,i #aacth ,,congress #b;d ,session ,h4 ,r4 #ecfd ,,in ,,the ,,house ,,of ,,representatives ,july #ca1 #bjad ,mr4 ,pallone 7for himself1 ,mr4 ,waxman1 ,ms4 ,schakowsky1 ,ms4 ,castor of ,florida1 ,mrs4 ,capps1 ,mrs4 ,christensen1 ,mr4 ,gene ,green of ,texas1 ,mr4 ,dingell1 ,mr4 ,butterfield1 ,mr4 ,sarbanes1 ,mr4 ,engel1 and ,mr4 ,matheson7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committee on ,ways and ,means1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to amend title ,,xxi of the ,social ,security ,act to extend and improve the ,children's ,health ,insurance ,program1 and for other purposes4 #a4 ,short title2 amendments to ,social ,security ,act2 references2 table of contents 7a7 ,short title ,this ,act may be cited as the ,,chip ,extension and ,improvement ,act of #bjad4 7b7 ,references to ,,chip2 ,medicaid2 ,secretary ,in this ,act3 7#a7 ,,chip ,the term ,,chip means the ,state ,children's ,health ,insurance ,program established under title ,,xxi of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;aa et seq47 7whether implemented under title ,,xix1 ,,xxi1 or both1 of the ,social ,security ,act74 7#b7 ,medicaid ,the term ,medicaid means the program for medical assistance established under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq474 7#c7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7c7 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title2 amendments to ,social ,security ,act2 references2 table of contents4 ,sec4 #b4 ,general effective date2 exception for ,state legislation2 reliance on law4 ,title ,i--,financing ,sec4 #aja4 #d-year extension of ,,chip funding4 ,sec4 #ajb4 ,performance incentive program improvements4 ,sec4 #ajc4 ,child enrollment contingency fund adjustment4 ,title ,,ii--,coverage ,stability and ,reduced ,bureaucracy ,sec4 #bja4 ,improving coverage stability4 ,sec4 #bjb4 ,assuring care continuity during transitions among ,,chip1 ,medicaid1 and qualified health plans4 ,sec4 #bjc4 ,continuous eligibility option for certain adults4 ,sec4 #bjd4 ,state flexibility to use administrative simplification policies for enrollment4 ,sec4 #bje4 ,outreach to targeted populations4 ,title ,,iii--,benefits and ,affordability ,sec4 #cja4 ,strengthened cost-sharing protections under ,,chip4 ,sec4 #cjb4 ,ensuring coverage of preventive health services under ,medicaid and ,,chip4 ,sec4 #cjc4 ,timely immunization coverage4 ,sec4 #cjd4 ,payment parity for ,medicaid primary care services4 ,title ,,iv--,access and ,quality ,subtitle ,a--,pediatric ,quality ,measures ,sec4 #dja4 ,extending the pediatric quality measures program4 ,sec4 #djb4 ,enhanced ,,fmap for activities related to pediatric quality measures4 ,sec4 #djc4 ,reporting of full set of pediatric quality measures4 ,sec4 #djd4 ,technical assistance to ,states for adopting and utilizing pediatric quality measures4 ,sec4 #dje4 ,improving the effectiveness of the pediatric quality measures4 ,sec4 #djf4 ,reports regarding ,state-specific quality of care measures applied under ,medicaid or ,,chip4 ,sec4 #djg4 ,advisory panel regarding pediatric quality4 ,sec4 #djh4 ,extending and expanding demonstration projects4 ,subtitle ,b--,continuing ,delivery ,system ,reform ,sec4 #daa4 ,supporting evidence-based care coordination in communities4 ,sec4 #dab4 ,ensuring care coordination for children4 ,subtitle ,c--,miscellaneous ,sec4 #dba4 ,assuring coverage continuity for former foster care children4 ,sec4 #dbb4 ,definition of therapeutic foster care as medical assistance4 ,sec4 #dbc4 ,technical correction4 #b4 ,general effective date2 exception for ,state legislation2 reliance on law 7a7 ,general effective date ,unless otherwise provided in this ,act1 subject to subsections 7b7 and 7c71 this ,act 7and the amendments made by this ,act7 shall take effect on ,october #a1 #bjad1 and shall apply to medical assistance and child health assistance furnished under titles ,,xix and ,,xxi1 respectively1 of the ,social ,security ,act on or after that date4 7b7 ,exception for ,state legislation ,in the case of a ,state plan under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 or a ,state child health plan under title ,,xxi of such ,act 7#db ,u4,s4,c4 #acig;aa et seq471 which the ,secretary determines requires ,state legislation in order for the respective plan to meet one or more additional requirements imposed by amendments made by this ,act1 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 ,act4 ,for purposes of the previous sentence1 in the case of a ,state that has a #b-year legislative session1 each year of the session shall be considered to be a separate regular session of the ,state legislature4 7c7 ,coordination of ,,chip funding for fiscal year #bjae ,notwithstanding any other provision of law1 insofar as funds have been appropriated under subsection 7a77#ah7 or 7m7 of section #bajd of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;dd71 as such subsections are in effect on the day before the date of the enactment of this ,act1 to provide allotments to ,states under ,,chip for fiscal year #bjae-- 7#a7 any amounts that are so appropriated that are not so allotted and obligated before ,april #a1 #bjae1 are rescinded2 and 7#b7 any amount provided for ,,chip allotments to a ,state under this ,act 7and the amendments made by this ,act7 for such fiscal year shall be reduced by the amount of such appropriations so allotted and obligated before such date4 7d7 ,reliance on law ,with respect to amendments made by this ,act that become effective as of a date-- 7#a7 such amendments are effective as of such date whether or not regulations implementing such amendments have been issued2 and 7#b7 ,federal financial participation for medical assistance or child health assistance furnished under title ,,xix or ,,xxi1 respectively1 of the ,social ,security ,act on or after such date by a ,state in good faith reliance on such amendments before the date of promulgation of final regulations1 if any1 to carry out such amendments 7or before the date of guidance1 if any1 regarding the implementation of such amendments7 shall not be denied on the basis of the ,state's failure to comply with such regulations or guidance4 ,i ,financing #aja4 #d-year extension of ,,chip funding 7a7 ,funding ,section #bajd7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;dd7a77 is amended-- 7#a7 in paragraph 7#ag71 by striking and at the end2 7#b7 by striking paragraph 7#ah7 and inserting the following new paragraph3 7#ah7 for fiscal year #bjae1 #ba1jfa1jjj1jjj2 2 and 7#c7 by adding at the end the following new paragraphs3 7#ai7 for fiscal year #bjaf1 #ai1cjj1jjj1jjj2 7#bj7 for fiscal year #bjag1 #bj1cjj1jjj1jjj2 7#ba7 for fiscal year #bjah1 #ba1cjj1jjj1jjj2 and 7#bb7 for fiscal year #bjai1 for purposes of making #b semi-annual allotments-- 7,a7 #b1hej1jjj1jjj for the period beginning on ,october #a1 #bjah1 and ending on ,march #ca1 #bjai2 and 7,b7 #b1hej1jjj1jjj for the period beginning on ,april #a1 #bjai1 and ending on ,september #cj1 #bjai4 4 7b7 ,allotments 7#a7 ,in general ,section #bajd7m7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;dd7m77 is amended-- 7,a7 in the subsection heading1 by striking #bjae and inserting #bjai2 7,b7 in paragraph 7#b7-- 7i7 in the paragraph heading1 by striking #bjad and inserting #bjah2 and 7ii7 by striking subparagraph 7,b7 and inserting the following new subparagraph3 7,b7 ,fiscal year #bjac and each succeeding fiscal year ,subject to paragraphs 7#d7 and 7#f71 from the amount made available under paragraphs 7#af7 through 7#ba7 of subsection 7a7 for fiscal year #bjac and each succeeding fiscal year1 respectively1 the ,secretary shall compute a ,state allotment for each ,state 7including the ,district of ,columbia and each commonwealth and territory7 for each such fiscal year as follows3 7i7 ,rebasing in fiscal year #bjac and each succeeding odd-numbered fiscal year ,for fiscal year #bjac and each succeeding odd-numbered fiscal year1 the allotment of the ,state is equal to the ,federal payments to the ,state that are attributable to 7and countable toward7 the total amount of allotments available under this section to the ,state in the preceding fiscal year 7including payments made to the ,state under subsection 7n7 for such preceding fiscal year as well as amounts redistributed to the ,state in such preceding fiscal year71 multiplied by the allotment increase factor under paragraph 7#e7 for such odd-numbered fiscal year4 7ii7 ,growth factor update for fiscal year #bjad and each succeeding even-numbered fiscal year ,for fiscal year #bjad and each succeeding even-numbered fiscal year1 the allotment of the ,state is equal to the sum of-- 7,i7 the amount of the ,state allotment under clause 7i7 for the preceding fiscal year2 and 7,,ii7 the amount of any payments made to the ,state under subsection 7n7 for such preceding fiscal year1 multiplied by the allotment increase factor under paragraph 7#e7 for such even-numbered fiscal year4 2 7,c7 in paragraph 7#c7-- 7i7 in the heading1 by striking #bjae and inserting #bjai2 7ii7 in subparagraph 7,a71 by striking paragraph 7#ah7 and inserting paragraph 7#bb72 7iii7 in subparagraph 7,b71 by striking paragraph 7#ah7 and inserting paragraph 7#bb72 7iv7 in subparagraph 7,c7-- 7,i7 by striking #bjad each place it appears and inserting #bjah2 and 7,,ii7 by striking #bjae and inserting #bjai2 and 7v7 in subparagraph 7,d7-- 7,i7 in clause 7i7-- 7aa7 in subclause 7,i71 by striking subsection 7a77#ah77;,a7 and inserting subsection 7a77#bb77;,a72 and 7bb7 in subclause 7,,ii71 by striking section #ajh of the ,children's ,health ,insurance ,program ,reauthorization ,act of #bjji and inserting section #aja7;b77#b7 of the ,,chip ,extension and ,improvement ,act of #bjad2 and 7,,ii7 in clause 7ii77,,ii71 by striking subsection 7a77#ah77;,b7 and inserting subsection 7a77#bb77;,b72 7,d7 in paragraph 7#d71 by striking #bjae and inserting #bjai2 7,e7 in paragraph 7#f7-- 7i7 in subparagraph 7,a71 by striking #bjae and inserting #bjai2 and 7ii7 in the second sentence1 by striking or fiscal year #bjad and inserting fiscal year #bjad1 fiscal year #bjaf1 or fiscal year #bjah2 and 7,f7 in paragraph 7#h7-- 7i7 in the paragraph heading1 by striking #bjae and inserting #bjai2 and 7ii7 by striking for a period in fiscal year #bjae and inserting for a period in fiscal year #bjai4 7#b7 ,supplemental appropriation for fiscal year #bjai ,there is appropriated to the ,secretary1 out of any money in the ,treasury not otherwise appropriated1 #af1gjj1jjj1jjj to accompany the allotment made for the period beginning on ,october #a1 #bjah1 and ending on ,march #ca1 #bjai1 under section #bajd7;a77#bb77;,a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;dd7a77#bb77;,a77 7as added by subsection 7a771 to remain available until expended4 ,such amount shall be used to provide allotments to ,states under paragraph 7#c7 of section #bajd7m7 of such ,act 7#db ,u4,s4,c4 #acig;dd7m77 7as amended by paragraph 7#a77;,c77 for the first #f months of fiscal year #bjai in the same manner as allotments are provided under subsection 7a77#bb77;,a7 of such section #bajd and subject to the same terms and conditions as apply to the allotments provided from such subsection 7a77#bb77;,a74 7c7 ,extension of qualifying states option ,section #baje7;g77#d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;ee7g77#d77 is amended-- 7#a7 in the paragraph heading1 by striking #bjae and inserting #bjai2 and 7#b7 in subparagraph 7,a71 by striking #bjae and inserting #bjai4 #ajb4 ,performance incentive program improvements 7a7 ,extension through fiscal year #bjai ,section #baje7;a77#c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;ee7a77#c77 is amended-- 7#a7 in subparagraph 7,a71 by striking #bjac and inserting #bjai2 7#b7 in subparagraph 7,e7-- 7,a7 in clause 7ii7-- 7i7 in the matter preceding subclause 7,i71 by inserting after the application of section #bajd7n77#c77;,d77ii7 with respect to such amounts1 after limitation12 7ii7 by striking subclause 7,i7 and inserting the following new subclause3 7,i7 ,unobligated national allotment for fiscal years #bjji through #bjae ,as of ,december #ca of fiscal year #bjji1 and as of ,december #ca of each succeeding fiscal year through fiscal year #bjae1 the portion1 if any1 of the amount appropriated under section #bajd7;a7 for such fiscal year that is unobligated for allotment to a ,state under section #bajd7m7 for such fiscal year or set aside under subsection 7a77#c7 or 7b77#b7 of section #baaa for such fiscal year4 2 7iii7 in subclause 7,,ii71 by striking #bjac and inserting #bjae2 and 7iv7 in subclause 7,,iii71 by striking #bjac and inserting #bjae2 7,b7 by redesignating clause 7iii7 as clause 7iv72 and 7,c7 by inserting after clause 7ii71 the following new clause3 7iii7 ,appropriation for fiscal years #bjaf through #bjai ,out of any money in the ,treasury not otherwise appropriated1 there are appropriated #ejj1jjj1jjj for each of fiscal years #bjaf through #bjai for making payments under this paragraph4 ,amounts appropriated for a fiscal year under this clause shall remain available for making payments under this paragraph until ,january #a of the following fiscal year4 ,any amounts of such appropriations that remain unexpended or unobligated as of such date shall be transferred and made available for making payments under section #bajd7n74 2 and 7#c7 in subparagraph 7,f77iii71 by striking #bjac and inserting #bjai4 7b7 ,updated performance incentive criteria for fiscal years #bjae through #bjai ,section #baje7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;ee7a77 is amended-- 7#a7 in paragraph 7#c77;,a71 by inserting or 7#e7 after paragraph 7#d72 7#b7 in paragraph 7#d7-- 7,a7 in the heading1 by inserting fiscal years #bjji through #bjad after for children2 and 7,b7 in the matter preceding subparagraph 7,a71 by striking for a fiscal year if and inserting for fiscal years #bjji through #bjad if2 and 7#c7 by adding at the end the following new paragraph3 7#e7 ,enrollment and retention provisions for children for fiscal year #bjae and succeeding fiscal years 7,a7 ,in general ,for purposes of paragraph 7#c77;,a71 a ,state meets the condition of this paragraph for fiscal year #bjae and any succeeding fiscal year if it is implementing at least #e of the enrollment and retention provisions specified in subparagraph 7,b7 7treating each clause as a separate enrollment and retention provision7 throughout the entire fiscal year4 7,b7 ,enrollment and retention provisions ,the enrollment and retention provisions specified in this subparagraph are the following3 7i7 ,continuous eligibility ,the ,state has elected the option of continuous eligibility for a full #ab months for all children 7as defined in section #aijb7;e77#ac77;,g771 as well as applying such policy under its ,state child health plan under this title4 7ii7 ,express ,lane eligibility ,the ,state is implementing the option described in section #aijb7;e77#ac7 under title ,,xix as well as1 pursuant to section #bajg7;e77#a71 under this title4 7iii7 ,presumptive eligibility ,the ,state is implementing section #aibj;,a under title ,,xix as well as1 pursuant to section #bajg7;e77#a71 under this title4 7iv7 ,premium assistance for employer-sponsored plans ,the ,state is implementing section #aijf;,a under title ,,xix or the option described in section #baje7;c77#aj7 under this title4 7v7 ,seamless coverage options ,in the case of a ,state that provides medical assistance under the ,state plan under title ,,xix through managed care entities 7as defined in section #aicb7;a77#a77;,b77 or health benefits coverage under the ,state child health plan through such entities1 the ,state shall ensure that at least one such entity offers a qualified health plan through the ,exchange established under title ,i of the ,patient ,protection and ,affordable ,care ,act in the ,state4 7vi7 ,retroactive coverage reinstatement upon premium payment ,the ,state child health plan1 in the case of an individual whose coverage under the plan has been terminated for failure to make premium payments1 provides assistance to such individual for purposes of the immediate reenrollment of the individual upon payment of outstanding premiums1 with coverage retroactive to the beginning of the most recent month for which an outstanding premium has been paid1 and shall not impose any waiting period or fee as a condition of such reenrollment4 7vii7 ,effective transition to the community for vulnerable youth 7,i7 ,in general ,subject to the subdivision 7,a7 following paragraph 7#bi7 of section #aije7;a71 the ,state1 before the date of the release of an eligible juvenile from any public institution1 and notwithstanding that the juvenile is an inmate of a public institution-- 7aa7 screens for eligibility for and processes any application for medical assistance submitted by1 or on behalf of1 such an eligible juvenile2 and 7bb7 refers such juvenile to health care providers for purposes of receiving the services described in section #aije7;a77#d77;,b7 7relating to early and periodic screening1 diagnostic1 and treatment services defined in section #aije7r774 7,,ii7 ,eligible juvenile ,for purposes of subclause 7,i71 the term eligible juvenile means an individual who-- 7aa7 is under #ai years of age 7or such higher age as the ,state has elected under section #dge7h77;,b77iii772 and 7bb7 is an inmate of a public institution4 7,,iii7 ,inmate of a public institution ,for purposes of this clause1 the term inmate of a public institution has the meaning given such term for purposes of applying the subdivision 7,a7 following paragraph 7#bi7 of section #aije7;a71 taking into account the exception in such subdivision for a patient of a medical institution4 4 #ajc4 ,child enrollment contingency fund adjustment 7a7 ,in general ,section #bajd7n7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;dd7n77 is amended-- 7#a7 in paragraph 7#b7-- 7,a7 by striking #bjad and inserting #bjah each place it appears in subparagraphs 7,a77ii7 and 7,b72 and 7,b7 by striking #bjae and inserting #bjai each place it appears in subparagraphs 7,a77ii7 and 7,b72 7#b7 in paragraph 7#c7-- 7,a7 in subparagraph 7,a7-- 7i7 in the heading1 by striking ,in general and inserting ,fiscal years #bjji through #bjae2 7ii7 in the matter preceding clause 7i7-- 7,i7 by striking a semi-annual allotment period for2 and 7,,ii7 by striking 7determined without regard to any redistribution it receives under subsection 7f7 that is available for expenditure during such fiscal year or period1 but including any carryover from a previous fiscal year72 7iii7 by striking or period each place it appears2 and 7iv7 in clause 7ii71 by striking 7or in which the period occurs72 7,b7 in subparagraph 7,b77ii71 by striking 7or semi-annual period occurring in a fiscal year72 7,c7 in subparagraph 7,c77ii71 by striking 7or semi-annual period occurring in a fiscal year72 7,d7 by redesignating subparagraphs 7,d71 7,e71 7,f71 and 7,g7 as subparagraphs 7,e71 7,f71 7,g71 and 7,h71 respectively2 7,e7 by inserting after subparagraph 7,c7 the following new subparagraph3 7,d7 ,fiscal years #bjaf through #bjai 7i7 ,in general ,for each of fiscal years #bjaf through #bjah and each semi-annual allotment period for fiscal year #bjai1 if the ,secretary determines that a ,state is a shortfall ,state described in subparagraph 7,i7 for that fiscal year or period1 the ,secretary shall pay the ,state from the ,fund1 in addition to any other payments made to a ,state under this title for the fiscal year or period an amount equal to the amount of projected expenditures for the ,state under this title for the fiscal year or period that exceeds the sum determined under subparagraph 7,i7 for the ,state and fiscal year or period4 7ii7 ,transfers ,notwithstanding any other provision of this title1 the following amounts shall also be available1 without fiscal year limitation1 for making payments from the ,fund3 7,i7 ,unobligated national allotment for fiscal years beginning with fiscal year #bjaf ,as of ,december #ca of fiscal year #bjaf1 and as of ,december #ca of each succeeding fiscal year1 the portion1 if any1 of the amount appropriated under subsection 7a7 for such fiscal year that is unobligated for allotment to a ,state under subsection 7m7 for such fiscal year4 7,,ii7 ,unexpended allotments not used for redistribution ,as of ,november #ae of fiscal year #bjaf and each succeeding fiscal year1 the total amount of allotments made to ,states under subsection 7a7 for the second preceding fiscal year that is not expended or redistributed under subsection 7f7 during the period in which such allotments are available for obligation4 7,,iii7 ,unexpended performance incentive funds ,as of ,september #a1 #bjag1 and as of ,september #a of each succeeding calendar year1 the portion1 if any1 of the amount appropriated under subparagraph 7,e77iii7 of section #baje7;a77#c7 for the preceding fiscal year that is not expended or obligated under such section4 7iii7 ,investment of fund ,the ,secretary of the ,treasury shall invest1 in interest bearing securities of the ,united ,states1 such currently available portions of the ,fund as are not immediately required for payments from the ,fund4 ,the income derived from these investments constitutes a part of the ,fund4 2 7,f7 in subparagraph 7,e7 7as so redesignated71 by inserting or 7,d7 after subparagraph 7,a72 and 7,g7 in subparagraph 7,h7 7as so redesignated71 by inserting and regarding the expenditures under the ,state child health plan after subparagraphs 7,a7 and 7,b72 and 7#c7 by adding at the end the following new subparagraph3 7,i7 ,shortfall ,states described ,for purposes of subparagraph 7,d71 with respect to a fiscal year or semi-annual allotment period1 a shortfall ,state is a ,state for which the ,secretary estimates1 on the basis of the most recent data available to the ,secretary1 that the projected expenditures for the ,state for the fiscal year or period under this title 7including in the form of coverage described in paragraph 7#a7 or 7#b7 of section #baja1 or both7 will exceed the sum of-- 7i7 the amount of the ,state's allotments for any preceding fiscal year or period that remains available for expenditure and that will not be expended by the end of the immediately preceding fiscal year2 7ii7 the amount 7if any7 that will be redistributed to the ,state under subsection 7f7 for the fiscal year or period2 7iii7 the portion1 if any1 of the amount appropriated under subparagraph 7,e77iii7 of section #baje7;a77#c7 for the preceding fiscal year or period that is not expended or obligated under such section2 and 7iv7 the amount of the ,state's allotment for the fiscal year or period4 4 7b7 ,conforming amendments ,section #bajd7;f77#b77;,a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acieg;dd7f77#b77;,a77 is amended-- 7#a7 in clause 7i71 by inserting and at the end2 7#b7 by striking clause 7ii72 and 7#c7 by redesignating clause 7iii7 as clause 7ii74 ,,ii ,coverage ,stability and ,reduced ,bureaucracy #bja4 ,improving coverage stability 7a7 ,in general ,section #bajb7;b77#a77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;bb7b77#a77;,b77 is amended-- 7#a7 in clause 7iii71 by striking in the case of a targeted low-income pregnant woman provided pregnancy-related assistance under section #baab2 and 7#b7 in clause 7iv71 by striking at ,state option14 7b7 ,conforming amendments 7#a7 ,section #baje7;c77#aj7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig7;ee77#aj77 is amended-- 7,a7 by striking subparagraph 7,f72 and 7,b7 by redesignating subparagraphs 7,g7 through 7,m7 as subparagraphs 7,f7 through 7,l71 respectively4 7#b7 ,section #baab7;b77#e7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acigll7b77#e77 is amended-- 7,a7 in the heading1 by striking or waiting period2 and 7,b7 by striking or any waiting period and all that follows through receipt of such assistance4 7c7 ,effective date ,the amendments made by this section shall take effect on the date of enactment of this ,act4 #bjb4 ,assuring care continuity during transitions among ,,chip1 ,medicaid1 and qualified health plans 7a7 ,minimum essential coverage 7#a7 ,in general ,section #ejjj;,a7f7 of the ,internal ,revenue ,code of #aihf is amended by adding at the end the following3 7#f7 ,pregnancy-related assistance under ,,chip ,with respect to a targeted low-income pregnant woman 7as defined in section #baab7;d77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acigll7d77#b7771 notwithstanding paragraph 7#a77;,a77iii71 the term minimum essential coverage1 at the option of such a woman1 shall not include pregnancy-related assistance 7as defined in section #baab7;d77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acigll7d77#a7774 4 7#b7 ,effective date ,the amendment made by this subsection applies to taxable years beginning after ,december #ca1 #bjad4 7b7 ,continuity of care ,the ,secretary of ,health and ,human ,services shall issue regulations for purposes of ensuring continuity of care for children who-- 7#a7 are undergoing an active course of treatment2 and 7#b7 involuntarily change coverage under health insurance1 the ,state plan under the ,medicaid program under title ,,xix of the ,social ,security ,act1 or the ,state child health plan under title ,,xxi of such ,act during such course of treatment for any reason1 including a reason related to a change in income1 health plan termination1 or a material change or changes to the plan's health benefits coverage4 7c7 ,ensuring comparability of coverage 7#a7 ,in general ,not later than #ah months after the date of the enactment of the ,,chip ,extension and ,improvement ,act of #bjad1 the ,secretary of ,health and ,human ,services shall review1 with respect to a ,state1 the benefits 7by each benefit class7 offered for children and the cost-sharing imposed with respect to such benefits by qualified health plans offered through an ,exchange established under title ,i of the ,patient ,protection and ,affordable ,care ,act in the ,state4 ,the ,secretary shall make the findings of such review available on the public ,internet site of the ,department of ,health and ,human ,services4 7#b7 ,regulations required ,if1 following such review1 the ,secretary determines that benefits and cost-sharing protections referred to in paragraph 7#a7 are not comparable to the benefits 7by each benefit class7 offered and cost-sharing protections provided under the ,state child health plan under title ,,xxi of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;aa et seq47 in the ,state1 the ,secretary1 not later than ,january #a1 #bjag1 shall issue a rule1 to apply with respect to plan years beginning in #bjai1 establishing requirements designed to ensure that such qualified health plans offer benefits and cost-sharing protections that are comparable to the benefits and cost-sharing protections provided under such ,state child health plan for plan year #bjai4 #bjc4 ,state flexibility to provide for continuous eligibility ,section #aijb7;e77#ab7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7e77#ab77 is amended to read as follows3 7#ab7 ,continuous eligibility option 7,a7 ,children ,at the option of the ,state1 the plan may provide that a child 7as defined in paragraph 7#ac77;,g77 who is determined to be eligible for benefits under a ,state plan approved under this title under subsection 7a77#aj77;,a7 shall remain eligible for those benefits until the earlier of-- 7i7 the end of a period 7not to exceed #ab months7 following the determination2 or 7ii7 the time that the child exceeds the age specified in such paragraph 7#ac77;,g74 7,b7 ,certain nonelderly adults 7i7 ,in general ,at the option of the ,state1 the plan may provide that in the case of an eligible adult who is determined to be eligible for benefits under a ,state plan approved under this title 7or a waiver of such plan71 the eligible adult shall remain eligible for those benefits until the end of a period 7not to exceed #ab months7 following the determination4 7ii7 ,eligible adult defined ,in this subparagraph1 the term eligible adult means-- 7,i7 an individual 7other than a child7 whose income eligibility under the ,state plan or under a waiver of the plan for medical assistance is determined under paragraph 7#ad72 and 7,,ii7 an individual included in any other group of individuals the ,secretary determines appropriate4 4 #bjd4 ,state flexibility to use administrative simplification policies for enrollment 7a7 ,permanent extension of ,medicaid and ,,chip express lane option ,section #aijb7;e77#ac7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7e77#ac77 is amended by striking subparagraph 7,i74 7b7 ,extending ,express ,lane eligibility to adults ,section #aijb7;e77#ac77;,a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7e77#ac77;,a77 is amended by adding at the end the following new clause3 7iii7 ,state option to extend express lane eligibility to adults 7,i7 ,in general ,at the option of the ,state1 the ,state may apply the provisions of this paragraph with respect to determining eligibility under this title for an eligible individual 7as defined in subclause 7,,ii774 ,in applying this paragraph in the case of a ,state making such an option1 any reference in this paragraph to a child with respect to this title 7other than a reference to child health assistance7 shall be deemed to be a reference to an eligible individual4 7,,ii7 ,eligible individual defined ,in this clause1 the term eligible individual means-- 7aa7 any individual 7other than a child7 whose income eligibility under the ,state plan or under a waiver of the plan for medical assistance is determined under paragraph 7#ad72 and 7bb7 an individual included in any other group of individuals the ,secretary determines appropriate4 4 #bje4 ,outreach to targeted populations 7a7 ,outreach and enrollment grants ,section #baac of the ,social ,security ,act 7#db ,u4,s4,c4 #acigmm7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#a71 by striking during the period of fiscal years #bjji through #bjae 2 and 7,b7 in paragraph 7#b7-- 7i7 in the heading1 by striking ,ten percent set aside and inserting ,set aside2 and 7ii7 by striking #aj percent and inserting #ae percent2 and 7#b7 in subsection 7g71 by inserting and #dj1jjj1jjj for each fiscal year thereafter1 to remain available until expended after #bjae14 7b7 ,requirement that managed care organizations provide language services to enrollees ,section #aicb7;b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifu-#b7;b77 is amended by adding at the end the following new paragraph3 7#i7 ,language services ,each contract with a managed care entity under section #aijc7m7 or under section #aije7t77#c7 shall require the entity to provide and pay for language services1 including oral interpretation and written translation services1 for an individual and the parent or guardian of such individual who is eligible for medical assistance under the ,state plan under this title and is enrolled with the entity and is limited ,english proficient when interacting with the entity or with any provider receiving payment from the entity4 ,such language services shall be provided in conjunction with all covered items and services that are available to such individuals under the contract4 4 7c7 ,medicaid health care disparities ,section #aidf of the ,social ,security ,act 7#db ,u4,s4,c4 #acifw-#e7 is amended by adding at the end the following new subsection3 7d7 ,appropriation ,out of any funds in the ,treasury not otherwise appropriated1 there are appropriated to carry out this section #bj1jjj1jjj1 to remain available until expended4 4 7d7 ,effective date ,the amendments made by this section take effect on the date of enactment of this ,act4 ,,iii ,benefits and ,affordability #cja4 ,strengthened cost-sharing protections under ,,chip ,section #bajc7;e7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;cc7e77 is amended-- 7#a7 in paragraph 7#c77;,b7-- 7,a7 by inserting 1 including with respect to benefits for dental services1 after ,state child health plan2 7,b7 by striking annual aggregate cost-sharing and inserting aggregate cost-sharing2 and 7,c7 by striking for the year involved and inserting 1 as applied on a quarterly or monthly basis 7as specified by the ,state72 and 7#b7 by adding at the end the following new paragraph3 7#e7 ,additional requirements 7,a7 ,tracking of expenses2 notice ,except as provided in subparagraph 7,b71 in the case of a ,state child health plan that imposes premiums1 deductibles1 cost sharing1 or similar charges that could 7as determined by the ,secretary7 cause families that include a targeted low-income child or a targeted low-income pregnant woman to have out-of-pocket expenses that exceed the limit imposed under paragraph 7#c77;,b7 for a month or quarter 7as applicable under the ,state plan71 the ,state child health plan shall-- 7i7 establish an electronic process for tracking such expenses that does not rely on documentation provided by the targeted low-income child1 the targeted low-income pregnant woman1 or the family2 and 7ii7 notify each such family-- 7,i7 of the aggregate monthly or quarterly limits on out-of-pocket expenses applicable to the family imposed under paragraph 7#c77;,b72 and 7,,ii7 that no premiums1 deductibles1 cost sharing1 or similar charges shall be imposed on any targeted low-income child or targeted low-income pregnant woman in the family for the remainder of any month or quarter with respect to which the family has reached the aggregate monthly or quarterly family limit imposed under such paragraph applicable to the family4 7,b7 ,managed care entities or organizations ,in the case of a ,state child health plan that provides child health assistance through managed care entities or organizations1 the entities or organizations shall1 with respect to families described in subparagraph 7,a7-- 7i7 establish an electronic process described in subparagraph 7,a77i72 and 7ii7 coordinate with the ,state agency responsible for implementing the ,state child health plan under this title to ensure that any premiums1 deductibles1 cost sharing1 or similar charges imposed on such a family are included in the aggregate limit applicable to the family under paragraph 7#c77;,b74 4 #cjb4 ,ensuring coverage of preventive health services under ,medicaid and ,,chip 7a7 ,medicaid 7#a7 ,clarifying preventive coverage ,section #aije7;a77#ac7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a77#ac77 is amended-- 7,a7 by striking subparagraphs 7,a7 and 7,b72 7,b7 by redesignating subparagraph 7,c7 as subparagraph 7,b72 and 7,c7 by inserting before subparagraph 7,b7 7as so redesignated7 the following new subparagraph3 7,a7 the items and services described in paragraphs 7#a7 through 7#e7 of section #bgac7;a7 of the ,public ,health ,service ,act2 and 4 7#b7 ,conforming amendment ,section #aijb7;a77#aj77;,a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#aj77;,a77 is amended in the matter preceding clause 7i71 by inserting 1 7#ac77;,a7 before 1 7#ag74 7b7 ,,chip ,section #bajc7;c77#a77;,d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;cc7c77#a77;,d77 is amended by striking ,well-baby and inserting ,items and services described in paragraphs 7#a7 through 7#e7 of section #bgac7;a7 of the ,public ,health ,service ,act1 including well-baby4 7c7 ,cost-,sharing prohibitions 7#a7 ,in general ,section #aiaf of the ,social ,security ,act 7#db ,u4,s4,c4 #acif7o77 is amended-- 7,a7 in subsection 7a77#b7-- 7i7 in subparagraph 7,d71 by striking or at the end2 7ii7 in subparagraph 7,e71 by striking hospice care 7as defined in section #aije7o772 and at the end and inserting hospice care 7as defined in section #aije7o771 or2 and 7iii7 by adding at the end the following new subparagraph3 7,f7 items and services described in section #aije7;a77#ac77;,a72 and 2 and 7,b7 in subsection 7b77#b7-- 7i7 in subparagraph 7,d71 by striking or at the end2 7ii7 in subparagraph 7,e71 by striking hospice care 7as defined in section #aije7o772 and at the end and inserting hospice care 7as defined in section #aije7o771 or2 and 7iii7 by adding at the end the following new subparagraph3 7,f7 items and services described in section #aije7;a77#ac77;,a72 and 4 7#b7 ,state option ,section #aiaf;,a7b77#c77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifo-#a7;b77#c77;,b77 is amended by adding at the end the following new clause3 7xi7 ,items and services described in section #aije7;a77#ac77;,a74 4 #cjc4 ,timely immunization coverage 7a7 ,coverage for newly approved vaccines within #cj days 7#a7 ,in general ,section #aibh7;e7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifs7e77 is amended by adding at the end the following new sentence3 ,each revision of the list established by such ,advisory ,committee shall apply to the purchase1 delivery1 and administration of pediatric vaccines under this section not later than #cj days after the date such ,advisory ,committee approves the revision44 7#b7 ,conforming amendment ,section #bajc7;c77#a77;,d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;cc7c77#a77;,d77 is amended by inserting 1 administered in accordance with the schedule referred to in section #aibh7;c77#b77;,b77i7 for pediatric vaccines after immunizations4 7b7 ,treatment of ,,chip-,eligible children as federally vaccine-,eligible children ,section #aibh7;b77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifs7b77#b77 is amended-- 7#a7 in subparagraph 7,a77i71 by inserting or ,,chip-eligible after medicaid-eligible2 and 7#b7 in subparagraph 7,b71 by striking clause 7i7 and inserting the following3 7i7 ,the term medicaid-eligible or ,,chip-eligible child means1 with respect to a child1 a child who is entitled to medical assistance under a ,state plan approved under this title or a waiver of such plan1 or who is eligible for child health assistance under a ,state child health plan approved under title ,,xxi4 4 7c7 ,effective date ,the amendments made by this section take effect on the date of enactment of this ,act4 #cjd4 ,payment parity for ,medicaid primary care services 7a7 ,in general ,section #aijb7;a77#ac77;,c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#ac77;,c77 is amended-- 7#a7 by striking #bjac and #bjad and inserting calendar years #bjad through #bjai2 7#b7 by striking 1 general internal medicine and inserting 1 general internal medicine1 neurology1 psychiatry1 obstetrics and gynecology2 7#c7 by inserting or a health care practitioner who is a nurse practitioner1 physician assistant1 or clinical nurse specialist 7as such terms are defined in section #ahfa7;aa77#e77 or a certified nurse midwife 7as defined in section #ahfa7;gg77#b77 after pediatric medicine2 and 7#d7 by striking such services and physician and inserting such services and physician or health care practitioner4 7b7 ,effective date ,the amendments made by this section shall apply to items and services furnished on or after the first day of the first calendar quarter that begins after the date of the enactment of this ,act4 ,,iv ,access and ,quality ,a ,pediatric ,quality ,measures #dja4 ,extending the pediatric quality measures program ,section #aaci;,a7i7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#i;a7i77 is amended by inserting 1 and for each of fiscal years #bjae through #bjai1 #ej1jjj1jjj1 after #de1jjj1jjj4 #djb4 ,enhanced ,,fmap for activities related to pediatric quality measures ,section #aijc7;a77#c77;,a77iii7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7a77#c77;,a77iii77 is amended to read as follows3 7iii7 #ie percent of so much of the sums expended during any such quarter in fiscal years #bjae1 #bjaf1 and #bjag1 #ij percent of so much of the sums expended during any such quarter in fiscal years #bjah and #bjai1 and the higher of an amount equal to the ,federal medical assistance percentage 7as defined in section #aije7;b77 or #ge percent of so much of the sums expended during any such quarter in any fiscal year thereafter 7as found necessary by the ,secretary for the proper and efficient administration of the ,state plan7 as are attributable to such developments or modifications of systems of the type described in clause 7i7 as are necessary for the efficient collection and reporting on the core set of child health quality measures under subsections 7a71 7b71 7c71 and 7f7 of section #aaci;,a2 and 4 #djc4 ,reporting of full set of pediatric quality measures ,section #aaci;,a7a77#d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#i;a7a77#d77 is amended-- 7#a7 in the heading1 by striking ,encourage voluntary and standardized and inserting ,standardized2 7#b7 by striking ,not later than and inserting the following3 7,a7 ,encouraging voluntary reporting ,not later than 2 and 7#c7 by adding at the end the following new subparagraph3 7,b7 ,other reporting ,not later than five years after the date of the enactment of the ,,chip ,extension and ,improvement ,act of #bjad1 the ,secretary shall require that each ,state submit information on the core set of child health quality measures 7as in effect on such date of enactment71 as updated under subsection 7b77#e74 4 #djd4 ,technical assistance to ,states for adopting and utilizing pediatric quality measures ,section #aaci;,a7a77#g7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#i;a7a77#g77 is amended to read as follows3 7#g7 ,technical assistance 7,a7 ,in general ,the ,secretary shall provide technical assistance to ,states to assist them in adopting and utilizing the core set of child health measures in administering the ,state plans under titles ,,xix and ,,xxi1 including by assisting ,states in building their data collection infrastructures4 7,b7 ,funding #e1jjj1jjj of the amount appropriated under subsection 7i7 for a fiscal year shall be used to carry out this paragraph4 4 #dje4 ,improving the effectiveness of the pediatric quality measures ,section #aaci;,a7b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#i;a7b77 is amended-- 7#a7 in paragraph 7#d7-- 7,a7 by striking the paragraph heading and inserting the following3 ,ensuring the development1 maintenance1 and reporting of a portfolio of pediatric quality measures2 7,b7 in subparagraph 7,a71 by striking and at the end2 7,c7 in subparagraph 7,b77iii7-- 7i7 by inserting establishment of a sustainable mechanism for maintaining and before updating2 and 7ii7 by striking as necessary4 and inserting in alignment with the most recent version of the ,blueprint for the ,measures ,management ,system published by the ,centers for ,medicare ,medicaid ,services1 as necessary2 and2 and 7,d7 by adding at the end the following new subparagraph3 7,c7 award grants or contracts to continue and enhance the pediatric quality measures program1 which shall include awarding grants and contracts with a particular emphasis on-- 7i7 patient and family experience or coordination of care2 7ii7 pediatric populations that are small in size and may be most effectively addressed by aggregating data across multiple ,states1 including pediatric populations with medical complexity and pediatric populations with rare conditions2 7iii7 the impacts of changes in life events over various stages of child and adolescent development1 including changes in morbidity and mortality1 dependence status1 and developmental stages1 and the impacts of such changes on subsequent health and health care quality2 and 7iv7 establishing a sustainable mechanism for identifying and assisting ,states in developing a standardized data infrastructure for the collection and national reporting of pediatric quality measures1 including developing precise data element definitions and utilizing consistent data collection methods4 2 7#b7 by striking paragraph 7#e7 and inserting the following new paragraph3 7#e7 ,revising1 strengthening1 and improving initial core measures 7,a7 ,in general ,the ,secretary shall annually issue a rule 7in accordance with section #eec of title #e1 ,united ,states ,code7 to amend the core set of child health quality measures described in subsection 7a7 so that such core set-- 7i7 is consistent with the purposes of the pediatric quality measures program established under paragraph 7#a72 7ii7 meets the conditions specified in paragraph 7#b72 7iii7 includes measures that-- 7,i7 were developed by the ,secretary in consultation with the entities specified in subparagraphs 7,a7 through 7,h7 of paragraph 7#c72 7,,ii7 were developed1 validated1 tested1 or maintained through a grant or contract awarded under paragraph 7#d72 and 7,,iii7 were submitted to the ,secretary for consideration that were not developed under such a grant or contract2 and 7iv7 takes into account the reports and demonstration projects described in subparagraphs 7c71 7d71 7e71 and 7f7 of this section4 7,b7 ,additional changes ,beginning not later than one year after the date of the enactment of the ,,chip ,extension and ,improvement ,act of #bjad1 the amendments made to the core set of measures under subparagraph 7,a7 shall include changes-- 7i7 to measure the type of children's health insurance coverage or other health benefits coverage available over time1 in addition to the presence1 stability1 and duration of such health insurance coverage or such health benefits coverage over time1 for purposes of examining enrollment changes of a child from one type of coverage to another2 7ii7 to ensure that the measures reflect the care provided to the diverse pediatric population1 including adolescents and children with special health care needs and the management of acute and chronic conditions2 7iii7 to ensure that the measures reflect care provided in all health care settings in which an individual enrolled in the ,state plan under title ,,xix receives care2 and 7iv7 to encourage the adoption of pediatric quality measures at the ,state1 plan1 community1 facility1 and provider level attribution1 as well as across different health care delivery and coverage systems1 including coverage provided through the ,exchanges established under title ,i of the ,patient ,protection and ,affordable ,care ,act4 2 7#c7 in paragraph 7#f7-- 7,a7 by striking clinical care and inserting clinical effectiveness1 patient safety1 population and public health1 patient and family engagement1 care coordination1 or efficiency2 and 7,b7 by striking in various institutional and ambulatory health care settings2 and 7#d7 by adding at the end the following new paragraph3 7#h7 ,funding #bj1jjj1jjj of the amount appropriated under subsection 7i7 for a fiscal year shall be used to carry out this subsection4 4 #djf4 ,reports regarding ,state-specific quality of care measures applied under ,medicaid or ,,chip ,section #aaci;,a7c77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#i;a7c77 is amended-- 7#a7 in subparagraph 7,a71 by striking and at the end2 7#b7 in subparagraph 7,b71 by striking the period at the end and inserting a semicolon2 and 7#c7 by adding at the end the following new subparagraphs3 7,c7 ,state-specific information on the annual progress toward1 and efforts to overcome barriers to1 reporting on all quality measures within the core set of child health quality measures1 as updated under subsection 7b77#e72 and 7,d7 beginning not later than #e years after the date of the enactment of this subparagraph1 ,state-specific information on all quality measures within the core set of child health quality measures1 as updated under subsection 7b77#e74 4 #djg4 ,advisory panel regarding pediatric quality 7a7 ,in general ,section #aaci;,a7g7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#i;a7g77 is amended-- 7#a7 in the heading1 by striking ,study of and inserting ,stakeholder input and reports on2 7#b7 by redesignating paragraph 7#b7 as paragraph 7#c72 and 7#c7 by inserting after paragraph 7#a7 the following new paragraph3 7#b7 ,pediatric ,quality ,measurement ,not later than #ah months after the date of the enactment of this paragraph1 the ,secretary1 in consultation with representatives of ,state agencies responsible for administering the ,medicaid program under title ,,xix and the ,children's ,health ,insurance ,program under title ,,xxi and representatives of relevant provider organizations1 shall submit 7and periodically update7 to the ,committee on ,energy and ,commerce of the ,house of ,representatives and the ,committee on ,finance of the ,senate a report that takes into account the priorities and goals to be established pursuant to section #ahij7;b77#g77;,e74 ,such report shall include-- 7,a7 strategic and detailed operational plans to address and overcome barriers to ,state collection of1 and reporting of1 all quality measures within the core set of child health quality measures1 as updated under subsection 7b77#e72 7,b7 an analysis of the types of incentives1 including ,federal funding and any associated amounts necessary for ,states to collect and report on all quality measures within the core set of child health quality measures1 as updated under subsection 7b77#e72 and 7,c7 a standardized format and plan for ,states to collect and report on all quality measures within the core set of child health quality measures1 as updated under subsection 7b77#e74 4 7b7 ,inclusion of child and adult health quality measures for multi-,stakeholder group input ,section #ahij7;b77#g7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;aaa7b77#g77 is amended-- 7#a7 in subparagraph 7,b77i77,i71 by inserting #aaci;,a7a71 #aaci;,b1 after sections2 and 7#b7 by adding at the end the following new subparagraph3 7,e7 ,pediatric ,quality ,measurement ,with respect to quality and efficiency measures for use pursuant to section #aaci;,a7a71 the entity shall convene a panel1 composed of health experts 7including experts employed by the ,federal ,government and experts not so employed7 to establish priorities and goals for child health to-- 7i7 advise and make recommendations to the ,secretary regarding changes that may be made to the core set of child health quality measures1 as updated under section #aaci;,a7b77#e72 7ii7 establish standards for the timeliness and accuracy of data collected and reported for purposes of such measures2 and 7iii7 review and make recommendations1 at least annually1 for strategies to enhance the timeliness1 accuracy1 and utility of such measures4 4 #djh4 ,extending and expanding demonstration projects 7a7 ,strengthening demonstration projects for improving the quality of children's health care and the use of health information technology ,section #aaci;,a7d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#i;a7d77 is amended-- 7#a7 in paragraph 7#a7-- 7,a7 in the matter preceding subparagraph 7,a7-- 7i7 by striking #bjji through #bjac1 the ,secretary shall award not more than #aj grants and inserting #bjae through #bjai1 the ,secretary shall award not fewer than #aj grants12 and 7ii7 by inserting 7including oral care7 after health care2 7,b7 in subparagraph 7,c71 by striking or at the end2 7,c7 in subparagraph 7,d71 by striking the period at the end and inserting a semicolon2 and 7,d7 by adding at the end the following new subparagraphs3 7,e7 examine and address barriers to effective delivery of perinatal care and its impact on birth outcomes and subsequent pregnancies and children's health2 7,f7 implement and expand pediatric and perinatal learning and quality improvement collaboratives on the quality of children's and pregnant women's health care1 including improving patient outcomes1 reducing health costs1 and addressing health disparities2 7,g7 encourage and evaluate the use at the ,state level of payment reform and related policy proposals for purposes of promoting higher quality of care for children1 including the shared savings program established under section #ahii and other methods of encouraging integrated care models2 or 7,h7 with respect to the model electronic health record format for children developed and disseminated under subsection 7f7-- 7i7 assess the extent to which the format has been incorporated into widely used electronic health record formats2 7ii7 implement standards and activities that result in increased use of such format2 and 7iii7 evaluate the impact of the increased use of such format4 2 7#b7 in paragraph 7#b7-- 7,a7 in subparagraph 7,a71 by striking and at the end2 7,b7 in subparagraph 7,b71 by striking the period at the end and inserting 2 and2 and 7,c7 by adding at the end the following new subparagraph3 7,c7 with respect to grants awarded for projects described in paragraph 7#a77;,f7-- 7i7 give priority to collaboratives that would demonstrate substantial impacts on the pediatric population by-- 7,i7 affecting a large percentage of such population or by substantially improving outcomes in a smaller population2 7,,ii7 reducing the cost of1 and other barriers to access to1 health care for children1 including children with medically complex illnesses or chronic conditions2 7,,iii7 having a high likelihood to reduce disparities in health status2 or 7,,iv7 potentially having long-term health impacts by addressing childhood precursors to adult conditions2 and 7ii7 encourage coordination with other sources of funding in the expansion of pediatric learning collaboratives1 including by coordinating care and utilizing community health workers 7as defined in section #cii,v7k7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;g-#aa7k7774 2 and 7#c7 in paragraph 7#d7-- 7,a7 by inserting ,for each of fiscal years #bjji through #bjac1 before #bj1jjj1jjj2 and 7,b7 by adding at the end the following new sentence3 ,for each of fiscal years #bjae through #bjai1 #be1jjj1jjj of the amount appropriated under subsection 7i7 for a fiscal year shall be used to carry out this subsection44 7b7 ,extending funding for childhood obesity demonstration projects ,section #aaci;,a7e77#h7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#i;a7e77#h77 is amended by inserting 1 and for the period of fiscal years #bjae through #bjai1 #be1jjj1jjj after #bjad4 ,b ,continuing ,delivery ,system ,reform #daa4 ,supporting evidence-based care coordination in communities 7a7 ,in general ,section #eaa7;j77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #gaa7;j77#a77 is amended-- 7#a7 in subparagraph 7,d71 by inserting and at the end2 7#b7 in subparagraph 7,e71 by striking fiscal year #bjad2 and and inserting each of fiscal years #bjad through #bjai42 and 7#c7 by striking subparagraph 7,f74 7b7 ,effective date ,the amendments made by this section shall take effect on the date of enactment of this ,act4 #dab4 ,ensuring care coordination for children ,section #bgjf of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #acif;a note7 is amended-- 7#a7 in subsection 7a77#b71 by striking #bjaf and inserting #bjai2 and 7#b7 in subsection 7e71 by striking appropriated and all that follows through the period at the end and inserting the following3 appropriated to carry out this section-- 7#a7 for fiscal year #bjad1 such sums as are necessary2 7#b7 for each of fiscal years #bjae through #bjai1 #ajj1jjj1jjj2 and 7#c7 for the period beginning on ,october #a1 #bjai1 and ending on ,december #ca1 #bjai1 #be1jjj1jjj4 4 ,c ,miscellaneous #dba4 ,assuring coverage continuity for former foster care children 7a7 ,in general ,section #aijb7;a77#aj77;,a77i77,,ix7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#aj77;,a77i77,,ix77 is amended-- 7#a7 in item 7bb71 by striking are not described in or enrolled under and inserting are not described in and are not enrolled under2 7#b7 in item 7cc71 by striking responsibility of the ,state and inserting responsibility of a ,state2 and 7#c7 in item 7dd71 by striking the ,state plan under this title or under a waiver of the and inserting a ,state plan under this title or under a waiver of such a4 7b7 ,effective date ,the amendments made by this section shall take effect on ,july #a1 #bjae4 #dbb4 ,definition of therapeutic foster care as medical assistance 7a7 ,in general ,section #aije of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#bh71 by striking and at the end2 7,b7 by redesignating paragraph 7#bi7 as paragraph 7#cj72 and 7,c7 by inserting after paragraph 7#bh7 the following new paragraph3 7#bi7 therapeutic foster care services described in subsection 7ee72 and 2 and 7#b7 by adding at the end the following new subsection3 7ee7 7#a7 ,for purposes of subsection 7a77#bi71 subject to subparagraph 7,c71 therapeutic foster care services described in this subsection are services provided for children who have not attained age #ba1 and who1 as a result of mental illness1 other emotional or behavioral disorders1 medically fragile conditions1 or developmental disabilities1 need the level of care provided in an institution 7including a psychiatric residential treatment facility7 or nursing facility the cost of which could be reimbursed under the ,state plan but who can be cared for or maintained in a community placement1 through a qualified therapeutic foster care program described in paragraph 7#b74 7#b7 ,a qualified therapeutic foster care program described in this paragraph is a program that-- 7,a7 is licensed by the ,state and accredited by the ,joint ,commission on ,accreditation of ,healthcare ,organizations1 the ,commission on ,accreditation of ,rehabilitation ,facilities1 the ,council on ,accreditation1 or by another equivalent accreditation agency 7or agencies7 as the ,secretary may recognize2 7,b7 provides structured daily activities1 including the development1 improvement1 monitoring1 and reinforcing of age-appropriate social1 communication and behavioral skills1 trauma-informed and gender-responsive services1 crisis intervention and crisis support services1 medication monitoring1 counseling1 and case management1 and may furnish other intensive community services2 and 7,c7 provides foster care parents with specialized training and consultation in the management of children with mental illness1 trauma1 other emotional or behavioral disorders1 medically fragile conditions1 or developmental disabilities1 and specific additional training on the needs of each child provided such services4 7#c7 ,in making coverage determinations under paragraph 7#a71 a ,state may employ medical necessity criteria that are similar to the medical necessity criteria applied to coverage determinations for other services and supports under this title4 7#d7 ,the services described in this subsection do not include the training referred to in paragraph 7#b77;,c74 4 7b7 ,effective date ,the amendments made by subsection 7a7 shall apply to calendar quarters beginning on or after the date of enactment of this ,act4 #dbc4 ,technical correction 7a7 ,in general ,section #aiag7;d77#d77;,a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifp7d77#d77;,a77 is amended by inserting the individual1 after for the benefit of such individual by4 7b7 ,effective date ,the amendment made by subsection 7a7 shall apply to trusts established on or after the date of the enactment of this ,act4