HR 3162 PCS
State would be denied coverage under this title for health 
care services because of such eligibility. In making such 
determination, the Secretary must receive assurances 
that— 
‘‘(1) there is no waiting list under this title in 
the State for targeted low-income children to receive 
child health assistance under this title; and 
‘‘(2) the State has in place an outreach pro-
gram to reach all targeted low-income children in 
families with incomes less than 200 percent of the 
poverty line.’’. 
SEC. 135. NO FEDERAL FUNDING FOR ILLEGAL ALIENS. 
Nothing in this Act allows Federal payment for indi-
viduals who are not legal residents. 
SEC. 136. AUDITING REQUIREMENT TO ENFORCE CITIZEN-
SHIP RESTRICTIONS ON ELIGIBILITY FOR 
MEDICAID AND CHIP BENEFITS. 
Section 1903(x) of the Social Security Act (as amend-
ed by section 405(c)(1)(A) of division B of the Tax Relief 
and Health Care Act of 2006 (Public Law 109–432)) is 
amended by adding at the end the following new para-
graph: 
‘‘(4)(A) Each State shall audit a statistically-based 
sample of cases of individuals whose eligibility for medical 
assistance (or child health assistance) is determined under 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00067
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
HR 3162 PCS
section 1902(a)(46)(B) or under subsection (v)(4)(A) in 
order to demonstrate to the satisfaction of the Secretary 
that Federal funds under this title or title XXI are not 
unlawfully spent for benefits for individuals who are not 
legal residents. In conducting such audits, a State may 
rely on case reviews regularly conducted pursuant to its 
Medicaid Quality Control or Payment Error Rate Meas-
urement (PERM) eligibility reviews under subsection (u) 
and the provisions of subsection (e) of section 1137 shall 
apply under this paragraph in the same manner as they 
apply under subsection (b) of such section. 
‘‘(B) The State shall remit to the Secretary the Fed-
eral share of any unlawful expenditures for benefits, for 
aliens who are not legal residents, which are identified 
under an audit conducted under subparagraph (A).’’. 
Subtitle E—Access 
SEC. 141. CHILDREN’S ACCESS, PAYMENT, AND EQUALITY 
COMMISSION. 
Title XIX of the Social Security Act is amended by 
inserting before section 1901 the following new section: 
‘‘CHILDREN’S ACCESS, PAYMENT, AND EQUALITY 
COMMISSION 
‘‘SEC. 1900. (a) ESTABLISHMENT.—There is hereby 
established as an agency of Congress the Children’s Ac-
cess, Payment, and Equality Commission (in this section 
referred to as the ‘Commission’). 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00068
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
HR 3162 PCS
‘‘(b) DUTIES.— 
‘‘(1) REVIEW OF PAYMENT POLICIES AND AN-
NUAL REPORTS.—The Commission shall— 
‘‘(A) review Federal and State payment 
policies of the Medicaid program established 
under this title (in this section referred to as 
‘Medicaid’) and the State Children’s Health In-
surance Program established under title XXI 
(in this section referred to as ‘CHIP’), includ-
ing topics described in paragraph (2); 
‘‘(B) review access to, and affordability of, 
coverage and services for enrollees under Med-
icaid and CHIP; 
‘‘(C) make recommendations to Congress 
concerning such policies; 
‘‘(D) by not later than March 1 of each 
year, submit to Congress a report containing 
the results of such reviews and its recommenda-
tions concerning such policies; and 
‘‘(E) by not later than June 1 of each 
year, submit to Congress a report containing an 
examination of issues affecting Medicaid and 
CHIP, including the implications of changes in 
health care delivery in the United States and in 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00069
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
HR 3162 PCS
the market for health care services on such pro-
grams. 
‘‘(2) SPECIFIC TOPICS TO BE REVIEWED.—Spe-
cifically, the Commission shall review the following: 
‘‘(A) The factors affecting expenditures for 
services in different sectors (such as physician, 
hospital and other sectors), payment methodolo-
gies, and their relationship to access and qual-
ity of care for Medicaid and CHIP beneficiaries. 
‘‘(B) The impact of Federal and State 
Medicaid and CHIP payment policies on access 
to services (including dental services) for chil-
dren (including children with disabilities) and 
other Medicaid and CHIP populations. 
‘‘(C) The impact of Federal and State 
Medicaid and CHIP policies on reducing health 
disparities, including geographic disparities and 
disparities among minority populations. 
‘‘(D) The overall financial stability of the 
health care safety net, including Federally- 
qualified health centers, rural health centers, 
school-based clinics, disproportionate share hos-
pitals, public hospitals, providers and grantees 
under section 2612(a)(5) of the Public Health 
Service Act (popularly known as the Ryan 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00070
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
HR 3162 PCS
White CARE Act), and other providers that 
have a patient base which includes a dispropor-
tionate number of uninsured or low-income in-
dividuals and the impact of CHIP and Medicaid 
policies on such stability. 
‘‘(E) The relation (if any) between pay-
ment rates for providers and improvement in 
care for children as measured under the chil-
dren’s health quality measurement program es-
tablished under section 151 of the Children’s 
Health and Medicare Protection Act of 2007. 
‘‘(F) The affordability, cost effectiveness, 
and accessibility of services needed by special 
populations under Medicaid and CHIP as com-
pared with private-sector coverage. 
‘‘(G) The extent to which the operation of 
Medicaid and CHIP ensures access, comparable 
to access under employer-sponsored or other 
private health insurance coverage (or in the 
case of federally-qualified health center services 
(as defined in section 1905(l)(2)) and rural 
health clinic services (as defined in section 
1905(l)(1)), access comparable to the access to 
such services under title XIX), for targeted low- 
income children. 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00071
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
HR 3162 PCS
‘‘(H) The effect of demonstrations under 
section 1115, benchmark coverage under section 
1937, and other coverage under section 1938, 
on access to care, affordability of coverage, pro-
vider ability to achieve children’s health quality 
performance measures, and access to safety net 
services. 
‘‘(3) COMMENTS ON CERTAIN SECRETARIAL RE-
PORTS.—If the Secretary submits to Congress (or a 
committee of Congress) a report that is required by 
law and that relates to payment policies under Med-
icaid or CHIP, the Secretary shall transmit a copy 
of the report to the Commission. The Commission 
shall review the report and, not later than 6 months 
after the date of submittal of the Secretary’s report 
to Congress, shall submit to the appropriate commit-
tees of Congress written comments on such report. 
Such comments may include such recommendations 
as the Commission deems appropriate. 
‘‘(4) AGENDA AND ADDITIONAL REVIEWS.—The 
Commission shall consult periodically with the 
Chairmen and Ranking Minority Members of the ap-
propriate committees of Congress regarding the 
Commission’s agenda and progress towards achiev-
ing the agenda. The Commission may conduct addi-
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00072
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
HR 3162 PCS
tional reviews, and submit additional reports to the 
appropriate committees of Congress, from time to 
time on such topics relating to the program under 
this title or title XXI as may be requested by such 
Chairmen and Members and as the Commission 
deems appropriate. 
‘‘(5) AVAILABILITY
OF
REPORTS.—The Com-
mission shall transmit to the Secretary a copy of 
each report submitted under this subsection and 
shall make such reports available to the public. 
‘‘(6) 
APPROPRIATE
COMMITTEE
OF
CON-
GRESS.—For purposes of this section, the term ‘ap-
propriate committees of Congress’ means the Com-
mittees on Energy and Commerce of the House of 
Representatives and the Committee on Finance of 
the Senate. 
‘‘(7) 
VOTING
AND
REPORTING
REQUIRE-
MENTS.—With respect to each recommendation con-
tained in a report submitted under paragraph (1), 
each member of the Commission shall vote on the 
recommendation, and the Commission shall include, 
by member, the results of that vote in the report 
containing the recommendation. 
‘‘(8) 
EXAMINATION
OF
BUDGET
CON-
SEQUENCES.—Before making any recommendations, 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00073
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS