I 

112TH CONGRESS 

2D SESSION H. R. 4147 

To amend title XIX of the Social Security Act to provide States an option 

to cover a children’s program of all-inclusive coordinated care (ChiPACC) 

under the Medicaid Program. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 6, 2012 

Mr. MORAN introduced the following bill; which was referred to the Committee 

on Energy and Commerce 

A BILL 

To amend title XIX of the Social Security Act to provide 

States an option to cover a children’s program of allinclusive coordinated care (ChiPACC) under the Medicaid Program. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘ChiPACC Act of 

5 2011’’. 


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1 SEC. 2. OPTIONAL MEDICAID COVERAGE OF CHILDREN’S 

2 PROGRAM OF ALL-INCLUSIVE COORDINATED 

3 CARE (CHIPACC). 

4 (a) IN GENERAL.—Section 1905(a) of the Social Se5 curity Act (42 U.S.C. 1396d(a)) is amended— 

6 (1) by striking ‘‘and’’ at the end of paragraph 

7 (28); 

8 (2) by redesignating paragraph (29) as para9 graph (30); and 

10 (3) by inserting after paragraph (28) the fol11 lowing new paragraph: 

12 ‘‘(29) services furnished under a children’s pro13 gram of all-inclusive coordinated care (ChiPACC) 

14 under section 1944; and’’. 

15 (b) CHILDREN’S PROGRAM OF ALL-INCLUSIVE CO16 ORDINATED CARE.—Title XIX of such Act is further 

17 amended by inserting after section 1943 the following new 

18 section: 

19 ‘‘SEC. 1944. CHILDREN’S PROGRAM OF ALL-INCLUSIVE CO20 ORDINATED CARE. 

21 ‘‘(a) STATE OPTION.— 

22 ‘‘(1) IN GENERAL.—A State may elect to pro23 vide medical assistance under this section to 

24 ChiPACC eligible individuals who are eligible for 

25 medical assistance under the State plan under this 

26 title and who choose to enroll in a children’s proVerDate Mar 15 2010 23:51 Mar 06, 2012 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H4147.IH H4147

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1 gram of all-inclusive coordinated care. In the case of 

2 an individual who chooses to enroll in such a pro3 gram pursuant to such an election— 

4 ‘‘(A) the individual shall receive benefits 

5 under the State plan solely through such pro6 gram; and 

7 ‘‘(B) the health care providers furnishing 

8 services under such program shall receive pay9 ment for providing such services in accordance 

10 with the terms of such program. 

11 ‘‘(2) NUMERICAL AND GEOGRAPHICAL LIMITA12 TIONS PERMITTED.—A State may establish— 

13 ‘‘(A) a numerical limit on the number of 

14 individuals who may be enrolled in the State’s 

15 ChiPACC; and 

16 ‘‘(B) geographic limitations on the service 

17 areas for a ChiPACC. 

18 ‘‘(b) CHIPACC AND OTHER TERMS DEFINED.—In 

19 this section: 

20 ‘‘(1) CHILDREN’S PROGRAM OF ALL-INCLUSIVE

21 COORDINATED CARE; CHIPACC.—The terms ‘chil22 dren’s program of all-inclusive coordinated care’ and 

23 ‘ChiPACC’ mean a program of coordinated care for 

24 ChiPACC eligible children that is established by a 


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1 State under this section and meets the following re2 quirements: 

3 ‘‘(A) OPERATION.—The program is admin4 istered by a single State agency. Such agency 

5 may provide for the operation of the program 

6 through arrangements between one or more 

7 other entities, such as a ChiPACC coordinator 

8 and such agency. 

9 ‘‘(B) COMPREHENSIVE BENEFITS.— 

10 ‘‘(i) IN GENERAL.—The program pro11 vides comprehensive health care items and 

12 services to ChiPACC eligible individuals in 

13 accordance with this section and regula14 tions (as such term is defined in paragraph 

15 (6)). 

16 ‘‘(ii) SCOPE AND PLAN FOR SERV17 ICES.—Such items and services shall— 

18 ‘‘(I) include items and services 

19 described in subsection (c)(1)(A) to 

20 the extent such items and services are 

21 appropriate for the individual; and 

22 ‘‘(II) be provided consistent with 

23 a comprehensive care plan developed 

24 by an interdisciplinary health profes25 sional team. 


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1 ‘‘(iii) QUALIFICATIONS OF PRO2 VIDERS.—Such items and services are pro3 vided through health care providers that— 

4 ‘‘(I) meet such certification or 

5 other quality requirements as may be 

6 necessary to participate in the pro7 gram of medical assistance under this 

8 title or in the program under title 

9 XVIII; and 

10 ‘‘(II) maintain records on 

11 ChiPACC eligible individuals enrolled 

12 in the program and to whom the pro13 vider furnishes services, reflecting 

14 both the specific care and services fur15 nished by the provider and the rela16 tionship of those services to the com17 prehensive plan of care for that indi18 vidual and to the delivery of other 

19 services to the individual through the 

20 program. 

21 ‘‘(2) CHIPACC ELIGIBLE INDIVIDUAL.—The 

22 term ‘ChiPACC eligible individual’ means, with re23 spect to a ChiPACC, an individual— 

24 ‘‘(A) who, at the time of enrollment in the 

25 ChiPACC, is a child (as defined under the State 


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1 plan for this purpose) and who is not older than 

2 such age as the State may specify; 

3 ‘‘(B) who suffers from a serious illness or 

4 health condition that is life threatening; 

5 ‘‘(C) for whom there is a reasonable likeli6 hood that the child’s life will be threatened by 

7 such illness or condition; 

8 ‘‘(D) whose health status is expected to de9 cline because of such illness or condition before 

10 attaining full adulthood (as defined under the 

11 State plan); 

12 ‘‘(E) resides in the service area of the 

13 ChiPACC; and 

14 ‘‘(F) is eligible for medical assistance 

15 under the State plan without regard to this sec16 tion (or, but for enrollment in a ChiPACC 

17 would, based on the individual’s illness or 

18 health condition or the projected cost of treat19 ment required for such illness or condition, be20 come so eligible). 

21 The Secretary may waive the application of subpara22 graph (F) with respect to eligibility for medical as23 sistance under the State plan without regard to this 

24 section in the case of individuals if the State dem25 onstrates to the satisfaction of the Secretary that 


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1 the sum of the additional expenditures under this 

2 title resulting from such waiver in a fiscal year will 

3 not exceed the aggregate savings in expenditures 

4 otherwise resulting from the implementation of this 

5 section in the fiscal year. 

6 ‘‘(3) CHIPACC COORDINATOR.—The term 

7 ‘ChiPACC coordinator’ means, with respect to a 

8 ChiPACC, an entity (which may be the State admin9 istering agency or another entity under an arrange10 ment with such an agency) that directs, supervises, 

11 and assures the coordination of comprehensive serv12 ices to ChiPACC eligible individuals enrolled in the 

13 ChiPACC consistent with the following: 

14 ‘‘(A) The entity must assure the direct and 

15 continuous involvement of an interdisciplinary 

16 health professional team in managing and co17 ordinating the provision of care and services 

18 within the coordinator’s responsibility to each 

19 such enrolled individual. 

20 ‘‘(B) The entity must include on its staff, 

21 or otherwise arrange for the provision of serv22 ices, through contracts or otherwise, of each of 

23 the types of the health care professionals and 

24 other service providers required to provide the 


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1 items and services required under subsection 

2 (c)(1)(A). 

3 ‘‘(C) To the extent consistent with provi4 sion of the highest quality of care to enrolled 

5 individuals— 

6 ‘‘(i) promote the utilization of volun7 teers in the provision of care and services 

8 under the ChiPACC, in accordance with 

9 standards set by the Secretary, which 

10 standards shall ensure a continuing level of 

11 effort to utilize such volunteers; and 

12 ‘‘(ii) ensure that records are main13 tained on the use of such volunteers and 

14 the cost savings and expansion of care and 

15 services achieved through the use of such 

16 volunteers. 

17 ‘‘(4) INTERDISCIPLINARY HEALTH PROFES18 SIONAL TEAM.—The term ‘interdisciplinary health 

19 professional team’ means, with respect to a 

20 ChiPACC, a group of health professionals that— 

21 ‘‘(A) includes at least— 

22 ‘‘(i) one physician (as defined in sec23 tion 1861(r)(1)); 

24 ‘‘(ii) one registered professional nurse; 

25 and 


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1 ‘‘(iii) one social worker, pastoral coun2 selor, or other counselor; 

3 ‘‘(B) develops a comprehensive plan of care 

4 for ChiPACC eligible individuals enrolled with 

5 the ChiPACC and furnishes, or supervises the 

6 provision of, care and services described in sub7 section (c)(1) to an individual enrolled in the 

8 ChiPACC; and 

9 ‘‘(C) through direct action and communica10 tion with health care providers furnishing serv11 ices under the ChiPACC, on behalf of or under 

12 the direction or supervision of a State admin13 istering agency or a ChiPACC coordinator, co14 ordinates the care and services furnished to 

15 such enrollees in a manner that takes into ac16 count the best interests of each such enrollee 

17 and the enrollee’s family. 

18 ‘‘(5) STATE ADMINISTERING AGENCY.—The 

19 term ‘State administering agency’ means, with re20 spect to the operation of a ChiPACC in a State, the 

21 agency of that State (which may be the single agen22 cy responsible for administration of the State plan 

23 under this title in the State) responsible for the im24 plementation, either directly or through arrangeVerDate Mar 15 2010 23:51 Mar 06, 2012 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H4147.IH H4147

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1 ments with one or more ChiPACC coordinators, of 

2 the ChiPACC under this section in the State. 

3 ‘‘(6) REGULATIONS.—Except as otherwise pro4 vided, the term ‘regulations’ refers to interim final 

5 or final regulations promulgated under subsection 

6 (g). 

7 ‘‘(c) SCOPE OF BENEFITS; BENEFICIARY SAFE8 GUARDS.— 

9 ‘‘(1) IN GENERAL.—Under a ChiPACC of a 

10 State, the State administering agency shall assure 

11 that— 

12 ‘‘(A) an individual enrolled in the 

13 ChiPACC is øcovered for¿, at a minimum— 

14 ‘‘(i) all items and services that are 

15 covered for any individual under this title, 

16 and all additional items and services speci17 fied in regulations, but without any limita18 tion or condition as to amount, duration, 

19 or scope; 

20 ‘‘(ii) access to covered items and serv21 ices, as needed, 24 hours per day, every 

22 day of the year; and 

23 ‘‘(iii) services that include comprehen24 sive, integrated palliative and curative 

25 services, expressive therapy and counseling, 


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1 and counseling and anticipatory bereave2 ment services to immediate family mem3 bers of the ChiPACC eligible individual, as 

4 part of the services to the eligible indi5 vidual; 

6 ‘‘(B) provision of such services to such in7 dividuals through a comprehensive, interdiscipli8 nary and multidisciplinary health and social 

9 services delivery system which integrates, as ap10 propriate to the individual recipient of services, 

11 acute and long-term care services, palliative, 

12 respite and curative treatment, counseling and 

13 support for family members who are caretakers 

14 or otherwise relevant to appropriate care and 

15 treatment of the individual, and such other 

16 services as may be furnished pursuant to regu17 lations and the provisions of the applicable 

18 State plan; and 

19 ‘‘(C) the ChiPACC is operated, and the 

20 services to enrolled individuals are furnished, in 

21 a manner that is consistent with Standards of 

22 Care and Practice Guidelines developed by Chil23 dren’s Hospice International for a Program of 

24 All-Inclusive Care for Children (as in effect as 


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1 of the date of the enactment of this section or 

2 such later date as the Secretary may specify). 

3 ‘‘(2) QUALITY ASSURANCE; PATIENT SAFE4 GUARDS.—With respect to a ChiPACC, the State 

5 administering agency shall assure the following: 

6 ‘‘(A) The provision of services under the 

7 ChiPACC meets Federal and State guidelines 

8 for quality assurance. 

9 ‘‘(B) Necessary safeguards have been es10 tablished to protect the health and welfare of 

11 individuals enrolled in the ChiPACC under this 

12 section. 

13 ‘‘(C) There is financial accountability of 

14 funds expended under this title with respect to 

15 such services. 

16 ‘‘(D) There is a written plan of quality as17 surance, and procedures implementing such 

18 plan, in accordance with regulations. 

19 ‘‘(E) Written safeguards of the rights of 

20 individuals enrolled in the ChiPACC, including 

21 a patient bill of rights and procedures for griev22 ances and appeals, in accordance with regula23 tions and with other requirements of this title 

24 and Federal and State law designed for the pro25 tection of patients. 


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1 ‘‘(F) There are in effect procedures for 

2 data collection, record maintenance and reten3 tion, and the development of outcome measures, 

4 and such other policies, systems, and proce5 dures as are sufficient to afford the Secretary 

6 and the State administering agency access to 

7 records and data relating to the ChiPACC, in8 cluding pertinent financial, medical, and per9 sonnel records. 

10 ‘‘(G) The agency shall submit to the Sec11 retary such reports as the Secretary finds (in 

12 consultation with State administering agencies) 

13 necessary to monitor the operation, cost, and 

14 effectiveness of ChiPACCs. 

15 ‘‘(3) COST-SHARING WAIVER.—A State admin16 istering agency may, in the case of a ChiPACC eligi17 ble individual enrolled in the State’s ChiPACC, 

18 waive deductibles, copayments, coinsurance, or other 

19 cost-sharing that would otherwise apply under the 

20 State plan under this title. 

21 ‘‘(d) ELIGIBILITY DETERMINATIONS.— 

22 ‘‘(1) IN GENERAL.—In determining whether an 

23 individual is a ChiPACC eligible individual, the 

24 State administering agency shall conduct an indeVerDate Mar 15 2010 23:51 Mar 06, 2012 Jkt 019200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6201 E:\BILLS\H4147.IH H4147

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1 pendent evaluation and assessment, which shall in2 clude the following: 

3 ‘‘(A) Where appropriate, consultation with 

4 the individual’s family, guardian, or other re5 sponsible individual. 

6 ‘‘(B) Consultation with appropriate treat7 ing and consulting health and support profes8 sionals caring for the individual. 

9 ‘‘(C) An examination of the individual’s 

10 relevant history, medical records, and care and 

11 support needs, guided by best practices and re12 search on effective strategies that result in im13 proved health and quality of life outcomes. 

14 ‘‘(2) CERTIFICATION.—Upon completion of the 

15 evaluation and assessment described in paragraph 

16 (1), an individual meeting the criteria of a ChiPACC 

17 eligible individual shall be certified as such, pursuant 

18 to procedures specified in regulations and the appli19 cable State plan. 

20 ‘‘(3) CONTINUATION OF ELIGIBILITY.—An indi21 vidual who is a ChiPACC eligible individual may be 

22 deemed to continue to be such an individual notwith23 standing a determination that the individual no 

24 longer meets the requirement of subsection (b)(2)(B) 

25 if, in accordance with regulations, it is reasonably 


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1 foreseeable that, if the individual is not furnished 

2 services under this section, the severity or impact of 

3 the individual’s illness or condition would increase to 

4 a degree that the individual would again meet such 

5 requirement before the individual attains adulthood 

6 or within the succeeding 12-month period. 

7 ‘‘(4) ANNUAL REEVALUATIONS.—Subject to 

8 such limitations as the Secretary may by regulation 

9 prescribe, the eligibility determination made under 

10 this subsection shall be reevaluated annually, except 

11 that such an annual evaluation may be waived, in 

12 accordance with regulations, in a case where the ad13 ministering State agency determines that there is no 

14 reasonable expectation of improvement or significant 

15 change in the individual’s illness or condition during 

16 a period to which the reevaluation requirement 

17 would otherwise be applicable. 

18 ‘‘(5) ENROLLMENT AND DISENROLLMENT.— 

19 ‘‘(A) VOLUNTARY DISENROLLMENT AT ANY

20 TIME.—The enrollment and disenrollment of 

21 ChiPACC eligible individuals in a ChiPACC 

22 shall be pursuant to procedures specified in reg23 ulations and the State plan, but shall permit an 

24 enrollee, or an enrollee’s guardian or other legal 

25 representative, acting on behalf of an enrollee, 


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1 to voluntarily disenroll for any reason at any 

2 time. 

3 ‘‘(B) LIMITATIONS ON DISENROLLMENT.— 

4 ‘‘(i) IN GENERAL.—Regulations, and 

5 the applicable State plan, shall provide 

6 that a ChiPACC may not involuntarily 

7 disenroll a ChiPACC eligible individual en8 rolled in the ChiPACC except— 

9 ‘‘(I) for disruptive or threatening 

10 behavior by the enrollee, or by a fam11 ily member with whom a health care 

12 provider providing services under the 

13 ChiPACC necessarily has contact in 

14 the provision of services, as defined in 

15 provisions of regulations (developed in 

16 close consultation with State admin17 istering agencies); or 

18 ‘‘(II) if there is a change in the 

19 individual’s medical condition, resi20 dency or geographic location, or finan21 cial situation such that the individual 

22 no longer is a ChiPACC eligible indi23 vidual and paragraph (3) does not 

24 apply to warrant continuation of en25 rollment. 


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1 ‘‘(ii) NO DISENROLLMENT FOR NON2 COMPLIANT BEHAVIOR.—Except as allowed 

3 under regulations, a ChiPACC may not 

4 disenroll a ChiPACC eligible individual on 

5 the ground that the individual has engaged 

6 in noncompliant behavior if such behavior 

7 is related to a mental or physical condition 

8 of the individual. For purposes of the pre9 ceding sentence, the term ‘noncompliant 

10 behavior’ includes repeated noncompliance 

11 with medical advice and repeated failure to 

12 appear for appointments. 

13 ‘‘(iii) TIMELY REVIEW OF PROPOSED

14 NONVOLUNTARY DISENROLLMENT.—A pro15 posed involuntary disenrollment under this 

16 subparagraph shall be subject to timely re17 view and final determination by the Sec18 retary or by the State administering agen19 cy (as applicable), prior to the proposed 

20 disenrollment becoming effective, pursuant 

21 to procedures prescribed in regulations. 

22 ‘‘(C) APPEALS.—If an individual is deter23 mined not to be a ChiPACC eligible individual 

24 upon application, any time after such services 

25 begin, or is disenrolled from a ChiPACC for 


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1 reasons described in subparagraph (B)(i)(I), the 

2 State plan under this title shall allow for an ap3 peal of such determination. During the course 

4 of the appeals process, an individual previously 

5 enrolled in a ChiPACC shall continue to be so 

6 enrolled and to receive benefits through the 

7 ChiPACC. 

8 ‘‘(6) CONSTRUCTION.—The fact that a 

9 ChiPACC eligible individual is enrolled under a 

10 ChiPACC shall not be construed as adversely affect11 ing the eligibility of the individual’s parents or care12 taker relatives for medical assistance under this 

13 title. 

14 ‘‘(e) PAYMENTS TO HEALTH CARE PROVIDERS

15 UNDER CHIPACC.— 

16 ‘‘(1) IN GENERAL.—Payments to health care 

17 providers furnishing items and services under a 

18 ChiPACC shall be paid on a capitated or fee-for19 service basis, according to regulations and as speci20 fied in the applicable State plan consistent with this 

21 subsection. 

22 ‘‘(2) USE OF INTEGRATED, BUDGET-NEUTRAL

23 FINANCING.—Payments under this subsection shall 

24 be made— 


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1 ‘‘(A) on a basis that permits provision for 

2 integrated financing methodologies that allow 

3 providers to pool payments received from public 

4 and private programs and individuals; and 

5 ‘‘(B) in amounts that are designed, accord6 ing to regulations, to ensure that aggregate 

7 payments under this section for individuals en8 rolled in a ChiPACC, whether made on a 

9 capitated basis or fee-for-service basis, do not 

10 exceed on average the aggregate payments that 

11 would have been paid under the State plan for 

12 such individuals if they were not so enrolled, 

13 taking into account the comparative case-mix of 

14 ChiPACC enrollees and such other factors as 

15 the Secretary determines to be appropriate. 

16 ‘‘(f) TERMINATION PROCEDURES.— 

17 ‘‘(1) IN GENERAL.—Under regulations— 

18 ‘‘(A) the Secretary may require a State ad19 ministering agency to terminate the participa20 tion of a ChiPACC coordinator for cause; and 

21 ‘‘(B) a State administering agency may 

22 terminate operation of a ChiPACC after appro23 priate notice to the Secretary and enrollees. 

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1 lishing procedures for termination of participation of 

2 ChiPACC coordinators, the Secretary may require a 

3 State administering agency to terminate participa4 tion of a ChiPACC coordinator for, among other 

5 reasons, the fact that— 

6 ‘‘(A) the Secretary determines that the 

7 ChiPACC coordinator has failed to comply sub8 stantially with requirements for a ChiPACC co9 ordinator under this section; and 

10 ‘‘(B) the State administering agency has 

11 failed to develop and successfully initiate, with12 in 30 days of the date of the receipt of written 

13 notice of such a determination for the ChiPACC 

14 coordinator, a plan to correct the coordinator’s 

15 deficiencies, or has failed to continue implemen16 tation of such a plan of correction. 

17 ‘‘(g) REGULATIONS.— 

18 ‘‘(1) IN GENERAL.—The Secretary shall issue 

19 interim final or final regulations to carry out this 

20 section. 

21 ‘‘(2) USE OF EXISTING STANDARDS.— 

22 ‘‘(A) IN GENERAL.—In issuing such regu23 lations, the Secretary shall, to the extent appro24 priate and consistent with the provisions of this 

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1 ments applied to Programs of All-Inclusive Care 

2 for Children demonstration waiver programs 

3 that have been implemented before (or as of) 

4 the date of the enactment of this section, in5 cluding standards of care and practice guide6 lines applied under such programs. 

7 ‘‘(B) FLEXIBILITY.—In order to provide 

8 for reasonable flexibility in adapting the service 

9 delivery model described in subparagraph (A) to 

10 the needs of particular organizations (such as 

11 those in rural areas or those that may deter12 mine it appropriate to use nonstaff physicians 

13 according to State licensing law requirements) 

14 under this section, the Secretary (in close con15 sultation with State administering agencies) 

16 may modify or waive provisions described in 

17 subparagraph (A) so long as any such modifica18 tion or waiver is not inconsistent with and 

19 would not impair the essential elements, objec20 tives, and requirements of this section, but may 

21 not modify or waive any of the following provi22 sions: 

23 ‘‘(i) The requirement of delivery of 

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1 seling and other medical and psycho-social 

2 services for ChiPACC eligible individual, to 

3 the extent such services would benefit the 

4 individual. 

5 ‘‘(ii) The requirement of delivery of 

6 counseling and bereavement services to im7 mediate family members of the ChiPACC 

8 enrollees as part of the services to the en9 rollee. 

10 ‘‘(iii) The requirement of an inter11 disciplinary health professional team ap12 proach to care management and service de13 livery to ChiPACC eligible individuals. 

14 ‘‘(iv) The provision of integrated fi15 nancing methodologies that allow for the 

16 pooling of payments received from public 

17 and private programs and individuals. 

18 ‘‘(v) The limitation on average aggre19 gate payment under subsection (e)(2). 

20 ‘‘(C) CONTINUATION OF MODIFICATIONS

21 OR WAIVERS OPERATIONAL REQUIREMENTS.—If 

22 a State agency administering a program of all23 inclusive coordinated care for seriously ill chil24 dren approved pursuant to waiver authority 

25 under section 1115 or 1915(c) has contractual 


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1 or other operating arrangements relating to 

2 such program which are not otherwise recog3 nized in regulation and which were in effect as 

4 of the date of the enactment of this section, the 

5 Secretary shall permit the agency to continue 

6 such arrangements so long as such arrange7 ments are found by the Secretary to be reason8 ably consistent with the objectives of a 

9 ChiPACC. 

10 ‘‘(3) CONSTRUCTION.—Nothing in this sub11 section shall be construed as preventing the Sec12 retary from including in regulations provisions to en13 sure the health and safety of individuals enrolled in 

14 a ChiPACC under this section that are in addition 

15 to those otherwise provided under this section. 

16 ‘‘(h) APPLICABILITY OF REQUIREMENTS.—With re17 spect to carrying out a ChiPACC under this section, the 

18 following requirements of this title (and regulations relat19 ing to such requirements) shall not apply: 

20 ‘‘(1) Section 1902(a)(1), relating to any re21 quirement that ChiPACCs or ChiPACC services be 

22 provided in all areas of a State. 

23 ‘‘(2) Section 1902(a)(10), insofar as such sec24 tion relates to comparability of services among dif25 ferent population groups. 


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1 ‘‘(3) Sections 1902(a)(23) and 1915(b)(4), re2 lating to freedom of choice of providers under a 

3 ChiPACC. 

4 ‘‘(4) Section 1903(m)(2)(A), insofar as it re5 stricts a ChiPACC provider from receiving prepaid 

6 capitation payments. 

7 ‘‘(5) Section 1905(o), limiting the scope of hos8 pice care. 

9 ‘‘(6) Such other provisions of this title that the 

10 Secretary determines are inapplicable to carrying out 

11 a ChiPACC under this section.’’. 

12 (c) CONTINUED DEMONSTRATION PROJECT AU13 THORITY.—Section 1944 of the Social Security Act, as 

14 added by subsection (b) shall not be construed as pre15 venting a State from developing, or the Secretary from 

16 approving, a project similar to or related to ChiPACCs 

17 (as described in such section) under existing authorities, 

18 including demonstration project and waiver authorities 

19 under this title or other provisions of this Act. 

20 (d) OTHER CONFORMING AMENDMENTS.—Section 

21 1905(r)(5) of such Act (42 U.S.C. 1396d(r)(5)) is amend22 ed by inserting before the period at the end the following: 

23 ‘‘, other than items and services that are only covered as 

24 section 1944 ChiPACC benefits’’. 


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1 (e) TIMELY ISSUANCE OF REGULATIONS; EFFECTIVE

2 DATE.—The Secretary of Health and Human Services 

3 shall promulgate regulations to carry out the amendments 

4 made by this section in a timely manner, so as to assure 

5 that it will be feasible for State agencies and entities to 

6 establish and operate ChiPACCs for periods beginning not 

7 later than 1 year after the date of the enactment of this 

8 Act. 

9 (f) FUNDS FOR TECHNICAL ASSISTANCE.—The Sec10 retary is authorized to expend funds appropriated to carry 

11 out title XIX of the Social Security Act to make grants 

12 to, or enter into contracts with, private entities or organi13 zations that are qualified to provide technical or other as14 sistance in developing and establishing ChiPACCs within 

15 the States, except that— 

16 (1) such funds may be expended solely for the 

17 purposes of implementing this section; and 

18 (2) a private entity or organization in receipt of 

19 such funds must have demonstrated expertise and a 

20 minimum of 5 years of experience in working with 

21 or assisting in the establishment of programs for 

22 comprehensive care of children meeting the descrip23 tion of ChiPACC eligible individuals under section 


rfrederick on DSK6VPTVN1PROD with BILLS
26 

•HR 4147 IH

1 1944(b) of the Social Security Act, as added by sub2 section (b). 

Æ 


rfrederick on DSK6VPTVN1PROD with BILLS