,i  #aag? ,,congress  #b;d ,session  ,h4
 ,r4 #iccf  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,novemb] #ag1         
#bjbb,mr4 ,higg9s ( ,new ,york 7=       
himself & ,ms4 ,ca/or ( ,florida7       
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce1 & 9 
addition to ! ,committee on ,ways &     
,means1 = a p]iod to be subsequ5tly     
det]m9$ by ! ,speak]1 9 ea* case =      
consid]ation ( su* provisions z fall )9 
! jurisdiction ( ! committee conc]n$  ,a
 ,,bill  ,to am5d title ,,xix ( !       
,social ,security ,act to require       
cov]age "u ,/ate plans "u ! ,m$icaid    
program = annual lung canc] scre5+ ) no 
co/ %>+ = individuals = :om scre5+ is   
recomm5d$ by ,u4,s4 ,prev5tive ,s]vices 
,task ,=ce guidel9es1 to exp& cov]age "u
 ,m$icaid ( c\nsel+ & ph>maco!rapy =    
cessation ( tobacco use1 & = o!r        
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,increas+ ,access to ,lung 
,canc] ,scre5+ ,act4  #b4 ,m$icaid      
cov]age ( annual lung canc] scre5+ ) no 

co/ %>+ = individuals = :om scre5+ is   
recomm5d$ by ,u4,s4 ,prev5tive ,s]vices 
,task ,=ce guidel9es  7a7 ,9 g5]al      
,section #aije7;a77#d7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#acif;d7a77#d77 is am5d$-- 7#a7 by /rik+
 & be=e 7,f72 &  7#b7 by ins]t+ be=e !  
semicolon at ! end ! foll[+3 2 & 7,g7 an
 annual lung canc] scre5+ = individuals 
:o are eligible "u ! plan & = :om scre5+
 is recomm5d$ by ! ,u4,s4 ,prev5tive    
,s]vices ,task ,=ce guidel9es1 )\t reg>d
 to prior au?orization4  7b7 ,no co/ %>+
  7#a7 ,9 g5]al ,subsections 7a77#b7 &  
7b77#b7 ( section #aiaf ( ! ,social     
,security ,act 7#db ,u4,s4,c4 #acifo7   
are ea* am5d$-- 7,a7 9 subp>agraph 7,g71
 by add+ at ! end 1 or2 &  7,b7 by add+ 
at ! end ! foll[+ new subp>agraph3  7,h7
 lung canc] scre5+ = :i* paym5t may be  
made "u ! ,/ate plan pursuant section to
 #aije7;a77#d77;,g72  4  7#b7           
,application to alt]native co/ %>+      
,section #aiaf;,a7b77#c77;,b7 ( !       
,social ,security ,act 7#db ,u4,s4,c4   

#acifo-#a7;b77#c77;,b77 is am5d$ by add+
 at ! end ! foll[+ new clause3  7xiv7   
,lung canc] scre5+ = :i* paym5t may be  
made "u ! ,/ate plan pursuant to section
 #aije7;a77#d77;,g74  4  7c7            
,application to ,m$icaid manag$ c>e     
organizations ,section #aicb7;b7 ( !    
,social ,security ,act 7#db ,u4,s4,c4   
#acifu-#b7;b77 is am5d$ by add+ at ! end
 ! foll[+ new p>agraph3  7#i7 ,lung     
canc] scre5+ ,ea* contract ) a m$icaid  
manag$ c>e organization "u section      
#aijc7m7 %all require ! organization to 
provide cov]age = lung canc] scre5+ =   
:i* paym5t may be made "u ! ,/ate plan  
pursuant to section #aije7;a77#d77;,g7  
)\t reg>d to prior au?orization4  4  7d7
 ,effective date  7#a7 ,9 g5]al ,subject
 to p>agraph 7#b71 ! am5dm5ts made by   
?is section %all apply ) respect to     
items & s]vices furni%$ on or aft]      
,janu>y #a1 #bjbc4  7#b7 ,exception if  
,/ate legislation requir$ ,9 ! case ( a 
,/ate plan = m$ical assi/ance "u title  
,,xix ( ! ,social ,security ,act :i* !  

,secret>y ( ,heal? & ,human ,s]vices    
det]m9es requires ,/ate legislation 7o!r
 ?an legislation appropriat+ funds7 9   
ord] = ! plan to meet ! additional      
requirem5ts impos$ by ! am5dm5ts made by
 ?is section1 ! ,/ate plan %all n be    
reg>d$ z fail+ to comply ) ! requirem5ts
 ( su* title solely on ! basis ( its    
failure to meet su* additional          
requirem5ts be=e ! fir/ day ( ! fir/    
cal5d> qu>t] beg9n+ aft] ! close ( !    
fir/ regul> session ( ! ,/ate           
legislature t beg9s aft] ! date ( !     
enactm5t ( ?is ,act4 ,= purposes ( !    
previ\s s5t5ce1 9 ! case ( a ,/ate t has
 a #b-ye> legislative session1 ea* ye> (
 su* session %all be deem$ to be a      
sep>ate regul> session ( ! ,/ate        
legislature4  #c4 ,exp&+ cov]age "u     
,m$icaid ( ,c\nsel+ & ,ph>maco!rapy =   
,cessation ( ,tobacco ,use to all       
,m$icaid individuals  7a7 ,9 g5]al      
,section #aije ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acif;d7 is am5d$-- 
7#a7 9 subsection 7a77#d77;,d7-- 7,a7 by

 /rik+ by pregnant wom52 &  7,b7 by     
ins]t+ )\t reg>d to prior au?orization  
aft] 7z def9$ 9 subsection 7bb772 &     
7#b7 9 subsection 7bb7-- 7,a7 9 p>agraph
 7#a7-- 7i7 by /rik+ ! fir/ place x     
appe>s by pregnant wom52 &  7ii7 by     
/rik+ by pregnant wom5 :o & ins]t+ by   
individuals :o2  7,b7 9 p>agraph        
7#b77;,a71 by /rik+ ) respect to        
pregnant wom52 &  7,c7 9 p>agraph       
7#b77;,b71 by /rik+ by pregnant wom54   
7b7 ,con=m+ am5dm5ts  7#a7 ,section     
#aibg7;d77#b77;,f7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#acifr-#h7;d77#b77;,f77 is am5d$ by     
/rik+ 1 9 ! case ( pregnant wom54  7#b7 
,section #aiaf ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acifo71 z am5d$ by 
section #a1 is fur!r am5d$-- 7,a7 9 ea* 
( subsections 7a77#b7 & 7b77#b7-- 7i7 9 
subp>agraph 7,b71 by /rik+ 1 & c\nsel+ &
 ph>maco!rapy = cessation ( tobacco use 
by pregnant wom5 7z def9$ 9 section     
#aije7;bb77 & cov]$ outpati5t drugs 7z  
def9$ 9 subsection 7k77#b7 ( section    

#aibg & includ+ nonprescription drugs   
describ$ 9 subsection 7d77#b7 ( su*     
section7 t are prescrib$ = purposes (   
promot+1 & :5 us$ to promote1 tobacco   
cessation by pregnant wom5 9 accordance 
) ! ,guidel9e ref]r$ to 9 section       
#aije7;bb77#b77;,a72  7ii7 9 subp>agraph
 7,h71 at ! end by add+ or2 &  7iii7 by 
add+ at ! end ! foll[+ new subp>agraph3 
7,i7 c\nsel+ & ph>maco!rapy = cessation 
( tobacco use 7z def9$ 9 section        
#aije7;bb77 & cov]$ outpati5t drugs 7z  
def9$ 9 subsection 7k77#b7 ( section    
#aibg & includ+ nonprescription drugs   
describ$ 9 subsection 7d77#b7 ( su*     
section7 t are prescrib$ = purposes (   
promot+1 & :5 us$ to promote1 tobacco   
cessation 9 accordance ) ! ,guidel9e    
ref]r$ to 9 section #aije7;bb77#b77;,a72
 &  4  7#c7 ,section                    
#aiaf;,a7b77#c77;,b7 ( su* ,act 7#db    
,u4,s4,c4 #acifo-#a7;b77#c77;,b771 z    
am5d$ by section #a1 is fur!r am5d$--   
7,a7 9 clause 7iii71 by /rik+ 1 &       
c\nsel+ & ph>maco!rapy = cessation (    

tobacco use by pregnant wom5 7z def9$ 9 
section #aije7;bb772 &  7,b7 by add+ at 
! end ! foll[+ new clause3  7xv7        
,c\nsel+ & ph>maco!rapy = cessation (   
tobacco use 7z def9$ 9 section          
#aije7;bb774  4  7c7 ,application to    
,m$icaid manag$ c>e organizations       
,section #aicb7;b7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #acifu-#b7;b771 z  
am5d$ by section #a1 is fur!r am5d$ by  
add+ at ! end ! foll[+ new p>agraph3    
7#aj7 ,cessation ( ,tobacco ,use ,ea*   
contract ) a m$icaid manag$ c>e         
organization "u section #aijc7m7 %all   
require ! organization to provide       
cov]age = c\nsel+ & ph>maco!rapy =      
cessation ( tobacco use )\t reg>d to    
prior au?orization4  4  7d7 ,effective  
date  7#a7 ,9 g5]al ,subject to p>agraph
 7#b71 ! am5dm5ts made by ?is section   
%all apply ) respect to items & s]vices 
furni%$ on or aft] ,janu>y #a1 #bjbc4   
7#b7 ,exception if ,/ate legislation    
requir$ ,9 ! case ( a ,/ate plan =      
m$ical assi/ance "u title ,,xix ( !     

,social ,security ,act :i* ! ,secret>y (
 ,heal? & ,human ,s]vices det]m9es      
requires ,/ate legislation 7o!r ?an     
legislation appropriat+ funds7 9 ord] = 
! plan to meet ! additional requirem5ts 
impos$ by ! am5dm5ts made by ?is        
section1 ! ,/ate plan %all n be reg>d$ z
 fail+ to comply ) ! requirem5ts ( su*  
title solely on ! basis ( its failure to
 meet su* additional requirem5ts be=e ! 
fir/ day ( ! fir/ cal5d> qu>t] beg9n+   
aft] ! close ( ! fir/ regul> session ( !
 ,/ate legislature t beg9s aft] ! date (
 ! enactm5t ( ?is ,act4 ,= purposes ( ! 
previ\s s5t5ce1 9 ! case ( a ,/ate t has
 a #b-ye> legislative session1 ea* ye> (
 su* session %all be deem$ to be a      
sep>ate regul> session ( ! ,/ate        
legislature4  #d4 ,cov]age "u ,m$ic>e & 
private heal? insurance ( annual lung   
canc] scre5+ )\t utilization managem5t  
requirem5ts  7a7 ,m$ic>e  7#a7 ,9 g5]al 
,section #ahcd ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #aciem7 is am5d$ by 
add+ at ! end ! foll[+ new subsection3  

7z7 ,special rule = annual lung canc]   
scre5+ ,not)/&+ any o!r provision ( ?is 
title1 9 ! case ( an annual lung canc]  
scre5+ = :i* b5efits are provid$ "u ?is 
"p = any individual = :om su* scre5+ is 
recomm5d$ 9 accordance ) guidel9es issu$
 by ! ,secret>y1 su* b5efits %all be    
provid$ )\t application ( any prior     
au?orization4  4  7#b7 ,application "u  
,m$ic>e ,advantage ,section             
#aheb7;a77#a77;,b7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#aciew-#bb7;a77#a77;,b77 is am5d$ by    
add+ at ! end ! foll[+ new clause3      
7vii7 ,prohibition ( application ( c]ta9
 requirem5ts = annual lung canc] scre5+ 
,9 ! case ( an annual lung canc] scre5+ 
= :i* b5efits are provid$ "u "p ,b = any
 individual = :om su* scre5+ is         
recomm5d$ 9 accordance ) guidel9es issu$
 by ! ,secret>y = purposes ( section    
#ahcd7z71 an ,,ma plan may n impose any 
prior au?orization ) respect to !       
cov]age ( su* scre5+ "u su* plan4  4    
7#c7 ,effective date ,! am5dm5ts made by

 ?is subsection %all apply ) respect to 
s]vices furni%$ on or aft] ,janu>y #a1  
#bjbc4  7b7 ,individual & gr\p heal?    
insurance m>kets  7#a7 ,9 g5]al ,section
 #bgac ( ! ,public ,heal? ,s]vice ,act  
7#db ,u4,s4,c4 #cjj;gg-7#c77 is am5d$ by
 add+ at ! end ! foll[+ new subsection3 
7d7 ,prohibition ( application ( c]ta9  
requirem5ts = annual lung canc] scre5+  
,a gr\p heal? plan & a heal? insurance  
issu] (f]+ gr\p or individual heal?     
insurance cov]age may n impose any prior
 au?orization ) respect to ! b5efits "u 
su* plan or cov]age = an annual lung    
canc] scre5+ = any individual = :om su* 
scre5+ is recomm5d$ by ! ,unit$ ,/ates  
,prev5tive ,s]vices ,task ,=ce4  4  7#b7
 ,effective date ,! am5dm5ts made by ?is
 subsection %all apply ) respect to plan
 ye>s beg9n+ on or aft] ,janu>y #a1     
#bjbc4