I
105TH CONGRESS
1ST SESSION
H. R. 3072
To amend title XIX of the Social Security Act and title XXVI of the
Public Health Service Act with respect to treatments regarding infection
with the virus commonly known as HIV.
IN THE HOUSE OF REPRESENTATIVES
NOVEMBER 13, 1997
Ms. PELOSI (for herself, Mr. GEPHARDT, Mrs. MORELLA, Mr. CUMMINGS, Mr.
FRANK of Massachusetts, Mr. ABERCROMBIE, Mr. ACKERMAN, Mr.
BONIOR, Ms. DELAURO, Mr. ENGEL, Ms. ESHOO, Mr. FARR of Califor-
nia, Mr. FAZIO of California, Mr. FILNER, Mr. FROST, Mr. GUTIERREZ,
Mr. HINCHEY, Mr. LANTOS, Mr. MCDERMOTT, Mr. MCGOVERN, Mrs.
MALONEY of New York, Mr. MATSUI, Mr. MEEHAN, Mrs. MEEK of Flor-
ida, Ms. MILLENDER-MCDONALD, Mr. MILLER of California, Mrs. MINK
of Hawaii, Mr. PAYNE, Ms. SANCHEZ, Mr. TOWNS, Ms. WATERS, Ms.
WOOLSEY, Ms. ROYBAL-ALLARD, and Ms. JACKSON-LEE of Texas) intro-
duced the following bill; which was referred to the Committee on Com-
merce
A BILL
To amend title XIX of the Social Security Act and title
XXVI of the Public Health Service Act with respect
to treatments regarding infection with the virus com-
monly known as HIV.
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 ‘‘HIV Treatment Im-
provement Act of 1997’’.
SEC. 2. MEDICAID COVERAGE OF HIV-INFECTION-RELATED
DRUG TREATMENT FOR CERTAIN INDIVID-
UALS.
(a) IN GENERAL.—Section 1902 of the Social Secu-
rity Act (42 U.S.C. 1396a) is amended—
(1) in subsection (a)(10)—
(A) by striking ‘‘and’’ at the end of sub-
paragraph (E);
(B) by adding ‘‘and’’ at the end of sub-
paragraph (F); and
(C) by inserting after subparagraph (F)
the following new subparagraph:
‘‘(G) for making medical assistance avail-
able for HIV-infection-related drug treatment
(as defined in subsection (aa)(2)) for certain
HIV-infected individuals (as defined in sub-
section (aa)(1));’’; and
(2) by adding at the end the following new sub-
section:
‘‘(aa)(1) HIV-infected individuals described in this
paragraph are individuals not described in subsection
(a)(10)(A)(i)—
‘‘(A) who have HIV infection;
‘‘(B) whose income (as determined under the
State plan under this title with respect to disabled
individuals) does not exceed the maximum amount
of income a disabled individual described in sub-
section (a)(10)(A)(i) may have and obtain medical
assistance under the plan; and
‘‘(C) whose resources (as determined under the
State plan under this title with respect to disabled
individuals) do not exceed the maximum amount of
resources a disabled individual described in sub-
section (a)(10)(A)(i) may have and obtain medical
assistance under the plan.
‘‘(2) For purposes of subsection (a)(10), subject to
paragraph (3), the term ‘HIV-infection-related drug treat-
ment’ means each of the following services to monitor and
treat HIV infection through drug treatment:
‘‘(A) Prescribed drugs.
‘‘(B) Physicians’ services and services described
in section 1905(a)(2).
‘‘(C) Diagnostic tests described in paragraphs
(3) and (13) of section 1905(a).
‘‘(D) Services, such as substance abuse and
mental health treatment and medical case manage-
ment services, to the extent required in order to as-
sure compliance with a regimen of drug treatment.
‘‘(3) HIV-infection-related drug treatment under a
State plan shall be such services described in paragraph
(2) as meet the needs of HIV-infected individuals, based
on the most current national guidelines that are recog-
nized by the Secretary and that relate to the treatment
of HIV infection through drug treatment and without re-
gard to any prescription drug formulary that would other-
wise be applied under the State plan.’’.
(b) CONFORMING AMENDMENTS.—
(1) Section 1902(a)(10) of such Act (42 U.S.C.
1396a(a)(10)) is further amended, in the matter fol-
lowing subparagraph (G), as inserted by subsection
(a)(1)—
(A) by striking ‘‘and’’ before ‘‘(XIII)’’, and
(B) by inserting before the semicolon at
the end the following: ‘‘and (XIV) the medical
assistance made available to an individual de-
scribed in subparagraph (G) who is eligible for
medical assistance only because of such sub-
paragraph shall be limited to medical assistance
for HIV-infection-related drug treatment (as
defined in subsection (aa)(2))’’.
(2) Section 1905(a) of such Act (42 U.S.C.
1396d(a)) is amended, in the matter before para-
graph (1)—
(A) by striking ‘‘or’’ at the end of clause
(x),
(B) by adding ‘‘or’’ at the end of clause
(xi), and
(C) by inserting after clause (xii) the fol-
lowing new clause:
‘‘(xii) 
individuals 
described 
in 
section
1902(aa)(1);’’.
(c) EFFECTIVE DATE.—(1) Except as provided in
paragraph (2), the amendments made by subsections (a)
and (b) shall apply to calendar quarters beginning on or
after the date of the enactment of this Act, without regard
to whether or not final regulations to carry out such
amendments have been promulgated by such date.
(2) In the case of a State plan for medical assistance
under title XIX of the Social Security Act which the Sec-
retary of Health and Human Services determines requires
State legislation (other than legislation appropriating
funds) in order for the plan to meet the additional require-
ments imposed by the amendments made by subsections
(a) and (b), the State plan shall not be regarded as failing
to comply with the requirements of such title solely on the
basis of its failure to meet these additional requirements
before the first day of the first calendar quarter beginning
after the close of the first regular session of the State leg-
islature that begins after the date of the enactment of this
Act. For purposes of the previous sentence, in the case
of a State that has a 2-year legislative session, each year
of such session shall be deemed to be a separate regular
session of the State legislature.
SEC. 3. PUBLIC HEALTH SERVICE ACT; MODIFICATIONS TO
PROGRAM OF TREATMENTS FOR HIV DIS-
EASE.
(a) REQUIREMENTS REGARDING TYPES OF TREAT-
MENTS.—Section 2616(c)) of the Public Health Service
Act (42 U.S.C. 300ff–26(c)) is amended—
(1) in the matter preceding paragraph (1), by
striking ‘‘the State shall—’’ and inserting ‘‘the
State—’’;
(2) by redesignating paragraphs (3) through
(5) as paragraphs (5) through (7);
(3) by striking paragraphs (1) and (2); and
(4) by inserting before paragraph (5) (as redes-
ignated by paragraph (2)) the following paragraphs:
‘‘(1) shall determine, in accordance with guide-
lines issued by the Secretary, which treatments and
which laboratory services are to be included in the
program under subsection (a);
‘‘(2) shall provide for the medical administra-
tion of such drugs in accordance with guidelines is-
sued by the Secretary for treatments described in
subsection (a) (or in accordance with guidelines rec-
ognized by the Secretary as appropriate guidelines
for such treatment);
‘‘(3) shall not for purposes of this section adopt
any policy medically inconsistent with the guidelines
of the Secretary that are referred to in paragraphs
(1) and (2);
‘‘(4) shall provide assistance for the purchase of
treatments and laboratory services included in the
program, and the provision of such ancillary devices
as are essential to administer the treatments;’’.
(b) NON-FEDERAL CONTRIBUTIONS AS CONDITION
FOR
RECEIPT
OF
CERTAIN
AMOUNTS.—Section
2618(b)(2)(H) of the Public Health Service Act (42
U.S.C. 300ff–28(b)(2)(H)) is amended to read as follows:
‘‘(H) APPROPRIATIONS
FOR
TREATMENT
DRUG PROGRAM.—
‘‘(i) With respect to the fiscal year in-
volved, if under section 2677 an appropria-
tions Act provides an amount exclusively
for carrying out section 2616, the portion
of such amount allocated to a State shall,
subject to clause (ii), be the product of—
‘‘(I) 100 percent of such amount;
and
‘‘(II) the percentage constituted
by the ratio of the State distribution
factor for the State (as determined
under subparagraph (B)) to the sum
of the State distribution factors for all
States.
‘‘(ii)(I) In the case of a State for
which the allocation determined under
clause (i) for the fiscal year involved ex-
ceeds $1,000,000, the State may not re-
ceive the allocation unless the State agrees
that, with respect to the costs to be in-
curred by the State in carrying out section
2616, the State will make available (di-
rectly or through donations from public or
private entities) non-Federal contributions
toward such costs in an amount that is not
less than 20 percent of such costs ($1 for
each $4 of Federal funds provided in the
allocation).
‘‘(II) Non-Federal contributions re-
quired in clause (i) may be in cash or in
kind, fairly evaluated, including plant,
equipment, or services. Amounts provided
by the Federal Government, and any por-
tion of any service subsidized by the Fed-
eral Government, may not be included in
determining the amount of such non-Fed-
eral contributions.’’.
(c) TECHNICAL AND CONFORMING AMENDMENTS.—
Section 2616 of the Public Health Service Act (42 U.S.C.
300ff–26) is amended—
(1) in subsection (a)—
(A) by striking ‘‘to provide’’ and all that
follows through ‘‘prevent’’ and inserting ‘‘to
provide treatments for HIV disease and for the
prevention of’’; and
(B) by inserting before the period ‘‘, and
to provide related laboratory services’’; and
(2) in subsection (c)—
(A) in each of paragraphs (5) through (7)
(as redesignated by subsection (a)(2) of this
section), by inserting ‘‘shall’’ after the para-
graph designation; and
(B) in paragraph (7) (as so redesignated),
by striking ‘‘progress’’ and all that follows
through 
‘‘subsection 
(a)’’ 
and 
inserting
‘‘progress made in making treatments described
in subsection (a)’’.
SEC. 4. PUBLIC HEALTH SERVICE ACT; MINIMUM GRANT
UNDER CARE GRANT PROGRAM REGARDING
HIV DISEASE.
Section 2618(b)(1)(A) of the Public Health Service
Act (42 U.S.C. 300ff–28(b)(1)(A)) is amended to read as
follows:
‘‘(A) each of the several States and the
District of Columbia for a fiscal year shall be
the greater of—
‘‘(i) $250,000; or
‘‘(ii) an amount determined under
paragraph (2); and’’.
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