‘‘(iii) EXCLUSIONS.—Such term does 
not include an agency that determines eli-
gibility for a program established under 
the Social Services Block Grant established 
under title XX or a private, for-profit or-
ganization. 
‘‘(iv) RULES
OF
CONSTRUCTION.— 
Nothing in this paragraph shall be con-
strued as— 
‘‘(I) exempting a State Medicaid 
agency from complying with the re-
quirements of section 1902(a)(4) re-
lating to merit-based personnel stand-
ards for employees of the State Med-
icaid agency and safeguards against 
conflicts of interest); or 
‘‘(II) authorizing a State Med-
icaid agency that elects to use Ex-
press Lane agencies under this sub-
paragraph to use the Express Lane 
option to avoid complying with such 
requirements for purposes of making 
eligibility determinations under the 
State Medicaid plan. 
VerDate Nov 24 2008 
04:53 Jan 16, 2009
Jkt 079200
PO 00000
Frm 00019
Fmt 6652
Sfmt 6201
E:\BILLS\H542.IH
H542
rfrederick on PROD1PC67 with BILLS
‘‘(v) ADDITIONAL
DEFINITIONS.—In 
this paragraph: 
‘‘(I) STATE.—The term ‘State’ 
means 1 of the 50 States or the Dis-
trict of Columbia. 
‘‘(II) STATE CHIP AGENCY.—The 
term ‘State CHIP agency’ means the 
State agency responsible for admin-
istering the State CHIP plan. 
‘‘(III) STATE
CHIP
PLAN.—The 
term ‘State CHIP plan’ means the 
State child health plan established 
under title XXI and includes any 
waiver of such plan. 
‘‘(IV) STATE
MEDICAID
AGEN-
CY.—The term ‘State Medicaid agen-
cy’ means the State agency respon-
sible for administering the State Med-
icaid plan. 
‘‘(V) STATE
MEDICAID
PLAN.— 
The term ‘State Medicaid plan’ means 
the State plan established under title 
XIX and includes any waiver of such 
plan. 
VerDate Nov 24 2008 
04:53 Jan 16, 2009
Jkt 079200
PO 00000
Frm 00020
Fmt 6652
Sfmt 6201
E:\BILLS\H542.IH
H542
rfrederick on PROD1PC67 with BILLS
‘‘(G) CHILD DEFINED.—For purposes of 
this paragraph, the term ‘child’ means an indi-
vidual under 19 years of age, or, at the option 
of a State, such higher age, not to exceed 21 
years of age, as the State may elect. 
‘‘(H) APPLICATION.—This paragraph shall 
not apply to with respect to eligibility deter-
minations made after September 30, 2014. 
‘‘(I) CONTINUED APPLICATION.—’’. 
(2) CHIP.—Section 2107(e)(1) of such Act (42 
U.S.C. 1397gg(e)(1)) is amended by redesignating 
subparagraphs (B), (C), and (D) as subparagraphs 
(C), (D), and (E), respectively, and by inserting 
after subparagraph (A) the following new subpara-
graph: 
‘‘(B) Section 1902(e)(13) (relating to the 
State option to rely on findings from an Ex-
press Lane agency to help evaluate a child’s eli-
gibility for medical assistance).’’. 
(b) EVALUATION AND REPORT.— 
(1) EVALUATION.—The Secretary shall con-
duct, by grant, contract, or interagency agreement, 
a comprehensive, independent evaluation of the op-
tion provided under the amendments made by sub-
VerDate Nov 24 2008 
01:54 Jan 21, 2009
Jkt 079200
PO 00000
Frm 00021
Fmt 6652
Sfmt 6201
E:\BILLS\H542.IH
H542
rfrederick on PROD1PC67 with BILLS
section (a). Such evaluation shall include an analysis 
of the effectiveness of the option, and shall include— 
(A) obtaining a statistically valid sample of 
the children who were enrolled in the State 
Medicaid plan or the State CHIP plan through 
reliance on a finding made by an Express Lane 
agency and determining the percentage of chil-
dren who were erroneously enrolled in such 
plans; 
(B) determining whether enrolling children 
in such plans through reliance on a finding 
made by an Express Lane agency improves the 
ability of a State to identify and enroll low-in-
come, uninsured children who are eligible but 
not enrolled in such plans; 
(C) evaluating the administrative costs or 
savings related to identifying and enrolling chil-
dren in such plans through reliance on such 
findings, and the extent to which such costs dif-
fer from the costs that the State otherwise 
would have incurred to identify and enroll low- 
income, uninsured children who are eligible but 
not enrolled in such plans; and 
(D) any recommendations for legislative or 
administrative changes that would improve the 
VerDate Nov 24 2008 
04:53 Jan 16, 2009
Jkt 079200
PO 00000
Frm 00022
Fmt 6652
Sfmt 6201
E:\BILLS\H542.IH
H542
rfrederick on PROD1PC67 with BILLS
effectiveness of enrolling children in such plans 
through reliance on such findings. 
(2) REPORT
TO
CONGRESS.—Not later than 
September 30, 2013, the Secretary shall submit a 
report to Congress on the results of the evaluation 
under paragraph (1). 
(3) FUNDING.— 
(A) IN GENERAL.—Out of any funds in the 
Treasury not otherwise appropriated, there is 
appropriated to the Secretary to carry out the 
evaluation under this subsection $5,000,000 for 
the period of fiscal years 2010 through 2013. 
(B) BUDGET AUTHORITY.—Subparagraph 
(A) constitutes budget authority in advance of 
appropriations Act and represents the obliga-
tion of the Federal Government to provide for 
the payment of such amount to conduct the 
evaluation under this subsection. 
(c) ELECTRONIC TRANSMISSION OF INFORMATION.— 
Section 1902 of such Act (42 U.S.C. 1396a) is amended 
by adding at the end the following new subsection: 
‘‘(dd) ELECTRONIC TRANSMISSION
OF INFORMA-
TION.—If the State agency determining eligibility for med-
ical assistance under this title or child health assistance 
under title XXI verifies an element of eligibility based on 
VerDate Nov 24 2008 
04:53 Jan 16, 2009
Jkt 079200
PO 00000
Frm 00023
Fmt 6652
Sfmt 6201
E:\BILLS\H542.IH
H542
rfrederick on PROD1PC67 with BILLS