,,ii #aad? ,,congress #b;d ,session ,s4 #cdgg ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,novemb] #ag1 #bjaf,ms4 ,hirono 7= h]self & ,mrs4 ,capito7 introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,f9ance ,a ,,bill ,to am5d title ,,xviii ( ! ,social ,security ,act to provide in=mation reg>d+ vacc9es = s5iors z "p ( ! ,m$ic>e ,y h&book & to ensure t ! treatm5t ( co/ %>+ = vacc9es "u ,m$ic>e "p ,d is consi/5t ) ! treatm5t ( vacc9es "u ,m$ic>e "p ,b1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,protect+ ,s5iors ,?r\gh ,immunization ,act ( #bjaf4 #b4 ,f9d+s ,congress makes ! foll[+ f9d+s3 7#a7 ,h]pes zo/]1 also kn[n z %+les1 is caus$ by ! reactivation ( ! v>icella-zo/] virus t causes *ick5pox 9 *ildhood4 ,! virus c reactivate lat] 9 life1 result+ 9 a pa9ful1 it*y ra% t c p]si/ = weeks1 mon?s1 or ye>s4 ,n only does ! risk ( h]pes zo/] itself increase ) age1 b1 among individuals :o exp]i5ce h]pes zo/]1 old] individuals are mu* m likely to exp]i5ce po/h]petic neuralgia non-pa9 complications1 hospitalizations1 & int]f]5ce ) activities ( daily liv+1 su* z eat+1 dress+1 & ba?+4 7#b7 ,po/h]petic neuralgia1 a complication ( %+les1 occurs r>ely among individuals "u age #dj b c occur 9 up to #a_/c ( untreat$ individuals age #fj & old]4 7#c7 ,! ,food & ,drug ,adm9i/ration approv$ ! h]pes zo/] vacc9e = individuals age #ej & old]4 ,! ,advisory ,committee on ,immunization ,practices pres5tly recomm5ds ! h]pes zo/] vacc9e = all individuals age #fj & old]4 7#d7 ,! ,heal?y ,p #bjbj t>get basel9e = ! h]pes zo/] vacc9e is #cj p]c5t cov]age = individuals age #fj & ov]4 ,?is b5*m>k is un=tunately l[ comp>$ to t ( o!r adult vacc9es su* z influ5za 7#gj p]c5t7 & pneumococcal disease 7#fj p]c5t74 ,ev5 at su* a l[ t>get1 ! cov]age rate is n be+ met4 ,! ,c5t]s = ,disease ,control & ,prev5tion report$ t 9 #bjad1 only #bh p]c5t ( adults age #fj & old] report$ receiv+ ! h]pes zo/] vacc9e4 7#e7 ,accord+ to ! #bjad ,national ,heal? ,int]view ,survey ( ! ,c5t]s = ,disease ,control & ,prev5tion1 vacc9ation rates = adults are #bj p]c5t = ,tetanus1 ,diph!ria1 & ,p]tussis1 #bh p]c5t = %+les1 #bd p]c5t = ,hepatitis ,b1 & #fa p]c5t = pneumonia4 ,!re are also disp>ities across adult vacc9ation rates4 ,adult immunization rates are g5]ally l[] among ,hispanics1 ,african-,am]icans1 & ,asians4 7#f7 ,m$ic>e cov]age = ! h]pes zo/] vacc9e "u ! ,prescription ,drug ,program "u "p ,d ( title ,,xviii ( ! ,social ,security ,act has result$ 9 _m b>ri]s to optimal & consi/5t uptake to prev5t %+les & its co/ly & pa9ful complications4 7#g7 ,lack ( aw>5ess & logi/ical & f9ancial *all5ges are ! mo/ (t5 cit$ reasons = ,m$ic>e b5efici>ies n be+ immuniz$ aga9/ ! v>icella-zo/] virus4 7#h7 ,h]pes zo/] is e/imat$ to acc\nt = m ?an #hg1jjj em]g5cy room visits & #bh1jjj inpati5t admissions ea* ye>4 ,av]age co/s across ! episode ( c>e 7 #a1hce & #ad1dbh p] pati5t 9 ! outpati5t & inpati5t sett+s1 respectively4 #c4 ,provision ( in=mation reg>d+ vacc9es = s5iors z "p ( ,m$ic>e ,y h&book & cov]age ( ! %+les vacc9e "u ,m$ic>e "p ,d 7a7 ,provision ( in=mation reg>d+ vacc9es = s5iors z "p ( ,m$ic>e ,y h&book 7#a7 ,9 g5]al ,section #ahjd ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie;b-#b7 is am5d$-- 7,a7 9 subsection 7a77#a71 by ins]t+ 1 includ+ in=mation ) respect to cov]age ( vacc9es = s5iors describ$ 9 subsection 7d7 be=e ! comma at ! end2 & 7,b7 by add+ at ! end ! foll[+ new subsection3 7d7 ,! notice provid$ "u subsection 7a7 %all include in=mation ) respect to vacc9es = s5iors1 includ+ in=mation ) respect to cov]age ( ! %+les vacc9e "u "p ,d = individuals enroll$ 9 a prescription drug plan "u su* "p4 4 7#b7 ,effective date ,! am5dm5ts made by ?is subsection %all apply to notices di/ribut$ prior to ea* ,m$ic>e op5 enrollm5t p]iod beg9n+ aft] ! date ( implem5tation ( section #ahfj;,d-#b7;b77#h71 z add$ by subsection 7b77#b74 7b7 ,cov]age ( ! %+les vacc9e "u ,m$ic>e "p ,d 7#a7 ,provision ( educational mat]ials reg>d+ ! availability ( ,,acip-recomm5d$ h]pes vacc9e ) no co/ %>+ ,section #ahfj;,d-#d7;a77#a77;,b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#ajd7;a77#a77;,b77 is am5d$ by add+ at ! end ! foll[+ new clause3 7v7 ,= plan ye>s beg9n+ on or aft] ,janu>y #a ( ! fir/ ye> beg9n+ m ?an #fj days aft] ! date ( ! enactm5t ( ?is clause1 in=mation reg>d+ access to ! %+les vacc9es ) no co/ %>+ "u ! plan4 4 7#b7 ,ensur+ treatm5t ( co/ %>+ is consi/5t ) treatm5t ( vacc9es "u ,m$ic>e "p ,b ,section #ahfj;,d-#b7;b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#ajb7;b77 is am5d$-- 7,a7 9 p>agraph 7#a77;,a71 by /rik+ ! cov]age & ins]t+ ,subject to p>agraph 7#h71 ! cov]age2 7,b7 9 p>agraph 7#b77;,a71 by /rik+ & 7,d7 & ins]t+ & 7,d7 & p>agraph 7#h72 7,c7 9 p>agraph 7#c77;,a71 by /rik+ & 7#d7 & ins]t+ 7#d71 & 7#h72 7,d7 9 p>agraph 7#d77;,a77i71 by /rik+ ,! cov]age & ins]t+ ,subject to p>agraph 7#h71 ! cov]age2 & 7,e7 by add+ at ! end ! foll[+ new p>agraph3 7#h7 ,treatm5t ( co/ %>+ = %+les vacc9e consi/5t ) treatm5t ( vacc9es "u "p ,b ,= plan ye>s beg9n+ on or aft] ,janu>y #a ( ! fir/ ye> beg9n+ m ?an #fj days aft] ! date ( ! enactm5t ( ?is p>agraph3 7,a7 ,no application ( d$uctible ,! d$uctible "u p>agraph 7#a7 %all n apply ) respect to ! %+les vacc9e4 7,b7 ,no application ( co9surance ,!re %all be no co9surance "u p>agraph 7#b7 ) respect to ! %+les vacc9e4 7,c7 ,no application ( initial cov]age limit ,! initial cov]age limit "u p>agraph 7#c7 %all n apply ) respect to ! %+les vacc9e4 7,d7 ,no co/ %>+ above annual out-(-pocket ?re%old ,!re %all be no co/ %>+ "u p>agraph 7#d7 ) respect to ! %+les vacc9e4 4 7#c7 ,con=m+ am5dm5ts to co/ %>+ = l[-income individuals ,section #ahfj;,d-#ad7;a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#aad7;a77 is am5d$-- 7,a7 9 p>agraph 7#a77;,d71 9 ea* ( clauses 7ii7 & 7iii71 by /rik+ ,9 ! case & ins]t+ ,subject to p>agraph 7#f71 9 ! case2 7,b7 9 p>agraph 7#b7-- 7i7 9 subp>agraph 7,d71 by /rik+ ,! sub/itution & ins]t+ ,subject to p>agraph 7#f71 ! sub/itution2 & 7ii7 9 subp>agraph 7,e71 by /rik+ subsection 7c7 & ins]t+ p>agraph 7#f7 & subsection 7c72 & 7,c7 by add+ at ! end ! foll[+ new p>agraph3 7#f7 ,no application ( co/ %>+ = %+les vacc9e ,consi/5t ) section #ahfj;,d-#b7;b77#h71 = plan ye>s beg9n+ on or aft] ,janu>y #a ( ! fir/ ye> beg9n+ m ?an #fj days aft] ! date ( ! enactm5t ( ?is p>agraph1 !re %all be no co/ %>+ "u ?is section ) respect to ! %+les vacc9e4 4 7c7 ,/udy & report 7#a7 ,/udy ,! ,secret>y ( ,heal? & ,human ,s]vices 7ref]r$ to 9 ?is subsection z ! ,secret>y71 act+ ?r\gh ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion1 9 collaboration ) ! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices1 %all conduct a /udy on ! uptake ( vacc9es1 includ+ ! h]pes zo/] vacc9e & ! tetanus1 diph!ria1 & p]tussis vacc9e1 & anticipat$ vacc9es aga9/ su* diseases z respiratory syncytial virus1 clo/ridium difficile1 & o!rs4 ,su* /udy %all include an analysis ( ways to-- 7,a7 increase ! basel9e t>get rate ( cov]age = curr5tly recomm5d$ vacc9es1 su* z h]pes zo/] vacc9e cov]age 9 ! ,heal?y ,p #bjcj goals2 7,b7 ensure t ! basel9e t>get focuses on r$uc+ racial & socio-economic disp>ities 9 ! vacc9e cov]age rates = all adult vacc9es1 includ+ ! h]pes zo/] vacc9e2 & 7,c7 help facilitate vacc9ation = ,m$ic>e b5efici>ies = vacc9es recomm5d$ by ! ,c5t]s = ,disease ,control & ,prev5tion bo? curr5tly & 9 ! future1 by develop+ & evaluat+ a specific set ( actions t w address physician & heal? c>e provid] adm9i/rative *all5ges1 su* z difficulty v]ify+ b5efici>y cov]age & complexity ( physician (fice bill+ ( vacc9es cov]$ "u ,m$ic>e "p ,d1 t impact access = b5efici>ies4 7#b7 ,report ,n lat] ?an #b ye>s aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y %all submit to ,congress a report conta9+ ! results ( ! /udy "u p>agraph 7#a71 toge!r ) recomm5dations = su* legislation & adm9i/rative action z ! ,secret>y det]m9es appropriate4