,,ii  #aai? ,,congress  #b;d ,session   
,s4 #deff  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,may #ai1 #bjbf,mr4    
,durb9 7= himself & ,ms4 ,hirono7       
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,f9ance  ,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,d72  7#b7 by /rik+ & be=e     
7,e72  7#c7 by /rik+ & be=e 7,f72 &     

7#d7 by ins]t+ be=e ! semicolon at ! end
 ! foll[+3 2 & 7,g7 an annual lung canc]
 scre5+ = individuals :o are eligible "u
 ! ,/ate plan or "u a waiv] ( su* plan &
 = :om su* scre5+ is recomm5d$ "u       
guidel9es publi%$ by ! ,unit$ ,/ates    
,prev5tive ,s]vices ,task ,=ce 7provid$ 
t su* guidel9es d n decrease ! recomm5d$
 frequ5cy ( lung canc] scre5+s = su*    
individuals or n>r[ ! population        
recomm5d$ = lung canc] scre5+ publi%$ by
 ! ,unit$ ,/ates ,prev5tive ,s]vices    
,task ,=ce on ,m>* #i1 #bjba71 )\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,i71
 by /rik+ or at ! end2  7,b7 9          
subp>agraph 7,j71 by /rik+ 2 & & ins]t+ 
1 or at ! end2 &  7,c7 by add+ at ! end 
! foll[+ new subp>agraph3  7,k7 lung    
canc] scre5+ = :i* paym5t may be made "u
 ! ,/ate plan or "u a waiv] ( su* 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  7xv7    
,lung canc] scre5+ = :i* paym5t may be  
made "u ! ,/ate plan or "u a waiv] ( su*
 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 or "u a    
waiv] ( su* 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 #bjbh4   
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 by /rik+ by      
pregnant wom5 ea* place x appe>s2  7,b7 
9 p>agraph 7#a71 by /rik+ tobacco use :o
 & ins]t+ tobacco use 7includ+ ! use (  
e-cig>ettes or vape p5s7 by individuals 
:o2 &  7,c7 9 p>agraph 7#b77;,a71 by    
/rik+ ) respect to 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 #b7;b77#a71 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,j71 by /rik+ or at ! end2  7,c7 9    
subp>agraph 7,k71 by /rik+ 2 & at ! end 
& ins]t+ 1 or2 &  7,d7 by add+ at ! end 
! foll[+ new subp>agraph3  7,l7 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 #b7;b77#b71 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  7xvi7       
,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 #b7;c71 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 #bjbh4   
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  
7bb7 ,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    

#ahcd7;bb71 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  
#bjbh4  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-#ac7 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 require 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 #bjbh4  #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 #bjbh ?r\gh #bjcb = 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 recomm5dations = h[ !  
,f$]al ,gov]nm5t c improve scre5+ = su* 
canc] among su* segm5ts4