,,ii #aae? ,,congress #a/ ,session ,s4 #dbh ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,febru>y #af1 #bjag,mr4 ,grassley 7= himself1 ,mr4 ,b5net1 ,mr4 ,portman1 ,ms4 ,h>ris1 ,mr4 ,blunt1 ,mr4 ,nelson1 ,mr4 ,br[n1 ,mr4 ,g>dn]1 & ,mrs4 ,murray7 introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,f9ance ,a ,,bill ,to am5d titles ,,xix & ,,xxi ( ! ,social ,security ,act to au?orize ,/ates to provide coord9at$ c>e to *ildr5 ) complex m$ical conditions ?r\gh enhanc$ p$iatric heal? homes1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,advanc+ ,c>e = ,exceptional ,kids ,act ( #bjag or ! ,,ace ,kids ,act ( #bjag4 #b4 ,/ate option to provide coord9at$ c>e to *ildr5 ) complex m$ical conditions ?r\gh enhanc$ p$iatric heal? homes 7a7 ,/ate ,m$icaid plan am5dm5t ,title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 is am5d$ by ins]t+ aft] section #aidf ! foll[+ new section3 #aidg4 ,/ate ,option to ,provide ,coord9at$ ,c>e ,?r\gh ,enhanc$ ,p$iatric ,heal? ,homes = ,*ildr5 ) ,complex ,m$ical ,conditions 7a7 ,9 g5]al ,not)/&+ section #aijb7;a77#a7 7relat+ to /atewid5ess7 & section #aijb7;a77#aj77;,b7 7relat+ to comp>ability71 beg9n+ ,janu>y #a1 #bjah1 a ,/ate1 at its option z a ,/ate plan am5dm5t1 may e/abli% an ,,ephh program to provide m$ical assi/ance "u ?is title = ,,ephh s]vices furni%$ to *ildr5 ) complex m$ical conditions :o are enroll$ 9 an enhanc$ p$iatric heal? home 7also ref]r$ to 9 ?is section z an ,,ephh7 "u an ,,ephh program agreem5t4 7b7 ,def9itions ,9 ?is section3 7#a7 ,*ild ) complex m$ical conditions ,! t]m *ild ) complex m$ical conditions means an individual :o-- 7,a7 is enroll$ 9 a ,/ate plan "u ?is title or title ,,xxi or "u a waiv] ( su* plan2 7,b7 is "u #ba ye>s ( age2 & 7,c7 has a *ronic m$ical condition or s]i\s injury t-- 7i7 affects two or m body sy/ems2 7ii7 affects cognitive or physical function+ 7su* z r$uc+ ! ability to p]=m ! activities ( daily liv+1 includ+ ! ability to engage 9 movem5t or mobility1 eat1 dr9k1 communicate1 or brea! indep5d5tly72 & 7iii7 ei!r-- 7,i7 requires int5sive heal?c>e int]v5tions 7su* z multiple m$ications1 !rapies1 or durable m$ical equipm5t7 & int5sive c>e coord9ation to optimize heal? & avoid hospitalizations or em]g5cy dep>tm5t visits2 or 7,,ii7 meets ! crit]ia = m$ical complexity "u exi/+ risk adju/m5t me?odologies us+ a recogniz$1 publicly available p$iatric gr\p+ sy/em 7su* z ! p$iatric complex conditions classification sy/em or ! ,p$iatric ,m$ical ,complexity ,algori?m7 select$ by ! ,secret>y 9 close collaboration ) ! ,/ate ag5cies responsible = adm9i/]+ ,/ate plans "u ?is title & a national panel ( p$iatric1 p$iatric specialty1 & p$iatric subspecialty exp]ts4 7#b7 ,enhanc$ p$iatric heal? home 7,,ephh72 ,,ephh s]vices2 ,,ephh program agreem5t 7,a7 ,9 g5]al ,! t]ms enhanc$ p$iatric heal? home & ,,ephh mean a provid]-sponsor$ entity qualifi$ to c>e = *ildr5 ) m$ically complex conditions t-- 7i7 satisfies ! requirem5ts ( subp>agraph 7,b72 7ii7 has ent]$ into an ,,ephh program agreem5t 7z def9$ 9 subp>agraph 7,d77 ) a ,/ate2 & 7iii7 provides or arranges = ! provision ( ,,ephh s]vices 7z def9$ 9 subp>agraph 7,c77 to *ildr5 ) complex m$ical conditions4 7,b7 ,requirem5ts ,! requirem5ts ( ?is subp>agraph are t ! entity demon/rates to ! ,/ate ) :i* ! entity desires to ent] into an ,,ephh program agreem5t t x-- 7i7 has exp]tise 9 provid+1 integrat+1 or coord9at+ prompt c>e = *ildr5 ) complex m$ical conditions1 includ+ access to p$iatric em]g5cy s]vices at all times2 7ii7 %all design an individualiz$ compreh5sive p$iatric family-c5t]$ c>e plan = ea* *ild ) complex m$ical conditions assign$ to ! entity1 & provide seamless p$iatric c>e coord9ation by a cu/omiz$ c>e team ) a designat$ team lead = ea* su* *ild & ! *ild's family2 7iii7 %all "w ) ! family ( ea* *ild ) complex m$ical conditions assign$ to ! entity to develop & incorporate ongo+ home c>e1 community-bas$ p$iatric prim>y c>e1 c>e f ! mo/ m$ically appropriate or family-pref]r$ *ildr5's hospital1 social support s]vices1 & local hospital p$iatric em]g5cy c>e into ! *ild's c>e plan consi/5t ) family *oice & ! ne$s ( ! *ild2 7iv7 %all include ! families ( *ildr5 ) complex m$ical conditions 9 ! deliv]y ( c>e & ! developm5t1 op]ation1 & evaluation ( its s]vices2 7v7 %all int]act ) *ildr5 ) complex m$ical conditions & _! families 9 a culturally & l+ui/ically appropriate mann]2 7vi7 %all provide integration & access to sub-specializ$ p$iatric s]vices & programs = *ildr5 ) complex m$ical conditions1 includ+ ! mo/ int5sive diagno/ic1 treatm5t1 & critical c>e levels z m$ically necess>y1 includ+ appropriate out-(-,/ate c>e2 7vii7 c coord9ate & integrate ! full range ( p$iatric m$ical1 surgical1 & behavioral speciali/s & subspeciali/s ne$$1 bas$ on cl9ical qualifications 7su* z bo>d c]tification7 & pati5t pref]5ce1 on ! c>e team to c>e = *ildr5 ) complex m$ical conditions1 z well z provid]s (f]+ specializ$ s]vices1 su* z rehabilitative & habilitative heal? c>e & private-duty nurs+1 if ne$$2 7viii7 c coord9ate ! provision ( outpati5t c>e ne$s1 includ+ durable m$ical equipm5t1 m$ical supplies1 & m$ical foods1 if ne$$2 7ix7 c arrange & coord9ate c>e = *ildr5 ) complex m$ical conditions f out-(-,/ate provid]s to ! maximum ext5t practicable = ! families ( su* *ildr5 & :]e m$ically necess>y 9 accordance ) ! guidance provid$ "u subsection 7d77#a72 7x7 c coord9ate & collect paym5ts by liable ?ird p>ties 7includ+ p>ties describ$ 9 section #aijb7;a77#be77;,a77 = c>e & s]vices provid$ or arrang$ = by ! entity2 & 7xi7 c collect & report on p$iatric quality measures appropriate = *ildr5 ) m$ically complex conditions z describ$ 9 subsection 7f77#a74 7,c7 ,,ephh s]vices 7i7 ,9 g5]al ,! t]m ,,ephh s]vices means timely1 high-quality p$iatric s]vices t are provid$ to *ildr5 ) complex m$ical conditions by an enhanc$ p$iatric heal? home "u an ,,ephh program agreem5t1 includ+ all s]vices = :i* m$ical assi/ance is available "u ! ,/ate plan "u ?is title ( ! ,/ate t is a p>ty to ! agreem5t 7or an am5dm5t to su* plan7 & ! s]vices describ$ 9 clause 7ii74 7ii7 ,s]vices describ$ ,! s]vices describ$ 9 ?is subp>agraph are ! foll[+3 7,i7 ,compreh5sive p$iatric c>e managem5t1 includ+ inpati5t & outpati5t hospital s]vices1 oral heal?1 behavioral heal?1 &1 :]e necess>y1 hospice c>e or o!r long-t]m s]vices & supports z def9$ by ! ,/ate4 7,,ii7 ,c>e coord9ation & heal? promotion4 7,,iii7 ,compreh5sive transitional c>e1 includ+ appropriate foll[-up1 f inpati5t to o!r sett+s4 7,,iv7 ,pati5t & family support 7includ+ au?oriz$ repres5tatives74 7,v7 ,ref]ral to community & social support s]vices1 if relevant4 7,,vi7 ,use ( heal? in=mation te*nology to l9k s]vices1 z feasible & appropriate4 7,,vii7 ,coord9at+ access to ! full range ( p$iatric specialty & subspecialty m$ical s]vices1 includ+ s]vices f out-(-,/ate provid]s1 z m$ically necess>y4 7,d7 ,,ephh program agreem5t ,! t]m ,,ephh program agreem5t means an agreem5t betwe5 a ,/ate & an ,,ephh t-- 7i7 requires ! ,,ephh to provide1 or arrange = or coord9ate ! provision (1 at a m9imum1 ! s]vices describ$ 9 clause 7ii7 ( subp>agraph 7,c72 7ii7 requires ! ,,ephh to c>ry out ! requirem5ts describ$ 9 subp>agraph 7,b7 & comply ) ! data collection requirem5ts ( subsection 7f72 7iii7 provides t ! ,/ate1 ) respect to *ildr5 ) complex m$ical conditions :o are resid5ts ( ! ,/ate & are assign$ to ! ,,ephh1 %all e/abli% policies & proc$ures = mak+ paym5ts to ! ,,ephh = provid+1 arrang+ =1 or coord9at+ ,,ephh s]vices furni%$ to su* *ildr5 9 ano!r ,/ate2 7iv7 is subject to all relevant requirem5ts impos$ by ,f$]al1 ,/ate1 & local law2 & 7v7 conta9s su* additional t]ms & conditions1 n inconsi/5t ) ?is section1 z ! p>ties may agree to4 7#c7 ,/ate adm9i/]+ ag5cy ,! t]m ,/ate adm9i/]+ ag5cy means ! ,/ate ag5cy 7:i* %all be ! ,/ate ag5cy responsible = adm9i/]+ ! ,/ate plan "u ?is title or ! ,/ate ag5cy responsible = adm9i/]+ ! ,/ate program "u title ,v7 responsible = adm9i/]+ ,,ephh program agreem5ts "u ?is section4 7c7 ,family pref]5ce = an enhanc$ p$iatric heal? home 7#a7 ,9 g5]al 7,a7 ,option to reque/ enrollm5t ,ea* *ild ) complex m$ical conditions :o is eligible to receive ,,ephh s]vices "u a ,/ate plan am5dm5t "u ?is section %all h ! option ( reque/+ to be enroll$ ) an ,,ephh ( ! *ild's *oice 9 accordance ) a process e/abli%$ by ! ,/ate4 7,b7 ,enrollm5t requirem5t ,an ,,ephh %all enroll any *ild ) complex m$ical conditions :o reque/s enrollm5t ) ! ,,ephh "u subp>agraph 7,a7 unless ! t]ms ( ! ,,ephh program agreem5t betwe5 ! ,,ephh & ! ,/ate all[ ! ,,ephh to decl9e ! *ild's reque/ on ! basis ( pre-e/abli%$ crit]ia specifi$ 9 ! agreem5t4 7#b7 ,outrea* & education ,ea* ,/ate ) a ,/ate plan am5dm5t "u ?is section %all conduct outrea* & education activities to raise aw>5ess among *ildr5 ) complex m$ical conditions & _! families ( ! option to enroll 9 an ,,ephh & may provide assi/ance to su* *ildr5 & _! families 9 mak+ decisions ) respect to su* enrollm5t4 ,! activities & assi/ance describ$ 9 ?is p>agraph may include activities & assi/ance c>ri$ out by-- 7,a7 family-to-family in=mation c5t]s "u section #eja7;c72 7,b7 family navigators2 7,c7 nonpr(it organizations2 & 7,d7 fai?-bas$ organizations4 7#c7 ,option to )draw f program 7,a7 ,9 g5]al ,any *ild ) complex m$ical conditions t opts into an enhanc$ p$iatric heal? home "u ?is subsection %all h ! option to dis5roll f ! home & to receive cov]$ s]vices "u ! ,/ate plan "u ?is title or ! ,/ate *ild heal? plan "u title ,,xxi4 7,b7 ,effective date ( disenrollm5t ,! dis5rollm5t ( a *ild ) complex m$ical conditions f an enhanc$ p$iatric heal? home %all take effect n lat] ?an #cj days aft] ! *ild notifies ! heal? home ( ! *ild's desire to dis5roll4 7#d7 ,transition assi/ance ,9 ! case ( an individual :o is enroll$ 9 an enhanc$ p$iatric heal? home "u ?is section & ^: enrollm5t ceases = any reason 7includ+ t ! individual no long] qualifies z a *ild ) complex m$ical conditions1 ! t]m9ation ( an ,,ephh program agreem5t1 or o!rwise71 ! enhanc$ p$iatric heal? home %all cont9ue to provide ,,ephh s]vices to ! individual dur+ a transition p]iod to ensure t ! individual's c>e is n compromis$1 help ! individual & ! individual's family self-manage ! individual's m$ical conditions to ! maximum ext5t practicable1 & provide assi/ance to ! individual & ! individual's family 9 obta9+ necess>y transitional c>e ?r\gh appropriate ref]rals & mak+ ! individual's m$ical records available to new provid]s4 7d7 ,coord9at+ c>e f out-(-,/ate provid]s 7#a7 ,guidance 7,a7 ,9 g5]al ,n lat] ?an #b ye>s aft] ! date ( ! enactm5t ( ?is section1 ! ,secret>y %all issue guidance to ,/ate ,m$icaid ,directors on be/ practices = ensur+ t *ildr5 ) complex m$ical conditions receive prompt c>e f out-(-,/ate provid]s :5 m$ically necess>y1 includ+ guidance reg>d+-- 7i7 arrang+ access to1 & provid+ paym5t =1 c>e = su* *ildr5 provid$ by out-(-,/ate provid]s2 7ii7 r$uc+ b>ri]s = su* *ildr5 receiv+ c>e f su* provid]s 9 a timely fa%ion2 7iii7 scre5+ & enroll+ out-(-,/ate provid]s1 includ+ ef=ts to /reaml9e ! process or r$uce ! burd5 on out-(-,/ate provid]s t d n regul>ly treat *ildr5 f ! ,/ate or t only treat a small numb] ( *ildr5 f ! ,/ate 7:i* may include provid+ = paym5t to su* a provid] )\t requir+ ! provid] to enroll 9 ! ,/ate plan72 7iv7 provid+ = paym5t to out-(-,/ate provid]s t provide c>e = *ildr5 ) complex m$ical conditions 9 em]g5cy & non-em]g5cy situations2 & 7v7 h[ ! guidance provid$ "u ?is subp>agraph int]acts ) ! requirem5ts ( section #dca4eb ( title #db1 ,code ( ,f$]al ,regulations4 7,b7 ,/akehold] input ,9 c>ry+ out subp>agraph 7,a71 ! ,secret>y %all issue a ,reque/ ,= ,in=mation to seek input f ,/ates1 pati5t or family advocates & organizations t repres5t pati5ts or families1 *ildr5's heal? gr\ps1 provid]s 7includ+ *ildr5's hospitals1 hospitals1 p$iatricians1 & o!r p$iatric provid]s71 manag$ c>e plans1 & o!r relevant /akehold]s4 7#b7 ,out-(-,/ate policies = ,e,p,h,hs ,a ,/ate elect+ to provide m$ical assi/ance pursuant to subsection 7a7 %all provide in=mation1 consi/5t ) guidance f ! ,secret>y1 to enhanc$ p$iatric heal? homes receiv+ paym5t "u ?is section1 reg>d+ ! ,/ate's policies & proc$ures = access+ c>e = *ildr5 ) complex m$ical conditions f out-(-,/ate provid]s4 ,= ! purpose ( help+ facilitate m$ically necess>y c>e = su* *ildr51 su* in=mation %all include in=mation on h[ out-(-,/ate provid]s :o provide s]vices to su* *ildr5 c receive paym5t by su* ,/ate ,m$icaid program4 7#c7 ,be/ practices ,a ,/ate elect+ to provide m$ical assi/ance pursuant to subsection 7a7 %all consid] adopt+ be/ practices = provid+ access to out-(-,/ate provid]s = *ildr5 ) complex m$ical conditions consi/5t ) guidance provid$ by ! ,secret>y "u p>agraph 7#a74 7e7 ,paym5ts to enhanc$ p$iatric heal? homes 7#a7 ,9 g5]al ,a ,/ate %all provide an ,,ephh ) paym5ts = ! provision ( ,,ephh s]vices to ea* *ild enroll$ ) an ,,ephh t has an ,,ephh program agreem5t ) ! ,/ate4 ,su* paym5ts = su* s]vices %all be treat$ 9 ! same mann] z paym5ts "u section #aide7;c77#a71 &1 ) respect to paym5ts = s]vices describ$ 9 section #aide7;h77#d77;,b7 provid$ by an ,,ephh to *ildr5 ) complex m$ical conditions enroll$ ) ! ,,ephh dur+ ! fir/ #h fiscal qu>t]s 9 :i* ! ,,ephh program agreem5t is 9 effect1 ! ,f$]al m$ical assi/ance p]c5tage applicable to su* paym5ts %all be equal to ! ,f$]al m$ical assi/ance p]c5tage specifi$ 9 section #aide7;c77#a74 7#b7 ,alt]native paym5t model me?odology ,paym5t to enhanc$ p$iatric heal? homes = ,,ephh s]vices furni%$ pursuant to a ,,ephh program agreem5t %all be made 9 a mann] to be det]m9$ by ! ,/ate us+ an agre$-^u alt]native paym5t me?odology develop$ "u p>agraph 7#d74 7#c7 ,,cms guidance on alt]native paym5t model me?odologies 7,a7 ,9 g5]al ,n lat] ?an ,janu>y #a1 #bjah1 ! ,secret>y %all publi% guidance describ+ be/ practices = ,/ates to employ 9 design+ & e/abli%+ alt]native paym5t model me?odologies :i* may be us$ by enhanc$ p$iatric heal? homes ) ,,ephh program agreem5ts 9 develop+ equitable1 alt]native paym5t model me?odologies = ,,ephh programs "u p>agraph 7#d74 ,! guidance %all include descriptions ( be/ practices relat$ to design+ %>$ sav+s & p]=mance-bas$ paym5t models t are risk-adju/$ = ! population enroll$ 9 ,,ephh programs1 & may include guidance relat$ to o!r alt]native paym5t models1 includ+ global paym5ts & bundl$ paym5ts4 7,b7 ,/akehold] input ,9 c>ry+ out subp>agraph 7,a71 ! ,secret>y %all issue a ,reque/ = ,in=mation to seek input f ,/ates1 ! ,m$icaid & ,,*ip ,paym5t & ,access ,commission1 provid]s 7includ+ *ildr5's hospitals1 hospitals1 p$iatricians1 & o!r p$iatric provid]s71 manag$ c>e plans1 *ildr5's heal? gr\ps1 family & b5efici>y advocates1 ! p$iatric heal? c>e community1 & o!r relevant /akehold]s4 7,c7 ,data analysis ,beg9n+ 9 ! fir/ ye> ( ! implem5tation ( enhanc$ p$iatric heal? homes1 ! ,secret>y %all analyze1 = purposes ( develop+ ! guidance requir$ "u ?is p>agraph-- 7i7 data collect$ "u subsection 7f77#a72 & 7ii7 o!r data z ! ,secret>y det]m9es appropriate4 7#d7 ,developm5t ( alt]native paym5t model me?odology 7,a7 ,9 g5]al ,ea* ,/ate1 9 collaboration ) any enhanc$ p$iatric heal? home t is op]at+ an ,,ephh program "u ?is section 9 ! ,/ate1 %all develop ! paym5t me?odology or me?odologies = paym5t "u ! ,/ate plan 9 accordance ) ?is subsection t-- 7i7 includes-- 7,i7 a risk adju/m5t me?od1 re-insurance sy/em1 or risk-corridor proc$ure to acc\nt = v>iations 9 acuity ( ! *ildr5 ) complex m$ical conditions enroll$ 9 enhanc$ p$iatric heal? homes2 & 7,,ii7 an alt]native paym5t model1 :i* may include a %>$ sav+s approa* or p]=mance-bas$ approa*1 su* z a bundl$ paym5t or risk-rew>d paym5t model2 7ii7 may be in=m$ by guidance publi%$ by ! ,secret>y "u p>agraph 7#c77;,a72 & 7iii7 consid]s data analyz$ "u p>agraph 7#c77;,c71 to ! maximum ext5t practicable4 7,b7 ,approval by ,/ate ,m$icaid ag5cy requir$ ,no paym5t may be made "u a paym5t me?odology develop$ "u ?is p>agraph unless-- 7i7 ! relevant ,/ate ag5cy responsible = adm9i/]+ ! ,/ate plan "u ?is title has approv$ su* me?odology2 & 7ii7 ! me?odology is describ$ 9 a ,/ate plan am5dm5t t has receiv$ approval f ! ,secret>y4 7f7 ,data & quality assurance 7#a7 ,data ,! data collection requirem5ts "u ?is p>agraph1 ) respect to an enhanc$ p$iatric heal? home1 are z foll[s3 7,a7 ,! home1 9 collaboration ) ! ,/ate & ! *ild's heal? plan if appropriate1 %all collect & submit claims data on claims submitt$ ) respect to *ildr5 :o are furni%$ ,,ephh s]vices4 ,aft] approval by ! ,/ate1 su* data %all be report$ 9 a /&>diz$ =mat 9 a timely mann] & made available to ! public = ! purposes ( e/abli%+ a national database on su* claims4 7,b7 ,! ,/ate %all submit to ! ,secret>y su* reports z ! ,secret>y f9ds necess>y to monitor ! op]ation1 co/1 & effectiv5ess ( ! ,,ephh s]vices furni%$ by ! home4 7#b7 ,developm5t ( /&>ds & measures ,! ,secret>y %all1 9 consultation ) ,/ates & enhanc$ p$iatric heal? homes ) ,,ephh program agreem5ts "u ?is section & national p$iatric policy organizations-- 7,a7 e/abli% a national set ( quality assurance & improvem5t protocols & proc$ures to apply "u ,,ephh programs e/abli%$ "u ?is section2 7,b7 develop p$iatric quality measures t are tailor$ to ! c>e & treatm5t ( *ildr5 ) complex m$ical conditions & acc\nt = ! heal? & well-be+1 c>e coord9ation1 *ild & family exp]i5ce1 & access to & co/ ( c>e = *ildr5 ) complex m$ical conditions2 7,c7 develop provid] accessibility /&>ds = access by *ildr5 ) complex m$ical conditions to ,,ephh s]vices2 & 7,d7 develop crit]ia = national p$iatric-focus$ c>e coord9ation = *ildr5 ) complex m$ical conditions4 7#c7 ,use ( exi/+ quality measures ,9 c>ry+ out p>agraph 7#b71 ! ,secret>y %all consid] incorporat+1 to ! ext5t applicable1 ! foll[+ measures3 7,a7 ,*ild heal? quality measures & measures = c5t]s ( excell5ce = *ildr5 ) complex ne$s develop$ "u ?is title1 title ,,xxi1 & section #aaci;,a4 7,b7 ,! ,heal?c>e ,effectiv5ess ,data & ,in=mation ,set 7,,h$is74 7,c7 ,o!r exi/+ quality measures1 z consid]$ appropriate by ! ,secret>y4 7#d7 ,national p$iatric policy organizations ,= purposes ( p>agraph 7#b71 ! national p$iatric policy organizations t ! ,secret>y %all consult ) %all include ! foll[+3 7,a7 ,acute c>e *ildr5's hospitals4 7,b7 ,specialty p$iatric hospitals4 7,c7 ,subacute1 rehabilitative1 & long-t]m c>e p$iatric hospitals4 7,d7 ,p$iatric provid]s1 includ+ prim>y c>e provid]s1 speciali/s1 & subspeciali/s4 7,e7 ,p$iatric home1 community1 & family c>e organizations1 includ+ organizations repres5t+ families or *ildr5 ) special ne$s4 7,f7 ,national p$iatric policy organizations ) specific exp]tise relat+ to *ildr5 ) complex m$ical conditions4 7,g7 ,su* o!r entities z ! ,secret>y %all det]m9e appropriate4 7#e7 ,/&>d ,m$icaid data set 7,a7 ,9 g5]al ,! ,secret>y1 ! ,/ates1 & ! enhanc$ p$iatric heal? homes ) ,,ephh program agreem5ts "u ?is section %all collaborate to obta9 consi/5t & v]ifiable ,m$icaid ,analytic ,extract data or a comp>able data set & %all e/abli% data-%>+ agreem5ts to fur!r support collaborative plann+ & c>e coord9ation = *ildr5 ) complex m$ical conditions4 7,b7 ,claims analysis 7i7 ,analysis by indep5d5t ?ird p>ty ,! ,secret>y %all commission an indep5d5t ?ird p>ty to p]=m claims analysis on ! data set develop$ "u subp>agraph 7,a7 to det]m9e ! utilization ( items & s]vices furni%$ "u ,,ephh programs to *ildr5 ) complex m$ical conditions1 & ! ov]all effectiv5ess ( ,,ephh programs4 7ii7 ,report ,= purposes ( build+ a national database1 ! ,secret>y %all submit to ,congress1 & make publicly available on ! ,int]net site ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices1 a report on ! analysis c>ri$ out "u clause 7i74 4 7b7 ,application "u ,,*ip ,section #bajg7;e77#a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;gg7e77#a77 is am5d$ by add+ at ! end ! foll[+ new subp>agraph3 7,p7 ,section #aidg 7relat+ to ! ,m$icaid ,,ephh program = *ildr5 ) complex m$ical conditions74 4 #c4 ,,macpac report 7a7 ,9 g5]al ,n lat] ?an #bd mon?s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,m$icaid & ,,*ip ,paym5t & ,access ,commission e/abli%$ "u section #aijj ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif7 %all submit a report to ,congress & ! ,secret>y ( ,heal? & ,human ,s]vices on *ildr5 ) complex m$ical conditions :i* includes ! in=mation describ$ 9 subsection 7b7 & su* recomm5dations z ! ,commission deems appropriate4 7b7 ,in=mation ,to be includ$ ,! in=mation describ$ 9 ?is subsection is ! foll[+ in=mation3 7#a7 ,! *>act]i/ics ( *ildr5 ) complex m$ical conditions1 includ+-- 7,a7 a lit]ature review exam9+-- 7i7 rese>* on su* *ildr52 & 7ii7 cl9ical measures or o!r gr\p+s :i* enable comp>ison among su* *ildr52 & 7,b7 in=mation ga!r$ f consultation ) m$ical & academic exp]ts engag$ 9 rese>* ab\t or treatm5t ( su* *ildr54 7#b7 ,*ildr5 ) complex m$ical conditions :o are enroll$ 9 a ,/ate ,m$icaid plan "u title ,,xix ( ! ,social ,security ,act 7or a waiv] ( su* plan71 includ+-- 7,a7 ! numb] ( su* *ildr52 7,b7 ! *ronic conditions1 s]i\s injuries1 life-?reat5+ illnesses1 or r>e diseases t su* *ildr5 h2 7,c7 ! numb] ( su* *ildr5 receiv+ s]vices "u ea* deliv]y sy/em or paym5t model & ! type ( paym5t model be+ us$2 & 7,d7 ! ext5t to :i* su* *ildr5 receive c>e coord9ation s]vices4 7#c7 ,! p$iatric provid]s :o s]ve *ildr5 ) complex m$ical conditions4 7#d7 ,! ext5t to :i* *ildr5 ) complex m$ical conditions receive or are d5i$ s]vices f out-(-,/ate provid]s t receive paym5t "u ! ,/ate ,m$icaid plan "u title ,,xix ( ! ,social ,security ,act 7or a waiv] ( su* plan7 & any b>ri]s to receiv+ su* s]vices 9 a timely fa%ion1 includ+ any v>iation 9 access to su* s]vices by deliv]y sy/em4 #d4 ,report to ,congress ,n lat] ?an #e ye>s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices %all submit ,congress1 & make publicly available on ! ,int]net site ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices1 a report evaluat+ & assess+ ! enhanc$ p$iatric heal? home program e/abli%$ "u section #aidg ( ! ,social ,security ,act 7z add$ by section #b71 = ! purposes ( det]m9+-- 7#a7 h[ ! program might be improv$2 & 7#b7 :e!r ! program %\ld be exp&$ to include p$iatric populations t are n *ildr5 ) complex m$ical conditions 7z su* t]m is def9$ = purposes ( ! program7 b :o w\ld /ill b5efit f ! type ( c>e coord9ation provid$ by an enhanc$ p$iatric heal? home4