H. R. 4386
One Hundred Sixth Congress
of the
United States of America
AT THE SECOND SESSION
Begun and held at the City of Washington on Monday,
the twenty-fourth day of January, two thousand
An Act
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, to amend the Public Health Service Act
and the Federal Food, Drug, and Cosmetic Act with respect to surveillance and
information concerning the relationship between cervical cancer and the human
papillomavirus (HPV), and for other purposes.
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Breast and Cervical Cancer
Prevention and Treatment Act of 2000’’.
SEC. 2. OPTIONAL MEDICAID COVERAGE OF CERTAIN BREAST OR CER-
VICAL 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 (XVI), by striking ‘‘or’’ at the end;
(B) in subclause (XVII), by adding ‘‘or’’ at the end;
and
(C) by adding at the end the following:
‘‘(XVIII) who are described in subsection (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 subsection are individuals
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 accordance 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
(42 U.S.C. 300gg(c)).’’.
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(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 (G)—
(A) by striking ‘‘and (XIII)’’ and inserting ‘‘(XIII)’’; and
(B) by inserting ‘‘, and (XIV) the medical assistance
made available to an individual described in subsection
(aa) who is eligible for medical assistance only because
of subparagraph (A)(10)(ii)(XVIII) shall be limited to med-
ical 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 paragraph (1)—
(A) in clause (xi), by striking ‘‘or’’ at the end;
(B) in clause (xii), by adding ‘‘or’’ at the end; and
(C) by inserting after clause (xii) the following:
‘‘(xiii) individuals described in section 1902(aa),’’.
(b) PRESUMPTIVE ELIGIBILITY.—
(1) IN GENERAL.—Title XIX of the Social Security 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 approved under
section 1902 may provide for making medical assistance available
to an individual described in section 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 ‘presump-
tive eligibility period’ means, with respect 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 preliminary information, that
the individual is described 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 during which the entity makes
the determination referred to in subparagraph (A),
such last day.
‘‘(2) QUALIFIED ENTITY.—
‘‘(A) IN GENERAL.—Subject to subparagraph (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 agency to be
capable of making determinations of the type described
in paragraph (1)(A).
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‘‘(B) REGULATIONS.—The Secretary may issue regula-
tions further limiting those entities that may become quali-
fied entities in order to prevent fraud and abuse and for
other reasons.
‘‘(C) RULE OF CONSTRUCTION.—Nothing in this para-
graph shall be construed as preventing a State from lim-
iting the classes of entities that may become qualified
entities, consistent with any limitations imposed under
subparagraph (B).
‘‘(c) ADMINISTRATION.—
‘‘(1) IN GENERAL.—The State agency shall provide qualified
entities with—
‘‘(A) such forms as are necessary for an application
to be made by an individual described in subsection (a)
for medical assistance under the State plan; and
‘‘(B) information on how to assist such individuals in
completing and filing such forms.
‘‘(2) NOTIFICATION REQUIREMENTS.—A qualified entity that
determines under subsection (b)(1)(A) that an individual
described in subsection (a) is presumptively eligible for medical
assistance under a State plan shall—
‘‘(A) notify the State agency of the determination within
5 working days after the date on which determination
is made; and
‘‘(B) inform such individual at the time the determina-
tion is made that an application for medical assistance
under the State plan is required to be made by not later
than the last day of the month following the month during
which the determination is made.
‘‘(3) APPLICATION FOR MEDICAL ASSISTANCE.—In the case
of an individual described in subsection (a) who is determined
by a qualified entity to be presumptively eligible for medical
assistance under a State plan, the individual shall apply for
medical assistance under such plan by not later than the last
day of the month following the month during which the deter-
mination is made.
‘‘(d) PAYMENT.—Notwithstanding any other provision of this
title, medical assistance that—
‘‘(1) is furnished to an individual described in subsection
(a)—
‘‘(A) during a presumptive eligibility period;
‘‘(B) by a entity that is eligible for payments under
the State plan; and
‘‘(2) is included in the care and services covered by the
State plan,
shall be treated as medical assistance provided by such plan for
purposes of clause (4) of the first sentence of section 1905(b).’’.
(2) CONFORMING AMENDMENTS.—
(A) Section 1902(a)(47) of the Social Security Act (42
U.S.C. 1396a(a)(47)) is amended by inserting before the
semicolon at the end the following: ‘‘and provide for making
medical assistance available to individuals described in
subsection (a) of section 1920B during a presumptive eligi-
bility period in accordance with such section’’.
(B) Section 1903(u)(1)(D)(v) of such Act (42 U.S.C.
1396b(u)(1)(D)(v)) is amended—
(i) by striking ‘‘or for’’ and inserting ‘‘, for’’; and
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(ii) by inserting before the period the following:
‘‘, or for medical assistance provided to an individual
described in subsection (a) of section 1920B during
a presumptive eligibility period under such section’’.
(c) ENHANCED MATCH.—The first sentence of section 1905(b)
of the Social Security Act (42 U.S.C. 1396d(b)) is amended—
(1) by striking ‘‘and’’ before ‘‘(3)’’; and
(2) by inserting before the period at the end the following:
‘‘, and (4) the Federal medical assistance percentage shall be
equal to the enhanced FMAP described in section 2105(b) with
respect to medical assistance provided to individuals who are
eligible for such assistance only on the basis of section
1902(a)(10)(A)(ii)(XVIII)’’.
(d) EFFECTIVE DATE.—The amendments made by this section
apply to medical assistance for items and services furnished on
or after October 1, 2000, without regard to whether final regulations
to carry out such amendments have been promulgated by such
date.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.