I 117th CONGRESS 2d Session H. R. 9402 IN THE HOUSE OF REPRESENTATIVES December 1, 2022 Ms. Williams of Georgia (for herself and Ms. Lee of California ) introduced the following bill; which was referred to the Committee on Energy and Commerce , and in addition to the Committees on Ways and Means , Armed Services , Veterans' Affairs , and Natural Resources , for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To require the coverage of testing for certain sexually transmitted infections without the imposition of cost sharing, and for other purposes.

1. Short title This Act may be cited as the Equity in STD Testing Act . 2. Coverage of testing for certain sexually transmitted infections without cost sharing (a) Coverage of testing under Medicare Advantage (1) Coverage Section 1852(a)(1)(B) of the Social Security Act ( 42 U.S.C. 1395w–22(a)(1)(B)(iv) ) is amended— (A) in clause (iv)— (i) by redesignating subclause (VIII) as subclause (IX); and (ii) by inserting after subclause (VII) the following new subclause: (VIII) Screening testing for each of HIV, gonorrhea, syphilis, trichomoniasis, and chlamydia (and the administration of such tests) for which benefits are provided under part B as an additional preventive service. ; and (B) in clause (v), by striking and (VI) and inserting (VI), and (VIII) . (2) Effective date The amendments made by this subsection shall take effect on the date of the enactment of this Act and shall apply with respect to plan years beginning after such date. (b) Coverage of testing under Medicaid (1) Coverage Section 1905(a) of such Act ( 42 U.S.C. 1396d(a)(3) ) is amended— (A) in paragraph (3)— (i) in subparagraph (A), by striking and at the end; (ii) in subparagraph (B), by adding and at the end; and (iii) by adding at the end the following new subparagraph: (C) screening testing for each of HIV, gonorrhea, syphilis, trichomoniasis, and chlamydia (and the administration of such tests), if such testing (or administration, as applicable) would be covered under health insurance coverage pursuant to section 2713(a)(1) of the Public Health Service Act for an individual enrolled under such coverage; ; and (B) in paragraph (13), in the matter preceding subparagraph (A), by inserting (other than testing and services described in paragraph (3)(C)) after preventive . (2) Elimination of cost-sharing Section 1916 of such Act ( 42 U.S.C. 1396o ) is amended— (A) in subsection (a)(2), as amended by section 11405(a)(2)(A)(i)(II)–(IV) of Public Law 117–169 — (i) in subparagraph (I), by striking or at the end; (ii) in subparagraph (J), by striking and at the end and inserting or ; and (iii) by adding at the end the following new subparagraph: (K) screening testing (and the administration of such tests) described in section 1905(a)(3)(C); and ; and (B) in subsection (b)(2), as amended by section 11405(a)(2)(A)(ii)(II)–(IV) of Public Law 117–169 — (i) in subparagraph (I), by striking or at the end; (ii) in subparagraph (J), by striking and at the end and inserting or ; and (iii) by adding at the end the following new subparagraph: (K) screening testing (and the administration of such tests) described in section 1905(a)(3)(C); and . (3) Application to alternative cost-sharing Section 1916A(b)(3)(B) of such Act ( 42 U.S.C. 1396o–1(b)(3)(B) ), as amended by section 11405(a)(2)(B) of Public Law 117–169 , is amended by adding at the end the following new clause: (xv) Screening testing (and the administration of such tests) described in section 1905(a)(3)(C). . (4) Effective date (A) In general Except as provided in subparagraph (B), the amendments made by this subsection shall take effect on the date of the enactment of this Act and shall apply with respect to calendar year quarters beginning on or after the date that is one year after such date. (B) Exception if State legislation required In the case of a State plan for medical assistance under title XIX of the Social Security Act which the Secretary of Health and Human Services determines requires State legislation (other than legislation appropriating funds) in order for the plan to meet the additional requirements imposed by the amendments made by this subsection, 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 legislature 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. (c) Coverage of testing for uninsured individuals as state option (1) Coverage Section 1902(a) of such Act ( 42 U.S.C. 1396a(a) ) is amended— (A) in paragraph (10)(A)(ii)— (i) in subclause (XXII), by striking or at the end; (ii) in subclause (XXIII), by adding or at the end; and (iii) by adding at the end the following new subclause: (XXIV) who are uninsured individuals (as defined in subsection (ss)) who receive the screening testing (and the administration of such tests) described in section 1905(a)(3)(C); ; (B) in the matter following paragraph (10)(G)— (i) by striking and (XIX) and inserting (XIX) ; and (ii) by striking the semicolon at the end and inserting , and (XX) the medical assistance made available to an uninsured individual (as defined in subsection (ss)) who is eligible for medical assistance only because of subparagraph (A)(ii)(XXIV) shall be limited to medical assistance for the screening testing (and the administration of such tests) described in section 1905(a)(3)(C); ; and (C) in paragraph (55), in the matter preceding subparagraph (A), by striking or (a)(10)(A)(ii)(XXIII) and inserting (a)(10)(A)(ii)(XXIII), or (a)(10)(A)(ii)(XXIV) . (2) Federal medical assistance percentage Section 1905(b) of such Act ( 42 U.S.C. 1396d(b) ) is amended by adding at the end the following new sentence: Notwithstanding the first sentence of this subsection, the Federal medical assistance percentage shall be 100 per centum with respect to (and, notwithstanding any other provision of this title, available for) medical assistance provided to uninsured individuals (as defined in section 1902(ss)) who are eligible for such assistance only on the basis of section 1902(a)(10)(A)(ii)(XXIV) and with respect to expenditures described in section 1903(a)(7) that a State demonstrates to the satisfaction of the Secretary are attributable to administrative costs related to providing for such medical assistance to such individuals under the State plan. . (3) Effective date The amendments made by this subsection shall take effect on the date of the enactment of this Act and shall apply with respect to calendar year quarters beginning on or after such date. (d) Coverage of testing under CHIP (1) Required coverage of sexually transmitted infections testing Section 2103(c) of such Act ( 42 U.S.C. 1397cc(c) ), as amended by section 11405(b)(1) of Public Law 117–169 , is amended by adding at the end the following new paragraph: (13) Required coverage of sexually transmitted infections testing The child health assistance provided to a targeted low-income child shall include coverage of any screening testing for each of HIV, gonorrhea, syphilis, trichomoniasis, and chlamydia (and the administration of such tests), if such testing (or administration, as applicable) would be covered under health insurance coverage pursuant to section 2713(a)(1) of the Public Health Service Act for an individual enrolled under such coverage. . (2) Elimination of cost-sharing Section 2103(e)(2) of such Act ( 42 U.S.C. 1397cc(e)(2) ) is amended— (A) in the heading, by inserting sexually transmitted infections testing, before or pregnancy-related assistance ; and (B) by inserting screening testing described in subsection (c)(12) (and the administration of such tests) before services described in section 1916(a)(2)(G) . (3) Effective date (A) In general Except as provided in subparagraph (B), the amendments made by this subsection shall take effect on the date of the enactment of this Act and shall apply with respect to calendar year quarters beginning on or after the date that is one year after such date. (B) Exception if State legislation required In the case of a State child health plan for child health assistance under title XXI of the Social Security Act which the Secretary of Health and Human Services determines requires State legislation (other than legislation appropriating funds) in order for the plan to meet the additional requirements imposed by the amendments made by this subsection, the State child health 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 legislature 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. (e) Coverage of testing with respect to Tricare (1) Coverage Title 10, United States Code, is amended— (A) in section 1074d— (i) by redesignating subsection (b) as subsection (c); and (ii) by inserting before subsection (c), as so redesignated, the following new subsection: (b) Coverage of sexually transmitted infections testing Members and former members of the uniformed services entitled to medical care under section 1074 or 1074a of this title shall also be entitled to screening testing for each of HIV, gonorrhea, syphilis, trichomoniasis, and chlamydia (and the administration of such tests), if such testing (or administration, as applicable) would be covered under health insurance coverage pursuant to section 2713(a)(1) of the Public Health Service Act for an individual enrolled under such coverage, as part of such medical care. ; and (B) in section 1079(a), by adding at the end the following new paragraph: (20) Screening testing for each of HIV, gonorrhea, syphilis, trichomoniasis, and chlamydia (and the administration of such tests), if such testing (or administration, as applicable) would be covered under health insurance coverage pursuant to section 2713(a)(1) of the Public Health Service Act for an individual enrolled under such coverage, shall be provided as appropriate. . (2) Elimination of cost-sharing Such title is further amended— (A) in section 1075a, by adding at the end the following new subsection: (d) Elimination of cost-Sharing for sexually transmitted infections testing Notwithstanding any other provision under this section, cost-sharing may not be imposed or collected with respect to any beneficiary enrolled in TRICARE Prime for screening testing for each of HIV, gonorrhea, syphilis, trichomoniasis, and chlamydia (and the administration of such tests), if such testing (or administration, as applicable) would be covered under health insurance coverage pursuant to section 2713(a)(1) of the Public Health Service Act for an individual enrolled under such coverage, that is provided under TRICARE Prime. ; (B) in section 1075(c), by adding at the end the following new paragraph: (4) Notwithstanding any other provision under this section, cost-sharing may not be imposed or collected with respect to any beneficiary enrolled in TRICARE Select for screening testing for each of HIV, gonorrhea, syphilis, trichomoniasis, and chlamydia (and the administration of such tests), if such testing (or administration, as applicable) would be covered under health insurance coverage pursuant to section 2713(a)(1) of the Public Health Service Act for an individual enrolled under such coverage, that is provided under TRICARE Select. ; and (C) in section 1086(d)(3)— (i) by redesignating subparagraph (C) as subparagraph (D); and (ii) by inserting before subparagraph (D), as so redesignated, the following new subparagraph: (C) Notwithstanding any other provision under this section, cost-sharing may not be imposed or collected under a plan under subsection (a) with respect to a person described in paragraph (2) for screening testing for each of HIV, gonorrhea, syphilis, trichomoniasis, and chlamydia (and the administration of such tests), if such testing (or administration, as applicable) would be covered under health insurance coverage pursuant to section 2713(a)(1) of the Public Health Service Act for an individual enrolled under such coverage. . (3) Effective date The amendments made by this subsection shall take effect on January 1 of the year following the date of the enactment of this Act. (f) Coverage of testing with respect to veterans (1) Coverage Chapter 17 of title 38, United States Code, is amended by inserting after section 1720J the following new section (and conforming the table of sections at the beginning of such chapter accordingly): 1720K. Sexually transmitted infections testing (a) Coverage of sexually transmitted infections testing The Secretary shall furnish screening testing for each of HIV, gonorrhea, syphilis, trichomoniasis, and chlamydia (and the administration of such tests), if such testing (or administration, as applicable) would be covered under health insurance coverage pursuant to section 2713(a)(1) of the Public Health Service Act for an individual enrolled under such coverage, to an eligible individual at a medical facility of the Department pursuant to this section. (b) Eligibility An individual is eligible for the testing described in subsection (a) if the individual is a veteran who is enrolled in the system of annual patient enrollment established under section 1705(a) of this title. (c) Prohibition on cost-Sharing Notwithstanding subsections (f) and (g) of section 1710 and section 1722A of this title, the Secretary may not require an eligible individual to make any copayment for, or charge such individual for any other cost of, the receipt of the testing described in subsection (a). . (2) Effective date The amendments made by this subsection shall take effect on January 1 of the year following the date of the enactment of this Act. (g) Coverage of testing with respect to Indians receiving purchased/Referred care (1) Coverage The Secretary of Health and Human Services shall cover, without the imposition of any cost sharing requirements, the cost of providing screening testing (and the administration of such tests) for each of HIV, gonorrhea, syphilis, trichomoniasis, and chlamydia, if such testing (or administration, as applicable) would be covered under health insurance coverage pursuant to section 2713(a)(1) of the Public Health Service Act for an individual enrolled under such coverage, to Indians (as defined in section 4 of the Indian Health Care Improvement Act ( 25 U.S.C. 1603 )) receiving health services through the Indian Health Service, including through an Urban Indian Organization, regardless of whether such tests have been authorized under the purchased/referred care system funded by the Indian Health Service or are covered as a health service of the Indian Health Service. (2) Effective date This subsection shall take effect on the date of the enactment of this Act and shall apply to items and services furnished on or after the first day of the calendar year beginning after such date.