I 

117TH CONGRESS 

1ST SESSION H. R. 3511 

To amend titles XIX and XXI of the Social Security Act to require a 

State child health plan to include coverage of screening blood lead tests, 

to codify such requirement under the Medicaid program, and for other 

purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 25, 2021 

Mr. KATKO (for himself, Mr. CICILLINE, Mr. FITZPATRICK, Ms. MOORE of 

Wisconsin, Mr. MORELLE, and Mr. GOTTHEIMER) 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 require a State child health plan to include coverage 

of screening blood lead tests, to codify such requirement 

under the Medicaid program, 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, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Preventing Lead Poi5 soning Act of 2021’’. 


pamtmann on DSKBC07HB2PROD with BILLS
2 

•HR 3511 IH

1 SEC. 2. REQUIRING A STATE CHILD HEALTH PLAN TO IN2 CLUDE COVERAGE OF SCREENING BLOOD 

3 LEAD TESTS; CODIFICATION OF REQUIRE4 MENT UNDER MEDICAID. 

5 (a) CHIP.— 

6 (1) IN GENERAL.—Section 2103 of the Social 

7 Security Act (42 U.S.C. 1397cc) is amended— 

8 (A) in subsection (a), in the matter pre9 ceding paragraph (1), by striking ‘‘paragraphs 

10 (5), (6), (7) and (8)’’ and inserting ‘‘para11 graphs (5) through (12)’’; and 

12 (B) in subsection (c), by adding at the end 

13 the following: 

14 ‘‘(12) COVERAGE OF SCREENING BLOOD LEAD

15 TESTS.— 

16 ‘‘(A) IN GENERAL.—The child health as17 sistance provided to a targeted low-income child 

18 shall include coverage of screening blood lead 

19 tests appropriate for age and risk factors and 

20 at the times and in the amounts specified in 

21 subparagraph (B). 

22 ‘‘(B) SPECIFIED TIMES AND AMOUNTS.— 

23 The times and amounts specified in this sub24 paragraph are, with respect to coverage of 

25 screening blood lead tests and a targeted low26 income child, the following: 


pamtmann on DSKBC07HB2PROD with BILLS
3 

•HR 3511 IH

1 ‘‘(i) 1 screening blood lead test at the 

2 age of 12 months; 

3 ‘‘(ii) 1 screening blood lead test at the 

4 age of 24 months; 

5 ‘‘(iii) in the case of a targeted low-in6 come child with no record of any screening 

7 blood lead test having been performed and 

8 who is between the ages of 24 months and 

9 72 months, 1 screening blood lead test; 

10 and 

11 ‘‘(iv) in the case of any targeted low12 income child, 1 or more screening blood 

13 lead tests at other such times as are rec14 ommended by the child’s health care pro15 vider.’’. 

16 (2) REPORTING REQUIREMENTS.— 

17 (A) IN GENERAL.—Section 2108 of such 

18 Act (42 U.S.C. 1397hh) is amended— 

19 (i) by redesignating the subsection (e) 

20 added by section 501(e)(2) of the Chil21 dren’s Health Insurance Program Reau22 thorization Act of 2009 (Public Law 111– 

23 3, 123 Stat. 87) as subsection (f); and 

24 (ii) by adding at the end of the sub25 section (e) added by section 402(a) of such 


pamtmann on DSKBC07HB2PROD with BILLS
4 

•HR 3511 IH

1 Act (Public Law 111–3, 123 Stat. 82), the 

2 following: 

3 ‘‘(8)(A) The number of children provided a 

4 screening blood lead test appropriate for age and 

5 risk factors in accordance with paragraph (12) of 

6 section 2103(c), at the times and in the amounts 

7 specified in subparagraph (B) of such paragraph. 

8 ‘‘(B) The number of screening blood lead tests 

9 conducted in the State in the fiscal year for all chil10 dren eligible for child health assistance up to 72 

11 months of age, without regard to the payor or source 

12 of funding for such screening blood lead tests.’’. 

13 (B) TECHNICAL AMENDMENT.—Section 

14 4302(b)(1)(B) of Public Law 111–148 is 

15 amended by inserting ‘‘, as added by section 

16 402(a) of Public Law 111–3,’’ after ‘‘(42 

17 U.S.C. 1397hh(e))’’. 

18 (3) EFFECTIVE DATE.— 

19 (A) IN GENERAL.—Subject to subpara20 graphs (B) and (C), the amendments made by 

21 this subsection shall take effect with respect to 

22 child health assistance provided on or after the 

23 date that is 1 year after the date of the enact24 ment of this Act. 


pamtmann on DSKBC07HB2PROD with BILLS
5 

•HR 3511 IH

1 (B) EXCEPTION FOR STATE LEGISLA2 TION.—In the case of a State child health plan 

3 under title XXI of the Social Security Act (or 

4 a waiver of such plan), which the Secretary of 

5 Health and Human Services determines re6 quires State legislation in order for the respec7 tive plan (or waiver) to meet any requirement 

8 imposed by the amendments made by this sub9 section, the respective plan (or waiver) shall not 

10 be regarded as failing to comply with the re11 quirements of such title solely on the basis of 

12 its failure to meet such an additional require13 ment before the 1st day of the 1st calendar 

14 quarter beginning after the close of the 1st reg15 ular session of the State legislature that begins 

16 after the date of enactment of this section. For 

17 purposes of the previous sentence, in the case 

18 of a State that has a 2-year legislative session, 

19 each year of the session shall be considered to 

20 be a separate regular session of the State legis21 lature. 

22 (C) TECHNICAL AMENDMENT.—The 

23 amendment made by paragraph (2)(B) shall 

24 take effect as if included in the enactment of 

25 Public Law 111–148. 


pamtmann on DSKBC07HB2PROD with BILLS
6 

•HR 3511 IH

1 (b) MEDICAID.— 

2 (1) SPECIFIED TIMES FOR SCREENING BLOOD

3 LEAD TESTS.—Section 1905(r) of the Social Secu4 rity Act (42 U.S.C. 1396d(r)) is amended— 

5 (A) in paragraph (1)(B)(iv), by inserting 

6 ‘‘and at the times and in the amounts specified 

7 in paragraph (6)’’ after ‘‘factors’’; and 

8 (B) by inserting after paragraph (5) the 

9 following: 

10 ‘‘(6) The times and amounts specified in this 

11 paragraph are, with respect to coverage of screening 

12 blood lead tests and an individual, the following: 

13 ‘‘(A) 1 screening blood lead test at the age 

14 of 12 months; 

15 ‘‘(B) 1 screening blood lead test at the age 

16 of 24 months; 

17 ‘‘(C) in the case of an individual with no 

18 record of any screening blood lead test having 

19 been performed and who is between the ages of 

20 24 months and 72 months, 1 screening blood 

21 lead test; and 

22 ‘‘(D) in the case of any individual who is 

23 eligible under the plan and is under the age of 

24 21, 1 or more screening blood lead tests at 


pamtmann on DSKBC07HB2PROD with BILLS
7 

•HR 3511 IH

1 other such times as are recommended by the in2 dividual’s health care provider.’’. 

3 (2) REPORTING REQUIREMENTS.—Section 

4 1902(a)(43)(D) of such Act (42 U.S.C. 

5 1396a(a)(43)(D)) is amended— 

6 (A) in clause (iii), by striking ‘‘section 

7 2108(e) and’’ and inserting ‘‘section 2108(e),’’; 

8 (B) in clause (iv), by striking the semi9 colon and inserting ‘‘, and’’; and 

10 (C) by inserting after clause (iv) the fol11 lowing: 

12 ‘‘(v)(I) the number of children pro13 vided a screening blood lead test appro14 priate for age and risk factors in accord15 ance with paragraph (1)(B)(iv) of section 

16 1905(r), at the times and in the amounts 

17 specified in paragraph (6) of such section, 

18 and 

19 ‘‘(II) the number of screening blood 

20 lead tests conducted in the State in the fis21 cal year for all children eligible for medical 

22 assistance up to 72 months of age, without 

23 regard to the payor or source of funding 

24 for such screening blood lead tests;’’. 


pamtmann on DSKBC07HB2PROD with BILLS
8 

•HR 3511 IH

1 (c) CLARIFICATION.—None of the amendments made 

2 by this section shall be construed as prohibiting a State 

3 from providing coverage of screening blood lead tests 

4 under title XIX or XXI of the Social Security Act at a 

5 frequency that is greater than the frequency described in 

6 such amendments or to an individual outside of the ages 

7 described in such amendments. 

8 SEC. 3. GRANTS FOR LEAD POISONING RELATED ACTIVI9 TIES. 

10 Section 317O of the Public Health Service Act (42 

11 U.S.C. 247b–16) is amended— 

12 (1) by redesignating subsections (c) and (d) as 

13 subsections (e) and (f), respectively; 

14 (2) by inserting after subsection (b) the fol15 lowing: 

16 ‘‘(c) GRANTS FOR PURPOSES OF STATE COORDINA17 TION.—For purposes of supporting State coordination of 

18 operations and activities as described in subsection (b), 

19 the Secretary, acting through the Director of the Centers 

20 for Disease Control and Prevention, shall award additional 

21 grants to States receiving amounts under subsection (a) 

22 to support the following activities in such States: 

23 ‘‘(1) Development or maintenance of a State24 based registry of data related to blood lead testing 

25 of children up to 6 years of age, which includes data 


pamtmann on DSKBC07HB2PROD with BILLS
9 

•HR 3511 IH

1 on the number of children up to 72 months of age 

2 tested for lead, the prevalence of confirmed elevated 

3 blood lead levels in tested children less than 6 years 

4 of age, and the insurance status of children tested 

5 for lead at less than 6 years of age. 

6 ‘‘(2) Development or maintenance of data-link7 ing capabilities between the State health department 

8 and State Medicaid office with respect to blood lead 

9 testing for children up to 72 months of age. 

10 ‘‘(3) Regular reporting, as defined by the Sec11 retary, of blood lead testing data for children up to 

12 72 months of age regardless of the payor or source 

13 of funding for such blood lead testing. 

14 ‘‘(d) BEST PRACTICES.—The Secretary, acting 

15 through the Director of the Centers for Disease Control 

16 and Prevention, shall publish best practices for data collec17 tion standards related to childhood blood lead testing, with 

18 the aim of improving data standardization across relevant 

19 State agencies.’’; and 

20 (3) in subsection (f), as so redesignated, by 

21 striking ‘‘such sums as may be necessary for each of 

22 the fiscal years 2001 through 2005’’ and inserting 

23 ‘‘$5,000,000 for each of fiscal years 2022 and 

24 2023’’. 

Æ 


pamtmann on DSKBC07HB2PROD with BILLS