I 

111TH CONGRESS 

1ST SESSION H. R. 722 

To amend title XIX of the Social Security Act to provide an option of 

States to cover a children’s program of all-inclusive coordinated care 

(ChiPACC) under the Medicaid Program. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 27, 2009 

Mr. MORAN of Virginia (for himself and Mr. YOUNG of Florida) 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 provide 

an option of States to cover a children’s program of 

all-inclusive coordinated care (ChiPACC) under the Medicaid Program. 

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 ‘‘ChiPACC Act of 

5 2009’’. 


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1 SEC. 2. OPTIONAL MEDICAID COVERAGE OF CHILDREN’S 

2 PROGRAM OF ALL-INCLUSIVE COORDINATED 

3 CARE (CHIPACC). 

4 (a) IN GENERAL.—Section 1905(a) of the Social Se5 curity Act (42 U.S.C. 1396d(a)) is amended— 

6 (1) by striking ‘‘and’’ at the end of paragraph 

7 (27); 

8 (2) by redesignating paragraph (28) as para9 graph (29); and 

10 (3) by inserting after paragraph (27) the fol11 lowing new paragraph: 

12 ‘‘(28) services furnished under a children’s pro13 gram of all-inclusive coordinated care (ChiPACC) 

14 under section 1942; and’’. 

15 (b) CHILDREN’S PROGRAM OF ALL-INCLUSIVE CO16 ORDINATED CARE (CHIPACC).—Title XIX of such Act is 

17 further amended by adding at the end the following new 

18 section: 

19 ‘‘CHILDREN’S PROGRAM OF ALL-INCLUSIVE

20 COORDINATED CARE (CHIPACC)

21 ‘‘SEC. 1942. (a) STATE OPTION.— 

22 ‘‘(1) IN GENERAL.—A State may elect to pro23 vide medical assistance under this section with re24 spect to a children’s program of all-inclusive coordi25 nated care to ChiPACC eligible individuals who are 

26 eligible for medical assistance under the State plan 


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1 and who are enrolled in the program. In the case of 

2 an individual enrolled in such a program pursuant to 

3 such an election— 

4 ‘‘(A) the individual shall receive benefits 

5 under the plan solely through such program; 

6 and 

7 ‘‘(B) the health care providers furnishing 

8 services under such program shall receive pay9 ment in accordance with the terms of such pro10 gram for providing such services. 

11 ‘‘(2) NUMERICAL AND GEOGRAPHICAL LIMITA12 TIONS PERMITTED.—A State may establish— 

13 ‘‘(A) a numerical limit on the number of 

14 individuals who may be enrolled in the State’s 

15 ChiPACC; and 

16 ‘‘(B) geographic limitations on the service 

17 areas for a ChiPACC. 

18 ‘‘(b) CHIPACC AND OTHER TERMS DEFINED.—In 

19 this section: 

20 ‘‘(1) CHILDREN’S PROGRAM OF ALL-INCLUSIVE

21 COORDINATED CARE; CHIPACC.—The terms ‘chil22 dren’s program of all-inclusive coordinated care’ and 

23 ‘ChiPACC’ mean a program of coordinated care for 

24 ChiPACC eligible children that is established by a 


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1 State under this section and meets the following re2 quirements: 

3 ‘‘(A) OPERATION.—The program is admin4 istered by a single State agency. Such agency 

5 may provide for the operation of the program 

6 through arrangements between one or more 

7 other entities, such as a ChiPACC coordinator, 

8 and such agency. 

9 ‘‘(B) COMPREHENSIVE BENEFITS.— 

10 ‘‘(i) IN GENERAL.—The program pro11 vides comprehensive health care items and 

12 services to ChiPACC eligible individuals in 

13 accordance with this section and regula14 tions. 

15 ‘‘(ii) SCOPE AND PLAN FOR SERV16 ICES.—Such items and services shall— 

17 ‘‘(I) include items and services 

18 described in subsection (c)(1)(A) to 

19 the extent such items and services are 

20 appropriate to the individual; and 

21 ‘‘(II) be provided consistent with 

22 a comprehensive care plan developed 

23 by an interdisciplinary health profes24 sional team. 


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1 ‘‘(iii) QUALIFICATIONS OF PRO2 VIDERS.—Such items and services are pro3 vided through health care providers that— 

4 ‘‘(I) meet such certification or 

5 other quality requirements as may be 

6 necessary to participate in the pro7 gram of medical assistance under this 

8 title or in the program under title 

9 XVIII; and 

10 ‘‘(II) maintain records on 

11 ChiPACC eligible individuals enrolled 

12 in the program and to whom the pro13 vider furnishes services, reflecting 

14 both the specific care and services fur15 nished by the provider and the rela16 tionship of those services to the com17 prehensive plan of care for that indi18 vidual and to the delivery of other 

19 services to the individual through the 

20 program. 

21 ‘‘(2) CHIPACC ELIGIBLE INDIVIDUAL.—The 

22 term ‘ChiPACC eligible individual’ means, with re23 spect to a ChiPACC, an individual— 

24 ‘‘(A) who, at the time of enrollment in the 

25 ChiPACC is a child (as defined under the State 


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1 plan for this purpose) and who is not older than 

2 such age as the State may specify; 

3 ‘‘(B) who suffers from a serious illness or 

4 health condition that is life threatening; 

5 ‘‘(C) for whom there is a reasonable likeli6 hood that the child’s life will be threatened by 

7 such illness or condition; 

8 ‘‘(D) whose health status is expected to de9 cline because of such illness or condition before 

10 attaining full adulthood (as defined under the 

11 State plan); 

12 ‘‘(E) resides in the service area of the 

13 ChiPACC; and 

14 ‘‘(F) is eligible for medical assistance 

15 under the State plan without regard to this sec16 tion (or, but for enrollment in a ChiPACC 

17 would, based on the individual’s illness or 

18 health condition or the projected cost of treat19 ment required for such illness or condition, be20 come so eligible). 

21 The Secretary may waive the application of subpara22 graph (F) with respect to eligibility for medical as23 sistance under the State plan without regard to this 

24 section in the case of individuals if the State dem25 onstrates to the satisfaction of the Secretary that 


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1 the sum of the additional expenditures under this 

2 title resulting from such waiver in a fiscal year will 

3 not exceed the aggregate savings in expenditures 

4 otherwise resulting from the implementation of this 

5 section in the fiscal year. 

6 ‘‘(3) CHIPACC COORDINATOR.—The term 

7 ‘ChiPACC coordinator’ means, with respect to a 

8 ChiPACC, an entity (which may be the State admin9 istering agency or another entity under an arrange10 ment with such an agency) that directs, supervises, 

11 and assures the coordination of comprehensive serv12 ices to ChiPACC eligible individuals enrolled in the 

13 ChiPACC consistent with the following: 

14 ‘‘(A) The entity must assure the direct and 

15 continuous involvement of an interdisciplinary 

16 health professional team in managing and co17 ordinating the provision of care and services 

18 within the coordinator’s responsibility to each 

19 such enrolled individual. 

20 ‘‘(B) The entity must include on its staff, 

21 or otherwise arrange for the provision of serv22 ices, through contracts or otherwise, of each of 

23 the types of the health care professionals and 

24 other service providers required to provide the 

25 items and services required under subsection 


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1 (c)(1)(A), to the extent such items and services 

2 are necessary and appropriate to the care of an 

3 enrolled individual. 

4 ‘‘(C) To the extent consistent with provi5 sion of the highest quality of care to enrolled 

6 individuals— 

7 ‘‘(i) promote the utilization of volun8 teers in the provision of care and services 

9 under the ChiPACC, in accordance with 

10 standards set by the Secretary, which 

11 standards shall ensure a continuing level of 

12 effort to utilize such volunteers; and 

13 ‘‘(ii) ensure that records are main14 tained on the use of such volunteers and 

15 the cost savings and expansion of care and 

16 services achieved through the use of such 

17 volunteers. 

18 ‘‘(4) INTERDISCIPLINARY HEALTH PROFES19 SIONAL TEAM.—The term ‘interdisciplinary health 

20 professional team’ means, with respect to a 

21 ChiPACC, a group of health professionals that— 

22 ‘‘(A) includes at least— 

23 ‘‘(i) one physician (as defined in sec24 tion 1861(r)(1)); 


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1 ‘‘(ii) one registered professional nurse; 

2 and 

3 ‘‘(iii) one social worker, pastoral coun4 selor, or other counselor; 

5 ‘‘(B) develops a comprehensive plan of care 

6 for ChiPACC eligible individuals enrolled with 

7 the ChiPACC and furnishes, or supervises the 

8 provision of, care and services described in sub9 section (c)(1) to an individual enrolled in the 

10 ChiPACC; and 

11 ‘‘(C) through direct action and communica12 tion with health care providers furnishing serv13 ices under the ChiPACC, on behalf of or under 

14 the direction or supervision of a State admin15 istering agency or a ChiPACC coordinator, co16 ordinates the care and services furnished to 

17 such enrollees in a manner that takes into ac18 count the best interests of each such enrollee 

19 and the enrollee’s family, as well as consider20 ations of cost and efficient use of available re21 sources. 

22 ‘‘(5) STATE ADMINISTERING AGENCY.—The 

23 term ‘State administering agency’ means, with re24 spect to the operation of a ChiPACC in a State, the 

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1 cy responsible for administration of the State plan 

2 under this title in the State) responsible for the im3 plementation, either directly or through arrange4 ments with one or more ChiPACC coordinators, of 

5 the ChiPACC under this section in the State. 

6 ‘‘(6) REGULATIONS.—Except as otherwise pro7 vided, the term ‘regulations’ refers to interim final 

8 or final regulations promulgated under subsection 

9 (g). 

10 ‘‘(c) SCOPE OF BENEFITS; BENEFICIARY SAFE11 GUARDS.— 

12 ‘‘(1) IN GENERAL.—Under a ChiPACC of a 

13 State, the State administering agency shall assure 

14 that— 

15 ‘‘(A) individuals enrolled in the ChiPACC 

16 are furnished, at a minimum— 

17 ‘‘(i) all items and services that are 

18 necessary and appropriate to their care 

19 and that are covered under this title, and 

20 all additional items and services specified 

21 in regulations, but without any limitation 

22 or condition as to amount, duration, or 

23 scope; 


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1 ‘‘(ii) access to covered items and serv2 ices, as needed, 24 hours per day, every 

3 day of the year; and 

4 ‘‘(iii) services that include comprehen5 sive, integrated palliative and curative 

6 services, expressive therapy and counseling, 

7 and counseling and anticipatory bereave8 ment services to immediate family mem9 bers of the ChiPACC eligible individual, as 

10 part of the services to the eligible indi11 vidual; 

12 ‘‘(B) provision of such services to such in13 dividuals through a comprehensive, interdiscipli14 nary and multidisciplinary health and social 

15 services delivery system which integrates, as ap16 propriate to the individual recipient of services, 

17 acute and long-term care services, palliative, 

18 respite and curative treatment, counseling and 

19 support for family members who are caretakers 

20 or otherwise relevant to appropriate care and 

21 treatment of the individual, and such other 

22 services as may be furnished pursuant to regu23 lations and the provisions of the applicable 

24 State plan; and 


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1 ‘‘(C) the ChiPACC is operated, and the 

2 services to enrolled individuals are furnished, in 

3 a manner that is consistent with Standards of 

4 Care and Practice Guidelines developed by Chil5 dren’s Hospice International for a Program of 

6 All-Inclusive Care for Children (as in effect as 

7 of the date of the enactment of this section or 

8 such later date as the Secretary may specify). 

9 ‘‘(2) QUALITY ASSURANCE; PATIENT SAFE10 GUARDS.—With respect to a ChiPACC, the State 

11 administering agency shall assure the following: 

12 ‘‘(A) The provision of services under the 

13 ChiPACC meets Federal and State guidelines 

14 for quality assurance. 

15 ‘‘(B) Necessary safeguards have been es16 tablished to protect the health and welfare of 

17 individuals enrolled in the ChiPACC under this 

18 section. 

19 ‘‘(C) There is financial accountability of 

20 funds expended under this title with respect to 

21 such services. 

22 ‘‘(D) There is a written plan of quality as23 surance, and procedures implementing such 

24 plan, in accordance with regulations. 


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1 ‘‘(E) Written safeguards of the rights of 

2 individuals enrolled in the ChiPACC, including 

3 a patient bill of rights and procedures for griev4 ances and appeals, in accordance with regula5 tions and with other requirements of this title 

6 and Federal and State law designed for the pro7 tection of patients. 

8 ‘‘(F) There are in effect procedures for 

9 data collection, record maintenance and reten10 tion, and the development of outcome measures, 

11 and such other policies, systems, and proce12 dures as are sufficient to afford the Secretary 

13 and the State administering agency access to 

14 records and data relating to the ChiPACC, in15 cluding pertinent financial, medical, and per16 sonnel records. 

17 ‘‘(G) The agency shall submit to the Sec18 retary such reports as the Secretary finds (in 

19 consultation with State administering agencies) 

20 necessary to monitor the operation, cost, and 

21 effectiveness of ChiPACCs. 

22 ‘‘(3) COST-SHARING WAIVER.—A State admin23 istering agency may, in the case of a ChiPACC eligi24 ble individual enrolled in the State’s ChiPACC, 

25 waive deductibles, copayments, coinsurance, or other 


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1 cost-sharing that would otherwise apply under the 

2 State plan under this title. 

3 ‘‘(d) ELIGIBILITY DETERMINATIONS.— 

4 ‘‘(1) IN GENERAL.—In determining whether an 

5 individual is a ChiPACC eligible individual, the 

6 State administering agency shall conduct an inde7 pendent evaluation and assessment, which shall in8 clude the following: 

9 ‘‘(A) Where appropriate, consultation with 

10 the individual’s family, guardian, or other re11 sponsible individual. 

12 ‘‘(B) Consultation with appropriate treat13 ing and consulting health and support profes14 sionals caring for the individual. 

15 ‘‘(C) An examination of the individual’s 

16 relevant history, medical records, and care and 

17 support needs, guided by best practices and re18 search on effective strategies that result in im19 proved health and quality of life outcomes. 

20 ‘‘(2) CERTIFICATION.—Upon completion of the 

21 evaluation and assessment described in paragraph 

22 (1), an individual meeting the criteria of a ChiPACC 

23 eligible individual shall be certified as such, pursuant 

24 to procedures specified in regulations and the appli25 cable State plan. 


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1 ‘‘(3) CONTINUATION OF ELIGIBILITY.—An indi2 vidual who is a ChiPACC eligible individual may be 

3 deemed to continue to be such an individual notwith4 standing a determination that the individual no 

5 longer meets the requirement of subsection (b)(2)(B) 

6 if, in accordance with regulations, it is reasonably 

7 foreseeable that, if the individual is not furnished 

8 services under this section, the severity or impact of 

9 the individual’s illness or condition would increase to 

10 a degree that the individual would again meet such 

11 requirement before the individual attains adulthood 

12 or within the succeeding 12-month period. 

13 ‘‘(4) ANNUAL REEVALUATIONS.—Subject to 

14 such limitations as the Secretary may by regulation 

15 prescribe, the eligibility determination made under 

16 this subsection shall be reevaluated annually, except 

17 that such an annual evaluation may be waived, in 

18 accordance with regulations, in a case where the ad19 ministering State agency determines that there is no 

20 reasonable expectation of improvement or significant 

21 change in the individual’s illness or condition during 

22 a period to which the reevaluation requirement 

23 would otherwise be applicable. 

24 ‘‘(5) ENROLLMENT AND DISENROLLMENT.— 


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1 ‘‘(A) VOLUNTARY DISENROLLMENT AT ANY

2 TIME.—The enrollment and disenrollment of 

3 ChiPACC eligible individuals in a ChiPACC 

4 shall be pursuant to procedures specified in reg5 ulations and the State plan, but shall permit an 

6 enrollee, or an enrollee’s guardian or other legal 

7 representative, acting on behalf of an enrollee, 

8 to voluntarily disenroll for any reason at any 

9 time. 

10 ‘‘(B) LIMITATIONS ON DISENROLLMENT.— 

11 ‘‘(i) IN GENERAL.—Regulations, and 

12 the applicable State plan, shall provide 

13 that a ChiPACC may not involuntarily 

14 disenroll a ChiPACC eligible individual en15 rolled in the ChiPACC except— 

16 ‘‘(I) for disruptive or threatening 

17 behavior by the enrollee, or by a fam18 ily member with whom a health care 

19 provider providing services under the 

20 ChiPACC necessarily has contact in 

21 the provision of services, as defined in 

22 provisions of regulations (developed in 

23 close consultation with State admin24 istering agencies); and 


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1 ‘‘(II) if there is a change in the 

2 individual’s medical condition, resi3 dency or geographic location, or finan4 cial situation such that the individual 

5 no longer is a ChiPACC eligible indi6 vidual and paragraph (3) does not 

7 apply to warrant continuation of en8 rollment. 

9 ‘‘(ii) NO DISENROLLMENT FOR NON10 COMPLIANT BEHAVIOR.—Except as allowed 

11 under regulations, a ChiPACC may not 

12 disenroll a ChiPACC eligible individual on 

13 the ground that the individual has engaged 

14 in noncompliant behavior if such behavior 

15 is related to a mental or physical condition 

16 of the individual. For purposes of the pre17 ceding sentence, the term ‘noncompliant 

18 behavior’ includes repeated noncompliance 

19 with medical advice and repeated failure to 

20 appear for appointments. 

21 ‘‘(iii) TIMELY REVIEW OF PROPOSED

22 NONVOLUNTARY DISENROLLMENT.—A pro23 posed involuntary disenrollment under this 

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1 retary or by the State administering agen2 cy (as applicable), prior to the proposed 

3 disenrollment becoming effective, pursuant 

4 to procedures prescribed in regulations. 

5 ‘‘(C) APPEALS.—If an individual is deter6 mined not to be a ChiPACC eligible individual 

7 upon application, any time after such services 

8 begin, or is disenrolled from a ChiPACC for 

9 reasons described in subparagraph (B)(i)(I), the 

10 State plan under this title shall allow for an ap11 peal of such determination. During the course 

12 of the appeals process, an individual previously 

13 enrolled in a ChiPACC shall continue to be so 

14 enrolled and to receive benefits through the 

15 ChiPACC. 

16 ‘‘(6) CONSTRUCTION.—The fact that a 

17 ChiPACC eligible individual is enrolled under a 

18 ChiPACC shall not be construed as adversely affect19 ing the eligibility of the individual’s parents or care20 taker relatives for medical assistance under this 

21 title. 

22 ‘‘(e) PAYMENTS TO HEALTH CARE PROVIDERS

23 UNDER CHIPACC.— 

24 ‘‘(1) IN GENERAL.—Payments to health care 

25 providers furnishing items and services under a 


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1 ChiPACC shall be paid on a capitated or fee-for2 service basis, according to regulations and as speci3 fied in the applicable State plan consistent with this 

4 subsection. 

5 ‘‘(2) USE OF INTEGRATED, BUDGET-NEUTRAL

6 FINANCING.—Payments under this subsection shall 

7 be made— 

8 ‘‘(A) on a basis that permits provision for 

9 integrated financing methodologies that allow 

10 providers to pool payments received from public 

11 and private programs and individuals; and 

12 ‘‘(B) in amounts that are designed, accord13 ing to regulations, to ensure that aggregate 

14 payments under this section for individuals en15 rolled in a ChiPACC, whether made on a 

16 capitated basis or fee-for-service basis, do not 

17 exceed on average the aggregate payments that 

18 would have been paid under the State plan for 

19 such individuals if they were not so enrolled, 

20 taking into account the comparative case-mix of 

21 ChiPACC enrollees and such other factors as 

22 the Secretary determines to be appropriate. 

23 ‘‘(f) TERMINATION PROCEDURES.— 

24 ‘‘(1) IN GENERAL.—Under regulations— 


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1 ‘‘(A) the Secretary may require a State ad2 ministering agency to terminate the participa3 tion of a ChiPACC coordinator for cause; and 

4 ‘‘(B) a State administering agency may 

5 terminate operation of a ChiPACC after appro6 priate notice to the Secretary and enrollees. 

7 ‘‘(2) CAUSES FOR COORDINATOR TERMI8 NATION.—In accordance with regulations estab9 lishing procedures for termination of participation of 

10 ChiPACC coordinators, the Secretary may require a 

11 State administering agency to terminate participa12 tion of a ChiPACC coordinator for, among other 

13 reasons, the fact that— 

14 ‘‘(A) the Secretary determines that the 

15 ChiPACC coordinator has failed to comply sub16 stantially with requirements for a ChiPACC co17 ordinator under this section; and 

18 ‘‘(B) the State administering agency has 

19 failed to develop and successfully initiate, with20 in 30 days of the date of the receipt of written 

21 notice of such a determination for the ChiPACC 

22 coordinator, a plan to correct the coordinator’s 

23 deficiencies, or has failed to continue implemen24 tation of such a plan of correction. 

25 ‘‘(g) REGULATIONS.— 


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1 ‘‘(1) IN GENERAL.—The Secretary shall issue 

2 interim final or final regulations to carry out this 

3 section. 

4 ‘‘(2) USE OF EXISTING STANDARDS.— 

5 ‘‘(A) IN GENERAL.—In issuing such regu6 lations, the Secretary shall, to the extent appro7 priate and consistent with the provisions of this 

8 section, incorporate the standards and require9 ments applied to Programs of All-Inclusive Care 

10 for Children demonstration waiver programs 

11 that have been implemented before (or as of) 

12 the date of the enactment of this section, in13 cluding standards of care and practice guide14 lines applied under such programs. 

15 ‘‘(B) FLEXIBILITY.—In order to provide 

16 for reasonable flexibility in adapting the service 

17 delivery model described in subparagraph (A) to 

18 the needs of particular organizations (such as 

19 those in rural areas or those that may deter20 mine it appropriate to use nonstaff physicians 

21 according to State licensing law requirements) 

22 under this section, the Secretary (in close con23 sultation with State administering agencies) 

24 may modify or waive provisions described in 

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1 tion or waiver is not inconsistent with and 

2 would not impair the essential elements, objec3 tives, and requirements of this section, but may 

4 not modify or waive any of the following provi5 sions: 

6 ‘‘(i) The requirement of delivery of 

7 comprehensive, integrated palliative, res8 pite and curative services, therapy, coun9 seling and other medical and psycho-social 

10 services for ChiPACC eligible individual, to 

11 the extent such services would benefit the 

12 individual. 

13 ‘‘(ii) The requirement of delivery of 

14 counseling and bereavement services to im15 mediate family members of the ChiPACC 

16 enrollees as part of the services to the en17 rollee. 

18 ‘‘(iii) The requirement of an inter19 disciplinary health professional team ap20 proach to care management and service de21 livery to ChiPACC eligible individuals. 

22 ‘‘(iv) The provision of integrated fi23 nancing methodologies that allow for the 

24 pooling of payments received from public 

25 and private programs and individuals. 


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1 ‘‘(v) The limitation on average aggre2 gate payment under subsection (e)(2). 

3 ‘‘(C) CONTINUATION OF MODIFICATIONS

4 OR WAIVERS OPERATIONAL REQUIREMENTS.—If 

5 a State agency administering a program of all6 inclusive coordinated care for seriously ill chil7 dren approved pursuant to waiver authority 

8 under section 1115 or 1915(c) has contractual 

9 or other operating arrangements relating to 

10 such program which are not otherwise recog11 nized in regulation and which were in effect as 

12 of the date of the enactment of this section, the 

13 Secretary shall permit the agency to continue 

14 such arrangements so long as such arrange15 ments are found by the Secretary to be reason16 ably consistent with the objectives of a 

17 ChiPACC. 

18 ‘‘(3) CONSTRUCTION.—Nothing in this sub19 section shall be construed as preventing the Sec20 retary from including in regulations provisions to en21 sure the health and safety of individuals enrolled in 

22 a ChiPACC under this section that are in addition 

23 to those otherwise provided under this section. 

24 ‘‘(h) WAIVERS OF REQUIREMENTS.—With respect to 

25 carrying out a ChiPACC under this section, the following 


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1 requirements of this title (and regulations relating to such 

2 requirements) shall not apply: 

3 ‘‘(1) Section 1902(a)(1), relating to any re4 quirement that ChiPACCs or ChiPACC services be 

5 provided in all areas of a State. 

6 ‘‘(2) Section 1902(a)(10), insofar as such sec7 tion relates to comparability of services among dif8 ferent population groups. 

9 ‘‘(3) Sections 1902(a)(23) and 1915(b)(4), re10 lating to freedom of choice of providers under a 

11 ChiPACC. 

12 ‘‘(4) Section 1903(m)(2)(A), insofar as it re13 stricts a ChiPACC provider from receiving prepaid 

14 capitation payments. 

15 ‘‘(5) Such other provisions of this title that the 

16 Secretary determines are inapplicable to carrying out 

17 a ChiPACC under this section. 

18 ‘‘(i) CONTINUED DEMONSTRATION PROJECT AU19 THORITY.—Nothing in this section shall be construed as 

20 preventing a State from developing, or the Secretary from 

21 approving, a project similar to or related to ChiPACCs 

22 as described in this section, under existing authorities, in23 cluding demonstration project and waiver authorities 

24 under this title or other provisions of this Act.’’. 


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1 (c) OTHER CONFORMING AMENDMENTS.—Section 

2 1905(r)(5) of such Act (42 U.S.C. 1396d(r)(5)) is amend3 ed by inserting before the period at the end the following: 

4 ‘‘, other than items and services to the extent such items 

5 and services are included under subsection (a) because of 

6 the application of paragraph (28)’’. 

7 (d) TIMELY ISSUANCE OF REGULATIONS; EFFECTIVE

8 DATE.—The Secretary of Health and Human Services 

9 shall promulgate regulations to carry out the amendments 

10 made by this section in a timely manner, so as to assure 

11 that it will be feasible for State agencies and entities to 

12 establish and operate ChiPACCs for periods beginning not 

13 later than 1 year after the date of the enactment of this 

14 Act. 

15 (e) FUNDS FOR TECHNICAL ASSISTANCE .—The Sec16 retary is authorized to expend funds appropriated to carry 

17 out title XIX of the Social Security Act to make grants 

18 to, or enter into contracts with, private entities or organi19 zations that are qualified to provide technical or other as20 sistance in developing and establishing ChiPACCs within 

21 the States, except that— 

22 (1) such funds may be expended solely for the 

23 purposes of implementing this section; and 

24 (2) a private entity or organization in receipt of 

25 such funds must have demonstrated expertise and a 


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1 minimum of 5 years of experience in working with 

2 or assisting in the establishment of programs for 

3 comprehensive care of children meeting the descrip4 tion of ChiPACC eligible individuals under section 

5 1942(b) of the Social Security Act, as added by sub6 section (b). 

Æ 


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