HR 3162 PCS
‘‘(C) Section 1902(e)(13) (relating to the 
State option to rely on findings from an Ex-
press Lane agency to help evaluate a child’s eli-
gibility for medical assistance).’’. 
(c) ELECTRONIC TRANSMISSION OF INFORMATION.— 
Section 1902 of such Act (42 U.S.C. 1396a) is amended 
by adding at the end the following new subsection: 
‘‘(dd) ELECTRONIC TRANSMISSION
OF INFORMA-
TION.—If the State agency determining eligibility for med-
ical assistance under this title or child health assistance 
under title XXI verifies an element of eligibility based on 
information from an Express Lane Agency (as defined in 
subsection (e)(13)(F)), or from another public agency, 
then the applicant’s signature under penalty of perjury 
shall not be required as to such element. Any signature 
requirement for an application for medical assistance may 
be satisfied through an electronic signature, as defined in 
section 1710(1) of the Government Paperwork Elimi-
nation Act (44 U.S.C. 3504 note). The requirements of 
subparagraphs (A) and (B) of section 1137(d)(2) may be 
met through evidence in digital or electronic form.’’. 
(d) AUTHORIZATION
OF
INFORMATION
DISCLO-
SURE.— 
(1) IN GENERAL.—Title XIX of the Social Se-
curity Act is amended— 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00043
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
HR 3162 PCS
(A) by redesignating section 1939 as sec-
tion 1940; and 
(B) by inserting after section 1938 the fol-
lowing new section: 
‘‘SEC. 1939. AUTHORIZATION TO RECEIVE PERTINENT IN-
FORMATION. 
‘‘(a) IN GENERAL.—Notwithstanding any other pro-
vision of law, a Federal or State agency or private entity 
in possession of the sources of data potentially pertinent 
to eligibility determinations under this title (including eli-
gibility files maintained by Express Lane agencies de-
scribed in section 1902(e)(13)(F), information described 
in paragraph (2) or (3) of section 1137(a), vital records 
information about births in any State, and information de-
scribed in sections 453(i) and 1902(a)(25)(I)) is author-
ized to convey such data or information to the State agen-
cy administering the State plan under this title, to the 
extent such conveyance meets the requirements of sub-
section (b). 
‘‘(b) REQUIREMENTS FOR CONVEYANCE.—Data or 
information may be conveyed pursuant to subsection (a) 
only if the following requirements are met: 
‘‘(1) The individual whose circumstances are 
described in the data or information (or such indi-
vidual’s parent, guardian, caretaker relative, or au-
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00044
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
HR 3162 PCS
thorized representative) has either provided advance 
consent to disclosure or has not objected to disclo-
sure after receiving advance notice of disclosure and 
a reasonable opportunity to object. 
‘‘(2) Such data or information are used solely 
for the purposes of— 
‘‘(A) identifying individuals who are eligi-
ble or potentially eligible for medical assistance 
under this title and enrolling or attempting to 
enroll such individuals in the State plan; and 
‘‘(B) verifying the eligibility of individuals 
for medical assistance under the State plan. 
‘‘(3) An interagency or other agreement, con-
sistent with standards developed by the Secretary— 
‘‘(A) prevents the unauthorized use, disclo-
sure, or modification of such data and other-
wise meets applicable Federal requirements 
safeguarding privacy and data security; and 
‘‘(B) requires the State agency admin-
istering the State plan to use the data and in-
formation obtained under this section to seek to 
enroll individuals in the plan. 
‘‘(c) CRIMINAL PENALTY.—A private entity described 
in the subsection (a) that publishes, discloses, or makes 
known in any manner, or to any extent not authorized by 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00045
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
HR 3162 PCS
Federal law, any information obtained under this section 
shall be fined not more than $1,000 or imprisoned not 
more than 1 year, or both, for each such unauthorized 
publication or disclosure. 
‘‘(d) RULE OF CONSTRUCTION.—The limitations and 
requirements that apply to disclosure pursuant to this sec-
tion shall not be construed to prohibit the conveyance or 
disclosure of data or information otherwise permitted 
under Federal law (without regard to this section).’’. 
(2) CONFORMING AMENDMENT TO TITLE XXI.— 
Section 
2107(e)(1) 
of 
such 
Act 
(42 
U.S.C. 
1397gg(e)(1)), as amended by subsection (b), is 
amended by adding at the end the following new 
subparagraph: 
‘‘(J) Section 1939 (relating to authoriza-
tion to receive data potentially pertinent to eli-
gibility determinations).’’. 
(3) CONFORMING AMENDMENT TO PROVIDE AC-
CESS TO DATA ABOUT ENROLLMENT IN INSURANCE 
FOR PURPOSES OF EVALUATING APPLICATIONS AND 
FOR CHIP.—Section 1902(a)(25)(I)(i) of such Act 
(42 U.S.C. 1396a(a)(25)(I)(i)) is amended— 
(A) by inserting ‘‘(and, at State option, in-
dividuals who are potentially eligible or who 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00046
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
HR 3162 PCS
apply)’’ after ‘‘with respect to individuals who 
are eligible’’; and 
(B) by inserting ‘‘under this title (and, at 
State option, child health assistance under title 
XXI)’’ after ‘‘the State plan’’. 
(e) EFFECTIVE DATE.—The amendments made by 
this section are effective on January 1, 2008. 
SEC. 113. APPLICATION OF MEDICAID OUTREACH PROCE-
DURES TO ALL CHILDREN AND PREGNANT 
WOMEN. 
(a) IN GENERAL.—Section 1902(a)(55) of the Social 
Security Act (42 U.S.C. 1396a(a)(55)) is amended— 
(1) in the matter before subparagraph (A), by 
striking ‘‘individuals for medical assistance under 
subsection 
(a)(10)(A)(i)(IV), 
(a)(10)(A)(i)(VI), 
(a)(10)(A)(i)(VII), or (a)(10)(A)(ii)(IX)’’ and insert-
ing ‘‘children and pregnant women for medical as-
sistance under any provision of this title’’; and 
(2) in subparagraph (B), by inserting before 
the semicolon at the end the following: ‘‘, which need 
not be the same application form for all such indi-
viduals’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) take effect on January 1, 2008. 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00047
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
HR 3162 PCS
SEC. 114. ENCOURAGING CULTURALLY APPROPRIATE EN-
ROLLMENT AND RETENTION PRACTICES. 
(a) USE OF MEDICAID FUNDS.—Section 1903(a)(2) 
of the Social Security Act (42 U.S.C. 1396b(a)(2)) is 
amended by adding at the end the following new subpara-
graph: 
‘‘(E) an amount equal to 75 percent of so much 
of the sums expended during such quarter (as found 
necessary by the Secretary for the proper and effi-
cient administration of the State plan) as are attrib-
utable to translation or interpretation services in 
connection with the enrollment and retention under 
this title of children of families for whom English is 
not the primary language; plus’’. 
(b) USE OF COMMUNITY HEALTH WORKERS FOR 
OUTREACH ACTIVITIES.— 
(1) IN GENERAL.—Section 2102(c)(1) of such 
Act (42 U.S.C. 1397bb(c)(1)) is amended by insert-
ing ‘‘(through community health workers and oth-
ers)’’ after ‘‘Outreach’’. 
(2) 
IN
FEDERAL
EVALUATION.—Section 
2108(c)(3)(B) 
of 
such 
Act 
(42 
U.S.C. 
1397hh(c)(3)(B)) is amended by inserting ‘‘(such as 
through community health workers and others)’’ 
after ‘‘including practices’’. 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00048
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
HR 3162 PCS
SEC. 115. CONTINUOUS COVERAGE UNDER CHIP. 
(a) IN GENERAL.—Section 2102(b) of the Social Se-
curity Act (42 U.S.C. 1397bb(b)) is amended by adding 
at the end the following new paragraph: 
‘‘(5) 12-MONTHS
CONTINUOUS
ELIGIBILITY.— 
In the case of a State child health plan that provides 
child health assistance under this title through a 
means other than described in section 2101(a)(2), 
the plan shall provide for implementation under this 
title of the 12-months continuous eligibility option 
described in section 1902(e)(12) for targeted low-in-
come children whose family income is below 200 per-
cent of the poverty line.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply to determinations (and redeter-
minations) of eligibility made on or after January 1, 2008. 
Subtitle C—Coverage 
SEC. 121. ENSURING CHILD-CENTERED COVERAGE. 
(a) ADDITIONAL REQUIRED SERVICES.— 
(1) 
CHILD-CENTERED
COVERAGE.—Section 
2103 of the Social Security Act (42 U.S.C. 1397cc) 
is amended— 
(A) in subsection (a)— 
(i) in the matter before paragraph 
(1), by striking ‘‘subsection (c)(5)’’ and in-
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00049
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
HR 3162 PCS
serting ‘‘paragraphs (5) and (6) of sub-
section (c)’’; and 
(ii) in paragraph (1), by inserting ‘‘at 
least’’ after ‘‘that is’’; and 
(B) in subsection (c)— 
(i) by redesignating paragraph (5) as 
paragraph (6); and 
(ii) by inserting after paragraph (4), 
the following: 
‘‘(5) DENTAL, FQHC, AND RHC SERVICES.—The 
child health assistance provided to a targeted low-in-
come child (whether through benchmark coverage or 
benchmark-equivalent coverage or otherwise) shall 
include coverage of the following: 
‘‘(A) Dental services necessary to prevent 
disease and promote oral health, restore oral 
structures to health and function, and treat 
emergency conditions. 
‘‘(B) Federally-qualified health center serv-
ices (as defined in section 1905(l)(2)) and rural 
health clinic services (as defined in section 
1905(l)(1)). 
Nothing in this section shall be construed as pre-
venting a State child health plan from providing 
such services as part of benchmark coverage or in 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00050
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
HR 3162 PCS
addition to the benefits provided through benchmark 
coverage.’’. 
(2) REQUIRED PAYMENT FOR FQHC AND RHC 
SERVICES.—Section 2107(e)(1) of such Act (42 
U.S.C. 1397gg(e)(1)), as amended by sections 
112(b) and 112(d)(2), is amended by inserting after 
subparagraph (C) the following new subparagraph: 
‘‘(D) Section 1902(bb) (relating to pay-
ment for services provided by Federally-quali-
fied health centers and rural health clinics).’’. 
(3) 
MENTAL
HEALTH
PARITY.—Section 
2103(a)(2)(C) 
of 
such 
Act 
(42 
U.S.C. 
1397aa(a)(2)(C)) is amended by inserting ‘‘(or 100 
percent in the case of the category of services de-
scribed in subparagraph (B) of such subsection)’’ 
after ‘‘75 percent’’. 
(4) EFFECTIVE DATE.—The amendments made 
by this subsection and subsection (d) shall apply to 
health benefits coverage provided on or after October 
1, 2008. 
(b) CLARIFICATION OF REQUIREMENT TO PROVIDE 
EPSDT SERVICES FOR ALL CHILDREN IN BENCHMARK 
BENEFIT PACKAGES UNDER MEDICAID.— 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00051
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
HR 3162 PCS
(1) IN GENERAL.—Section 1937(a)(1) of the 
Social Security Act (42 U.S.C. 1396u–7(a)(1)) is 
amended— 
(A) in subparagraph (A)— 
(i) in the matter before clause (i), by 
striking ‘‘Notwithstanding any other provi-
sion of this title’’ and inserting ‘‘Subject to 
subparagraph (E)’’; and 
(ii) by striking ‘‘enrollment in cov-
erage that provides’’ and all that follows 
and inserting ‘‘benchmark coverage de-
scribed in subsection (b)(1) or benchmark 
equivalent coverage described in subsection 
(b)(2).’’; 
(B) by striking subparagraph (C) and in-
serting the following new subparagraph: 
‘‘(C) STATE
OPTION
TO
PROVIDE
ADDI-
TIONAL BENEFITS.—A State, at its option, may 
provide such additional benefits to benchmark 
coverage described in subsection (b)(1) or 
benchmark equivalent coverage described in 
subsection (b)(2) as the State may specify.’’; 
and 
(C) by adding at the end the following new 
subparagraph: 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00052
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
HR 3162 PCS
‘‘(E) REQUIRING
COVERAGE
OF
EPSDT 
SERVICES.—Nothing in this paragraph shall be 
construed as affecting a child’s entitlement to 
care and services described in subsections 
(a)(4)(B) and (r) of section 1905 and provided 
in accordance with section 1902(a)(43) whether 
provided through benchmark coverage, bench-
mark equivalent coverage, or otherwise.’’. 
(2) EFFECTIVE DATE.—The amendments made 
by paragraph (1) shall take effect as if included in 
the amendment made by section 6044(a) of the Def-
icit Reduction Act of 2005. 
(c) CLARIFICATION OF COVERAGE OF SERVICES IN 
SCHOOL-BASED HEALTH CENTERS INCLUDED AS CHILD 
HEALTH ASSISTANCE.— 
(1) IN GENERAL.—Section 2110(a)(5) of such 
Act (42 U.S.C. 1397jj(a)(5)) is amended by insert-
ing after ‘‘health center services’’ the following: ‘‘and 
school-based health center services for which cov-
erage is otherwise provided under this title when fur-
nished by a school-based health center that is au-
thorized to furnish such services under State law’’. 
(2) EFFECTIVE DATE.—The amendment made 
by paragraph (1) shall apply to child health assist-
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00053
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
HR 3162 PCS
ance furnished on or after the date of the enactment 
of this Act. 
(d) ASSURING ACCESS TO CARE.— 
(1) STATE
CHILD
HEALTH
PLAN
REQUIRE-
MENT.—Section 2102(a)(7)(B) of such Act (42 
U.S.C. 1397bb(c)(2)) is amended by inserting ‘‘and 
services described in section 2103(c)(5)’’ after 
‘‘emergency services’’. 
(2) REFERENCE TO EFFECTIVE DATE.—For the 
effective date for the amendments made by this sub-
section, see subsection (a)(5). 
SEC. 122. IMPROVING BENCHMARK COVERAGE OPTIONS. 
(a) LIMITATION
ON SECRETARY-APPROVED COV-
ERAGE.— 
(1) UNDER CHIP.—Section 2103(a)(4) of the 
Social Security Act (42 U.S.C. 1397cc(a)(4)) is 
amended by inserting before the period at the end 
the following: ‘‘if the health benefits coverage is at 
least equivalent to the benefits coverage in a bench-
mark benefit package described in subsection (b)’’. 
(2) UNDER MEDICAID.—Section 1937(b)(1)(D) 
of the Social Security Act (42 U.S.C. 1396u– 
7(b)(1)(D)) is amended by inserting before the pe-
riod at the end the following: ‘‘if the health benefits 
coverage is at least equivalent to the benefits cov-
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00054
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
HR 3162 PCS
erage in benchmark coverage described in subpara-
graph (A), (B), or (C)’’. 
(b) REQUIREMENT
FOR MOST POPULAR FAMILY 
COVERAGE FOR STATE EMPLOYEE COVERAGE BENCH-
MARK.— 
(1) CHIP.—Section 2103(b)(2) of such Act (42 
U.S.C. 1397(b)(2)) is amended by inserting ‘‘and 
that has been selected most frequently by employees 
seeking dependent coverage, among such plans that 
provide such dependent coverage, in either of the 
previous 2 plan years’’ before the period at the end. 
(2) MEDICAID.—Section 1937(b)(1)(B) of such 
Act is amended by inserting ‘‘and that has been se-
lected most frequently, by employees seeking depend-
ent coverage, among such plans that provide such 
dependent coverage, in either of the previous 2 plan 
years’’ before the period at the end. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to health benefits coverage pro-
vided on or after October 1, 2008. 
SEC. 123. PREMIUM GRACE PERIOD. 
(a) IN GENERAL.—Section 2103(e)(3) of the Social 
Security Act (42 U.S.C. 1397cc(e)(3)) is amended by add-
ing at the end the following new subparagraph: 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00055
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
HR 3162 PCS
‘‘(C) PREMIUM GRACE PERIOD.—The State 
child health plan— 
‘‘(i) shall afford individuals enrolled 
under the plan a grace period of at least 
30 days from the beginning of a new cov-
erage period to make premium payments 
before the individual’s coverage under the 
plan may be terminated; and 
‘‘(ii) shall provide to such an indi-
vidual, not later than 7 days after the first 
day of such grace period, notice— 
‘‘(I) that failure to make a pre-
mium payment within the grace pe-
riod will result in termination of cov-
erage under the State child health 
plan; and 
‘‘(II) of the individual’s right to 
challenge the proposed termination 
pursuant to the applicable Federal 
regulations. 
For purposes of clause (i), the term ‘new cov-
erage period’ means the month immediately fol-
lowing the last month for which the premium 
has been paid.’’. 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00056
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS