I
106TH CONGRESS
1ST SESSION
H. R. 1070
To amend title XIX of the Social Security Act to provide medical assistance
for certain women screened and found to have breast or cervical cancer
under a federally funded screening program.
IN THE HOUSE OF REPRESENTATIVES
MARCH 11, 1999
Mr. LAZIO (for himself, Ms. ESHOO, Ms. ROS-LEHTINEN, Mrs. CAPPS, Mrs.
MORELLA, Mrs. KELLY, Mr. BROWN of Ohio, Mr. GEORGE MILLER of
California, Mr. HORN, Mr. DIXON, Ms. PELOSI, Mr. LATOURETTE, Mr.
WAXMAN, Mr. SERRANO, Mr. GILMAN, Mr. MALONEY of Connecticut, Mr.
MEEHAN, Mr. WELDON of Pennsylvania, Mr. UNDERWOOD, Mr. SHOWS,
Mr. ABERCROMBIE, Mr. MCHUGH, Mr. ETHERIDGE, Mr. SANDERS, Mrs.
CLAYTON, Mr. WALSH, Mr. MCGOVERN, Mr. MCNULTY, Mr. FROST, Mr.
NEY, Mr. OLVER, Ms. MILLENDER-MCDONALD, Mr. CROWLEY, Mr.
SUNUNU, Mr. CLEMENT, Mr. STARK, Ms. CARSON, Mr. FOLEY, Mr.
COYNE, Mr. LANTOS, Mr. INSLEE, Mrs. WILSON, Mr. SHERMAN, Mr.
BALDACCI, Mr. BOEHLERT, Mr. LUTHER, Mr. HINOJOSA, Mr. DEFAZIO,
Mr. QUINN, Mr. PRICE of North Carolina, Mr. RANGEL, Mr. WEYGAND,
Mr. FORBES, Mr. MEEKS of New York, Mr. NADLER, Mr. BARRETT of
Wisconsin, Ms. WOOLSEY, Mr. KUCINICH, Mr. KING, Ms. SLAUGHTER,
Mrs. TAUSCHER, Mr. BILBRAY, Mr. THOMPSON of Mississippi, Mr. HIN-
CHEY, Mr. KLECZKA, Mr. PAYNE, Mr. WYNN, Mr. JEFFERSON, Mr.
SMITH of New Jersey, Mr. MASCARA, Mr. LOBIONDO, Mr. OBERSTAR,
Mr. LEACH, Mr. RUSH, Mr. MATSUI, Mr. DINGELL, Mrs. EMERSON, Mr.
FILNER, Mrs. MYRICK, and Ms. LOFGREN) introduced the following bill;
which was referred to the Committee on Commerce
A BILL
To amend title XIX of the Social Security Act to provide
medical assistance for certain women screened and found
to have breast or cervical cancer under a federally funded
screening program.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. OPTIONAL MEDICAID COVERAGE OF CERTAIN
BREAST OR CERVICAL CANCER PATIENTS.
(a) 
COVERAGE
AS
OPTIONAL
CATEGORICALLY
NEEDY GROUP.—
(1) IN
GENERAL.—Section 1902(a)(10)(A)(ii)
of 
the 
Social 
Security 
Act 
(42 
U.S.C.
1396a(a)(10)(A)(ii)) is amended—
(A) in subclause (XIII), by striking ‘‘or’’
at the end;
(B) in subclause (XIV), by adding ‘‘or’’ at
the end; and
(C) by adding at the end the following:
‘‘(XV) who are described in sub-
section (aa) (relating to certain breast
or cervical cancer patients);’’.
(2) GROUP DESCRIBED.—Section 1902 of the
Social Security Act (42 U.S.C. 1396a) is amended
by adding at the end the following:
‘‘(aa) Individuals described in this paragraph are in-
dividuals who—
‘‘(1) 
are 
not 
described 
in 
subsection
(a)(10)(A)(i);
‘‘(2) have not attained age 65;
‘‘(3) have been screened for breast and cervical
cancer under the Centers for Disease Control and
Prevention breast and cervical cancer early detection
program established under title XV of the Public
Health Service Act (42 U.S.C. 300k et seq.) in ac-
cordance with the requirements of section 1504 of
that Act (42 U.S.C. 300n) and need treatment for
breast or cervical cancer; and
‘‘(4) are not otherwise covered under creditable
coverage, as defined in section 2701(c) of the Public
Health Service Act (45 U.S.C. 300gg(c)).’’.
(3) 
LIMITATION
ON
BENEFITS.—Section
1902(a)(10) of the Social Security Act (42 U.S.C.
1396a(a)(10)) is amended in the matter following
subparagraph (F)—
(A) by striking ‘‘and (XIII)’’ and inserting
‘‘(XIII)’’; and
(B) by inserting ‘‘, and (XIV) the medical
assistance made available to an individual de-
scribed in subsection (aa) who is eligible for
medical assistance only because of subpara-
graph (A)(10)(ii)(XV) shall be limited to medi-
cal assistance provided during the period in
which such an individual requires treatment for
breast or cervical cancer’’ before the semicolon.
(4) 
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) in clause (x), by striking ‘‘or’’ at the
end;
(B) in clause (xi), by adding ‘‘or’’ at the
end; and
(C) by inserting after clause (xi) the fol-
lowing:
‘‘(xii) 
individuals 
described 
in 
section
1902(aa),’’.
(b) PRESUMPTIVE ELIGIBILITY.—
(1) IN GENERAL.—Title XIX of the Social Se-
curity Act (42 U.S.C. 1396 et seq.) is amended by
inserting after section 1920A the following:
‘‘PRESUMPTIVE ELIGIBILITY FOR CERTAIN BREAST OR
CERVICAL CANCER PATIENTS
‘‘SEC. 1920B. (a) STATE OPTION.—A State plan ap-
proved under section 1902 may provide for making medi-
cal assistance available to an individual described in sec-
tion 1902(aa) (relating to certain breast or cervical cancer
patients) during a presumptive eligibility period.
‘‘(b) DEFINITIONS.—For purposes of this section:
‘‘(1) PRESUMPTIVE ELIGIBILITY PERIOD.—The
term ‘presumptive eligibility period’ means, with re-
spect to an individual described in subsection (a),
the period that—
‘‘(A) begins with the date on which a
qualified entity determines, on the basis of pre-
liminary information, that the individual is de-
scribed in section 1902(aa); and
‘‘(B) ends with (and includes) the earlier
of—
‘‘(i) the day on which a determination
is made with respect to the eligibility of
such individual for services under the State
plan; or
‘‘(ii) in the case of such an individual
who does not file an application by the last
day of the month following the month dur-
ing which the entity makes the determina-
tion referred to in subparagraph (A), such
last day.
‘‘(2) QUALIFIED ENTITY.—
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (B), the term ‘qualified entity’ means
any entity that—
‘‘(i) is eligible for payments under a
State plan approved under this title; and
‘‘(ii) is determined by the State agen-
cy to be capable of making determinations
of the type described in paragraph (1)(A).
‘‘(B) REGULATIONS.—The Secretary may
issue regulations further limiting those entities
that may become qualified entities in order to
prevent fraud and abuse and for other reasons.
‘‘(C) RULE OF CONSTRUCTION.—Nothing
in this paragraph shall be construed as prevent-
ing a State from limiting the classes of entities
that may become qualified entities, consistent
with any limitations imposed under subpara-
graph (B).
‘‘(c) ADMINISTRATION.—
‘‘(1) IN GENERAL.—The State agency shall pro-
vide qualified entities with—
‘‘(A) such forms as are necessary for an
application to be made by an individual de-
scribed in subsection (a) for medical assistance
under the State plan; and
‘‘(B) information on how to assist such in-
dividuals in completing and filing such forms.