,i #aae? ,,congress #a/ ,session ,h4 ,r4 #afd ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,janu>y #c1 #bjag,mr4 ,ha/+s introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce1 & 9 addition to ! ,committees on ,education & ! ,work=ce1 ,ways & ,means1 & ,ov]sight & ,gov]nm5t ,re=m1 = a p]iod to be subsequ5tly det]m9$ by ! ,speak]1 9 ea* case = consid]ation ( su* provisions z fall )9 ! jurisdiction ( ! committee conc]n$ ,a ,,bill ,to provide = an evid5ce-bas$ /rategy = volunt>y scre5+ = ,,hiv_/,,aids & o!r common sexually transmitt$ infections1 & = o!r purposes4 #a4 ,%ort title2 table ( cont5ts 7a7 ,%ort title ,?is ,act may be cit$ z ! ,increas+ ,access to ,volunt>y ,scre5+ = ,,hiv_/,,aids & ,s,t,is ,act ( #bjag4 7b7 ,table ( cont5ts ,! table ( cont5ts = ?is ,act is z foll[s3 ,sec4 #a4 ,%ort title2 table ( cont5ts4 ,sec4 #b4 ,f9d+s4 ,sec4 #c4 ,purpose4 ,sec4 #d4 ,def9itions4 ,title ,i--,cov]age ( ,,hiv_/,,aids & ,,/i scre5+ "u public heal? c>e programs & gr\p heal? plans2 ,cov]age ( c>e "u ,m$icaid4 ,sec4 #aja4 ,cov]age ( r\t9e ,,hiv_/,,aids & ,,/i scre5+ te/s "u ,m$icaid4 ,sec4 #ajb4 ,cov]age ( ,,hiv_/,,aids & ,,/i scre5+ te/s "u ,m$ic>e4 ,sec4 #ajc4 ,cov]age = r\t9e ,,hiv_/,,aids & ,,/i scre5+ "u gr\p heal? plans4 ,sec4 #ajd4 ,optional ,m$icaid cov]age ( l[-income ,,hiv_/,,aids infect$ individuals4 ,title ,,ii--,increas$ data collection & education = hi/orically und]repres5t$ populations ,sec4 #bja4 ,p liv+ ) disabilities4 ,sec4 #bjb4 ,wom5 :o h sex ) wom54 ,sec4 #bjc4 ,transg5d] community4 ,sec4 #bjd4 ,report4 #b4 ,f9d+s ,congress f9ds ! foll[+3 7#a7 ,! ,,cdc e/imates #bj1jjj1jjj new sexually transmitt$ infections 7,s,t,is7 occur ea* ye> 9 ! ,unit$ ,/ates1 & #ej p]c5t ( sexually active ,am]icans w contract a ,,/i at "s po9t 9 _! lives1 ! majority ( :i* may be asymptomatic = an ext5d$ am\nt ( "t4 7#b7 ,ov] #a1bjj1jjj p 9 ! ,unit$ ,/ates are liv+ ) ,,hiv1 & someone is infect$ ) ,,hiv 9 ! ,unit$ ,/ates e #i4e m9utes4 7#c7 ,,hiv_/,,aids & ,s,t,is are syndemics4 ,,hiv infection c increase a p]son's risk = acquir+ c]ta9 ,s,t,is1 z well z affect _! frequ5cy1 sev]ity1 & heal+ "t1 :ile ,s,t,is increase ! risk ( ,,hiv transmission1 impair$ f]tility1 reproductive tract canc]1 & adv]se pregnancy outcomes4 7#d7 ,_m common long-t]m & initially asymptomatic ,s,t,is su* z *lamydia1 gonorrhea1 h]pes1 syphilis1 inflammatory pelvic disease1 viral hepatitis1 & ,,hiv_/,,aids rema9 undiagnos$1 or diagnos$ at lat] /ages1 lead+ to increas$ rates ( mortality1 morbidity1 disability1 & transmission4 7#e7 ,9 fact1 ! ,,cdc e/imates ov] #c4f million ,am]icans are liv+ ) *ronic hepatitis & mo/ d n "k !y are infect$4 ,*ronic hepatitis ,b c rema9 asymptomatic = ye>s &1 left undiagnos$ & untreat$1 c lead to s]i\s complications4 ,additionally1 individuals infect$ ) hepatitis ,c virus 7,,hcv7 are at risk = *ronic liv] disease or o!r ,,hcv-relat$ *ronic diseases decades aft] infection4 7#f7 ,/igma1 culture1 language1 lack ( education1 lack ( insurance1 limit$ "t1 co/ & res\rces 9 m$ical sett+s1 & an inaccurate p]ception ( risk among communities & provid]s all contribute to insuffici5t rates ( scre5+ = ,,hiv_/,,aids & ,s,t,is4 7#g7 ,! ,c5t]s = ,disease ,control & ,prev5tion & ! ,unit$ ,/ates ,prev5tive ,s]vices ,task ,=ce recognize scre5+ z an effective public heal? tool t all[s provid]s to adm9i/] treatm5t be=e symptoms develop & implem5t int]v5tions t w r$uce ! likelihood ( ,,hiv_/,,aids & ,,/i transmission & r$uce ! developm5t ( adv]se outcomes4 7#h7 ,! ,,cdc recomm5ds t volunt>y scre5+ = ,,hiv_/,,aids be integrat$ into r\t9e cl9ical c>e :ile pres]v+ pati5t confid5tiality & ! "r ( ! pati5t to decl9e te/+ & scre5+4 7#i7 ,! ,,cdc also recomm5ds t all unvacc9at$1 un9fect$ p]sons be+ evaluat$ = a ,,/i %\ld receive hepatitis ,b vacc9ation4 ,fur!rmore1 anti-,,hcv te/+ is recomm5d$ = r\t9e scre5+ ( asymptomatic p]sons bas$ on _! risk = infection or bas$ on a recogniz$ exposure4 7#aj7 ,inaccurate p]ceptions ( risk among heal? c>e provid]s & pati5ts1 misdiagnosis1 ageism1 g5]ational m9d-sets1 & biological factors h contribut$ to increas$ rates 9 transmission & late detection ( ,,hiv_/,,aids & ,s,t,is ov] ! pa/ decade4 7#aa7 ,heal? equity & disp>ities rema9 a significant public heal? *all5ge1 ) ! burd5 ( ,,hiv_/,,aids & ,s,t,is fall+ disproportionately on diff]5t populations4 7#ab7 ,al?\gh ,african-,am]icans acc\nt = ab\t #ac p]c5t ( ! ,unit$ ,/ates population1 !y acc\nt = ne>ly half ( all ,,hiv_/,,aids cases & infections & h high] in/ances ( mortality & morbidity = mo/ ,s,t,is & ,,hiv_/,,aids4 ,also1 ,african-,am]ican wom5 :o h sex ) m5 acc\nt = ! majority ( ,,hiv_/,,aids infections among all wom5 9 ! ,unit$ ,/ates4 7#ac7 ,,hiv_/,,aids cont9ues to be mo/ preval5t among m5 :o h sex ) m5 7,,msm74 ,cont9u$ support & increas$ fund+ = community-bas$ programs & behavioral int]v5tions t are culturally compet5t are key to rea*+ ,,msm1 especially "y ,,msm ( color4 7#ad7 ,transg5d] p]sons are p>ticul>ly vuln]able to contract+ ,,hiv_/,,aids & ,s,t,is due to high rates ( survival sex among trans-females1 discrim9ation 9 education1 employm5t1 & h\s+1 & ! abs5ce ( education & prev5tion me?ods culturally relevant to ! transg5d] community4 7#ae7 ,heal? c>e provid]s mu/ be prop]ly educat$ to treat gr\ps1 su* z ,,msm1 transg5d] p]sons1 ,african-,am]icans1 & ,lat9os :o are disproportionately affect$ by ,,hiv_/,,aids & o!r ,s,t,is1 & also improve int]v5tions = gr\ps t h be5 hi/orically und]repres5t$ 9 heal? int]v5tions = ,s,t,is1 su* z wom5 :o h sex ) wom51 individuals ov] ! age ( #ej1 ,asian & ,pacific ,isl&] ,am]icans1 ,native ,am]icans1 & p]sons liv+ ) disabilities4 7#af7 ,wom5 liv+ ) mobility impairm5ts (t5 lack access to scre5+ = ,s,t,is & o!r wom5's heal? s]vices su* z pelvic exam9ations & mammograms due to1 among o!r factors1 ! lack ( provid] aw>5ess1 exp]i5ce1 & access to equipm5t4 7#ag7 ,all individuals engag+ 9 oral1 anal1 or g5ital sexual contact mu/ h access to volunt>y scre5+ = ,,hiv_/,,aids & o!r ,s,t,is4 ,scre5+ mu/ be confid5tial1 rapid1 accurate1 & m$ically appropriate4 ,scre5+ mu/ be (f]$ reg>dless ( age1 race1 class1 sexual behavior1 sexual ori5tation1 g5d] id5tity1 or disability4 7#ah7 ,! ,congress supports ! goals ( ! ,national ,,hiv_/,,aids ,/rategy &1 9 p>ticul>1 ! goal ( #ij p]c5t ( individuals kn[+ _! ,,hiv_/,,aids /atus4 #c4 ,purpose ,! purposes ( ?is ,act are z foll[s3 7#a7 ,increase access1 quality1 & af=dability = volunt>y & m$ically appropriate scre5+ = ,,hiv_/,,aids & o!r ,s,t,is1 includ+ *lamydia1 gonorrhea1 syphilis1 viral hepatitis1 & human papillomavirus1 = all p]sons engag+ 9 v>i\s =ms ( sexual activity1 includ+ oral1 g5ital1 or anal sex4 7#b7 ,r$uce ! spread1 morbidity1 & mortality ( ,,hiv_/,,aids & o!r ,s,t,is4 7#c7 ,r$uce ! disproportionate incid5ce ( ,,hiv_/,,aids & o!r ,s,t,is 9 c]ta9 gr\ps ?r\gh e>ly detection & treatm5t & compreh5sive education = heal? c>e provid]s1 c5t]s1 & communities4 7#d7 ,support ! execution ( o!r sci5tifically bas$ int]v5tions t are culturally compet5t & age appropriate & are prov5 to r$uce ! incid5ce ( ,,hiv_/,,aids & o!r ,s,t,is4 #d4 ,def9itions ,9 ?is ,act3 7#a7 ,,cdc ,! t]m ,,cdc means ! ,c5t]s = ,disease ,control & ,prev5tion4 7#b7 ,,cms ,! t]m ,,cms means ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices4 7#c7 ,director ,! t]m ,director means ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion4 7#d7 ,,hiv_/,,aids ,! t]m ,,hiv_/,,aids means infection ) ! human immunodefici5cy virus & includes acquir$ immune defici5cy syndrome & any condition aris+ f su* syndrome4 7#e7 ,,msm ,! t]m ,,msm means m5 :o h sex ) m54 7#f7 ,secret>y ,! t]m ,secret>y means ! ,secret>y ( ,heal? & ,human ,s]vices4 7#g7 ,/ate ,! t]m ,/ate means ea* ( ! #ej ,/ates1 ! ,di/rict ( ,columbia1 ! ,unit$ ,/ates ,virg9 ,isl&s1 ,guam1 ! ,commonweal? ( ,pu]to ,rico1 ! ,commonweal? ( ! ,nor!rn ,m>iana ,isl&s1 & ,am]ican ,samoa4 7#h7 ,,/i ,! t]m ,,/i means a sexually transmitt$ infection t is recogniz$ by ! ,,cdc1 includ+ *lamydia1 gonorrhea1 syphilis1 viral hepatitis1 & human papillomavirus4 7#i7 ,,wsw ,! t]m ,,wsw means wom5 :o h sex ) wom54 ,i ,cov]age ( ,,hiv_/,,aids & ,,/i scre5+ "u public heal? c>e programs & gr\p heal? plans2 ,cov]age ( c>e "u ,m$icaid4 #aja4 ,cov]age ( r\t9e ,,hiv_/,,aids & ,,/i scre5+ te/s "u ,m$icaid 7a7 ,inclusion 9 ,/ate plan ,section #aijb7;a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77 is am5d$ 9 p>agraph 7#aj77;,a71 9 ! matt] be=e clause 7i71 by /rik+ & 7#bh7 & ins]t+ 7#bh71 & 7#bi74 7b7 ,inclusion 9 m$ical assi/ance 7#a7 ,9 g5]al ,section #aije7;a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a77 is am5d$-- 7,a7 9 p>agraph 7#bh71 by /rik+ & at ! end2 7,b7 by r$esignat+ p>agraph 7#bi7 z p>agraph 7#cj72 & 7,c7 by ins]t+ aft] p>agraph 7#bh7 ! foll[+3 7#bi7 r\t9e ,,hiv_/,,aids & ,,/i scre5+ s]vices 7z def9$ 9 subsection 7ee774 4 7#b7 ,def9ition ( s]vices ,section #aije ( su* ,act is am5d$ by add+ at ! end ! foll[+3 7ee7 7#a7 ,= purposes ( ?is section1 ! t]m r\t9e ,,hiv_/,,aids & ,,/i scre5+ s]vices means all ( ! foll[+3 7,a7 ,a scre5+ te/ = ,,hiv_/,,aids or any o!r ,,/i1 if su* te/ is provid$ to an individual :o-- 7i7 is eligible = m$ical assi/ance "u ! ,/ate plan2 & 7ii7 is describ$ 9 clauses 7ii7 ?r\gh 7v7 ( section #ahfa7;jjj77#a77;,a74 7,b7 ,ea* ( ! s]vices describ$ 9 subp>agraphs 7,b7 ?r\gh 7,f7 ( section #ahfa7;jjj77#a74 7#b7 ,def9itions ,= purposes ( ?is subsection1 ! t]ms ,,hiv_/,,aids & ,,/i h ! same mean+ giv5 su* t]ms 9 section #ahfa7;jjj77#b74 4 7c7 ,no co/ %>+ = ,,hiv_/,,aids te/+ 7#a7 ,9 g5]al ,section #aiaf7;a77#b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acifo7a77#b77 is am5d$-- 7,a7 9 subp>agraph 7,d71 by /rik+ or at ! end2 7,b7 9 subp>agraph 7,e71 by /rik+ 2 & at ! end & ins]t+ 1 or2 & 7,c7 by add+ at ! end ! foll[+3 7,f7 r\t9e ,,hiv_/,,aids & ,,/i scre5+ s]vices 7z su* t]m is def9$ 9 section #aije7;ee772 & 4 7#b7 ,limitation on ,/ate option = alt]native co/ %>+ ,section #aiaf;,a7b77#c77;,b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acifo-#a7;b77#c77;,b77 is am5d$ by add+ at ! end ! foll[+3 7xi7 ,r\t9e ,,hiv_/,,aids & ,,/i scre5+ s]vices 7z su* t]m is def9$ 9 section #aije7;ee774 4 7d7 ,effective date 7#a7 ,9 g5]al ,except z provid$ by p>agraph 7#b71 ! am5dm5ts made by ?is section %all take effect on ! date ( ! enactm5t ( ?is section & %all apply to s]vices furni%$ on or aft] su* date4 7#b7 ,rules = *anges requir+ ,/ate legislation ,9 ! case ( a ,/ate plan = m$ical assi/ance "u title ,,xix ( ! ,social ,security ,act :i* ! ,secret>y ( ,heal? & ,human ,s]vices det]m9es requires ,/ate legislation 7o!r ?an legislation appropriat+ funds7 9 ord] = ! plan to meet ! additional requirem5t impos$ by ! am5dm5ts made by ?is section1 ! ,/ate plan %all n be reg>d$ z fail+ to comply ) ! requirem5ts ( su* title solely on ! basis ( its failure to meet ?is additional requirem5t be=e ! fir/ day ( ! fir/ cal5d> qu>t] beg9n+ aft] ! close ( ! fir/ regul> session ( ! ,/ate legislature t beg9s aft] ! date ( ! enactm5t ( ?is ,act4 ,= purposes ( ! previ\s s5t5ce1 9 ! case ( a ,/ate t has a #b-ye> legislative session1 ea* ye> ( su* session %all be deem$ to be a sep>ate regul> session ( ! ,/ate legislature4 #ajb4 ,cov]age ( ,,hiv_/,,aids & ,,/i scre5+ te/s "u ,m$ic>e ,section #ahfa ( ! ,social ,security ,act is am5d$-- 7#a7 9 subsection 7s7-- 7,a7 by /rik+ & at ! end ( p>agraph 7#ad72 7,b7 by /rik+ ! p]iod at ! end ( p>agraph 7#ae7 & ins]t+ 2 &2 7,c7 by r$esignat+ p>agraphs 7#af7 & 7#ag7 z p>agraphs 7#ag7 & 7#ah71 respectively2 & 7,d7 by ins]t+ aft] p>agraph 7#ae7 ! foll[+3 7#af7 r\t9e ,,hiv_/,,aids & ,,/i scre5+ s]vices 7z su* t]m is def9$ 9 subsection 7jjj774 2 & 7#b7 by add+ at ! end ! foll[+3 7jjj7 ,r\t9e ,,hiv_/,,aids & ,,/i scre5+ s]vices 7#a7 ,= purposes ( ?is section1 ! t]m r\t9e ,,hiv_/,,aids & ,,/i scre5+ s]vices means all ( ! foll[+3 7,a7 ,a scre5+ te/ = ,,hiv_/,,aids or any o!r ,,/i1 if su* te/ is provid$ 9 any heal? c>e sett+ 7o!r ?an an inpati5t hospital sett+7 & is provid$ to an individual :o-- 7i7 is enroll$ 9 "p ,b2 7ii7 is at lea/ #ac ye>s ( age2 7iii7 ) respect to a te/ = ,,hiv_/,,aids1 is n kn[n to ! heal? c>e provid] 7directly1 ?r\gh in=mation provid$ by ! individual1 or ?r\gh access to an electronic m$ical record7 to h _h a previ\s positive te/ = ,,hiv_/,,aids2 7iv7 subject to subp>agraph 7,b71 ) respect to a te/ = ,,hiv_/,,aids or a ,,/i1 is n kn[n to ! heal? c>e provid] 7directly1 ?r\gh in=mation provid$ by ! individual1 or ?r\gh access to an electronic m$ical record7 to h _h a te/ = ! same condition )9 ! previ\s #f mon?s2 & 7v7 has be5 in=m$ t su* a te/ w be adm9i/]$ & has n object$ to su* a te/4 7,b7 ,if a te/ describ$ "u subp>agraph 7,a7 is reactive & is =-- 7i7 ,,hiv_/,,aids1 a confirmatory te/2 or 7ii7 a ,,/i o!r ?an ,,hiv_/,,aids1 if reasonable & necess>y1 a confirmatory te/4 7,c7 ,! int]pretation ( any te/s provid$ "u subp>agraph 7,a7 & subp>agraph 7,b74 7,d7 ,in=m+ an individual :o receives a te/ "u subp>agraph 7,a7 or subp>agraph 7,b7 ( ! results ( su* te/s z close 9 "t z possible to ! det]m9ation ( su* results4 7,e7 ,if an individual te/s positive = ,,hiv_/,,aids on a scre5+ te/ "u subp>agraph 7,a7 & any confirmatory te/ "u subp>agraph 7,b7-- 7i7 po/-te/ c\nsel+ conc]n+ ,,hiv_/,,aids & ,s,t,is at ! "t ! individual is in=m$ ( ! results ( ! te/2 & 7ii7 if appropriate1 a ref]ral to m$ical or m5tal heal? s]vices4 7,f7 ,if an individual te/s positive = a ,,/i on a scre5+ te/ "u subp>agraph 7,a7 & any confirmatory te/ "u subp>agraph 7,b71 ! provision ( in=mation to su* individual on ! risk ( ,s,t,is & ,,hiv_/,,aids & behaviors t r$uce ! risk ( exposure to su* conditions4 7#b7 ,def9itions ,= purposes ( ?is subsection3 7,a7 ,,hiv_/,,aids ,! t]m ,,hiv_/,,aids means infection ) ! human immunodefici5cy virus & includes acquir$ immune defici5cy syndrome & any condition aris+ f su* syndrome4 7,b7 ,,/i ,! t]m ,,/i means a sexually transmitt$ infection or sexually transmitt$ disease t is recogniz$ by ! ,c5t]s = ,disease ,control & ,prev5tion1 includ+ *lamydia1 gonorrhea1 syphilis1 hepatitis ,b1 hepatitis ,c1 & human papillomavirus4 4 #ajc4 ,cov]age = r\t9e ,,hiv_/,,aids & ,,/i scre5+ "u gr\p heal? plans 7a7 ,gr\p heal? plans 7#a7 ,public ,heal? ,s]vice ,act am5dm5t ,title ,,xxvii ( ! ,public ,heal? ,s]vice ,act is am5d$ by ins]t+ aft] section #bgbh ( su* ,act 7#db ,u4,s4,c4 #cjj;gg-#bh71 z r$esignat$ by section #ajja7b7 ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7,public ,law #aaa-adh71 ! foll[+3 #bgbi4 ,cov]age = r\t9e ,,hiv_/,,aids & ,,/i scre5+ 7a7 ,cov]age ,a gr\p heal? plan1 & a heal? insurance issu] provid+ gr\p or individual heal? insurance cov]age1 %all provide cov]age = r\t9e ,,hiv_/,,aids & ,,/i scre5+ "u t]ms & conditions t are no less favorable ?an ! t]ms & conditions applicable to o!r r\t9e heal? scre5+s4 7b7 ,prohibitions ,a gr\p heal? plan1 & a heal? insurance issu] provid+ gr\p or individual heal? insurance cov]age1 %all n-- 7#a7 d5y to an individual eligibility1 or cont9u$ eligibility1 to enroll or to r5ew cov]age "u ! t]ms ( ! plan1 solely = ! purpose ( avoid+ ! requirem5ts ( ?is section2 7#b7 d5y cov]age = r\t9e ,,hiv_/,,aids or ,,/i scre5+ on ! basis t !re are no kn[n risk factors pres5t1 or ! scre5+ is n cl9ically indicat$1 m$ically necess>y1 or pursuant to a ref]ral1 cons5t1 or recomm5dation by any heal? c>e provid]2 7#c7 provide monet>y paym5ts1 rebates1 or o!r b5efits to individuals to enc\rage su* individuals to accept less ?an ! m9imum protections available "u ?is section2 7#d7 p5alize or o!rwise r$uce or limit ! reimbursem5t ( a provid] because su* provid] provid$ c>e to an individual p>ticipant or b5efici>y 9 accordance ) ?is section2 7#e7 provide inc5tives 7monet>y or o!rwise7 to a provid] to induce su* provid] to provide c>e to an individual p>ticipant or b5efici>y 9 a mann] inconsi/5t ) ?is section2 or 7#f7 d5y to an individual p>ticipant or b5efici>y cont9u$ eligibility to enroll or to r5ew cov]age "u ! t]ms ( ! plan1 solely because ( ! results ( an ,,hiv_/,,aids or ,,/i te/1 or o!r ,,hiv_/,,aids & ,,/i scre5+ proc$ure1 = ! individual or any o!r individual4 7c7 ,rules ( ,con/ruction ,no?+ 9 ?is section %all be con/ru$-- 7#a7 to require an individual :o is a p>ticipant or b5efici>y to und]go ,,hiv_/,,aids or ,,/i scre5+2 or 7#b7 z prev5t+ a gr\p heal? plan or issu] f impos+ d$uctibles1 co9surance1 or o!r co/-%>+ 9 relation to ,,hiv_/,,aids or ,,/i scre5+1 except t su* d$uctibles1 co9surance or o!r co/-%>+ may n be great] ?an ! d$uctibles1 co9surance1 or o!r co/-%>+ impos$ on o!r r\t9e heal? scre5+s4 7d7 ,notice ,a gr\p heal? plan "u ?is "p %all comply ) ! notice requirem5t "u section #gaf7;d7 ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd ) respect to ! requirem5ts ( ?is section z if su* section appli$ to su* plan4 7e7 ,preemption ,no?+ 9 ?is section %all be con/ru$ to preempt any ,/ate law 9 effect on ! date ( enactm5t ( ?is section ) respect to heal? insurance cov]age t requires cov]age ( at lea/ ! cov]age ( ,,hiv_/,,aids or ,,/i scre5+ o!rwise requir$ "u ?is section4 4 7#b7 ,,erisa am5dm5ts ,! ,employee ,retirem5t ,income ,security ,act ( #aigd is am5d$ z foll[s3 7,a7 ,9 subp>t ,b ( "p #g ( subtitle ,b ( title ,i1 by add+ at ! end ! foll[+ new section3 #gaf4 ,cov]age = r\t9e ,,hiv_/,,aids & ,,/i scre5+ 7a7 ,cov]age ,a gr\p heal? plan1 & a heal? insurance issu] (f]+ gr\p heal? insurance cov]age1 %all provide cov]age = r\t9e ,,hiv scre5+ "u t]ms & conditions t are no less favorable ?an ! t]ms & conditions applicable to o!r r\t9e heal? scre5+s4 7b7 ,prohibitions ,a gr\p heal? plan1 & a heal? insurance issu] (f]+ gr\p heal? insurance cov]age1 %all n-- 7#a7 d5y to an individual eligibility1 or cont9u$ eligibility1 to enroll or to r5ew cov]age "u ! t]ms ( ! plan1 solely = ! purpose ( avoid+ ! requirem5ts ( ?is section2 7#b7 d5y cov]age = r\t9e ,,hiv scre5+ on ! basis t !re are no kn[n risk factors pres5t1 or ! scre5+ is n cl9ically indicat$1 m$ically necess>y1 or pursuant to a ref]ral1 cons5t1 or recomm5dation by any heal? c>e provid]2 7#c7 provide monet>y paym5ts1 rebates1 or o!r b5efits to individuals to enc\rage su* individuals to accept less ?an ! m9imum protections available "u ?is section2 7#d7 p5alize or o!rwise r$uce or limit ! reimbursem5t ( a provid] because su* provid] provid$ c>e to an individual p>ticipant or b5efici>y 9 accordance ) ?is section2 7#e7 provide inc5tives 7monet>y or o!rwise7 to a provid] to induce su* provid] to provide c>e to an individual p>ticipant or b5efici>y 9 a mann] inconsi/5t ) ?is section2 or 7#f7 d5y to an individual p>ticipant or b5efici>y cont9u$ eligibility to enroll or to r5ew cov]age "u ! t]ms ( ! plan1 solely because ( ! results ( an ,,hiv te/ or o!r ,,hiv scre5+ proc$ure = ! individual or any o!r individual4 7c7 ,rules ( con/ruction ,no?+ 9 ?is section %all be con/ru$-- 7#a7 to require an individual :o is a p>ticipant or b5efici>y to und]go ,,hiv_/,,aids or ,,/i scre5+2 or 7#b7 z prev5t+ a gr\p heal? plan or issu] f impos+ d$uctibles1 co9surance1 or o!r co/-%>+ 9 relation to ,,hiv_/,,aids or ,,/i scre5+1 except t su* d$uctibles1 co9surance or o!r co/-%>+ may n be great] ?an ! d$uctibles1 co9surance1 or o!r co/-%>+ impos$ on o!r r\t9e heal? scre5+s4 7d7 ,notice "u gr\p heal? plan ,a gr\p heal? plan1 & a heal? insurance issu] provid+ heal? insurance cov]age 9 connection ) a gr\p heal? plan1 %all provide notice to ea* p>ticipant & b5efici>y "u su* plan reg>d+ ! cov]age requir$ by ?is section 9 accordance ) regulations promulgat$ by ! ,secret>y4 ,su* notice %all be 9 writ+ & prom95tly position$ 9 any lit]ature or correspond5ce made available or di/ribut$ by ! plan or issu] & %all be transmitt$1 by :i*ev] is e>lie/ ( ! foll[+3 7#a7 ,9 ! next mail+ made by ! plan or issu] to ! p>ticipant or b5efici>y4 7#b7 ,z "p ( any ye>ly in=mational packet s5t to ! p>ticipant or b5efici>y4 7#c7 ,n lat] ?an ,july #a1 #bjag4 7e7 ,preemption2 relation to ,/ate laws 7#a7 ,9 g5]al ,no?+ 9 ?is section %all be con/ru$ to preempt any ,/ate law 9 effect on ! date ( enactm5t ( ?is section ) respect to heal? insurance cov]age t requires cov]age ( at lea/ ! cov]age ( ,,hiv_/,,aids or ,,/i scre5+ o!rwise requir$ "u ?is section4 7#b7 ,,erisa ,no?+ 9 ?is section %all be con/ru$ to affect or modify ! provisions ( section #ead ) respect to gr\p heal? plans4 4 7,b7 ,9 section #gcb7;a7 ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd 7#bi ,u4,s4,c4 #aaia;a7a771 by /rik+ section #gaa & ins]t+ sections #gaa & #gaf4 7,c7 ,9 ! table ( cont5ts 9 section #a ( su* ,act1 by ins]t+ aft] ! item relat+ to section #gad ! foll[+ new item3 ,sec4 #gae4 ,additional m>ket re=ms4 ,sec4 #gaf4 ,cov]age = r\t9e ,,hiv_/,,aids & ,,/i scre5+4 4 7#c7 ,int]nal ,rev5ue ,code am5dm5ts 7,a7 ,9 g5]al ,! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by ins]t+ aft] section #ihae ! foll[+ new section3 #ihaf4 ,cov]age = r\t9e ,,hiv_/,,aids & ,,/i scre5+ 7a7 ,cov]age ,a gr\p heal? plan %all provide cov]age = r\t9e ,,hiv_/,,aids & ,,/i scre5+ "u t]ms & conditions t are no less favorable ?an ! t]ms & conditions applicable to o!r r\t9e heal? scre5+s4 7b7 ,prohibitions ,a gr\p heal? plan %all n-- 7#a7 d5y to an individual eligibility1 or cont9u$ eligibility1 to enroll or to r5ew cov]age "u ! t]ms ( ! plan1 solely = ! purpose ( avoid+ ! requirem5ts ( ?is section2 7#b7 d5y cov]age = r\t9e ,,hiv_/,,aids or ,,/i scre5+ on ! basis t !re are no kn[n risk factors pres5t1 or ! scre5+ is n cl9ically indicat$1 m$ically necess>y1 or pursuant to a ref]ral1 cons5t1 or recomm5dation by any heal? c>e provid]2 7#c7 provide monet>y paym5ts1 rebates1 or o!r b5efits to individuals to enc\rage su* individuals to accept less ?an ! m9imum protections available "u ?is section2 7#d7 p5alize or o!rwise r$uce or limit ! reimbursem5t ( a provid] because su* provid] provid$ c>e to an individual p>ticipant or b5efici>y 9 accordance ) ?is section2 7#e7 provide inc5tives 7monet>y or o!rwise7 to a provid] to induce su* provid] to provide c>e to an individual p>ticipant or b5efici>y 9 a mann] inconsi/5t ) ?is section2 or 7#f7 d5y to an individual p>ticipant or b5efici>y cont9u$ eligibility to enroll or to r5ew cov]age "u ! t]ms ( ! plan1 solely because ( ! results ( an ,,hiv_/,,aids or ,,/i te/1 or o!r ,,hiv_/,,aids & ,,/i scre5+ proc$ure1 = ! individual or any o!r individual4 7c7 ,rules ( con/ruction ,no?+ 9 ?is section %all be con/ru$-- 7#a7 to require an individual :o is a p>ticipant or b5efici>y to und]go ,,hiv_/,,aids or ,,/i scre5+2 or 7#b7 z prev5t+ a gr\p heal? plan or issu] f impos+ d$uctibles1 co9surance1 or o!r co/-%>+ 9 relation to ,,hiv_/,,aids or ,,/i scre5+1 except t su* d$uctibles1 co9surance or o!r co/-%>+ may n be great] ?an ! d$uctibles1 co9surance1 or o!r co/-%>+ impos$ on o!r r\t9e heal? scre5+s4 4 7,b7 ,con=m+ am5dm5t ,section #dihj;,d7d77#a7 ( su* ,code is am5d$ by /rik+ section #ihaa & ins]t+ sections #ihaa & #ihaf4 7,c7 ,cl]ical am5dm5t ,! table ( cont5ts = sub*apt] ,b ( *apt] #a ( su* ,code is am5d$ by ins]t+ aft] ! item relat+ to section #ihae ! foll[+ new item3 ,sec4 #ihaf4 ,cov]age = r\t9e ,,hiv_/,,aids & ,,/i scre5+4 4 7b7 ,application "u ,f$]al ,employees ,heal? ,b5efits ,program ,section #hijb ( title #e1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new subsection3 7p7 ,a contract may n be made or a plan approv$ :i* does n comply ) ! requirem5ts ( section #bgbi ( ! ,public ,heal? ,s]vice ,act4 4 7c7 ,effective dates ,not)/&+ any o!r provision ( law1 ! am5dm5ts made by subsections 7a7 & 7b7 %all apply ) respect to plan ye>s beg9n+ on or aft] ,july #a1 #bjag1 & ) respect to heal? insurance cov]age issu$ on or aft] su* date4 7d7 ,coord9ation ( adm9i/ration ,! ,secret>y ( ,labor1 ! ,secret>y ( ,heal? & ,human ,s]vices1 & ! ,secret>y ( ! ,treasury %all ensure1 ?r\gh ! execution ( an int]ag5cy memor&um ( und]/&+ among su* ,secret>ies1 t-- 7#a7 regulations1 rul+s1 & int]pretations issu$ by su* ,secret>ies relat+ to ! same matt] ov] :i* two or m su* ,secret>ies h responsibility "u ! provisions ( ?is section 7& ! am5dm5ts made !reby7 are adm9i/]$ s z to h ! same effect at all times2 & 7#b7 coord9ation ( policies relat+ to en=c+ ! same requirem5ts ?r\gh su* ,secret>ies 9 ord] to h a coord9at$ en=cem5t /rategy t avoids duplication ( en=cem5t ef=ts & assigns priorities 9 en=cem5t4 #ajd4 ,optional ,m$icaid cov]age ( l[-income ,,hiv_/,,aids infect$ individuals 7a7 ,9 g5]al ,section #aijb ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7 is am5d$-- 7#a7 9 subsection 7a77#aj77;,a77ii7-- 7,a7 by /rik+ or at ! end ( subclause 7,,xxi72 7,b7 by add+ or at ! end ( subclause 7,,xxii72 & 7,c7 by add+ at ! end ! foll[+3 7,,xxiii7 on or be=e ,decemb] #ca1 #bjag1 :o are describ$ 9 subsection 7ll7 7relat+ to ,,hiv_/,,aids infect$ individuals72 2 & 7#b7 by add+ at ! end ! foll[+3 7ll7 individuals describ$ 9 ?is subsection are individuals-- 7#a7 :o are n describ$ 9 subsection 7a77#aj77;,a77i72 7#b7 :o h ,,hiv_/,,aids1 z def9$ "u section #aije7;ee72 7#c7 ^: income 7z det]m9$ "u ! ,/ate plan "u ?is title ) respect to disabl$ individuals7 does n exce$ ! maximum am\nt ( income a disabl$ individual describ$ 9 subsection 7a77#aj77;,a77i7 may h to obta9 m$ical assi/ance "u ! plan2 & 7#d7 ^: res\rces 7z det]m9$ "u ! ,/ate plan "u ?is title ) respect to disabl$ individuals7 d n exce$ ! maximum am\nt ( res\rces a disabl$ individual describ$ 9 subsection 7a77#aj77;,a77i7 may h to obta9 m$ical assi/ance "u ! plan4 4 7b7 ,enhanc$ mat* 7#a7 ,9 g5]al ,! fir/ s5t5ce ( section #aije7;b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7b77 is am5d$ by /rik+ section #aijb7;a77#aj77;,a77ii77,,xviii7 & ins]t+ subclause 7,,xviii7 & subclause 7,,xxiii7 ( section #aijb7;a77#aj77;,a77ii74 7#b7 ,con=m+ am5dm5ts ,section #aije7;a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a77 is am5d$ 9 ! matt] prec$+ p>agraph 7#a7-- 7,a7 by /rik+ or at ! end ( clause 7xv72 7,b7 by /rik+ or at ! end ( clause 7xvi72 7,c7 by add+ or at ! end ( clause 7xvii72 & 7,d7 by ins]t+ aft] clause 7xvii7 ! foll[+3 7xviii7 individuals describ$ 9 section #aijb7;a77#aj77;,a77ii77,,xxiii72 4 7c7 ,exemption f fund+ limitation = t]ritories ,section #aajh7;g7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acjh7;g77 is am5d$ by add+ at ! end ! foll[+3 7#f7 ,disreg>d+ m$ical assi/ance = optional l[-income ,,hiv_/,,aids infect$ individuals ,! limitations "u subsection 7f7 & ! previ\s provisions ( ?is subsection %all n apply to am\nts exp5d$ = m$ical assi/ance = individuals describ$ 9 section #aijb7ll7 :o are only eligible = su* assi/ance on ! basis ( section #aijb7;a77#aj77;,a77ii77,,xxiii74 4 7d7 ,effective date 7#a7 ,9 g5]al ,except z provid$ by p>agraph 7#b71 ! am5dm5ts made by ?is section %all take effect on ! date ( ! enactm5t ( ?is section & %all apply to s]vices furni%$ on or aft] su* date4 7#b7 ,rules = *anges requir+ ,/ate legislation ,9 ! case ( a ,/ate plan = m$ical assi/ance "u title ,,xix ( ! ,social ,security ,act :i* ! ,secret>y ( ,heal? & ,human ,s]vices det]m9es requires ,/ate legislation 7o!r ?an legislation appropriat+ funds7 9 ord] = ! plan to meet ! additional requirem5t impos$ by ! am5dm5ts made by ?is section1 ! ,/ate plan %all n be reg>d$ z fail+ to comply ) ! requirem5ts ( su* title solely on ! basis ( its failure to meet ?is additional requirem5t be=e ! fir/ day ( ! fir/ cal5d> qu>t] beg9n+ aft] ! close ( ! fir/ regul> session ( ! ,/ate legislature t beg9s aft] ! date ( ! enactm5t ( ?is ,act4 ,= purposes ( ! previ\s s5t5ce1 9 ! case ( a ,/ate t has a #b-ye> legislative session1 ea* ye> ( su* session %all be deem$ to be a sep>ate regul> session ( ! ,/ate legislature4 ,,ii ,increas$ data collection & education = hi/orically und]repres5t$ populations #bja4 ,p liv+ ) disabilities 7a7 ,track+ ( in=mation ,! ,director %all-- 7#a7 track national ,,hiv_/,,aids & ,,/i scre5+ tr5ds & ! burd5s ( ,,hiv_/,,aids & ,s,t,is among p ) disabilities1 includ+ su* p]sons ) m5tal1 physical1 cognitive1 intellectual1 or developm5tal disabilities2 & 7#b7 id5tify & assess ! b>ri]s t prev5t su* p]sons f access+ ,,hiv_/,,aids & ,,/i scre5+4 7b7 ,track+ me?odology 7#a7 ,9 g5]al ,! track+ me?ods us$ by ! ,secret>y "u subsection 7a7 %all-- 7,a7 focus ^u hi/orically und]repres5t$ communities1 includ+ ! deaf & he>+ loss-relat$ community & ! cognitive1 intellectual1 developm5tal1 mobility1 or m5tal heal? disability communities2 & 7,b7 consid] o!r factors t may contribute to increas$ burd5s ( ,,hiv_/,,aids & ,s,t,is1 includ+ race1 socio-economic /atus1 region1 g5d] id5tity1 & sexual behavior4 7#b7 ,sexual assault data ,track+ "u subsection 7a7 %all include data collection on ! incid5ce ( sexual assault on p ) m5tal1 physical1 cognitive1 intellectual1 or developm5tal disabilities = ! purposes ( und]/&+ ! preval5ce ( ,,hiv_/,,aids & ,s,t,is t result f su* assaults4 7c7 ,deaf & he>+ loss community 7#a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh ! ,director1 %all "w ) appropriate organizations & in/itutions to make compreh5sive sex education mat]ials t promote volunt>y scre5+ = ,,hiv_/,,aids & ,s,t,is accessible to ! deaf & he>+ loss community ?r\gh language 7includ+ ,am]ican ,sign ,language71 modalities 7includ+ highly graphic =mats ) m9imal text71 & culturally appropriate in=mation deliv]y4 7#b7 ,heal? c>e]s & education ,! ,secret>y %all-- 7,a7 "w ) appropriate individuals1 organizations1 & in/itutions to increase ! numb] ( p :o are deaf or liv+ ) he>+ loss 9 public heal? c>e]s = ! purposes (-- 7i7 build+ ! public heal? infra/ructure to improve data collection2 & 7ii7 heal? in=mation dissem9ation to p :o are deaf or :o live ) he>+ loss2 & 7,b7 engage /ud5ts 9 elem5t>y s*ool1 high s*ool1 college1 & graduate s*ool = ! purposes ( c>ry+ out ?is p>agraph4 7d7 ,cognitive & intellectual disability community ,! ,secret>y1 act+ ?r\gh ! ,director1 %all "w ) appropriate national & local organizations to make compreh5sive sex education mat]ials accessible to p ) intellectual disabilities by-- 7#a7 us+ pla9 language2 7#b7 educat+ s]vice provid]s ab\t ! signs & symptoms ( sexual assault among p ) cognitive & intellectual disabilities2 & 7#c7 us+ o!r appropriate in=mation deliv]y /rategies4 7e7 ,wom5 liv+ ) sev]e physical disabilities ,! ,secret>y1 act+ ?r\gh ! ,director1 %all "w ) ,f$]al1 ,/ate1 & local entities to track access to pelvic exam9ations1 mammograms1 & o!r wom5's heal? s]vices = wom5 ) sev]e mobility impairm5ts ) ! goal ( improv+ access to su* s]vices4 #bjb4 ,wom5 :o h sex ) wom5 7a7 ,national scre5+ guidel9es ,! ,secret>y1 act+ ?r\gh ! ,director1 %all "w ) ,f$]al1 ,/ate1 & local heal? entities to ensure t national scre5+ guidel9es = c]vical canc] /ate t ,,wsw %\ld be subject to ! same scre5+ guidel9es = c]vical canc] z wom5 :o h sex only ) m54 7b7 ,in=mation collection ,! ,secret>y1 act+ ?r\gh ! ,director1 %all1 ) respect to ! ,,wsw community-- 7#a7 track national tr5ds 9 scre5+ = ,,hiv_/,,aids & o!r ,s,t,is2 & 7#b7 collect in=mation on-- 7,a7 ! burd5s & behavior ( ,,hiv_/,,aids & ,s,t,is2 & 7,b7 o!r reproductive heal? conc]ns4 #bjc4 ,transg5d] community 7a7 ,data collection ,! ,secret>y1 act+ ?r\gh ! ,director1 %all "w ) ,f$]al1 ,/ate1 & local heal? entities & transg5d] communities to improve in=mation collection conc]n+ ! transmission1 morbidity1 & scre5+ = ,,hiv_/,,aids & o!r ,s,t,is 9 transg5d] communities4 7b7 ,in=mation classification ,= purposes ( acquir+ a compreh5sive und]/&+ ( ! unique heal? tr5ds among1 & aspects (1 ! transg5d] community1 ! ,secret>y %all promulgate regulations requir+ t1 = purposes ( public heal? /udies requir+ data collection1 ! fact t an individual is transg5d] %all be a di/9ct category & data po9t4 #bjd4 ,report 7a7 ,9 g5]al ,n lat] ?an #c ye>s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all submit a report to ,congress on ! activities requir$ "u ?is ,act4 7b7 ,cont5ts ,! report issu$ to ,congress "u subsection 7a7 %all include-- 7#a7 in=mation on ! success ( volunt>y scre5+ = ,,hiv_/,,aids & ,s,t,is1 z well z o!r me?ods = prev5t+ ! transmission ( ,,hiv_/,,aids & ,s,t,is among ,m$icaid & ,m$ic>e b5efici>ies1 pati5ts at f$]ally qualifi$ heal? c5t]s1 individuals ) heal? insurance1 ,,msm1 ,,wsw1 p]sons liv+ ) disabilities1 ! transg5d] community1 & o!r gr\ps t h be5 hi/orically und]repres5t$ 9 public heal? int]v5tions = ,,hiv_/,,aids & ,s,t,is2 & 7#b7 recomm5dations on h[ to improve exi/+ measures ) respect to race1 socioeconomic /atus1 region1 g5d] id5tity1 disability1 age1 & sexual behavior-- 7,a7 to increase access to scre5+2 & 7,b7 to decrease ! disp>ities 9 mortality & morbidity f ,,hiv_/,,aids & o!r ,s,t,is4