I 

117TH CONGRESS 

1ST SESSION H. R. 2347 

To amend title XIX of the Social Security Act to ensure adequate access 

to vaccines under the Medicaid program and the Vaccines for Children 

program, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 1, 2021 

Ms. SCHRIER (for herself, Mr. JOYCE of Pennsylvania, Mr. BUTTERFIELD, 

and Mr. MCKINLEY) 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 ensure 

adequate access to vaccines under the Medicaid program 

and the Vaccines for Children program, 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 ‘‘Strengthening the Vac5 cines for Children Program Act of 2021’’. 


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1 SEC. 2. ENSURING ADEQUATE ACCESS TO VACCINES 

2 UNDER THE MEDICAID PROGRAM AND THE 

3 VACCINES FOR CHILDREN PROGRAM. 

4 (a) ENCOURAGING INVOLVEMENT OF PROVIDERS.— 

5 Paragraph (3) of section 1928(c) of the Social Security 

6 Act (42 U.S.C. 1396s(c)) is amended— 

7 (1) by redesignating subparagraphs (A) and 

8 (B) as clauses (i) and (ii), respectively, and moving 

9 the margins of each such clause, as so redesignated, 

10 2 ems to the right; 

11 (2) by striking ‘‘PROVIDERS’’ and all that fol12 lows through ‘‘Each program’’ and inserting ‘‘PRO13 VIDERS.— 

14 ‘‘(A) IN GENERAL.—Each program’’; and 

15 (3) by adding at the end the following: 

16 ‘‘(B) INCENTIVE PAYMENTS.— 

17 ‘‘(i) IN GENERAL.—The Secretary 

18 shall pay to each provider that requests 

19 payment under this subparagraph and that 

20 is a program-registered provider under this 

21 section for the duration of the period be22 ginning on the date of the enactment of 

23 this subparagraph, and ending on Decem24 ber 31, 2022— 

25 ‘‘(I) an amount equal to $5,000, 

26 to be paid as soon as practicable after 


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1 the date of the enactment of this sub2 paragraph; 

3 ‘‘(II) an amount equal to $2,500, 

4 to be paid as soon as practicable after 

5 January 1, 2022; and 

6 ‘‘(III) an amount equal to 

7 $2,500, to be paid as soon as prac8 ticable after January 1, 2023. 

9 ‘‘(ii) USE OF FUNDS.—Payments 

10 made under clause (i) may only be used by 

11 a provider for purposes of carrying out the 

12 program under this section (including any 

13 operational expenses associated with the 

14 furnishing of vaccines under such program, 

15 as specified by the Secretary). 

16 ‘‘(iii) RECOUPMENT OF PAYMENTS.— 

17 The Secretary may conduct reviews of pro18 viders receiving payments under this sub19 paragraph to ensure that such payments 

20 are used in accordance with clause (ii) and 

21 recoup from such providers any such pay22 ments not so used in accordance with such 

23 clause.’’. 

24 (b) EXPANSION OF DEFINITION OF FEDERALLY VAC25 CINE-ELIGIBLE CHILD.—Paragraph (2) of section 


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1 1928(b) of the Social Security Act (42 U.S.C. 1396s(b)) 

2 is amended— 

3 (1) in subparagraph (A)— 

4 (A) in clause (iii), by striking ‘‘A child 

5 who’’ and all that follows through the period at 

6 the end and inserting ‘‘A child who is adminis7 tered a qualified pediatric vaccine and is not in8 sured with respect to such vaccine.’’; and 

9 (B) by adding at the end the following new 

10 clause: 

11 ‘‘(v) A child who is enrolled for child 

12 health assistance under a State child 

13 health plan approved under title XXI.’’; 

14 and 

15 (2) in subparagraph (B)(ii)(II), by striking ‘‘for 

16 purposes of subparagraph (A)(iii)(II)’’ and inserting 

17 ‘‘for purposes of subparagraph (A)(iii)’’. 

18 (c) MINIMUM PAYMENT REQUIREMENT FOR VACCINE

19 ADMINISTRATION SERVICES.— 

20 (1) IN GENERAL.—Section 1902(a)(13) of the 

21 Social Security Act (42 U.S.C. 1396a(a)(13)) is 

22 amended— 

23 (A) in subparagraph (B), by striking 

24 ‘‘and’’ at the end; 


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1 (B) in subparagraph (C), by striking the 

2 semicolon and inserting ‘‘; and’’; and 

3 (C) by adding at the end the following new 

4 subparagraph: 

5 ‘‘(D) for payment for vaccine administra6 tion services (including vaccine counseling and 

7 educational services) furnished by a provider 

8 during the period beginning on the date of the 

9 enactment of this subparagraph, and ending on 

10 December 31, 2022 (including, notwithstanding 

11 subsection (c)(2)(C)(ii) of section 1928, any 

12 such services furnished with respect to a vac13 cine furnished under the program established 

14 by the State pursuant to such section to a med15 icaid-eligible child (as defined in subsection 

16 (b)(2)(B)(i) of such section)), at a rate not less 

17 than 100 percent of the payment rate that ap18 plies to such services and provider under part 

19 B of title XVIII;’’. 

20 (2) MANAGED CARE PLANS.—Section 1932(f) 

21 of the Social Security Act (42 U.S.C. 1396u–2(f)) is 

22 amended— 

23 (A) in the header, by striking ‘‘PAYMENT

24 FOR PRIMARY CARE SERVICES’’ and inserting 

25 ‘‘PAYMENTS’’; 


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1 (B) by striking ‘‘section 1902(a)(13)(C)’’ 

2 and inserting ‘‘subparagraph (C) of section 

3 1902(a)(13) and vaccine administration services 

4 described in subparagraph (D) of such section’’; 

5 (C) by striking ‘‘such section’’ and insert6 ing ‘‘such subparagraph (C) or (D), respec7 tively’’; and 

8 (D) by adding at the end the following new 

9 sentence: ‘‘The provisions of the preceding sen10 tence shall apply to contracts entered into with, 

11 and payments made by, other specified entities 

12 (as defined in section 1903(m)(9)(D)(iii)) in the 

13 same manner as such provisions apply with re14 spect to contracts entered into with, and pay15 ments made by, medicaid managed care organi16 zations.’’. 

17 (3) CHIP.—Section 2103(c) of the Social Secu18 rity Act (42 U.S.C. 1397cc(c)) is amended by add19 ing at the end the following new paragraph: 

20 ‘‘(11) VACCINE ADMINISTRATION SERVICES.— 

21 The child health assistance provided to a targeted 

22 low-income child shall include payment for vaccine 

23 administration services (including vaccine counseling 

24 and educational services) furnished by a provider 

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1 actment of this paragraph, and ending on December 

2 31, 2022 (including, notwithstanding subsection 

3 (c)(2)(C)(ii) of section 1928, any such services fur4 nished to such child with respect to a vaccine fur5 nished under the program established by the State 

6 pursuant to such section), at a rate not less than 

7 100 percent of the payment rate that applies to such 

8 services and provider under part B of title XVIII.’’. 

9 (d) COVERAGE OF VACCINE COUNSELING AND EDU10 CATIONAL SERVICES UNDER MEDICAID.— 

11 (1) IN GENERAL.—Section 1905(a) of the So12 cial Security Act (42 U.S.C. 1396d) is amended— 

13 (A) in paragraph (29), by striking ‘‘and’’ 

14 at the end; 

15 (B) by redesignating paragraph (30) as 

16 paragraph (31); and 

17 (C) by inserting after paragraph (29) the 

18 following new paragraph: 

19 ‘‘(30) vaccine counseling and educational serv20 ices furnished to children under the age of 19 on or 

21 after the date of the enactment of this paragraph, 

22 including any such services furnished as part of a 

23 multiple component vaccine (identified as of October 

24 1, 2020, by CPT code 90461) and including any 

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1 lished by the State pursuant to section 1928 to a 

2 medicaid-eligible child (as defined in subsection (b) 

3 of such section),’’. 

4 (2) MANDATORY BENEFIT.—Section 

5 1902(a)(10)(A) of the Social Security Act (42 

6 U.S.C. 1396a(a)(10)(A)) is amended by striking 

7 ‘‘and (29)’’ and inserting ‘‘(29), and (30)’’. 

8 (e) CLARIFICATION OF COVERAGE OF PEDIATRIC

9 VACCINES AND VACCINE COUNSELING AND EDUCATIONAL

10 SERVICES UNDER THE VACCINES FOR CHILDREN PRO11 GRAM.—Section 1928(c)(2)(C)(ii) of the Social Security 

12 Act (42 U.S.C. 1396s(c)(2)(C)(ii)) is amended to read as 

13 follows: 

14 ‘‘(ii) The provider may impose— 

15 ‘‘(I) in the case of a qualified pedi16 atric vaccine not described in subclause 

17 (II), a fee for the administration of and 

18 counseling for such vaccine so long as the 

19 fee in the case of a federally vaccine-eligi20 ble child does not exceed the costs of such 

21 administration and counseling (as deter22 mined by the Secretary based on actual re23 gional costs for such administration and 

24 counseling); and 


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1 ‘‘(II) in the case of a qualified pedi2 atric vaccine that is a multiple component 

3 vaccine, a separate charge for the adminis4 tration of and counseling for each compo5 nent of such vaccine so long as the charge 

6 in the case of a federally vaccine-eligible 

7 child does not exceed— 

8 ‘‘(aa) with respect to the first 

9 component of such vaccine, the costs 

10 of such administration and counseling 

11 for such component (as determined by 

12 the Secretary based on actual regional 

13 costs for such administration and 

14 counseling for such first component); 

15 and 

16 ‘‘(bb) with respect to a subse17 quent component of such vaccine, the 

18 payment rate that applies to such ad19 ministration and counseling for such 

20 component and provider under part B 

21 of title XVIII.’’. 

22 (f) INCREASE IN FEDERAL MEDICAL ASSISTANCE

23 PERCENTAGE.— 

24 (1) IN GENERAL.—Subject to paragraph (2), 

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1 riod beginning on January 1, 2021, and ending on 

2 December 31, 2022, the Federal medical assistance 

3 percentage determined for each State, including the 

4 District of Columbia, American Samoa, Guam, the 

5 Commonwealth of the Northern Mariana Islands, 

6 Puerto Rico, and the United States Virgin Islands, 

7 under section 1905(b) of the Social Security Act (42 

8 U.S.C. 1396d(b)), after application of section 6008 

9 of the Families First Coronavirus Response Act 

10 (Public Law 116–127) (if applicable), shall be in11 creased by 1 percentage point. 

12 (2) REQUIREMENTS.— 

13 (A) IN GENERAL.—A State described in 

14 paragraph (1) may not receive the increase de15 scribed in such paragraph in the Federal med16 ical assistance percentage for such State, with 

17 respect to a quarter, if such State does not en18 sure culturally competent and effective mes19 sages for vaccination outreach to child popu20 lations, which may include the dissemination of 

21 information highlighting— 

22 (i) advancements in research and vac23 cine development that have saved millions 

24 of individuals from death and disability 

25 from now-preventable diseases; 


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1 (ii) information on how individuals 

2 across the lifespan benefit from immuniza3 tions, including those who cannot be vac4 cinated and rely on community immunity; 

5 (iii) information on the dangers of not 

6 being vaccinated, including the potential 

7 for infectious disease outbreaks within 

8 communities; and 

9 (iv) information on vaccine safety and 

10 the systems in place to monitor vaccine 

11 safety. 

12 (B) REQUIREMENT FOR CERTAIN

13 STATES.—Section 1905(cc) of the Social Secu14 rity Act (42 U.S.C. 1396d(cc)) is amended— 

15 (i) by inserting ‘‘and section 2(e) of 

16 the Strengthening the Vaccines for Chil17 dren Program Act of 2021’’ before ‘‘, ex18 cept that in applying’’; and 

19 (ii) by inserting ‘‘, and in applying 

20 such treatments to the increases in the 

21 Federal medical assistance percentage 

22 under section 2(e) of the Strengthening the 

23 Vaccines for Children Program Act of 

24 2021, the reference to ‘December 31, 

25 2009’ shall be deemed to be a reference to 


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1 ‘December 31, 2020’ ’’ before the period at 

2 the end. 

3 (g) TRIBAL EPIDEMIOLOGY CENTER DATA AC4 CESS.—With respect to data access for tribal epidemiology 

5 centers established under section 214 of the Indian Health 

6 Care Improvement Act (25 U.S.C. 1621m), the Director 

7 of the Centers for Disease control and Prevention may cre8 ate a data sharing strategy that ensures such centers have 

9 access to data, data sets, monitoring systems, delivery sys10 tems, and other protected health information with respect 

11 to health care and public health surveillance systems of 

12 child and adolescent health necessary to accomplish such 

13 centers’ public health authority responsibilities described 

14 in such section or section 164.501 of title 45, Code of Fed15 eral Regulations. 

16 (h) REPORTS.— 

17 (1) IN GENERAL.—For each of fiscal years 

18 2021 and 2022, the Director of the Centers for Dis19 ease Control and Prevention, in coordination with 

20 each State that has established a pediatric vaccine 

21 distribution program under section 1928 of the So22 cial Security Act (42 U.S.C. 1396s), shall publish on 

23 the public internet website of the Centers for Dis24 ease Control and Prevention, in such manner as de25 termined appropriate by the Director, information 


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1 on vaccination rates under each such program dur2 ing such year, including such rates disaggregated by 

3 region, age, sex, race, ethnicity, and other demo4 graphic factors determined appropriate by the Direc5 tor. 

6 (2) EFFECTS ON VACCINATION RATES AND PRO7 GRAM PARTICIPATION.—Not later than 2 years after 

8 the date of the enactment of this Act, the Comp9 troller General of the United States shall submit to 

10 Congress a report containing an analysis of the ef11 fects of the provisions of, and the amendments made 

12 by, this Act on— 

13 (A) vaccination rates under the pediatric 

14 vaccine distribution program under section 

15 1928 of the Social Security Act (42 U.S.C. 

16 1396s); and 

17 (B) provider participation in such pro18 gram. 

Æ 


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