARIFICATION TREATMENT OF REGIONAL MEDICAL CENTER.
[[Page(3) 123is STAT.obligated to serve all patients, regardless of ability to pay;
103]] (3) is obligated to serve all patients, regardless of ability to pay;
[[PageSubtitle 123C--Other STAT.Provisions SEC.
104]] Subtitle C--Other Provisions SEC.
<<NOTE:OUTREACH REGARDING HEALTH INSURANCE OPTIONS AVAILABLE TO CHILDREN.
15 USC 657p.>> OUTREACH REGARDING HEALTH INSURANCE OPTIONS AVAILABLE TO CHILDREN.
(B) information regarding options available to the owners and employees of small business concerns to make insurance more affordable, including Federal and State tax deductions and credits for health care-related expenses and health insurance expenses and Federal tax exclusion for health insurance options available under employer-employer-sponsored [[Pagecafeteria 123plans STAT.under section 125 of the Internal Revenue Code of 1986;
105]] sponsored cafeteria plans under section 125 of the Internal Revenue Code of 1986;
[[Page(5) 123The STAT.rapid growth in health insurance costs over the last few years has forced many employers, particularly small employers, to increase deductibles and co-pays or to drop coverage completely.
106]] (5) The rapid growth in health insurance costs over the last few years has forced many employers, particularly small employers, to increase deductibles and co-pays or to drop coverage completely.
(a) Cigars.--Section 5701(a) of the Internal Revenue Code of <<NOTE:1986 is amended-- (1) by striking ``$1.828 cents per thousand ($1.594 cents per thousand on cigars removed during 2000 or 2001)'' in paragraph (1) and inserting ``$50.33 per thousand'', (2) by striking ``20.719 percent (18.063 percent on cigars removed during 2000 or 2001)'' in paragraph (2) and inserting ``52.75 percent'', and (3) by striking ``$48.75 per thousand ($42.50 per thousand on cigars removed during 2000 or 2001)'' in paragraph (2) and inserting ``40.26 cents per cigar''.
26 USC 5701.>> is amended-- (1) by striking ``$1.828 cents per thousand ($1.594 cents per thousand on cigars removed during 2000 or 2001)'' in paragraph (1) and inserting ``$50.33 per thousand'', (2) by striking ``20.719 percent (18.063 percent on cigars removed during 2000 or 2001)'' in paragraph (2) and inserting ``52.75 percent'', and (3) by striking ``$48.75 per thousand ($42.50 per thousand on cigars removed during 2000 or 2001)'' in paragraph (2) and inserting ``40.26 cents per cigar''.
(d) Cigarette Tubes.--Section 5701(d) of such Code is amended by striking ``2.44 cents (2.13 cents on cigarette tubes removed during 2000 or 2001)'' and inserting ``6.30 cents''.
(e) Smokeless Tobacco.--Section 5701(e) of such Code is amended-- (1) by striking ``58.5 cents (51 cents on snuff removed during 2000 or 2001)'' in paragraph (1) and inserting ``$1.51'', and (2) by striking ``19.5 cents (17 cents on chewing tobacco removed during 2000 or 2001)'' in paragraph (2) and inserting ``50.33 cents''.
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View plain text versions (6)
- Enrolled Enrolled Bill Current html February 09, 2009
- Chaptered Public Law html February 04, 2009
- Engrossed Amendment Engrossed Amendment Senate html January 29, 2009
- Placed on Calendar Senate View text html January 16, 2009
- Engrossed Engrossed in House html January 14, 2009
- Introduced Introduced in House html January 13, 2009
Action History
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Became Public Law No: 111-3.
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Signed by President.
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Presented to President.
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Cleared for White House.
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Motion to reconsider laid on the table Agreed to without objection.
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On motion that the House agree to the Senate amendment Agreed to by the Yeas and Nays: 290 - 135 (Roll No. 50). (text as House agreed to Senate amendment: CR H934-961)
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The previous question was ordered pursuant to the rule. (consideration: CR H974)
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DEBATE - The House proceeded with one hour of debate on the motion to agree to the Senate amendment to H.R. 2.
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Pursuant to the provisions of H. Res. 107, Mr. Waxman moved to agree to the Senate amendment. (consideration: CR H934-975)
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Rule H. Res. 107 passed House.
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Rules Committee Resolution H. Res. 107 Reported to House. Upon the adoption of H. Res. 107, it shall be in order to take from the Speaker's table the bill H.R. 2 with the Senate amendment thereto, and for the Chair to entertain a motion to concur in the Senate amendment. The Senate amendment and the motion shall be considered as read. The motion shall be debatable for one hour.
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Message on Senate action sent to the House.
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S.AMDT.63 SA 63 previously adopted was further modified by Unanimous Consent. (consideration: CR S1232; text as further modified: CR S1232)
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Senate insists on its amendment, asks for a conference, appoints conferees Baucus; Rockefeller; Conrad; Grassley; Hatch. (consideration: CR S1049)
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Passed Senate with an amendment by Yea-Nay Vote. 66 - 32. Record Vote Number: 31. (text: CR 1/30/2009 S1206-1232)
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S.AMDT.93 Amendment SA 93 not agreed to in Senate by Yea-Nay Vote. 17 - 81. Record Vote Number: 30.
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S.AMDT.93 Amendment SA 93 proposed by Senator Hutchison. (consideration: CR S1045-1046; text: CR S1045)To provide assistance for States with percentages of children with no health insurance coverage above the national average.
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S.AMDT.63 Amendment SA 63 as modified agreed to in Senate by Yea-Nay Vote. 55 - 43. Record Vote Number: 29.
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S.AMDT.49 Amendment SA 49 not agreed to in Senate by Voice Vote.
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S.AMDT.50 Amendment SA 50 agreed to in Senate by Voice Vote.
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S.AMDT.86 Amendment SA 86 not agreed to in Senate by Yea-Nay Vote. 36 - 62. Record Vote Number: 28.
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S.AMDT.85 Amendment SA 85 not agreed to in Senate by Yea-Nay Vote. 40 - 58. Record Vote Number: 27.
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S.AMDT.97 Amendment SA 97 agreed to in Senate by Unanimous Consent.
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S.AMDT.97 Amendment SA 97 proposed by Senator Rockefeller for Senator Baucus. (consideration: CR S1043; text: CR S1043)Of a technical nature.
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S.AMDT.96 Amendment SA 96 agreed to in Senate by Unanimous Consent.
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S.AMDT.95 Amendment SA 95 agreed to in Senate by Unanimous Consent.
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S.AMDT.94 Amendment SA 94 agreed to in Senate by Unanimous Consent.
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S.AMDT.96 Amendment SA 96 proposed by Senator Baucus. (consideration: CR S1042-1043; text: CR S1042)To clarify that no eligible entity that receives an outreach and enrollment grant is required to provide matching funds.
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S.AMDT.95 Amendment SA 95 proposed by Senator Baucus. (consideration: CR S1042; text: CR S1042)To make technical corrections to the State option to provide dental-only supplemental coverage.
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S.AMDT.94 Amendment SA 94 proposed by Senator Baucus. (consideration: CR S1042; text: CR S1042)To make a technical correction to the option to cover legal immigrant children and pregnant women.
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S.AMDT.63 Amendment SA 63 proposed by Senator Bingaman. (consideration: CR S1040, S1044-1045; text: CR S1040; text as modified: CR S1040)To clarify that new paperwork and enrollment barriers are not created in the Express Lane Enrollment option and that income may be determined by Express Lane agencies based on State income tax records or returns.
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S.AMDT.71 Amendment SA 71 not agreed to in Senate by Voice Vote.
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S.AMDT.71 Amendment SA 71 proposed by Senator Grassley. (consideration: CR S1036-1038; text: CR S1037)To extend the State Children's Health Insurance Program for 6 quarters in order to enact bipartisan, comprehensive health care reform.
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S.AMDT.83 Amendment SA 83 not agreed to in Senate by Voice Vote.
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S.AMDT.86 Amendment SA 86 proposed by Senator Coburn. (consideration: CR S1033-1036, S1043-1044)To ensure that American children have high-quality health coverage that fits their individual needs.
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S.AMDT.85 Amendment SA 85 proposed by Senator DeMint. (consideration: CR S1032-1033, S1038-1040, S1040-1042, S1043; text: CR S1032)To provide an above-the-line Federal income tax deduction for health care costs of certain children in an amount comparable to the average federal share of the benefit provided to any non-citizen child for medical assistance or child health assistance.
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S.AMDT.80 Amendment SA 80 not agreed to in Senate by Yea-Nay Vote. 39 - 59. Record Vote Number: 26.
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S.AMDT.74 Motion to table amendment SA 74 agreed to in Senate by Yea-Nay Vote. 54 - 44. Record Vote Number: 25.
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S.AMDT.47 Amendment SA 47 not agreed to in Senate by Yea-Nay. 36 - 62. Record Vote Number: 24.
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S.AMDT.83 Amendment SA 83 proposed by Senator Grassley. (consideration: CR S1025-1029, S1030-1031, S1036)In the nature of a substitute.
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S.AMDT.47 Amendment SA 47 proposed by Senator Baucus for Senator Coburn. (consideration: CR S1016-1019, S1030, S1031)To ensure that children do not lose their private insurance and that uninsured children can get access to private insurance.
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S.AMDT.74 Amendment SA 74 proposed by Senator Bunning. (consideration: CR S1015-1016, S1019-1025, S1029-1030, S1031; text: CR S1015; text as modified: CR S1031)To eliminate any exceptions to the prohibition on States receiving an enhanced Federal matching rate for providing coverage to children whose family income exceeds 300 percent of the poverty line.
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S.AMDT.80 Amendment SA 80 proposed by Senator Hatch. (consideration: CR S1009-1015, S1031-1032; text: CR S1009)To codify regulations specifying that an unborn child is eligible for child health assistance.
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S.AMDT.50 Considered by Senate. (consideration: CR S1007, S1044)
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S.AMDT.49 Considered by Senate. (consideration: CR S1007, S1044)
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Considered by Senate. (consideration: CR S1007-1050)
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S.AMDT.50 Amendment SA 50 proposed by Senator Coburn. (consideration: CR S987; text: CR S987)To restore fiscal discipline by making the Medicaid and SCHIP programs more accountable and efficient.
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S.AMDT.49 Amendment SA 49 proposed by Senator Coburn. (consideration: CR S986-987; text: CR S986)To prevent fraud and restore fiscal accountability to the Medicaid and SCHIP programs.
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S.AMDT.77 Amendment SA 77 not agreed to in Senate by Yea-Nay. 47 - 51. Record Vote Number: 23.
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S.AMDT.46 Amendment SA 46 not agreed to in Senate by Yea-Nay Vote. 42 - 56. Record Vote Number: 22.
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S.AMDT.79 Proposed amendment SA 79 withdrawn in Senate. (consideration: CR S982)
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S.AMDT.79 Amendment SA 79 proposed by Senator Brown. (consideration: CR S980-982; text: CR S980-981)To strengthen and protect health care access, and to benefit children in need of cancer care or other acute care services.
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S.AMDT.58 Proposed amendment SA 58 withdrawn in Senate. (consideration: CR S978)
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S.AMDT.58 Amendment SA 58 proposed by Senator Webb. (consideration: CR S978-980)To amend the Internal Revenue Code of 1986 to provide a revenue source through the treatment of income of partners for performing investment management services as ordinary income received for performance of services and reduce accordingly the tobacco tax increase as a revenue source.
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S.AMDT.77 Amendment SA 77 proposed by Senator Murkowski. (consideration: CR S976-978, S986; text: CR S976)To provide for the development of best practice recommendations and to ensure coverage of low income children.
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S.AMDT.75 Amendment SA 75 not agreed to in Senate by Yea-Nay Vote. 36 - 60. Record Vote Number: 21.
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S.AMDT.67 Motion to table amendment SA 67 agreed to in Senate by Yea-Nay. 64 - 33. Record Vote Number: 20.
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S.AMDT.46 Amendment SA 46 proposed by Senator Kyl. (consideration: CR S967-968, S969-976, S982-986)To reinstate the crowd out policy agreed to in section 116 of H.R. 3963 (CHIPRA II), as agreed to and passed by the House and Senate.
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S.AMDT.75 Amendment SA 75 proposed by Senator Roberts. (consideration: CR S962-967, S969; text: CR S962)To prohibit CHIP coverage for higher income children and to prohibit any payments to a State from its CHIP allotments for any fiscal year quarter in which the State Medicaid income eligibility level for children is greater than the income eligibility level for children under CHIP.
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S.AMDT.67 Amendment SA 67 proposed by Senator Cornyn. (consideration: CR S961-962, S967, S968-969; text: CR S961)To ensure redistributed funds go towards coverage of low-income children or outreach and enrollment of low-income children, rather than to States that will use the funds to cover children from higher income families.
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S.AMDT.65 Amendment SA 65 not agreed to in Senate by Yea-Nay Vote. 37 - 60. Record Vote Number: 19.
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S.AMDT.65 Amendment SA 65 proposed by Senator Martinez. (consideration: CR S955-961; text: CR S955)To restore the prohibition on funding of nongovernmental organizations that promote abortion as a method of birth control (the "Mexico City Policy").
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S.AMDT.40 Amendment SA 40 not agreed to in Senate by Yea-Nay Vote. 32 - 65. Record Vote Number: 18.
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S.AMDT.41 Amendment SA 41 not agreed to in Senate by Voice Vote.
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S.AMDT.41 Considered by Senate. (consideration: CR S950, S954)
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S.AMDT.40 Considered by Senate. (consideration: CR S950-954, S954-955)
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Considered by Senate. (consideration: CR S950-990)
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S.AMDT.41 Amendment SA 41 proposed by Senator Grassley.
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S.AMDT.40 Amendment SA 40 proposed by Senator McConnell.
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S.AMDT.41 Amendment SA 41 modified to reflect a first degree status by Unanimous Consent.
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S.AMDT.40 Amendment SA 40 modified to reflect a first degree status by Unanimous Consent.
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S.AMDT.39 Amendment SA 39 agreed to in Senate by Unanimous Consent.
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S.AMDT.43 Motion to table amendment SA 43 agreed to in Senate by Yea-Nay Vote. 60 - 37. Record Vote Number: 16.
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S.AMDT.45 Amendment SA 45 not agreed to in Senate by Voice Vote.
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S.AMDT.43 Amendment SA 43 proposed by Senator DeMint to Amendment SA 39. (consideration: CR S859-866, S879-880; text: CR S859-860)To require States to impose cost-sharing for any individual enrolled in a State child health plan whose income exceeds 200 percent of the poverty line.
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S.AMDT.45 Amendment SA 45 proposed by Senator Hatch to Amendment SA 39. (consideration: CR S857-859, S880-881; text: CR S857)To prohibit any Federal matching payment for Medicaid or CHIP coverage of noncitizen children or pregnant women until a State demonstrates that it has enrolled 95 percent of the children eligible for Medicaid or CHIP who reside in the State and whose family income does not exceed 200 percent of the poverty line.
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S.AMDT.41 Amendment SA 41 proposed by Senator Grassley to Amendment SA 39. (consideration: CR S854-857; text: CR S854)To strike the option to provide coverage to legal immigrants and increase the enrollment of uninsured low income American children.
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S.AMDT.40 Amendment SA 40 proposed by Senator McConnell to Amendment SA 39. (consideration: CR S852-854, S885)In the nature of a substitute.
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S.AMDT.39 Amendment SA 39 proposed by Senator Reid for Senator Baucus. (consideration: CR S852, S885)In the nature of a substitute.
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Considered by Senate. (consideration: CR S852-866, S867-881, S881-885)
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Measure laid before Senate by unanimous consent. (consideration: CR S820-822)
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Read twice. Placed on Senate Legislative Calendar under General Orders. Calendar No. 18.
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Received in the Senate.
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Motion to reconsider laid on the table Agreed to without objection.
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On passage Passed by recorded vote: 289 - 139 (Roll no. 16). (text: CR H216-245)
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On motion to recommit with instructions Failed by the Yeas and Nays: 179 - 247 (Roll no. 15).
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The previous question on the motion to recommit with instructions was ordered without objection. (consideration: CR H266)
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DEBATE - The House proceeded with 10 minutes of debate on the Deal (GA) motion to recommit with instructions. The instructions in the motion seek to report the same back to the House forthwith with amendments to determine the use of funds for the Children's Health Insurance Program.
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Mr. Deal (GA) moved to recommit with instructions to Energy and Commerce. (consideration: CR H264-267)
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The previous question was ordered pursuant to the rule. (consideration: CR H263)
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DEBATE - The House proceeded with one hour of debate on H.R. 2.
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Rule provides for consideration of H.R. 2 with 1 hour of general debate. Previous question shall be considered as ordered without intervening motions except motion to recommit with or without instructions. Measure will be considered read. Bill is closed to amendments. The Resolution waives all points of order against consideration of the bill except those arising under clause 9 or 10 of rule XXI.
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Considered under the provisions of rule H. Res. 52. (consideration: CR H216-268)
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Rule H. Res. 52 passed House.
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Referred to the Subcommittee on Health.
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Rules Committee Resolution H. Res. 52 Reported to House. Rule provides for consideration of H.R. 2 with 1 hour of general debate. Previous question shall be considered as ordered without intervening motions except motion to recommit with or without instructions. Measure will be considered read. Bill is closed to amendments. The Resolution waives all points of order against consideration of the bill except those arising under clause 9 or 10 of rule XXI.
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Referred to House Education and Labor
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Referred to House Ways and Means
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Referred to House Energy and Commerce
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Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Labor, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Sponsorship breakdown
Export CSV (upgrade) →0 sponsors · 0 co-sponsors · 547 not signed on
Sponsors (0)
None.
Co-sponsors (0)
None.
Not signed on (547)
547 members have not signed on to this bill.
Show all 547 →"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.
Subjects
Frequently asked questions
- What does HR 2 do?
- Children's Health Insurance Program Reauthorization Act of 2009 - (Sec. 3) Makes the amendments made by this Act effective on April 1, 2009, regardless of whether final regulations have been promulgated to carry them out.Allows certain state plans under titles XIX (Medicaid) or XXI (State Children's Health Insurance Program) (SCHIP, referred to in this Act as CHIP) of the Social Security Act (SSA) that require state legislation to meet additional requirements imposed by this Act additional time to make required plan changes.Provides for coordination of CHIP funding for FY2009.Title I: Financing - Subtitle A: Funding - (Sec. 101) Amends SSA title XXI to reauthorize the CHIP program through FY2013 at increased levels. (Sec. 102) Provides for the determination of allotments for the 50 states, the District of Columbia, and the commonwealths and territories for FY2009-FY2013.(Sec. 103) Establishes in the Treasury the Child Enrollment Contingency Fund for payments to a state to eliminate its shortfall (the amount by which its available federal CHIP allotments are not adequate to cover its CHIP expenditures).(Sec. 104) Directs the Secretary of Health and Human Services to make a performance bonus payment to states to offset additional Medicaid and CHIP child enrollment costs resulting from enrollment and retention efforts. Limits the use of such payments to reducing the number of low-income children who do not have health insurance coverage in the state. Makes appropriations for FY2009 for such payments. Requires certain funds transfers to cover FY2009-FY2013. (Sec. 105) Reduces the availability of allotments for FY2009 and each ensuing fiscal year from three to two years.(Sec. 106) Amends SSA title XXI to require redistribution of unused allotments to states with funding shortfalls for fiscal years beginning with FY2007.Revises requirements for the redistribution of unused allotments for FY2006.(Sec. 107) Allows qualifying states the option to receive the enhanced portion of the CHIP matching rate for Medicaid coverage of certain children.Repeals the March 31, 2009, termination date of (thus making permanent) the authority for a state to use certain funds to pay for medical assistance to individuals under age 19 whose family income exceeds 150% of the poverty line.(Sec. 108) Makes a one-time appropriation of additional funds to the Secretary of Health and Human Services for FY2013.(Sec. 109) Revises funding requirements for the territories under CHIP and Medicaid for FY2009-FY2013.Removes federal matching payments for data reporting systems from the overall limit on payments to Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa.Directs the Comptroller General to report to the appropriate congressional committees on federal funding under Medicaid and CHIP for such territories.Subtitle B: Focus on Low-Income Children and Pregnant Women - (Sec. 111) Gives states the option to cover targeted low-income pregnant women under CHIP through a state plan amendment if certain conditions are met, including that the state has established an income eligibility level of at least 185% of the federal poverty line for pregnant women under Medicaid. Sets the minimum income eligibility level for children under age 19 at 200% of the poverty line applicable to a family of the size involved. Provides for automatic enrollment for children born to women receiving pregnancy-related assistance.(Sec. 112) Provides for phase-out of CHIP coverage for nonpregnant childless adults, leaving states an option to apply for a Medicaid waiver to continue coverage for such adults. Requires extension of an expiring waiver at state request, but only through calendar 2009 and only for childless adults who were covered through that year. Prescribes terms and conditions for coverage of parents of targeted low-income children.Directs the Comptroller General to study and report to Congress on whether: (1) the coverage of a parent, a caretaker relative, or a legal guardian of a targeted low-income child under a state CHIP health plan increases the enrollment of, or the quality of care for, children; and (2) such parents, relatives, and legal guardians who enroll in such a plan are more likely to enroll their children in such a plan or in a state Medicaid plan.(Sec. 113) Eliminates counting Medicaid child presumptive eligibility costs against CHIP allotment.(Sec. 114) Limits the matching rate for states that propose to cover children with effective family income that exceeds 300% of the poverty line. Exempts from this denial (grandfathers) any state that already has an approved state plan amendment or waiver to provide such expenditures. (Sec. 115) Allows the Secretary, at state option, to provide the state with the federal medical assistance percentage determined for the state for Medicaid with respect to certain expenditures or otherwise made to provide medical assistance under Medicaid to a child who could be covered by the state under CHIP.Allows a state to cover: (1) certain individuals and thereby receive federal financial participation for medical assistance for them under Medicaid; or (2) receive such federal financial participation for children made eligible as a result of an income or resource eligibility level expansion.Title II: Outreach and Enrollment - Subtitle A: Outreach and Enrollment Activities - (Sec. 201) Amends SSA title XXI to direct the Secretary to award grants during FY2009-FY2013 for outreach and enrollment efforts to increase the enrollment and participation of eligible children under CHIP and Medicaid.Makes appropriations for FY2009-FY2013. Directs the Secretary to develop and implement a national enrollment campaign to improve the enrollment of underserved child populations in CHIP and Medicaid programs.Allows payments under CHIP and Medicaid for translation or interpreting services in connection with the enrollment of, retention of, and use of services by, individuals for whom English is not their primary language.(Sec. 202) Amends SSA title XI to provide for increased outreach and enrollment of Indians in CHIP and Medicaid.Waives the 10% cap on CHIP payments for outreach with respect to any expenditures for outreach activities to families of Indian children likely to be eligible for child health assistance under the state Medicaid plan or related waivers.(Sec. 203) Authorizes a state plan under the Medicaid and CHIP programs to rely on findings from an Express Lane agency to conduct simplified eligibility determinations.Amends SSA title XIX to authorize a federal or state agency or private entity in possession of the sources of data directly relevant for Medicaid eligibility determination (including eligibility files maintained by an Express Lane agency) to convey such information to the state Medicaid agency, if such conveyance meets specified requirements. Prescribes civil and criminal penalties for improper disclosure of such information.Directs the Secretary to enter into agreements necessary to permit a state that elects the Express Lane option to receive data directly relevant to determining eligibility and the correct amount of benefits under CHIP or Medicaid from: (1) the National Directory of New Hires; and (2) data regarding enrollment in insurance that may help to facilitate outreach and enrollment under the state Medicaid and CHIP plans and such other programs as the Secretary may specify.Subtitle B: Reducing Barriers to Enrollment - (Sec. 211) Gives states the option, as an alternative to the current documentation requirement, to verify a declaration of U.S. citizenship or nationality for purposes of Medicaid or CHIP eligibility through verification of a name and Social Security number with the Commissioner of Social Security. Prescribes a procedure for investigating any inconsistency between the name and number presented and the name and number in the records maintained by the Commissioner.Applies such documentation requirements to CHIP.Makes appropriations to the Commissioner of Social Security to carry out such responsibilities.(Sec. 212) Requires state child health insurance plans to describe procedures used to reduce administrative barriers to enrollment of children and eligible pregnant women under Medicaid or CHIP.(Sec. 213) Requires the Secretary, in order to assure continuity of coverage, to develop a model process for the coordination of the enrollment, retention, and coverage under Medicaid and CHIP of children who frequently change their state of residency or otherwise are temporarily located outside of their state of residency.(Sec. 214) Permits states to waive certain restrictions which result in a five-year delay for coverage of necessary health services for children and women residing lawfully in the United States under the Medicaid program and CHIP.Title III: Reducing Barriers to Providing Premium Assistance - Subtitle A: Additional State Option for Providing Premium Assistance - (Sec. 301) Gives states the option to provide a premium assistance subsidy for qualified employer-sponsored coverage to all targeted low-income children eligible for CHIP who have access to such coverage, if the child (or the child's parent) voluntarily elects to receive such a subsidy. Allows employers to opt-out of being paid the subsidy directly, in which event the state shall pay the employee.Amends SSA title XIX to allow a state to elect to offer a similar voluntary premium assistance subsidy for qualified employer-sponsored coverage to all individuals under age 19 entitled to Medicaid.Directs the Comptroller General to study and report to Congress on cost and coverage issues relating to any state premium assistance programs for which federal Medicaid and CHIP matching payments are made.(Sec. 302) Requires state CHIP plans to describe procedures in place to provide outreach, education, and enrollment assistance for families of children likely to be eligible for premium assistance subsidies under CHIP.Waives the 10% cap on CHIP payments for outreach activities to families of children likely to be eligible for premium assistance payments under the state child health plan or related waivers.Subtitle B: Coordinating Premium Assistance With Private Coverage - (Sec. 311) Amends the Internal Revenue Code to require a group health plan to permit an employee who is eligible, but not enrolled, for coverage under the plan to enroll if either of the following conditions are met: (1) the employee or dependent covered under Medicaid or CHIP has coverage terminated as a result of loss of eligibility, and the employee requests coverage under the group health plan within 60 days after such termination; or (2) the employee or dependent becomes eligible for Medicaid or CHIP assistance if the employee requests coverage within 60 days after the eligibility determination date.Directs the Secretary and the Secretary of Labor jointly to establish a Medicaid, CHIP, and Employer-Sponsored Coverage Coordination Working Group to: (1) develop the model coverage disclosure form; and (2) identify impediments to the effective coordination of coverage available to families.Title IV: Strengthening Quality of Care And Health Outcomes of Children - (Sec. 401) Amends SSA title XI to direct the Secretary to identify and publish for general comment an initial, recommended core set of child health quality measures for use by state Medicaid and CHIP programs, health insurance issuers and managed care entities that contract with such programs, and item and service providers. Directs the Secretary to identify existing quality of care measures for children that are: (1) in use under public and privately sponsored health care arrangements; or (2) part of reporting systems that measure both the presence and duration of health insurance coverage over time.Directs the Secretary to establish a pediatric quality measures program to improve and strengthen such initial core child health care quality measures.Directs the Secretary to award: (1) grants and contracts for the development, testing, and validation of new, emerging, and innovative evidence-based measures for children's health care services; and (2) up to 10 grants to states and child health providers for demonstration projects to evaluate promising ideas for improving the quality of children's health care and the use of health information technology. Specifies funding.Directs the Secretary to conduct a childhood obesity demonstration project. Authorizes appropriations for FY2008-FY2012.Directs the Secretary to establish a program to encourage the development and dissemination of a model electronic health record format for children enrolled in a state Medicaid or CHIP plan.Requires the Institute of Medicine to study and report to Congress on pediatric health and health care quality measures.Makes FY2009-FY2013 appropriations to carry out this section. Increases the matching rate for collecting and reporting on child health measures.(Sec. 402) Specifies the information each state must cover in its annual CHIP report to the Secretary, including eligibility criteria, enrollment, and retention data.Requires the Comptroller General to study and report to the appropriate congressional committees on children's access to primary and specialty services under Medicaid and CHIP.(Sec. 403) Requires a state child health plan to provide for application of certain managed care quality safeguards to CHIP coverage, state agencies, enrollment brokers, managed care entities, and managed care organizations in the same manner such safeguards are applied under the Medicaid program.Title V: Improving Access to Benefits - (Sec. 501) Requires the child health assistance provided to a targeted low-income child to include coverage of dental services necessary to prevent disease and promote oral health, restore oral structures to health and function, and treat emergency conditions.Gives states with a separate CHIP program the option to provide dental-only supplemental coverage for any child enrolled in a group health plan or employer-offered health insurance coverage who would otherwise satisfy the requirements for a targeted low-income child under a state child health plan. Allows a state child health plan, at state option, to waive a waiting period for a child provided dental-only supplemental coverage. Requires the Secretary to develop, through entities that fund or provide prenatal care services to targeted low-income children under CHIP, 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.Directs the Secretary to work with states, pediatric dentists, and other dental providers to include on the Insure Kids Now website (http://www.insurekidsnow.gov/) and hotline (1-877-KIDS-NOW) a current and accurate list, updated quarterly, 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 CHIP, together (on the website) with a description of the services.Directs the Comptroller General to study and report to Congress on children's access to dental services in underserved areas and to oral health care. (Sec. 502) Provides for the parity of mental health services in CHIP plans with all covered medical and surgical benefits.(Sec. 503) Applies the prospective payment system (PPS) to services provided by federally-qualified health centers (FQHCs) and rural health clinics.(Sec. 504) Requires a state child health plan to afford individuals enrolled under it a grace period of at least 30 days from beginning of a new coverage period to make premium payments before the individual's coverage under the plan may be terminated.(Sec. 505) Provides that nothing in SSA title XXI shall be construed as limiting a state's ability to provide child health assistance for covered items and services that are furnished through school-based health centers.(Sec. 506) Establishes the Medicaid and CHIP Payment and Access Commission (MACPAC) to: (1) review policies of Medicaid and CHIP affecting children's access to covered items and services; and (2) report and make recommendations to Congress concerning them. Authorizes appropriations. Title VI: Program Integrity and Other Miscellaneous Provisions - Subtitle A: Program Integrity and Data Collection - (Sec. 601) Applies a minimum FMAP of 90% to expenditures related to administration of payment error rate measurement (PERM) requirements applicable to CHIP.Waives the 10% cap on CHIP administrative costs for all expenditures related to the administration of PERM requirements.Prohibits the Secretary from calculating or publishing any national or state-specific error rate based on the application of PERM requirements to CHIP until after a final rule implementing such requirements is in effect for all states. Specifies requirements for any calculation of a national error rate or a state specific error rate after such a final rule is in effect for all states.Requires the final rule implementing the PERM requirements to include: (1) clearly defined criteria for errors for both states and providers; (2) a clearly defined process for appealing error determinations by review contractors or specified agency and personnel; and (3) clearly defined responsibilities and deadlines for states in implementing any corrective action plans.Directs the Secretary to review the Medicaid Eligibility Quality Control (MEQC) requirements with PERM requirements and coordinate consistent implementation of both sets of requirements, while reducing redundancies.Prescribes requirements for a state option to substitute data resulting from the application of the PERM requirements to the state for data obtained from the application of MEQC requirements to the state, and vice versa, for specified purposes.Directs the Secretary to establish state-specific sample sizes for application of the PERM requirements with respect to state child health plans beginning with FY2009.(Sec. 602) Appropriates increased amounts for FY2009 for data collection regarding low-income children without health insurance coverage.Requires the Secretary of Commerce, among other things, to make appropriate adjustments to the Current Population Survey (CPA) to: (1) develop more accurate state-specific estimates of the number of children enrolled under Medicaid; and (2) include health insurance survey information in the American Community Survey (ACS) related to children.Authorizes the Secretary to transition to the use of all, or some combination of, ACS estimates, instead of the CPS, if the Secretary of Commerce so recommends.(Sec. 603) Directs the Secretary, directly or through contracts or interagency agreements, to conduct an independent subsequent evaluation of 10 states with approved child health plans. Makes FY2009 appropriations for such evaluation.(Sec. 604) Revises requirements for audits of state CHIP programs. Declares that the Comptroller General (as well as the Secretary and the Office of Inspector General), for evaluation and audit purposes, shall have access to any books, accounts, and other documents related to the expenditure of federal CHIP funds that are in state or local government, grantee, or contractor possession, custody, or control.(Sec. 605) Declares that: (1) nothing in this Act allows federal payment for individuals who are not lawfully residing in the United States; and (2) SSA titles XI, XIX (Medicaid), and XXI (CHIP) provide for the disallowance of federal financial participation for erroneous expenditures under Medicaid and under CHIP, respectively.Subtitle B: Miscellaneous Health Provisions - (Sec. 611) Amends the Deficit Reduction Act of 2005 to make a technical amendment to the requirement to provide early and periodic screening, diagnostic, and treatment (EPSDT) services for all children in benchmark benefit packages.(Sec. 612) Amends the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 to repeal the requirement that the Secretary refer to CHIP as SCHIP or the state children's health insurance program. (Sec. 613) Prohibits the Secretary from approving any new health opportunity account demonstration programs.(Sec. 614) Provides that, only for purposes of computing the FMAP for a state for a fiscal year, beginning with FY2006, and applying it under Medicaid, any significantly disproportionate employer pension or insurance fund contribution shall be disregarded in computing the state's per capita income, but shall not be disregarded in computing the per capita income for the continental United States (and Alaska) and Hawaii.Prohibits any state from having its FMAP reduced as a result of the application of this section.Directs the Secretary to report to Congress on: (1) the problems presented by the current treatment of pension and insurance fund contributions in the use of Bureau of Economic Affairs calculations for the FMAP and for Medicaid; and (2) possible alternative methodologies to mitigate such problems.(Sec. 615) Provides that nothing in the prohibition on use of voluntary contributions, and the limitation on use of provider-specific taxes to obtain federal financial participation under Medicaid, shall be construed by the Secretary as prohibiting a state's use of funds as the nonfederal share of Medicaid expenditures where such funds are transferred from or certified by a publicly-owned regional medical center located in another state, so long as the Secretary determines that such use is proper and in the interest of the Medicaid program.(Sec. 616) Amends SSA title XIX, as amended by the Medicare Improvements for Patients and Providers Act of 2008, to extend the Medicaid disproportionate share hospital (DSH) allotments for Hawaii and Tennessee. (Sec. 617) Directs the Comptroller General to report to Congress on the extent to which state payment rates for Medicaid managed care organizations under Medicaid are actuarially sound.Subtitle C: Other Provisions - (Sec. 621) Establishes a task force to conduct a nationwide campaign of education and outreach for small business concerns regarding the availability of coverage for children through private insurance options, the Medicaid program, and CHIP.(Sec. 622) Expresses the sense of the Senate that it: (1) recognizes the necessity to improve affordability and access to health insurance for all Americans; (2) acknowledges the value of building upon the existing private health insurance market; and (3) affirms its intent to enact legislation this year that, with appropriate consumer protections, improves access to affordable and meaningful health insurance coverage for employees of small business and individuals.Title VII: Revenue Provisions - (Sec. 701) Amends the Internal Revenue Code to increase excise tax rates on cigars, cigarettes, cigarette papers and tubes, smokeless tobacco, pipe tobacco, and roll-your-own tobacco. Imposes a tax on floor stocks of tobacco products (other than certain cigars and cigarette papers and tubes), reduced by a $500 tax credit. Requires payment of such floor stock taxes on or before August 1, 2009. Extends the floor stock tax to articles located in a foreign trade zone on any tax increase date.(Sec. 702) Applies administrative tax law provisions relating to permits, inventories, reporting, and recordkeeping to manufacturers and importers of processed tobacco (i.e., any tobacco other than tobacco products).Expands the authority of the Secretary of the Treasury to deny, suspend, or revoke permits for manufacturing or importing tobacco products.Revises the definition of "roll-your-own tobacco" to include cigars or cigar wrappers.Amends the Tariff Act of 1930 to apply limitation periods for assessment of tax under the Internal Revenue Code to alcohol and tobacco excise taxes. Imposes an immediate excise tax on any tobacco products, cigarette paper, or tubes produced in the United States at any place other than the premises of a lawful manufacturer of such products. (Sec. 703) Directs the Secretary of the Treasury to study and report to Congress on: (1) the magnitude of tobacco smuggling in the United States; and (2) any recommendations for the most effective steps to reduce it.(Sec. 704) Amends the Tax Increase Prevention and Reconciliation Act of 2005 to increase by 0.5% the amount of any required installment of corporate estimated tax otherwise due in July, August, or September 2013.
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- This bill has been enacted into law. Introduced January 13, 2009. Enacted.
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