,,ii #aafth ,,congress #ast ,session ,s4 #caaf ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,december #ai1 #bjai,ms4 ,collins 7for herself1 ,mr4 ,jones1 ,ms4 ,mc,sally1 and ,mr4 ,menendez7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to enable ,states to better provide access to whole genome sequencing clinical services for certain undiagnosed children under the ,medicaid program1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,ending the ,diagnostic ,odyssey ,act of #bjai4 #b4 ,state option to provide whole genome sequencing clinical services for certain children ,title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 is amended by inserting after section #aidf the following new section3 #aidg4 ,state option to provide whole genome sequencing clinical services for certain children 7a7 ,in general ,notwithstanding section #aijb7;a77#a7 7relating to statewideness71 section #aijb7;a77#aj77;,b7 7relating to comparability71 and any other provision of this title which the ,secretary determines is necessary to waive in order to implement this section1 beginning ,january #a1 #bjbj1 a ,state1 at its option as a ,state plan amendment1 may provide for medical assistance under this title to an eligible individual for purposes of providing the individual with whole genome sequencing clinical services4 7b7 ,payments 7#a7 ,in general ,a ,state shall provide a health care provider 7as defined by the ,state7 with payments for the provision of whole genome sequencing clinical services to any eligible individual4 ,payments made to a health care provider for such services shall be treated as medical assistance for purposes of section #aijc7;a71 except that1 during the first #ab fiscal year quarters that the ,state plan amendment is in effect1 the ,federal medical assistance percentage applicable to such payments shall be equal to #ge percent4 7#b7 ,methodology ,the ,state shall specify in the ,state plan amendment the methodology the ,state will use for determining payment for the provision of whole genome sequencing clinical services4 ,such methodology for determining payment shall be established consistent with section #aijb7;a77#cj77;,a74 7#c7 ,planning grants 7,a7 ,in general ,beginning ,january #a1 #bjbj1 the ,secretary may award planning grants to ,states for purposes of developing a ,state plan amendment under this section4 ,a planning grant awarded to a ,state under this paragraph shall remain available until expended4 7,b7 ,state contribution ,a ,state awarded a planning grant shall contribute an amount equal to the ,state percentage determined under section #aije7;b7 for each fiscal year for which the grant is awarded4 7c7 ,hospital referrals ,a ,state shall include in the ,state plan amendment a requirement for any hospital that is a participating provider under the ,state plan 7or a waiver of such plan7 to establish procedures for referring any eligible individual who seeks or needs treatment in a hospital emergency department to a health care provider who is qualified 7as determined by the ,state7 to provide whole genome sequencing clinical services4 7d7 ,reports by ,states ,not later than #c years after the date on which a ,state plan amendment under this section is approved1 the ,state shall submit a report to the ,administrator of the ,centers for ,medicare ,medicaid ,services and the ,administrator of the ,health ,resources and ,services ,administration on-- 7#a7 the extent to which whole genome sequencing clinical services reduce health disparities2 and 7#b7 the extent to which coverage under the ,state plan 7or a waiver of such plan7 impedes the use of genetic and genomic testing that may improve clinical outcomes for eligible individuals enrolled in the ,state plan 7or under a waiver of such plan74 7e7 ,reports by health care providers ,each ,state that provides medical assistance for whole genome sequencing clinical services under this section shall require that1 as a condition for receiving payment for whole genome sequencing clinical services provided to an eligible individual1 a health care provider shall report to the ,state1 in accordance with such requirements as the ,secretary shall specify1 on all applicable measures for determining the quality of such services4 7f7 ,definitions ,in this section3 7#a7 ,eligible individual ,the term eligible individual means an individual-- 7,a7 who is eligible for medical assistance under the ,state plan 7or a waiver of such plan72 7,b7 who is under the age of #ba 7or1 at the option of the ,state1 under the age of #bj1 #ai1 or #ah as the ,state may choose71 or in the case of an individual described in section #aijb7;a77#aj77;,a77i77,,ix71 under the age of #bf2 and 7,c7 who-- 7i7 has been referred or admitted to an intensive care unit1 or has been seen by at least #a medical specialist1 for a suspected genetic or undiagnosed disease2 or 7ii7 is suspected by at least #a medical specialist to have a neonatal- or pediatric-onset genetic disease4 7#b7 ,whole genome sequencing clinical services ,the term whole genome sequencing clinical services1 with respect to an eligible individual-- 7,a7 means the unbiased sequencing of all deoxyribonucleic acid bases in the genome of such individual and1 if for the sole benefit of the individual1 a biological parent of such individual for the purpose of determining whether one or more potentially disease-causing genetic variants are present in the genome of such individual or such biological parent2 and 7,b7 includes any analysis1 interpretation1 and data report derived from such sequencing4 4