I 

114TH CONGRESS 

1ST SESSION H. R. 546 

To amend titles XIX and XXI of the Social Security Act to provide States 

with the option of providing services to children with medically complex 

conditions under the Medicaid program and Children’s Health Insurance 

Program through a care coordination program focused on improving 

health outcomes for children with medically complex conditions and lowering costs, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 27, 2015 

Mr. BARTON (for himself, Ms. CASTOR of Florida, Ms. HERRERA BEUTLER, 

Mr. GENE GREEN of Texas, Ms. ESHOO, Mr. REICHERT, Mr. HONDA, 

Mr. CHABOT, Ms. JENKINS of Kansas, Ms. SINEMA, and Mr. BILIRAKIS) 

introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend titles XIX and XXI of the Social Security Act 

to provide States with the option of providing services 

to children with medically complex conditions under the 

Medicaid program and Children’s Health Insurance Program through a care coordination program focused on 

improving health outcomes for children with medically 

complex conditions and lowering costs, 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, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Advancing Care for 

3 Exceptional Kids Act of 2015’’ or the ‘‘ACE Kids Act of 

4 2015’’. 

5 SEC. 2. FINDINGS. 

6 Congress finds the following: 

7 (1) Approximately 3,000,000 children in the 

8 United States suffer from medically complex condi9 tions and approximately 2,000,000 of such children 

10 are enrolled in State plans under the Medicaid pro11 gram under title XIX of the Social Security Act. 

12 (2) Such children account for an estimated 6 

13 percent of Medicaid enrollees and approximately 40 

14 percent of children’s Medicaid spending is due to the 

15 severity of the illnesses of such children. 

16 (3) The creation of nationally designated chil17 dren’s hospital networks focused upon better coordi18 nation and integration of care for such pediatric 

19 population will result in improved health outcomes 

20 and savings under the Medicaid program and the 

21 Children’s Health Insurance Program under title 

22 XXI of the Social Security Act. 


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1 SEC. 3. ESTABLISHMENT OF MEDICAID AND CHIP CARE CO2 ORDINATION PROGRAM FOR CHILDREN WITH 

3 MEDICALLY COMPLEX CONDITIONS AS MED4 ICAID STATE OPTION. 

5 (a) MEDICAID.—Title XIX of the Social Security Act 

6 (42 U.S.C. 1396 et seq.) is amended by adding at the end 

7 the following new section: 

8 ‘‘MEDICAID CHILDREN’S CARE COORDINATION PROGRAMS

9 FOR CHILDREN WITH COMPLEX MEDICAL CONDITIONS

10 ‘‘SEC. 1947. 

11 ‘‘(a) IN GENERAL.—Beginning January 1, 2016, a 

12 State, at its option as a State plan amendment, may elect 

13 to provide medical assistance for items and services fur14 nished to eligible children enrolled in an MCCC program 

15 that meets the requirements of this section. As a condition 

16 on an eligible child’s receipt of medical assistance under 

17 this title, the State shall require, under such an amend18 ment, that the eligible child be enrolled in an MCCC pro19 gram that meets the requirements of this section. 

20 ‘‘(b) MCCC PROGRAM REQUIREMENTS.—An MCCC 

21 program meets the requirements of this section if the 

22 MCCC program— 

23 ‘‘(1) coordinates, integrates, and provides for 

24 the furnishing of the full range of MCCC program 

25 services to eligible children enrolled in the program; 


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1 ‘‘(2) enrolls eligible children in accordance with 

2 subsection (c); 

3 ‘‘(3) is operating under a program agreement 

4 that meets the requirements of subsection (d); and 

5 ‘‘(4) meets the pediatric network adequacy 

6 standards developed under subsection (e). 

7 ‘‘(c) ELIGIBILITY DETERMINATIONS; ASSIGN8 MENT.— 

9 ‘‘(1) ENROLLMENT.—Subject to the assignment 

10 requirements of paragraph (2), the enrollment and 

11 disenrollment of eligible children in an MCCC pro12 gram shall be carried out in accordance with the re13 quirements of this section and the applicable pro14 gram agreement. 

15 ‘‘(2) NETWORK ASSIGNMENT.— 

16 ‘‘(A) IN GENERAL.—Eligible children shall 

17 be prospectively enrolled in an MCCC program 

18 by the State by assigning such eligible children 

19 to a nationally designated children’s hospital 

20 network for an initial period of up to 90 days 

21 beginning on the date on which the child is as22 signed to such hospital network, unless the 

23 child opts not to participate in any MCCC pro24 gram in accordance with a process established 

25 by the State. 


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1 ‘‘(B) BASIS FOR INITIAL ASSIGNMENT.— 

2 Such an assignment shall be made as follows: 

3 ‘‘(i) First, by considering the preva4 lence of visits by the child to a pediatrician 

5 or other specialist who is participating in 

6 the nationally designated children’s hos7 pital network. 

8 ‘‘(ii) Second, by considering the selec9 tion of the child’s family. 

10 ‘‘(iii) Third, by considering the loca11 tion of the primary residence of the child. 

12 ‘‘(iv) Fourth, by considering the prox13 imity of the child to regional referral net14 works established by the nationally des15 ignated children’s hospital network. 

16 ‘‘(C) LIMITATION ON CERTAIN ASSIGN17 MENTS.—In the case of the assignment of a 

18 child under subparagraph (A) through the con19 sideration of a factor specified in clause (iii) or 

20 (iv) of subparagraph (B), such an assignment 

21 may only be made to a nationally designated 

22 children’s hospital network that ensures access 

23 to a medical home that is located not more than 

24 30 miles of the primary residence of the child. 


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1 ‘‘(D) REASSIGNMENT.—Following the 90- 

2 day period referred to in subparagraph (A), the 

3 child may elect— 

4 ‘‘(i) to be assigned to the nationally 

5 designated children’s hospital network of 

6 their choice that has a program agreement 

7 in effect with respect to an MCCC pro8 gram in which the child is eligible to enroll; 

9 or 

10 ‘‘(ii) to not participate in any MCCC 

11 program and receive care through enroll12 ment in the State plan under this title or 

13 the State child health plan under title 

14 XXI. 

15 ‘‘(d) PROGRAM AGREEMENTS.— 

16 ‘‘(1) IN GENERAL.—The Secretary, in close co17 operation with the State administering agencies 

18 electing to provide the medical assistance described 

19 in subsection (a), shall establish procedures for en20 tering into, extending, and terminating program 

21 agreements under this section. 

22 ‘‘(2) TERMS.— 

23 ‘‘(A) IN GENERAL.—A program agreement 

24 entered into under this section by the Sec25 retary, a State administering agency, and a naVerDate Sep 11 2014 00:26 Feb 03, 2015 Jkt 049200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H546.IH H546

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1 tionally designated children’s hospital network 

2 shall provide for each of the following terms: 

3 ‘‘(i) The agreement shall designate 

4 the service area of the MCCC program 

5 that is the subject of the agreement. 

6 ‘‘(ii) The agreement shall be effective 

7 for a contract year, but may be extended 

8 for additional contract years in the absence 

9 of a notice by a party to terminate, and is 

10 subject to termination by the Secretary 

11 and the State administering agency at any 

12 time for cause (as provided under the 

13 agreement). 

14 ‘‘(iii) The agreement shall require 

15 that the nationally designated children’s 

16 hospital network submit care management 

17 network and coverage plans to the Sec18 retary that are centered around medical 

19 home models and that describe the govern20 ance of the network. 

21 ‘‘(iv) The agreement shall require the 

22 hospital network to meet all applicable re23 quirements imposed by State and local 

24 laws. 


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1 ‘‘(v) The agreement shall require such 

2 State, in the case of eligible children who 

3 are residents of the State, to make pay4 ments to the hospital network, regardless 

5 of whether MCCC program services are 

6 furnished to such eligible children in an7 other State. 

8 ‘‘(vi) The agreement shall require that 

9 the standards and measures developed 

10 under subsection (e) be applied to the hos11 pital network, including measures requir12 ing, with respect to network adequacy 

13 standards, that the hospital network estab14 lish such provider networks for primary, 

15 secondary, and tertiary care as are nec16 essary to ensure the adequate furnishing of 

17 MCCC program services to eligible children 

18 enrolled in the MCCC program that is the 

19 subject of the agreement. 

20 ‘‘(vii) The agreement shall require the 

21 hospital network to comply with the data 

22 collection and recordkeeping requirements 

23 of subparagraph (C). 

24 ‘‘(viii) The agreement shall require 

25 the hospital network to accept as payment 


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1 any payment made using the risk-based 

2 methodology developed under subsection 

3 (g). 

4 ‘‘(ix) The agreement shall contain 

5 such additional terms and conditions as 

6 the parties may agree to, so long as such 

7 terms and conditions are consistent with 

8 this section. 

9 ‘‘(B) SERVICE AREA REQUIREMENTS.—In 

10 designating a service area under subparagraph 

11 (A)(i), the Secretary (in consultation with the 

12 relevant State administering agency) shall— 

13 ‘‘(i) ensure that such service area pro14 vides convenient access for eligible children 

15 to MCCC program services, without lim16 iting the size of, or number of, nationally 

17 designated children’s hospital networks 

18 providing such services; 

19 ‘‘(ii) ensure that such hospital net20 works and the population of eligible chil21 dren in the proposed service area are suffi22 cient to support the delivery of MCCC pro23 gram services and to avoid the unnecessary 

24 duplication of services and the impairment 


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1 of the financial and service viability of an2 other MCCC program. 

3 ‘‘(C) DATA AND RECORDKEEPING RE4 QUIREMENTS.—The data collection and record5 keeping requirements under this subparagraph, 

6 with respect to a nationally designated chil7 dren’s hospital network, are as follows: 

8 ‘‘(i) The hospital network shall collect 

9 claims data on claims submitted with re10 spect to eligible children who are furnished 

11 MCCC program services under an MCCC 

12 program. Such data shall be reported in a 

13 standardized format and made available to 

14 the public for purposes of establishing a 

15 national database on such claims. 

16 ‘‘(ii) The hospital network shall main17 tain, and provide the Secretary and the 

18 State administering agency access to, the 

19 records relating to the MCCC program op20 erated by the hospital network, including 

21 pertinent financial, medical, and personnel 

22 records. 

23 ‘‘(iii) The hospital network shall sub24 mit to the Secretary and the State admin25 istering agency such reports as the SecVerDate Sep 11 2014 00:26 Feb 03, 2015 Jkt 049200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H546.IH H546

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1 retary finds (in consultation with the State 

2 administering agency) necessary to monitor 

3 the operation, cost, and effectiveness of the 

4 MCCC program operated by the hospital 

5 network. 

6 ‘‘(3) TERMINATION OF AGREEMENTS.—The 

7 Secretary shall issue regulations establishing the cir8 cumstances under which— 

9 ‘‘(A) the Secretary or a State admin10 istering agency may terminate an MCCC pro11 gram agreement for cause; and 

12 ‘‘(B) a nationally designated children’s 

13 hospital network may terminate such an agree14 ment after appropriate notice to the Secretary, 

15 the State administering agency, and enrollees. 

16 ‘‘(e) QUALITY ASSURANCE.— 

17 ‘‘(1) DEVELOPMENT OF STANDARDS AND MEAS18 URES.—The Secretary shall, in consultation with na19 tionally designated children’s hospital networks and 

20 national pediatric policy organizations (such as the 

21 Children’s Hospital Association and the American 

22 Academy of Pediatrics)— 

23 ‘‘(A) establish a national set of quality as24 surance and improvement protocols and proce25 dures to apply under MCCC programs; 


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1 ‘‘(B) develop pediatric quality measures; 

2 ‘‘(C) develop pediatric network adequacy 

3 standards for access by eligible children to 

4 MCCC program services; and 

5 ‘‘(D) develop criteria for national pediatric6 focused care coordination for eligible children. 

7 ‘‘(2) USE OF PQMP MEASURES.—In carrying 

8 out paragraph (1), the Secretary shall apply, to the 

9 extent applicable, child health quality measures and 

10 measures for centers of excellence for children with 

11 complex needs developed under this title, title XXI, 

12 and section 1139A and take into account HEDIS 

13 quality measures as required under section 

14 1852(e)(3) and other quality measures. 

15 ‘‘(f) STANDARD MEDICAID DATA SET.— 

16 ‘‘(1) IN GENERAL.—The Secretary, the States, 

17 and the nationally designated children’s hospital net18 works shall collaborate to obtain consistent and 

19 verifiable Medicaid Analytic Extract data or a com20 parable data set and shall establish data-sharing 

21 agreements to further support collaborative planning 

22 and care coordination for medically complex chil23 dren. 

24 ‘‘(2) CLAIMS ANALYSIS.—The Secretary shall— 


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1 ‘‘(A) perform claims analysis on the data 

2 set developed under paragraph (1) to determine 

3 the utilization of items and services furnished 

4 under an MCCC program to eligible children; 

5 and 

6 ‘‘(B) for purposes of building a national 

7 database, submit to Congress, and make pub8 licly available on the Internet site of the Cen9 ters for Medicare and Medicaid Services, a re10 port on such claims in a standardized format. 

11 ‘‘(3) PAYMENT FOR REPORTING INCENTIVES.— 

12 The State plan may provide for pay-for-reporting in13 centives during the first two years of any program 

14 agreement entered into under this section to ensure 

15 participation and analysis of consistent data under 

16 this paragraph to enable the development of an ap17 propriate risk-based payment methodology under 

18 subsection (g). 

19 ‘‘(g) PAYMENTS TO NATIONALLY DESIGNATED CHIL20 DREN’S HOSPITAL NETWORKS.— 

21 ‘‘(1) IN GENERAL.—The State plan shall pro22 vide for payment to nationally designated children’s 

23 hospital networks pursuant to the terms of a pro24 gram agreement using a risk-based payment methVerDate Sep 11 2014 00:26 Feb 03, 2015 Jkt 049200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6201 E:\BILLS\H546.IH H546

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1 odology (or methodologies) established in accordance 

2 with this subsection. 

3 ‘‘(2) TRANSITION FROM FEE-FOR-SERVICE TO

4 RISK-BASED PAYMENT MODEL.— 

5 ‘‘(A) IN GENERAL.—Subject to subpara6 graph (B), payment to nationally designated 

7 children’s hospital networks under this sub8 section shall be based initially on a fee-for-serv9 ice payment model and shall gradually transi10 tion, over a 5-year period, to an equitable, risk11 based payment model using a methodology de12 veloped under paragraph (3). For the first two 

13 years of such period, a nationally designated 

14 children’s hospital network may receive, in addi15 tion to any fee-for-service payments made to 

16 such hospital network, per capita care coordina17 tion payments with respect to expenditures for 

18 items and services furnished to eligible children 

19 enrolled in the MCCC program operated by the 

20 hospital network through medical home pro21 grams and other care coordination activities for 

22 which an all-inclusive payment model is more 

23 suitable than fee-for-service reimbursement. 

24 ‘‘(B) EXCEPTION FOR CERTAIN STATES.— 

25 Subparagraph (A) shall not apply in the case of 


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1 a State that, as of the date of the enactment 

2 of this section, uses a risk-based payment meth3 odology with respect to payments made for 

4 items and services furnished to eligible children 

5 under the State plan or State child health plan. 

6 ‘‘(C) DATA ANALYSIS DURING INITIAL PE7 RIOD.—During the first two years of the imple8 mentation of an MCCC program, the Secretary 

9 shall analyze data collected under subsection (f) 

10 for purposes of developing a risk-based payment 

11 methodology that would be implemented begin12 ning with the third year of implementation of 

13 the MCCC program. 

14 ‘‘(3) DEVELOPMENT OF RISK-BASED PAYMENT

15 METHODOLOGY.—The relevant State administering 

16 agency shall develop, in coordination with the Med17 icaid and CHIP Payment and Access Commission 

18 and the pediatric health care provider community, 

19 payment methodologies for payment under the State 

20 plan in accordance with this subsection that— 

21 ‘‘(A) take into account the data analyzed 

22 under paragraph (2)(C); 

23 ‘‘(B) are actuarially sound, determined 

24 using an actuarial method that ensures that 


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1 such methodologies reflect historic pediatric 

2 claims data; 

3 ‘‘(C) include— 

4 ‘‘(i) a risk adjustment method, re-in5 surance system, or risk-corridor procedure 

6 to account for variations in acuity of the 

7 eligible children enrolled in MCCC pro8 grams; and 

9 ‘‘(ii) a shared savings approach, which 

10 may include a form of bundled payment or 

11 risk-reward payment model that aligns 

12 payment with both cost savings and quality 

13 improvement; and 

14 ‘‘(D) may provide for a model for making 

15 payments other than payments made on a per16 member, per-month basis. 

17 ‘‘(h) WAIVERS OF REQUIREMENTS.— 

18 ‘‘(1) IN GENERAL.—With respect to carrying 

19 out an MCCC program under this section, the fol20 lowing provisions of law shall not apply: 

21 ‘‘(A) Section 1902(a)(1), relating to 

22 statewideness. 

23 ‘‘(B) Section 1902(a)(10), insofar as such 

24 section relates to comparability of services 

25 among different population groups. 


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1 ‘‘(C) Sections 1902(a)(23) and 1915(b)(4), 

2 relating to freedom of choice of providers. 

3 ‘‘(D) Section 1903(m)(2)(A), insofar as 

4 such section would prohibit a nationally des5 ignated children’s hospital network from receiv6 ing certain payments. 

7 ‘‘(E) Such other provisions of this title, 

8 title XVIII, sections 1128A and 1128B, and 

9 any provisions of the Federal antitrust laws as 

10 the Secretary determines are inapplicable or the 

11 waiver of which are necessary for purposes of 

12 carrying out an MCCC program under this sec13 tion. 

14 ‘‘(2) APPLICATION IN STATES OPERATING

15 UNDER DEMONSTRATION PROJECTS.— 

16 ‘‘(A) IN GENERAL.—In the case of any 

17 State which is providing medical assistance to 

18 its residents under a waiver described in sub19 paragraph (B), the Secretary shall not require 

20 that the State meet the requirements of this 

21 section in the same manner as the State would 

22 be required to meet such requirements if the 

23 State had in effect a plan approved under this 

24 title. 


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1 ‘‘(B) WAIVER DESCRIBED.—A waiver de2 scribed in this subparagraph is a waiver grant3 ed under section 1115 under which a State— 

4 ‘‘(i) provides for coverage through a 

5 medicaid managed care plan of all or a 

6 certain proportion of MCCC program serv7 ices furnished to eligible children in the 

8 State through a nationally designated chil9 dren’s hospital network; 

10 ‘‘(ii) assigns such eligible children to 

11 such a network in accordance with sub12 section (c); 

13 ‘‘(iii) requires that the State and such 

14 network enter into a program agreement 

15 that meets the requirements applicable to 

16 program agreements under subsection (d); 

17 and 

18 ‘‘(iv) uses a payment methodology to 

19 make payments made for MCCC program 

20 services furnished to eligible children that 

21 is consistent with the requirements of sub22 section (g). 

23 ‘‘(i) PREEMPTION OF STATE LAW.—A State may not 

24 impose any requirement on the nationally qualified chil25 dren’s hospital network’s operation of an MCCC program 


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1 under a program agreement that meets the requirements 

2 of this section that is inconsistent with or would otherwise 

3 impede the satisfaction by such hospital network of the 

4 requirements of this section (including the requirements 

5 of such program agreement). 

6 ‘‘(j) DEFINITIONS.—In this section: 

7 ‘‘(1) ELIGIBLE CHILD.—The term ‘eligible 

8 child’ means, with respect to an MCCC program, an 

9 individual who is under the age of 18 and who— 

10 ‘‘(A) is eligible for medical assistance 

11 under the State plan under this title or child 

12 health assistance under the State child health 

13 plan under title XXI; and 

14 ‘‘(B) has a chronic, physical, develop15 mental, behavioral, or emotional condition 

16 that— 

17 ‘‘(i) affects two or more body systems; 

18 ‘‘(ii) requires intensive care coordina19 tion to avoid excessive hospitalizations or 

20 emergency department visits; or 

21 ‘‘(iii) meets the criteria for medical 

22 complexity using risk adjustment meth23 odologies (such as Clinical Risk Groups or 

24 another recognized pediatric population 

25 grouping system) agreed upon by the SecVerDate Sep 11 2014 00:26 Feb 03, 2015 Jkt 049200 PO 00000 Frm 00019 Fmt 6652 Sfmt 6201 E:\BILLS\H546.IH H546

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1 retary in coordination with a national 

2 panel of pediatric experts. 

3 ‘‘(2) MCCC PROGRAM.—The term ‘MCCC pro4 gram’ means a Medicaid coordinated care program 

5 that provides eligible children with MCCC program 

6 services through a nationally designated children’s 

7 hospital network in accordance with a program 

8 agreement that meets the requirements of subsection 

9 (d). 

10 ‘‘(3) MCCC PROGRAM SERVICES.—The term 

11 ‘MCCC program services’ means the full range of 

12 items and services for which medical assistance is 

13 available under a State plan for children, including 

14 pediatric care management services and pediatric-fo15 cused care coordination and health promotion, as 

16 specified in the program agreement. 

17 ‘‘(4) NATIONALLY DESIGNATED CHILDREN’S

18 HOSPITAL NETWORK.—The term ‘nationally des19 ignated children’s hospital network’ means a net20 work of hospitals and health care providers— 

21 ‘‘(A) anchored by a qualified children’s 

22 hospital or hospitals with principal governance 

23 responsibility over the hospital network; 


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1 ‘‘(B) in which the full complement of 

2 health care providers needed to provide the best 

3 care for children in the network participate; and 

4 ‘‘(C) that represents the interests of physi5 cians, other health care providers, parents of 

6 medically complex children, and other relatives 

7 of such children. 

8 ‘‘(5) PROGRAM AGREEMENT.—The term ‘pro9 gram agreement’ means an agreement between a na10 tionally designated children’s hospital network, the 

11 Secretary, and a State administering agency for the 

12 operation of an MCCC program by the hospital net13 work in the State that meets the requirements of 

14 this section. 

15 ‘‘(6) QUALIFIED CHILDREN’S HOSPITAL.—The 

16 term ‘qualified children’s hospital’ means a chil17 dren’s hospital that— 

18 ‘‘(A) qualifies to receive payment under 

19 section 340E of the Public Health Service Act 

20 (relating to children’s hospitals that operate 

21 graduate medical education programs); or 

22 ‘‘(B) meets 3 or more of the following cri23 teria: 

24 ‘‘(i) MINIMUM PEDIATRIC DIS25 CHARGES.—The hospital has at least 5,000 


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1 annual pediatric discharges (including neo2 nates, but excluding obstetrics and normal 

3 newborns) for the most recent cost report4 ing period for which data are available. 

5 ‘‘(ii) MINIMUM NUMBER OF BEDS.— 

6 The hospital has 100 licensed pediatric 

7 beds, not including beds in neonatal inten8 sive care units but including beds in pedi9 atric intensive care units and other acute 

10 care beds. 

11 ‘‘(iii) ACCESS TO PEDIATRIC EMER12 GENCY SERVICES.—The hospital has access 

13 (through ownership or otherwise) to pedi14 atric emergency services. 

15 ‘‘(iv) MEDICAID RELIANT.—At least 

16 30 percent of the pediatric discharges or 

17 inpatient days (excluding observation days) 

18 in the hospital for the most recent cost re19 porting period for which data are available 

20 were children eligible for medical assist21 ance under this title or for children’s 

22 health assistance under title XXI. 

23 ‘‘(v) AFFILIATION WITH ACCREDITED

24 PEDIATRIC RESIDENCY TRAINING PRO25 GRAM.—The hospital sponsors or is affiliVerDate Sep 11 2014 00:26 Feb 03, 2015 Jkt 049200 PO 00000 Frm 00022 Fmt 6652 Sfmt 6201 E:\BILLS\H546.IH H546

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1 ated with a pediatric residency program 

2 that is accredited by the Accreditation 

3 Council for Graduate Medical Education. 

4 ‘‘(vi) PEDIATRIC MEDICAL HOME PRO5 GRAMS.—The hospital has established and 

6 implemented demonstrable pediatric med7 ical home programs dedicated to medically 

8 complex children. 

9 ‘‘(7) STATE ADMINISTERING AGENCY.—The 

10 term ‘State administering agency’ means, with re11 spect to the operation of an MCCC program in a 

12 State, the agency of that State (which may be the 

13 single agency responsible for administration of the 

14 State plan under this title in the State) responsible 

15 for administering program agreements under this 

16 section.’’. 

17 (b) INCLUSION AS MEDICAL ASSISTANCE.—Section 

18 1905(a) of the Social Security Act (42 U.S.C. 1396d(a)) 

19 is amended— 

20 (1) in paragraph (28), by striking ‘‘and’’ at the 

21 end; 

22 (2) by redesignating paragraph (29) as para23 graph (30); and 

24 (3) by inserting after paragraph (28) the fol25 lowing new paragraph: 


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1 ‘‘(29) items and services furnished under an 

2 MCCC program under section 1947 to eligible chil3 dren enrolled in an MCCC program under such sec4 tion; and’’. 

5 (c) APPLICATION UNDER CHIP.—Section 2107(e)(1) 

6 of the Social Security Act (42 U.S.C. 1397gg(e)(1)) is 

7 amended by adding at the end the following new subpara8 graph: 

9 ‘‘(P) Section 1947 (relating to Medicaid 

10 Children’s Care Coordination programs for chil11 dren with complex medical conditions).’’. 

12 (d) REGULATIONS.—Not later than 120 days after 

13 the date of the enactment of this Act, the Secretary of 

14 Health and Human Services shall make rules on the 

15 record, after opportunity for an agency hearing to carry 

16 out the amendments made by this section in accordance 

17 with sections 556 and 557 of title 5, United States Code. 

Æ 


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