II 

118TH CONGRESS 

2D SESSION S. 5182 

To amend title XIX of the Social Security Act to require the collection 

of information regarding social determinants of health, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 25, 2024 

Mr. SULLIVAN (for himself and Ms. CORTEZ MASTO) introduced the following 

bill; which was read twice and referred to the Committee on Finance 

A BILL 

To amend title XIX of the Social Security Act to require 

the collection of information regarding social determinants of health, and for other purposes. 

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 ‘‘Utilizing National 

5 Data, Effectively Reforming Standards and Tools, to Ad6 dress Negative Determinates of Health Act’’ or the ‘‘UN7 DERSTAND Act’’. 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
2 

•S 5182 IS

1 SEC. 2. COLLECTION OF INFORMATION RELATED TO SO2 CIAL DETERMINANTS OF THE HEALTH OF 

3 MEDICAID AND CHIP BENEFICIARIES. 

4 (a) REPORTING OF INFORMATION.—Section 1946 of 

5 the Social Security Act (42 U.S.C. 1396w–5) is amended 

6 by adding at the end the following: 

7 ‘‘(d) COLLECTION OF INFORMATION RELATED TO

8 SOCIAL DETERMINANTS OF HEALTH.— 

9 ‘‘(1) DEVELOPMENT OF UNIFORM REPORTING

10 FIELD.— 

11 ‘‘(A) IN GENERAL.—Not later than 18 

12 months after the date of enactment of this sub13 section, the Secretary, in consultation with the 

14 States, shall develop a model uniform reporting 

15 field through the transformed Medicaid Statis16 tical Information System (T–MSIS), as ap17 proved by the Secretary, for collecting stand18 ardized and aggregated State-level information 

19 related to social determinants that may factor 

20 into the health of beneficiaries under this title 

21 who are eligible for medical assistance for which 

22 Federal financial participation is available and 

23 beneficiaries under title XXI who are eligible 

24 for child health assistance for which Federal fi25 nancial participation is available which the 

26 States, notwithstanding section 1902(a)(7) and 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
3 

•S 5182 IS

1 as a condition for meeting the requirements of 

2 section 1902(a)(6) and section 2107(b)(1), shall 

3 use to annually report such information. 

4 ‘‘(B) IMPLEMENTATION.—In carrying out 

5 the requirements of subparagraph (A), the Sec6 retary shall— 

7 ‘‘(i) determine the appropriate pro8 viders and frequency with which such pro9 viders may submit standardized informa10 tion to States to be used to complete the 

11 uniform reporting field developed under 

12 such subparagraph; 

13 ‘‘(ii) issue guidance for ensuring com14 pliance with applicable laws regarding ben15 eficiary informed consent, privacy, and an16 onymity with respect to the information 

17 collected through the uniform reporting 

18 field; 

19 ‘‘(iii) with respect to the collection of 

20 information relating to beneficiaries who 

21 are children, issue guidance on the collec22 tion of such information from a parent, 

23 legal guardian, or any other person who is 

24 legally authorized to share such informa25 tion on behalf of the child when the direct 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
4 

•S 5182 IS

1 collection of such information from chil2 dren may not otherwise be feasible or ap3 propriate; and 

4 ‘‘(iv) issue guidance on how to reduce 

5 duplicative screenings of beneficiaries, or 

6 to ensure that information collected from a 

7 screening is entered into a beneficiary’s 

8 health record so that other providers who 

9 treat that beneficiary can see that a 

10 screening has been conducted for that ben11 eficiary. 

12 ‘‘(2) SOCIAL DETERMINANTS OF HEALTH DE13 FINED.— 

14 ‘‘(A) IN GENERAL.—For purposes of this 

15 title and title XXI, the term ‘social deter16 minants of health’ means the standardized defi17 nitions developed in accordance with paragraph 

18 (1) for identifying social determinants of health 

19 needs identified in the ICD–10 diagnostic codes 

20 Z55 through Z63, Z65, and Z75 (as in effect 

21 on the date of enactment of this subsection). 

22 ‘‘(B) INCORPORATION MEASURES OF REL23 ATIVE SEVERITY.—The Secretary shall issue 

24 guidance relating to incorporating measures for 

25 quantifying, with respect to an individual, the 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
5 

•S 5182 IS

1 relative severity of a social determinant of 

2 health need of the individual as identified by a 

3 diagnostic code referred to in subparagraph 

4 (A). 

5 ‘‘(3) RULES OF CONSTRUCTION.— 

6 ‘‘(A) FEDERAL PRIVACY REQUIRE7 MENTS.—Nothing in this subsection shall be 

8 construed to supersede any Federal privacy or 

9 confidentiality requirement, including the regu10 lations promulgated under section 264(c) of the 

11 Health Insurance Portability and Accountability 

12 Act of 1996 and section 543 of the Public 

13 Health Service Act and any regulations promul14 gated thereunder. 

15 ‘‘(B) NO REQUIREMENT FOR THE PROVI16 SION OF MEDICAL ASSISTANCE.—Nothing in 

17 this subsection shall be construed as allowing 

18 for medical assistance for items and services for 

19 which Federal financial participation is not per20 mitted under this title. 

21 ‘‘(4) STATE REQUIREMENT TO COLLECT INFOR22 MATION FROM PROVIDERS.—As a condition for 

23 meeting the requirements of section 1902(a)(6) and 

24 section 2107(b)(1), a State shall ensure that the 

25 providers identified by the Secretary under paraVerDate Sep 11 2014 02:06 Oct 09, 2024 Jkt 059200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S5182.IS S5182

kjohnson on DSK7ZCZBW3PROD with $$_JOB
6 

•S 5182 IS

1 graph (1)(B)(i) are conducting screenings for social 

2 needs and submitting standardized information with 

3 appropriate frequency (as identified by the Secretary 

4 under such paragraph). 

5 ‘‘(5) APPLICATION TO TERRITORIES.— 

6 ‘‘(A) IN GENERAL.—To the extent that the 

7 Secretary determines that it is not practicable 

8 for a State specified in subparagraph (B) to re9 port information in accordance with the uni10 form reporting field made available under para11 graph (1), this subsection shall not apply with 

12 respect to such State. 

13 ‘‘(B) TERRITORIES SPECIFIED.—The 

14 States specified in this subparagraph are Puer15 to Rico, the Virgin Islands, Guam, American 

16 Samoa, and the Northern Mariana Islands.’’. 

17 (b) REPORT.—Section 1946(b)(2) of such Act (42 

18 U.S.C. 1396w–5(b)(2)) is amended— 

19 (1) by striking ‘‘Not later than’’ and inserting 

20 the following: 

21 ‘‘(A) INITIAL REPORTS.—Not later than’’; 

22 and 

23 (2) by adding at the end the following: 

24 ‘‘(B) REPORT ON COLLECTION OF INFOR25 MATION RELATED TO SOCIAL DETERMINANTS


kjohnson on DSK7ZCZBW3PROD with $$_JOB
7 

•S 5182 IS

1 OF HEALTH.—Not later than 4 years after the 

2 date of the enactment of this subparagraph, the 

3 Secretary shall submit to Congress a report 

4 that includes aggregate findings and trends 

5 across respective beneficiary populations for im6 proving the identification of social determinants 

7 of health for beneficiaries under this title who 

8 are eligible for medical assistance for which 

9 Federal financial participation is available and 

10 beneficiaries under title XXI who are eligible 

11 for child health assistance for which Federal fi12 nancial participation is available based on anal13 yses of the data collected under subsection 

14 (d).’’. 

Æ 


kjohnson on DSK7ZCZBW3PROD with $$_JOB