,i #aai? ,,congress #a/ ,session ,h4 ,r4 #fagh ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,novemb] #bj1 #bjbe,ms4 ,ca/or ( ,florida 7= h]self1 ,mr4 ,fitzpatrick1 & ,ms4 ,wass]man ,s*ultz7 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$icaid cov]age ( annual lung canc] scre5+ ) no co/ %>+ = c]ta9 individuals 7a7 ,9 g5]al ,section #aije7;a77#d7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a77#d77 is am5d$-- 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 su* scre5+ is recomm5d$ "u guidel9es publi%$ by ! ,unit$ ,/ates ,prev5tive ,s]vices ,task ,=ce1 )\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 #bjbf4 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$ 9 ea* ( subsections 7a77#b7 & 7b77#b7-- 7,a7 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 7,b7 9 subp>agraph 7,h71 at ! end by add+ or2 & 7,c7 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 #bjbf4 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 #bjbf4 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 #bjbf4 #e4 ,lung canc] scre5+ education & outrea* 7a7 ,9 g5]al ,! ,secret>y ( ,heal? & ,human ,s]vices 79 ?is section ref]r$ to z ! ,secret>y71 9 consultation ) pati5t & lung canc] advocacy gr\ps1 %all conduct an education & outrea* campaign = purposes ( in=m+ individuals & heal? c>e provid]s (-- 7#a7 ! importance ( lung canc] scre5+s2 & 7#b7 ! categories ( individuals :o %\ld receive su* scre5+s4 7b7 ,mann] ( outrea* ,! ,secret>y may c>ry out ! campaign describ$ 9 subsection 7a7 directly1 by contract1 ?r\gh ! issuance ( grants1 or o!rwise4 ,9 c>ry+ out su* campaign1 ! ,secret>y %all ensure t ! campaign is t>get$ to rea* individuals at high risk ( lung canc]4 7c7 ,fund+ ,!re are au?oriz$ to be appropriat$ #aj1jjj1jjj = ea* ( fiscal ye>s #bjbf ?r\gh #bjcj = purposes ( c>ry+ out ?is section4 #f4 ,report ,n lat] ?an #a ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all conduct a /udy & submit to ,congress a report on ! demographics ( individuals diagnos$ ) lung canc] & individuals scre5$ = su* canc]4 ,su* report %all id5tify-- 7#a7 any segm5ts ( ! population diagnos$ ) lung canc] b n captur$ 9 curr5t scre5+ eligibility guidel9es 7su* z firefight]s1 vet]ans1 & wom5 "u #ej ye>s ( age72 & 7#b7 actions ! ,f$]al ,gov]nm5t c\ld take to improve scre5+ = su* canc] among su* segm5ts4