I 
117TH CONGRESS 
1ST SESSION H. R. 3511 
To amend titles XIX and XXI of the Social Security Act to require a 
State child health plan to include coverage of screening blood lead tests, 
to codify such requirement under the Medicaid program, and for other 
purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 25, 2021 
Mr. KATKO (for himself, Mr. CICILLINE, Mr. FITZPATRICK, Ms. MOORE of 
Wisconsin, Mr. MORELLE, and Mr. GOTTHEIMER) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce 
A BILL 
To amend titles XIX and XXI of the Social Security Act 
to require a State child health plan to include coverage 
of screening blood lead tests, to codify such requirement 
under the Medicaid 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 ‘‘Preventing Lead Poi-
soning Act of 2021’’. 
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SEC. 2. REQUIRING A STATE CHILD HEALTH PLAN TO IN-
CLUDE COVERAGE OF SCREENING BLOOD 
LEAD TESTS; CODIFICATION OF REQUIRE-
MENT UNDER MEDICAID. 
(a) CHIP.— 
(1) IN GENERAL.—Section 2103 of the Social 
Security Act (42 U.S.C. 1397cc) is amended— 
(A) in subsection (a), in the matter pre-
ceding paragraph (1), by striking ‘‘paragraphs 
(5), (6), (7) and (8)’’ and inserting ‘‘para-
graphs (5) through (12)’’; and 
(B) in subsection (c), by adding at the end 
the following: 
‘‘(12) COVERAGE OF SCREENING BLOOD LEAD 
TESTS.— 
‘‘(A) IN GENERAL.—The child health as-
sistance provided to a targeted low-income child 
shall include coverage of screening blood lead 
tests appropriate for age and risk factors and 
at the times and in the amounts specified in 
subparagraph (B). 
‘‘(B) SPECIFIED TIMES AND AMOUNTS.— 
The times and amounts specified in this sub-
paragraph are, with respect to coverage of 
screening blood lead tests and a targeted low- 
income child, the following: 
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‘‘(i) 1 screening blood lead test at the 
age of 12 months; 
‘‘(ii) 1 screening blood lead test at the 
age of 24 months; 
‘‘(iii) in the case of a targeted low-in-
come child with no record of any screening 
blood lead test having been performed and 
who is between the ages of 24 months and 
72 months, 1 screening blood lead test; 
and 
‘‘(iv) in the case of any targeted low- 
income child, 1 or more screening blood 
lead tests at other such times as are rec-
ommended by the child’s health care pro-
vider.’’. 
(2) REPORTING REQUIREMENTS.— 
(A) IN GENERAL.—Section 2108 of such 
Act (42 U.S.C. 1397hh) is amended— 
(i) by redesignating the subsection (e) 
added by section 501(e)(2) of the Chil-
dren’s Health Insurance Program Reau-
thorization Act of 2009 (Public Law 111– 
3, 123 Stat. 87) as subsection (f); and 
(ii) by adding at the end of the sub-
section (e) added by section 402(a) of such 
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Act (Public Law 111–3, 123 Stat. 82), the 
following: 
‘‘(8)(A) The number of children provided a 
screening blood lead test appropriate for age and 
risk factors in accordance with paragraph (12) of 
section 2103(c), at the times and in the amounts 
specified in subparagraph (B) of such paragraph. 
‘‘(B) The number of screening blood lead tests 
conducted in the State in the fiscal year for all chil-
dren eligible for child health assistance up to 72 
months of age, without regard to the payor or source 
of funding for such screening blood lead tests.’’. 
(B) 
TECHNICAL
AMENDMENT.—Section 
4302(b)(1)(B) of Public Law 111–148 is 
amended by inserting ‘‘, as added by section 
402(a) of Public Law 111–3,’’ after ‘‘(42 
U.S.C. 1397hh(e))’’. 
(3) EFFECTIVE DATE.— 
(A) IN
GENERAL.—Subject to subpara-
graphs (B) and (C), the amendments made by 
this subsection shall take effect with respect to 
child health assistance provided on or after the 
date that is 1 year after the date of the enact-
ment of this Act. 
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(B) EXCEPTION
FOR
STATE
LEGISLA-
TION.—In the case of a State child health plan 
under title XXI of the Social Security Act (or 
a waiver of such plan), which the Secretary of 
Health and Human Services determines re-
quires State legislation in order for the respec-
tive plan (or waiver) to meet any requirement 
imposed by the amendments made by this sub-
section, the respective plan (or waiver) shall not 
be regarded as failing to comply with the re-
quirements of such title solely on the basis of 
its failure to meet such an additional require-
ment before the 1st day of the 1st calendar 
quarter beginning after the close of the 1st reg-
ular session of the State legislature that begins 
after the date of enactment of this section. For 
purposes of the previous sentence, in the case 
of a State that has a 2-year legislative session, 
each year of the session shall be considered to 
be a separate regular session of the State legis-
lature. 
(C) 
TECHNICAL
AMENDMENT.—The 
amendment made by paragraph (2)(B) shall 
take effect as if included in the enactment of 
Public Law 111–148. 
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(b) MEDICAID.— 
(1) SPECIFIED TIMES FOR SCREENING BLOOD 
LEAD TESTS.—Section 1905(r) of the Social Secu-
rity Act (42 U.S.C. 1396d(r)) is amended— 
(A) in paragraph (1)(B)(iv), by inserting 
‘‘and at the times and in the amounts specified 
in paragraph (6)’’ after ‘‘factors’’; and 
(B) by inserting after paragraph (5) the 
following: 
‘‘(6) The times and amounts specified in this 
paragraph are, with respect to coverage of screening 
blood lead tests and an individual, the following: 
‘‘(A) 1 screening blood lead test at the age 
of 12 months; 
‘‘(B) 1 screening blood lead test at the age 
of 24 months; 
‘‘(C) in the case of an individual with no 
record of any screening blood lead test having 
been performed and who is between the ages of 
24 months and 72 months, 1 screening blood 
lead test; and 
‘‘(D) in the case of any individual who is 
eligible under the plan and is under the age of 
21, 1 or more screening blood lead tests at 
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other such times as are recommended by the in-
dividual’s health care provider.’’. 
(2) 
REPORTING
REQUIREMENTS.—Section 
1902(a)(43)(D) 
of 
such 
Act 
(42 
U.S.C. 
1396a(a)(43)(D)) is amended— 
(A) in clause (iii), by striking ‘‘section 
2108(e) and’’ and inserting ‘‘section 2108(e),’’; 
(B) in clause (iv), by striking the semi-
colon and inserting ‘‘, and’’; and 
(C) by inserting after clause (iv) the fol-
lowing: 
‘‘(v)(I) the number of children pro-
vided a screening blood lead test appro-
priate for age and risk factors in accord-
ance with paragraph (1)(B)(iv) of section 
1905(r), at the times and in the amounts 
specified in paragraph (6) of such section, 
and 
‘‘(II) the number of screening blood 
lead tests conducted in the State in the fis-
cal year for all children eligible for medical 
assistance up to 72 months of age, without 
regard to the payor or source of funding 
for such screening blood lead tests;’’. 
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(c) CLARIFICATION.—None of the amendments made 
by this section shall be construed as prohibiting a State 
from providing coverage of screening blood lead tests 
under title XIX or XXI of the Social Security Act at a 
frequency that is greater than the frequency described in 
such amendments or to an individual outside of the ages 
described in such amendments. 
SEC. 3. GRANTS FOR LEAD POISONING RELATED ACTIVI-
TIES. 
Section 317O of the Public Health Service Act (42 
U.S.C. 247b–16) is amended— 
(1) by redesignating subsections (c) and (d) as 
subsections (e) and (f), respectively; 
(2) by inserting after subsection (b) the fol-
lowing: 
‘‘(c) GRANTS FOR PURPOSES OF STATE COORDINA-
TION.—For purposes of supporting State coordination of 
operations and activities as described in subsection (b), 
the Secretary, acting through the Director of the Centers 
for Disease Control and Prevention, shall award additional 
grants to States receiving amounts under subsection (a) 
to support the following activities in such States: 
‘‘(1) Development or maintenance of a State- 
based registry of data related to blood lead testing 
of children up to 6 years of age, which includes data 
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on the number of children up to 72 months of age 
tested for lead, the prevalence of confirmed elevated 
blood lead levels in tested children less than 6 years 
of age, and the insurance status of children tested 
for lead at less than 6 years of age. 
‘‘(2) Development or maintenance of data-link-
ing capabilities between the State health department 
and State Medicaid office with respect to blood lead 
testing for children up to 72 months of age. 
‘‘(3) Regular reporting, as defined by the Sec-
retary, of blood lead testing data for children up to 
72 months of age regardless of the payor or source 
of funding for such blood lead testing. 
‘‘(d) BEST
PRACTICES.—The Secretary, acting 
through the Director of the Centers for Disease Control 
and Prevention, shall publish best practices for data collec-
tion standards related to childhood blood lead testing, with 
the aim of improving data standardization across relevant 
State agencies.’’; and 
(3) in subsection (f), as so redesignated, by 
striking ‘‘such sums as may be necessary for each of 
the fiscal years 2001 through 2005’’ and inserting 
‘‘$5,000,000 for each of fiscal years 2022 and 
2023’’. 
Æ 
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