,i  #aai? ,,congress  #b;d ,session  ,h4
 ,r4 #hbfj  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,april #ad1 #bjbf,mrs4
 ,*]filus-,mc,cormick 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 ,,xxvii ( ! ,public ,heal? ,s]vice
 ,act & titles ,,xviii & ,,xix ( !      
,social ,security ,act to require       
cov]age ( c]ta9 c>diovascul> te/s )\t   
co/ %>+ "u gr\p heal? plans1 gr\p &     
individual heal? insurance cov]age1 & ! 
,m$ic>e & ,m$icaid programs4  #a4 ,%ort 
title ,?is ,act may be cit$ z !         
,c>diovascul> ,disease ,e>ly ,detection 
& ,prev5tion ,act ( #bjbf4  #b4 ,f9d+s  
,congress f9ds ! foll[+3  7#a7          
,c>diovascul> disease is ! lead+ cause (
 dea? 9 ! ,unit$ ,/ates4  7#b7 ,r\t9e   
*ole/]ol panels (t5 fail to detect      

elevat$ ,lipoprote97a7 7,lp7a77 &       
,apolipoprote9 ,b 7,apo,b7 levels4  7#c7
 ,approximately #a 9 #e ,am]icans h     
elevat$ ,lp7a7 levels4  7#d7 ,elevat$   
,apo,b levels pr$ict c>diovascul> risk  
bett] ?an ,,ldl *ole/]ol alone4  7#e7   
,ne>ly #ej p]c5t ( he>t attack survivors
 die )9 five ye>s )\t effective risk    
managem5t4  #c4 ,requir+ cov]age ( c]ta9
 c>diovascul> te/s )\t co/ %>+ "u gr\p  
heal? plans1 gr\p & individual heal?    
insurance cov]age1 & ! ,m$ic>e &        
,m$icaid programs  7a7 ,public ,heal?   
,s]vice ,act ,section #bgac7;a7 ( !     
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #cjj;gg-#ac7;a77 is am5d$--   
7#a7 9 p>agraph 7#b71 by /rik+ & at !   
end2  7#b7 9 p>agraph 7#c71 by /rik+ !  
p]iod & ins]t+ a semicolon2  7#c7 by    
r$esignat+ p>agraphs 7#d7 & 7#e7 z      
p>agraphs 7#e7 & 7#f71 respectively2 &  
7#d7 by ins]t+ aft] p>agraph 7#c7 !     
foll[+ new p>agraph3  7#d7 ) respect to 
individuals ) a family hi/ory (         
premature c>diovascul> disease1 a       

p]sonal hi/ory ( myoc>dial inf>ction1   
/roke1 or elevat$ ,,ldl *ole/]ol1 a     
diagnosis ( diabetes mellitus or        
obesity1 or o!r recogniz$ c>diovascul>  
risk factors1 te/+ = lipoprote97a7 &    
apolipoprote9 ,b levels2 &  4  7b7      
,m$ic>e  7#a7 ,9 g5]al ,section         
#ahfa7xx77#a7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #aciex7xx77#a77 is      
am5d$-- 7,a7 by r$esignat+ subp>agraph  
7,b7 z subp>agraph 7,c72  7,b7 by ins]t+
 aft] subp>agraph 7,a7 ! foll[+ new     
subp>agraph3  7,b7 ,9 ! case ( an       
individual ) a family hi/ory ( premature
 c>diovascul> disease1 a p]sonal hi/ory 
( myoc>dial inf>ction1 /roke1 or elevat$
 ,,ldl *ole/]ol1 a diagnosis ( diabetes 
mellitus or obesity1 or o!r recogniz$   
c>diovascul> risk factors1 lipoprote97a7
 & apolipoprote9 ,b levels4  2 &  7,c7 9
 ! flu% matt] at ! end1 by /rik+        
subp>agraph 7,b7 & ins]t+ subp>agraph   
7,c74  7#b7 ,no application ( co/ %>+   
,section #ahcc ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #aciel7 is am5d$--  

7,a7 9 subsection 7a77#a77,y71 by ins]t+
 7o!r ?an te/s = levels describ$ 9      
section #ahfa7ww77#a77;,b7 furni%$ to an
 individual describ$ 9 su* section7 aft]
 describ$ 9 subp>agraph 7,a72 &  7,b7 9 
subsection 7b77#a71 by /rik+ = !        
individual4 ins]t+ = ! individual or t  
are te/s = levels describ$ 9 section    
#ahfa7ww77#a77;,b7 furni%$ to an        
individual describ$ 9 su* section4  7c7 
,m$icaid  7#a7 ,9 g5]al ,section        
#aije7;a7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #acif;d7a77 is am5d$--   
7,a7 9 p>agraph 7#ca71 by /rik+ & at !  
end2  7,b7 by r$esignat+ p>agraph 7#cb7 
z p>agraph 7#cc72 &  7,c7 by ins]t+ aft]
 p>agraph 7#ca7 ! foll[+ new p>agraph3  
7#cb7 te/+ = lipoprote97a7 &            
apolipoprote9 ,b levels furni%$ to an   
individual ) a family hi/ory ( premature
 c>diovascul> disease1 a p]sonal hi/ory 
( myoc>dial inf>ction1 /roke1 or elevat$
 ,,ldl *ole/]ol1 a diagnosis ( diabetes 
mellitus or obesity1 or o!r recogniz$   
c>diovascul> risk factors2 &  4  7#b7   

,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$--  7i7 9          
subp>agraph 7,i71 by /rik+ or at ! end2 
7ii7 9 subp>agraph 7,j71 by /rik+ 2 & & 
ins]t+ 1 or2 &  7iii7 by add+ at ! end !
 foll[+ new subp>agraph3  7,k7 te/+ =   
lipoprote97a7 & apolipoprote9 ,b levels 
furni%$ to an individual describ$ 9     
section #aije7;a77#cb72 &  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  7xv7    
,te/+ = lipoprote97a7 & apolipoprote9 ,b
 levels furni%$ to an individual        
describ$ 9 section #aije7;a77#cb74  4   
7#c7 ,m&atory cov]age ,section          
#aijb7;a77#aj77;,a7 ( ! ,social         
,security ,act 7#db ,u4,s4,c4           
#acif;a7a77#aj77;,a77 is am5d$ by /rik+ 
& 7#cj7 & ins]t+ 7#cj71 & 7#cb74  7#d7  
,b5*m>k cov]age & b5*m>k-equival5t      

cov]age ,section #aicg7;b7 ( ! ,social  
,security ,act 7#db ,u4,s4,c4           
#acifu-#g7;b77 is am5d$ by add+ at ! end
 ! foll[+ new p>agraph3  7#i7 ,cov]age (
 c]ta9 lipid level te/+ ,not)/&+ !      
previ\s provisions ( ?is section1 a     
,/ate may n provide = m$ical assi/ance  
?r\gh enrollm5t ( an individual ) b5*m>k
 cov]age or b5*m>k-equival5t cov]age "u 
?is section unless su* cov]age provides1
 ) respect to an individual describ$ 9  
section #aije7;a77#cb71 te/+ =          
lipoprote97a7 & apolipoprote9 ,b levels4
  4  7d7 ,effective date ,! am5dm5ts    
made by--  7#a7 subsection 7a7 %all     
apply ) respect to plan ye>s beg9n+ on  
or aft] ! date t is #ahj days aft] !    
date ( ! enactm5t ( ?is ,act2 &  7#b7   
subsections 7b7 & 7c7 %all apply )      
respect to items & s]vices & m$ical     
assi/ance1 respectively1 furni%$ on or  
aft] su* date4