I 
112TH CONGRESS 
1ST SESSION 
H. R. 912 
To amend the Public Health Service Act to establish a national screening 
program at the Centers for Disease Control and Prevention and to 
amend title XIX of the Social Security Act to provide States the option 
to increase screening in the United States population for the prevention, 
early detection, and timely treatment of colorectal cancer. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 3, 2011 
Ms. GRANGER introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
A BILL 
To amend the Public Health Service Act to establish a na-
tional screening program at the Centers for Disease Con-
trol and Prevention and to amend title XIX of the Social 
Security Act to provide States the option to increase 
screening in the United States population for the preven-
tion, early detection, and timely treatment of colorectal 
cancer. 
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 ‘‘Colorectal Cancer Pre-
vention, Early Detection, and Treatment Act’’. 
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SEC. 2. PREVENTIVE HEALTH MEASURES WITH RESPECT 
TO COLORECTAL CANCER. 
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 317T the following new section: 
‘‘SEC. 317U. PREVENTIVE HEALTH MEASURES WITH RE-
SPECT TO COLORECTAL CANCER. 
‘‘(a) GRANT PROGRAM AUTHORIZATION.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention, may make grants to eligible 
entities for the purpose of carrying out a program 
described in subsection (b). An eligible entity that is 
a recipient of a grant under this subsection may use 
such grant to carry out such programs directly or 
through grants to, or contracts with, public and not- 
for-profit private entities. 
‘‘(2) ELIGIBLE
ENTITY
DEFINED.—For pur-
poses of this section, the term ‘eligible entity’ in-
cludes the following: 
‘‘(A) A State, including, in addition to the 
several States, the District of Columbia, Guam, 
the Commonwealth of Puerto Rico, the North-
ern Mariana Islands, the Virgin Islands, Amer-
ican Samoa, and the Trust Territory of the Pa-
cific Islands. 
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‘‘(B) An Indian tribe or tribal organiza-
tion, as such terms are defined in section 4 of 
the Indian Self-Determination and Education 
Assistance Act. 
‘‘(b) PROGRAMS DESCRIBED.— 
‘‘(1) IN GENERAL.—Subject to paragraph (2), a 
program described in this subsection shall use evi-
dence-based strategies and population-based public 
health approaches, including public education and 
outreach, professional training and development, 
quality assurance monitoring, surveillance, and eval-
uation, to increase quality colorectal cancer screen-
ing in the population aged 50 years and older, or for 
individuals under 50 who are at high risk. A pro-
gram described in this subsection is a program for 
planning or implementing each of the following: 
‘‘(A) 
Providing 
evidence-based, 
rec-
ommended screenings for colorectal cancer to 
individuals who— 
‘‘(i) are 50 years of age or older; or 
‘‘(ii)(I) are under 50 years of age; and 
‘‘(II) are at high risk for such cancer, 
as determined in accordance with sub-
section (e)(2). 
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‘‘(B) Providing appropriate case manage-
ment and referrals for medical treatment of in-
dividuals screened pursuant to subparagraph 
(A). 
‘‘(C) Ensuring (directly or through coordi-
nation or an arrangement with health care pro-
viders or programs) the full continuum of fol-
low-up and cancer care for individuals so 
screened, including appropriate follow-up for 
abnormal tests, diagnostic services, therapeutic 
services, and treatment of detected cancers and 
management of unanticipated medical complica-
tions. 
‘‘(D) Carrying out activities to improve the 
education, training, and skills of health profes-
sionals (including allied health professionals) to 
ensure the use of evidence-based recommended 
and quality screening and follow up in the pre-
vention, detection, and control of colorectal can-
cer, which activities are carried out pursuant to 
the participation of the health professionals in 
the program. 
‘‘(E) Establishing mechanisms through 
which the eligible entity involved can monitor 
the quality of screening and diagnostic follow- 
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up procedures for colorectal cancer, including 
the interpretation of such procedures. 
‘‘(F) Evaluating the activities described in 
this subsection through appropriate surveillance 
and program monitoring activities. 
‘‘(G) Developing and disseminating find-
ings derived through such evaluations and the 
collection of data on outcomes. 
‘‘(H) Developing and disseminating public 
information and education programs for the 
prevention, detection, and control of colorectal 
cancer and promoting the benefits of receiving 
screenings to populations recommended for 
screening. 
‘‘(2) SUPPLEMENT
NOT
SUPPLANT.—In the 
case of an eligible entity that implements a universal 
colorectal screening program under which the eligi-
ble entity makes available funds for activities de-
scribed in subparagraph (A), (B), or (C) of para-
graph (1), such entity shall be able to receive grant 
funds under subsection (a) only for purposes of— 
‘‘(A) carrying out those activities under 
this subsection that are not so funded; or 
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‘‘(B) supplementing (and not supplanting) 
funds made available by the entity for such 
funded program. 
‘‘(c) PRIORITY FOR LOW-INCOME, UNINSURED AND 
UNDERINSURED INDIVIDUALS.—A grant may be made 
under subsection (a) to an eligible entity only if the eligible 
entity agrees that, in providing screenings under sub-
section (b)(1)(A), the eligible entity will give priority to 
low-income individuals who lack adequate coverage, as de-
termined by the Secretary, under health insurance and 
health plans with respect to screenings for colorectal can-
cer. 
‘‘(d) SPECIAL CONSIDERATION FOR CERTAIN APPLI-
CANTS.—In making grants under subsection (a) for a fis-
cal year, the Secretary shall give special consideration to 
the following eligible entities: 
‘‘(1) In the case of services under such sub-
section for women, to such entities that, for such 
year, are grantees under title XV. 
‘‘(2) In the case of services under such sub-
section for men, to such entities that, for such year, 
are grantees under section 317D. 
‘‘(3) To such entities that coordinate with other 
Federal, State, and local colorectal cancer programs. 
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‘‘(4) To such entities with an existing program 
to provide cancer screening to individuals. 
‘‘(e) USE OF CERTAIN STANDARDS UNDER MEDI-
CARE PROGRAM.—A grant may be made under subsection 
(a) to an eligible entity only if the eligible entity provides, 
as applicable, assurances as follows: 
‘‘(1) Screenings under subsection (b)(1)(A) will 
be carried out as preventive health measures in ac-
cordance with evidence-based screening guidelines 
and procedures and in accordance with the standard 
of care required for purposes of title XVIII of the 
Social Security Act to carry out colorectal screening 
tests defined in section 1861(pp)(1) of such Act. 
‘‘(2) An individual will be considered high risk 
for purposes of subsection (b)(1)(A)(ii) only if the 
individual is high risk within the meaning of section 
1861(pp)(2) of such Act. 
‘‘(3) The payment made from the grant for a 
screening procedure under subsection (b)(1)(A) will 
not exceed the amount that would be paid under 
part B of title XVIII of such Act if payment were 
made under such part for furnishing the procedure 
to an individual enrolled under such part. 
‘‘(f) RELATIONSHIP TO ITEMS AND SERVICES UNDER 
OTHER PROGRAMS.—A grant under subsection (a) may 
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be made to an eligible entity only if the eligible entity, 
as applicable, provides assurances that the grant will not 
be expended to make payment for any item or service to 
the extent that payment has been made, or can reasonably 
be expected to be made, with respect to such item or serv-
ice— 
‘‘(1) under any State compensation program, 
under an insurance policy, or under any Federal or 
State health benefits program; or 
‘‘(2) by an entity that provides health services 
on a prepaid basis. 
‘‘(g) RECORDS AND AUDITS.—A grant under sub-
section (a) may be made to an eligible entity only if the 
eligible entity provides assurances that the eligible entity 
will— 
‘‘(1) establish such fiscal control and fund ac-
counting procedures as may be necessary to ensure 
proper disbursal of, and accounting for, amounts re-
ceived under subsection (a); and 
‘‘(2) upon request, provide records maintained 
pursuant to paragraph (1) to the Secretary or the 
Comptroller General of the United States for pur-
poses of auditing the expenditures of the grant by 
the eligible entity. 
‘‘(h) REQUIREMENT OF MATCHING FUNDS.— 
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‘‘(1) IN
GENERAL.—The Secretary may not 
make a grant under subsection (a) to an eligible en-
tity for a fiscal year unless the eligible entity agrees, 
with respect to the costs to be incurred by the eligi-
ble entity for such fiscal year in carrying out the ac-
tivities described in subsection (b), to make available 
non-Federal contributions (in cash or in kind under 
paragraph (2)) toward such costs in an amount 
equal to not less than $1 for each $3 of Federal 
funds provided in the grant for such fiscal year. 
Such contributions may be made directly or through 
donations from public or private entities. 
‘‘(2) DETERMINATION
OF
AMOUNT
OF
NON- 
FEDERAL CONTRIBUTION.— 
‘‘(A) IN GENERAL.—Non-Federal contribu-
tions required in paragraph (1) may be in cash 
or in kind, fairly evaluated, including equipment 
or services (and excluding indirect or overhead 
costs). Amounts provided by the Federal Gov-
ernment, or services assisted or subsidized to 
any significant extent by the Federal Govern-
ment, may not be included in determining the 
amount of such non-Federal contributions. 
‘‘(B) 
MAINTENANCE
OF
EFFORT.—In 
making a determination of the amount of non- 
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Federal contributions for purposes of paragraph 
(1), the Secretary may include only non-Federal 
contributions in excess of the average amount 
of non-Federal contributions made by the eligi-
ble entity involved toward the activities de-
scribed in subsection (b) for the 2-year period 
preceding the first fiscal year for which the eli-
gible entity is applying to receive a grant under 
subsection (a). 
‘‘(C) INCLUSION OF RELEVANT NON-FED-
ERAL
CONTRIBUTIONS
FOR
MEDICAID.—In 
making a determination of the amount of non- 
Federal contributions for purposes of paragraph 
(1), the Secretary shall, subject to subpara-
graphs (A) and (B) of this paragraph, include 
any non-Federal amounts expended pursuant to 
title XIX of the Social Security Act by the eligi-
ble entity involved toward the activities de-
scribed in subparagraphs (A) and (B) of sub-
section (b)(1). 
‘‘(i) ADDITIONAL REQUIREMENTS.— 
‘‘(1) LIMITATION
ON
ADMINISTRATIVE
EX-
PENSES.—The Secretary may not make a grant to 
an eligible entity under subsection (a) unless the eli-
gible entity provides assurances that not more than 
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10 percent of the grant will be expended for admin-
istrative expenses with respect to the activities fund-
ed by the grant. 
‘‘(2) STATEWIDE PROVISION OF SERVICES.— 
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (B), the Secretary may not make a grant 
under subsection (a) to an eligible entity unless 
the eligible entity provides assurances that any 
program funded by such grant will be made 
available throughout the State, including avail-
ability to members of an Indian tribe or tribal 
organization (as such terms are defined in sec-
tion 4 of the Indian Self-Determination and 
Education Assistance Act). 
‘‘(B) WAIVER.—The Secretary may waive 
the requirement under subparagraph (A) for an 
eligible entity if the Secretary determines that 
compliance by the eligible entity with the re-
quirement would result in an inefficient alloca-
tion of resources with respect to carrying out 
the purposes described in subsection (a). 
‘‘(j) TECHNICAL ASSISTANCE
AND PROVISION
OF 
SUPPLIES AND SERVICES IN LIEU OF GRANT FUNDS.— 
‘‘(1) TECHNICAL ASSISTANCE.—The Secretary 
may provide training and technical assistance with 
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respect to the planning, development, and operation 
of any program funded by a grant under subsection 
(a). The Secretary may provide such technical as-
sistance directly to eligible entities or through grants 
to, or contracts with, public and private entities. 
‘‘(2) PROVISION OF SUPPLIES AND SERVICES IN 
LIEU OF GRANT FUNDS.— 
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (B), upon the request of an eligible entity 
receiving a grant under subsection (a), the Sec-
retary for the purpose of aiding the eligible en-
tity to carry out a program under subsection 
(b)— 
‘‘(i) may provide supplies, equipment, 
and services to the eligible entity; and 
‘‘(ii) may detail to the eligible entity 
any officer or employee of the Department 
of Health and Human Services. 
‘‘(B) CORRESPONDING REDUCTION IN PAY-
MENTS.—With respect to a request made by an 
eligible entity under subparagraph (A), the Sec-
retary shall reduce the amount of payments 
made under the grant under subsection (a) to 
the eligible entity by an amount equal to the 
fair market value of any supplies, equipment, or 
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services provided by the Secretary and the costs 
of detailing personnel (including pay, allow-
ances, and travel expenses) under subparagraph 
(A). The Secretary shall, for the payment of ex-
penses incurred in complying with such request, 
expend the amounts withheld. 
‘‘(k) REPORTS.—A grant under subsection (a) may 
be made only if the applicant involved agrees to submit 
to the Secretary such reports as the Secretary may require 
with respect to the grant. 
‘‘(l) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(1) IN
GENERAL.—For the purpose of car-
rying out this section, there are authorized to be ap-
propriated $120,000,000 for each of fiscal years 
2012 through 2016. 
‘‘(2) SET-ASIDE
FOR
TECHNICAL
ASSISTANCE 
AND PROVISION OF SUPPLIES AND SERVICES.—Of 
the amount appropriated under paragraph (1) for a 
fiscal year, the Secretary shall reserve not to exceed 
20 percent for carrying out subsection (j).’’. 
SEC. 3. OPTIONAL MEDICAID COVERAGE OF CERTAIN PER-
SONS 
SCREENED 
AND 
FOUND 
TO 
HAVE 
COLORECTAL CANCER. 
(a) 
COVERAGE
AS
OPTIONAL
CATEGORICALLY 
NEEDY GROUP.— 
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(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 (XXI), by striking ‘‘or’’ at 
the end; 
(B) in subclause (XXII), by adding ‘‘or’’ at 
the end; and 
(C) by adding at the end the following: 
‘‘(XXIII) who are described in 
subsection (ll) (relating to certain per-
sons screened and found to need 
treatment from complications from 
screening or have colorectal cancer);’’. 
(2) GROUP DESCRIBED.—Section 1902 of the 
Social Security Act (42 U.S.C. 1396a) is amended 
by adding at the end the following: 
‘‘(ll) Individuals described in this subsection are indi-
viduals who— 
‘‘(1) 
are 
not 
described 
in 
subsection 
(a)(10)(A)(i); 
‘‘(2) have not attained age 65; 
‘‘(3) have been screened for colorectal cancer 
and need treatment for complications due to screen-
ing or colorectal cancer; and 
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‘‘(4) are not otherwise covered under creditable 
coverage, as defined in section 2704(c) of the Public 
Health Service Act.’’. 
(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 ‘‘(XV)’’ and inserting ‘‘, 
(XV)’’; 
(B) by striking ‘‘setting and (XVI)’’ and 
inserting ‘‘setting, (XVII)’’; and 
(C) by inserting ‘‘, and (XVIII) the med-
ical assistance made available to an individual 
described in subsection (ll) who is eligible for 
medical assistance only because of subpara-
graph (A)(10)(ii)(XXIII) shall be limited to 
medical assistance provided during the period in 
which such an individual requires treatment for 
complications due to screening or colorectal 
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)— 
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(A) in clause (xvi), by striking ‘‘or’’ at the 
end; 
(B) in clause (xvii), by adding ‘‘or’’ at the 
end; and 
(C) by inserting after clause (xvii) the fol-
lowing: 
‘‘(xviii) individuals described in sec-
tion 1902(ll),’’. 
(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 1920C the following: 
‘‘OPTIONAL APPLICATION OF PRESUMPTIVE ELIGIBILITY 
PROVISIONS
FOR
CERTAIN
PERSONS
WITH 
COLORECTAL CANCER 
‘‘SEC. 1920D. A State may elect to apply the provi-
sions of section 1920B to individuals described in section 
1902(ll) (relating to certain colorectal cancer patients) in 
the same manner as such section applies to individuals de-
scribed in section 1902(aa) (relating to certain breast or 
cervical cancer patients).’’. 
(2) CONFORMING AMENDMENTS.— 
(A) Section 1902(a)(47) of the Social Se-
curity Act (42 U.S.C. 1396a(a)(47)), as amend-
ed by sections 2202(a) and 2303(b)(2) of Pub-
lic Law 111–148, is amended— 
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(i) by inserting before the first semi-
colon the following: ‘‘ and provide for mak-
ing medical assistance available to individ-
uals described in section 1920D during a 
presumptive eligibility period in accordance 
with such section’’; and 
(ii) effective as of January 1, 2014, in 
subparagraph (B), by striking ‘‘or 1920C’’ 
and inserting ‘‘1920C, or 1920D’’. 
(B) Section 1903(u)(1)(D)(v) of such Act 
(42 U.S.C. 1396b(u)(1)(d)(v)) is amended by 
inserting ‘‘, or for medical assistance provided 
to an individual described in section 1920D 
during a presumptive eligibility period under 
such section’’ after ‘‘1920B during a presump-
tive eligibility period under such section’’. 
(c) ENHANCED MATCH.—The first sentence of sec-
tion 1905(b) of the Social Security Act (42 U.S.C. 
1396d(b)) is amended— 
(1) by striking ‘‘and’’ before ‘‘(4)’’; and 
(2) by inserting before the period at the end the 
following: ‘‘, and (5) the Federal medical assistance 
percentage shall be equal to the enhanced FMAP de-
scribed in section 2105(b) with respect to medical 
assistance provided to individuals who are eligible 
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for such assistance only on the basis of section 
1902(a)(10)(A)(ii)(XXIII)’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section apply to medical assistance for items and serv-
ices furnished on or after October 1, 2011, without regard 
to whether final regulations to carry out such amendments 
have been promulgated by such date. 
Æ 
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