,i  #aai? ,,congress  #b;d ,session  ,h4
 ,r4 #hdbe  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,april #ba1 #bjbf,ms4 
,s*ri] 7= h]self & ,mr4 ,joyce (        
,p5nsylvania7 introduc$ ! foll[+ bill2  
:i* 0 ref]r$ to ! ,committee on ,en]gy &
 ,comm]ce  ,a ,,bill  ,to am5d title    
,,xix ( ! ,social ,security ,act to     
ensure access to immunizations "u !     
,m$icaid program & ! ,vacc9es = ,*ildr5 
program1 & = o!r purposes4  #a4 ,%ort   
title ,?is ,act may be cit$ z ! ,/r5g!n+
 ! ,vacc9es = ,*ildr5 ,program ,act (   
#bjbf4  #b4 ,ensur+ access to           
immunizations "u ! ,m$icaid program & ! 
,vacc9es = ,*ildr5 program  7a7         
,expansion ( def9ition ( f$]ally        
vacc9e-,eligible *ild ,p>agraph 7#b7 (  
section #aibh7;b7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #acifs7b77 is       
am5d$--  7#a7 9 subp>agraph 7,a7-- 7,a7 
9 clause 7iii71 by /rik+ ,a *ild :o &   
all t foll[s ?r\gh ! p]iod at ! end &   
ins]t+ ,a *ild :o is adm9i/]$ a qualifi$
 p$iatric vacc9e & is n insur$ ) respect

 to su* vacc9e42 &  7,b7 by add+ at !   
end ! foll[+ new clause3  7v7 ,a *ild :o
 is enroll$ = *ild heal? assi/ance "u a 
,/ate *ild heal? plan approv$ "u title  
,,xxi4  2 &  7#b7 9 subp>agraph         
7,b77ii77,,ii71 by /rik+ = purposes (   
subp>agraph 7,a77iii77,,ii7 & ins]t+ =  
purposes ( subp>agraph 7,a77iii74  7b7  
,m9imum paym5t requirem5t = vacc9e      
adm9i/ration & c\nsel+ s]vices  7#a7 ,9 
g5]al ,section #aijb7;a77#ac7 ( !       
,social ,security ,act 7#db ,u4,s4,c4   
#acif;a7a77#ac77 is am5d$-- 7,a7 9      
subp>agraph 7,b71 by /rik+ & at ! end2  
7,b7 9 subp>agraph 7,c71 by /rik+ !     
semicolon & ins]t+ 2 &2 &  7,c7 by add+ 
at ! end ! foll[+ new subp>agraph3  7,d7
 = paym5t = vacc9e adm9i/ration &       
c\nsel+ s]vices furni%$ by a provid]    
dur+ ! p]iod beg9n+ on ! date ( !       
enactm5t ( ?is subp>agraph1 & end+ on   
,decemb] #ca1 #bjbh 7includ+1 not)/&+   
subsection 7c77#b77;,c77ii7 ( section   
#aibh1 any su* s]vices furni%$ ) respect
 to a vacc9e furni%$ "u ! program       

e/abli%$ by ! ,/ate pursuant to su*     
section to a m$icaid-eligible *ild 7z   
def9$ 9 subsection 7b77#b77;,b77i7 ( su*
 section771 at a rate n less ?an #ajj   
p]c5t ( ! paym5t rate t applies to su*  
s]vices & provid] "u "p ,b ( title      
,,xviii2  4  7#b7 ,manag$ c>e plans     
,section #aicb7;f7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #acifu-#b7;f77 is  
am5d$--  7,a7 9 ! head]1 by /rik+ paym5t
 = prim>y c>e s]vices & ins]t+ paym5ts2 
7,b7 by /rik+ section                   
#aijb7;a77#ac77;,c7 & ins]t+ subp>agraph
 7,c7 ( section #aijb7;a77#ac7 & vacc9e 
adm9i/ration & c\nsel+ s]vices describ$ 
9 subp>agraph 7,d7 ( su* section2  7,c7 
by /rik+ su* section & ins]t+ su*       
subp>agraph 7,c7 or 7,d71 respectively2 
&  7,d7 by add+ at ! end ! foll[+ new   
s5t5ce3 ,! provisions ( ! prec$+ s5t5ce 
%all apply to contracts ent]$ into )1 & 
paym5ts made by1 o!r specifi$ entities  
7z def9$ 9 section                      
#aijc7m77#i77;,d77iii77 9 ! same mann] z
 su* provisions apply ) respect to      

contracts ent]$ into )1 & paym5ts made  
by1 m$icaid manag$ c>e organizations44  
7#c7 ,,*ip ,section #bajc7;c7 ( !       
,social ,security ,act 7#db ,u4,s4,c4   
#acig;cc7c77 is am5d$ by add+ at ! end !
 foll[+ new p>agraph3  7#aa7 ,vacc9e    
adm9i/ration s]vices ,! *ild heal?      
assi/ance provid$ to a t>get$ l[-income 
*ild %all include paym5t = vacc9e       
adm9i/ration & c\nsel+ s]vices furni%$  
by a provid] dur+ ! p]iod beg9n+ on !   
date ( ! enactm5t ( ?is p>agraph1 & end+
 on ,decemb] #ca1 #bjbh 7includ+1       
not)/&+ subsection 7c77#b77;,c77ii7 (   
section #aibh1 any su* s]vices furni%$  
to su* *ild ) respect to a vacc9e       
furni%$ "u ! program e/abli%$ by ! ,/ate
 pursuant to su* section71 at a rate n  
less ?an #ajj p]c5t ( ! paym5t rate t   
applies to su* s]vices & provid] "u "p  
,b ( title ,,xviii4  4  7c7             
,cl>ification ( cov]age ( p$iatric      
vacc9e adm9i/ration & vacc9e c\nsel+ &  
educational s]vices "u ! ,vacc9es =     
,*ildr5 program ,section                

#aibh7;c77#b77;,c7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #acifs7c77#b77;,c77
 is am5d$-- 7#a7 9 clause 7ii71 by am5d+
 su* clause to read z foll[s3  7ii7 ,!  
provid] may impose-- 7,i7 9 ! case ( a  
qualifi$ p$iatric vacc9e n describ$ 9   
subclause 7,,ii71 a fee = ! adm9i/ration
 ( & c\nsel+ = su* vacc9e 7:i*1 9 ! case
 ( a c\nsel+ fee1 may be s impos$       
reg>dless ( :e!r su* vacc9e is actually 
adm9i/]$7 s long z ! fee 9 ! case ( a   
f$]ally vacc9e-eligible *ild does n     
exce$ ! co/s ( su* adm9i/ration &       
c\nsel+ 7z det]m9$ by ! ,secret>y bas$  
on actual regional co/s = su*           
adm9i/ration & c\nsel+ & updat$ z       
det]m9$ appropriate by ! ,secret>y to   
take into acc\nt *anges 9 su* co/s1     
includ+ *anges attributable to !        
inclusion ( new qualifi$ p$iatric       
vacc9es 9 ! program e/abli%$ "u ?is     
section72 &  7,,ii7 9 ! case ( a        
qualifi$ p$iatric vacc9e t is a multiple
 compon5t vacc9e1 a sep>ate *>ge = !    
adm9i/ration ( & c\nsel+ = ea* compon5t 

( su* vacc9e 7:i*1 9 ! case ( a c\nsel+ 
fee1 may be s impos$ reg>dless ( :e!r   
su* compon5t is actually adm9i/]$7 s    
long z ! *>ge 9 ! case ( a f$]ally      
vacc9e-eligible *ild does n exce$-- 7aa7
 ) respect to ! fir/ compon5t ( su*     
vacc9e1 ! co/s ( su* adm9i/ration &     
c\nsel+ = su* compon5t 7z det]m9$ by !  
,secret>y bas$ on actual regional co/s =
 su* adm9i/ration & c\nsel+ = su* fir/  
compon5t & updat$ z det]m9$ appropriate 
by ! ,secret>y to take into acc\nt      
*anges 9 su* co/s1 includ+ *anges       
attributable to ! inclusion ( new       
qualifi$ p$iatric vacc9es 9 ! program   
e/abli%$ "u ?is section72 &  7bb7 )     
respect to a subsequ5t compon5t ( su*   
vacc9e1 ! paym5t rate t applies to su*  
adm9i/ration & c\nsel+ = su* compon5t & 
provid] "u "p ,b ( title ,,xviii4  2 &  
7#b7 9 clause 7iii71 by ins]t+ or       
c\nsel+ aft] an adm9i/ration4  7d7      
,increase 9 ,f$]al m$ical assi/ance     
p]c5tage  7#a7 ,9 g5]al ,subject to     
p>agraph 7#b71 = ea* cal5d> qu>t]       

occurr+ dur+ ! p]iod beg9n+ on or aft]  
,janu>y #a1 #bjbg1 ! ,f$]al m$ical      
assi/ance p]c5tage det]m9$ = ea* ,/ate1 
includ+ ! ,di/rict ( ,columbia1 ,am]ican
 ,samoa1 ,guam1 ! ,commonweal? ( !      
,nor!rn ,m>iana ,isl&s1 ,pu]to ,rico1 & 
! ,unit$ ,/ates ,virg9 ,isl&s1 "u       
section #aije7;b7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #acif;d7b77 %all be 
increas$ by #a p]c5tage po9t4  7#b7     
,requirem5ts  7,a7 ,9 g5]al ,a ,/ate    
describ$ 9 p>agraph 7#a7 may n receive !
 increase describ$ 9 su* p>agraph 9 !   
,f$]al m$ical assi/ance p]c5tage = su*  
,/ate1 ) respect to a qu>t]1 if su*     
,/ate does n ensure culturally compet5t 
& effective messages = vacc9ation       
outrea* to *ild populations1 :i* may    
include ! dissem9ation ( in=mation      
highlight+--  7i7 advancem5ts 9 rese>* &
 vacc9e developm5t t h sav$ millions (  
individuals f dea? & disability f       
n[-prev5table diseases2  7ii7 in=mation 
on h[ individuals across ! lifespan     
b5efit f immunizations1 includ+ ^? :o _c

 be vacc9at$ & rely on community        
immunity2  7iii7 in=mation on ! dang]s (
 n be+ vacc9at$1 includ+ ! pot5tial =   
infecti\s disease outbreaks )9          
communities2 &  7iv7 in=mation on vacc9e
 safety & ! sy/ems 9 place to monitor   
vacc9e safety4  7,b7 ,requirem5t = c]ta9
 ,/ates ,section #aije7;cc7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#acif;d7cc77 is am5d$-- 7i7 by ins]t+ & 
section #b7;d7 ( ! ,/r5g!n+ ! ,vacc9es =
 ,*ildr5 ,program ,act ( #bjbf be=e 1   
except t 9 apply+2 &  7ii7 by ins]t+ 1 &
 9 apply+ su* treatm5ts to ! increases 9
 ! ,f$]al m$ical assi/ance p]c5tage "u  
section #b7;e7 ( ! ,/r5g!n+ ! ,vacc9es =
 ,*ildr5 ,program ,act ( #bjbf1 !       
ref]5ce to ,decemb] #ca1 #bjji %all be  
deem$ to be a ref]5ce to ,decemb] #ca1  
#bjbe be=e ! p]iod at ! end4  7e7       
,tribal epidemiology c5t] data access ,)
 respect to data access = tribal        
epidemiology c5t]s e/abli%$ "u section  
#bad ( ! ,indian ,heal? ,c>e ,improvem5t
 ,act 7#be ,u4,s4,c4 #afbam71 !         

,director ( ! ,c5t]s = ,disease control 
& ,prev5tion may create a data %>+      
/rategy t ensures su* c5t]s h access to 
data1 data sets1 monitor+ sy/ems1       
deliv]y sy/ems1 & o!r protect$ heal?    
in=mation ) respect to heal? c>e &      
public heal? surveillance sy/ems ( *ild 
& adolesc5t heal? necess>y to accompli% 
su* c5t]s' public heal? au?ority        
responsibilities describ$ 9 su* section 
or section #afd4eja ( title #de1 ,code (
 ,f$]al ,regulations4  7f7 ,reports     
7#a7 ,9 g5]al ,= ea* ( fiscal ye>s #bjbg
 & #bjbh1 ! ,director ( ! ,c5t]s =      
,disease ,control & ,prev5tion1 9       
coord9ation ) ea* ,/ate t has e/abli%$ a
 p$iatric vacc9e di/ribution program "u 
section #aibh ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acifs71 %all publi% on 
! public int]net website ( ! ,c5t]s =   
,disease ,control & ,prev5tion1 9 su*   
mann] z det]m9$ appropriate by !        
,director1 in=mation on vacc9ation rates
 "u ea* su* program dur+ su* ye>1       
includ+ su* rates disaggregat$ by       

region1 age1 sex1 race1 e?nicity1 & o!r 
demographic factors det]m9$ appropriate 
by ! ,director4  7#b7 ,effects on       
vacc9ation rates & program p>ticipation 
,n lat] ?an #b ye>s aft] ! date ( !     
enactm5t ( ?is ,act1 ! ,comptroll]      
,g5]al ( ! ,unit$ ,/ates %all submit to 
,congress a report conta9+ an analysis (
 ! effects ( ! provisions (1 & !        
am5dm5ts made by1 ?is ,act on--  7,a7   
vacc9ation rates "u ! p$iatric vacc9e   
di/ribution program "u section #aibh ( !
 ,social ,security ,act 7#db ,u4,s4,c4  
#acifs72 &  7,b7 provid] p>ticipation 9 
su* program4