I

107TH CONGRESS

1ST SESSION H. R. 1142

To amend title XIX of the Social Security Act to permit uninsured individuals

to obtain coverage under the Medicaid Program, to assure coverage

of prescription drugs, alcohol and drug abuse treatment services, mental

health services, long-term care services, and other services, and for other

purposes.

IN THE HOUSE OF REPRESENTATIVES

MARCH 21, 2001

Mr. CONYERS (for himself, Mrs. CHRISTENSEN, Mr. BONIOR, and Mrs. JONES

of Ohio) 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 permit

uninsured individuals to obtain coverage under the Medicaid Program, to assure coverage of prescription drugs,

alcohol and drug abuse treatment services, mental health

services, long-term care services, and other services, 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 ‘‘Working American

3 Families Access to Health Care Act of 2001’’ or ‘‘Medi4 Access Act of 2001’’.

5 SEC. 2. MEDI-ACCESS PROGRAM.

6 (a) AVAILABILITY OF MEDICAID COVERAGE FOR UN7 INSURED INDIVIDUAL UNDER MEDI-ACCESS.—

8 (1) EXPANSION TO INDIVIDUALS WITH FAMILY

9 INCOME BELOW 400 PERCENT (OR 600 PERCENT IN

10 2004) OF POVERTY LINE WITHOUT APPLYING ANY

11 ASSET TEST.—

12 (A) IN GENERAL.—Section 1902 of the So13 cial Security Act (42 U.S.C. 1396a) is

14 amended—

15 (i) in subsection (a)(10)(A)(i)—

16 (I) by striking ‘‘or’’ at the end of

17 subclause (VI);

18 (II) by striking the semicolon at

19 the end of subclause (VII) and insert20 ing ‘‘, or’’; and

21 (III) by adding at the end the

22 following new subclause:

23 ‘‘(VIII) described in subsection

24 (cc);’’; and

25 (ii) by adding at the end, as amended

26 by section 2(a) of the Breast and Cervical
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1 Cancer Prevention and Treatment Act of

2 2000 (Public Law 106–354; 114 Stat.

3 1381) and section 702(b) of the Medicare,

4 Medicaid, and SCHIP Benefits Improve5 ment and Protection Act of 2000 (as en6 acted into law by section 1(a)(6) of Public

7 Law 106–554), the following new sub8 section:

9 ‘‘(cc)(1) For purposes of (a)(10)(A)(i)(VIII), individ10 uals described in this subsection are individuals who meet

11 the following requirements:

12 ‘‘(A) Subject to paragraph (2), the income of

13 the individual’s family does not exceed 400 percent

14 (or, effective January 1, 2004, 600 percent) of the

15 poverty line (as defined in section 2110(c)(5)) appli16 cable to a family of the size involved.

17 ‘‘(B) The individual is not otherwise described

18 or covered under this title under any other provision.

19 ‘‘(C) Subject to paragraph (2), the individual

20 does not have creditable coverage (described in sec21 tion 2701(c)(1) of the Public Health Service Act,

22 but not taking into account subparagraph (F) of

23 that section or eligibility for benefits under title

24 XXI).
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1 ‘‘(2) The requirements of subparagraphs (A) and (C)

2 of paragraph (1) shall not apply in the case of an indi3 vidual if it is clearly demonstrated with respect to that

4 individual that—

5 ‘‘(A) the individual has a life threatening, or a

6 severe and debilitating, illness or injury; and

7 ‘‘(B)(i) any private health plan or health bene8 fits coverage under which the individual is covered

9 will not cover the illness or injury due to pre-existing

10 condition policies, or (ii) the individual or family

11 member would pay excessively high monthly pre12 miums or out-of-pocket expenses if covered under

13 such a plan or coverage due to having such illness

14 or injury.

15 Eligibility under this paragraph shall be determined by the

16 State on a case-by-case basis.

17 ‘‘(3) An individual who is described in this subsection

18 is eligible for medical assistance without regard to the

19 amount of the assets or resources of the individual or the

20 individual’s family.’’.

21 (B) NO PREMIUMS FOR INDIVIDUALS WITH

22 INCOME BELOW 300 PERCENT OF POVERTY

23 LINE; REQUIRING PREMIUMS ONLY FOR INDI24 VIDUALS WITH HIGHER INCOME.—Section 1916

25 of such Act (42 U.S.C. 1396o) is amended—
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1 (i) in subsection (a), by striking ‘‘Sub2 ject to subsection (g)’’ and inserting ‘‘Sub3 ject to subsections (g) and (h)’’; and

4 (ii) by adding at the end the following

5 new subsection:

6 ‘‘(h) With respect to an individual provided medical

7 assistance only under subclause (VIII) of section

8 1902(a)(10)(A)(i), if the individual’s family income—

9 ‘‘(1) does not exceed 300 percent of the poverty

10 line (as defined in section 2110(c)(5)) applicable to

11 a family of the size involved, a State shall not re12 quire payment of any monthly premium;

13 ‘‘(2) exceeds 300 percent (but does not exceed

14 350 percent) of such poverty line applicable to a

15 family of the size involved, a State shall require such

16 individuals to pay a monthly premium equal to $25

17 per month for each individual in the family so cov18 ered, but not to exceed $100 per month for all indi19 viduals in the family;

20 ‘‘(3) exceeds 350 percent (but does not exceed

21 400 percent) of such poverty line, the State shall re22 quire such individuals to pay a monthly premium

23 equal to $50 per month for each individual in the

24 family so covered, but not to exceed $150 per month

25 for all individuals in the family; or
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1 ‘‘(4) exceeds 400 percent of such poverty line,

2 the State shall require such individuals to pay a

3 monthly premium equal to $150 per month for each

4 individual in the family so covered, but not to exceed

5 $450 per month for all individuals in the family.

6 A State may enter into an arrangement with an employer

7 that employs at least 2, but fewer than 51, employees

8 under which the employer will pay directly for premiums

9 established under this subsection. Nothing in this sub10 section shall be construed as authorizing the use of pre11 miums collected under this subsection for vouchers for the

12 purchase of private health insurance.’’.

13 (C) MISCELLANEOUS CONFORMING

14 AMENDMENT.—(i) Section 1903(f)(4) of such

15 Act (42 U.S.C. 1396b(f)(4)) is amended by in16 serting ‘‘1902(a)(10)(A)(i)(VIII),’’ after

17 ‘‘1902(a)(10)(A)(i)(VII),’’.

18 (D) TECHNICAL AMENDMENTS.—(i) Sec19 tion 1902 of such Act (42 U.S.C. 1396a), as

20 amended by section 702(b) of the Medicare,

21 Medicaid, and SCHIP Benefits Improvement

22 and Protection Act of 2000 (as enacted into law

23 by section 1(a)(6) of Public Law 106–554), is

24 amended by redesignating the subsection (aa)

25 added by such section as subsection (bb).
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1 (ii) Section 1902(a)(15) of such Act (42

2 U.S.C. 1396a(a)(15)), as added by section

3 702(a)(2) of the Medicare, Medicaid, and

4 SCHIP Benefits Improvement and Protection

5 Act of 2000 (as so enacted into law), is amend6 ed by striking ‘‘subsection (aa)’’ and inserting

7 ‘‘subsection (bb)’’.

8 (iii) Section 1915(b) of such Act (42

9 U.S.C. 1396n(b)), as amended by section

10 702(c)(2) of the Medicare, Medicaid, and

11 SCHIP Benefits Improvement and Protection

12 Act of 2000 (as so enacted into law), is amend13 ed by striking ‘‘1902(aa)’’ and inserting

14 ‘‘1902(bb)’’.

15 (2) CLARIFICATION OF COVERAGE OF UNIN16 SURED MEN AND WOMEN, REGARDLESS OF MARITAL

17 STATUS.—Section 1905(a) of such Act (42 U.S.C.

18 1396d(a)) is amended, in the matter before para19 graph (1)—

20 (A) by striking ‘‘or’’ at the end of clause

21 (xi);

22 (B) by adding ‘‘or’’ at the end of clause

23 (xii); and

24 (C) by inserting after clause (xii) the fol25 lowing new clause:
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1 ‘‘(xiii) individuals described in section 1902(cc)

2 (which includes uninsured men and women, regard3 less of marital status),’’.

4 (3) MAKING PRESUMPTIVE ELIGIBILITY MANDA5 TORY.—

6 (A) IN GENERAL.—Sections 1920 and

7 1920A of such Act (42 U.S.C. 1396r–1, 1396r–

8 1a) are each amended by striking ‘‘may pro9 vide’’ and inserting ‘‘shall provide’’.

10 (B) EXPANSION OF PRESUMPTIVE ELIGI11 BILITY TO ALL INDIVIDUALS.—Title XIX of the

12 Act is amended by inserting after section

13 1920A the following new section:

14 ‘‘PRESUMPTIVE ELIGIBILITY FOR OTHER INDIVIDUALS

15 ‘‘SEC. 1920B. (a) A State plan approved under sec16 tion 1902 shall provide for making medical assistance with

17 respect to health care items and services covered under

18 the State plan available to all individuals during a pre19 sumptive eligibility period.

20 ‘‘(b) For purposes of this section:

21 ‘‘(1) The term ‘presumptive eligibility period’

22 means, with respect to an individual, the period

23 that—

24 ‘‘(A) begins with the date on which a

25 qualified entity determines, on the basis of pre26 liminary information, that the family income of
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1 the individual does not exceed the applicable in2 come level of eligibility under the State plan,

3 and

4 ‘‘(B) ends with (and includes) the earlier

5 of—

6 ‘‘(i) the day on which a determination

7 is made with respect to the eligibility of

8 the individual for medical assistance under

9 the State plan, or

10 ‘‘(ii) in the case of an individual on

11 whose behalf an application is not filed by

12 the last day of the month following the

13 month during which the entity makes the

14 determination referred to in subparagraph

15 (A), such last day.

16 ‘‘(3)(A) Subject to subparagraph (B), the term

17 ‘qualified entity’ means any entity that—

18 ‘‘(i)(I) is eligible for payments under a

19 State plan approved under this title and pro20 vides items and services described in subsection

21 (a) or (II) is a qualified provider described in

22 section 1920(b)(2); and

23 ‘‘(ii) is determined by the State agency to

24 be capable of making determinations of the type

25 described in paragraph (1)(A).
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1 ‘‘(B) The Secretary may issue regulations fur2 ther limiting those entities that may become quali3 fied entities in order to prevent fraud and abuse and

4 for other reasons.

5 ‘‘(C) Nothing in this section shall be construed

6 as preventing a State from limiting the classes of en7 tities that may become qualified entities, consistent

8 with any limitations imposed under subparagraph

9 (B).

10 ‘‘(c)(1) The State agency shall provide qualified enti11 ties with—

12 ‘‘(A) such forms as are necessary for an appli13 cation to be made on behalf of a child for medical

14 assistance under the State plan, and

15 ‘‘(B) information on how to assist parents,

16 guardians, and other persons in completing and fil17 ing such forms.

18 ‘‘(2) A qualified entity that determines under sub19 section (b)(1)(A) that an individual is presumptively eligi20 ble for medical assistance under a State plan shall—

21 ‘‘(A) notify the State agency of the determina22 tion within 5 working days after the date on which

23 determination is made, and

24 ‘‘(B) inform the individual at the time the de25 termination is made that an application for medical
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1 assistance under the State plan is required to be

2 made by not later than the last day of the month

3 following the month during which the determination

4 is made.

5 ‘‘(3) In the case of an individual who is determined

6 by a qualified entity to be presumptively eligible for med7 ical assistance under a State plan, the individual shall

8 make application for medical assistance under such plan

9 by not later than the last day of the month following the

10 month during which the determination is made.

11 ‘‘(d) Notwithstanding any other provision of this title,

12 medical assistance for items and services described in sub13 section (a) that—

14 ‘‘(1) are furnished to an individual—

15 ‘‘(A) during a presumptive eligibility pe16 riod,

17 ‘‘(B) by an entity that is eligible for pay18 ments under the State plan; and

19 ‘‘(2) are included in the care and services cov20 ered by a State plan;

21 shall be treated as medical assistance provided by such

22 plan for purposes of section 1903.’’.

23 (C) CONFORMING AMENDMENT.—Section

24 1902(a)(47) of such Act (42 U.S.C.
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1 1396a(a)(47)) is amended by striking ‘‘at the

2 option of the State,’’.

3 (4) MINIMUM ELIGIBILITY PERIOD FOR CAT4 EGORICALLY NEEDY.—Section 1902(e) of such Act

5 (42 U.S.C. 1396a(e)) is amended by adding at the

6 end the following new paragraph:

7 ‘‘(13) The State plan shall provide that an individual

8 who is determined to be eligible for benefits under a State

9 plan approved under this title under subsection (a)(10)(A)

10 shall remain eligible for those benefits until the end of the

11 12-month period following the date of such determina12 tion.’’.

13 (5) COVERAGE OF LEGAL IMMIGRANTS.—Sec14 tion 1902 of such Act (42 U.S.C. 1396a), as amend15 ed by paragraph (1)(A)(ii), is amended by adding at

16 the end the following new subsection:

17 ‘‘(dd) Notwithstanding any other provision of law, the

18 provisions title IV of the Personal Responsibility and

19 Work Opportunity Reconciliation Act of 1996 (and of sec20 tion 213A of the Immigration and Nationality Act) shall

21 not apply to eligibility for medical assistance under this

22 title for individuals who are lawful permanent residents

23 of the United States.’’.

24 (6) MAIL-IN AND ON-LINE APPLICATION PROC25 ESS.—Section 1902(a)(8) of such Act (42 U.S.C.
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1 1396a(a)(8)) is amended after ‘‘opportunity to do

2 so’’ the following: ‘‘and may do so through an appli3 cation submitted by mail or through electronic

4 means through the Internet, provide that applica5 tions are not longer than 3 pages and are made

6 available in different languages in order to provide

7 a fair and accessible application process,’’.

8 (7) CONFORMING TERMINATION OF SCHIP.—

9 With respect to items and services furnished on or

10 after October 1, 2002, no Federal payments shall be

11 made under section 2105(a) of the Social Security

12 Act (42 U.S.C. 1397ee(a)).

13 (b) REQUIRING COVERAGE OF EARLY AND PERIODIC

14 SCREENING, DIAGNOSTIC, AND TREATMENT SERVICES

15 (EPSDT), COVERAGE OF REHABILITATIVE SERVICES

16 FOR DISABLED OR DEVELOPMENTALLY DELAYED CHIL17 DREN, PRESCRIPTION DRUGS, MENTAL HEALTH AND

18 PSYCHIATRIC SERVICES, ASSISTIVE TECHNOLOGY DE19 VICES AND SERVICES, DURABLE MEDICAL EQUIPMENT,

20 DRUG AND ALCOHOL TREATMENT SERVICES FOR ALL

21 MEDICAID ELIGIBLE INDIVIDUALS, ASSISTIVE TECH22 NOLOGY DEVICES AND SERVICES, DURABLE MEDICAL

23 EQUIPMENT, PRENATAL AND POSTNATAL CARE, AND RE24 PRODUCTIVE HEALTH SERVICES.—
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1 (1) REQUIRING COVERAGE OF SCREENING,

2 DENTAL, VISION, HEARING, AND FOLLOWUP SERV3 ICES (EPSDT) FOR INDIVIDUALS OF ALL AGES.—

4 (A) IN GENERAL.—Section 1905(a)(4)(B)

5 of such Act (42 U.S.C. 1396d(a)(4)(B)) is

6 amended by striking ‘‘and are under the age of

7 21’’.

8 (B) CONFORMING AMENDMENTS.—Section

9 1905(r) of such Act (42 U.S.C. 1396d(r)) is

10 amended, in each of paragraphs (1)(A)(i),

11 (2)(A)(i), (3)(A)(i), and (4)(A)(i), by inserting

12 ‘‘, including for children, organizations’’ after

13 ‘‘organizations’’.

14 (2) REQUIRING COVERAGE OF REHABILITATIVE

15 SERVICES AND ASSISTIVE TECHNOLOGIES FOR DIS16 ABLED OR DEVELOPMENTALLY DELAYED CHIL17 DREN.—Section 1905(r)(5) of such Act (42 U.S.C.

18 1396d(r)(5)) is amended by inserting before the pe19 riod at the end the following: ‘‘, and including reha20 bilitative services and assistive technologies for dis21 abled or developmentally disabled children, regard22 less of whether the disability was discovered by the

23 screening services’’.
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1 (3) REQUIRING COVERAGE OF PRESCRIPTION

2 DRUGS.—Section 1902(a)(10) of such Act (42

3 U.S.C. 1396a(a)(10)) is amended—

4 (A) in subparagraph (A), by inserting

5 ‘‘(12),’’ after ‘‘(5),’’;

6 (B) in subparagraph (D)(iv), by inserting

7 ‘‘, (12),’’ after ‘‘(5)’’;

8 (C) by striking ‘‘and’’ at the end of sub9 paragraph (F);

10 (D) by adding ‘‘and’’ at the end of sub11 paragraph (G); and

12 (E) by inserting after subparagraph (G)

13 the following new subparagraph:

14 ‘‘(H) that the plan shall not deny medical

15 assistance for prescribed drugs for individuals

16 described in subparagraph (A)(i) if the drugs

17 have been prescribed by a treating physician (or

18 any other treating health care professional au19 thorized under law to prescribe the drugs);’’.

20 (4) REQUIRING COVERAGE OF DRUG AND ALCO21 HOL TREATMENT SERVICES.—

22 (A) REQUIREMENT.—Section 1902(a)(10)

23 of such Act (42 U.S.C. 1396a(a)(10)) is

24 amended—
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1 (i) in subparagraph (A), by striking

2 ‘‘(17) and (21)’’ and inserting ‘‘(10), (17),

3 (21), and (27)’’; and

4 (ii) in subparagraph (D)(iv), by strik5 ing ‘‘and (17)’’ and inserting ‘‘(10), (17),

6 and (27)’’ and by striking ‘‘through (24)’’

7 and inserting ‘‘through (27)’’.

8 (B) DRUG AND ALCOHOL TREATMENT

9 SERVICES DESCRIBED.—Section 1905(a) of

10 such Act (42 U.S.C. 1396d(a)) is amended—

11 (i) by striking ‘‘and’’ at the end of

12 paragraph (26);

13 (ii) by redesignating paragraph (27)

14 as paragraph (28); and

15 (iii) by inserting after paragraph (26)

16 the following new paragraph:

17 ‘‘(27) alcohol and drug treatment services, in18 cluding coverage of inpatient and outpatient treat19 ment without durational restriction; and’’.

20 (5) REQUIRING COVERAGE OF INPATIENT AND

21 OUTPATIENT MENTAL HEALTH AND PSYCHIATRIC

22 SERVICES.—Section 1905(a)(5) of such Act (42

23 U.S.C. 1396d(a)(5)) is amended—

24 (A) by striking ‘‘and’’ before ‘‘(B)’’; and
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1 (B) by inserting before the semicolon at

2 the end the following: ‘‘, and (C) mental health

3 services and psychiatric services furnished by a

4 physician or other qualified mental health pro5 fessional, whether furnished on an inpatient or

6 outpatient basis’’.

7 (6) REQUIRING COVERAGE OF MENTAL HEALTH

8 SERVICES WITHOUT DURATIONAL RESTRICTION.—

9 Section 1902(a)(10) of such Act (42 U.S.C.

10 1396a(a)(10)) is amended—

11 (A) by striking ‘‘and’’ at the end of sub12 paragraph (F);

13 (B) by adding ‘‘and’’ at the end of sub14 paragraph (G); and

15 (C) by inserting after subparagraph (G)

16 the following new subparagraph:

17 ‘‘(H) that does not impose durational lim18 its with respect to medical assistance for mental

19 health services;’’.

20 (7) REQUIRING COVERAGE OF SOME CHIRO21 PRACTIC SERVICES.—Section 1902(a)(10)(A) of such

22 Act (42 U.S.C. 1396a(a)(10)(A)) is amended, in the

23 matter before clause (i), by inserting ‘‘and profes24 sional services of chiropractors (other than electrical
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1 stimulation and for up to 2 visits per month)’’ after

2 ‘‘(21) of section 1905(a)’’.

3 (8) REQUIRING COVERAGE OF ASSISTIVE TECH4 NOLOGY DEVICES AND SERVICES, DURABLE MEDICAL

5 EQUIPMENT, SEXUALLY-TRANSMITTED DISEASE

6 (STD) DIAGNOSIS AND TREATMENT, AND PRENATAL

7 AND POST-NATAL CARE.—Section 1905(a)(3) of such

8 Act (42 U.S.C. 1396d(a)(3)) is amended by insert9 ing before the semicolon at the end the following: ‘‘,

10 assistive technology devices and services, durable

11 medical equipment, diagnosis and treatment for sex12 ually-transmitted disease, and prenatal and post13 natal care’’.

14 (9) REQUIRING COVERAGE OF REPRODUCTIVE

15 HEALTH SERVICES.—Section 1905(a)(4)(C) of such

16 Act (42 U.S.C. 1396d(a)(4)(C)) is amended by in17 serting ‘‘, including reproductive health services such

18 as fertility drugs and contraceptives’’ after ‘‘such

19 services and supplies’’.

20 (c) FMAP.—

21 (1) FEDERAL ASSUMPTION OF INCREASED EX22 PENSES.—Section 1903 of such Act (42 U.S.C.

23 1396b) is amended by inserting after subsection (g)

24 the following new subsection:
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1 ‘‘(h) Notwithstanding subsection (a), with respect to

2 expenditures incurred under the plan which are attrib3 utable to additional populations, or services, covered as a

4 result of the implementation of the amendments made by

5 the Working American Families Access to Health Care

6 Act of 2001 (including administrative costs related to such

7 implementation), the percentages otherwise specified

8 under such subsection with respect to such expenditures

9 shall be increased to 100 percent. For purposes of apply10 ing the previous sentence, the fact that a population or

11 service was covered under this title under a waiver under

12 section 1115 shall not be taken into account and shall not

13 prevent such sentence applying to such population or serv14 ice.’’.

15 (2) SPECIAL RULES IN APPLYING TO TERRI16 TORIES.—(A) Section 1905(b)(2) of such Act (42

17 U.S.C. 1396d(b)(2)) is amended by striking ‘‘50

18 percent’’ and inserting ‘‘70 percent’’.

19 (B) Section 1108 of such Act (42 U.S.C. 1308)

20 is amended—

21 (i) in subsection (f), by striking ‘‘sub22 section (g)’’ and inserting ‘‘subsections (g) and

23 (h)’’; and

24 (ii) by adding at the end the following new

25 subsection:
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1 ‘‘(h) The limitations under subsection (f)—

2 ‘‘(1) shall not apply with respect to expendi3 tures described in section 1903(h); and

4 ‘‘(2) with respect to other expenditures made

5 for fiscal years beginning with fiscal year 2002 with

6 respect to a territory shall be 250 percent of the

7 amount otherwise permitted under such subsection

8 and subsection (g) with respect to such territory.’’.

9 (d) STATE-LIKE TREATMENT OF TERRITORIES.—

10 Section 1108 of such Act (42 U.S.C. 1308) is amended—

11 (1) in subsection (f), by striking ‘‘subsection

12 (g)’’ and inserting ‘‘subsections (g) and (h)’’; and

13 (2) by adding at the end the following new sub14 section:

15 ‘‘(h) EXEMPTION OF CERTAIN EXPENDITURES FROM

16 LIMITATION.—Amounts of expenditures attributable to

17 medical assistance provided under section

18 1902(a)(10)(A)(i)(VIII) (or otherwise required to carry

19 out the amendments made by the Working American

20 Families Access to Health Care Act of 2001) shall not

21 be taken into account in applying subsections (f) and

22 (g).’’.

23 (e) REQUIRED USE OF COMMUNITY-BASED ORGANI24 ZATIONS IN EXPENDITURES FOR OUTREACH AND

25 MEDIA.—Section 1903(i) of such Act (42 U.S.C.
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1 1396b(i)) is amended by inserting after paragraph (8) the

2 following new paragraph:

3 ‘‘(9) with respect to amounts expended for out4 reach and media education campaigns (including

5 amounts expended for assistance to those applying

6 for medical assistance), unless at least 25 percent of

7 such amounts are made available for such expendi8 tures through community-based organizations; or’’.

9 (f) FLOOR FOR MEDICAID HMO PAYMENT FOR ALL

10 SERVICES.—Section 1932(b) of such Act (42 U.S.C.

11 1396u–2(b)) is amended by adding at the end the fol12 lowing new paragraph:

13 ‘‘(9) PAYMENT FLOOR FOR ALL SERVICES.—A

14 medicaid managed care organization shall not reim15 burse a hospital or other health care provider or pro16 fessional for the provision of services under this sec17 tion at a rate that is less the fee-for-service rate pro18 vided by the State for payment for such a hospital,

19 provider, or professional for such services under this

20 title in the case of individuals who are not enrolled

21 with such an organization under this section.’’.

22 (g) TOLL-FREE NUMBER.—Section 1902 of such Act

23 (42 U.S.C. 1396a) is amended by inserting after sub24 section (j) the following new subsection:
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1 ‘‘(k) The Secretary shall establish a toll-free tele2 phone number at which individuals who are eligible for

3 medical assistance under this title may file complaints con4 cerning health care providers who do not accept medical

5 assistance under this title for services they provide or con6 cerning other problems they have with the program under

7 this title.’’.

8 (h) COLLECTION OF DATA BY RACE AND ETH9 NICITY.—The Secretary of Health and Human Services

10 shall provide for the collection of data on enrollment, re11 ceipt of services, and health outcomes under the medicaid

12 program under title XIX of the Social Security Act, bro13 ken down at least by the race and ethnicity of medicaid

14 recipients. The Director of the Office of Management and

15 Budget shall make such revisions in data collection stand16 ards as may be necessary to carry out this subsection.

17 (i) EFFECTIVE DATE.—The amendments made by

18 this section shall take effect on January 1, 2002.

Æ