IB 
Union Calendar No. 137 
117TH CONGRESS 
1ST SESSION H. R. 3894 
[Report No. 117–187] 
To require the Secretary of Health and Human Services to issue and dissemi-
nate guidance to States to clarify strategies to address social deter-
minants of health under the Medicaid program and the Children’s Health 
Insurance Program, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 15, 2021 
Ms. BLUNT ROCHESTER (for herself and Mr. BILIRAKIS) introduced the 
following bill; which was referred to the Committee on Energy and Commerce 
NOVEMBER 30, 2021 
Additional sponsor: Mr. RUIZ 
NOVEMBER 30, 2021 
Reported with an amendment, committed to the Committee of the Whole 
House on the State of the Union, and ordered to be printed 
[Strike out all after the enacting clause and insert the part printed in italic] 
[For text of introduced bill, see copy of bill as introduced on June 15, 2021] 
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A BILL 
To require the Secretary of Health and Human Services 
to issue and disseminate guidance to States to clarify 
strategies to address social determinants of health under 
the Medicaid program and the Children’s Health Insur-
ance Program, and for other purposes. 
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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 ‘‘Collecting and Ana-
lyzing Resources Integral and Necessary for Guidance for 
Social Determinants Act of 2021’’ or the ‘‘CARING for So-
cial Determinants Act of 2021’’. 
SEC. 2. REQUIREMENT TO ISSUE GUIDANCE TO CLARIFY 
STRATEGIES TO ADDRESS SOCIAL DETER-
MINANTS OF HEALTH IN THE MEDICAID PRO-
GRAM AND THE CHILDREN’S HEALTH INSUR-
ANCE PROGRAM. 
Not later than 3 years after the date of the enactment 
of this Act, and not less frequently than once every 3 years 
thereafter, the Secretary of Health and Human Services 
shall update the State Health Office letter 21-001, issued 
on January 7, 2021, to clarify strategies to address social 
determinants of health under the Medicaid program and the 
Children’s Health Insurance Program. Such update shall 
include the following: 
(1) Guidance to State Medicaid agencies regard-
ing the strategies that States can implement under 
authorities in existence as of such update under title 
XIX of the Social Security Act, title XXI of such Act, 
or section 1115 of such Act to address social deter-
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minants of health in the provision of health care, in-
cluding strategies specifically targeting children re-
ceiving medical assistance under a State plan under 
title XIX of such Act (or a waiver of such plan) or 
child health assistance under a State child health 
plan under title XXI of such Act. 
(2) Guidance on how States can encourage and 
incentivize managed care entities to address social de-
terminants of health through contracts with such enti-
ties. 
(3) Updated examples from States with respect 
to how States are addressing social determinants of 
health in the provision of health care under the Med-
icaid program under title XIX of the Social Security 
Act and the Children’s Health Insurance Program 
under title XXI of such Act, including through pay-
ment models. 
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Union Calendar No. 137 
117TH CONGRESS 
1ST SESSION 
H. R. 3894 
[Report No. 117–187] 
A BILL 
To require the Secretary of Health and Human 
Services to issue and disseminate guidance to 
States to clarify strategies to address social de-
terminants of health under the Medicaid program 
and the Children’s Health Insurance Program, 
and for other purposes. 
NOVEMBER 30, 2021 
Reported with an amendment, committed to the Com-
mittee of the Whole House on the State of the Union, 
and ordered to be printed 
VerDate Sep 11 2014 
03:04 Dec 02, 2021
Jkt 029200
PO 00000
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