,i  #aafth ,,congress  #ast ,session    
,h4 ,r4 #dfba  ,,in ,,the ,,house ,,of  
,,representatives  ,october #h1         
#bjai,ms4 ,blunt ,rochester 7for herself
 and ,mr4 ,bilirakis7 introduced the    
following bill2 which was referred to   
the ,committee on ,energy and ,commerce 
,a ,,bill  ,to require the ,secretary of
 ,health and ,human ,services to issue  
and disseminate guidance to ,states to  
clarify strategies to address social    
determinants of health under the        
,medicaid program and the ,children's   
,health ,insurance ,program1 and for    
other purposes4  #a4 ,short title ,this 
,act may be cited as the ,collecting and
 ,analyzing ,resources ,integral and    
,necessary for ,guidance for ,social    
,determinants ,act of #bjai or the      
,,caring for ,social ,determinants ,act 
of #bjai4  #b4 ,findings2 purpose  7a7  
,findings ,congress makes the following 
findings3 7#a7 ,social determinants of  
health are the conditions in which      
people are born1 grow1 live1 play1 work 

and age2 they include factors like      
socioeconomic status1 education1        
housing1 transportation1 nutrition and  
literacy4  7#b7 ,research has shown that
 addressing social determinants of      
health is important for improving       
overall health and reducing health      
inequities4  7#c7 ,social determinants  
that negatively impact health can have  
harmful neurodevelopmental and          
biological consequences that develop in 
childhood and manifest in adulthood4    
7#d7 ,there is a growing body of        
evidence suggesting that policies that  
specifically address social needs1      
including policies targeting children   
and families1 can improve community     
health outcomes and have the potential  
to reduce health care spending4  7#e7   
,some ,state ,medicaid programs have    
begun testing innovative delivery and   
payment models designed to improve      
health outcomes and reduce costs by     
implementing strategies to address      
social determinants of health under     

existing ,medicaid authorities as well  
as through the use of waivers1 though   
payment incentives linked to social     
determinant of health are not common4   
7#f7 ,despite a growing focus on social 
determinants of health in ,state managed
 care contracts1 most ,states do not    
provide necessary guidance for managed  
care organizations as to how they may   
use existing authority under ,federal   
law to provide patients with services   
that can improve health by addressing   
social determinants4  7#g7 ,centers for 
,medicare  ,medicaid ,services guidance 
and technical assistance are critical   
tools that could increase adoption of   
strategies to address social            
determinants of health among ,state     
,medicaid agencies4  7b7 ,purposes ,it  
is the purpose of this ,act to provide  
,states with additional operational     
clarity and examples of the strategies  
they can leverage through existing      
authority and waivers to address social 
determinants of health for the ,medicaid

 population4  #c4 ,requirement to issue 
guidance to clarify strategies to       
address social determinants of health in
 the ,medicaid program and the          
,children's ,health ,insurance ,program 
,not later than #b years after the date 
of the enactment of this ,act1 the      
,secretary of ,health and ,human        
,services shall issue and disseminate   
guidance to ,states to clarify          
strategies to address social            
determinants of health under the        
,medicaid program and the ,children's   
,health ,insurance ,program4 ,such      
guidance shall include the following3   
7#a7 ,guidance and technical assistance 
to ,state ,medicaid agencies regarding  
the strategies that ,states can         
implement under existing authorities    
under title ,,xi1 ,,xix1 or ,,xxi of the
 ,social ,security ,act1 or through     
waivers1 to address social determinants 
of health in the provision of health    
care1 including strategies specifically 
targeting the pediatric population4     

7#b7 ,guidance and technical assistance 
on how ,states can encourage and        
incentivize managed care organizations  
to address social determinants of health
 through contracts with such            
organizations4  7#c7 ,a compendium of   
examples from ,states with respect to   
how ,states are currently addressing    
social determinants of health in the    
provision of health care under the      
,medicaid program and the ,children's   
,health ,insurance ,program1 including  
through payment models4