I 

114TH CONGRESS 

2D SESSION H. R. 5717 

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

Medicaid data and to expand coverage of tobacco cessation services 

to mothers of newborns. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 11, 2016 

Mr. LANCE 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 improve 

collection of Medicaid data and to expand coverage of 

tobacco cessation services to mothers of newborns. 

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 ‘‘Medicaid Data and 

5 Benefit Improvement Act of 2016’’. 

6 SEC. 2. IMPROVING MEDICAID DATA. 

7 Section 1903(d) of the Social Security Act (42 U.S.C. 

8 1396b(d)) is amended by adding at the end the following 

9 new paragraph: 


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1 ‘‘(7)(A) In each CMS–64 or other quarterly expense 

2 report required to be submitted (for each quarter begin3 ning on or after the date that is 2 years after the date 

4 that the form for such reports is revised, and guidance 

5 is issued, under subparagraph (B)) by a State for pur6 poses of reconciling amounts paid to such State based on 

7 estimates under this subsection with amounts to be paid 

8 under subsection (a), such State shall include data on ex9 penditures for medical assistance within each category of 

10 service disaggregated by each category of individuals (as 

11 specified by the Secretary in accordance with subpara12 graph (C)) used in determining the eligibility of individ13 uals for medical assistance under the State plan or under 

14 a waiver of the plan. 

15 ‘‘(B) Not later than 12 months after the date of the 

16 enactment of this paragraph, the Secretary shall revise the 

17 form for the CMS–64, or such other quarterly expense re18 port, and issue necessary guidance for the use of such re19 vised form, to enable States to comply with the require20 ment under subparagraph (A). 

21 ‘‘(C) In specifying eligibility categories for purposes 

22 of subparagraph (A), the Secretary shall include as a sepa23 rate eligibility category each of the following: 

24 ‘‘(i) Pregnant women. 


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1 ‘‘(ii) With respect to individuals described in 

2 section 1902(a)(10)(A)(i)(VIII), each of the fol3 lowing categories of such individuals: 

4 ‘‘(I) Newly eligible individuals (as defined 

5 in section 1905(y)(2)(A)) for whom the Federal 

6 medical assistance percentage for amounts ex7 pended for medical assistance is specified under 

8 section 1905(y)(1). 

9 ‘‘(II) Individuals described in subpara10 graph (A) of section 1905(z)(2) for whom the 

11 Federal medical assistance percentage is speci12 fied under such section. 

13 ‘‘(III) Individuals who are not described in 

14 subclause (I) or (II). 

15 ‘‘(iii) Each of the populations, not otherwise de16 scribed in clause (i) or (ii), by which a report under 

17 section 1902(a)(75)(A) is disaggregated.’’. 

18 SEC. 3. MEDICAID COVERAGE OF TOBACCO CESSATION 

19 SERVICES FOR MOTHERS OF NEWBORNS. 

20 (a) IN GENERAL.—Section 1905(bb) of the Social Se21 curity Act (42 U.S.C. 1396d(bb)) is amended by adding 

22 at the end the following new paragraph: 

23 ‘‘(4) A woman shall continue to be treated as de24 scribed in this subsection as a pregnant woman through 


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1 the end of the 1-year period beginning on the date of the 

2 birth of a child of the woman.’’. 

3 (b) CONFORMING AMENDMENTS.— 

4 (1) Subsections (a)(2)(B) and (b)(2)(B) of sec5 tion 1916 of the Social Security Act (42 U.S.C. 

6 1396o) are each amended by inserting ‘‘(and women 

7 described in section 1905(bb) as pregnant women 

8 pursuant to paragraph (4) of such section)’’ after 

9 ‘‘tobacco cessation by pregnant women’’. 

10 (2) Section 1927(d)(2)(F) of the Social Secu11 rity Act (42 U.S.C. 1396r–8(d)(2)(F)) is amended 

12 by inserting ‘‘(and women described in section 

13 1905(bb) as pregnant women pursuant to paragraph 

14 (4) of such section)’’ after ‘‘pregnant women’’. 

15 (c) EFFECTIVE DATE.— 

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

17 the amendments made by this section shall apply 

18 with respect to items and services furnished on or 

19 after the date that is one year after the date of the 

20 enactment of this Act. 

21 (2) EXCEPTION FOR STATE LEGISLATION.—In 

22 the case of a State plan under title XIX of the So23 cial Security Act, which the Secretary of Health and 

24 Human Services determines requires State legisla25 tion in order for the plan to meet any requirement 


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1 imposed by amendments made by this section, the 

2 plan shall not be regarded as failing to comply with 

3 the requirements of such title solely on the basis of 

4 its failure to meet such an additional requirement 

5 before the first day of the first calendar quarter be6 ginning after the close of the first regular session of 

7 the State legislature that begins after the effective 

8 date specified in paragraph (1). For purposes of the 

9 previous sentence, in the case of a State that has a 

10 2-year legislative session, each year of the session 

11 shall be considered to be a separate regular session 

12 of the State legislature. 

13 (d) REPORT.—Not later than two years after the date 

14 of the enactment of this Act, the Inspector General of the 

15 Department of Health and Human Services shall submit 

16 to Congress a report that assesses the use of the tobacco 

17 cessation service benefit under the Medicaid program, in18 cluding under the amendments made by this section. Such 

19 report shall include an assessment of— 

20 (1) the extent that States are encouraging the 

21 use of such benefit, such as through promotion of 

22 beneficiary and provider awareness of such benefit; 

23 and 

24 (2) gaps in the delivery of such benefit. 

Æ 


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