‘‘(i) IN GENERAL.—The program pro-
vides or coordinates the provision of com-
prehensive items and services to ChiPACC 
eligible individuals (as defined in para-
graph (2)) in accordance with this section. 
‘‘(ii) SCOPE
AND
PLAN
FOR
SERV-
ICES.—Such items and services shall— 
‘‘(I) include items and services 
described in subsections (c)(1) and 
(c)(2), to the extent such items and 
services are medically necessary as de-
termined by the State; and 
‘‘(II) be provided consistent with 
a comprehensive care plan developed 
by an interdisciplinary health profes-
sional team (as defined in paragraph 
(4)). 
‘‘(C) QUALIFICATIONS
OF
PROVIDERS.— 
Such items and services are provided through— 
‘‘(i) health care providers that meet 
such certification or other Federal or State 
requirements as may be necessary to par-
ticipate in the program of medical assist-
ance under this title or in the program 
under title XVIII; or 
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‘‘(ii) in the case of counselors as de-
scribed in (4)(iii), individuals who are le-
gally authorized to provide counseling serv-
ices under State law or a regulatory mech-
anism provided by State law or, if no law 
or regulatory mechanism is applicable, by 
determination of the State. 
‘‘(D) STANDARDS AND GUIDELINES.—The 
ChiPACC is operated and the services to en-
rolled individuals are furnished in a manner 
that is informed by generally recognized profes-
sional guidelines, the Secretary may substitute 
the revision through sub-regulatory guidance. 
The Secretary may adopt other standards and 
guidelines consistent with the purposes of this 
section. 
‘‘(2) CHIPACC ELIGIBLE
INDIVIDUAL.—The 
term ‘ChiPACC eligible individual’ means, with re-
spect to a ChiPACC, an individual— 
‘‘(A) who, at the time of enrollment in the 
ChiPACC, is under 21 years of age; 
‘‘(B) who resides in the service area of a 
ChiPACC as determined by the State; 
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‘‘(C) who is eligible for medical assistance 
under the State plan without regard to this sec-
tion; 
‘‘(D) who suffers from a serious illness or 
health condition and for whom there is a rea-
sonable likelihood that the individual’s life will 
be threatened by such illness or condition; and 
‘‘(E) whose health status is expected to de-
cline because of such illness or condition before 
attaining the age of 21. 
‘‘(3) 
CHIPACC 
COORDINATOR.—The 
term 
‘ChiPACC coordinator’ means, with respect to a 
ChiPACC, an entity that, through the assignment of 
one or more case managers— 
‘‘(A) directs, supervises, and ensures the 
coordination of services to ChiPACC eligible in-
dividuals enrolled in the ChiPACC; and 
‘‘(B) ensures the direct and continuous in-
volvement of an interdisciplinary health profes-
sional team (as described in paragraph (4)) in 
managing and coordinating the provision of 
care and services within the coordinator’s re-
sponsibility, as determined by the State, to each 
such enrolled individual. 
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‘‘(4) INTERDISCIPLINARY
HEALTH
PROFES-
SIONAL
TEAM.—The term ‘interdisciplinary health 
professional team’ means, with respect to a 
ChiPACC, a group of professionals that— 
‘‘(A) includes at least— 
‘‘(i) one physician (as described in 
section 1861(r)); 
‘‘(ii) one registered nurse; 
‘‘(iii) one social worker, pastoral coun-
selor, or other counselor; and 
‘‘(iv) one case manager, who may be 
one of the individuals described in clauses 
(i) through (iii); 
‘‘(B) develops a comprehensive care plan 
for each ChiPACC eligible individual enrolled 
with the ChiPACC that takes into account the 
best interests of such individual and such indi-
vidual’s family; and 
‘‘(C) coordinates the provision of services 
described in subsections (c)(1) and (c)(2), as 
determined by the state, to an individual en-
rolled in the ChiPACC by members of the team 
or by other providers of services. 
‘‘(5) PALLIATIVE SERVICES.—The term ‘pallia-
tive services’ means, for the purposes of this section, 
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patient and family-centered care that optimizes qual-
ity of life for an individual with a serious illness or 
condition by— 
‘‘(A) anticipating, preventing, and treating 
the individual’s suffering throughout the con-
tinuum of illness; 
‘‘(B) addressing the physical, intellectual, 
emotional, social and spiritual needs of the indi-
vidual; and 
‘‘(C) facilitating the individual’s autonomy, 
access to information, and choice. 
‘‘(c) SCOPE OF BENEFITS.— 
‘‘(1) IN
GENERAL.—Under a ChiPACC of a 
State, the State shall ensure that an individual en-
rolled in the ChiPACC is covered for necessary serv-
ices including— 
‘‘(A) any early and periodic screening diag-
nostic and treatment service, as described in 
section 1905(r); and 
‘‘(B) any additional services that may be 
necessary to ensure that such coverage includes 
at least the elements described in paragraph 
(2). 
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‘‘(2) ELEMENTS OF A PROGRAM OF ALL-INCLU-
SIVE COORDINATED CARE.—The elements referred 
to in paragraph (1)(A)(ii) are— 
‘‘(A) medical and long-term care services 
and supports as described in section 1905 or as 
may be available to the individual under waiver 
programs approved under section 1915; 
‘‘(B) palliative services as described in sub-
section (b)(5); 
‘‘(C) counseling services and expressive 
therapy; 
‘‘(D) respite care; and 
‘‘(E) anticipatory bereavement and be-
reavement services to the immediate family 
members of the ChiPACC eligible individual. 
‘‘(3) COST-SHARING WAIVERS.—A State may, 
in the case of a ChiPACC eligible individual enrolled 
in the State’s ChiPACC, waive deductibles, copay-
ments, coinsurance, or other cost-sharing that would 
otherwise apply under the State plan under this 
title, as described in sections 1916 and 1916A. 
‘‘(d) RECORDS.—A provider participating in an inter-
disciplinary health professional team shall maintain 
records on ChiPACC eligible individuals enrolled in the 
program and to whom the provider furnishes services, re-
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flecting both the specific care and services furnished by 
the provider and the relationship of those services to the 
comprehensive plan of care for that individual and to the 
delivery of other services. 
‘‘(e) ELIGIBILITY
DETERMINATIONS.—In deter-
mining whether an individual is a ChiPACC eligible indi-
vidual, the State shall conduct, directly or under arrange-
ment, an assessment based on a determination by a physi-
cian and consultation with appropriate treating and con-
sulting health and support professionals caring for the in-
dividual. 
‘‘(f) PAYMENTS TO HEALTH CARE PROVIDERS AND 
CHIPACC COORDINATORS UNDER CHIPACC.—Payments 
to health care providers, a ChiPACC coordinator, or mem-
bers of an interdisciplinary health professional team fur-
nishing items and services under a ChiPACC shall be 
made on a fee-for-service basis, through a Medicaid man-
aged 
care 
organization 
(as 
described 
in 
section 
1903(m)(1)), or as otherwise allowable under the State 
plan under this title, and determined in a manner to en-
sure such payments are sufficient to support the ongoing 
care provided by such providers, coordinator, and team. 
‘‘(g) 
QUALITY
ASSURANCE; 
PATIENT
SAFE-
GUARDS.— 
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‘‘(1) 
IN
GENERAL.—With 
respect 
to 
a 
ChiPACC, the State shall adopt quality assurance 
provisions and patient safeguards, which may be the 
same as those in existing State systems, applicable 
to ChiPACC coordinators and interdisciplinary 
health professional teams. 
‘‘(2) CONSTRUCTION.—Nothing in this section 
shall be construed as preventing the Secretary from 
imposing requirements to ensure the health and 
safety of individuals enrolled in a ChiPACC under 
this section that are in addition to those otherwise 
provided under this section. 
‘‘(h) APPLICABILITY OF REQUIREMENTS.—With re-
spect to a State plan amendment under this section, the 
following requirements of this title (and regulations relat-
ing to such requirements) shall not apply: 
‘‘(1) Section 1902(a)(1), relating to any re-
quirement that ChiPACCs or ChiPACC services be 
provided in all areas of a State. 
‘‘(2) Section 1902(a)(10), insofar as such sec-
tion relates to comparability of services among dif-
ferent population groups, and to permit a ChiPACC 
program operating under this State plan amendment 
to enroll only individuals under age 21. 
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‘‘(3) Section 1905(o), insofar as it limits eligi-
bility for hospice care to individuals with a medical 
prognosis of a life expectancy of six months or less, 
as described in section 1861(dd)(3)(A).’’. 
(b) APPLICATION UNDER CHIP.—Section 2107(e)(1) 
of the Social Security Act (42 U.S.C. 1397gg(e)(1)), as 
amended by section 9822 of the American Rescue Plan 
Act of 2021, is further amended by adding at the end the 
following new subparagraph: 
‘‘(U) Section 1948 (relating to Medicaid 
children’s program of all-inclusive coordinated 
care).’’. 
(c) CONTINUED
DEMONSTRATION
PROJECT
AU-
THORITY.—Section 1948 of the Social Security Act, as 
added by subsection (a), shall not be construed as pre-
venting a State from developing, or the Secretary of 
Health and Human Services from approving, a project 
similar to or related to ChiPACCs (as described in such 
section) under alternative authorities, including dem-
onstration project and waiver authorities under title XIX 
of such Act or other provisions of such Act. 
Æ 
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