I
106TH CONGRESS
2D SESSION
H. R. 4386
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 cer-
vical cancer and the human papillomavirus (HPV), and for other pur-
poses.
IN THE HOUSE OF REPRESENTATIVES
MAY 4, 2000
Mrs. MYRICK (for herself, Ms. DANNER, and Mr. LAZIO) introduced the
following bill; which was referred to the Committee on Commerce
A BILL
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 Representa-
tives 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 CERVICAL 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 (XIII), by striking ‘‘or’’
at the end;
(B) in subclause (XIV), by adding ‘‘or’’ at
the end; and
(C) by adding at the end the following:
‘‘(XV) who are described in sub-
section (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 paragraph are in-
dividuals 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 ac-
cordance 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 (45 U.S.C. 300gg(c)).’’.
(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 (F)—
(A) by striking ‘‘and (XIII)’’ and inserting
‘‘(XIII)’’; and
(B) by inserting ‘‘, and (XIV) the medical
assistance made available to an individual de-
scribed in subsection (aa) who is eligible for
medical assistance only because of subpara-
graph (A)(10)(ii)(XV) 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 para-
graph (1)—
(A) in clause (x), by striking ‘‘or’’ at the
end;
(B) in clause (xi), by adding ‘‘or’’ at the
end; and
(C) by inserting after clause (xi) the fol-
lowing:
‘‘(xii) 
individuals 
described 
in 
section
1902(aa),’’.
(b) PRESUMPTIVE ELIGIBILITY.—
(1) IN GENERAL.—Title XIX of the Social Se-
curity 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 ap-
proved under section 1902 may provide for making med-
ical assistance available to an individual described in sec-
tion 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 ‘presumptive eligibility period’ means, with re-
spect 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 pre-
liminary information, that the individual is de-
scribed 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 dur-
ing which the entity makes the determina-
tion referred to in subparagraph (A), such
last day.
‘‘(2) QUALIFIED ENTITY.—
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (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 agen-
cy to be capable of making determinations
of the type described in paragraph (1)(A).
‘‘(B) REGULATIONS.—The Secretary may
issue regulations further limiting those entities
that may become qualified entities in order to
prevent fraud and abuse and for other reasons.
‘‘(C) RULE OF CONSTRUCTION.—Nothing
in this paragraph shall be construed as pre-
venting a State from limiting the classes of en-
tities that may become qualified entities, con-
sistent with any limitations imposed under sub-
paragraph (B).
‘‘(c) ADMINISTRATION.—
‘‘(1) IN GENERAL.—The State agency shall pro-
vide qualified entities with—
‘‘(A) such forms as are necessary for an
application to be made by an individual de-
scribed in subsection (a) for medical assistance
under the State plan; and
‘‘(B) information on how to assist such in-
dividuals in completing and filing such forms.
‘‘(2) NOTIFICATION REQUIREMENTS.—A quali-
fied 
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 deter-
mination within 5 working days after the date
on which determination is made; and
‘‘(B) inform such individual at the time
the determination 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
ASSIST-
ANCE.—In the case of an individual described in
subsection (a) who is determined by a qualified enti-
ty 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 dur-
ing which the determination is made.
‘‘(d) PAYMENT.—Notwithstanding any other provi-
sion of this title, medical assistance that—
‘‘(1) is furnished to an individual described in
subsection (a)—
‘‘(A) during a presumptive eligibility pe-
riod;
‘‘(B) by a entity that is eligible for pay-
ments 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 section 1903(a)(5).’’.
(2) CONFORMING AMENDMENTS.—
(A) Section 1902(a)(47) of the Social Se-
curity Act (42 U.S.C. 1396a(a)(47)) is amend-
ed 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 pre-
sumptive eligibility 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
(ii) by inserting before the period the
following: ‘‘, or for medical assistance pro-
vided to an individual described in sub-
section (a) of section 1920B during a pre-
sumptive eligibility period under such sec-
tion’’.
(c) EFFECTIVE DATE.—The amendments made by
this section apply to medical assistance for items and serv-
ices furnished on or after October 1, 2000, without regard
to whether final regulations to carry out such amendments
have been promulgated by such date.
SEC. 3. HUMAN PAPILLOMAVIRUS; ACTIVITIES OF CENTERS
FOR DISEASE CONTROL AND PREVENTION.
Part B of title III of the Public Health Service Act
(42 U.S.C. 243 et seq.) is amended by inserting after sec-
tion 317G the following section:
‘‘HUMAN PAPILLOMAVIRUS
‘‘SEC. 317H. (a) SURVEILLANCE.—
‘‘(1) IN
GENERAL.—The Secretary, acting
through the Director of the Centers for Disease
Control and Prevention, shall—
‘‘(A) enter into cooperative agreements
with States and other entities to conduct sen-
tinel surveillance or other special studies that
would determine the prevalence in various age
groups and populations of specific types of
human papillomavirus (referred to in this sec-
tion as ‘HPV’) in different sites in various re-
gions of the United States, through collection of
special specimens for HPV using a variety of
laboratory-based testing and diagnostic tools;
and
‘‘(B) develop and analyze data from the
HPV sentinel surveillance system described in
subparagraph (A).
‘‘(2) REPORT.—The Secretary shall make a
progress report to the Congress with respect to
paragraph (1) not later than one year after the ef-
fective date of this section.
‘‘(b) PREVENTION ACTIVITIES; EDUCATION PRO-
GRAM.—
‘‘(1) IN
GENERAL.—The Secretary, acting
through the Director of the Centers for Disease
Control and Prevention, shall conduct prevention re-
search on HPV, including—
‘‘(A) behavioral and other research on the
impact of HPV-related diagnoses on individuals;
‘‘(B) formative research to assist with the
development of educational messages and infor-
mation for the public, for patients, and for their
partners about HPV;
‘‘(C) surveys of physician and public
knowledge, attitudes, and practices about gen-
ital HPV infection; and
‘‘(D) upon the completion of and based on
the findings under subparagraphs (A) through
(C), develop and disseminate educational mate-
rials for the public and health care providers re-
garding HPV and its impact and prevention.
‘‘(2) REPORT; FINAL
PROPOSAL.—The Sec-
retary shall make a progress report to the Congress
with respect to paragraph (1) not later than one
year after the effective date of this section, and shall
develop a final proposal not later than two years
after such effective date, including a detailed sum-
mary of the significant findings and problems. The
report shall outline the further steps needed to make
HPV a reportable disease and the best strategies to
prevent future infections.
‘‘(c) CONDOM EFFECTIVENESS; EDUCATION.—The
Secretary shall require that the Department of Health and
Human Services and all contractors, grantees, and sub-
grantees of such Department specifically state the effec-
tiveness or lack of effectiveness of condoms in preventing
the transmission of HPV, herpes, and other sexually
transmitted diseases in all informational materials related
to condoms or sexually transmitted diseases that are made
available to the public. The Secretary shall assure that
such information is made available to relevant operating
divisions and offices of the Department of Health and
Human Services. This subsection shall be effective within
6 months of the date of its enactment.’’.
SEC. 4. LABELING OF CONDOMS WITH RESPECT TO HUMAN
PAPILLOMAVIRUS.
(a) IN GENERAL.—Section 502 of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 352) is amended by
adding at the end the following:
‘‘(u) If it is a condom, unless its label and labeling
bear information providing that condoms do not effectively
prevent the transmission of the human papillomavirus and
that such virus can cause cervical cancer.’’.
(b) APPLICABILITY.—The amendment made by sub-
section (a) applies to condoms manufactured on or after
the expiration of the 180-day period beginning on the date
of the enactment of this Act.
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