(i) the entity has obtained the immu-
nization status of such child, and
(ii) the entity has begun to provide
(or is providing) for immunizations of such
child in accordance with the standards es-
tablished for early and periodic screening,
diagnostic, and treatment services under
such title.
(2) EXPLANATION
OF
RIGHTS.—The expla-
nation of rights described in this paragraph shall in-
clude an explanation of an enrollee’s rights under
such title in relation to enrollment with the entity,
including an explanation of—
(A) the enrollee’s rights to benefits from the en-
tity,
(B) the restrictions on payments under such
title for services furnished other than by or through
the entity,
(C) out-of-area coverage provided by the entity,
(D) the entity’s coverage of emergency services
and urgently needed care, and
(E) appeal rights of enrollees.
(3) EXPLANATION OF ACCESS TO CARE.—The
explanation of access to care described in this para-
graph includes an explanation of the following fea-
tures of the benefits offered by the entity under such
title:
(A) Access to care, including choice of phy-
sician, physician location, and hospital coverage.
(B) The information required under sec-
tion 9914 of the Internal Revenue Code of
1986.
(b) PROMULGATION OF REQUIREMENTS FOR ORI-
ENTATION AND MEDICAL PROFILE.—Not later that 180
days after the date of the enactment of this Act, the Sec-
retary of Health and Human Services shall, by rule, first
specify the elements of the orientation and of the medical
profile described in section 1876(c)(3)(G) of the Social Se-
curity Act. Chapter 8 of title 5, United States Code, shall
not apply to such rule. Such rule shall apply on a final
basis, pending notice and opportunity for public comment.
(c) EFFECTIVE DATES.—
(1) IN GENERAL.—Subject to paragraph (2),
subsection (a) applies with respect to enrollees as of
the date that is 60 days after the date on which the
Secretary first publishes the rule under subsection
(b) in the Federal Register.
(2) 
IMMUNIZATION
REQUIREMENTS.—Sub-
section (a)(1)(C) applies with respect to enrollees as
of the first day of the first month that begins more
than 60 days after the date on which the Secretary
first publishes the rule under subsection (b) in the
Federal Register.
SEC. 302. REQUIREMENT FOR MEDICAID CAPITATED PLANS
TO ASSURE APPROPRIATE CHILDHOOD IM-
MUNIZATIONS.
(a) IN GENERAL.—Notwithstanding any other provi-
sion of law, no payment shall be made to a State under
title XIX of the Social Security Act with respect to ex-
penditures incurred by it for payment (determined under
a prepaid capitation basis or under any other risk basis)
for services provided by any entity (including a health in-
suring organization) which is responsible for the provision
(directly or through arrangements with providers of serv-
ices) of immunizations for children unless (and until)—
(1) the entity has obtained the immunization
status of each child enrolled with the entity, and
(2) the entity has begun to provide (or is pro-
viding) for immunizations of each such child in ac-
cordance with the standards established for early
and periodic screening, diagnostic, and treatment
services under such title.
(b) EFFECTIVE DATE.—Subsection (a) shall apply to
expenditures by States for months beginning more than
180 days after the date of the enactment of this Act.
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