II 

111TH CONGRESS 

1ST SESSION S. 1003 

To increase immunization rates. 

IN THE SENATE OF THE UNITED STATES 

MAY 7, 2009 

Mr. REED introduced the following bill; which was read twice and referred to 

the Committee on Health, Education, Labor, and Pensions 

A BILL 

To increase immunization rates. 

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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Immunization Improvement Act of 2009’’. 

6 (b) TABLE OF CONTENTS.—The table of contents for 

7 this Act is as follows: 

Sec. 1. Short title; table of contents. 

Sec. 2. Findings. 

Sec. 3. State authority to purchase recommended vaccines for adults. 

Sec. 4. Demonstration program to improve immunization coverage. 

Sec. 5. Reauthorization of immunization program. 

Sec. 6. Inclusion of recommended immunizations under part B of the Medicare 

program with no beneficiary cost-sharing. 

Sec. 7. Medicaid coverage of recommended adult immunizations. 

Sec. 8. Vaccine administration fees. 

Sec. 9. Health insurance coverage for recommended immunizations. 


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Sec. 10. Immunization information systems. 

Sec. 11. Reports. 

1 SEC. 2. FINDINGS. 

2 Congress makes the following findings: 

3 (1) Immunizations recommended for routine 

4 use have been proven to be clinically effective in im5 proving health and preventing the spread of disease. 

6 Routine childhood immunizations prevent over 

7 14,000,000 cases of disease and over 33,500 deaths 

8 over the lifetime of children born in any given year. 

9 In addition to protecting individuals from disease, 

10 immunization provides population-based (herd) im11 munity. 

12 (2) An economic evaluation of the impact of 

13 seven vaccines routinely given as part of the child14 hood immunization schedule found that the vaccines 

15 are cost-effective. Over the lifetime of children born 

16 in any given year, these immunizations result in an 

17 annual cost savings of $10,000,000,000 in direct 

18 medical costs and over $40,000,000,000 in indirect 

19 societal costs. 

20 (3) There are significant and persistent gaps in 

21 public and private health insurance coverage of im22 munizations. About 11 percent of young children 

23 and 21 percent of adolescents are underinsured for 

24 immunizations. Among adults, 59 percent are underVerDate Nov 24 2008 00:05 May 13, 2009 Jkt 079200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1003.IS S1003

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1 insured and 17 percent are completely uninsured for 

2 immunizations. According to the Institute of Medi3 cine, even those with insurance increasingly have to 

4 pay higher deductibles and copayments for immuni5 zations. 

6 (4) Each year, vaccine-preventable diseases 

7 cause the deaths of more than 42,000 people and 

8 hundreds of thousands cases of illness. 

9 (5) In 2003, the Institute of Medicine’s Com10 mittee on the Evaluation of Vaccine Purchase Fi11 nancing made the following conclusions: 

12 (A) Current public and private financing 

13 strategies for immunization have had substan14 tial success, especially in improving immuniza15 tion rates for young children. However, signifi16 cant disparities remain in assuring access to 

17 recommended vaccines across geographic and 

18 demographic populations. 

19 (B) Many young children, adolescents, and 

20 high-risk adults have no or limited insurance 

21 for recommended vaccines. Gaps and frag22 mentation in insurance benefits create barriers 

23 for both vulnerable populations and clinicians 

24 that can contribute to lower immunization 

25 rates. 


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1 SEC. 3. STATE AUTHORITY TO PURCHASE RECOMMENDED 

2 VACCINES FOR ADULTS. 

3 Section 317 of the Public Health Service Act (42 

4 U.S.C. 247b) is amended by adding at the end the fol5 lowing: 

6 ‘‘(l) AUTHORITY TO PURCHASE RECOMMENDED VAC7 CINES FOR ADULTS.— 

8 ‘‘(1) IN GENERAL.—The Secretary may nego9 tiate and enter into contracts with manufacturers of 

10 vaccines for the purchase and delivery of vaccines 

11 for adults otherwise provided vaccines under grants 

12 under this section. 

13 ‘‘(2) STATE PURCHASE.—A State may obtain 

14 adult vaccines (subject to amounts specified to the 

15 Secretary by the State in advance of negotiations) 

16 through the purchase of vaccines from manufactur17 ers at the applicable price negotiated by the Sec18 retary under this subsection.’’. 

19 SEC. 4. DEMONSTRATION PROGRAM TO IMPROVE IMMUNI20 ZATION COVERAGE. 

21 Section 317 of the Public Health Service Act (42 

22 U.S.C. 247b), as amended by section 3, is further amend23 ed by adding at the end the following: 

24 ‘‘(m) DEMONSTRATION PROGRAM TO IMPROVE IM25 MUNIZATION COVERAGE.— 


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1 ‘‘(1) IN GENERAL.—The Secretary, acting 

2 through the Director of the Centers for Disease 

3 Control and Prevention, shall establish a demonstra4 tion program to award grants to States to improve 

5 the provision of recommended immunizations for 

6 children, adolescents, and adults through the use of 

7 evidence-based, population-based interventions for 

8 high-risk populations. 

9 ‘‘(2) STATE PLAN.—To be eligible for a grant 

10 under paragraph (1), a State shall submit to the 

11 Secretary an application at such time, in such man12 ner, and containing such information as the Sec13 retary may require, including a State plan that de14 scribes the interventions to be implemented under 

15 the grant and how such interventions match with 

16 local needs and capabilities, as determined through 

17 consultation with local authorities. 

18 ‘‘(3) USE OF FUNDS.—Funds received under a 

19 grant under this subsection shall be used to imple20 ment interventions that are recommended by the 

21 Task Force on Community Preventive Services (as 

22 established by the Secretary, acting through the Di23 rector of the Centers for Disease Control and Pre24 vention) or other evidence-based interventions, in25 cluding— 


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1 ‘‘(A) providing immunization reminders or 

2 recalls for target populations of clients, pa3 tients, and consumers; 

4 ‘‘(B) educating targeted populations and 

5 health care providers concerning immunizations 

6 in combination with one or more other interven7 tions; 

8 ‘‘(C) reducing out-of-pocket costs for fami9 lies for vaccines and their administration; 

10 ‘‘(D) carrying out immunization-promoting 

11 strategies for participants or clients of public 

12 programs, including assessments of immuniza13 tion status, referrals to health care providers, 

14 education, provision of on-site immunizations, 

15 or incentives for immunization; 

16 ‘‘(E) providing for home visits that pro17 mote immunization through education, assess18 ments of need, referrals, provision of immuniza19 tions, or other services; 

20 ‘‘(F) providing reminders or recalls for im21 munization providers; 

22 ‘‘(G) conducting assessments of, and pro23 viding feedback to, immunization providers; or 

24 ‘‘(H) any combination of one or more 

25 interventions described in this paragraph. 


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1 ‘‘(4) CONSIDERATION.—In awarding grants 

2 under this subsection, the Secretary shall consider 

3 any reviews or recommendations of the Task Force 

4 on Community Preventive Services. 

5 ‘‘(5) EVALUATION.—Not later than 3 years 

6 after the date on which a State receives a grant 

7 under this subsection, the State shall submit to the 

8 Secretary an evaluation of progress made toward im9 proving immunization coverage rates among high10 risk populations within the State. 

11 ‘‘(6) REPORT TO CONGRESS.—Not later than 4 

12 years after the date of enactment of the Immuniza13 tion Improvement Act of 2009, the Secretary shall 

14 submit to Congress a report concerning the effective15 ness of the demonstration program established under 

16 this subsection together with recommendations on 

17 whether to continue and expand such program. 

18 ‘‘(7) AUTHORIZATION OF APPROPRIATIONS.— 

19 There is authorized to be appropriated to carry out 

20 this subsection, such sums as may be necessary for 

21 each of fiscal years 2010 through 2014.’’. 

22 SEC. 5. REAUTHORIZATION OF IMMUNIZATION PROGRAM. 

23 Section 317(j) of the Public Health Service Act (42 

24 U.S.C. 247b(j)) is amended— 


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1 (1) in paragraph (1), by striking ‘‘for each of 

2 the fiscal years 1998 through 2005’’; and 

3 (2) in paragraph (2), by striking ‘‘after October 

4 1, 1997,’’. 

5 SEC. 6. INCLUSION OF RECOMMENDED IMMUNIZATIONS 

6 UNDER PART B OF THE MEDICARE PROGRAM 

7 WITH NO BENEFICIARY COST-SHARING. 

8 (a) IN GENERAL.—Paragraph (10) of section 

9 1861(s) of the Social Security Act (42 U.S.C. 1395x(s)) 

10 is amended to read as follows: 

11 ‘‘(10) vaccines recommended for routine use by 

12 the Advisory Committee on Immunization Practices 

13 (an advisory committee established by the Secretary, 

14 acting through the Director of the Centers for Dis15 ease Control and Prevention) and their administra16 tion;’’. 

17 (b) CONFORMING AMENDMENTS.— 

18 (1) Section 1833 of the Social Security Act (42 

19 U.S.C. 1395l) is amended, in each of subsections 

20 (a)(1)(B), (a)(2)(G), (a)(3)(A), (b)(1), by striking 

21 ‘‘1861(s)(10)(A)’’ or ‘‘1861(s)(10)(B)’’ and insert22 ing ‘‘1861(s)(10)’’ each place it appears. 

23 (2) Section 1842(o)(1)(A)(iv) of the Social Se24 curity Act (42 U.S.C. 1395u(o)(1)(A)(iv)) is amend25 ed by striking ‘‘subparagraph (A) or (B) of’’. 


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1 (3) Section 1847A(c)(6) of the Social Security 

2 Act (42 U.S.C. 1395w–3a(c)(6)) is amended by 

3 striking subparagraph (G). 

4 (4) Section 1860D–2(e)(1) of the Social Secu5 rity Act (42 U.S.C. 1395w–102(e)(1)) is amended 

6 by striking ‘‘a vaccine’’ and all that follows through 

7 ‘‘its administration) and’’. 

8 (5) Section 1861(ww)(2)(A) of the Social Secu9 rity Act (42 U.S.C. 1395x(ww)(2)(A)) is amended 

10 by striking ‘‘Pneumococcal, influenza, and hepatitis 

11 B’’ and inserting ‘‘Any’’. 

12 (6) Section 1866(a)(2)(A) of the Social Security 

13 Act (42 U.S.C. 1395cc(a)(2)(A)) is amended by 

14 striking ‘‘1861(s)(10)(A)’’ and inserting 

15 ‘‘1861(s)(10)’’. 

16 (c) EFFECTIVE DATE.—The amendments made by 

17 this section shall apply to vaccines administered on or 

18 after January 1, 2010. 

19 SEC. 7. MEDICAID COVERAGE OF RECOMMENDED ADULT 

20 IMMUNIZATIONS. 

21 (a) MANDATORY COVERAGE OF RECOMMENDED IM22 MUNIZATIONS FOR ADULTS.—Section 1905(a)(4) of the 

23 Social Security Act (42 U.S.C. 1396d(a)(4)) is amended— 

24 (1) by striking ‘‘and’’ before ‘‘(C)’’; and 


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1 (2) by inserting after the semicolon the fol2 lowing: ‘‘and (D) with respect to an adult individual, 

3 vaccines recommended for routine use by the Advi4 sory Committee on Immunization Practices (an advi5 sory committee established by the Secretary, acting 

6 through the Director of the Centers for Disease 

7 Control and Prevention) and their administration;’’. 

8 (b) PROHIBITION ON COST-SHARING.— 

9 (1) IN GENERAL.—Section 1916 of the Social 

10 Security Act (42 U.S.C. 1396o), as amended by sec11 tion 5006(a)(1)(A) of division B of Public Law 111– 

12 5, is amended— 

13 (A) in subsection (a), by striking ‘‘and (j)’’ 

14 and inserting ‘‘, (j), and (k)’’; and 

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

16 ‘‘(k) The State plan shall require that no provider 

17 participating under the State plan may impose a copay18 ment, cost-sharing charge, or similar charge for vaccines 

19 or their administration that the State is required to pro20 vide under sections 1902(a)(10)(A) and 1905(a)(4)(D).’’. 

21 (2) TECHNICAL AND CONFORMING AMEND22 MENT.—The second sentence of section 1916A(a)(1) 

23 of such Act (42 U.S.C. 1396o–1(a)(1)) is amended 

24 by striking ‘‘or (i)’’ and inserting ‘‘(i), (j), or (k)’’. 


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1 (c) ALLOWING FOR MEDICAID REBATES.—Section 

2 1927(k)(2)(B) of such Act (42 U.S.C. 1396r–8(k)(2)(B)) 

3 is amended by striking ‘‘, other than a vaccine’’ and in4 serting ‘‘(including vaccines described in section 

5 1905(a)(4)(D) but excluding qualified pediatric vaccines 

6 under section 1928)’’. 

7 (d) EFFECTIVE DATE.— 

8 (1) IN GENERAL.—Except as provided in para9 graphs (2) and (3), the amendments made by this 

10 section take effect on October 1, 2010. 

11 (2) EXTENSION OF EFFECTIVE DATE FOR

12 STATE LAW AMENDMENT.—In the case of a State 

13 plan under title XIX of the Social Security Act (42 

14 U.S.C. 1396 et seq.) which the Secretary of Health 

15 and Human Services determines requires State legis16 lation in order for the plan to meet the additional 

17 requirements imposed by the amendments made by 

18 this section, the State plan shall not be regarded as 

19 failing to comply with the requirements of such title 

20 solely on the basis of its failure to meet these addi21 tional requirements before the first day of the first 

22 calendar quarter beginning after the close of the 

23 first regular session of the State legislature that be24 gins after the date of enactment of this Act. For 

25 purposes of the previous sentence, in the case of a 


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1 State that has a 2-year legislative session, each year 

2 of the session is considered to be a separate regular 

3 session of the State legislature. 

4 (3) MEDICAID REBATES.—The amendment 

5 made by subsection (c) takes effect on October 1, 

6 2010, and applies to rebate agreements entered into 

7 under section 1927 of the Social Security Act (42 

8 U.S.C. 1396r–8) on or after that date. 

9 SEC. 8. VACCINE ADMINISTRATION FEES. 

10 (a) REVIEW OF FEDERALLY ESTABLISHED MAX11 IMUM ALLOWABLE ADMINISTRATIVE FEES.—Not later 

12 than October 1, 2010, the Administrator of the Centers 

13 for Medicare & Medicaid Services and the Director of the 

14 Centers for Disease Control and Prevention, jointly 

15 shall— 

16 (1) review the regional maximum charge for 

17 vaccine administration for each State established 

18 under the Vaccines for Children program under sec19 tion 1928 of the Social Security Act (42 U.S.C. 

20 1396s) to determine the appropriateness and ade21 quacy of such rates; and 

22 (2) update such rates, as appropriate, based on 

23 the results of such review and taking into account 

24 all appropriate costs related to the administration of 

25 vaccines under that program. 


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1 (b) FEDERAL REIMBURSEMENT FOR VACCINE AD2 MINISTRATION FOR NON-MEDICAID VACCINE-ELIGIBLE

3 CHILDREN.— 

4 (1) IN GENERAL.—Section 1928 of the Social 

5 Security Act (42 U.S.C. 1396s) is amended— 

6 (A) in subsection (a)(1)(B), by inserting 

7 ‘‘and is entitled to receive reimbursement for 

8 any fee imposed by the provider for the admin9 istration of such vaccine consistent with sub10 section (c)(2)(C) (not to exceed the amount ap11 plicable under clause (iv) of such subsection) to 

12 a federally vaccine-eligible child who is de13 scribed in clause (ii), (iii), or (iv) of subsection 

14 (b)(2),’’ after ‘‘delivery to the provider,’’; 

15 (B) in subsection (a)(2), by adding at the 

16 end the following new subparagraph: 

17 ‘‘(D) REIMBURSEMENT FOR VACCINE

18 ADMINISTRATION FOR NON-MEDICAID ELI19 GIBLE CHILDREN.—The Secretary shall 

20 pay each State such amounts as are nec21 essary for the State to reimburse each pro22 gram-registered provider in the State for 

23 an administration fee imposed consistent 

24 with subsection (c)(2)(C) (not to exceed 

25 the amount applicable under clause (iv) of 


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1 such subsection) for the administration of 

2 a qualified pediatric vaccine to a federally 

3 vaccine-eligible child who is described in 

4 clause (ii), (iii), or (iv) of subsection 

5 (b)(2).’’; 

6 (C) in subsection (c)(2)(C), by adding at 

7 the end the following new clause: 

8 ‘‘(IV) In the case of a federally vac9 cine-eligible child who is described in 

10 clause (ii), (iii), or (iv) of subsection 

11 (b)(2), the State shall pay the provider an 

12 amount equal to the administration fee es13 tablished under the State plan approved 

14 under this title for the administration of a 

15 qualified pediatric vaccine to a medicaid-el16 igible child.’’; and 

17 (D) by striking subsection (g). 

18 (2) CONFORMING AMENDMENTS.—Section 1928 

19 of such Act (42 U.S.C. 1396s), as amended by para20 graph (1), is amended— 

21 (A) by redesignating subsection (h) as sub22 section (g); 

23 (B) in subsection (a)(1)(A), by striking 

24 ‘‘(h)(8)’’ and inserting ‘‘(g)(8)’’; and 


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1 (C) in subsection (b)(2)(A)(iv), by striking 

2 ‘‘(h)(3)’’ and inserting ‘‘(g)(3)’’. 

3 SEC. 9. HEALTH INSURANCE COVERAGE FOR REC4 OMMENDED IMMUNIZATIONS. 

5 (a) AMENDMENTS TO THE PUBLIC HEALTH SERVICE

6 ACT.— 

7 (1) GROUP HEALTH COVERAGE.—Subpart 2 of 

8 part A of title XXVII of the Public Health Service 

9 Act (42 U.S.C. 300gg–4 et seq.) is amended by add10 ing at the end the following: 

11 ‘‘SEC. 2708. COVERAGE OF RECOMMENDED IMMUNIZA12 TIONS. 

13 ‘‘A group health plan, and a health insurance issuer 

14 offering group health insurance coverage, shall provide for 

15 coverage, without the application of deductibles, coinsur16 ance, or copayments, of vaccines recommended for routine 

17 use by the Advisory Committee on Immunization Practices 

18 (as established by the Secretary, acting through the Direc19 tor of the Centers for Disease Control and Prevention) 

20 and their administration.’’. 

21 (2) INDIVIDUAL HEALTH INSURANCE COV22 ERAGE.—Subpart 2 of part B of title XXVII of the 

23 Public Health Service Act (42 U.S.C. 300gg–51 et 

24 seq.) is amended by adding at the end the following: 


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1 ‘‘SEC. 2754. COVERAGE OF RECOMMENDED IMMUNIZA2 TIONS. 

3 ‘‘The provisions of section 2708 shall apply to health 

4 insurance coverage offered by a health insurance issuer 

5 in the individual market in the same manner as such pro6 visions apply to health insurance coverage offered by a 

7 health insurance issuer in connection with a group health 

8 plan in the small or large group market.’’. 

9 (b) AMENDMENTS TO ERISA.— 

10 (1) IN GENERAL.—Subpart B of part 7 of sub11 title B of title I of the Employee Retirement Income 

12 Security Act of 1974 is amended by adding at the 

13 end the following: 

14 ‘‘SEC. 715. COVERAGE OF RECOMMENDED IMMUNIZATIONS. 

15 ‘‘A group health plan, and a health insurance issuer 

16 offering group health insurance coverage, shall provide for 

17 coverage, without the application of deductibles, coinsur18 ance, or copayments, of vaccines recommended for routine 

19 use by the Advisory Committee on Immunization Practices 

20 (as established by the Secretary, acting through the Direc21 tor of the Centers for Disease Control and Prevention) 

22 and their administration.’’. 

23 (2) TECHNICAL AMENDMENTS.— 

24 (A) Section 732(a) of such Act (29 U.S.C. 

25 1191a(a)) is amended by striking ‘‘section 711’’ 

26 and inserting ‘‘sections 711 and 715’’. 


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1 (B) The table of contents in section 1 of 

2 such Act is amended by inserting after the item 

3 relating to section 713 the following new item: 

‘‘Sec. 715. Coverage of recommended immunizations.’’. 

4 (c) INTERNAL REVENUE CODE AMENDMENTS.— 

5 (1) IN GENERAL.—Subchapter B of chapter 

6 100 of the Internal Revenue Code of 1986 is amend7 ed— 

8 (A) in the table of sections, by inserting 

9 after the item relating to section 9813 the fol10 lowing new item: 

‘‘Sec. 9814. Coverage of recommended immunizations.’’; 

11 and 

12 (B) by inserting after section 9813 the fol13 lowing: 

14 ‘‘SEC. 9814. COVERAGE OF RECOMMENDED IMMUNIZA15 TIONS. 

16 ‘‘A group health plan, and a health insurance issuer 

17 offering group health insurance coverage, shall provide for 

18 coverage, without the application of deductibles, coinsur19 ance, or copayments, of vaccines recommended for routine 

20 use by the Advisory Committee on Immunization Practices 

21 (as established by the Secretary, acting through the Direc22 tor of the Centers for Disease Control and Prevention) 

23 and their administration.’’. 


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1 (d) EXCEPTION FOR COLLECTIVE BARGAINING

2 AGREEMENTS.—Nothing in this section shall be construed 

3 to preempt any provision of a collective bargaining agree4 ment that is in effect on the date of enactment of this 

5 section. 

6 (e) EFFECTIVE DATE.—The amendments made by 

7 this section shall apply to plan years beginning with the 

8 first plan year during which the Congressional Budget Of9 fice determines that any health reform legislation enacted 

10 by Congress will provide health insurance coverage to 95 

11 percent or more of the population of the United States. 

12 SEC. 10. IMMUNIZATION INFORMATION SYSTEMS. 

13 (a) HEALTH INFORMATION TECHNOLOGY INFRA14 STRUCTURE.—Section 3011(a) of the Public Health Serv15 ice Act (as added by section 13301 of the American Recov16 ery and Reinvestment Act of 2009) is amended by adding 

17 at the end the following: 

18 ‘‘(8) Improvement and expansion of immuniza19 tion information systems (as defined in section 

20 3000), including activities to— 

21 ‘‘(A) support the integration and linkage of 

22 such systems with electronic birth records, 

23 health care providers, other preventive health 

24 services information systems, and health infor25 mation exchanges; 


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1 ‘‘(B) support interstate data exchange; 

2 ‘‘(C) ensure that such systems are inter3 operable with electronic health record systems; 

4 ‘‘(D) provide technical support, such as 

5 training, data reporting, data quality and com6 pleteness review, and decision support, to im7 munization providers to integrate the use of 

8 such systems; 

9 ‘‘(E) develop, in consultation with manu10 facturers, vendors, and specialty professional 

11 organizations, continuing education materials 

12 relating to the use of such systems; 

13 ‘‘(F) ensure that such systems can provide 

14 complete and accurate data to monitor immuni15 zation coverage, uptake, and the impact of 

16 shortages in the population served within their 

17 jurisdiction; and 

18 ‘‘(G) ensure the privacy, confidentiality, 

19 and security of all data and data exchanges 

20 with such systems.’’. 

21 (b) STATE GRANTS.—Section 3013(d) of the Public 

22 Health Service Act (as added by section 13301 of the 

23 American Recovery and Reinvestment Act of 2009) is 

24 amended— 


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1 (1) in paragraph (9), by striking ‘‘and’’ at the 

2 end; 

3 (2) by redesignating paragraph (10) as para4 graph (11); and 

5 (3) by inserting after paragraph (9), the fol6 lowing: 

7 ‘‘(10) improving and expanding immunization 

8 information systems (as defined in section 3000); 

9 and’’. 

10 (c) DEFINITION.—Section 3000 of the Public Health 

11 Service Act (as added by section 13301 of the American 

12 Recovery and Reinvestment Act of 2009) is amended— 

13 (1) by redesignating paragraphs (9) through 

14 (14) as paragraphs (10) through (15), respectively; 

15 and 

16 (2) by inserting after paragraph (8), the fol17 lowing: 

18 ‘‘(9) IMMUNIZATION INFORMATION SYSTEM.— 

19 The term ‘immunization information system’ means 

20 an immunization registry or a confidential, popu21 lation-based, computerized information system that 

22 collects vaccination data within a geographic area, 

23 consolidates vaccination records from multiple health 

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1 cations, and is capable of exchanging immunization 

2 information with health care providers.’’. 

3 SEC. 11. REPORTS. 

4 (a) COSTS OF PUBLIC AND PRIVATE VACCINE AD5 MINISTRATION.—Not later than 5 years after the date of 

6 enactment of this Act, and every 5 years thereafter, the 

7 Director of the Centers for Disease Control and Preven8 tion jointly with the Administrator of the Centers for 

9 Medicare & Medicaid Services shall collect and publish 

10 data relating to the costs associated with public and pri11 vate vaccine administration, including the costs associated 

12 with the delivery of vaccines, activities such as reporting 

13 data to immunization registries, and maintenance of ap14 propriate storage requirements for vaccines. 

15 (b) SECTION 317 IMMUNIZATION PROGRAM.—Not 

16 later than February 1, 2010, and each February 1 there17 after, the Director of the Centers for Disease Control and 

18 Prevention shall submit to Congress a report concerning 

19 the size and scope of the appropriations needed for each 

20 fiscal year for vaccine purchases, vaccination infrastruc21 ture, vaccine administration, and vaccine safety under sec22 tion 317 of the Public Health Service Act (42 U.S.C. 

23 247b). 

24 (c) ANNUAL PUBLICATION OF STATE-ESTABLISHED

25 ADMINISTRATIVE FEES UNDER MEDICAID.—Beginning 


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1 October 1, 2009, and annually thereafter, the Adminis2 trator of the Centers for Medicare & Medicaid Services 

3 and the Director of the Centers for Disease Control and 

4 Prevention jointly shall make publicly available the admin5 istrative fee established under each State Medicaid pro6 gram for administering a qualified pediatric vaccine to a 

7 vaccine-eligible child under the Vaccines for Children pro8 gram under section 1928 of the Social Security Act (42 

9 U.S.C. 1396s) with the State and Federal contribution for 

10 such fee separately identified. 

Æ 


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