,i  #aaf? ,,congress  #a/ ,session  ,h4 
,r4 #dcic  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,septemb] #ah1        
#bjai,mr4 ,swalwell ( ,cali=nia 7=      
himself1 ,mr4 ,fitzpatrick1 ,mr4        
,gallego1 ,mr4 ,r\da1 & ,ms4 ,norton7   
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce  ,a  
,,bill  ,to am5d title ,,xix ( ! ,social
 ,security ,act to provide = a ,/ate    
option "u ! ,/ate ,m$icaid plan to      
provide ,,dna sequ5c+ cl9ical s]vices = 
c]ta9 *ildr51 provide = a /udy by !     
,national ,academy ( ,m$ic9e on ! use ( 
g5etic & g5omic te/+ to improve heal?   
c>e1 & = o!r purposes4  #a4 ,%ort title 
,?is ,act may be cit$ z ! ,advanc+      
,access to ,precision ,m$ic9e ,act4  #b4
 ,/ate option to provide ,,dna sequ5c+  
cl9ical s]vices = c]ta9 *ildr5 ,title   
,,xix ( ! ,social ,security ,act 7#db   
,u4,s4,c4 #acif et seq47 is am5d$ by    
add+ at ! end ! foll[+ new section3     
#aidg4 ,/ate option to provide ,,dna    
sequ5c+ cl9ical s]vices = c]ta9 *ildr5  

7a7 ,9 g5]al ,not)/&+ section           
#aijb7;a77#a7 7relat+ to /atewid5ess71  
section #aijb7;a77#aj77;,b7 7relat+ to  
comp>ability71 & any o!r provision ( ?is
 title = :i* ! ,secret>y det]m9es x is  
necess>y to waive 9 ord] to implem5t ?is
 section1 beg9n+ on ! fir/ day ( ! fir/ 
fiscal qu>t] t beg9s on or aft] ! date (
 ! enactm5t ( ?is section1 a ,/ate1 at  
its option z a ,/ate plan am5dm5t1 may  
provide = m$ical assi/ance "u ?is title 
to an eligible individual = purposes (  
provid+ ! individual ) ,,dna sequ5c+    
cl9ical s]vices4  7b7 ,paym5ts  7#a7 ,9 
g5]al ,a ,/ate %all provide a heal? c>e 
provid] 7z def9$ by ! ,/ate7 ) paym5ts =
 ! provision ( ,,dna sequ5c+ cl9ical    
s]vices to any eligible individual4     
,paym5ts made to a heal? c>e provid] =  
su* s]vices %all be treat$ z m$ical     
assi/ance = purposes ( section          
#aijc7;a71 except t1 dur+ ! fir/ #h     
fiscal ye> qu>t]s t ! ,/ate plan am5dm5t
 is 9 effect1 ! ,f$]al m$ical assi/ance 
p]c5tage applicable to su* paym5ts %all 

be equal to #ge p]c5t4  7#b7 ,me?odology
 ,! ,/ate %all specify 9 ! ,/ate plan   
am5dm5t ! me?odology ! ,/ate w use =    
det]m9+ paym5t = ! provision ( ,,dna    
sequ5c+ cl9ical s]vices4 ,su* me?odology
 = det]m9+ paym5t %all be e/abli%$      
consi/5t ) section #aijb7;a77#cj77;,a74 
7#c7 ,plann+ grants  7,a7 ,9 g5]al      
,beg9n+ on ! date describ$ 9 subsection 
7a71 ! ,secret>y may aw>d plann+ grants 
to ,/ates = purposes ( develop+ a ,/ate 
plan am5dm5t "u ?is section4 ,a plann+  
grant aw>d$ to a ,/ate "u ?is p>agraph  
%all rema9 available until exp5d$4  7,b7
 ,/ate contribution ,a ,/ate aw>d$ a    
plann+ grant %all contribute an am\nt   
equal to ! ,/ate p]c5tage det]m9$ "u    
section #aije7;b7 = ea* fiscal ye> = :i*
 ! grant is aw>d$4  7c7 ,hospital       
ref]rals ,a ,/ate %all include 9 ! ,/ate
 plan am5dm5t a requirem5t = any        
hospital t is a p>ticipat+ provid] "u ! 
,/ate plan 7or a waiv] ( su* plan7 to   
e/abli% proc$ures = ref]r+ any eligible 
individual :o seeks or ne$s treatm5t 9 a

 hospital em]g5cy dep>tm5t to a heal?   
c>e provid] :o is qualifi$ 7z det]m9$ by
 ! ,/ate7 to provide ,,dna sequ5c+      
cl9ical s]vices4  7d7 ,reports by ,/ates
 ,n lat] ?an ?ree ye>s aft] ! date on   
:i* ! ,/ate plan am5dm5t "u ?is section 
is approv$1 a ,/ate %all submit a report
 to ! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e 
,m$icaid ,s]vices & ! ,adm9i/rator ( !  
,heal? ,res\rces & ,s]vices             
,adm9i/ration on--  7#a7 ! ext5t to :i* 
,,dna sequ5c+ cl9ical s]vices r$uce     
heal? disp>ities2 &  7#b7 ! ext5t to :i*
 cov]age "u ! ,/ate plan 7or a waiv] (  
su* plan7 imp$es ! use ( g5etic & g5omic
 te/+ t may improve cl9ical outcomes =  
eligible individuals enroll$ 9 ! ,/ate  
plan 7or "u a waiv] ( su* plan74  7e7   
,reports by heal? c>e provid]s ,z a     
condition = receiv+ paym5t = ,,dna      
sequ5c+ cl9ical s]vices provid$ to an   
eligible individual1 a heal? c>e provid]
 %all report to ! ,/ate1 9 accordance ) 
su* requirem5ts z ! ,secret>y %all      
specify1 on all applicable measures =   

det]m9+ ! quality ( su* s]vices4  7f7   
,def9itions ,9 ?is section3 7#a7        
,eligible individual ,! t]m eligible    
individual means an individual :o--     
7,a7 is eligible = m$ical assi/ance "u !
 ,/ate plan 7or a waiv] ( su* plan72    
7,b7 is "u ! age ( #ba 7or1 at ! option 
( ! ,/ate1 "u ! age ( #bj1 #ai1 or #ah z
 ! ,/ate may *oose71 or 9 ! case ( an   
individual describ$ 9 section           
#aijb7;a77#aj77;,a77i77,,ix71 "u ! age (
 #bf2  7,c7 has be5 ref]r$ or admitt$ to
 a p$iatric int5sive c>e unit = a *ronic
 or undiagnos$ disease2  7,d7 has be5   
se5 by at lea/ "o m$ical speciali/ = su*
 *ronic or undiagnos$ disease2 &  7,e7  
is suspect$ by at lea/ "o m$ical        
speciali/ to h a p$iatric-onset g5etic  
disease4  7#b7 ,,dna sequ5c+ cl9ical    
s]vices ,! t]m ,,dna sequ5c+ cl9ical    
s]vices1 ) respect to an eligible       
individual-- 7,a7 means a det]m9ation ( 
an exact sequ5ce ( deoxyribonucleic acid
 bases 9 ! g5ome ( su* individual1 &1 if
 = ! sole b5efit ( ! individual1 a      

biological p>5t ( su* individual = !    
purpose ( det]m9+ :e!r "o or m          
pot5tially disease-caus+ g5etic v>iants 
are pres5t 9 ! g5ome ( su* individual or
 su* biological p>5t2 &  7,b7 includes--
 7i7 sequ5c+ ( ! entire g5ome1 ( !      
exome1 ( a panel ( g5es1 or o!r regions 
( ! g5ome2 &  7ii7 any analysis1        
int]pretation1 & data report d]iv$ f su*
 sequ5c+4  4  #c4 ,national ,academy (  
,m$ic9e /udy  7a7 ,9 g5]al ,n lat] ?an  
#d ye>s aft] ! date ( ! enactm5t ( ?is  
,act1 ! ,secret>y ( ,heal? & ,human     
,s]vices %all ent] into an arrangem5t ) 
! ,national ,academy ( ,m$ic9e "u :i* ! 
,academy agrees to /udy--  7#a7 h[      
g5etic & g5omic te/+ may improve        
prev5tative c>e & precision m$ic9e2     
7#b7 h[ g5etic & g5omic te/+ may r$uce  
heal? disp>ities2  7#c7 h[ ! ,f$]al     
,gov]nm5t may help to r$uce b>ri]s to   
g5etic & g5omic te/+1 includ+-- 7,a7    
enc\rag+ ! expansion ( heal? insurance  
cov]age ( g5etic & g5omic te/+1 includ+ 
diagno/ic1 pr$ictive1 & presymptomatic  

te/+1 & ,,dna sequ5c+ cl9ical s]vices 7z
 def9$ 9 section #aidg ( ! ,social      
,security ,act 7z add$ by section #b772 
7,b7 support+ ! collection ( evid5ce = !
 cl9ical utility & appropriate use (    
g5etic & g5omic te/s2 &  7,c7 improv+   
access to g5etic c\nselors1 pa?ologi/s1 
& o!r relevant pr(essions1 includ+      
/r5g!n+ relat$ work=ce education & tra9+
 ef=ts2  7#d7  7,a7 ! ext5t to :i*      
cov]age provisions 9 ! ,m$ic>e &        
,m$icaid programs "u titles ,,xviii &   
,,xix ( ! ,social ,security ,act 7#db   
,u4,s4,c4 #acie et seq41 #acif et seq47 
may re/ra9 ! use ( g5etic & g5omic te/+ 
t may improve cl9ical outcomes =        
b5efici>ies2  7,b7 ! ext5t to :i*       
cov]age provid$ pursuant to section     
#aidg ( ! ,social ,security ,act 7z add$
 by section #b7 increas$ ! use ( g5etic 
& g5omic te/+ & improv$ cl9ical outcomes
 = b5efici>ies2 &  7,c7 h[ ! ,c5t]s =   
,m$ic>e  ,m$icaid ,s]vices may make     
cov]age det]m9ations t bett] suit a     
precision m$ic9e approa* to treatm5t2 & 

7#e7 h[ g5etic & g5omic te/+ may improve
 heal? outcomes = all populations 9 !   
,unit$ ,/ates1 includ+--  7,a7          
individuals ) a r>e disease1 includ+--  
7i7 a metabolic disease2  7ii7 a h]$it>y
 canc] syndrome2 &  7iii7 a neurologic  
disease ) kn[n treatm5ts2 &  7,b7       
special populations1 includ+-- 7i7      
infants & *ildr52  7ii7 critically ill  
7non-infecti\s & non-trauma7 pati5ts2   
7iii7 transplant pati5ts2  7iv7         
individuals ) c>diac disease2 &  7v7    
individuals )1 or :o h a family hi/ory  
(1 a bir? defect or developm5tal        
disability4  7b7 ,report  7#a7 ,9 g5]al 
,! arrangem5t "u subsection 7a7 %all    
provide = ! ,national ,academy ( ,m$ic9e
 to submit1 n lat] ?an #f ye>s aft] !   
date ( enactm5t ( ?is ,act1 a report on 
! results ( ! /udy "u subsection 7a7    
to--  7,a7 ! ,secret>y ( ,heal? & ,human
 ,s]vices2  7,b7 ! ,committee on ,ways &
 ,means & ! ,committee on ,en]gy &      
,comm]ce ( ! ,h\se ( ,repres5tatives2 & 
7,c7 ! ,committee on ,f9ance & !        

,committee on ,heal?1 ,education1       
,labor1 & ,p5sions ( ! ,s5ate4  7#b7    
,consultation ,! arrangem5t "u          
subsection 7a7 %all provide = !         
,national ,academy ( ,m$ic9e1 9 develop+
 ! report requir$ by p>agraph 7#a71 to  
consult ) physicians1 o!r heal?         
pr(essionals1 heal? educators1 heal?    
pr(essional organizations1 relevant     
companies1 pati5ts1 pati5t              
organizations1 ! ,heal? ,res\rces &     
,s]vices ,adm9i/ration1 ! ,national     
,canc] ,in/itute1 ! ,national ,in/itutes
 ( ,heal?1 ! ,ag5cy = ,heal?c>e ,rese>* 
& ,quality1 & ! ,c5t]s = ,m$ic>e        
,m$icaid ,s]vices4  7#c7 ,use (         
in=mation ,! ,national ,academy (       
,m$ic9e %all1 to ! ext5t possible1 9    
conduct+ ! /udy "u subsection 7a71      
utilize in=mation includ$ 9 ! reports   
submitt$ pursuant to subsections 7d7 &  
7e7 ( section #aidg ( ! ,social         
,security ,act 7z add$ by section #b74