I 
117TH CONGRESS 
1ST SESSION H. R. 2347 
To amend title XIX of the Social Security Act to ensure adequate access 
to vaccines under the Medicaid program and the Vaccines for Children 
program, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 1, 2021 
Ms. SCHRIER (for herself, Mr. JOYCE of Pennsylvania, Mr. BUTTERFIELD, 
and Mr. MCKINLEY) introduced the following bill; which was referred to 
the Committee on Energy and Commerce 
A BILL 
To amend title XIX of the Social Security Act to ensure 
adequate access to vaccines under the Medicaid program 
and the Vaccines for Children program, 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 ‘‘Strengthening the Vac-
cines for Children Program Act of 2021’’. 
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SEC. 2. ENSURING ADEQUATE ACCESS TO VACCINES 
UNDER THE MEDICAID PROGRAM AND THE 
VACCINES FOR CHILDREN PROGRAM. 
(a) ENCOURAGING INVOLVEMENT OF PROVIDERS.— 
Paragraph (3) of section 1928(c) of the Social Security 
Act (42 U.S.C. 1396s(c)) is amended— 
(1) by redesignating subparagraphs (A) and 
(B) as clauses (i) and (ii), respectively, and moving 
the margins of each such clause, as so redesignated, 
2 ems to the right; 
(2) by striking ‘‘PROVIDERS’’ and all that fol-
lows through ‘‘Each program’’ and inserting ‘‘PRO-
VIDERS.— 
‘‘(A) IN GENERAL.—Each program’’; and 
(3) by adding at the end the following: 
‘‘(B) INCENTIVE PAYMENTS.— 
‘‘(i) IN
GENERAL.—The Secretary 
shall pay to each provider that requests 
payment under this subparagraph and that 
is a program-registered provider under this 
section for the duration of the period be-
ginning on the date of the enactment of 
this subparagraph, and ending on Decem-
ber 31, 2022— 
‘‘(I) an amount equal to $5,000, 
to be paid as soon as practicable after 
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the date of the enactment of this sub-
paragraph; 
‘‘(II) an amount equal to $2,500, 
to be paid as soon as practicable after 
January 1, 2022; and 
‘‘(III) 
an 
amount 
equal 
to 
$2,500, to be paid as soon as prac-
ticable after January 1, 2023. 
‘‘(ii) 
USE
OF
FUNDS.—Payments 
made under clause (i) may only be used by 
a provider for purposes of carrying out the 
program under this section (including any 
operational expenses associated with the 
furnishing of vaccines under such program, 
as specified by the Secretary). 
‘‘(iii) RECOUPMENT OF PAYMENTS.— 
The Secretary may conduct reviews of pro-
viders receiving payments under this sub-
paragraph to ensure that such payments 
are used in accordance with clause (ii) and 
recoup from such providers any such pay-
ments not so used in accordance with such 
clause.’’. 
(b) EXPANSION OF DEFINITION OF FEDERALLY VAC-
CINE-ELIGIBLE
CHILD.—Paragraph 
(2) 
of 
section 
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1928(b) of the Social Security Act (42 U.S.C. 1396s(b)) 
is amended— 
(1) in subparagraph (A)— 
(A) in clause (iii), by striking ‘‘A child 
who’’ and all that follows through the period at 
the end and inserting ‘‘A child who is adminis-
tered a qualified pediatric vaccine and is not in-
sured with respect to such vaccine.’’; and 
(B) by adding at the end the following new 
clause: 
‘‘(v) A child who is enrolled for child 
health assistance under a State child 
health plan approved under title XXI.’’; 
and 
(2) in subparagraph (B)(ii)(II), by striking ‘‘for 
purposes of subparagraph (A)(iii)(II)’’ and inserting 
‘‘for purposes of subparagraph (A)(iii)’’. 
(c) MINIMUM PAYMENT REQUIREMENT FOR VACCINE 
ADMINISTRATION SERVICES.— 
(1) IN GENERAL.—Section 1902(a)(13) of the 
Social Security Act (42 U.S.C. 1396a(a)(13)) is 
amended— 
(A) in subparagraph (B), by striking 
‘‘and’’ at the end; 
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(B) in subparagraph (C), by striking the 
semicolon and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(D) for payment for vaccine administra-
tion services (including vaccine counseling and 
educational services) furnished by a provider 
during the period beginning on the date of the 
enactment of this subparagraph, and ending on 
December 31, 2022 (including, notwithstanding 
subsection (c)(2)(C)(ii) of section 1928, any 
such services furnished with respect to a vac-
cine furnished under the program established 
by the State pursuant to such section to a med-
icaid-eligible child (as defined in subsection 
(b)(2)(B)(i) of such section)), at a rate not less 
than 100 percent of the payment rate that ap-
plies to such services and provider under part 
B of title XVIII;’’. 
(2) MANAGED CARE PLANS.—Section 1932(f) 
of the Social Security Act (42 U.S.C. 1396u–2(f)) is 
amended— 
(A) in the header, by striking ‘‘PAYMENT 
FOR PRIMARY CARE SERVICES’’ and inserting 
‘‘PAYMENTS’’; 
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(B) by striking ‘‘section 1902(a)(13)(C)’’ 
and inserting ‘‘subparagraph (C) of section 
1902(a)(13) and vaccine administration services 
described in subparagraph (D) of such section’’; 
(C) by striking ‘‘such section’’ and insert-
ing ‘‘such subparagraph (C) or (D), respec-
tively’’; and 
(D) by adding at the end the following new 
sentence: ‘‘The provisions of the preceding sen-
tence shall apply to contracts entered into with, 
and payments made by, other specified entities 
(as defined in section 1903(m)(9)(D)(iii)) in the 
same manner as such provisions apply with re-
spect to contracts entered into with, and pay-
ments made by, medicaid managed care organi-
zations.’’. 
(3) CHIP.—Section 2103(c) of the Social Secu-
rity Act (42 U.S.C. 1397cc(c)) is amended by add-
ing at the end the following new paragraph: 
‘‘(11) VACCINE ADMINISTRATION SERVICES.— 
The child health assistance provided to a targeted 
low-income child shall include payment for vaccine 
administration services (including vaccine counseling 
and educational services) furnished by a provider 
during the period beginning on the date of the en-
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actment of this paragraph, and ending on December 
31, 2022 (including, notwithstanding subsection 
(c)(2)(C)(ii) of section 1928, any such services fur-
nished to such child with respect to a vaccine fur-
nished under the program established by the State 
pursuant to such section), at a rate not less than 
100 percent of the payment rate that applies to such 
services and provider under part B of title XVIII.’’. 
(d) COVERAGE OF VACCINE COUNSELING AND EDU-
CATIONAL SERVICES UNDER MEDICAID.— 
(1) IN GENERAL.—Section 1905(a) of the So-
cial Security Act (42 U.S.C. 1396d) is amended— 
(A) in paragraph (29), by striking ‘‘and’’ 
at the end; 
(B) by redesignating paragraph (30) as 
paragraph (31); and 
(C) by inserting after paragraph (29) the 
following new paragraph: 
‘‘(30) vaccine counseling and educational serv-
ices furnished to children under the age of 19 on or 
after the date of the enactment of this paragraph, 
including any such services furnished as part of a 
multiple component vaccine (identified as of October 
1, 2020, by CPT code 90461) and including any 
such services furnished under the program estab-
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lished by the State pursuant to section 1928 to a 
medicaid-eligible child (as defined in subsection (b) 
of such section),’’. 
(2) 
MANDATORY
BENEFIT.—Section 
1902(a)(10)(A) of the Social Security Act (42 
U.S.C. 1396a(a)(10)(A)) is amended by striking 
‘‘and (29)’’ and inserting ‘‘(29), and (30)’’. 
(e) CLARIFICATION
OF COVERAGE
OF PEDIATRIC 
VACCINES AND VACCINE COUNSELING AND EDUCATIONAL 
SERVICES UNDER THE VACCINES FOR CHILDREN PRO-
GRAM.—Section 1928(c)(2)(C)(ii) of the Social Security 
Act (42 U.S.C. 1396s(c)(2)(C)(ii)) is amended to read as 
follows: 
‘‘(ii) The provider may impose— 
‘‘(I) in the case of a qualified pedi-
atric vaccine not described in subclause 
(II), a fee for the administration of and 
counseling for such vaccine so long as the 
fee in the case of a federally vaccine-eligi-
ble child does not exceed the costs of such 
administration and counseling (as deter-
mined by the Secretary based on actual re-
gional costs for such administration and 
counseling); and 
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‘‘(II) in the case of a qualified pedi-
atric vaccine that is a multiple component 
vaccine, a separate charge for the adminis-
tration of and counseling for each compo-
nent of such vaccine so long as the charge 
in the case of a federally vaccine-eligible 
child does not exceed— 
‘‘(aa) with respect to the first 
component of such vaccine, the costs 
of such administration and counseling 
for such component (as determined by 
the Secretary based on actual regional 
costs for such administration and 
counseling for such first component); 
and 
‘‘(bb) with respect to a subse-
quent component of such vaccine, the 
payment rate that applies to such ad-
ministration and counseling for such 
component and provider under part B 
of title XVIII.’’. 
(f) INCREASE IN FEDERAL MEDICAL ASSISTANCE 
PERCENTAGE.— 
(1) IN GENERAL.—Subject to paragraph (2), 
for each calendar quarter occurring during the pe-
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riod beginning on January 1, 2021, and ending on 
December 31, 2022, the Federal medical assistance 
percentage determined for each State, including the 
District of Columbia, American Samoa, Guam, the 
Commonwealth of the Northern Mariana Islands, 
Puerto Rico, and the United States Virgin Islands, 
under section 1905(b) of the Social Security Act (42 
U.S.C. 1396d(b)), after application of section 6008 
of the Families First Coronavirus Response Act 
(Public Law 116–127) (if applicable), shall be in-
creased by 1 percentage point. 
(2) REQUIREMENTS.— 
(A) IN GENERAL.—A State described in 
paragraph (1) may not receive the increase de-
scribed in such paragraph in the Federal med-
ical assistance percentage for such State, with 
respect to a quarter, if such State does not en-
sure culturally competent and effective mes-
sages for vaccination outreach to child popu-
lations, which may include the dissemination of 
information highlighting— 
(i) advancements in research and vac-
cine development that have saved millions 
of individuals from death and disability 
from now-preventable diseases; 
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(ii) information on how individuals 
across the lifespan benefit from immuniza-
tions, including those who cannot be vac-
cinated and rely on community immunity; 
(iii) information on the dangers of not 
being vaccinated, including the potential 
for infectious disease outbreaks within 
communities; and 
(iv) information on vaccine safety and 
the systems in place to monitor vaccine 
safety. 
(B) 
REQUIREMENT
FOR
CERTAIN 
STATES.—Section 1905(cc) of the Social Secu-
rity Act (42 U.S.C. 1396d(cc)) is amended— 
(i) by inserting ‘‘and section 2(e) of 
the Strengthening the Vaccines for Chil-
dren Program Act of 2021’’ before ‘‘, ex-
cept that in applying’’; and 
(ii) by inserting ‘‘, and in applying 
such treatments to the increases in the 
Federal 
medical 
assistance 
percentage 
under section 2(e) of the Strengthening the 
Vaccines for Children Program Act of 
2021, the reference to ‘December 31, 
2009’ shall be deemed to be a reference to 
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‘December 31, 2020’ ’’ before the period at 
the end. 
(g) TRIBAL
EPIDEMIOLOGY
CENTER
DATA
AC-
CESS.—With respect to data access for tribal epidemiology 
centers established under section 214 of the Indian Health 
Care Improvement Act (25 U.S.C. 1621m), the Director 
of the Centers for Disease control and Prevention may cre-
ate a data sharing strategy that ensures such centers have 
access to data, data sets, monitoring systems, delivery sys-
tems, and other protected health information with respect 
to health care and public health surveillance systems of 
child and adolescent health necessary to accomplish such 
centers’ public health authority responsibilities described 
in such section or section 164.501 of title 45, Code of Fed-
eral Regulations. 
(h) REPORTS.— 
(1) IN
GENERAL.—For each of fiscal years 
2021 and 2022, the Director of the Centers for Dis-
ease Control and Prevention, in coordination with 
each State that has established a pediatric vaccine 
distribution program under section 1928 of the So-
cial Security Act (42 U.S.C. 1396s), shall publish on 
the public internet website of the Centers for Dis-
ease Control and Prevention, in such manner as de-
termined appropriate by the Director, information 
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on vaccination rates under each such program dur-
ing such year, including such rates disaggregated by 
region, age, sex, race, ethnicity, and other demo-
graphic factors determined appropriate by the Direc-
tor. 
(2) EFFECTS ON VACCINATION RATES AND PRO-
GRAM PARTICIPATION.—Not later than 2 years after 
the date of the enactment of this Act, the Comp-
troller General of the United States shall submit to 
Congress a report containing an analysis of the ef-
fects of the provisions of, and the amendments made 
by, this Act on— 
(A) vaccination rates under the pediatric 
vaccine distribution program under section 
1928 of the Social Security Act (42 U.S.C. 
1396s); and 
(B) provider participation in such pro-
gram. 
Æ 
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