117 HR 4200 IH: Residential Substance Use Disorder Treatment Act of 2021
U.S. House of Representatives
2021-06-28
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

I117th CONGRESS1st SessionH. R. 4200IN THE HOUSE OF REPRESENTATIVESJune 28, 2021Ms. Jackson Lee (for herself and Mr. Jeffries) introduced the following bill; which was referred to the Committee on the JudiciaryA BILLTo amend the Omnibus Crime Control and Safe Streets Act of 1968 to reauthorize the residential substance use disorder treatment program, and for other purposes.1.Short titleThis Act may be cited as the Residential Substance Use Disorder Treatment Act of 2021. 2.Residential substance use disorder treatment program(a)AmendmentsPart S of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (34 U.S.C. 10421 et seq.) is amended—(1)in the part heading, by striking substance abuse and inserting substance use disorder;(2)in section 1901 (34 U.S.C. 10421)—(A)in subsection (a)—(i)in paragraph (1)—(I)by striking substance abuse each place it appears and inserting substance use disorder; and(II)by inserting after programs the following: , including medication-assisted treatment programs, which shall be permitted to use any type of medication that has been approved to treat substance use disorders pursuant to section 505 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355), or any type of biological product licensed under section 351 of the Public Health Service Act (42 U.S.C. 262),; and(ii)in paragraph (3), by striking substance abuse each place it appears and inserting substance use disorder;(B)in subsection (b), by striking substance abuse and inserting substance use disorder; and(C)in subsection (c)—(i)by striking part for treatment and inserting “part for—(1)treatment;(ii)in paragraph (1), as so designated, by striking the period at the end and inserting ; and; and(iii)by adding at the end the following:(2)expanding residential substance use disorder treatment programs to use not less than 1 medication or treatment that has been approved to treat substance use disorders pursuant to section 505 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355).;(3)in section 1902 (34 U.S.C. 10422)—(A)in subsection (b)—(i)in the subsection heading, by striking abuse and inserting use; and(ii)by striking substance abuse each place it appears and inserting substance use disorder;(B)in subsection (c), by striking substance abuse each place it appears and inserting substance use disorder;(C)in subsection (d), by striking substance abuse treatment and inserting substance use disorder treatment;(D)in subsection (f), by striking substance abuse and inserting substance use disorder; and(E)by adding at the end the following:(g)Training requirement(1)In generalTo be eligible to receive funds under this part, the chief medical officer of the prison or jail or appropriate staff overseeing the program shall complete training, before or within a reasonable amount of time after receiving the funds, on, at a minimum—(A)the science of addiction;(B)the latest research and clinical guidance for detoxification and withdrawal management and the treatment of substance use disorders in criminal justice settings;(C)strategies for continuity of care during and after incarceration; (D)an overview of—(i)all medications for the treatment of substance use disorders;(ii)how to obtain certification as an opioid treatment provider (OTP) or waivers under the Controlled Substances Act (21 U.S.C. 801 et seq.) for prescribing certain medications; and(iii)evidence-based behavioral therapies used in addition to medication to improve medication adherence and treatment outcomes; and(E)any other topic determined by the Attorney General, in coordination with the Secretary of Health and Human Services and in consultation with experts in addiction science, to be a core element for successful training under this paragraph. (2)RequirementThe training required under paragraph (1) shall include guidance on how to—(A)engage relevant stakeholders;(B)identify available resources for, and gaps and barriers to, providing residential substance use disorder treatment; and(C)develop a plan to overcome obstacles to administering and offering medication-assisted treatment.(h)Provider affiliationAny entity, including a prison or jail, that receives Federal funds for a program or activity that offers medication-assisted treatment shall have an affiliation with a provider that can—(1)prescribe not less than 1 medication-assisted treatment to patients after release from the entity; and(2)discuss the risks and benefits of, and alternatives to, medication-assisted treatment with patients.; and(4)in section 1904 (34 U.S.C. 10424)—(A)by amending subsection (c) to read as follows:(c)Local allocation(1)In generalNot less than 10 percent of the total amount made available to a State under subsection (a) for any fiscal year shall be used by the State to make grants to local correctional and detention facilities in the State (provided such facilities exist therein).(2)Jail-based substance use treatment programsA jail-based substance use disorder treatment program described in paragraph (1) may be made available to any individual who is—(A)awaiting trial or is otherwise in pre-trial detention; or(B)serving a sentence of imprisonment in the jail.; and(B)by amending subsection (d) to read as follows:(d)Evidence-Based treatments(1)In generalA State may use amounts received under this part to—(A)provide any type of medication-assisted treatment that has been approved to treat substance use disorders pursuant to section 505 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355), and any type of biological product licensed under section 351 of the Public Health Service Act (42 U.S.C. 262), and prescribe overdose reversal medications during the residential substance use disorder treatment program or after care;(B)cover costs associated with the training required under section 1902(g); (C)obtain waivers under clause (ii) or (iv) of section 303(g)(2)(G) of the Controlled Substances Act (21 U.S.C. 823(g)(2)(G)); and(D)obtain certification as an opioid treatment provider (OTP) in accordance with part 8 of title 42, Code of Federal Regulations, or any successor thereto, or the prescription of medications to treat substance use disorders. (2)DefinitionIn this subsection, the term medication-assisted treatment means a treatment plan that combines behavioral therapy with any type of medication that has been approved to treat substance use disorders pursuant to section 505 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355), or any type of biological product licensed under section 351 of the Public Health Service Act (42 U.S.C. 262)..(b)Authorization of appropriationsSection 1001(a)(17) of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (34 U.S.C. 10261(a)(17)) is amended to read as follows:(17)There are authorized to be appropriated to carry out the projects under part S $40,000,000 for each of fiscal years 2022 through 2026..(c)DefinitionSection 901(25) of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (34 U.S.C. 10251(25)) is amended to read as follows:(25)the term residential substance use disorder treatment program means a course of comprehensive individual and group substance use disorder treatment services in residential treatment facilities that, to the greatest extent practicable, follow the guidance entitled, Promising Practice Guidelines for Residential Substance Abuse Treatment, published in November 2017 by the Bureau of Justice Assistance, or as thereafter amended to conform to current standards of care;.


116 HR 1921 : Ocean Acidification Innovation Act of 2019
U.S. House of Representatives
2019-06-10
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

		IIB
		116th CONGRESS1st Session
		H. R. 1921
		IN THE SENATE OF THE UNITED STATES
		June 10, 2019Received; read twice and referred to the Committee on Commerce, Science, and TransportationAN ACT
		To authorize Federal agencies to establish prize competitions for innovation or adaptation
			 management development relating to ocean acidification.

 1.Short titleThis Act may be cited as the Ocean Acidification Innovation Act of 2019. 2.Prize competitionsSection 12404 of the Federal Ocean Acidification Research And Monitoring Act of 2009 (33 U.S.C. 3703) is amended by adding at the end the following:

				(d)Prize competitions
 (1)In GeneralAny Federal agency with a representative serving on the interagency working group established under this section may, either individually or in cooperation with one or more agencies, carry out a program to award prizes competitively under section 24 of the Stevenson-Wydler Technology Innovation Act of 1980 (15 U.S.C. 3719). An agency seeking to carry out such a program shall carry out such program in coordination with the chair of such interagency working group.
 (2)PurposesAny prize competition carried out under this subsection shall be for the purpose of stimulating innovation to advance our Nation’s ability to understand, research, or monitor ocean acidification or its impacts, or to develop management or adaptation options for responding to ocean acidification.
 (3)Priority programsPriority shall be given to establishing programs under this section that address communities, environments, or industries that are in distress due to the impacts of ocean acidification, including—
 (A)the development of monitoring or management options for communities or industries that are experiencing significant financial hardship;
 (B)the development of adaptation options to alleviate economic harm and job loss caused by ocean acidification;
 (C)the development of measures to help vulnerable communities or industries, with an emphasis on rural communities and businesses; and
 (D)the development of adaptation and management options for impacted shellfish industries.. 3.Determination of Budgetary EffectsThe budgetary effects of this Act, for the purpose of complying with the Statutory Pay-As-You-Go Act of 2010, shall be determined by reference to the latest statement titled Budgetary Effects of PAYGO Legislation for this Act, submitted for printing in the Congressional Record by the Chairman of the House Budget Committee, provided that such statement has been submitted prior to the vote on passage.

	Passed the House of Representatives June 5, 2019.Cheryl L. Johnson,Clerk


116 S1751 RS: Bureau of Reclamation Pumped Storage Hydropower Development Act
U.S. Senate
2019-06-05
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

IICalendar No. 260116th CONGRESS1st SessionS. 1751[Report No. 116–140]IN THE SENATE OF THE UNITED STATESJune 5, 2019Ms. Cantwell introduced the following bill; which was read twice and referred to the Committee on Energy and Natural ResourcesOctober 23, 2019Reported by Ms. Murkowski, with an amendmentOmit the part struck through and insert the part printed in italicA BILLTo amend the Reclamation Project Act of 1939 to authorize pumped storage hydropower development
			 utilizing multiple Bureau of Reclamation reservoirs.

 1.Short titleThis Act may be cited as the Bureau of Reclamation Pumped Storage Hydropower Development Act. 2.Authority for pumped storage hydropower development using multiple Bureau of Reclamation reservoirsSection 9(c) of the Reclamation Project Act of 1939 (43 U.S.C. 485h(c)) is amended—
 (1)in paragraph (1), in the fourth sentence, by striking , including small conduit hydropower development and inserting and reserve to the Secretary the exclusive authority to develop small conduit hydropower using Bureau of Reclamation facilities and pumped storage hydropower exclusively using Bureau of Reclamation reservoirs; and
 (2)in paragraph (8), by striking has been filed with the Federal Energy Regulatory Commission as of August 9, 2013 as of the date of the enactment of the Bureau of Reclamation Small Conduit Hydropower Development and Rural Jobs Act and inserting was filed with the Federal Energy Regulatory Commission before August 9, 2013, and is still pending.
			3.Limitations on issuance of certain leases of power privilege
 (a)DefinitionsIn this section: (1)CommissionThe term Commission means the Federal Energy Regulatory Commission.
 (2)DirectorThe term Director means the Director of the Office of Hearings and Appeals. (3)Office of Hearings and AppealsThe term Office of Hearings and Appeals means the Office of Hearings and Appeals of the Department of the Interior.
 (4)PartyThe term party, with respect to a study plan agreement, means each of the following parties to the study plan agreement:
 (A)The proposed lessee. (B)The Tribes.
 (5)ProjectThe term project means a proposed pumped storage facility that— (A)would use multiple Bureau of Reclamation reservoirs; and
 (B)as of June 1, 2017, was subject to a preliminary permit issued by the Commission pursuant to section 4(f) of the Federal Power Act (16 U.S.C. 797(f)).
 (6)Proposed lesseeThe term proposed lessee means the proposed lessee of a project. (7)SecretaryThe term Secretary means the Secretary of the Interior.
 (8)Study planThe term study plan means the plan described in subsection (d)(1). (9)Study plan agreementThe term study plan agreement means an agreement entered into under subsection (b)(1) and described in subsection (c).
 (10)TribesThe term Tribes means— (A)the Confederated Tribes of the Colville Reservation; and
 (B)the Spokane Tribe of Indians of the Spokane Reservation.
 (b)Requirement for issuance of leases of power privilegeThe Secretary shall not issue a lease of power privilege pursuant to section 9(c)(1) of the Reclamation Project Act of 1939 (43 U.S.C. 485h(c)(1)) (as amended by section 2) for a project unless—
 (1)the proposed lessee and the Tribes have entered into a study plan agreement; or
 (2)the Secretary or the Director, as applicable, makes a final determination for—
 (A)a study plan agreement under subsection (c)(2); or (B)a study plan under subsection (d).
					(c)Study plan agreement requirements
 (1)In generalA study plan agreement shall— (A)establish the deadlines for the proposed lessee to formally respond in writing to comments and study requests about the project previously submitted to the Commission;
 (B)allow for the parties to submit additional comments and study requests if any aspect of the project, as proposed, differs from an aspect of the project, as described in a preapplication document provided to the Commission;
 (C)except as expressly agreed to by the parties or as provided in paragraph (2) or subsection (d), require that the proposed lessee conduct each study described in—
 (i)a study request about the project previously submitted to the Commission; or
 (ii)any additional study request submitted in accordance with the study plan agreement;
 (D)require that the proposed lessee study any potential adverse economic effects of the project on the Tribes, including effects on—
 (i)annual payments to the Confederated Tribes of the Colville Reservation under section 5(b) of the Confederated Tribes of the Colville Reservation Grand Coulee Dam Settlement Act (Public Law 103–436; 108 Stat. 4579); and
 (ii)annual payments to the Spokane Tribe of Indians of the Spokane Reservation authorized after the date of enactment of this Act, the amount of which derives from the annual payments described in clause (i);
 (E)establish a protocol for communication and consultation between the parties; (F)provide mechanisms for resolving disputes between the parties regarding implementation and enforcement of the study plan agreement; and
 (G)contain other provisions determined to be appropriate by the parties. (2)Disputes (A)In generalIf the parties cannot agree to the terms of a study plan agreement or implementation of those terms, the parties shall submit to the Director, for final determination on the terms or implementation of the study plan agreement, notice of the dispute, consistent with paragraph (1)(F), to the extent the parties have agreed to a study plan agreement.
 (B)InclusionA dispute covered by subparagraph (A) may include the view of a proposed lessee that an additional study request submitted in accordance with paragraph (1)(B) is not reasonably calculated to assist the Secretary in evaluating the potential impacts of the project.
 (C)TimingThe Director shall issue a determination regarding a dispute under subparagraph (A) not later than 120 days after the date on which the Director receives notice of the dispute under that subparagraph.
					(d)Study plan
 (1)In generalThe proposed lessee shall submit to the Secretary for approval a study plan that details the proposed methodology for performing each of the studies—
 (A)identified in the study plan agreement of the proposed lessee; or
 (B)determined by the Director in a final determination regarding a dispute under subsection (c)(2).
 (2)Initial determinationNot later than 60 days after the date on which the Secretary receives the study plan under paragraph (1), the Secretary shall make an initial determination that—
 (A)approves the study plan; (B)rejects the study plan on the grounds that the study plan—
 (i)lacks sufficient detail on a proposed methodology for a study identified in the study plan agreement; or
 (ii)is inconsistent with the study plan agreement; or
 (C)imposes additional study plan requirements that the Secretary determines are necessary to adequately define the potential effects of the project on—
 (i)the exercise of the paramount hunting, fishing, and boating rights of the Tribes reserved pursuant to the Act of June 29, 1940 (54 Stat. 703, chapter 460; 16 U.S.C. 835d et seq.);
 (ii)the annual payments described in clauses (i) and (ii) of subsection (c)(1)(D); (iii)the Columbia Basin project (as defined in section 1 of the Act of May 27, 1937 (50 Stat. 208, chapter 269; 57 Stat. 14, chapter 14; 16 U.S.C. 835));
 (iv)historic properties and cultural or spiritually significant resources; and (v)the environment.
						(3)Objections
 (A)In generalNot later than 30 days after the date on which the Secretary makes an initial determination under paragraph (2), the Tribes or the proposed lessee may submit to the Director an objection to the initial determination.
 (B)Final determinationNot later than 120 days after the date on which the Director receives an objection under subparagraph (A), the Director shall—
 (i)hold a hearing on the record regarding the objection; and (ii)make a final determination that establishes the study plan, including a description of studies the proposed lessee is required to perform.
 (4)No objectionsIf no objections are submitted by the deadline described in paragraph (3)(A), the initial determination of the Secretary under paragraph (2) shall be final.
				(e)Conditions of lease
				(1)Consistency with rights of Tribes; protection, mitigation, and enhancement of fish and wildlife
 (A)In generalAny lease of power privilege issued by the Secretary for a project under subsection (b) shall contain conditions—
 (i)to ensure that the project is consistent with, and will not interfere with, the exercise of the paramount hunting, fishing, and boating rights of the Tribes reserved pursuant to the Act of June 29, 1940 (54 Stat. 703, chapter 460; 16 U.S.C. 835d et seq.); and
 (ii)to adequately and equitably protect, mitigate damages to, and enhance fish and wildlife, including related spawning grounds and habitat, affected by the development, operation, and management of the project.
 (B)Recommendations of the TribesThe conditions required under subparagraph (A) shall be based on joint recommendations of the Tribes.
					(C)Resolving inconsistencies
 (i)In generalIf the Secretary determines that any recommendation of the Tribes under subparagraph (B) is not reasonably calculated to ensure the project is consistent with subparagraph (A) or is inconsistent with the requirements of the Reclamation Project Act of 1939 (43 U.S.C. 485 et seq.), the Secretary shall attempt to resolve any such inconsistency with the Tribes, giving due weight to the recommendations and expertise of the Tribes.
 (ii)Publication of findingsIf, after an attempt to resolve an inconsistency under clause (i), the Secretary does not adopt in whole or in part a recommendation of the Tribes under subparagraph (B), the Secretary shall issue each of the following findings, including a statement of the basis for each of the findings:
 (I)A finding that adoption of the recommendation is inconsistent with the requirements of the Reclamation Project Act of 1939 (43 U.S.C. 485 et seq.).
 (II)A finding that the conditions selected by the Secretary to be contained in the lease of power privilege under subparagraph (A) comply with the requirements of clauses (i) and (ii) of that subparagraph.
							(2)Annual charges payable by licensee
 (A)In generalSubject to subparagraph (B), any lease of power privilege issued by the Secretary for a project under subsection (b) shall contain conditions that require the lessee of the project to make direct payments to the Tribes through reasonable annual charges in an amount that recompenses the Tribes for any adverse economic effect of the project identified in a study performed pursuant to the study plan agreement for the project.
					(B)Agreement
 (i)In generalThe amount of the annual charges described in subparagraph (A) shall be established through agreement between the proposed lessee and the Tribes.
 (ii)ConditionThe agreement under clause (i), including any modification of the agreement, shall be deemed to be a condition to the lease of power privilege issued by the Secretary for a project under subsection (b).
						(C)Dispute resolution
 (i)In generalIf the proposed lessee and the Tribes cannot agree to the terms of an agreement under subparagraph (B)(i), the proposed lessee and the Tribes shall submit notice of the dispute to the Director.
 (ii)ResolutionThe Director shall resolve the dispute described in clause (i) not later than 180 days after the date on which the Director receives notice of the dispute under that clause.
 (3)Additional conditionsThe Secretary may include in any lease of power privilege issued by the Secretary for a project under subsection (b) other conditions determined appropriate by the Secretary, on the condition that the conditions shall be consistent with the Reclamation Project Act of 1939 (43 U.S.C. 485 et seq.).
 (4)ConsultationIn establishing conditions under this subsection, the Secretary shall consult with the Tribes.
 (f)DeadlinesThe Secretary or any officer of the Office of Hearing and Appeals before whom a proceeding is pending under this section may extend any deadline or enlarge any timeframe described in this section—
 (1)at the discretion of the Secretary or the officer; or (2)on a showing of good cause by any party.
 (g)Judicial reviewAny final action of the Secretary or the Director made pursuant to this section shall be subject to judicial review in accordance with chapter 7 of title 5, United States Code.
 (h)Effect on other projectsNothing in this section establishes any precedent or is binding on any Bureau of Reclamation lease of power privilege, other than for a project.October 23, 2019Reported with an amendment


116 S1481 IS: Healthy Maternity and Obstetric Medicine Act
U.S. Senate
2019-05-15
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

II116th CONGRESS1st SessionS. 1481IN THE SENATE OF THE UNITED STATESMay 15, 2019Mr. Brown (for himself, Ms. Smith, Mrs. Gillibrand, Mr. Markey, Ms. Klobuchar, Mr. Tester, Ms. Hassan, Mr. Blumenthal, Ms. Harris, Mr. Casey, Mr. Whitehouse, Mr. Booker, Mr. Merkley, Mr. Peters, Mr. King, Ms. Rosen, Mr. Leahy, Ms. Cortez Masto, Ms. Baldwin, Mr. Jones, and Mr. Kaine) introduced the following bill; which was read twice and referred to the Committee on FinanceA BILLTo amend title XXVII of the Public Health Service Act to provide for a special enrollment period
 for pregnant women, and for other purposes.1.Short titleThis Act may be cited as the Healthy Maternity and Obstetric Medicine Act or the Healthy MOM Act.2.Findings and purpose(a)FindingsCongress finds the following:(1)Pregnancy is a significant life event for millions of women in the United States each year.(2)For more than 30 years, our Nation, through the Medicaid program, has recognized that pregnant women need immediate access to affordable care, and has allowed women who meet income-eligibility requirements to enroll in Medicaid coverage when they become pregnant.(3)Congress recognized the central importance of maternity coverage by classifying maternity and newborn care as one of the ten essential health benefits that must now be covered on most individual and small group health insurance plans under section 1302(b)(1) of the Patient Protection and Affordable Care Act (42 U.S.C. 18022(b)(1)).(4)Congress has also recognized the significant challenge of maternal mortality and the need to eliminate disparities in maternal health outcomes for pregnancy-related and pregnancy-associated deaths, and to improve health outcomes for both mothers and babies through passage of the Preventing Maternal Deaths Act of 2018 (Public Law 115–344).(5)Access to comprehensive maternity coverage allows women to access important pregnancy-related care, which is demonstrated to improve health outcomes for women and newborns and reduce financial costs for both consumers and insurers.(6)Uninsured women, women with grandfathered and transitional health plans, self-funded student health plans, and catastrophic and high-deductible health plans may lack access to comprehensive and affordable maternity coverage.(7)Employer health plans that exclude dependent daughters from maternity coverage leave young women without coverage for their pregnancy, even though Federal law has long held that treating pregnancy differently than other conditions is sex-based discrimination.(8)A special enrollment period is especially important for young adults, who are at high risk for unintended pregnancies, yet young adults are frequently enrolled in catastrophic coverage, which often has fewer benefits, more restrictions, and higher deductibles.(9)This coverage would be an equalizer for communities of color. The maternal mortality rate varies drastically by race and ethnicity, and where a woman lives. The rising maternal mortality rate in the United States is driven predominantly by the disproportionately high African-American maternal mortality rate, which is four times more than the rate for White women.(10)According to the Centers for Disease Control and Prevention, about 700 women die each year in the United States from pregnancy-related complications. Black and American Indian/Alaska Native women are about three times more likely to die from a pregnancy-related cause than White women.(11)Data demonstrates that 3 in 5 pregnancy-related deaths could be prevented. Improving access to care is one way to help prevent deaths, regardless of race or ethnicity.(12)Timely maternity care improves the health of pregnant women, as well as birth outcomes and the health of babies throughout their lifetimes. Pregnancy-related maternal mortality is three to four times higher among women who receive no maternity care compared to women who do. Regular maternity care can detect or mitigate serious pregnancy-related health complications, including preeclampsia, placental abruption, complications from diabetes, complications from heart disease, and Graves’ disease, all of which can result in morbidity or mortality for the mother or newborn.(13)The Centers for Disease Control and Prevention reports that more than half of all maternal deaths occur at delivery or in the first postpartum year, whereas just more than one-third of pregnancy-related or pregnancy-associated deaths occur while a person is still pregnant. Yet, for women eligible for the Medicaid program on the basis of pregnancy, such Medicaid coverage lapses at the end of the month on which the 60th postpartum day lands.(14)Timely maternity care and adequate postpartum care can reduce short- and long-term health care costs. If a woman does not have access to affordable maternity care during her pregnancy, and she or her newborn experiences pregnancy complications that result in health problems after birth, their insurer may end up paying much higher costs than if the insurer had covered the woman’s maternity care during her pregnancy. Intensive maternity care can reduce hospital and neonatal intensive care unit admissions among infants, resulting in cost savings of $1,768 to $5,560 per birth. For women with high-risk pregnancies, intensive maternity care saves $1.37 for every $1 invested in maternity care.(b)PurposeThe purpose of this Act is to protect the health of women and newborns by ensuring that all women eligible for coverage through the Exchanges established under title I of the Patient Protection and Affordable Care Act (Public Law 111–148) and women eligible for other individual or group health plan coverage can access affordable health coverage during their pregnancy.3.Providing for a special enrollment period for pregnant individuals(a)Public Health Service ActSection 2702(b)(2) of the Public Health Service Act (42 U.S.C. 300gg–1(b)(2)) is amended by inserting including a special enrollment period for pregnant individuals, beginning on the date on which the pregnancy is reported to the health insurance issuer before the period at the end.(b)Patient protection and affordable care actSection 1311(c)(6) of the Patient Protection and Affordable Care Act (42 U.S.C. 18031(c)(6)) is amended—(1)in subparagraph (C), by striking and at the end;(2)by redesignating subparagraph (D) as subparagraph (E); and(3)by inserting after subparagraph (C) the following new subparagraph:(D)a special enrollment period for pregnant individuals, beginning on the date on which the pregnancy is reported to the Exchange; and.(c)Special enrollment periods(1)Internal Revenue CodeSection 9801(f) of the Internal Revenue Code of 1986 (26 U.S.C. 9801(f)) is amended by adding at the end the following new paragraph:(4)For pregnant individuals(A)A group health plan shall permit an employee who is eligible, but not enrolled, for coverage under the terms of the plan (or a dependent of such an employee if the dependent is eligible, but not enrolled, for coverage under such terms) to enroll for coverage under the terms of the plan upon pregnancy, with the special enrollment period beginning on the date on which the pregnancy is reported to the group health plan or the pregnancy is confirmed by a health care provider.(B)The Secretary shall promulgate regulations with respect to the special enrollment period under subparagraph (A), including establishing a time period for pregnant individuals to enroll in coverage and effective date of such coverage..(2)ERISASection 701(f) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1181(f)) is amended by adding at the end the following:(4)For pregnant individuals(A)A group health plan or health insurance issuer in connection with a group health plan shall permit an employee who is eligible, but not enrolled, for coverage under the terms of the plan (or a dependent of such an employee if the dependent is eligible, but not enrolled, for coverage under such terms) to enroll for coverage under the terms of the plan upon pregnancy, with the special enrollment period beginning on the date on which the pregnancy is reported to the group health plan or health insurance issuer or the pregnancy is confirmed by a health care provider.(B)The Secretary shall promulgate regulations with respect to the special enrollment period under subparagraph (A), including establishing a time period for pregnant individuals to enroll in coverage and effective date of such coverage..(d)Effective dateThe amendments made by this section shall apply with respect to plan years beginning after the 2019 plan year.4.Coverage of maternity care for dependent childrenSection 2719A of the Public Health Service Act (42 U.S.C. 300gg–19a) is amended by adding at the end the following:(e)Coverage of maternity careA group health plan, or health insurance issuer offering group or individual health insurance coverage, that provides coverage for dependents shall ensure that such plan or coverage includes coverage for maternity care associated with pregnancy, childbirth, and postpartum care for all participants, beneficiaries, or enrollees, including dependents, including coverage of labor and delivery. Such coverage shall be provided to all pregnant dependents regardless of age..5.Federal employee health benefit plans(a)Coverage of pregnancy(1)In generalThe Director of the Office of Personnel Management shall issue such regulations as are necessary to ensure that pregnancy is considered a change in family status and a qualifying life event for an individual who is eligible to enroll, but is not enrolled, in a health benefit plan under chapter 89 title 5, United States Code.(2)Effective dateThe requirement in paragraph (1) shall apply with respect to any contract entered into under section 8902 of such title beginning 12 months after the date of enactment of this Act.(b)Designating certain FEHBP-Related services as excepted services under the Anti-Deficiency Act(1)In generalSection 8905 of title 5, United States Code, is amended by adding at the end the following:(i)Any services by an officer or employee under this chapter relating to enrolling individuals in a health benefits plan under this chapter, or changing the enrollment of an individual already so enrolled due to an event described in section 5(a)(1) of the Healthy MOM Act, shall be deemed, for purposes of section 1342 of title 31, services for emergencies involving the safety of human life or the protection of property..(2)ApplicationThe amendment made by paragraph (1) shall apply to any lapse in appropriations beginning on or after the date of enactment of this Act.6.Continuation of Medicaid income eligibility standard for pregnant individuals and infantsSection 1902(l)(2)(A) of the Social Security Act (42 U.S.C. 1396a(l)(2)(A)) is amended—(1)in clause (i), by striking and not more than 185 percent;(2)in clause (ii)—(A)in subclause (I), by striking and after the comma;(B)in subclause (II), by striking the period at the end and inserting , and; and(C)by adding at the end the following:(III)January 1, 2020, is the percentage provided under clause (v).; and(3)by adding at the end the following new clause:(v)The percentage provided under clause (ii) for medical assistance provided on or after January 1, 2020, with respect to individuals described in subparagraph (A) or (B) of paragraph (1) shall not be less than—(I)the percentage specified for such individuals by the State in an amendment to its State plan (whether approved or not) as of January 1, 2014; or(II)if no such percentage is specified as of January 1, 2014, the percentage established for such individuals under the State's authorizing legislation or provided for under the State's appropriations as of that date..7.12-month continuous coverage for pregnant and postpartum individuals under Medicaid and CHIP(a)Medicaid(1)Required for all eligibility pathwaysParagraph (5) of section 1902(e) of the Social Security Act (42 U.S.C. 1396a(e)) is amended to read as follows:(5)Any individual who is eligible for medical assistance under the State plan or a waiver of such plan and who is, or who while so eligible becomes, pregnant, shall continue to be eligible under the plan or waiver for medical assistance that provides at least essential health benefits as described in section 1302(b) of the Patient Protection and Affordable Care Act, through the end of the month in which the 1-year period (beginning on the last day of her pregnancy) ends, regardless of the basis for the individual's eligibility for medical assistance, including if the individual's eligibility for medical assistance is on the basis of being pregnant..(2)Conforming amendmentsTitle XIX of the Social Security Act (42 U.S.C. 1396 et seq.) is amended—(A)in section 1902—(i)in subsection (a)(10), in the matter following subparagraph (G) by striking (VII) the medical assistance and all that follows through complicate pregnancy,;(ii)in subsection (e)(6), by striking 60-day and inserting 1-year; and(iii)in subsection (l)(1)(A), by striking 60-day and inserting 1-year;(B)in section 1903(v)(4)(A)(i), by striking 60-day and inserting 1-year; and(C)in section 1905(a), in the 4th sentence in the matter following paragraph (30), by striking 60-day and inserting 1-year.(b)CHIP(1)In generalSection 2107(e)(1) of the Social Security Act (42 U.S.C. 1397gg(e)(1)) is amended—(A)by redesignating subparagraphs (H) through (S) as subparagraphs (I) through (T), respectively; and(B)by inserting after subparagraph (G), the following:(H)Section 1902(e)(5) (requiring 12-month continuous coverage for pregnant individuals)..(2)Conforming amendmentsSubsections (d)(2)(A) and (f)(2) of section 2112 of the Social Security Act (42 U.S.C. 1397ll) are each amended by striking 60-day and inserting 1-year.(c)Effective date(1)In generalSubject to paragraph (2), the amendments made by this section shall take effect on the 1st day of the 1st calendar quarter that begins on or after the date that is 1 year after the date of enactment of this Act.(2)Exception for State legislationIn the case of a State plan under title XIX of the Social Security Act or a State child health plan under title XXI of such Act that the Secretary of Health and Human Services determines requires State legislation in order for the respective plan to meet any requirement imposed by amendments made by this section, the respective plan 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 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 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 the session shall be considered to be a separate regular session of the State legislature.8.Relationship to other lawsNothing in this Act (or an amendment made by this Act) shall be construed to invalidate or limit the remedies, rights, and procedures of any Federal law or the law of any State or political subdivision of any State or jurisdiction that provides greater or equal protection for enrollees in a group health plan or group or individual health insurance offered by a health insurance issuer.


117 S646 IS: Stabilize Medicaid and CHIP Coverage Act of 2021
U.S. Senate
2021-04-04
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

II117th CONGRESS1st SessionS. 646IN THE SENATE OF THE UNITED STATESMarch 9, 2021Mr. Brown (for himself, Ms. Baldwin, Ms. Warren, and Mr. Whitehouse) introduced the following bill; which was read twice and referred to the Committee on FinanceA BILLTo amend titles XIX and XXI of the Social Security Act to provide for 12-month continuous enrollment under Medicaid and the Children's Health Insurance Program, and for other purposes.1.Short titleThis Act may be cited as the Stabilize Medicaid and CHIP Coverage Act of 2021.2.FindingsCongress finds the following:(1)Every year millions of people are enrolled in Medicaid and the Children’s Health Insurance Program (in this section referred to as CHIP), but subsequently lose their coverage, despite still being eligible, because of inefficient and cumbersome paperwork and logistical requirements.(2)Data show that the typical enrollee receives Medicaid coverage for about ¾ of the year and that coverage periods are lower for non-elderly, non-disabled adults than for those with disabilities, seniors, and children.(3)Medicaid enrollees with coverage disruption are more likely to be hospitalized for illnesses, like asthma, diabetes, or cardiovascular disease, that can be effectively managed through ongoing primary medical care and medication, are less likely to be screened for breast cancer, and may have poorer cancer outcomes.(4)Children enrolled in CHIP also experience disruptions in health coverage and care. For example, during just a 1-year period, over 1/3 of CHIP enrollees were also enrolled in a State’s Medicaid program. Transitions between Medicaid and CHIP can cause disruptions in care because the health care coverage and participating providers vary between the two programs.(5)Interruptions in coverage can impair the receipt of effective primary care and lead to expensive hospitalizations or emergency room visits.(6)Unnecessary enrollment, disenrollment, and reenrollment in Medicaid and CHIP result in higher administrative expenses for reenrollment and result in more people uninsured at any given time.(7)Stable coverage under Medicaid and CHIP lowers average monthly medical costs. Continuous enrollment also permits better prevention and disease management, leading to fewer serious illnesses and hospitalizations.(8)Children with stable coverage are less likely to have unmet medical needs, allowing children to receive the preventive care that is necessary to help them grow into healthy adults.3.12-month continuous enrollment(a)Requirement of 12-Month continuous enrollment under medicaid(1)In generalSection 1902(e)(12) of the Social Security Act (42 U.S.C. 1396a(e)), is amended to read as follows:(12)12-month continuous enrollment(A)In generalNotwithstanding any other provision of this title, a State plan approved under this title or under any waiver of such plan approved pursuant to section 1115 or section 1915, shall provide that an individual who is determined to be eligible for benefits under such plan (or waiver) shall be considered to meet the eligibility requirements met on the date of application and shall remain eligible and enrolled for such benefits through the end of the month in which the 12-month period (beginning on the date of determination of eligibility) ends.(B)Promoting retention of eligible and enrolled persons beyond 12 monthsThe Secretary shall—(i)identify methods that promote the retention of individuals who are enrolled under the State plan or under a waiver of such plan and who remain eligible for medical assistance beyond the 12-month period described in subparagraph (A); and(ii)actively promote the adoption of such enrollment retention methods by States, which shall include, but not be limited to, issuing guidance and developing resources on State best practices.(C)Enrollment and retention reporting(i)In generalNot later than 1 year after the date of enactment of the Stabilize Medicaid and CHIP Coverage Act of 2021, the Secretary shall publish the procedures that States are expected to use to provide annual enrollment and retention reports beginning not later than 2 years after the date of enactment of such Act.(ii)State reporting requirementsAt a minimum, the reporting procedures published under clause (i) shall include a description of State eligibility criteria and enrollment procedures under this title and data regarding enrollment and retention using standardized reporting formats determined by the Secretary.(iii)Secretary report and publication(I)In generalThe Secretary annually shall publish enrollment and retention performance results for all States not later than 6 months after the deadline for each annual State enrollment and retention reporting period.(II)Estimated enrollment continuity ratiosEach annual report published by the Secretary under subclause (I) shall include estimates of Medicaid enrollment continuity ratios for each State in accordance with the requirements of subclause (III).(III)RequirementsThe Secretary shall develop both overall enrollment continuity ratios for all enrollees and separate enrollment continuity ratios for each of the following categories:(aa)Children.(bb)Individuals whose eligibility category is related to having attained age 65.(cc)Individuals whose eligibility category is related to disability or blindness.(dd)Individuals whose eligibility category is related to their status as parents and caretaker relatives of children under 19 or who are otherwise not elderly, blind or disabled adults..(b)Requirement of 12-Month continuous enrollment under CHIP(1)In generalSection 2102(b) of the Social Security Act (42 U.S.C. 1397bb(b)) is amended by adding at the end the following new paragraph:(6)Requirement for 12-month continuous enrollmentNotwithstanding any other provision of this title, a State child health plan that provides child health assistance under this title through a means other than that described in section 2101(a)(2), shall provide that an individual who is determined to be eligible for benefits under such plan shall be considered to meet the eligibility requirements met on the date of application and shall remain eligible and enrolled for such benefits through the end of the month in which the 12-month period (beginning on the date of determination of eligibility) ends..(2)Conforming amendments(A)Enrollment and retention provisionsSection 2105(a)(4)(A) of the Social Security Act (42 U.S.C. 1397ee(a)(4)(A)) is amended—(i)by striking has elected the option of and inserting is in compliance with the requirement for; and(ii)by striking applying such policy under its State child health plan under this title and inserting in compliance with section 2102(b).(B)Application of medicaid retention and reporting requirementsSection 2107(e)(1) of the Social Security Act (42 U.S.C. 1397gg(e)(1)) is amended—(i)by redesignating subparagraphs (H) through (S) as subparagraphs (I) through (T), respectively; and(ii)by inserting after subparagraph (G), the following:(H)Subparagraphs (B) and (C) of section 1902(e)(12) (relating to promotion of enrollment beyond 12 months and reporting requirements)(without regard to items (bb), (cc), and (dd) of subparagraph (C)(iii)(III) of that section)..(c)Effective date(1)In generalExcept as provided in paragraph (2) or (3), the amendments made by subsections (a) and (b) shall apply to determinations (and redeterminations) of eligibility made on or after the date that is 18 months after the date of the enactment of this Act.(2)Extension of effective date for state law amendmentIn the case of a State plan under title XIX or State child health plan under title XXI of the Social Security Act (42 U.S.C. 1396 et seq.; 42 U.S.C. 1397aa et seq.) which the Secretary of Health and Human Services determines requires State legislation (other than legislation appropriating funds) in order for the respective plan to meet the additional requirements imposed by the amendments made by subsections (a) or (b), respectively, the respective plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such applicable 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 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 the session is considered to be a separate regular session of the State legislature.(3)Option to implement 12-month continuous eligibility prior to effective dateA State may elect through a State plan amendment under title XIX or XXI of the Social Security Act (42 U.S.C. 1396 et seq.; 42 U.S.C. 1397aa et seq.) to apply the amendments made by subsection (a) or (b), respectively, on any date prior to the 18-month date specified in paragraph (1), but not sooner than the date of the enactment of this Act.4.Preventing the application under chip of coverage waiting periods(a)In generalSection 2102(b)(1)(B) of the Social Security Act (42 U.S.C. 1397bb(b)(1)(B)) is amended—(1)in clause (iii)—(A)by striking in the case of and inserting in the case of a targeted low-income child (including a child provided dental-only supplemental coverage under section 2110(b)(5)) or in the case of ; and(B)by adding and after the semicolon;(2)by striking clause (iv); and(3)by redesignating clause (v) as clause (iv).(b)Conforming amendmentsSection 2105(c)(10) of the Social Security Act (42 U.S.C. 1397ee(c)(10)) is amended by striking subparagraph (F) and redesignating subparagraphs (G) through (M) as subparagraphs (F) through (L), respectively.(c)Effective dateThe amendments made by this section shall take effect on the date of enactment of this Act.5.Medicaid performance bonuses for enrollment and retention improvements for certain individualsSection 1903 of the Social Security Act (42 U.S.C. 1396b) is amended by adding at the end the following new subsection:(cc)Performance bonuses for enrollment and retention of low-Income individuals(1)In generalA State may qualify for performance bonuses related to the enrollment and retention of individuals (including children) described in section 1902(e)(12)(C)(iii)(III). For purposes of this paragraph, a State meets the condition of this paragraph for such individuals if, for each category of individuals specified in section 1902(e)(12)(C)(iii)(III), the State is implementing at least 3 of the following enrollment and retention provisions (treating each subparagraph as a separate enrollment and retention provision) throughout the entire fiscal year:(A)Aligning treatment of income under medicaid with that of other insurance affordability programsThe State implements policies, including prorating income over annual periods, so as to align its treatment of income for purposes of a determination of eligibility for medical assistance with that of other affordability insurance programs with the goal of eliminating inconsistent determinations among these programs.(B)Maintaining coverage for individuals during periods of transitionThe State implements the following policies:(i)In generalUpon determination that an individual is no longer eligible for medical assistance, the State implements policies to maintain eligibility for medical assistance, including enrollment in the managed care organization in which the individual was enrolled at the time of the determination of ineligibility, during the period of time in which—(I)eligibility-related information is transmitted to the other insurance affordability programs;(II)a determination is made as to for which other insurance affordability program the individual is eligible, if any; and(III)coverage in such program and any related managed care organization becomes effective.(ii)Managed care organization continuityThe State implements policies to enroll the individual in the managed care organization in which the individual was a member prior to the loss of medical assistance eligibility, if such managed care organization participates in the other insurance affordability program, unless the individual voluntarily selects a separate managed care organization.(C)Enhanced data-sharing between the state and an american health benefit exchange and agenciesThe State utilizes findings from an American Health Benefit Exchange, an Express Lane Agency (as identified by the State and as described in section 1902(e)(13)(F)), the Social Security Administration, or other agencies administering employment, educational, or social services programs as identified by the State, to document income, residency, age, or other relevant information in determining or renewing eligibility.(D)Eligibility based on pending statusThe State maintains eligibility for enrollees whose renewal status has not yet been determined and for whom eligibility based on alternative eligibility criteria has not yet been ruled out.(E)Default reenrollment in managed care organizationIn the case of individuals who are determined to be eligible for medical assistance under this title after the loss of eligibility for fewer than 6 months, and who previously had been members of a managed care organization, the State re-enrolls the individual in the managed care organization in which the individual was a member prior to the loss of eligibility, unless the individual voluntarily selects a separate managed care organization.(2)Performance bonus payment to support 12-month continuous enrollment for
 medicaid enrollees(A)Authority to make bonus payments(i)In generalThe Secretary shall make a bonus payment for fiscal years beginning with the first fiscal year that begins on or after the date that is 3 years after the date of enactment of the Stabilize Medicaid and CHIP Coverage Act of 2021, and annually thereafter to the extent there are funds available under paragraph (3)(A), to each State that satisfies the requirements of subparagraph (B).(ii)RegulationsPayments to States under this subsection for a fiscal year shall be allocated annually among eligible States in accordance with regulations promulgated by the Secretary not later than the date that is 6 months prior to October 1 of the first fiscal year for which payments are made under this paragraph.(iii)TimingA payment to a State under this subsection for a fiscal year shall be made as a single payment not later than the last day of the first calendar quarter of the succeeding fiscal year.(B)State eligibility for bonus paymentsA State shall be eligible for bonus payments under this subsection if—(i)the State has adopted at least 3 of the 5 policies described in subparagraphs (A) through (E) of paragraph (1) for each category of individuals specified in section 1902(e)(12)(C)(iii)(III); and(ii)the State is able to demonstrate improvement in the continuity of enrollment by child, aged, blind, and disabled, and adult populations, compared to the State’s baseline performance with respect to continuity of enrollment for such populations in fiscal year 2021 or such later year as the Secretary, by regulation, shall specify.(3)Amounts available for payments(A)In generalThe total amount of bonus payments made under this subsection for all fiscal years shall be equal to $500,000,000, to be available until expended.(B)Budget authorityThis paragraph constitutes budget authority in advance of appropriations Acts and represents the obligation of the Secretary to provide for the payment of amounts provided under this paragraph.(4)Uses of enrollment and retention performance bonusesNothing in this subsection shall prohibit a State from establishing criteria which would permit the State to distribute a portion of the proceeds of any bonus payments received pursuant to this subsection to financially support providers and managed care entities participating under the State plan or under a waiver of such plan who have contributed to improved enrollment and retention activities..