,,ii  #aaf? ,,congress  #a/ ,session    
,s4 #acbc  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,may #f1 #bjai ,mr4    
,portman 7= himself & ,mr4 ,casey7      
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,f9ance  ,a ,,bill  ,to am5d titles     
,,xviii & ,,xix ( ! ,social ,security   
,act to collect in=mation "u ,m$ic>e1   
,m$icaid1 & ! ,*ildr5's ,heal?          
,insurance ,program relat$ to social    
det]m9ants ( heal?1 & = o!r purposes4   
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,utiliz+ ,national ,data1 ,effectively
 ,re=m+ ,/&>ds & ,tools1 to ,address    
,negative ,det]m9ates ( ,heal? ,act or !
 ,,und]/& ,act4  #b4 ,collection (      
in=mation relat$ to social det]m9ants ( 
! heal? ( ,m$ic>e b5efici>ies  7a7      
,report+ ( in=mation ,section #ahji ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#acie;b-#aj7 is am5d$ by add+ at ! end !
 foll[+3  7d7 ,collection ( in=mation   
relat$ to social det]m9ants ( heal?     
7#a7 ,propos$ rule  7,a7 ,9 g5]al ,n    

lat] ?an ,octob] #a1 #bjbj1 ! ,secret>y 
%all issue a propos$ rule s z to all[ = 
! collection ( in=mation relat$ to      
social det]m9ants t may factor into !   
heal? ( b5efici>ies "u ?is title4 ,!    
propos$ rule %all all[ = ! collection ( 
su* in=mation f lic5s$ heal?            
pr(essionals 7z def9$ 9 section         
#ahai7;b77#e77;,g77 & community heal?   
work]s 7z def9$ 9 section               
#baac7;f77#d774  7,b7 ,phas$-9          
implem5tation2 public availability (    
in=mation ,! ,secret>y %all--  7i7      
phase-9 implem5tation ( ! collection (  
in=mation 9 accordance ) subp>agraph    
7,a7 ov] a #c-ye> p]iod1 9 su* mann] z !
 ,secret>y det]m9es appropriate 9 ord]  
to m9imize any adv]se impact on ! lic5s$
 heal? pr(essionals provid+ su*         
in=mation2 &  7ii7 make su* in=mation   
collect$ available to ! public & updat$ 
at lea/ annually dur+ ! phase-9 p]iod4  
7#b7 ,social det]m9ants ( heal? ,!      
in=mation collect$ 9 accordance )       
p>agraph 7#a7 %all include 7b is n      

limit$ to7 ! foll[+ possible social     
det]m9ants ( heal?1 z id5tifi$ 9 !      
,,icd-#aj diagno/ic codes ,z#ee ?r\gh   
,z#fe 7or any su* successor diagno/ic   
codes73 7,a7 ,problems relat$ to        
education & lit]acy4  7,b7 ,employm5t & 
unemploym5t4  7,c7 ,occupations exposure
 risk factors4  7,d7 ,problems relat$ to
 h\s+ & economic circum/ances4  7,e7    
,problems relat$ to social environm5ts4 
7,f7 ,problems relat$ to upbr++4  7,g7  
,problems relat$ to family circum/ances1
 includ+ prim>y support gr\ps4  7,h7    
,psy*osocial circum/ances result+ f     
pregnancy4  7,i7 ,conviction 9 civil or 
crim9al proce$+s4  4  7b7 ,report on    
data analyses ,section #ahji7;b77#b7 (  
su* ,act 7#db ,u4,s4,c4                 
#acie;b-#aj7;b77#b77 is am5d$-- 7#a7 by 
/rik+ ,n lat] ?an & ins]t+ ! foll[+3    
7,a7 ,initial reports ,n lat] ?an  2 &  
7#b7 by add+ at ! end ! foll[+3  7,b7   
,reports on collection ( in=mation      
relat$ to social det]m9ants ( heal? ,n  
lat] ?an #e ye>s aft] ! date ( !        

enactm5t ( ?is subp>agraph1 ! ,secret>y 
%all submit to ,congress a report t     
includes aggregate f9d+s & tr5ds across 
respective b5efici>y populations =      
improv+ ! id5tification ( heal? c>e     
disp>ities = b5efici>ies "u ?is title   
bas$ on analyses ( ! data collect$ "u   
subsection 7d74  4  #c4 ,collection (   
in=mation relat$ to social det]m9ants ( 
! heal? ( ,m$icaid & ,,*ip b5efici>ies  
7a7 ,report+ ( in=mation ,section #aidf 
( ! ,social ,security ,act 7#db         
,u4,s4,c4 #acifw-#e7 is am5d$ by add+ at
 ! end ! foll[+3  7d7 ,collection (     
in=mation relat$ to social det]m9ants ( 
heal?  7#a7 ,developm5t ( model uni=m   
report+ field  7,a7 ,9 g5]al ,n lat] ?an
 ,octob] #a1 #bjbj1 ! ,secret>y %all1 9 
consultation ) ! ,/ates1 develop & make 
available to ! ,/ates a model uni=m     
report+ field t ,/ates may use =        
purposes ( report+ to ! ,secret>y ?r\gh 
! ,trans=m$ ,m$icaid ,/ati/ical         
,in=mation ,sy/em 7,t-,,msis7 7or a     
successor sy/em7 in=mation relat$ to    

social det]m9ants t may factor into !   
heal? ( b5efici>ies "u ?is title &      
b5efici>ies "u title ,,xxi & be collect$
 f lic5s$ heal? pr(essionals 7z def9$ 9 
section #aiai7;b77#e77;,g77 & community 
heal? work]s 7z def9$ 9 section         
#baac7;f77#d774  7,b7 ,phas$-9          
implem5tation2 public availability (    
in=mation ,! ,secret>y %all--  7i7      
phase-9 implem5tation ( ! collection (  
in=mation 9 accordance ) subp>agraph    
7,a7 ov] a #c-ye> p]iod1 9 su* mann] z !
 ,secret>y det]m9es appropriate 9 ord]  
to m9imize any adv]se impact on ! lic5s$
 heal? pr(essionals & community heal?   
work]s provid+ su* in=mation2 &  7ii7   
make su* in=mation collect$ available to
 ! public & updat$ at lea/ annually dur+
 ! phase-9 p]iod4  7#b7 ,social         
det]m9ants ( heal? ,! in=mation collect$
 9 accordance ) p>agraph 7#a7 %all      
include 7b is n limit$ to7 ! foll[+     
possible social det]m9ants ( heal?1 z   
id5tifi$ 9 ! ,,icd-#aj diagno/ic codes  
,z#ee ?r\gh ,z#fe 7or any su* successor 

diagno/ic codes73 7,a7 ,problems relat$ 
to education & lit]acy4  7,b7 ,employm5t
 & unemploym5t4  7,c7 ,occupations      
exposure risk factors4  7,d7 ,problems  
relat$ to h\s+ & economic circum/ances4 
7,e7 ,problems relat$ to social         
environm5ts4  7,f7 ,problems relat$ to  
upbr++ & family circum/ances includ+    
prim>y support gr\ps4  7,g7 ,psy*osocial
 circum/ances result+ f pregnancy4  7,h7
 ,conviction 9 civil or crim9al         
proce$+s4  4  7b7 ,report on data       
analyses ,section #aidf7;b77#b7 ( su*   
,act 7#db ,u4,s4,c4 #acifw-#e7;b77#b77  
is am5d$--  7#a7 by /rik+ ,n lat] ?an & 
ins]t+ ! foll[+3  7,a7 ,initial reports 
,n lat] ?an  2 &  7#b7 by add+ at ! end 
! foll[+3  7,b7 ,reports on collection (
 in=mation relat$ to social det]m9ants (
 heal? ,n lat] ?an #e ye>s aft] ! date (
 ! enactm5t ( ?is subp>agraph1 !        
,secret>y %all submit to ,congress a    
report t includes aggregate f9d+s &     
tr5ds across respective b5efici>y       
populations = improv+ ! id5tification ( 

heal? c>e disp>ities = b5efici>ies "u   
?is title & b5efici>ies "u title ,,xxi  
bas$ on analyses ( ! data collect$ "u   
subsection 7d74  4  #d4 ,collection (   
in=mation relat$ to social det]m9ants ( 
! heal? ( individuals receiv+ c>e ?r\gh 
heal? c5t]s ,"p ,a ( title ,,iii ( !    
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bda et seq47 is am5d$ by add+
 at ! end ! foll[+3  #caj;,b4           
,collection ( in=mation relat$ to social
 det]m9ants ( heal?  7a7 ,9 g5]al  7#a7 
,9 g5]al ,n lat] ?an ,octob] #a1 #bjbj1 
! ,secret>y1 act+ ?r\gh ! ,adm9i/rator (
 ! ,heal? ,res\rces & ,s]vices          
,adm9i/ration1 %all promulgate          
regulations to all[ = ! collection (    
in=mation relat$ to social det]m9ants t 
may factor into ! heal? ( individuals   
receiv+ s]vices at f$]ally qualifi$     
heal? c5t]s 7z def9$ 9 section          
#ahfa7;aa77#d7 ( ! ,social ,security    
,act74 ,su* regulations %all all[ = !   
collection ( su* in=mation f lic5s$     
heal? pr(essionals 7z def9$ 9 section   

#aiai7;b77#e77;,g7 ( ! ,social ,security
 ,act7 & community heal? work]s 7z def9$
 9 section #baac7;f77#d7 ( ! ,social    
,security ,act7 provid+ s]vices at su*  
heal? c5t]s4  7#b7 ,phas$-9             
implem5tation2 public availability (    
in=mation ,! ,secret>y %all-- 7,a7      
phase-9 implem5tation ( ! collection (  
in=mation 9 accordance ) p>agraph 7#a7  
ov] a #c-ye> p]iod1 9 su* mann] z !     
,secret>y det]m9es appropriate 9 ord] to
 m9imize any adv]se impact on ! lic5s$  
heal? pr(essionals & community heal?    
work]s provid+ su* in=mation2 &  7,b7   
make su* in=mation collect$ available to
 ! public & updat$ at lea/ annually dur+
 ! phase-9 p]iod4  7b7 ,social          
det]m9ants ( heal? ,! in=mation collect$
 9 accordance ) subsection 7a7 %all     
include 7b is n limit$ to7 ! foll[+     
possible social det]m9ants ( heal?1 z   
id5tifi$ 9 ! ,,icd-#aj diagno/ic codes  
,z#ee ?r\gh ,z#fe 7or any su* successor 
diagno/ic codes73  7#a7 ,problems relat$
 to education & lit]acy4  7#b7          

,employm5t & unemploym5t4  7#c7         
,occupations exposure risk factors4     
7#d7 ,problems relat$ to h\s+ & economic
 circum/ances4  7#e7 ,problems relat$ to
 social environm5ts4  7#f7 ,problems    
relat$ to upbr++4  7#g7 ,problems relat$
 to family circum/ances1 includ+ prim>y 
support gr\ps4  7#h7 ,psy*osocial       
circum/ances result+ f pregnancy4  7#i7 
,conviction 9 civil or crim9al proce$+s4
  7c7 ,reports on collection ( in=mation
 relat$ to social det]m9ants ( heal? ,n 
lat] ?an #e ye>s aft] ! date ( !        
enactm5t ( ?is section1 ! ,secret>y %all
 submit to ,congress a report t includes
 aggregate f9d+s & tr5ds across         
respective pati5t populations = improv+ 
! id5tification ( heal? c>e disp>ities =
 individuals receiv+ heal? s]vices at   
f$]ally qualifi$ heal? c5t]s bas$ on    
analyses ( ! data collect$ "u subsection
 7a74  4