II 

117TH CONGRESS 

1ST SESSION S. 2691 

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 SENATE OF THE UNITED STATES 

AUGUST 10, 2021 

Mr. REED (for himself and Mrs. CAPITO) 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 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) EXPANSION OF DEFINITION OF FEDERALLY VAC5 CINE-ELIGIBLE CHILD.—Paragraph (2) of section 

6 1928(b) of the Social Security Act (42 U.S.C. 1396s(b)) 

7 is amended— 

8 (1) in subparagraph (A)— 

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

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

11 the end and inserting ‘‘A child who is adminis12 tered a qualified pediatric vaccine and is not in13 sured with respect to such vaccine.’’; and 

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

15 clause: 

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

17 health assistance under a State child 

18 health plan approved under title XXI.’’; 

19 and 

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

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

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

23 (b) COVERAGE OF VACCINE COUNSELING AND EDU24 CATIONAL SERVICES UNDER MEDICAID.— 

25 (1) IN GENERAL.—Section 1905(a) of the So26 cial Security Act (42 U.S.C. 1396d) is amended— 


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1 (A) in paragraph (30), by striking ‘‘and’’ 

2 at the end; 

3 (B) by redesignating paragraph (31) as 

4 paragraph (32); and 

5 (C) by inserting after paragraph (30) the 

6 following new paragraph: 

7 ‘‘(31) vaccine counseling and educational serv8 ices furnished to children under the age of 19 on or 

9 after the date of the enactment of this paragraph, 

10 including any such services furnished as part of a 

11 multiple component vaccine (identified as of July 1, 

12 2021, by CPT code 90461) and including any such 

13 services furnished under the program established by 

14 the State pursuant to section 1928 to a vaccine-eli15 gible child (as defined in subsection (b) of such sec16 tion); and’’. 

17 (2) MANDATORY BENEFIT.—Section 

18 1902(a)(10)(A) of the Social Security Act (42 

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

20 ‘‘and (30)’’ and inserting ‘‘(30), and (31)’’. 

21 (c) CLARIFICATION OF COVERAGE OF PEDIATRIC

22 VACCINES AND VACCINE COUNSELING AND EDUCATIONAL

23 SERVICES UNDER THE VACCINES FOR CHILDREN PRO24 GRAM.—Section 1928(c)(2)(C)(ii) of the Social Security 


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

2 follows: 

3 ‘‘(ii) The provider may impose— 

4 ‘‘(I) in the case of a qualified pedi5 atric vaccine not described in subclause 

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

7 counseling for such vaccine so long as the 

8 fee in the case of a federally vaccine-eligi9 ble child does not exceed the costs of such 

10 administration and counseling (as deter11 mined by the Secretary based on actual re12 gional costs for such administration and 

13 counseling); and 

14 ‘‘(II) in the case of a qualified pedi15 atric vaccine that is a multiple component 

16 vaccine, a separate charge for the adminis17 tration of and counseling for each compo18 nent of such vaccine so long as the charge 

19 in the case of a federally vaccine-eligible 

20 child does not exceed— 

21 ‘‘(aa) with respect to the first 

22 component of such vaccine, the costs 

23 of such administration and counseling 

24 for such component (as determined by 

25 the Secretary based on actual regional 


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1 costs for such administration and 

2 counseling for such first component); 

3 and 

4 ‘‘(bb) with respect to a subse5 quent component of such vaccine, the 

6 payment rate that applies to such ad7 ministration and counseling for such 

8 component and provider under part B 

9 of title XVIII.’’. 

10 (d) MINIMUM PAYMENT REQUIREMENT FOR VAC11 CINE ADMINISTRATION SERVICES.—Section 1902(a)(13) 

12 of the Social Security Act (42 U.S.C. 1396a(a)(13)) is 

13 amended— 

14 (1) in subparagraph (B), by striking ‘‘; and’’ 

15 and inserting a semicolon; 

16 (2) in subparagraph (C), by striking the semi17 colon at the end and inserting ‘‘; and’’; and 

18 (3) by adding at the end the following new sub19 paragraph: 

20 ‘‘(D) for payment for vaccine administra21 tion, counseling and educational services pro22 vided on or after the date of the enactment of 

23 this subparagraph, with regard to vaccine ad24 ministration and counseling services furnished 

25 by a provider for each additional component of 


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1 a vaccine after the first component, at a rate 

2 that is at least 80 percent of the payment rate 

3 that applies to such services and provider for 

4 the first or only component of a vaccine under 

5 the State plan at the time of service;’’. 

6 (e) INCREASE IN FEDERAL MEDICAL ASSISTANCE

7 PERCENTAGE.— 

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

9 for each calendar quarter occurring during the pe10 riod beginning on January 1, 2022, and ending on 

11 December 31, 2023, the Federal medical assistance 

12 percentage determined for each State, including the 

13 District of Columbia, American Samoa, Guam, the 

14 Commonwealth of the Northern Mariana Islands, 

15 Puerto Rico, and the United States Virgin Islands, 

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

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

18 of the Families First Coronavirus Response Act 

19 (Public Law 116–127) (if applicable), shall be in20 creased by 1 percentage point. 

21 (2) REQUIREMENTS.— 

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

23 paragraph (1) may not receive the increase de24 scribed in such paragraph in the Federal med25 ical assistance percentage for such State, with 


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1 respect to a quarter, if, throughout such quar2 ter, such State does not ensure culturally com3 petent and effective messages for vaccination 

4 outreach to child populations, which may in5 clude the dissemination of information high6 lighting— 

7 (i) advancements in research and vac8 cine development that have saved millions 

9 of individuals from death and disability 

10 from now-preventable diseases; 

11 (ii) information on how individuals 

12 across the lifespan benefit from immuniza13 tions, including those who cannot be vac14 cinated and rely on community immunity; 

15 (iii) information on the dangers of not 

16 being vaccinated, including the potential 

17 for infectious disease outbreaks within 

18 communities; and 

19 (iv) information on vaccine safety and 

20 the systems in place to monitor vaccine 

21 safety. 

22 (B) REQUIREMENT FOR CERTAIN

23 STATES.—Section 1905(cc) of the Social Secu24 rity Act (42 U.S.C. 1396d(cc)) is amended— 


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1 (i) by striking ‘‘and section 6008’’ 

2 and inserting ‘‘, section 6008’’; 

3 (ii) inserting ‘‘, and section 2(e) of the 

4 Strengthening the Vaccines for Children 

5 Program Act of 2021’’ before ‘‘, except 

6 that in applying’’; and 

7 (iii) by inserting ‘‘, and in applying 

8 such treatments to the increases in the 

9 Federal medical assistance percentage 

10 under section 2(e) of the Strengthening the 

11 Vaccines for Children Program Act of 

12 2021, the reference to ‘December 31, 

13 2009’ shall be deemed to be a reference to 

14 ‘December 31, 2021’ ’’ before the period at 

15 the end. 

16 (f) TRIBAL EPIDEMIOLOGY CENTER DATA AC17 CESS.—With respect to data access for tribal epidemiology 

18 centers established under section 214 of the Indian Health 

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

20 of the Centers for Disease Control and Prevention may 

21 create a data sharing strategy that ensures such centers 

22 have access to data, data sets, monitoring systems, deliv23 ery systems, and other protected health information with 

24 respect to health care and public health surveillance sys25 tems of child and adolescent health necessary to accomVerDate Sep 11 2014 21:50 Aug 13, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S2691.IS S2691

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1 plish such centers’ public health authority responsibilities 

2 described in such section or section 164.501 of title 45, 

3 Code of Federal Regulations. 

4 (g) REPORTS.— 

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

6 2022 and 2023, the Director of the Centers for Dis7 ease Control and Prevention, in coordination with 

8 each State that has established a pediatric vaccine 

9 distribution program under section 1928 of the So10 cial Security Act (42 U.S.C. 1396s), shall publish on 

11 the public internet website of the Centers for Dis12 ease Control and Prevention, in such manner as de13 termined appropriate by the Director, information 

14 on vaccination rates under each such program dur15 ing such year, including such rates disaggregated by 

16 region, age, sex, race, ethnicity, and other demo17 graphic factors determined appropriate by the Direc18 tor. 

19 (2) EFFECTS ON VACCINATION RATES AND PRO20 GRAM PARTICIPATION.—Not later than 2 years after 

21 the date of the enactment of this Act, the Comp22 troller General of the United States shall submit to 

23 Congress a report containing an analysis of the ef24 fects of the provisions of, and the amendments made 

25 by, this Act on— 


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1 (A) vaccination rates under the pediatric 

2 vaccine distribution program under section 

3 1928 of the Social Security Act (42 U.S.C. 

4 1396s); and 

5 (B) provider participation in such pro6 gram. 

Æ 


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