,,ii  #aahth ,,congress  #b;d ,session  
,s4 #eahb  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,september #be1
 #bjbd,mr4 ,sullivan 7for himself and   
,ms4 ,cortez ,masto7 introduced the     
following bill2 which was read twice and
 referred to the ,committee on ,finance 
,a ,,bill  ,to amend title ,,xix of the 
,social ,security ,act to require the   
collection of information regarding     
social determinants of health1 and for  
other purposes4  #a4 ,short title ,this 
,act may be cited as the ,utilizing     
,national ,data1 ,effectively ,reforming
 ,standards and ,tools1 to ,address     
,negative ,determinates of ,health ,act 
or the ,,understand ,act4  #b4          
,collection of information related to   
social determinants of the health of    
,medicaid and ,,chip beneficiaries  7a7 
,reporting of information ,section #aidf
 of the ,social ,security ,act 7#db     
,u4,s4,c4 #acifw-#e7 is amended by      
adding at the end the following3  7d7   
,collection of information related to   

social determinants of health  7#a7     
,development of uniform reporting field 
7,a7 ,in general ,not later than #ah    
months after the date of enactment of   
this subsection1 the ,secretary1 in     
consultation with the ,states1 shall    
develop a model uniform reporting field 
through the transformed ,medicaid       
,statistical ,information ,system       
7,t-,,msis71 as approved by the         
,secretary1 for collecting standardized 
and aggregated ,state-level information 
related to social determinants that may 
factor into the health of beneficiaries 
under this title who are eligible for   
medical assistance for which ,federal   
financial participation is available and
 beneficiaries under title ,,xxi who are
 eligible for child health assistance   
for which ,federal financial            
participation is available which the    
,states1 notwithstanding section        
#aijb7;a77#g7 and as a condition for    
meeting the requirements of section     
#aijb7;a77#f7 and section #bajg7;b77#a71

 shall use to annually report such      
information4  7,b7 ,implementation ,in  
carrying out the requirements of        
subparagraph 7,a71 the ,secretary       
shall-- 7i7 determine the appropriate   
providers and frequency with which such 
providers may submit standardized       
information to ,states to be used to    
complete the uniform reporting field    
developed under such subparagraph2  7ii7
 issue guidance for ensuring compliance 
with applicable laws regarding          
beneficiary informed consent1 privacy1  
and anonymity with respect to the       
information collected through the       
uniform reporting field2  7iii7 with    
respect to the collection of information
 relating to beneficiaries who are      
children1 issue guidance on the         
collection of such information from a   
parent1 legal guardian1 or any other    
person who is legally authorized to     
share such information on behalf of the 
child when the direct collection of such
 information from children may not      

otherwise be feasible or appropriate2   
and  7iv7 issue guidance on how to      
reduce duplicative screenings of        
beneficiaries1 or to ensure that        
information collected from a screening  
is entered into a beneficiary's health  
record so that other providers who treat
 that beneficiary can see that a        
screening has been conducted for that   
beneficiary4  7#b7 ,social determinants 
of health defined  7,a7 ,in general ,for
 purposes of this title and title ,,xxi1
 the term social determinants of health 
means the standardized definitions      
developed in accordance with paragraph  
7#a7 for identifying social determinants
 of health needs identified in the      
,,icd-#aj diagnostic codes ,z#ee through
 ,z#fc1 ,z#fe1 and ,z#ge 7as in effect  
on the date of enactment of this        
subsection74  7,b7 ,incorporation       
measures of relative severity ,the      
,secretary shall issue guidance relating
 to incorporating measures for          
quantifying1 with respect to an         

individual1 the relative severity of a  
social determinant of health need of the
 individual as identified by a          
diagnostic code referred to in          
subparagraph 7,a74  7#c7 ,rules of      
construction  7,a7 ,federal privacy     
requirements ,nothing in this subsection
 shall be construed to supersede any    
,federal privacy or confidentiality     
requirement1 including the regulations  
promulgated under section #bfd7;c7 of   
the ,health ,insurance ,portability and 
,accountability ,act of #aiif and       
section #edc of the ,public ,health     
,service ,act and any regulations       
promulgated thereunder4  7,b7 ,no       
requirement for the provision of medical
 assistance ,nothing in this subsection 
shall be construed as allowing for      
medical assistance for items and        
services for which ,federal financial   
participation is not permitted under    
this title4  7#d7 ,state requirement to 
collect information from providers ,as a
 condition for meeting the requirements 

of section #aijb7;a77#f7 and section    
#bajg7;b77#a71 a ,state shall ensure    
that the providers identified by the    
,secretary under paragraph 7#a77;,b77i7 
are conducting screenings for social    
needs and submitting standardized       
information with appropriate frequency  
7as identified by the ,secretary under  
such paragraph74  7#e7 ,application to  
territories  7,a7 ,in general ,to the   
extent that the ,secretary determines   
that it is not practicable for a ,state 
specified in subparagraph 7,b7 to report
 information in accordance with the     
uniform reporting field made available  
under paragraph 7#a71 this subsection   
shall not apply with respect to such    
,state4  7,b7 ,territories specified    
,the ,states specified in this          
subparagraph are ,puerto ,rico1 the     
,virgin ,islands1 ,guam1 ,american      
,samoa1 and the ,northern ,mariana      
,islands4  4  7b7 ,report ,section      
#aidf7;b77#b7 of such ,act 7#db         
,u4,s4,c4 #acifw-#e7;b77#b77 is         

amended-- 7#a7 by striking ,not later   
than and inserting the following3  7,a7 
,initial reports ,not later than  2 and 
7#b7 by adding at the end the following3
  7,b7 ,report on collection of         
information related to social           
determinants of health ,not later than  
#d years after the date of the enactment
 of this subparagraph1 the ,secretary   
shall submit to ,congress a report that 
includes aggregate findings and trends  
across respective beneficiary           
populations for improving the           
identification of social determinants of
 health for beneficiaries under this    
title who are eligible for medical      
assistance for which ,federal financial 
participation is available and          
beneficiaries under title ,,xxi who are 
eligible for child health assistance for
 which ,federal financial participation 
is available based on analyses of the   
data collected under subsection 7d74  4