,,ii  #aai? ,,congress  #a/ ,session    
,s4 #cefj  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,decemb] #ah1 #bjbe,ms4
 ,hassan 7= h]self1 ,ms4 ,murk[ski1 ,ms4
 ,duckwor?1 & ,ms4 ,coll9s7 introduc$ ! 
foll[+ bill2 :i* 0 read twice & ref]r$  
to ! ,committee on ,f9ance  ,a ,,bill   
,to am5d title ,,xviii ( ! ,social      
,security ,act to provide cov]age (     
contraceptive items & s]vices at no     
co/-%>+ "u ! ,m$ic>e program1 & = o!r   
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,clos+ ! ,contraception    
,cov]age ,gap ,act4  #b4 ,provid+       
cov]age ( contraceptive items & s]vices 
at no co/-%>+ "u ! ,m$ic>e program  7a7 
,"p ,b cov]age  7#a7 ,9 g5]al ,section  
#ahfa ( ! ,social ,security ,act 7#db   
,u4,s4,c4 #aciex7 is am5d$-- 7,a7 9     
subsection 7s77#b7-- 7i7 9 subp>agraph  
7,,jj71 by ins]t+ & aft] ! semicolon at 
! end2 &  7ii7 by add+ at ! end ! foll[+
 new subp>agraph3  7,,kk7 contraceptive 
items & s]vices 7z def9$ 9 subsection   
7nnn77 furni%$ to individuals on or aft]

 ,janu>y #a1 #bjbg2  2 &  7,b7 by add+  
at ! end ! foll[+ new subsection3  7nnn7
 ,contraceptive items & s]vices  7#a7 ,9
 g5]al ,! t]m contraceptive items &     
s]vices means items & s]vices furni%$ by
 a physician or practition] 7z def9$ 9  
section #ahdb7;b77#ah77;,c77-- 7,a7 t-- 
7i7 align ) guidance z ( ,janu>y #ab1   
#bjbb1 issu$ 9 accordance ) 9 section   
#bgac7;a77#d7 ( ! ,public ,heal? ,s]vice
 ,act 7includ+ pati5t-c5t]$ c\nsel+     
s]vices72 &  7ii7 may be furni%$ = !    
purpose ( contraception2 or  7,b7 t are 
ancill>y cl9ical s]vices4  7#b7         
,ancill>y cl9ical s]vices ,= purposes ( 
p>agraph 7#a77;,b71 ! t]m ancill>y      
cl9ical s]vices means-- 7,a7 cl9ical    
s]vices t are relat$ to ! items &       
s]vices describ$ 9 p>agraph 7#a77;,a71  
includ+ consultations1 exam9ations1     
proc$ures1 device ins]tion1 ultras\nd1  
pa9 managem5t1 pati5t education1        
ref]rals1 & c\nsel+2 &  7,b7 foll[-up   
s]vices relat$ to ! provision or use ( !
 items & s]vices describ$ 9 p>agraph    

7#a77;,a71 includ+ managem5t ( side     
effects1 c\nsel+ = cont9u$ adh]5ce1 &   
device removal4  7#c7 ,cl>ification ,!  
t]m contraceptive items & s]vices       
includes items & s]vices describ$ 9     
p>agraph 7#a7 reg>dless ( :e!r su* items
 & s]vices are actually furni%$ =       
purposes ( contraception4  7#d7         
,pati5t-c5t]$ c\nsel+ s]vices ,=        
purposes ( p>agraph 7#a77;,a71 !        
,secret>y %all issue guidance reg>d+ !  
cov]age ( pati5t-c5t]$ c\nsel+4 ,su*    
guidance %all-- 7,a7 align ) guidance z 
( ,janu>y #ab1 #bjbb1 issu$ 9 accordance
 ) section #bgac7;a77#d7 ( ! ,public    
,heal? ,s]vice ,act42 &  7,b7 include ! 
cov]age ( c\nsel+ to all pati5ts on !   
full range ( contraceptive items &      
s]vices describ$ 9 p>agraph 7#a74  4    
7#b7 ,paym5t ,section #ahcc ( ! ,social 
,security ,act 7#db ,u4,s4,c4 #aciel7 is
 am5d$-- 7,a7 9 subsection 7a77#a7-- 7i7
 by /rik+ & be=e 7,,hh72 &  7ii7 by     
ins]t+ ! foll[+ be=e ! semicolon3 &     
7,,ii7 ) respect to contraceptive items 

& s]vices 7z def9$ 9 section            
#ahfa7nnn771 ! am\nt paid %all be an    
am\nt equal to #ajj p]c5t ( ! less] ( ! 
actual *>ge = ! items & s]vices or !    
am\nt det]m9$ "u a paym5t basis det]m9$ 
appropriate by ! ,secret>y2 &  7,b7 9   
subsection 7b71 9 ! fir/ s5t5ce-- 7i7 by
 /rik+ 1 & 7#ac7 & ins]t+ 7#ac72 &  7ii7
 by /rik+ #ahfa7n744 & ins]t+ #ahfa7n71 
& 7#ad7 su* d$uctible %all n apply )    
respect to contraceptive items & s]vices
 7z def9$ 9 section #ahfa7nnn7744  7#c7 
,exclusion modification ,section        
#ahfb7;a77#a7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #aciey7a77#a77 is       
am5d$-- 7,a7 9 subp>agraph 7,o71 by     
/rik+ & at ! end2  7,b7 9 subp>agraph   
7,p71 by /rik+ ! semicolon & ins]t+ 1 &2
 &  7,c7 by add+ at ! end ! foll[+ new  
subp>agraph3  7,q7 9 ! case (           
contraceptive items & s]vices 7z def9$ 9
 section #ahfa7nnn771 :i* are n furni%$ 
or ord]$ by a physician or practition]  
7z def9$ 9 section #ahdb7;b77#ah77;,c772
  4  7#d7 ,quality measures ,! ,secret>y

 ( ,heal? & ,human ,s]vices may1 = !    
purposes ( ensur+ quality 9 s]vices1    
develop measures ( contraceptive        
c\nsel+1 c>e1 & access1 includ+ b n     
limit$ to validat$ survey in/rum5ts4    
7b7 ,"p ,c co/-,%>+ = contraceptive     
items & s]vices  7#a7 ,9 g5]al ,section 
#aheb7;a77#a77;,b7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#aciew-#bb7;a77#a77;,b77 is am5d$-- 7,a7
 9 clause 7iv7-- 7i7 by r$esignat+      
subclause 7,,viii7 z subclause 7,,ix72 &
  7ii7 by ins]t+ aft] subclause 7,,vii7 
! foll[+ new subclause3  7,,viii7       
,contraceptive items & s]vices 7z def9$ 
9 section #ahfa7nnn774  2 &  7,b7 9     
clause 7v71 by /rik+ & 7,,vi7 & ins]t+  
7,,vi71 & 7,,viii74  7#b7 ,effective    
date ,! am5dm5ts made by ?is subsection 
%all apply ) respect to plan ye>s beg9n+
 on or aft] ,janu>y #a1 #bjbg4  7c7 ,"p 
,d cov]age & co/-,%>+ = contraceptive   
drugs  7#a7 ,cov]age ,section           
#ahfj;,d-#d7;b77#c77;,g7 ( ! ,social    
,security ,act 7#db ,u4,s4,c4           

#aciew-#ajd7;b77#c77;,g77 is am5d$--    
7,a7 9 clause 7ii77,i71 by add+ at ! end
 ! foll[+ new s5t5ce3 ,su* id5tification
 %all include ! drugs describ$ 9 clause 
7iv77,,vii742 &  7,b7 9 clause 7iv71 by 
add+ at ! end ! foll[+ new subclause3   
7,,vii7 ,cov]$ "p ,d drugs describ$ 9   
guidel9es issu$ pursuant to section     
#bgac7;a77#d7 ( ! ,public ,heal? ,s]vice
 ,act & t may be furni%$ = purposes (   
contraception 7reg>dless ( :e!r su*     
drugs are actually furni%$ = purposes ( 
contraception74  4  7#b7 ,co/-%>+       
,section #ahfj;,d-#b ( ! ,social        
,security ,act 7#db ,u4,s4,c4           
#aciew-#ajb7 is am5d$-- 7,a7 9          
subsection 7b7-- 7i7 9 p>agraph         
7#a77;,a71 9 ! matt] prec$+ clause 7i71 
by /rik+ & 7#i7 & ins]t+ 1 7#i71 &      
7#aj72  7ii7 9 p>agraph 7#b77;,a71 9 !  
matt] prec$+ clause 7i71 by /rik+ & 7#i7
 & ins]t+ 1 7#i71 & 7#aj72 &  7iii7 by  
add+ at ! end ! foll[+ new p>agraph3    
7#aj7 ,treatm5t ( co/-%>+ =             
contraceptive drugs ,= plan ye>s beg9n+ 

on or aft] ,janu>y #a1 #bjbg1 ) respect 
to a cov]$ "p ,d drug t is describ$ 9   
guidel9es issu$ pursuant to section     
#bgac7;a77#d7 ( ! ,public ,heal? ,s]vice
 ,act & t may be furni%$ = purposes (   
contraception 7reg>dless ( :e!r su* drug
 is actually furni%$ = purposes (       
contraception7-- 7,a7 ! d$uctible "u    
p>agraph 7#a7 %all n apply2 &  7,b7 !re 
%all be no co9surance or o!r co/-%>+ "u 
?is "p ) respect to su* drug4  2 &  7,b7
 9 subsection 7c71 by add+ at ! end !   
foll[+ new p>agraph3  7#g7 ,treatm5t (  
co/-%>+ = contraceptive drugs ,! cov]age
 is provid$ 9 accordance ) subsection   
7b77#aj74  4  7#c7 ,con=m+ am5dm5ts to  
co/-%>+ = l[-income individuals ,section
 #ahfj;,d-#ad7;a7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #aciew-#aad7;a77 is 
am5d$-- 7,a7 9 p>agraph 7#a77;,d71 9 ea*
 ( clauses 7ii7 & 7iii71 by /rik+       
p>agraph 7#f7 & ins]t+ p>agraphs 7#f7 & 
7#g72 &  7,b7 by add+ at ! end ! foll[+ 
new p>agraph3  7#g7 ,no application (   
co/-%>+ or d$uctible = contraceptive    

drugs ,= plan ye>s beg9n+ on or aft]    
,janu>y #a1 #bjbg1 ) respect to a cov]$ 
"p ,d drug t is describ$ 9 guidel9es    
issu$ pursuant to section #bgac7;a77#d7 
( ! ,public ,heal? ,s]vice ,act & t is  
furni%$ = purposes ( contraception--    
7,a7 ! d$uctible "u section             
#ahfj;,d-#b7;b77#a7 %all n apply2 &     
7,b7 !re %all be no co/-%>+ "u ?is      
section ) respect to su* drug4  4  7#d7 
,effective date ,! am5dm5ts made by ?is 
subsection %all apply ) respect to plan 
ye>s beg9n+ on or aft] ,janu>y #a1      
#bjbg4  7d7 ,ensur+ comp>able cov]age = 
dual eligible individuals ,9 implem5t+ !
 am5dm5ts made by ?is section1 !        
,secret>y ( ,heal? & ,human ,s]vices    
%all ensure t ! cov]age ( contraceptive 
items & s]vices 7z def9$ 9 section      
#ahfa7nnn77 ( ! ,social ,security ,act  
7z add$ by subsection 7a77 & cov]$ "p ,d
 drugs describ$ 9 section               
#ahfj;,d-#d7;b77#c77;,g77,,vii7 ( su*   
,act 7z add$ by subsection 7c77#a77 )   
respect to individuals :o are dually    

eligible = b5efits "u ! ,m$ic>e program 
"u title ,,xviii ( su* ,act & = m$ical  
assi/ance "u a ,/ate plan "u title ,,xix
 ( su* ,act 7or a waiv] ( su* plan7 is  
at lea/ z compreh5sive z ! cov]age ( su*
 items & s]vices & drugs = su*          
individuals "u su* ,/ate plans 7or      
waiv]s ( su* plans71 z det]m9$ by !     
,secret>y bas$ on an annual review ( su*
 ,/ate plans 7& waiv]s ( su* plans74    
#c4 ,,hhs /udy & report on prescription 
drug cov]age = ,m$ic>e b5efici>ies liv+ 
) disabilities  7a7 ,/udy ,! ,secret>y (
 ,heal? & ,human ,s]vices 79 ?is section
 ref]r$ to z ! ,secret>y7 %all conduct a
 /udy on-- 7#a7 ! adequacy ( access to  
prescription drug cov]age1 includ+ oral 
contraceptives1 among ,m$ic>e           
b5efici>ies liv+ ) disabilities :o are  
enroll$ "u ! orig9al ,m$ic>e            
fee-=-s]vice program "u p>ts ,a & ,b (  
title ,,xviii ( ! ,social ,security ,act
 7b n enroll$ "u "p ,c or ,d ( su* title
 ,,xviii72 &  7#b7 provid+ cov]age (    
ov]-!-c\nt] contraceptive drugs "u !    

,m$ic>e program "u su* title ,,xviii )  
no co/-%>+4  7b7 ,report ,n lat] ?an #a 
ye> aft] ! date ( enactm5t ( ?is ,act1 !
 ,secret>y %all submit to ,congress a   
report on ! /udy conduct$ "u subsection 
7a71 toge!r ) recomm5dations = su*      
legislation & adm9i/rative action z !   
,secret>y det]m9es appropriate4  #d4    
,,gao /udy & report on contraceptive    
cov]age requirem5ts "u comm]cial &      
public heal? plans  7a7 ,/udy ,!        
,comptroll] ,g5]al ( ! ,unit$ ,/ates 79 
?is section ref]r$ to z ! ,comptroll]   
,g5]al7 %all conduct a /udy on ! =ms (  
heal? insurance 7includ+ comm]cial plans
 & public heal? programs 7includ+       
,m$icaid1 ,m$ic>e1 & ,,tric>e771 t are n
 requir$ by ,/ate or ,f$]al law to d "o 
or bo? ( ! foll[+3 7#a7 ,cov] all =ms ( 
contraception approv$ by ! ,food & ,drug
 ,adm9i/ration4  7#b7 ,waive co/-%>+ =  
su* contraception4  7b7 ,report ,n lat] 
?an #a ye> aft] ! date ( enactm5t ( ?is 
,act1 ! ,comptroll] ,g5]al %all submit  
to ,congress a report on ! /udy conduct$

 "u subsection 7a71 toge!r )            
recomm5dations = su* legislation &      
adm9i/rative action z ! ,comptroll]     
,g5]al det]m9es appropriate4  #e4 ,,gao 
/udy & report on diff]5ce 9 cov]age (   
contraceptive items & s]vices = dual    
eligibles  7a7 ,/udy ,! ,comptroll]     
,g5]al ( ! ,unit$ ,/ates 79 ?is section 
ref]r$ to z ! ,comptroll] ,g5]al7 %all  
conduct a /udy on ! diff]5ce 9 cov]age (
 contraceptive items & s]vices =        
individuals :o are dually eligible =    
,m$ic>e & ,m$icaid b5efits4  7b7 ,report
 ,n lat] ?an #b ye>s aft] ! date (      
enactm5t ( ?is ,act1 ! ,comptroll]      
,g5]al %all submit to ,congress a report
 on ! /udy conduct$ "u subsection 7a71  
toge!r ) recomm5dations = su*           
legislation & adm9i/rative action z !   
,secret>y det]m9es appropriate4