In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.

[EX Q]: SECTION 1. SHORT TITLE.

This Act may be cited as the ''Contractors and Federal Spending
Accountability Act of 2008''.

SEC. 2. DATABASE FOR CONTRACTING OFFICERS AND SUSPENSION AND DEBARMENT
OFFICIALS.

(a) In General.--Subject to the authority, direction, and control
of the Director of the Office of Management and Budget, the
Administrator of General Services shall establish and maintain a
database of information regarding integrity and performance of persons
awarded Federal contracts and grants for use by Federal officials
having authority over contracts and grants.
(b) Persons Covered.--The database shall cover any person awarded a
Federal contract or grant if any information described in subsection
(c) exists with respect to such person.
(c) Information Included.--With respect to a person awarded a
Federal contract or grant, the database shall include information (in
the form of a brief description) for at least the most recent 5-year
period regarding--
(1) any civil or criminal proceeding, or any administrative
proceeding to the extent that such proceeding results in both a
finding of fault on the part of the person and the payment of
restitution to a government of $5,000 or more, concluded by the
Federal Government or any State government against the person,
and any amount paid by the person to the Federal Government or
a State government;
(2) all Federal contracts and grants awarded to the person
that were terminated in such period due to default;
(3) all Federal suspensions and debarments of the person in
that period;
(4) all Federal administrative agreements entered into by
the person and the Federal Government in that period to resolve
a suspension or debarment proceeding and, to the maximum extent
practicable, agreements involving a suspension or debarment
proceeding entered into by the person and a State government in
that period; and
(5) all final findings by a Federal official in that period
that the person has been determined not to be a responsible
source under either subparagraph (C) or (D) of section 4(7) of
the Office of Federal Procurement Policy Act (41 U.S.C.
403(7)).
(d) Requirements Relating to Information in Database.--
(1) Direct input and update.--The Administrator shall
design and maintain the database in a manner that allows the
appropriate officials of each Federal agency to directly input
and update in the database information relating to actions it
has taken with regard to contractors or grant recipients.
(2) Timeliness and accuracy.--The Administrator shall
develop policies to require--
(A) the timely and accurate input of information
into the database;
(B) notification of any covered person when
information relevant to the person is entered into the
database; and
(C) an opportunity for any covered person to append
comments to information about such person in the
database.
(e) Availability.--
(1) Availability to all federal agencies.--The
Administrator shall make the database available to all Federal
agencies.
(2) Availability to the public.--The Administrator shall
make the database available to the public by posting the
database on the General Services Administration website.
(3) Limitation.--This subsection does not require the
public availability of information that is exempt from public
disclosure under section 552(b) of title 5, United States Code.

SEC. 3. REVIEW OF DATABASE.

(a) Requirement to Review Database.--Prior to the award of a
contract or grant, an official responsible for awarding a contract or
grant shall review the database established under section 2.
(b) Requirement to Document Present Responsibility.--In the case of
a prospective awardee of a contract or grant against which a judgment
or conviction has been rendered more than once within any 3-year period
for the same or similar offences, if each judgment or conviction is a
cause for debarment, the official responsible for awarding the contract
or grant shall document why the prospective awardee is considered
presently responsible.

SEC. 4. DISCLOSURE IN APPLICATIONS.

(a) Requirement.--Not later than 180 days after the date of the
enactment of this Act, Federal regulations shall be amended to require
that in applying for any Federal grant or submitting a proposal or bid
for any Federal contract a person shall disclose in writing information
described in section 2(c).
(b) Covered Contracts and Grants.--This section shall apply only to
contracts and grants in an amount greater than the simplified
acquisition threshold, as defined in section 4(11) of the Office of
Federal Procurement Policy Act (41 U.S.C. 401(11)).

SEC. 5. ROLE OF INTERAGENCY COMMITTEE.

(a) Requirement.--The Interagency Committee on Debarment and
Suspension shall--
(1) resolve issues regarding which of several Federal
agencies is the lead agency having responsibility to initiate
suspension or debarment proceedings;
(2) coordinate actions among interested agencies with
respect to such action;
(3) encourage and assist Federal agencies in entering into
cooperative efforts to pool resources and achieve operational
efficiencies in the Governmentwide suspension and debarment
system;
(4) recommend to the Office of Management and Budget
changes to Government suspension and debarment system and its
rules, if such recommendations are approved by a majority of
the Interagency Committee;
(5) authorize the Office of Management and Budget to issue
guidelines that implement those recommendations;
(6) authorize the chair of the Committee to establish
subcommittees as appropriate to best enable the Interagency
Committee to carry out its functions; and
(7) submit to the Congress an annual report on--
(A) the progress and efforts to improve the
suspension and debarment system;
(B) member agencies' active participation in the
committee's work; and
(C) a summary of each agency's activities and
accomplishments in the Governmentwide debarment system.
(b) Definition.--The term ''Interagency Committee on Debarment and
Suspension'' means such committee constituted under sections 4 and 5
and of Executive Order 12549.

SEC. 6. AUTHORIZATION OF INDEPENDENT AGENCIES.

Any agency, commission, or organization of the Federal Government
to which Executive Order 12549 does not apply is authorized to
participate in the Governmentwide suspension and debarment system and
may recognize the suspension or debarment issued by an executive branch
agency in its own procurement or assistance activities.

SEC. 7. AUTHORIZATION OF APPROPRIATIONS.

There are authorized to be appropriated to the Administrator of
General Services such funds as may be necessary to establish the
database described in section 2.

SEC. 8. REPORT TO CONGRESS.

(a) Report Required.--Not later than 180 days after the date of the
enactment of this Act, the Administrator of General Services shall
submit to Congress a report.
(b) Contents of Report.--The report shall contain the following:
(1) A list of all databases that include information about
Federal contracting and Federal grants.
(2) Recommendations for further legislation or
administrative action that the Administrator considers
appropriate to create a centralized, comprehensive Federal
contracting and Federal grant database.

Passed the House of Representatives April 23, 2008.

Attest:

LORRAINE C. MILLER,

Clerk.
[EX A]: Contractors and Federal Spending Accountability Act of 2008 - (Sec. 2) Requires the Administrator of General Services, subject to the authority of the Director of the Office of Management and Budget (OMB), to establish and maintain on a General Services Administration (GSA) website a database of information regarding the integrity and performance of persons awarded federal contracts and grants for use by federal officials. Authorizes appropriations. Requires the Administrator to make the database available to all federal agencies.

Requires the database to include information, for the last five years, regarding: (1) any civil or criminal proceeding, or and administrative proceeding resulting in a finding of fault and payment of restitution to a government of $5,000 or more, concluded by the federal government and state governments against such persons; and (2) federal contacts and grants terminated due to defaults by such persons; (3) federal suspensions and debarments of such persons; (4) federal and state administrative agreements to resolve suspension or debarment proceedings; and (5) final findings by a federal official that such a person has been determined not to be a responsible source under the Office of Federal Procurement Policy Act.

Requires federal regulations to be amended to require applicants for federal grants or contracts exceeding the simplified acquisition threshold to disclose such information in writing.

Requires the Administrator to develop policies to require: (1) notification of any covered person when information relevant to the person is entered into the database; and (2) an opportunity for any covered person to append comments to information about such person in the database.

(Sec. 3) Requires an official to: (1) review such database prior to awarding a contract or grant; and (2) document why a prospective contract or grant awardee against whom a judgment or conviction for the same offense, or similar offences, has been rendered more than once within any three-year period, if each judgment or conviction is a cause for debarment, is considered presently responsible.

(Sec. 5) Requires the Interagency Committee on Debarment and Suspension to: (1) resolve issues regarding determination of the lead agency responsible for initiating suspension or debarment proceedings; (2) coordinate actions among interested agencies; (3) encourage and assist federal agencies in entering into cooperative efforts to pool resources and achieve operational efficiencies in the government-wide suspension and debarment system; (4) recommend to OMB changes to such system and its rules; (5) authorize OMB to issue guidelines that implement such recommendations; (6) authorize the Committee's chair to establish subcommittees; and (7) report to Congress annually on progress and efforts to improve such system, member agencies' active participation in the committee's work, and a summary of each agency's activities and accomplishments in such system. (Sec. 6) Allows federal agencies, commissions, or organizations not currently participating in the federal suspension and debarment system to participate and to recognize suspensions or debarments issued by participating agencies.

(Sec. 8) Requires the Administrator to submit a report to Congress that includes: (1) a list of all databases that include information about federal contracting and grants; and (2) recommendations for legislation or administrative action to create a centralized, comprehensive federal contracting and grant database.

[EX Q]: SECTION 1. SHORT TITLE.

This Act may be cited as the ''Paycheck Fairness Act''.

SEC. 2. FINDINGS.

Congress makes the following findings:
(1) Women have entered the workforce in record numbers.
(2) Even in the 1990's, women earn significantly lower pay
than men for work on jobs that require equal skill, effort, and
responsibility and that are performed under similar working
conditions. These pay disparities exist in both the private and
governmental sectors. In many instances, the pay disparities
can only be due to continued intentional discrimination or the
lingering effects of past discrimination.
(3) The existence of such pay disparities--
(A) depresses the wages of working families who
rely on the wages of all members of the family to make
ends meet;
(B) prevents the optimum utilization of available
labor resources;
(C) has been spread and perpetuated, through
commerce and the channels and instrumentalities of
commerce, among the workers of the several States;
(D) burdens commerce and the free flow of goods in
commerce;
(E) constitutes an unfair method of competition in
commerce;
(F) leads to labor disputes burdening and
obstructing commerce and the free flow of goods in
commerce;
(G) interferes with the orderly and fair marketing
of goods in commerce; and
(H) in many instances, may deprive workers of equal
protection on the basis of sex in violation of the 5th
and 14th amendments.
(4)(A) Artificial barriers to the elimination of
discrimination in the payment of wages on the basis of sex
continue to exist more than 3 decades after the enactment of
the Fair Labor Standards Act of 1938 (29 U.S.C. 201 et seq.)
and the Civil Rights Act of 1964 (42 U.S.C. 2000a et seq.).
(B) Elimination of such barriers would have positive
effects, including--
(i) providing a solution to problems in the economy
created by unfair pay disparities;
(ii) substantially reducing the number of working
women earning unfairly low wages, thereby reducing the
dependence on public assistance; and
(iii) promoting stable families by enabling all
family members to earn a fair rate of pay;
(iv) remedying the effects of past discrimination
on the basis of sex and ensuring that in the future
workers are afforded equal protection on the basis of
sex; and
(v) ensuring equal protection pursuant to Congress'
power to enforce the 5th and 14th amendments.
(5) With increased information about the provisions added
by the Equal Pay Act of 1963 and wage data, along with more
effective remedies, women will be better able to recognize and
enforce their rights to equal pay for work on jobs that require
equal skill, effort, and responsibility and that are performed
under similar working conditions.
(6) Certain employers have already made great strides in
eradicating unfair pay disparities in the workplace and their
achievements should be recognized.

SEC. 3. ENHANCED ENFORCEMENT OF EQUAL PAY REQUIREMENTS.

(a) Required Demonstration for Affirmative Defense.--Section
6(d)(1) of the Fair Labor Standards Act of 1938 (29 U.S.C. 206(d)(1))
is amended by striking ''(iv) a differential'' and all that follows
through the period and inserting the following: ''(iv) a differential
based on a bona fide factor other than sex, such as education, training
or experience, except that this clause shall apply only if--
''(I) the employer demonstrates that--
''(aa) such factor--
''(AA) is job-related with
respect to the position in
question; or
''(BB) furthers a
legitimate business purpose,
except that this item shall not
apply where the employee
demonstrates that an
alternative employment practice
exists that would serve the
same business purpose without
producing such differential and
that the employer has refused
to adopt such alternative
practice; and
''(bb) such factor was actually
applied and used reasonably in light of
the asserted justification; and
''(II) upon the employer succeeding under
subclause I, the employee fails to demonstrate
that the differential produced by the reliance
of the employer on such factor is itself the
result of discrimination on the basis of sex by
the employer.
''An employer that is not otherwise in compliance with this
paragraph may not reduce the wages of any employee in order to
achieve such compliance.''.
(b) Application of Provisions.--Section 6(d)(1) of the Fair Labor
Standards Act of 1938 (29 U.S.C. 206(d)(1)) is amended by adding at the
end the following: ''The provisions of this subsection shall apply to
applicants for employment if such applicants, upon employment by the
employer, would be subject to any provisions of this section.''.
(c) Elimination of Establishment Requirement.--Section 6(d) of the
Fair Labor Standards Act of 1938 (29 U.S.C. 206(d)) is amended--
(1) by striking '', within any establishment in which such
employees are employed,''; and
(2) by striking ''in such establishment'' each place it
appears.
(d) Nonretaliation Provision.--Section 15(a)(3) of the Fair Labor
Standards Act of 1938 (29 U.S.C. 215(a)(3)) is amended--
(1) by striking ''or has'' each place it appears and
inserting ''has''; and
(2) by inserting before the semicolon the following: '', or
has inquired about, discussed, or otherwise disclosed the wages
of the employee or another employee, or because the employee
(or applicant) has made a charge, testified, assisted, or
participated in any manner in an investigation, proceeding,
hearing, or action under section 6(d)''.
(e) Enhanced Penalties.--Section 16(b) of the Fair Labor Standards
Act of 1938 (29 U.S.C. 216(b)) is amended--
(1) by inserting after the first sentence the following:
''Any employer who violates section 6(d) shall additionally be
liable for such compensatory or punitive damages as may be
appropriate, except that the United States shall not be liable
for punitive damages.'';
(2) in the sentence beginning ''An action to'', by striking
''either of the preceding sentences'' and inserting ''any of
the preceding sentences of this subsection'';
(3) in the sentence beginning ''No employees shall'', by
striking ''No employees'' and inserting ''Except with respect
to class actions brought to enforce section 6(d), no
employee'';
(4) by inserting after the sentence referred to in
paragraph (3), the following: ''Notwithstanding any other
provision of Federal law, any action brought to enforce section
6(d) may be maintained as a class action as provided by the
Federal Rules of Civil Procedure.''; and
(5) in the sentence beginning ''The court in''--
(A) by striking ''in such action'' and inserting
''in any action brought to recover the liability
prescribed in any of the preceding sentences of this
subsection''; and
(B) by inserting before the period the following:
'', including expert fees''.
(f) Action by Secretary.--Section 16(c) of the Fair Labor Standards
Act of 1938 (29 U.S.C. 216(c)) is amended--
(1) in the first sentence--
(A) by inserting ''or, in the case of a violation
of section 6(d), additional compensatory or punitive
damages,'' before ''and the agreement''; and
(B) by inserting before the period the following:
'', or such compensatory or punitive damages, as
appropriate'';
(2) in the second sentence, by inserting before the period
the following: ''and, in the case of a violation of section
6(d), additional compensatory or punitive damages'';
(3) in the third sentence, by striking ''the first
sentence'' and inserting ''the first or second sentence''; and
(4) in the last sentence--
(A) by striking ''commenced in the case'' and
inserting ''commenced--
''(1) in the case'';
(B) by striking the period and inserting
''; or''; and
(C) by adding at the end the following:
''(2) in the case of a class action brought to enforce
section 6(d), on the date on which the individual becomes a
party plaintiff to the class action''.

SEC. 4. TRAINING.

The Equal Employment Opportunity Commission and the Office of
Federal Contract Compliance Programs, subject to the availability of
funds appropriated under section 9(b), shall provide training to
Commission employees and affected individuals and entities on matters
involving discrimination in the payment of wages.

SEC. 5. RESEARCH, EDUCATION, AND OUTREACH.

The Secretary of Labor shall conduct studies and provide
information to employers, labor organizations, and the general public
concerning the means available to eliminate pay disparities between men
and women, including--
(1) conducting and promoting research to develop the means
to correct expeditiously the conditions leading to the pay
disparities;
(2) publishing and otherwise making available to employers,
labor organizations, professional associations, educational
institutions, the media, and the general public the findings
resulting from studies and other materials, relating to eliminating the
pay disparities;
(3) sponsoring and assisting State and community
informational and educational programs;
(4) providing information to employers, labor
organizations, professional associations, and other interested
persons on the means of eliminating the pay disparities;
(5) recognizing and promoting the achievements of
employers, labor organizations, and professional associations
that have worked to eliminate the pay disparities; and
(6) convening a national summit to discuss, and consider
approaches for rectifying, the pay disparities.

SEC. 6. TECHNICAL ASSISTANCE AND EMPLOYER RECOGNITION PROGRAM.

(a) Guidelines.--
(1) In general.--The Secretary of Labor shall develop
guidelines to enable employers to evaluate job categories based
on objective criteria such as educational requirements, skill
requirements, independence, working conditions, and responsibility,
including decisionmaking responsibility and de facto supervisory
responsibility.
(2) Use.--The guidelines developed under paragraph (1)
shall be designed to enable employers voluntarily to compare
wages paid for different jobs to determine if the pay scales
involved adequately and fairly reflect the educational
requirements, skill requirements, independence, working
conditions, and responsibility for each such job with the goal
of eliminating unfair pay disparities between occupations
traditionally dominated by men or women.
(3) Publication.--The guidelines shall be developed under
paragraph (1) and published in the Federal Register not later
than 180 days after the date of enactment of this Act.
(b) Employer Recognition.--
(1) Purpose.--It is the purpose of this subsection to
emphasize the importance of, encourage the improvement of, and
recognize the excellence of employer efforts to pay wages to
women that reflect the real value of the contributions of such
women to the workplace.
(2) In general.--To carry out the purpose of this
subsection, the Secretary of Labor shall establish a program
under which the Secretary shall provide for the recognition of
employers who, pursuant to a voluntary job evaluation conducted
by the employer, adjust their wage scales (such adjustments
shall not include the lowering of wages paid to men) using the
guidelines developed under subsection (a) to ensure that women
are paid fairly in comparison to men.
(3) Technical assistance.--The Secretary of Labor may
provide technical assistance to assist an employer in carrying
out an evaluation under paragraph (2).
(c) Regulations.--The Secretary of Labor shall promulgate such
rules and regulations as may be necessary to carry out this section.

SEC. 7. ESTABLISHMENT OF THE NATIONAL AWARD FOR PAY EQUITY IN THE
WORKPLACE.

(a) In General.--There is established the Robert Reich National
Award for Pay Equity in the Workplace, which shall be evidenced by a
medal bearing the inscription ''Robert Reich National Award for Pay
Equity in the Workplace''. The medal shall be of such design and
materials, and bear such additional inscriptions, as the Secretary of
Labor may prescribe.
(b) Criteria for Qualification.--To qualify to receive an award
under this section a business shall--
(1) submit a written application to the Secretary of Labor,
at such time, in such manner, and containing such information
as the Secretary may require, including at a minimum
information that demonstrates that the business has made
substantial effort to eliminate pay disparities between men and
women, and deserves special recognition as a consequence; and
(2) meet such additional requirements and specifications as
the Secretary of Labor determines to be appropriate.
(c) Making and Presentation of Award.--
(1) Award.--After receiving recommendations from the
Secretary of Labor, the President or the designated
representative of the President shall annually present the
award described in subsection (a) to businesses that meet the
qualifications described in subsection (b).
(2) Presentation.--The President or the designated
representative of the President shall present the award under
this section with such ceremonies as the President or the
designated representative of the President may determine to be
appropriate.
(d) Business.--In this section, the term ''business'' includes--
(1)(A) a corporation, including a nonprofit corporation;
(B) a partnership;
(C) a professional association;
(D) a labor organization; and
(E) a business entity similar to an entity described in any
of subparagraphs (A) through (D);
(2) an entity carrying out an education referral program, a
training program, such as an apprenticeship or management
training program, or a similar program; and
(3) an entity carrying out a joint program, formed by a
combination of any entities described in paragraph (1) or (2).

SEC. 8. COLLECTION OF PAY INFORMATION BY THE EQUAL EMPLOYMENT
OPPORTUNITY COMMISSION.

Section 709 of the Civil Rights Act of 1964 (42 U.S.C. 2000e-8) is
amended by adding at the end the following:
''(f)(1) Not later than 18 months after the date of enactment of
this subsection, the Commission shall--
''(A) complete a survey of the data that is currently
available to the Federal Government relating to employee pay
information for use in the enforcement of Federal laws
prohibiting pay discrimination and, in consultation with other
relevant Federal agencies, identify additional data collections
that will enhance the enforcement of such laws; and
''(B) based on the results of the survey and consultations
under subparagraph (A), issue regulations to provide for the
collection of pay information data from employers as described
by the sex, race, and national origin of employees.
''(2) In implementing paragraph (1), the Commission shall have as
its primary consideration the most effective and efficient means for
enhancing the enforcement of Federal laws prohibiting pay
discrimination. For this purpose, the Commission shall consider factors
including the imposition of burdens on employers, the frequency of
required reports (including which employers should be required to
prepare reports), appropriate protections for maintaining data
confidentiality, and the most effective format for the data collection
reports.''.

SEC. 9. AUTHORIZATION OF APPROPRIATIONS.

There are authorized to be appropriated such sums as may be
necessary to carry out this Act.
[EX A]: Paycheck Fairness Act - Amends the Fair Labor Standards Act of 1938 (FLSA) to revise remedies for and enforcement of prohibitions against sex discrimination in the payment of wages (such FLSA prohibitions are also known as the Equal Pay Act).
(Sec. 3) Amends FLSA to provide for enhanced enforcement of equal pay requirements, adding a nonretaliation requirement. Increases penalties for such violations. Provides for the Secretary of Labor to seek additional compensatory or punitive damages in such cases.
(Sec. 4) Requires the Equal Employment Opportunity Commission (EEOC) and the Office of Federal Contract Compliance Programs to train EEOC employees and affected individuals and entities on matters involving wage discrimination.
(Sec. 5) Directs the Secretary to conduct studies and provide information to employers, labor organizations, and the general public concerning the means available to eliminate pay disparities between men and women, including convening a national summit and carrying out other specified activities.
(Sec. 6) Directs the Secretary to: (1) develop guidelines for employer evaluations of job categories based on objective criteria, to be used voluntarily by employers to compare wages for different jobs to determine if pay scales adequately and fairly reflect each job's educational and skill requirements, independence, working conditions, and responsibility, in order to eliminate unfair pay disparities between occupations traditionally dominated by men or women; and (2) establish a program to recognize employers who use such guidelines to ensure that women are paid fairly in comparison to men without lowering men's wages. Authorizes the Secretary to provide technical assistance for employers to carry out such evaluations.
(Sec. 7) Establishes the Robert Reich National Award for Pay Equity in the Workplace, which shall be evidenced by a medal. Sets forth criteria for specified types of entities to receive such an award.
(Sec. 8) Expresses the sense of the Senate that the President should: (1) take appropriate steps to increase the amount of information available with respect to wage disparities; and (2) consider ways to collect such information that maximize its utility, protect individual privacy, and minimize reporting burdens.
(Sec. 9) Authorizes appropriations.

[EX Q]: SECTION 1. SHORT TITLE.

This Act may be cited as the ''Medical Nutrition Equity Act of
2017''.

SEC. 2. FINDINGS.

Congress finds the following:
(1) Specialized food is often medically necessary for the
safe and effective management of many digestive and inherited
metabolic disorders that impact digestion, absorption, and
metabolism of nutrients.
(2) Although medically necessary food is essential for
patients, it is often expensive and not uniformly reimbursed by
health insurance, leaving many families with an insurmountable
financial burden.
(3) As a result, many patients who cannot afford medically
necessary food may experience adverse health consequences from
suboptimal disease management, including hospitalization,
intellectual impairment, behavioral dysfunction, inadequate
growth, nutrient deficiencies, and even death.

SEC. 3. COVERAGE OF MEDICALLY NECESSARY FOOD AND VITAMINS FOR DIGESTIVE
AND INHERITED METABOLIC DISORDERS UNDER FEDERAL HEALTH
PROGRAMS AND PRIVATE HEALTH INSURANCE.

(a) Coverage Under the Medicare Program.--
(1) Medically necessary food.--
(A) In general.--Section 1861(s)(2) of the Social
Security Act (42 U.S.C. 1395x(s)(2)) is amended--
(i) in subparagraph (FF), by striking
''and'' at the end;
(ii) in subparagraph (GG), by inserting
''and'' at the end; and
(iii) by adding at the end the following
new subparagraph:
''(HH) medically necessary food (as defined in subsection
(jjj)) and the medical equipment and supplies necessary to
administer such food (other than medical equipment and supplies
described in subsection (n));''.
(B) Definition.--Section 1861 of the Social
Security Act (42 U.S.C. 1395x) is amended by adding at
the end the following new subsection:

''Medically Necessary Food

''(jjj)(1) Subject to paragraph (2), the term 'medically necessary
food' means food, including a low protein modified food product and an
amino acid preparation product, that is--
''(A) furnished pursuant to the prescription, order, or
recommendation (as applicable) of a physician or other health
care professional qualified to make such prescription, order,
or recommendation, for the dietary management of a covered
disease or condition;
''(B) a specially formulated and processed product (as
opposed to a naturally occurring foodstuff used in its natural
state) for the partial or exclusive feeding of an individual by
means of oral intake or enteral feeding by tube;
''(C) intended for the dietary management of an individual
who, because of therapeutic or chronic medical needs, has
limited or impaired capacity to ingest, digest, absorb, or
metabolize ordinary foodstuffs or certain nutrients, or who has
other special medically determined nutrient requirements, the
dietary management of which cannot be achieved by the
modification of the normal diet alone;
''(D) intended to be used under medical supervision, which
may include in a home setting; and
''(E) intended only for an individual receiving active and
ongoing medical supervision wherein the individual requires
medical care on a recurring basis for, among other things,
instructions on the use of the food.
''(2) For purposes of paragraph (1), the term 'medically necessary
food' does not include the following:
''(A) Foods taken as part of an overall diet designed to
reduce the risk of a disease or medical condition or as weight
loss products, even if they are recommended by a physician or
other health professional.
''(B) Foods marketed as gluten-free for the management of
celiac disease or non-celiac gluten sensitivity.
''(C) Foods marketed for the management of diabetes.
''(D) Other products determined appropriate by the
Secretary.
''(3) In this subsection, the term 'covered disease or condition'
means the following diseases or conditions:
''(A) Inherited metabolic disorders, including the
following:
''(i) Disorders classified as metabolic disorders
on the Recommended Uniform Screening Panel Core
Conditions list of the Secretary of Health and Human
Services' Advisory Committee on Heritable Disorders in
Newborns and Children.
''(ii) N-acetyl glutamate synthase deficiency.
''(iii) Ornithine transcarbamlyase deficiency.
''(iv) Carbamoyl phosphate synthestase deficiency.
''(v) Inherited disorders of mitochondrial
functioning.
''(B) Medical and surgical conditions of malabsorption,
including the following:
''(i) Impaired absorption of nutrients caused by
disorders affecting the absorptive surface, functional
length, and motility of the gastrointestinal tract,
including short bowel syndrome and chronic intestinal
pseudo-obstruction.
''(ii) Malabsorption due to liver or pancreatic
disease.
''(C) Immunoglobulin E and non-Immunoglobulin E-mediated
allergies to food proteins, including the following:
''(i) Immunoglobulin E and non-Immunoglobulin E-
mediated allergies to food proteins.
''(ii) Food protein-induced enterocolitis syndrome.
''(iii) Eosinophilic disorders, including
eosinophilic esophagitis, eosinophilic gastroenteritis,
eosinophilic colitis, and post-transplant eosinophilic
disorders.
''(D) Inflammatory or immune mediated conditions of the
alimentary tract, including the following:
''(i) Inflammatory bowel disease, including Crohn's
disease, ulcerative colitis, and indeterminate colitis.
''(ii) Gastroesophageal reflux disease that is
nonresponsive to standard medical therapies.
''(E) Any other disease or condition determined appropriate
by the Secretary.
''(4) In this subsection, the term ' low protein modified food
product' means a product formulated to have less than one gram of
protein per serving.''.
(C) Payment.--Section 1833(a)(1) of the Social
Security Act (42 U.S.C. 1395l(a)(1)) is amended--
(i) by striking ''and'' before ''(BB)'';
and
(ii) by inserting before the semicolon at
the end the following: '', and (CC) with
respect to medically necessary food (as defined
in section 1861(jjj)), the amount paid shall be
an amount equal to 80 percent of the lesser of
the actual charge for the services or the
amount determined under a fee schedule
established by the Secretary for purposes of
this subparagraph.''.
(D) Effective date.--The amendments made by this
subsection shall apply to items and services furnished
on or after the date that is 1 year after the date of
the enactment of this Act.
(2) Inclusion of medically necessary vitamins as a covered
part d drug.--
(A) In general.--Section 1860D-2(e)(1) of the
Social Security Act (42 U.S.C. 1395w-102(e)(1)) is
amended--
(i) in subparagraph (A), by striking ''or''
at the end;
(ii) in subparagraph (B), by striking the
comma at the end and inserting ''; or''; and
(iii) by inserting after subparagraph (B)
the following new subparagraph:
''(C) medically necessary vitamins used for the
management of a covered disease or condition (as
defined in section 1861(jjj)(3)) pursuant to the
prescription, order, or recommendation (as applicable)
of a physician or other health care professional
qualified to make such prescription, order, or
recommendation,''.
(B) Effective date.--The amendments made by
subparagraph (A) shall apply to plan years beginning on
or after the date that is 1 year after the date of the
enactment of this Act.
(b) Coverage Under the Medicaid Program.--
(1) In general.--Section 1905(a) of the Social Security Act
(42 U.S.C. 1396d(a)) is amended--
(A) in paragraph (28), by striking ''and'' at the
end;
(B) by redesignating paragraph (29) as paragraph
(31); and
(C) by inserting after paragraph (28) the following
new paragraphs:
''(29) medically necessary food (as defined in section
1861(jjj)) and the medical equipment and supplies necessary to
administer such food;
''(30) medically necessary vitamins used for the management
of a covered disease or condition (as defined in section
1861(jjj)(3)) pursuant to the prescription, order, or
recommendation (as applicable) of a physician or other health
care professional qualified to make such prescription, order,
or recommendation; and''.
(2) Conforming amendments.--
(A) Mandatory benefits.--Section 1902(a)(10)(A) of
the Social Security Act (42 U.S.C. 1396a(a)(10)(A)) is
amended, in the matter preceding clause (i), by
striking ''and (28)'' and inserting ''(28), (29), and
(30)''.
(B) Exception to coverage restriction.--Section
1927(d)(2)(E) of the Social Security Act (42 U.S.C.
1396r-8(d)(2)(E)) is amended by inserting ''and except
for medically necessary vitamins described in section
1905(a)(30)'' before the period at the end.
(3) Effective date.--
(A) In general.--Subject to subparagraph (B), the
amendments made by this subsection shall take effect on
the date that is 1 year after the date of the enactment
of this Act.
(B) Exception to effective date 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 this 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 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 Under CHIP.--
(1) In general.--Section 2103(c) of the Social Security Act
(42 U.S.C. 1397cc(c)) is amended by adding at the end the
following:
''(9) Medically necessary food.--The child health
assistance provided to a targeted low-income child under the
plan shall include coverage of medically necessary food (as
defined in section 1861(jjj)) and the medical equipment and
supplies necessary to administer such food.
''(10) Certain vitamins.--The child health assistance
provided to a targeted low-income child under the plan shall
include coverage of medically necessary vitamins used for the
management of a covered disease or condition (as defined in
section 1861(jjj)(3)) pursuant to the prescription, order, or
recommendation (as applicable) of a physician or other health
care professional qualified to make such prescription, order,
or recommendation.''.
(2) Conforming amendment.--Section 2103(a) of the Social
Security Act (42 U.S.C. 1397cc(a)) is amended, in the matter
preceding paragraph (1), by striking ''and (7)'' and inserting
''(7), (9), and (10)''.
(3) Effective date.--
(A) In general.--Subject to subparagraph (B), the
amendments made by this subsection shall take effect on
the date that is 1 year after the date of the enactment
of this Act.
(B) Exception to effective date 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
this 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 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.
(d) Modification of Diseases and Conditions Covered Under TRICARE
Program.--Section 1077(h)(3) of title 10, United States Code, is
amended--
(1) in subparagraph (D), by striking ''and'';
(2) by redesignating subparagraph (E) as subparagraph (F);
and
(3) by inserting after subparagraph (D) the following:
''(E) Immunoglobulin E or non-Immunoglobulin E mediated
allergies to food proteins.''.
(e) Coverage Under FEHBP.--
(1) In general.--Section 8902 of title 5, United States
Code, is amended by adding at the end the following:
''(p) A contract for a plan under this chapter shall require the
carrier to provide coverage for--
''(1) medically necessary food (as defined in section
1861(jjj) of the Social Security Act) and the medical equipment
and supplies necessary to administer such food; and
''(2) medically necessary vitamins in the same manner
provided for under section 1860D-2(e)(1)(C) of the Social
Security Act.''.
(2) Effective date.--The amendment made by paragraph (1)
shall apply with respect to contract years beginning on or
after the date that is 1 year after the date of enactment of
this Act.
(f) Coverage Under Private Health Insurance.--
(1) In general.--Subpart II of part A of title XXVII of the
Public Health Service Act (42 U.S.C. 300gg-11 et seq.) is
amended by adding at the end the following:

''SEC. 2729. COVERAGE OF MEDICALLY NECESSARY FOOD AND VITAMINS.

''A health insurance issuer offering group or individual health
insurance coverage shall provide coverage for--
''(1) medically necessary food (as defined in section
1861(jjj) of the Social Security Act) and the medical equipment
and supplies necessary to administer such food; and
''(2) medically necessary vitamins in the same manner
provided for under section 1860D-2(e)(1)(C) of the Social
Security Act.''.
(2) Effective date.--The amendment made by paragraph (1)
shall apply to plan years beginning on or after the date that
is 1 year after the date of the enactment of this Act.
[EX A]:
Medical Nutrition Equity Act of 2017 This bill provides for coverage, under Medicare, Medicaid, other specified federal health-care programs, and private health insurance,of foods and vitamins that are medically necessary for the management ofcertain digestive and metabolic disordersand conditions.