174 
‘‘(i) the development of consensus on 
evidence-based measures for children’s 
health care services; 
‘‘(ii) the dissemination of such meas-
ures to public and private purchasers of 
health care for children; and 
‘‘(iii) the updating of such measures 
as necessary. 
‘‘(5) REVISING, STRENGTHENING, AND IMPROV-
ING INITIAL CORE MEASURES.—Beginning no later 
than January 1, 2012, and annually thereafter, the 
Secretary shall publish recommended changes to the 
core measures described in subsection (a) that shall 
reflect the testing, validation, and consensus process 
for the development of pediatric quality measures 
described in subsection paragraphs (1) through (4). 
‘‘(6) DEFINITION
OF
PEDIATRIC
QUALITY 
MEASURE.—In this subsection, the term ‘pediatric 
quality measure’ means a measurement of clinical 
care that is capable of being examined through the 
collection and analysis of relevant information, that 
is developed in order to assess 1 or more aspects of 
pediatric health care quality in various institutional 
and ambulatory health care settings, including the 
structure of the clinical care system, the process of 
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care, the outcome of care, or patient experiences in 
care. 
‘‘(c) ANNUAL STATE REPORTS REGARDING STATE- 
SPECIFIC QUALITY OF CARE MEASURES APPLIED UNDER 
MEDICAID OR CHIP.— 
‘‘(1) ANNUAL
STATE
REPORTS.—Each State 
with a State plan approved under title XIX or a 
State child health plan approved under title XXI 
shall annually report to the Secretary on the— 
‘‘(A) State-specific child health quality 
measures applied by the States under such 
plans, including measures described in subpara-
graphs (A) and (B) of subsection (a)(6); and 
‘‘(B) State-specific information on the 
quality of health care furnished to children 
under such plans, including information col-
lected through external quality reviews of man-
aged care organizations under section 1932 of 
the Social Security Act (42 U.S.C. 1396u–4) 
and benchmark plans under sections 1937 and 
2103 of such Act (42 U.S.C. 1396u–7, 1397cc). 
‘‘(2) PUBLICATION.—Not later than September 
30, 2009, and annually thereafter, the Secretary 
shall collect, analyze, and make publicly available the 
information reported by States under paragraph (1). 
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‘‘(d) DEMONSTRATION PROJECTS
FOR IMPROVING 
THE QUALITY OF CHILDREN’S HEALTH CARE AND THE 
USE OF HEALTH INFORMATION TECHNOLOGY.— 
‘‘(1) IN GENERAL.—During the period of fiscal 
years 2008 through 2012, the Secretary shall award 
not more than 10 grants to States and child health 
providers to conduct demonstration projects to 
evaluate promising ideas for improving the quality of 
children’s health care provided under title XIX or 
XXI, including projects to— 
‘‘(A) experiment with, and evaluate the use 
of, new measures of the quality of children’s 
health care under such titles (including testing 
the validity and suitability for reporting of such 
measures); 
‘‘(B) promote the use of health information 
technology in care delivery for children under 
such titles; 
‘‘(C) evaluate provider-based models which 
improve the delivery of children’s health care 
services under such titles, including care man-
agement for children with chronic conditions 
and the use of evidence-based approaches to im-
prove the effectiveness, safety, and efficiency of 
health care services for children; or 
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‘‘(D) demonstrate the impact of the model 
electronic health record format for children de-
veloped and disseminated under subsection (f) 
on improving pediatric health, including the ef-
fects of chronic childhood health conditions, and 
pediatric health care quality as well as reducing 
health care costs. 
‘‘(2) REQUIREMENTS.—In awarding grants 
under this subsection, the Secretary shall ensure 
that— 
‘‘(A) only 1 demonstration project funded 
under a grant awarded under this subsection 
shall be conducted in a State; and 
‘‘(B) demonstration projects funded under 
grants awarded under this subsection shall be 
conducted evenly between States with large 
urban areas and States with large rural areas. 
‘‘(3) 
AUTHORITY
FOR
MULTISTATE 
PROJECTS.—A demonstration project conducted with 
a grant awarded under this subsection may be con-
ducted on a multistate basis, as needed. 
‘‘(4) FUNDING.—$20,000,000 of the amount 
appropriated under subsection (i) for a fiscal year 
shall be used to carry out this subsection. 
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‘‘(e) 
CHILDHOOD
OBESITY
DEMONSTRATION 
PROJECT.— 
‘‘(1) AUTHORITY
TO
CONDUCT
DEMONSTRA-
TION.—The Secretary, in consultation with the Ad-
ministrator of the Centers for Medicare & Medicaid 
Services, shall conduct a demonstration project to 
develop a comprehensive and systematic model for 
reducing childhood obesity by awarding grants to eli-
gible entities to carry out such project. Such model 
shall— 
‘‘(A) identify, through self-assessment, be-
havioral risk factors for obesity among children; 
‘‘(B) identify, through self-assessment, 
needed clinical preventive and screening benefits 
among those children identified as target indi-
viduals on the basis of such risk factors; 
‘‘(C) provide ongoing support to such tar-
get individuals and their families to reduce risk 
factors and promote the appropriate use of pre-
ventive and screening benefits; and 
‘‘(D) be designed to improve health out-
comes, satisfaction, quality of life, and appro-
priate use of items and services for which med-
ical assistance is available under title XIX or 
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‘‘(i) educate families regarding the re-
lationship between nutrition, eating habits, 
physical activity, and obesity; 
‘‘(ii) educate families about effective 
strategies to improve nutrition, establish 
healthy eating patterns, and establish ap-
propriate levels of physical activity; and 
‘‘(iii) educate and guide parents re-
garding the ability to model and commu-
nicate positive health behaviors. 
‘‘(4) PRIORITY.—In awarding grants under 
paragraph (1), the Secretary shall give priority to 
awarding grants to eligible entities— 
‘‘(A) that demonstrate that they have pre-
viously applied successfully for funds to carry 
out activities that seek to promote individual 
and community health and to prevent the inci-
dence of chronic disease and that can cite pub-
lished 
and 
peer-reviewed 
research 
dem-
onstrating that the activities that the entities 
propose to carry out with funds made available 
under the grant are effective; 
‘‘(B) that will carry out programs or ac-
tivities that seek to accomplish a goal or goals 
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set by the State in the Healthy People 2010 
plan of the State; 
‘‘(C) that provide non-Federal contribu-
tions, either in cash or in-kind, to the costs of 
funding activities under the grants; 
‘‘(D) that develop comprehensive plans 
that include a strategy for extending program 
activities developed under grants in the years 
following the fiscal years for which they receive 
grants under this subsection; 
‘‘(E) located in communities that are medi-
cally underserved, as determined by the Sec-
retary; 
‘‘(F) located in areas in which the average 
poverty rate is at least 150 percent or higher of 
the average poverty rate in the State involved, 
as determined by the Secretary; and 
‘‘(G) that submit plans that exhibit multi-
sectoral, cooperative conduct that includes the 
involvement of a broad range of stakeholders, 
including— 
‘‘(i) community-based organizations; 
‘‘(ii) local governments; 
‘‘(iii) local educational agencies; 
‘‘(iv) the private sector; 
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‘‘(v) State or local departments of 
health; 
‘‘(vi) accredited colleges, universities, 
and community colleges; 
‘‘(vii) health care providers; 
‘‘(viii) State and local departments of 
transportation and city planning; and 
‘‘(ix) other entities determined appro-
priate by the Secretary. 
‘‘(5) PROGRAM DESIGN.— 
‘‘(A) INITIAL DESIGN.—Not later than 1 
year after the date of enactment of the Chil-
dren’s Health Insurance Program Reauthoriza-
tion Act of 2007, the Secretary shall design the 
demonstration 
project. 
The 
demonstration 
should draw upon promising, innovative models 
and incentives to reduce behavioral risk factors. 
The Administrator of the Centers for Medicare 
& Medicaid Services shall consult with the Di-
rector of the Centers for Disease Control and 
Prevention, the Director of the Office of Minor-
ity Health, the heads of other agencies in the 
Department of Health and Human Services, 
and such professional organizations, as the Sec-
retary determines to be appropriate, on the de-
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sign, conduct, and evaluation of the demonstra-
tion. 
‘‘(B) NUMBER AND PROJECT AREAS.—Not 
later than 2 years after the date of enactment 
of the Children’s Health Insurance Program 
Reauthorization Act of 2007, the Secretary 
shall award 1 grant that is specifically designed 
to determine whether programs similar to pro-
grams to be conducted by other grantees under 
this subsection should be implemented with re-
spect to the general population of children who 
are eligible for child health assistance under 
State child health plans under title XXI in 
order to reduce the incidence of childhood obe-
sity among such population. 
‘‘(6) REPORT TO CONGRESS.—Not later than 3 
years after the date the Secretary implements the 
demonstration project under this subsection, the 
Secretary shall submit to Congress a report that de-
scribes the project, evaluates the effectiveness and 
cost effectiveness of the project, evaluates the bene-
ficiary satisfaction under the project, and includes 
any such other information as the Secretary deter-
mines to be appropriate. 
‘‘(7) DEFINITIONS.—In this subsection: 
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‘‘(A) 
FEDERALLY-QUALIFIED
HEALTH 
CENTER.—The term ‘Federally-qualified health 
center’ has the meaning given that term in sec-
tion 1905(l)(2)(B). 
‘‘(B) INDIAN
TRIBE.—The term ‘Indian 
tribe’ has the meaning given that term in sec-
tion 4 of the Indian Health Care Improvement 
Act (25 U.S.C. 1603). 
‘‘(C) SELF-ASSESSMENT.—The term ‘self- 
assessment’ means a form that— 
‘‘(i) includes questions regarding— 
‘‘(I) behavioral risk factors; 
‘‘(II) 
needed 
preventive 
and 
screening services; and 
‘‘(III) target individuals’ pref-
erences for receiving follow-up infor-
mation; 
‘‘(ii) is assessed using such computer 
generated assessment programs; and 
‘‘(iii) allows for the provision of such 
ongoing support to the individual as the 
Secretary determines appropriate. 
‘‘(D) ONGOING SUPPORT.—The term ‘on-
going support’ means— 
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‘‘(i) to provide any target individual 
with information, feedback, health coach-
ing, and recommendations regarding— 
‘‘(I) the results of a self-assess-
ment given to the individual; 
‘‘(II) behavior modification based 
on the self-assessment; and 
‘‘(III) any need for clinical pre-
ventive and screening services or 
treatment including medical nutrition 
therapy; 
‘‘(ii) to provide any target individual 
with referrals to community resources and 
programs available to assist the target in-
dividual in reducing health risks; and 
‘‘(iii) to provide the information de-
scribed in clause (i) to a health care pro-
vider, if designated by the target individual 
to receive such information. 
‘‘(8) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
this subsection, $25,000,000 for the period of fiscal 
years 2008 through 2012. 
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189 
‘‘(f) 
DEVELOPMENT
OF
MODEL
ELECTRONIC 
HEALTH RECORD FORMAT FOR CHILDREN ENROLLED IN 
MEDICAID OR CHIP.— 
‘‘(1) IN GENERAL.—Not later than January 1, 
2009, the Secretary shall establish a program to en-
courage the development and dissemination of a 
model electronic health record format for children 
enrolled in the State plan under title XIX or the 
State child health plan under title XXI that is— 
‘‘(A) subject to State laws, accessible to 
parents, caregivers, and other consumers for 
the sole purpose of demonstrating compliance 
with school or leisure activity requirements, 
such as appropriate immunizations or physicals; 
‘‘(B) designed to allow interoperable ex-
changes that conform with Federal and State 
privacy and security requirements; 
‘‘(C) structured in a manner that permits 
parents and caregivers to view and understand 
the extent to which the care their children re-
ceive is clinically appropriate and of high qual-
ity; and 
‘‘(D) capable of being incorporated into, 
and otherwise compatible with, other standards 
developed for electronic health records. 
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‘‘(2) FUNDING.—$5,000,000 of the amount ap-
propriated under subsection (i) for a fiscal year shall 
be used to carry out this subsection. 
‘‘(g) STUDY OF PEDIATRIC HEALTH AND HEALTH 
CARE QUALITY MEASURES.— 
‘‘(1) IN
GENERAL.—Not later than July 1, 
2009, the Institute of Medicine shall study and re-
port to Congress on the extent and quality of efforts 
to measure child health status and the quality of 
health care for children across the age span and in 
relation to preventive care, treatments for acute con-
ditions, and treatments aimed at ameliorating or 
correcting physical, mental, and developmental con-
ditions in children. In conducting such study and 
preparing such report, the Institute of Medicine 
shall— 
‘‘(A) consider all of the major national 
population-based reporting systems sponsored 
by the Federal Government that are currently 
in place, including reporting requirements 
under Federal grant programs and national 
population surveys and estimates conducted di-
rectly by the Federal Government; 
‘‘(B) identify the information regarding 
child health and health care quality that each 
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191 
system is designed to capture and generate, the 
study and reporting periods covered by each 
system, and the extent to which the information 
so generated is made widely available through 
publication; 
‘‘(C) identify gaps in knowledge related to 
children’s health status, health disparities 
among subgroups of children, the effects of so-
cial conditions on children’s health status and 
use and effectiveness of health care, and the re-
lationship between child health status and fam-
ily income, family stability and preservation, 
and children’s school readiness and educational 
achievement and attainment; and 
‘‘(D) make recommendations regarding im-
proving and strengthening the timeliness, qual-
ity, and public transparency and accessibility of 
information about child health and health care 
quality. 
‘‘(2) FUNDING.—Up to $1,000,000 of the 
amount appropriated under subsection (i) for a fis-
cal year shall be used to carry out this subsection. 
‘‘(h) RULE
OF CONSTRUCTION.—Notwithstanding 
any other provision in this section, no evidence based qual-
ity measure developed, published, or used as a basis of 
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measurement or reporting under this section may be used 
to establish an irrebuttable presumption regarding either 
the medical necessity of care or the maximum permissible 
coverage for any individual child who is eligible for and 
receiving medical assistance under title XIX or child 
health assistance under title XXI . 
‘‘(i) APPROPRIATION.—Out of any funds in the 
Treasury not otherwise appropriated, there is appro-
priated for each of fiscal years 2008 through 2012, 
$45,000,000 for the purpose of carrying out this section 
(other than subsection (e)). Funds appropriated under 
this subsection shall remain available until expended.’’. 
(b) INCREASED MATCHING RATE FOR COLLECTING 
AND REPORTING ON CHILD HEALTH MEASURES.—Sec-
tion 1903(a)(3)(A) (42 U.S.C. 1396b(a)(3)(A)), is amend-
ed— 
(1) by striking ‘‘and’’ at the end of clause (i); 
and 
(2) by adding at the end the following new 
clause: 
‘‘(iii) an amount equal to the Federal med-
ical assistance percentage (as defined in section 
1905(b)) of so much of the sums expended dur-
ing such quarter (as found necessary by the 
Secretary for the proper and efficient adminis-
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193 
tration of the State plan) as are attributable to 
such developments or modifications of systems 
of the type described in clause (i) as are nec-
essary for the efficient collection and reporting 
on child health measures; and’’. 
SEC. 502. IMPROVED INFORMATION REGARDING ACCESS 
TO COVERAGE UNDER CHIP. 
(a) INCLUSION OF PROCESS AND ACCESS MEASURES 
IN ANNUAL STATE REPORTS.—Section 2108 (42 U.S.C. 
1397hh) is amended— 
(1) in subsection (a), in the matter preceding 
paragraph (1), by striking ‘‘The State’’ and insert-
ing ‘‘Subject to subsection (e), the State’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(e) INFORMATION REQUIRED FOR INCLUSION IN 
STATE ANNUAL REPORT.—The State shall include the fol-
lowing information in the annual report required under 
subsection (a): 
‘‘(1) Eligibility criteria, enrollment, and reten-
tion data (including data with respect to continuity 
of coverage or duration of benefits). 
‘‘(2) Data regarding the extent to which the 
State uses process measures with respect to deter-
mining the eligibility of children under the State 
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child health plan, including measures such as 12- 
month continuous eligibility, self-declaration of in-
come for applications or renewals, or presumptive 
eligibility. 
‘‘(3) Data regarding denials of eligibility and 
redeterminations of eligibility. 
‘‘(4) Data regarding access to primary and spe-
cialty services, access to networks of care, and care 
coordination provided under the State child health 
plan, using quality care and consumer satisfaction 
measures included in the Consumer Assessment of 
Healthcare Providers and Systems (CAHPS) survey. 
‘‘(5) If the State provides child health assist-
ance in the form of premium assistance for the pur-
chase of coverage under a group health plan, data 
regarding the provision of such assistance, including 
the extent to which employer-sponsored health insur-
ance coverage is available for children eligible for 
child health assistance under the State child health 
plan, the range of the monthly amount of such as-
sistance provided on behalf of a child or family, the 
number of children or families provided such assist-
ance on a monthly basis, the income of the children 
or families provided such assistance, the benefits 
and cost-sharing protection provided under the State 
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child health plan to supplement the coverage pur-
chased with such premium assistance, the effective 
strategies the State engages in to reduce any admin-
istrative barriers to the provision of such assistance, 
and, the effects, if any, of the provision of such as-
sistance on preventing the coverage provided under 
the State child health plan from substituting for cov-
erage provided under employer-sponsored health in-
surance offered in the State. 
‘‘(6) To the extent applicable, a description of 
any State activities that are designed to reduce the 
number of uncovered children in the State, including 
through a State health insurance connector program 
or support for innovative private health coverage ini-
tiatives.’’. 
(b) GAO STUDY AND REPORT ON ACCESS TO PRI-
MARY AND SPECIALITY SERVICES.— 
(1) IN GENERAL.—The Comptroller General of 
the United States shall conduct a study of children’s 
access to primary and specialty services under Med-
icaid and CHIP, including— 
(A) the extent to which providers are will-
ing to treat children eligible for such programs; 
(B) information on such children’s access 
to networks of care; 
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(C) geographic availability of primary and 
specialty services under such programs; 
(D) the extent to which care coordination 
is provided for children’s care under Medicaid 
and CHIP; and 
(E) as appropriate, information on the de-
gree of availability of services for children under 
such programs. 
(2) REPORT.—Not later than 2 years after the 
date of enactment of this Act, the Comptroller Gen-
eral shall submit a report to the appropriate com-
mittees of Congress on the study conducted under 
paragraph (1) that includes recommendations for 
such Federal and State legislative and administra-
tive changes as the Comptroller General determines 
are necessary to address any barriers to access to 
children’s care under Medicaid and CHIP that may 
exist. 
SEC. 503. APPLICATION OF CERTAIN MANAGED CARE 
QUALITY SAFEGUARDS TO CHIP. 
Section 2107(e)(1) (42 U.S.C. 1397gg(e)(1)), as 
amended by section 204(b), is amended by redesignating 
subparagraph (E) (as added by such section) as subpara-
graph (F) and by inserting after subparagraph (D) the 
following new subparagraph: 
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‘‘(E) Subsections (a)(4), (a)(5), (b), (c), 
(d), and (e) of section 1932 (relating to require-
ments for managed care).’’. 
TITLE VI—MISCELLANEOUS 
SEC. 601. TECHNICAL CORRECTION REGARDING CURRENT 
STATE AUTHORITY UNDER MEDICAID. 
(a) IN GENERAL.—Only with respect to expenditures 
for medical assistance under a State Medicaid plan, in-
cluding any waiver of such plan, for fiscal years 2007 and 
2008, a State may elect, notwithstanding the fourth sen-
tence of subsection (b) of section 1905 of the Social Secu-
rity Act (42 U.S.C. 1396d) or subsection (u) of such sec-
tion— 
(1) to cover individuals described in section 
1902(a)(10)(A)(ii)(IX) of the Social Security Act 
and, at its option, to apply less restrictive meth-
odologies 
to 
such 
individuals 
under 
section 
1902(r)(2) of such Act or 1931(b)(2)(C) of such Act 
and thereby receive Federal financial participation 
for medical assistance for such individuals under 
title XIX of the Social Security Act; or 
(2) to receive Federal financial participation for 
expenditures for medical assistance under title XIX 
of such Act for children described in paragraph 
(2)(B) or (3) of section 1905(u) of such Act based 
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on the Federal medical assistance percentage, as 
otherwise determined based on the first and third 
sentences of subsection (b) of section 1905 of the 
Social Security Act, rather than on the basis of an 
enhanced FMAP (as defined in section 2105(b) of 
such Act). 
(b) REPEAL.—Effective October 1, 2008, subsection 
(a) is repealed. 
(c) HOLD HARMLESS.—No State that elects the op-
tion described in subsection (a) shall be treated as not hav-
ing been authorized to make such election and to receive 
Federal financial participation for expenditures for med-
ical assistance described in that subsection for fiscal years 
2007 and 2008 as a result of the repeal of the subsection 
under subsection (b). 
SEC. 602. PAYMENT ERROR RATE MEASUREMENT (‘‘PERM’’). 
(a) EXPENDITURES RELATED TO COMPLIANCE WITH 
REQUIREMENTS.— 
(1) ENHANCED
PAYMENTS.—Section 2105(c) 
(42 U.S.C. 1397ee(c)), as amended by section 
401(a), is amended by adding at the end the fol-
lowing new paragraph: 
‘‘(11) 
ENHANCED
PAYMENTS.—Notwith-
standing subsection (b), the enhanced FMAP with 
respect to payments under subsection (a) for ex-
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penditures related to the administration of the pay-
ment error rate measurement (PERM) requirements 
applicable to the State child health plan in accord-
ance with the Improper Payments Information Act 
of 2002 and parts 431 and 457 of title 42, Code of 
Federal Regulations (or any related or successor 
guidance or regulations) shall in no event be less 
than 90 percent.’’. 
(2) EXCLUSION OF FROM CAP ON ADMINISTRA-
TIVE
EXPENDITURES.—Section 2105(c)(2)(C) (42 
U.S.C. 1397ee(c)(2)C)), as amended by section 
402(b), is amended by adding at the end the fol-
lowing: 
‘‘(v) PAYMENT
ERROR
RATE
MEAS-
UREMENT
(PERM)
EXPENDITURES.—Ex-
penditures related to the administration of 
the payment error rate measurement 
(PERM) requirements applicable to the 
State child health plan in accordance with 
the Improper Payments Information Act of 
2002 and parts 431 and 457 of title 42, 
Code of Federal Regulations (or any re-
lated or successor guidance or regula-
tions).’’. 
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(b) FINAL RULE REQUIRED TO BE IN EFFECT FOR 
ALL STATES.—Notwithstanding parts 431 and 457 of 
title 42, Code of Federal Regulations (as in effect on the 
date of enactment of this Act), the Secretary shall not cal-
culate or publish any national or State-specific error rate 
based on the application of the payment error rate meas-
urement (in this section referred to as ‘‘PERM’’) require-
ments to CHIP until after the date that is 6 months after 
the date on which a final rule implementing such require-
ments in accordance with the requirements of subsection 
(c) is in effect for all States. Any calculation of a national 
error rate or a State specific error rate after such final 
rule in effect for all States may only be inclusive of errors, 
as defined in such final rule or in guidance issued within 
a reasonable time frame after the effective date for such 
final rule that includes detailed guidance for the specific 
methodology for error determinations. 
(c) REQUIREMENTS FOR FINAL RULE.—For pur-
poses of subsection (b), the requirements of this sub-
section are that the final rule implementing the PERM 
requirements shall include— 
(1) clearly defined criteria for errors for both 
States and providers; 
(2) a clearly defined process for appealing error 
determinations by review contractors; and 
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fiscal year or may elect to not have any payment 
error rate determined on the basis of such data and, 
instead, shall be treated as if fiscal year 2011 were 
the first fiscal year for which the PERM require-
ments apply to the State. 
(e) HARMONIZATION OF MEQC AND PERM.— 
(1) REDUCTION OF REDUNDANCIES.—The Sec-
retary shall review the Medicaid Eligibility Quality 
Control (in this subsection referred to as the 
‘‘MEQC’’) requirements with the PERM require-
ments and coordinate consistent implementation of 
both 
sets 
of 
requirements, 
while 
reducing 
redundancies. 
(2) STATE OPTION TO APPLY PERM DATA.—A 
State may elect, for purposes of determining the er-
roneous excess payments for medical assistance ratio 
applicable to the State for a fiscal year under section 
1903(u) of the Social Security Act (42 U.S.C. 
1396b(u)) to substitute data resulting from the ap-
plication of the PERM requirements to the State 
after the final rule implementing such requirements 
is in effect for all States for data obtained from the 
application of the MEQC requirements to the State 
with respect to a fiscal year. 
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(f) IDENTIFICATION OF IMPROVED STATE-SPECIFIC 
SAMPLE SIZES.—The Secretary shall establish State-spe-
cific sample sizes for application of the PERM require-
ments with respect to State child health plans for fiscal 
years beginning with fiscal year 2009, on the basis of such 
information as the Secretary determines appropriate. In 
establishing such sample sizes, the Secretary shall, to the 
greatest extent practicable— 
(1) minimize the administrative cost burden on 
States under Medicaid and CHIP; and 
(2) maintain State flexibility to manage such 
programs. 
SEC. 603. ELIMINATION OF COUNTING MEDICAID CHILD 
PRESUMPTIVE ELIGIBILITY COSTS AGAINST 
TITLE XXI ALLOTMENT. 
Section 2105(a)(1) (42 U.S.C. 1397ee(a)(1)) is 
amended— 
(1) in the matter preceding subparagraph (A), 
by striking ‘‘(or, in the case of expenditures de-
scribed in subparagraph (B), the Federal medical 
assistance percentage (as defined in the first sen-
tence of section 1905(b)))’’; and 
(2) by striking subparagraph (B) and inserting 
the following new subparagraph: 
‘‘(B) [reserved]’’. 
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204 
SEC. 604. IMPROVING DATA COLLECTION. 
(a) 
INCREASED
APPROPRIATION.—Section 
2109(b)(2) (42 U.S.C. 1397ii(b)(2)) is amended by strik-
ing ‘‘$10,000,000 for fiscal year 2000’’ and inserting 
‘‘$20,000,000 for fiscal year 2008’’. 
(b) USE OF ADDITIONAL FUNDS.—Section 2109(b) 
(42 U.S.C. 1397ii(b)), as amended by subsection (a), is 
amended— 
(1) by redesignating paragraph (2) as para-
graph (4); and 
(2) by inserting after paragraph (1), the fol-
lowing new paragraphs: 
‘‘(2) ADDITIONAL REQUIREMENTS.—In addition 
to making the adjustments required to produce the 
data described in paragraph (1), with respect to 
data collection occurring for fiscal years beginning 
with fiscal year 2008, in appropriate consultation 
with the Secretary of Health and Human Services, 
the Secretary of Commerce shall do the following: 
‘‘(A) Make appropriate adjustments to the 
Current Population Survey to develop more ac-
curate State-specific estimates of the number of 
children enrolled in health coverage under title 
XIX or this title. 
‘‘(B) Make appropriate adjustments to the 
Current Population Survey to improve the sur-
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vey estimates used to compile the State-specific 
and national number of low-income children 
without health insurance for purposes of deter-
mining allotments under subsections (c) and (i) 
of section 2104 and making payments to States 
from the CHIP Incentive Bonuses Pool estab-
lished under subsection (j) of such section, the 
CHIP Contingency Fund established under sub-
section (k) of such section, and, to the extent 
applicable to a State, from the block grant set 
aside under section 2112(b)(2)(A)(i) for each of 
fiscal years 2010 through 2012. 
‘‘(C) Include health insurance survey infor-
mation in the American Community Survey re-
lated to children. 
‘‘(D) Assess whether American Community 
Survey estimates, once such survey data are 
first available, produce more reliable estimates 
than the Current Population Survey with re-
spect to the purposes described in subparagraph 
(B). 
‘‘(E) On the basis of the assessment re-
quired under subparagraph (D), recommend to 
the Secretary of Health and Human Services 
whether American Community Survey estimates 
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should be used in lieu of, or in some combina-
tion with, Current Population Survey estimates 
for the purposes described in subparagraph (B). 
‘‘(F) Continue making the adjustments de-
scribed in the last sentence of paragraph (1) 
with respect to expansion of the sample size 
used in State sampling units, the number of 
sampling units in a State, and using an appro-
priate verification element. 
‘‘(3) AUTHORITY
FOR
THE
SECRETARY
OF 
HEALTH AND HUMAN SERVICES TO TRANSITION TO 
THE USE OF ALL, OR SOME COMBINATION OF, ACS 
ESTIMATES UPON RECOMMENDATION OF THE SEC-
RETARY OF COMMERCE.—If, on the basis of the as-
sessment required under paragraph (2)(D), the Sec-
retary of Commerce recommends to the Secretary of 
Health and Human Services that American Commu-
nity Survey estimates should be used in lieu of, or 
in some combination with, Current Population Sur-
vey estimates for the purposes described in para-
graph (2)(B), the Secretary of Health and Human 
Services may provide for a period during which the 
Secretary may transition from carrying out such 
purposes through the use of Current Population 
Survey estimates to the use of American Community 
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