I 
115TH CONGRESS 
1ST SESSION 
H. R. 164 
To provide for an evidence-based strategy for voluntary screening for HIV/ 
AIDS and other common sexually transmitted infections, and for other 
purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 3, 2017 
Mr. HASTINGS introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committees on 
Education and the Workforce, Ways and Means, and Oversight and Gov-
ernment Reform, for a period to be subsequently determined by the 
Speaker, in each case for consideration of such provisions as fall within 
the jurisdiction of the committee concerned 
A BILL 
To provide for an evidence-based strategy for voluntary 
screening for HIV/AIDS and other common sexually 
transmitted infections, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Increasing Access to Voluntary Screening for HIV/AIDS 
and STIs Act of 2017’’. 
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(b) TABLE OF CONTENTS.—The table of contents for 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. Findings. 
Sec. 3. Purpose. 
Sec. 4. Definitions. 
TITLE I—COVERAGE OF HIV/AIDS AND STI SCREENING UNDER 
PUBLIC 
HEALTH 
CARE 
PROGRAMS 
AND 
GROUP 
HEALTH 
PLANS; COVERAGE OF CARE UNDER MEDICAID. 
Sec. 101. Coverage of routine HIV/AIDS and STI screening tests under Med-
icaid. 
Sec. 102. Coverage of HIV/AIDS and STI screening tests under Medicare. 
Sec. 103. Coverage for routine HIV/AIDS and STI screening under group 
health plans. 
Sec. 104. Optional Medicaid coverage of low-income HIV/AIDS infected individ-
uals. 
TITLE II—INCREASED DATA COLLECTION AND EDUCATION FOR 
HISTORICALLY UNDERREPRESENTED POPULATIONS 
Sec. 201. People living with disabilities. 
Sec. 202. Women who have sex with women. 
Sec. 203. Transgender community. 
Sec. 204. Report. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) The CDC estimates 20,000,000 new sexu-
ally transmitted infections (STIs) occur each year in 
the United States, and 50 percent of sexually active 
Americans will contract a STI at some point in their 
lives, the majority of which may be asymptomatic for 
an extended amount of time. 
(2) Over 1,200,000 people in the United States 
are living with HIV, and someone is infected with 
HIV in the United States every 9.5 minutes. 
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(3) HIV/AIDS and STIs are syndemics. HIV 
infection can increase a person’s risk for acquiring 
certain STIs, as well as affect their frequency, sever-
ity, and healing time, while STIs increase the risk 
of HIV transmission, impaired fertility, reproductive 
tract cancer, and adverse pregnancy outcomes. 
(4) Many common long-term and initially 
asymptomatic STIs such as chlamydia, gonorrhea, 
herpes, syphilis, inflammatory pelvic disease, viral 
hepatitis, and HIV/AIDS remain undiagnosed, or di-
agnosed at later stages, leading to increased rates of 
mortality, morbidity, disability, and transmission. 
(5) In fact, the CDC estimates over 3.6 million 
Americans are living with chronic hepatitis and most 
do not know they are infected. Chronic hepatitis B 
can remain asymptomatic for years and, left 
undiagnosed and untreated, can lead to serious com-
plications. Additionally, individuals infected with 
hepatitis C virus (HCV) are at risk for chronic liver 
disease or other HCV-related chronic diseases dec-
ades after infection. 
(6) Stigma, culture, language, lack of edu-
cation, lack of insurance, limited time, cost and re-
sources in medical settings, and an inaccurate per-
ception of risk among communities and providers all 
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contribute to insufficient rates of screening for HIV/ 
AIDS and STIs. 
(7) The Centers for Disease Control and Pre-
vention and the United States Preventive Services 
Task Force recognize screening as an effective pub-
lic health tool that allows providers to administer 
treatment before symptoms develop and implement 
interventions that will reduce the likelihood of HIV/ 
AIDS and STI transmission and reduce the develop-
ment of adverse outcomes. 
(8) The CDC recommends that voluntary 
screening for HIV/AIDS be integrated into routine 
clinical care while preserving patient confidentiality 
and the right of the patient to decline testing and 
screening. 
(9) The CDC also recommends that all 
unvaccinated, uninfected persons being evaluated for 
a STI should receive hepatitis B vaccination. Fur-
thermore, anti-HCV testing is recommended for rou-
tine screening of asymptomatic persons based on 
their risk for infection or based on a recognized ex-
posure. 
(10) Inaccurate perceptions of risk among 
health care providers and patients, misdiagnosis, 
ageism, generational mind-sets, and biological fac-
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tors have contributed to increased rates in trans-
mission and late detection of HIV/AIDS and STIs 
over the past decade. 
(11) Health equity and disparities remain a sig-
nificant public health challenge, with the burden of 
HIV/AIDS and STIs falling disproportionately on 
different populations. 
(12) Although African-Americans account for 
about 13 percent of the United States population, 
they account for nearly half of all HIV/AIDS cases 
and infections and have higher instances of mor-
tality and morbidity for most STIs and HIV/AIDS. 
Also, African-American women who have sex with 
men account for the majority of HIV/AIDS infec-
tions among all women in the United States. 
(13) HIV/AIDS continues to be most prevalent 
among men who have sex with men (MSM). Contin-
ued support and increased funding for community- 
based programs and behavioral interventions that 
are culturally competent are key to reaching MSM, 
especially young MSM of color. 
(14) Transgender persons are particularly vul-
nerable to contracting HIV/AIDS and STIs due to 
high rates of survival sex among trans-females, dis-
crimination in education, employment, and housing, 
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and the absence of education and prevention meth-
ods culturally relevant to the transgender commu-
nity. 
(15) Health care providers must be properly 
educated to treat groups, such as MSM, transgender 
persons, African-Americans, and Latinos who are 
disproportionately affected by HIV/AIDS and other 
STIs, and also improve interventions for groups that 
have been historically underrepresented in health 
interventions for STIs, such as women who have sex 
with women, individuals over the age of 50, Asian 
and Pacific Islander Americans, Native Americans, 
and persons living with disabilities. 
(16) Women living with mobility impairments 
often lack access to screening for STIs and other 
women’s health services such as pelvic examinations 
and mammograms due to, among other factors, the 
lack of provider awareness, experience, and access to 
equipment. 
(17) All individuals engaging in oral, anal, or 
genital sexual contact must have access to voluntary 
screening for HIV/AIDS and other STIs. Screening 
must be confidential, rapid, accurate, and medically 
appropriate. Screening must be offered regardless of 
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age, race, class, sexual behavior, sexual orientation, 
gender identity, or disability. 
(18) The Congress supports the goals of the 
National HIV/AIDS Strategy and, in particular, the 
goal of 90 percent of individuals knowing their HIV/ 
AIDS status. 
SEC. 3. PURPOSE. 
The purposes of this Act are as follows: 
(1) Increase access, quality, and affordability 
for voluntary and medically appropriate screening 
for HIV/AIDS and other STIs, including chlamydia, 
gonorrhea, syphilis, viral hepatitis, and human 
papillomavirus, for all persons engaging in various 
forms of sexual activity, including oral, genital, or 
anal sex. 
(2) Reduce the spread, morbidity, and mortality 
of HIV/AIDS and other STIs. 
(3) Reduce the disproportionate incidence of 
HIV/AIDS and other STIs in certain groups 
through early detection and treatment and com-
prehensive education for health care providers, cen-
ters, and communities. 
(4) Support the execution of other scientifically 
based interventions that are culturally competent 
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and age appropriate and are proven to reduce the in-
cidence of HIV/AIDS and other STIs. 
SEC. 4. DEFINITIONS. 
In this Act: 
(1) CDC.—The term ‘‘CDC’’ means the Cen-
ters for Disease Control and Prevention. 
(2) CMS.—The term ‘‘CMS’’ means the Cen-
ters for Medicare & Medicaid Services. 
(3) DIRECTOR.—The term ‘‘Director’’ means 
the Director of the Centers for Disease Control and 
Prevention. 
(4) HIV/AIDS.—The term ‘‘HIV/AIDS’’ means 
infection with the human immunodeficiency virus 
and includes acquired immune deficiency syndrome 
and any condition arising from such syndrome. 
(5) MSM.—The term ‘‘MSM’’ means men who 
have sex with men. 
(6) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
(7) STATE.—The term ‘‘State’’ means each of 
the 50 States, the District of Columbia, the United 
States Virgin Islands, Guam, the Commonwealth of 
Puerto Rico, the Commonwealth of the Northern 
Mariana Islands, and American Samoa. 
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(8) STI.—The term ‘‘STI’’ means a sexually 
transmitted infection that is recognized by the CDC, 
including chlamydia, gonorrhea, syphilis, viral hepa-
titis, and human papillomavirus. 
(9) WSW.—The term ‘‘WSW’’ means women 
who have sex with women. 
TITLE 
I—COVERAGE 
OF 
HIV/ 
AIDS 
AND 
STI 
SCREENING 
UNDER 
PUBLIC 
HEALTH 
CARE PROGRAMS AND GROUP 
HEALTH PLANS; COVERAGE 
OF CARE UNDER MEDICAID. 
SEC. 101. COVERAGE OF ROUTINE HIV/AIDS AND STI 
SCREENING TESTS UNDER MEDICAID. 
(a) INCLUSION IN STATE PLAN.—Section 1902(a) of 
the Social Security Act (42 U.S.C. 1396a(a)) is amended 
in paragraph (10)(A), in the matter before clause (i), by 
striking ‘‘and (28)’’ and inserting ‘‘(28), and (29)’’. 
(b) INCLUSION IN MEDICAL ASSISTANCE.— 
(1) IN GENERAL.—Section 1905(a) of the So-
cial Security Act (42 U.S.C. 1396d(a)) is amend-
ed— 
(A) in paragraph (28), by striking ‘‘and’’ 
at the end; 
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(B) by redesignating paragraph (29) as 
paragraph (30); and 
(C) by inserting after paragraph (28) the 
following: 
‘‘(29) routine HIV/AIDS and STI screening 
services (as defined in subsection (ee)).’’. 
(2) DEFINITION OF SERVICES.—Section 1905 
of such Act is amended by adding at the end the fol-
lowing: 
‘‘(ee)(1) For purposes of this section, the term ‘rou-
tine HIV/AIDS and STI screening services’ means all of 
the following: 
‘‘(A) A screening test for HIV/AIDS or any 
other STI, if such test is provided to an individual 
who— 
‘‘(i) is eligible for medical assistance under 
the State plan; and 
‘‘(ii) is described in clauses (ii) through (v) 
of section 1861(jjj)(1)(A). 
‘‘(B) Each of the services described in subpara-
graphs (B) through (F) of section 1861(jjj)(1). 
‘‘(2) DEFINITIONS.—For purposes of this subsection, 
the terms ‘HIV/AIDS’ and ‘STI’ have the same meaning 
given such terms in section 1861(jjj)(2).’’. 
(c) NO COST SHARING FOR HIV/AIDS TESTING.— 
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(1) IN GENERAL.—Section 1916(a)(2) of the 
Social Security Act (42 U.S.C. 1396o(a)(2)) is 
amended— 
(A) in subparagraph (D), by striking ‘‘or’’ 
at the end; 
(B) in subparagraph (E), by striking ‘‘; 
and’’ at the end and inserting ‘‘, or’’; and 
(C) by adding at the end the following: 
‘‘(F) routine HIV/AIDS and STI screening 
services (as such term is defined in section 
1905(ee)); and’’. 
(2) LIMITATION ON STATE OPTION FOR ALTER-
NATIVE COST SHARING.—Section 1916A(b)(3)(B) of 
the Social Security Act (42 U.S.C. 1396o– 
1(b)(3)(B)) is amended by adding at the end the fol-
lowing: 
‘‘(xi) Routine HIV/AIDS and STI 
screening services (as such term is defined 
in section 1905(ee)).’’. 
(d) EFFECTIVE DATE.— 
(1) IN GENERAL.—Except as provided by para-
graph (2), the amendments made by this section 
shall take effect on the date of the enactment of this 
section and shall apply to services furnished on or 
after such date. 
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(2) RULES
FOR
CHANGES
REQUIRING
STATE 
LEGISLATION.—In the case of a State plan for med-
ical assistance under title XIX of the Social Security 
Act which the Secretary of Health and Human Serv-
ices determines requires State legislation (other than 
legislation appropriating funds) in order for the plan 
to meet the additional requirement imposed by the 
amendments made by this section, the State plan 
shall not be regarded as failing to comply with the 
requirements of such title solely on the basis of its 
failure to meet this additional requirement before 
the first day of the first calendar quarter beginning 
after the close of the first regular session of the 
State legislature that begins after the date of the en-
actment of this Act. For purposes of the previous 
sentence, in the case of a State that has a 2-year 
legislative session, each year of such session shall be 
deemed to be a separate regular session of the State 
legislature. 
SEC. 102. COVERAGE OF HIV/AIDS AND STI SCREENING 
TESTS UNDER MEDICARE. 
Section 1861 of the Social Security Act is amended— 
(1) in subsection (s)— 
(A) by striking ‘‘and’’ at the end of para-
graph (14); 
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(B) by striking the period at the end of 
paragraph (15) and inserting ‘‘; and’’; 
(C) by redesignating paragraphs (16) and 
(17) as paragraphs (17) and (18), respectively; 
and 
(D) by inserting after paragraph (15) the 
following: 
‘‘(16) routine HIV/AIDS and STI screening 
services (as such term is defined in subsection 
(jjj)).’’; and 
(2) by adding at the end the following: 
‘‘(jjj) ROUTINE HIV/AIDS AND STI SCREENING 
SERVICES.—(1) For purposes of this section, the term 
‘routine HIV/AIDS and STI screening services’ means all 
of the following: 
‘‘(A) A screening test for HIV/AIDS or any 
other STI, if such test is provided in any health care 
setting (other than an inpatient hospital setting) and 
is provided to an individual who— 
‘‘(i) is enrolled in part B; 
‘‘(ii) is at least 13 years of age; 
‘‘(iii) with respect to a test for HIV/AIDS, 
is not known to the health care provider (di-
rectly, through information provided by the in-
dividual, or through access to an electronic 
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medical record) to have had a previous positive 
test for HIV/AIDS; 
‘‘(iv) subject to subparagraph (B), with re-
spect to a test for HIV/AIDS or a STI, is not 
known to the health care provider (directly, 
through information provided by the individual, 
or through access to an electronic medical 
record) to have had a test for the same condi-
tion within the previous 6 months; and 
‘‘(v) has been informed that such a test 
will be administered and has not objected to 
such a test. 
‘‘(B) If a test described under subparagraph 
(A) is reactive and is for— 
‘‘(i) HIV/AIDS, a confirmatory test; or 
‘‘(ii) a STI other than HIV/AIDS, if rea-
sonable and necessary, a confirmatory test. 
‘‘(C) The interpretation of any tests provided 
under subparagraph (A) and subparagraph (B). 
‘‘(D) Informing an individual who receives a 
test under subparagraph (A) or subparagraph (B) of 
the results of such tests as close in time as possible 
to the determination of such results. 
‘‘(E) If an individual tests positive for HIV/ 
AIDS on a screening test under subparagraph (A) 
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and any confirmatory test under subparagraph 
(B)— 
‘‘(i) post-test counseling concerning HIV/ 
AIDS and STIs at the time the individual is in-
formed of the results of the test; and 
‘‘(ii) if appropriate, a referral to medical or 
mental health services. 
‘‘(F) If an individual tests positive for a STI on 
a screening test under subparagraph (A) and any 
confirmatory test under subparagraph (B), the pro-
vision of information to such individual on the risk 
of STIs and HIV/AIDS and behaviors that reduce 
the risk of exposure to such conditions. 
‘‘(2) DEFINITIONS.—For purposes of this subsection: 
‘‘(A) 
HIV/AIDS.—The 
term 
‘HIV/AIDS’ 
means infection with the human immunodeficiency 
virus and includes acquired immune deficiency syn-
drome and any condition arising from such syn-
drome. 
‘‘(B) STI.—The term ‘STI’ means a sexually 
transmitted infection or sexually transmitted disease 
that is recognized by the Centers for Disease Con-
trol and Prevention, including chlamydia, gonorrhea, 
syphilis, hepatitis B, hepatitis C, and human 
papillomavirus.’’. 
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SEC. 103. COVERAGE FOR ROUTINE HIV/AIDS AND STI 
SCREENING UNDER GROUP HEALTH PLANS. 
(a) GROUP HEALTH PLANS.— 
(1) PUBLIC
HEALTH
SERVICE
ACT
AMEND-
MENT.—Title XXVII of the Public Health Service 
Act is amended by inserting after section 2728 of 
such Act (42 U.S.C. 300gg–28), as redesignated by 
section 1001(2) of the Patient Protection and Af-
fordable Care Act (Public Law 111–148), the fol-
lowing: 
‘‘SEC. 2729. COVERAGE FOR ROUTINE HIV/AIDS AND STI 
SCREENING. 
‘‘(a) COVERAGE.—A group health plan, and a health 
insurance issuer providing group or individual health in-
surance coverage, shall provide coverage for routine HIV/ 
AIDS and STI screening under terms and conditions that 
are no less favorable than the terms and conditions appli-
cable to other routine health screenings. 
‘‘(b) PROHIBITIONS.—A group health plan, and a 
health insurance issuer providing group or individual 
health insurance coverage, shall not— 
‘‘(1) deny to an individual eligibility, or contin-
ued eligibility, to enroll or to renew coverage under 
the terms of the plan, solely for the purpose of 
avoiding the requirements of this section; 
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‘‘(2) deny coverage for routine HIV/AIDS or 
STI screening on the basis that there are no known 
risk factors present, or the screening is not clinically 
indicated, medically necessary, or pursuant to a re-
ferral, consent, or recommendation by any health 
care provider; 
‘‘(3) provide monetary payments, rebates, or 
other benefits to individuals to encourage such indi-
viduals to accept less than the minimum protections 
available under this section; 
‘‘(4) penalize or otherwise reduce or limit the 
reimbursement of a provider because such provider 
provided care to an individual participant or bene-
ficiary in accordance with this section; 
‘‘(5) provide incentives (monetary or otherwise) 
to a provider to induce such provider to provide care 
to an individual participant or beneficiary in a man-
ner inconsistent with this section; or 
‘‘(6) deny to an individual participant or bene-
ficiary continued eligibility to enroll or to renew cov-
erage under the terms of the plan, solely because of 
the results of an HIV/AIDS or STI test, or other 
HIV/AIDS and STI screening procedure, for the in-
dividual or any other individual. 
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‘‘(c) RULES OF CONSTRUCTION.—Nothing in this 
section shall be construed— 
‘‘(1) to require an individual who is a partici-
pant or beneficiary to undergo HIV/AIDS or STI 
screening; or 
‘‘(2) as preventing a group health plan or issuer 
from imposing deductibles, coinsurance, or other 
cost-sharing in relation to HIV/AIDS or STI screen-
ing, except that such deductibles, coinsurance or 
other cost-sharing may not be greater than the 
deductibles, coinsurance, or other cost-sharing im-
posed on other routine health screenings. 
‘‘(d) NOTICE.—A group health plan under this part 
shall comply with the notice requirement under section 
716(d) of the Employee Retirement Income Security Act 
of 1974 with respect to the requirements of this section 
as if such section applied to such plan. 
‘‘(e) PREEMPTION.—Nothing in this section shall be 
construed to preempt any State law in effect on the date 
of enactment of this section with respect to health insur-
ance coverage that requires coverage of at least the cov-
erage of HIV/AIDS or STI screening otherwise required 
under this section.’’. 
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(2) ERISA AMENDMENTS.—The Employee Re-
tirement Income Security Act of 1974 is amended as 
follows: 
(A) In subpart B of part 7 of subtitle B 
of title I, by adding at the end the following 
new section: 
‘‘SEC. 716. COVERAGE FOR ROUTINE HIV/AIDS AND STI 
SCREENING. 
‘‘(a) COVERAGE.—A group health plan, and a health 
insurance issuer offering group health insurance coverage, 
shall provide coverage for routine HIV screening under 
terms and conditions that are no less favorable than the 
terms and conditions applicable to other routine health 
screenings. 
‘‘(b) PROHIBITIONS.—A group health plan, and a 
health insurance issuer offering group health insurance 
coverage, shall not— 
‘‘(1) deny to an individual eligibility, or contin-
ued eligibility, to enroll or to renew coverage under 
the terms of the plan, solely for the purpose of 
avoiding the requirements of this section; 
‘‘(2) deny coverage for routine HIV screening 
on the basis that there are no known risk factors 
present, or the screening is not clinically indicated, 
medically necessary, or pursuant to a referral, con-
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sent, or recommendation by any health care pro-
vider; 
‘‘(3) provide monetary payments, rebates, or 
other benefits to individuals to encourage such indi-
viduals to accept less than the minimum protections 
available under this section; 
‘‘(4) penalize or otherwise reduce or limit the 
reimbursement of a provider because such provider 
provided care to an individual participant or bene-
ficiary in accordance with this section; 
‘‘(5) provide incentives (monetary or otherwise) 
to a provider to induce such provider to provide care 
to an individual participant or beneficiary in a man-
ner inconsistent with this section; or 
‘‘(6) deny to an individual participant or bene-
ficiary continued eligibility to enroll or to renew cov-
erage under the terms of the plan, solely because of 
the results of an HIV test or other HIV screening 
procedure for the individual or any other individual. 
‘‘(c) RULES OF CONSTRUCTION.—Nothing in this 
section shall be construed— 
‘‘(1) to require an individual who is a partici-
pant or beneficiary to undergo HIV/AIDS or STI 
screening; or 
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‘‘(2) as preventing a group health plan or issuer 
from imposing deductibles, coinsurance, or other 
cost-sharing in relation to HIV/AIDS or STI screen-
ing, except that such deductibles, coinsurance or 
other cost-sharing may not be greater than the 
deductibles, coinsurance, or other cost-sharing im-
posed on other routine health screenings. 
‘‘(d) NOTICE UNDER GROUP HEALTH PLAN.—A 
group health plan, and a health insurance issuer providing 
health insurance coverage in connection with a group 
health plan, shall provide notice to each participant and 
beneficiary under such plan regarding the coverage re-
quired by this section in accordance with regulations pro-
mulgated by the Secretary. Such notice shall be in writing 
and prominently positioned in any literature or cor-
respondence made available or distributed by the plan or 
issuer and shall be transmitted, by whichever is earliest 
of the following: 
‘‘(1) In the next mailing made by the plan or 
issuer to the participant or beneficiary. 
‘‘(2) As part of any yearly informational packet 
sent to the participant or beneficiary. 
‘‘(3) Not later than July 1, 2017. 
‘‘(e) PREEMPTION; RELATION TO STATE LAWS.— 
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‘‘(1) IN
GENERAL.—Nothing in this section 
shall be construed to preempt any State law in effect 
on the date of enactment of this section with respect 
to health insurance coverage that requires coverage 
of at least the coverage of HIV/AIDS or STI screen-
ing otherwise required under this section. 
‘‘(2) ERISA.—Nothing in this section shall be 
construed to affect or modify the provisions of sec-
tion 514 with respect to group health plans.’’. 
(B) In section 732(a) of the Employee Re-
tirement Income Security Act of 1974 (29 
U.S.C. 1191a(a)), by striking ‘‘section 711’’ 
and inserting ‘‘sections 711 and 716’’. 
(C) In the table of contents in section 1 of 
such Act, by inserting after the item relating to 
section 714 the following new item: 
‘‘Sec. 715. Additional market reforms. 
‘‘Sec. 716. Coverage for routine HIV/AIDS and STI screening.’’. 
(3) 
INTERNAL
REVENUE
CODE
AMEND-
MENTS.— 
(A) IN GENERAL.—The Internal Revenue 
Code of 1986 is amended by inserting after sec-
tion 9815 the following new section: 
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‘‘SEC. 9816. COVERAGE FOR ROUTINE HIV/AIDS AND STI 
SCREENING. 
‘‘(a) COVERAGE.—A group health plan shall provide 
coverage for routine HIV/AIDS and STI screening under 
terms and conditions that are no less favorable than the 
terms and conditions applicable to other routine health 
screenings. 
‘‘(b) PROHIBITIONS.—A group health plan shall 
not— 
‘‘(1) deny to an individual eligibility, or contin-
ued eligibility, to enroll or to renew coverage under 
the terms of the plan, solely for the purpose of 
avoiding the requirements of this section; 
‘‘(2) deny coverage for routine HIV/AIDS or 
STI screening on the basis that there are no known 
risk factors present, or the screening is not clinically 
indicated, medically necessary, or pursuant to a re-
ferral, consent, or recommendation by any health 
care provider; 
‘‘(3) provide monetary payments, rebates, or 
other benefits to individuals to encourage such indi-
viduals to accept less than the minimum protections 
available under this section; 
‘‘(4) penalize or otherwise reduce or limit the 
reimbursement of a provider because such provider 
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provided care to an individual participant or bene-
ficiary in accordance with this section; 
‘‘(5) provide incentives (monetary or otherwise) 
to a provider to induce such provider to provide care 
to an individual participant or beneficiary in a man-
ner inconsistent with this section; or 
‘‘(6) deny to an individual participant or bene-
ficiary continued eligibility to enroll or to renew cov-
erage under the terms of the plan, solely because of 
the results of an HIV/AIDS or STI test, or other 
HIV/AIDS and STI screening procedure, for the in-
dividual or any other individual. 
‘‘(c) RULES OF CONSTRUCTION.—Nothing in this 
section shall be construed— 
‘‘(1) to require an individual who is a partici-
pant or beneficiary to undergo HIV/AIDS or STI 
screening; or 
‘‘(2) as preventing a group health plan or issuer 
from imposing deductibles, coinsurance, or other 
cost-sharing in relation to HIV/AIDS or STI screen-
ing, except that such deductibles, coinsurance or 
other cost-sharing may not be greater than the 
deductibles, coinsurance, or other cost-sharing im-
posed on other routine health screenings.’’. 
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(B) CONFORMING
AMENDMENT.—Section 
4980D(d)(1) of such Code is amended by strik-
ing ‘‘section 9811’’ and inserting ‘‘sections 
9811 and 9816’’. 
(C) CLERICAL AMENDMENT.—The table of 
contents for subchapter B of chapter 1 of such 
Code is amended by inserting after the item re-
lating to section 9815 the following new item: 
‘‘Sec. 9816. Coverage for routine HIV/AIDS and STI screening.’’. 
(b) APPLICATION UNDER FEDERAL EMPLOYEES 
HEALTH BENEFITS PROGRAM.—Section 8902 of title 5, 
United States Code, is amended by adding at the end the 
following new subsection: 
‘‘(p) A contract may not be made or a plan approved 
which does not comply with the requirements of section 
2729 of the Public Health Service Act.’’. 
(c) EFFECTIVE DATES.—Notwithstanding any other 
provision of law, the amendments made by subsections (a) 
and (b) shall apply with respect to plan years beginning 
on or after July 1, 2017, and with respect to health insur-
ance coverage issued on or after such date. 
(d) COORDINATION OF ADMINISTRATION.—The Sec-
retary of Labor, the Secretary of Health and Human Serv-
ices, and the Secretary of the Treasury shall ensure, 
through the execution of an interagency memorandum of 
understanding among such Secretaries, that— 
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(1) regulations, rulings, and interpretations 
issued by such Secretaries relating to the same mat-
ter over which two or more such Secretaries have re-
sponsibility under the provisions of this section (and 
the amendments made thereby) are administered so 
as to have the same effect at all times; and 
(2) coordination of policies relating to enforcing 
the same requirements through such Secretaries in 
order to have a coordinated enforcement strategy 
that avoids duplication of enforcement efforts and 
assigns priorities in enforcement. 
SEC. 104. OPTIONAL MEDICAID COVERAGE OF LOW-INCOME 
HIV/AIDS INFECTED INDIVIDUALS. 
(a) IN GENERAL.—Section 1902 of the Social Secu-
rity Act (42 U.S.C. 1396a) is amended— 
(1) in subsection (a)(10)(A)(ii)— 
(A) by striking ‘‘or’’ at the end of sub-
clause (XXI); 
(B) by adding ‘‘or’’ at the end of subclause 
(XXII); and 
(C) by adding at the end the following: 
‘‘(XXIII) on or before December 
31, 2017, who are described in sub-
section (ll) (relating to HIV/AIDS in-
fected individuals);’’; and 
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(2) by adding at the end the following: 
‘‘(ll) individuals described in this subsection are indi-
viduals— 
‘‘(1) who are not described in subsection 
(a)(10)(A)(i); 
‘‘(2) who have HIV/AIDS, as defined under 
section 1905(ee); 
‘‘(3) whose income (as determined under the 
State plan under this title with respect to disabled 
individuals) does not exceed the maximum amount 
of income a disabled individual described in sub-
section (a)(10)(A)(i) may have to obtain medical as-
sistance under the plan; and 
‘‘(4) whose resources (as determined under the 
State plan under this title with respect to disabled 
individuals) do not exceed the maximum amount of 
resources a disabled individual described in sub-
section (a)(10)(A)(i) may have to obtain medical as-
sistance under the plan.’’. 
(b) ENHANCED MATCH.— 
(1) IN GENERAL.—The first sentence of section 
1905(b) of the Social Security Act (42 U.S.C. 
1396d(b)) 
is 
amended 
by 
striking 
‘‘section 
1902(a)(10)(A)(ii)(XVIII)’’ and inserting ‘‘subclause 
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(XVIII) 
and 
subclause 
(XXIII) 
of 
section 
1902(a)(10)(A)(ii)’’. 
(2) 
CONFORMING
AMENDMENTS.—Section 
1905(a) of the Social Security Act (42 U.S.C. 
1396d(a)) is amended in the matter preceding para-
graph (1)— 
(A) by striking ‘‘or’’ at the end of clause 
(xv); 
(B) by striking ‘‘or’’ at the end of clause 
(xvi); 
(C) by adding ‘‘or’’ at the end of clause 
(xvii); and 
(D) by inserting after clause (xvii) the fol-
lowing: 
‘‘(xviii) individuals described in sec-
tion 1902(a)(10)(A)(ii)(XXIII);’’. 
(c) EXEMPTION FROM FUNDING LIMITATION FOR 
TERRITORIES.—Section 1108(g) of the Social Security 
Act (42 U.S.C. 1308(g)) is amended by adding at the end 
the following: 
‘‘(6) DISREGARDING MEDICAL ASSISTANCE FOR 
OPTIONAL
LOW-INCOME
HIV/AIDS
INFECTED
INDI-
VIDUALS.—The limitations under subsection (f) and 
the previous provisions of this subsection shall not 
apply to amounts expended for medical assistance 
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for individuals described in section 1902(ll) who are 
only eligible for such assistance on the basis of sec-
tion 1902(a)(10)(A)(ii)(XXIII).’’. 
(d) EFFECTIVE DATE.— 
(1) IN GENERAL.—Except as provided by para-
graph (2), the amendments made by this section 
shall take effect on the date of the enactment of this 
section and shall apply to services furnished on or 
after such date. 
(2) RULES
FOR
CHANGES
REQUIRING
STATE 
LEGISLATION.—In the case of a State plan for med-
ical assistance under title XIX of the Social Security 
Act which the Secretary of Health and Human Serv-
ices determines requires State legislation (other than 
legislation appropriating funds) in order for the plan 
to meet the additional requirement imposed by the 
amendments made by this section, the State plan 
shall not be regarded as failing to comply with the 
requirements of such title solely on the basis of its 
failure to meet this additional requirement before 
the first day of the first calendar quarter beginning 
after the close of the first regular session of the 
State legislature that begins after the date of the en-
actment of this Act. For purposes of the previous 
sentence, in the case of a State that has a 2-year 
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legislative session, each year of such session shall be 
deemed to be a separate regular session of the State 
legislature. 
TITLE II—INCREASED DATA COL-
LECTION 
AND 
EDUCATION 
FOR HISTORICALLY UNDER-
REPRESENTED POPULATIONS 
SEC. 201. PEOPLE LIVING WITH DISABILITIES. 
(a) TRACKING
OF
INFORMATION.—The Director 
shall— 
(1) track national HIV/AIDS and STI screen-
ing trends and the burdens of HIV/AIDS and STIs 
among people with disabilities, including such per-
sons with mental, physical, cognitive, intellectual, or 
developmental disabilities; and 
(2) identify and assess the barriers that prevent 
such persons from accessing HIV/AIDS and STI 
screening. 
(b) TRACKING METHODOLOGY.— 
(1) IN GENERAL.—The tracking methods used 
by the Secretary under subsection (a) shall— 
(A) focus upon historically underrep-
resented communities, including the deaf and 
hearing loss-related community and the cog-
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nitive, intellectual, developmental, mobility, or 
mental health disability communities; and 
(B) consider other factors that may con-
tribute to increased burdens of HIV/AIDS and 
STIs, including race, socio-economic status, re-
gion, gender identity, and sexual behavior. 
(2) SEXUAL ASSAULT DATA.—Tracking under 
subsection (a) shall include data collection on the in-
cidence of sexual assault on people with mental, 
physical, cognitive, intellectual, or developmental dis-
abilities for the purposes of understanding the prev-
alence of HIV/AIDS and STIs that result from such 
assaults. 
(c) DEAF AND HEARING LOSS COMMUNITY.— 
(1) 
IN
GENERAL.—The 
Secretary, 
acting 
through the Director, shall work with appropriate 
organizations and institutions to make comprehen-
sive sex education materials that promote voluntary 
screening for HIV/AIDS and STIs accessible to the 
deaf and hearing loss community through language 
(including American Sign Language), modalities (in-
cluding highly graphic formats with minimal text), 
and culturally appropriate information delivery. 
(2) HEALTH CAREERS AND EDUCATION.—The 
Secretary shall— 
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(A) work with appropriate individuals, or-
ganizations, and institutions to increase the 
number of people who are deaf or living with 
hearing loss in public health careers for the 
purposes of— 
(i) building the public health infra-
structure to improve data collection; and 
(ii) health information dissemination 
to people who are deaf or who live with 
hearing loss; and 
(B) engage students in elementary school, 
high school, college, and graduate school for the 
purposes of carrying out this paragraph. 
(d) COGNITIVE
AND
INTELLECTUAL
DISABILITY 
COMMUNITY.—The Secretary, acting through the Direc-
tor, shall work with appropriate national and local organi-
zations to make comprehensive sex education materials ac-
cessible to people with intellectual disabilities by— 
(1) using plain language; 
(2) educating service providers about the signs 
and symptoms of sexual assault among people with 
cognitive and intellectual disabilities; and 
(3) using other appropriate information delivery 
strategies. 
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(e) WOMEN LIVING WITH SEVERE PHYSICAL DIS-
ABILITIES.—The Secretary, acting through the Director, 
shall work with Federal, State, and local entities to track 
access to pelvic examinations, mammograms, and other 
women’s health services for women with severe mobility 
impairments with the goal of improving access to such 
services. 
SEC. 202. WOMEN WHO HAVE SEX WITH WOMEN. 
(a) NATIONAL SCREENING GUIDELINES.—The Sec-
retary, acting through the Director, shall work with Fed-
eral, State, and local health entities to ensure that na-
tional screening guidelines for cervical cancer state that 
WSW should be subject to the same screening guidelines 
for cervical cancer as women who have sex only with men. 
(b) INFORMATION COLLECTION.—The Secretary, act-
ing through the Director, shall, with respect to the WSW 
community— 
(1) track national trends in screening for HIV/ 
AIDS and other STIs; and 
(2) collect information on— 
(A) the burdens and behavior of HIV/ 
AIDS and STIs; and 
(B) other reproductive health concerns. 
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