Preventing Lead Poisoning Act of 2021
Bill: S.1826 | Sponsor: Sen. Menendez, Robert (D-NJ)
Policy area: Health

Summary:
Preventing Lead Poisoning Act of 2021
This bill requires coverage under the Children's Health Insurance Program (CHIP) of screening blood lead tests. Specifically, CHIP must cover a child's test once at the age of 12 months and once at the age of 24 months, or once between the ages of 24 months and 72 months if the child has never been assessed, as well as testing at such other times as recommended by a child's health care provider. The bill also provides statutory authority for these requirements (regarding testing intervals) for state Medicaid programs.

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 Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Preventing Lead Poisoning Act of 
2021''.

SEC. 2. REQUIRING A STATE CHILD HEALTH PLAN TO INCLUDE COVERAGE OF 
              SCREENING BLOOD LEAD TESTS; CODIFICATION OF REQUIREMENT 
              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 preceding 
                paragraph (1), by striking ``paragraphs (5), (6), (7) 
                and (8)'' and inserting ``paragraphs (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 assistance 
                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 subparagraph are, with 
                respect to coverage of screening blood lead tests and a 
                targeted low-income child, the following:
                            ``(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-
                        income 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 recommended by 
                        the child's health care provider.''.
            (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 Children's 
                        Health Insurance Program Reauthorization Act of 
                        2009 (Public Law 111-3, 123 Stat. 87) as 
                        subsection (f); and
                            (ii) by adding at the end of the subsection 
                        (e) added by section 402(a) of such 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 children 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 subparagraphs (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 enactment of this Act.
                    (B) Exception for state legislation.--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 
                requires State legislation in order for the respective 
                plan (or waiver) to meet any requirement imposed by the 
                amendments made by this subsection, the respective plan 
                (or waiver) shall not be regarded as failing to comply 
                with the requirements of such title solely on the basis 
                of its failure to meet such an additional requirement 
                before the 1st day of the 1st calendar quarter 
                beginning after the close of the 1st regular 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 legislature.
                    (C) Technical amendment.--The amendment made by 
                paragraph (2)(B) shall take effect as if included in 
                the enactment of Public Law 111-148.
    (b) Medicaid.--
            (1) Specified times for screening blood lead tests.--
        Section 1905(r) of the Social Security 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 other such times as are 
                recommended by the individual'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 semicolon and 
                inserting ``, and''; and
                    (C) by inserting after clause (iv) the following:
                            ``(v)(I) the number of children provided a 
                        screening blood lead test appropriate for age 
                        and risk factors in accordance 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 fiscal 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;''.
    (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 ACTIVITIES.

    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 following:
    ``(c) Grants for Purposes of State Coordination.--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 on the number of children up 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-linking 
        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 Secretary, 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 collection 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''.
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