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‘‘(D) pursuant to the application of section 
1902(e)(4) (and, in the case of an individual who is 
eligible for medical assistance on such basis, the in-
dividual shall be deemed to have provided satisfac-
tory documentary evidence of citizenship or nation-
ality and shall not be required to provide further 
documentary evidence on any date that occurs dur-
ing or after the period in which the individual is eli-
gible for medical assistance on such basis; or’’. 
(c) DOCUMENTATION FOR NATIVE AMERICANS .— 
Section 1903(x)(3)(B) of such Act is amended— 
(1) by redesignating clause (v) as clause (vi); 
and 
(2) by inserting after clause (iv) the following 
new clause: 
‘‘(v) For an individual who is a member of, or 
enrolled in or affiliated with, a federally-recognized 
Indian tribe, a document issued by such tribe evi-
dencing such membership, enrollment, or affiliation 
with the tribe (such as a tribal enrollment card or 
certificate of degree of Indian blood), and, only with 
respect to those federally-recognized Indian tribes lo-
cated within States having an international border 
whose membership includes individuals who are not 
citizens of the United States, such other forms of 
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documentation (including tribal documentation, if 
appropriate) as the Secretary, after consulting with 
such tribes, determines to be satisfactory documen-
tary evidence of citizenship or nationality for pur-
poses of satisfying the requirement of this subpara-
graph.’’. 
(d) REASONABLE OPPORTUNITY.—Section 1903(x) 
of such Act, as amended by subsection (a)(2), is further 
amended by adding at the end the following new para-
graph: 
‘‘(5) In the case of an individual declaring to be a 
citizen or national of the United States with respect to 
whom a State requires the presentation of satisfactory 
documentary evidence of citizenship or nationality under 
section 1902(a)(46)(B), the individual shall be provided 
at least the reasonable opportunity to present satisfactory 
documentary evidence of citizenship or nationality under 
this subsection as is provided under clauses (i) and (ii) 
of section 1137(d)(4)(A) to an individual for the submittal 
to the State of evidence indicating a satisfactory immigra-
tion status and shall not be denied medical assistance on 
the basis of failure to provide such documentation until 
the individual has had such an opportunity.’’. 
(e) EFFECTIVE DATE.— 
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(1) RETROACTIVE APPLICATION.—The amend-
ments made by this section shall take effect as if in-
cluded in the enactment of the Deficit Reduction Act 
of 2005 (Public Law 109–171; 120 Stat. 4). 
(2) RESTORATION
OF
ELIGIBILITY.—In the 
case of an individual who, during the period that 
began on July 1, 2006, and ends on the date of the 
enactment of this Act, was determined to be ineli-
gible for medical assistance under a State Medicaid 
program solely as a result of the application of sub-
sections (i)(22) and (x) of section 1903 of the Social 
Security Act (as in effect during such period), but 
who would have been determined eligible for such as-
sistance if such subsections, as amended by this sec-
tion, had applied to the individual, a State may 
deem the individual to be eligible for such assistance 
as of the date that the individual was determined to 
be ineligible for such medical assistance on such 
basis. 
SEC. 144. ACCESS TO DENTAL CARE FOR CHILDREN. 
(a) 
DENTAL
EDUCATION
FOR
PARENTS
OF 
NEWBORNS.—The Secretary of Health and Human Serv-
ices shall develop and implement, through entities that 
fund or provide perinatal care services to targeted low- 
income children under a State child health plan under title 
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XXI of the Social Security Act, a program to deliver oral 
health educational materials that inform new parents 
about risks for, and prevention of, early childhood caries 
and the need for a dental visit within their newborn’s first 
year of life. 
(b) PROVISION
OF DENTAL SERVICES THROUGH 
FQHCS.— 
(1) MEDICAID.—Section 1902(a) of the Social 
Security Act (42 U.S.C. 1396a(a)) is amended— 
(A) by striking ‘‘and’’ at the end of para-
graph (69); 
(B) by striking the period at the end of 
paragraph (70) and inserting ‘‘; and’’; and 
(C) by inserting after paragraph (70) the 
following new paragraph: 
‘‘(71) provide that the State will not prevent a 
Federally-qualified health center from entering into 
contractual relationships with private practice dental 
providers in the provision of Federally-qualified 
health center services.’’. 
(2) CHIP.—Section 2107(e)(1) of such Act (42 
U.S.C. 1397g(e)(1)), as amended by section 112(b), 
is amended by inserting after subparagraph (A) the 
following new subparagraph: 
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‘‘(B) Section 1902(a)(71) (relating to lim-
iting FQHC contracting for provision of dental 
services).’’. 
(3) EFFECTIVE DATE.—The amendments made 
by this subsection shall take effect on January 1, 
2008. 
(c) 
REPORTING
INFORMATION
ON
DENTAL 
HEALTH.— 
(1) MEDICAID.—Section 1902(a)(43)(D)(iii) of 
such Act (42 U.S.C. 1396a(a)(43)(D)(iii)) is amend-
ed by inserting ‘‘and other information relating to 
the provision of dental services to such children de-
scribed in section 2108(e)’’ after ‘‘receiving dental 
services,’’. 
(2) CHIP.—Section 2108 of such Act (42 
U.S.C. 1397hh) is amended by adding at the end 
the following new subsection: 
‘‘(e) INFORMATION ON DENTAL CARE FOR CHIL-
DREN.— 
‘‘(1) IN GENERAL.—Each annual report under 
subsection (a) shall include the following information 
with respect to care and services described in section 
1905(r)(3) provided to targeted low-income children 
enrolled in the State child health plan under this 
title at any time during the year involved: 
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‘‘(A) The number of enrolled children by 
age grouping used for reporting purposes under 
section 1902(a)(43). 
‘‘(B) For children within each such age 
grouping, information of the type contained in 
questions 12(a)–(c) of CMS Form 416 (that 
consists of the number of enrolled targeted low 
income children who receive any, preventive, or 
restorative dental care under the State plan). 
‘‘(C) For the age grouping that includes 
children 8 years of age, the number of such 
children who have received a protective sealant 
on at least one permanent molar tooth. 
‘‘(2) INCLUSION OF INFORMATION ON ENROLL-
EES IN MANAGED CARE PLANS.—The information 
under paragraph (1) shall include information on 
children who are enrolled in managed care plans and 
other private health plans and contracts with such 
plans under this title shall provide for the reporting 
of such information by such plans to the State.’’. 
(3) EFFECTIVE DATE.—The amendments made 
by this subsection shall be effective for annual re-
ports submitted for years beginning after date of en-
actment. 
(d) GAO STUDY AND REPORT.— 
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(1) STUDY.—The Comptroller General of the 
United States shall provide for a study that exam-
ines— 
(A) access to dental services by children in 
underserved areas; and 
(B) the feasibility and appropriateness of 
using qualified mid-level dental health pro-
viders, in coordination with dentists, to improve 
access for children to oral health services and 
public health overall. 
(2) REPORT.—Not later than 1 year after the 
date of the enactment of this Act, the Comptroller 
General shall submit to Congress a report on the 
study conducted under paragraph (1). 
SEC. 145. PROHIBITING INITIATION OF NEW HEALTH OP-
PORTUNITY ACCOUNT DEMONSTRATION PRO-
GRAMS. 
After the date of the enactment of this Act, the Sec-
retary of Health and Human Services may not approve 
any new demonstration programs under section 1938 of 
the Social Security Act (42 U.S.C. 1396u–8). 
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Subtitle F—Quality and Program 
Integrity 
SEC. 151. PEDIATRIC HEALTH QUALITY MEASUREMENT 
PROGRAM. 
(a) 
QUALITY
MEASUREMENT
OF
CHILDREN’S 
HEALTH.— 
(1) ESTABLISHMENT OF PROGRAM TO DEVELOP 
QUALITY
MEASURES
FOR
CHILDREN’S
HEALTH.— 
The Secretary of Health and Human Services (in 
this section referred to as the ‘‘Secretary’’) shall es-
tablish a child health care quality measurement pro-
gram (in this subsection referred to as the ‘‘chil-
dren’s health quality measurement program’’) to de-
velop and implement— 
(A) pediatric quality measures on chil-
dren’s health care that may be used by public 
and private health care purchasers (and a sys-
tem for reporting such measures); and 
(B) measures of overall program perform-
ance that may be used by public and private 
health care purchasers. 
The Secretary shall publish, not later than Sep-
tember 30, 2009, the recommended measures under 
the program for application under the amendments 
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made by subsection (b) for years beginning with 
2010. 
(2) MEASURES.— 
(A) 
SCOPE.—The 
measures 
developed 
under the children’s health quality measure-
ment program shall— 
(i) provide comprehensive information 
with respect to the provision and outcomes 
of health care for young children, school 
age children, and older children; 
(ii) be designed to identify disparities 
by pediatric characteristics (including, at a 
minimum, those specified in subparagraph 
(C)) in child health and the provision of 
health care; 
(iii) be designed to ensure that the 
data required for such measures is col-
lected and reported in a standard format 
that permits comparison at a State, plan, 
and provider level, and between insured 
and uninsured children; 
(iv) take into account existing meas-
ures of child health quality and be periodi-
cally updated; 
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(v) include measures of clinical health 
care quality which meet the requirements 
for pediatric quality measures in para-
graph (1); 
(vi) improve and augment existing 
measures of clinical health care quality for 
children’s health care and develop new and 
emerging measures; and 
(vii) increase the portfolio of evidence- 
based pediatric quality measures available 
to public and private purchasers, providers, 
and consumers. 
(B) SPECIFIC MEASURES.—Such measures 
shall include measures relating to at least the 
following aspects of health care for children: 
(i) The proportion of insured (and un-
insured) children who receive age-appro-
priate preventive health and dental care 
(including age appropriate immunizations) 
at each stage of child health development. 
(ii) The proportion of insured (and 
uninsured) children who receive dental care 
for restoration of teeth, relief of pain and 
infection, and maintenance of dental 
health. 
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(iii) The effectiveness of early health 
care interventions for children whose as-
sessments indicate the presence or risk of 
physical or mental conditions that could 
adversely affect growth and development. 
(iv) The effectiveness of treatment to 
ameliorate the effects of diagnosed physical 
and mental health conditions, including 
chronic conditions. 
(v) The proportion of children under 
age 21 who are continuously insured for a 
period of 12 months or longer. 
(vi) The effectiveness of health care 
for children with disabilities. 
(vii) Data on State efforts to reduce 
hospitalization rate of premature infants 
under the age of 12 months who were born 
prior to 35 weeks. 
In carrying out clause (vi), the Secretary shall 
develop quality measures and best practices re-
lating to cystic fibrosis. 
(C) REPORTING METHODOLOGY FOR ANAL-
YSIS
BY
PEDIATRIC
CHARACTERISTICS.—The 
children’s health quality measurement program 
shall describe with specificity such measures 
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and the process by which such measures will be 
reported in a manner that permits analysis 
based on each of the following pediatric charac-
teristics: 
(i) Age. 
(ii) Gender. 
(iii) Race. 
(iv) Ethnicity. 
(v) Primary language of the child’s 
parents (or caretaker relative). 
(vi) Disability or chronic condition 
(including cystic fibrosis). 
(vii) Geographic location. 
(viii) Coverage status under public 
and private health insurance programs. 
(D) PEDIATRIC
QUALITY
MEASURE.—In 
this subsection, the term ‘‘pediatric quality 
measure’’ means a measurement of clinical care 
that assesses one or more aspects of pediatric 
health care quality (in various settings) includ-
ing the structure of the clinical care system, the 
process and outcome of care, or patient experi-
ence in such care. 
(3) CONSULTATION
IN
DEVELOPING
QUALITY 
MEASURES FOR CHILDREN’S HEALTH SERVICES.—In 
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developing and implementing the children’s health 
quality measurement program, the Secretary shall 
consult with— 
(A) States; 
(B) pediatric hospitals, pediatricians, and 
other primary and specialized pediatric health 
care professionals (including members of the al-
lied health professions) who specialize in the 
care and treatment of children, particularly 
children with special physical, mental, and de-
velopmental health care needs; 
(C) dental professionals; 
(D) health care providers that furnish pri-
mary health care to children and families who 
live in urban and rural medically underserved 
communities or who are members of distinct 
population sub-groups at heightened risk for 
poor health outcomes; 
(E) national organizations representing 
children, including children with disabilities and 
children with chronic conditions; 
(F) national organizations and individuals 
with expertise in pediatric health quality per-
formance measurement; and 
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(G) voluntary consensus standards setting 
organizations and other organizations involved 
in the advancement of evidence based measures 
of health care. 
(4) USE OF GRANTS AND CONTRACTS.—In car-
rying out the children’s health quality measurement 
program, the Secretary may award grants and con-
tracts to develop, test, validate, update, and dissemi-
nate quality measures under the program. 
(5) TECHNICAL
ASSISTANCE.—The Secretary 
shall provide technical assistance to States to estab-
lish for the reporting of quality measures under ti-
tles XIX and XXI of the Social Security Act in ac-
cordance with the children’s health quality measure-
ment program. 
(b) DISSEMINATION OF INFORMATION ON THE QUAL-
ITY OF PROGRAM PERFORMANCE.—Not later than Janu-
ary 1, 2009, and annually thereafter, the Secretary shall 
collect, analyze, and make publicly available on a public 
website of the Department of Health and Human Services 
in an online format— 
(1) a complete list of all measures in use by 
States as of such date and used to measure the 
quality of medical and dental health services fur-
nished to children enrolled under title XIX of XXI 
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of the Social Security Act by participating providers, 
managed care entities, and plan issuers; and 
(2) information on health care quality for chil-
dren contained in external quality review reports re-
quired under section 1932(c)(2) of such Act (42 
U.S.C. 1396u–2) or produced by States that admin-
ister separate plans under title XXI of such Act. 
(c) REPORTS TO CONGRESS ON PROGRAM PERFORM-
ANCE.—Not later than January 1, 2010, and every 2 
years thereafter, the Secretary shall report to Congress 
on— 
(1) the quality of health care for children en-
rolled under titles XIX and XXI of the Social Secu-
rity Act under the children’s health quality measure-
ment program; and 
(2) patterns of health care utilization with re-
spect to the measures specified in subsection 
(a)(2)(B) among children by the pediatric character-
istics listed in subsection (a)(2)(C). 
SEC. 152. APPLICATION OF CERTAIN MANAGED CARE 
QUALITY SAFEGUARDS TO CHIP. 
(a) IN GENERAL.—Section 2103(f) of Social Security 
Act (42 U.S.C. 1397bb(f)) is amended by adding at the 
end the following new paragraph: 
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