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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 5182 Introduced in Senate (IS)]

<DOC>

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.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Utilizing National Data, Effectively 
Reforming Standards and Tools, to Address Negative Determinates of 
Health Act'' or the ``UNDERSTAND Act''.

SEC. 2. COLLECTION OF INFORMATION RELATED TO SOCIAL DETERMINANTS OF THE 
              HEALTH OF MEDICAID AND CHIP BENEFICIARIES.

    (a) Reporting of Information.--Section 1946 of the Social Security 
Act (42 U.S.C. 1396w-5) is amended by adding at the end the following:
    ``(d) Collection of Information Related to Social Determinants of 
Health.--
            ``(1) Development of uniform reporting field.--
                    ``(A) In general.--Not later than 18 months after 
                the date of enactment of this subsection, the 
                Secretary, in consultation with the States, shall 
                develop a model uniform reporting field through the 
                transformed Medicaid Statistical Information System (T-
                MSIS), as approved by the Secretary, for collecting 
                standardized and aggregated State-level information 
                related to social determinants that may factor into the 
                health of beneficiaries under this title who are 
                eligible for medical assistance for which Federal 
                financial participation is available and beneficiaries 
                under title XXI who are eligible for child health 
                assistance for which Federal financial participation is 
                available which the States, notwithstanding section 
                1902(a)(7) and as a condition for meeting the 
                requirements of section 1902(a)(6) and section 
                2107(b)(1), shall use to annually report such 
                information.
                    ``(B) Implementation.--In carrying out the 
                requirements of subparagraph (A), the Secretary shall--
                            ``(i) determine the appropriate providers 
                        and frequency with which such providers may 
                        submit standardized information to States to be 
                        used to complete the uniform reporting field 
                        developed under such subparagraph;
                            ``(ii) issue guidance for ensuring 
                        compliance with applicable laws regarding 
                        beneficiary informed consent, privacy, and 
                        anonymity with respect to the information 
                        collected through the uniform reporting field;
                            ``(iii) with respect to the collection of 
                        information relating to beneficiaries who are 
                        children, issue guidance on the collection of 
                        such information from a parent, legal guardian, 
                        or any other person who is legally authorized 
                        to share such information on behalf of the 
                        child when the direct collection of such 
                        information from children may not otherwise be 
                        feasible or appropriate; and
                            ``(iv) issue guidance on how to reduce 
                        duplicative screenings of beneficiaries, or to 
                        ensure that information collected from a 
                        screening is entered into a beneficiary's 
                        health record so that other providers who treat 
                        that beneficiary can see that a screening has 
                        been conducted for that beneficiary.
            ``(2) Social determinants of health defined.--
                    ``(A) In general.--For purposes of this title and 
                title XXI, the term `social determinants of health' 
                means the standardized definitions developed in 
                accordance with paragraph (1) for identifying social 
                determinants of health needs identified in the ICD-10 
                diagnostic codes Z55 through Z63, Z65, and Z75 (as in 
                effect on the date of enactment of this subsection).
                    ``(B) Incorporation measures of relative 
                severity.--The Secretary shall issue guidance relating 
                to incorporating measures for quantifying, with respect 
                to an individual, the relative severity of a social 
                determinant of health need of the individual as 
                identified by a diagnostic code referred to in 
                subparagraph (A).
            ``(3) Rules of construction.--
                    ``(A) Federal privacy requirements.--Nothing in 
                this subsection shall be construed to supersede any 
                Federal privacy or confidentiality requirement, 
                including the regulations promulgated under section 
                264(c) of the Health Insurance Portability and 
                Accountability Act of 1996 and section 543 of the 
                Public Health Service Act and any regulations 
                promulgated thereunder.
                    ``(B) No requirement for the provision of medical 
                assistance.--Nothing in this subsection shall be 
                construed as allowing for medical assistance for items 
                and services for which Federal financial participation 
                is not permitted under this title.
            ``(4) State requirement to collect information from 
        providers.--As a condition for meeting the requirements of 
        section 1902(a)(6) and section 2107(b)(1), a State shall ensure 
        that the providers identified by the Secretary under paragraph 
        (1)(B)(i) are conducting screenings for social needs and 
        submitting standardized information with appropriate frequency 
        (as identified by the Secretary under such paragraph).
            ``(5) Application to territories.--
                    ``(A) In general.--To the extent that the Secretary 
                determines that it is not practicable for a State 
                specified in subparagraph (B) to report information in 
                accordance with the uniform reporting field made 
                available under paragraph (1), this subsection shall 
                not apply with respect to such State.
                    ``(B) Territories specified.--The States specified 
                in this subparagraph are Puerto Rico, the Virgin 
                Islands, Guam, American Samoa, and the Northern Mariana 
                Islands.''.
    (b) Report.--Section 1946(b)(2) of such Act (42 U.S.C. 1396w-
5(b)(2)) is amended--
            (1) by striking ``Not later than'' and inserting the 
        following:
                    ``(A) Initial reports.--Not later than''; and
            (2) by adding at the end the following:
                    ``(B) Report on collection of information related 
                to social determinants of health.--Not later than 4 
                years after the date of the enactment of this 
                subparagraph, the Secretary shall submit to Congress a 
                report that includes aggregate findings and trends 
                across respective beneficiary populations for improving 
                the identification of social determinants of health for 
                beneficiaries under this title who are eligible for 
                medical assistance for which Federal financial 
                participation is available and beneficiaries under 
                title XXI who are eligible for child health assistance 
                for which Federal financial participation is available 
                based on analyses of the data collected under 
                subsection (d).''.
                                 <all>
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