[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 10096 Introduced in House (IH)]
<DOC>
118th CONGRESS
2d Session
H. R. 10096
To amend title XIX of the Social Security Act to ensure access to
immunizations under the Medicaid program and the Vaccines for Children
program, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
November 1, 2024
Ms. Schrier (for herself and Mr. Joyce of Pennsylvania) introduced the
following bill; which was referred to the Committee on Energy and
Commerce
_______________________________________________________________________
A BILL
To amend title XIX of the Social Security Act to ensure access to
immunizations under the Medicaid program and the Vaccines for Children
program, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Strengthening the Vaccines for
Children Program Act of 2024''.
SEC. 2. ENSURING ACCESS TO IMMUNIZATIONS UNDER THE MEDICAID PROGRAM AND
THE VACCINES FOR CHILDREN PROGRAM.
(a) Encouraging Involvement of Providers.--Paragraph (3) of section
1928(c) of the Social Security Act (42 U.S.C. 1396s(c)) is amended--
(1) by redesignating subparagraphs (A) and (B) as clauses
(i) and (ii), respectively, and moving the margins of each such
clause, as so redesignated, 2 ems to the right;
(2) by striking ``providers'' and all that follows through
``Each program'' and inserting ``providers.--
``(A) In general.--Each program''; and
(3) by adding at the end the following:
``(B) Incentive payments.--
``(i) In general.--
``(I) Payment for program-
registered providers.--The Secretary
shall pay to each provider that
requests payment under this subclause
and that is a program-registered
provider under this section as of the
date of the enactment of this
subparagraph an amount equal to $7,500,
to be paid as soon as practicable after
such date of enactment.
``(II) Additional payment to
incentivize continued participation.--
The Secretary shall pay to each
provider that requests payment under
this subclause and that is a program-
registered provider under this section
for the duration of the period
beginning on the date of the enactment
of this subparagraph and ending on
December 31, 2026, and amount equal to
$2,500, to be paid as soon as
practicable after January 1, 2027.
``(ii) Use of funds.--Payments made under
clause (i) may only be used by a provider for
purposes of carrying out the program under this
section (including any operational expenses
associated with the furnishing of immunizations
under such program, as specified by the
Secretary).
``(iii) Recoupment of payments.--The
Secretary may conduct reviews of providers
receiving payments under this subparagraph to
ensure that such payments are used in
accordance with clause (ii) and recoup from
such providers any such payments not so used in
accordance with such clause.''.
(b) Expansion of Definition of Federally Vaccine-Eligible Child.--
Paragraph (2) of section 1928(b) of the Social Security Act (42 U.S.C.
1396s(b)) is amended--
(1) in subparagraph (A)--
(A) in clause (iii), by striking ``A child who''
and all that follows through the period at the end and
inserting ``A child who is administered a qualified
pediatric vaccine and is not insured with respect to
such vaccine.''; and
(B) by adding at the end the following new clause:
``(v) A child who is enrolled for child
health assistance under a State child health
plan approved under title XXI.''; and
(2) in subparagraph (B)(ii)(II), by striking ``for purposes
of subparagraph (A)(iii)(II)'' and inserting ``for purposes of
subparagraph (A)(iii)''.
(c) Minimum Payment Requirement for Vaccine Administration and
Counseling Services.--
(1) In general.--Section 1902(a)(13) of the Social Security
Act (42 U.S.C. 1396a(a)(13)) is amended--
(A) in subparagraph (B), by striking ``and'' at the
end;
(B) in subparagraph (C), by striking the semicolon
and inserting ``; and''; and
(C) by adding at the end the following new
subparagraph:
``(D) for payment for vaccine administration and
counseling services furnished by a provider during the
period beginning on the date of the enactment of this
subparagraph, and ending on December 31, 2026
(including, notwithstanding subsection (c)(2)(C)(ii) of
section 1928, any such services furnished with respect
to a vaccine furnished under the program established by
the State pursuant to such section to a medicaid-
eligible child (as defined in subsection (b)(2)(B)(i)
of such section)), at a rate not less than 100 percent
of the payment rate that applies to such services and
provider under part B of title XVIII;''.
(2) Managed care plans.--Section 1932(f) of the Social
Security Act (42 U.S.C. 1396u-2(f)) is amended--
(A) in the header, by striking ``Payment for
Primary Care Services'' and inserting ``Payments''; and
(B) by striking ``section 1902(a)(13)(C)'' and
inserting ``subparagraph (C) of section 1902(a)(13) and
vaccine administration and counseling services
described in subparagraph (D) of such section''; and
(C) by striking ``such section'' and inserting
``such subparagraph (C) or (D), respectively''; and
(D) by adding at the end the following new
sentence: ``The provisions of the preceding sentence
shall apply to contracts entered into with, and
payments made by, other specified entities (as defined
in section 1903(m)(9)(D)(iii)) in the same manner as
such provisions apply with respect to contracts entered
into with, and payments made by, medicaid managed care
organizations.''.
(3) CHIP.--Section 2103(c) of the Social Security Act (42
U.S.C. 1397cc(c)) is amended by adding at the end the following
new paragraph:
``(11) Vaccine administration services.--The child health
assistance provided to a targeted low-income child shall
include payment for vaccine administration and counseling
services furnished by a provider during the period beginning on
the date of the enactment of this paragraph, and ending on
December 31, 2026 (including, notwithstanding subsection
(c)(2)(C)(ii) of section 1928, any such services furnished to
such child with respect to a vaccine furnished under the
program established by the State pursuant to such section), at
a rate not less than 100 percent of the payment rate that
applies to such services and provider under part B of title
XVIII.''.
(d) Clarification of Coverage of Pediatric Vaccine Administration
and Vaccine Counseling and Educational Services Under the Vaccines for
Children Program.--Section 1928(c)(2)(C)(ii) of the Social Security Act
(42 U.S.C. 1396s(c)(2)(C)(ii)) is amended to read as follows:
``(ii) The provider may impose--
``(I) in the case of a qualified pediatric
vaccine not described in subclause (II), a fee
for the administration of and counseling for
such vaccine so long as the fee in the case of
a federally vaccine-eligible child does not
exceed the costs of such administration and
counseling (as determined by the Secretary
based on actual regional costs for such
administration and counseling and updated as
determined appropriate by the Secretary to take
into account changes in such costs, including
changes attributable to the inclusion of new
qualified pediatric vaccines in the program
established under this section); and
``(II) in the case of a qualified pediatric
vaccine that is a multiple component vaccine, a
separate charge for the administration of and
counseling for each component of such vaccine
so long as the charge in the case of a
federally vaccine-eligible child does not
exceed--
``(aa) with respect to the first
component of such vaccine, the costs of
such administration and counseling for
such component (as determined by the
Secretary based on actual regional
costs for such administration and
counseling for such first component and
updated as determined appropriate by
the Secretary to take into account
changes in such costs, including
changes attributable to the inclusion
of new qualified pediatric vaccines in
the program established under this
section); and
``(bb) with respect to a subsequent
component of such vaccine, the payment
rate that applies to such
administration and counseling for such
component and provider under part B of
title XVIII.''.
(e) Increase in Federal Medical Assistance Percentage.--
(1) In general.--Subject to paragraph (2), for each
calendar quarter occurring during the period beginning on or
after January 1, 2025, the Federal medical assistance
percentage determined for each State, including the District of
Columbia, American Samoa, Guam, the Commonwealth of the
Northern Mariana Islands, Puerto Rico, and the United States
Virgin Islands, under section 1905(b) of the Social Security
Act (42 U.S.C. 1396d(b)), after application of section 6008 of
the Families First Coronavirus Response Act (Public Law 116-
127) (if applicable), shall be increased by 1 percentage point.
(2) Requirements.--
(A) In general.--A State described in paragraph (1)
may not receive the increase described in such
paragraph in the Federal medical assistance percentage
for such State, with respect to a quarter, if such
State does not ensure culturally competent and
effective messages for vaccination outreach to child
populations, which may include the dissemination of
information highlighting--
(i) advancements in research and vaccine
development that have saved millions of
individuals from death and disability from now-
preventable diseases;
(ii) information on how individuals across
the lifespan benefit from immunizations,
including those who cannot be vaccinated and
rely on community immunity;
(iii) information on the dangers of not
being vaccinated, including the potential for
infectious disease outbreaks within
communities; and
(iv) information on vaccine safety and the
systems in place to monitor vaccine safety.
(B) Requirement for certain states.--Section
1905(cc) of the Social Security Act (42 U.S.C.
1396d(cc)) is amended--
(i) by inserting ``and section 2(e) of the
Strengthening the Vaccines for Children Program
Act of 2024'' before ``, except that in
applying''; and
(ii) by inserting ``, and in applying such
treatments to the increases in the Federal
medical assistance percentage under section
2(e) of the Strengthening the Vaccines for
Children Program Act of 2024, the reference to
`December 31, 2009' shall be deemed to be a
reference to `December 31, 2023''' before the
period at the end.
(f) Tribal Epidemiology Center Data Access.--With respect to data
access for tribal epidemiology centers established under section 214 of
the Indian Health Care Improvement Act (25 U.S.C. 1621m), the Director
of the Centers for Disease control and Prevention may create a data
sharing strategy that ensures such centers have access to data, data
sets, monitoring systems, delivery systems, and other protected health
information with respect to health care and public health surveillance
systems of child and adolescent health necessary to accomplish such
centers' public health authority responsibilities described in such
section or section 164.501 of title 45, Code of Federal Regulations.
(g) Reports.--
(1) In general.--For each of fiscal years 2025 and 2026,
the Director of the Centers for Disease Control and Prevention,
in coordination with each State that has established a
pediatric vaccine distribution program under section 1928 of
the Social Security Act (42 U.S.C. 1396s), shall publish on the
public internet website of the Centers for Disease Control and
Prevention, in such manner as determined appropriate by the
Director, information on vaccination rates under each such
program during such year, including such rates disaggregated by
region, age, sex, race, ethnicity, and other demographic
factors determined appropriate by the Director.
(2) Effects on vaccination rates and program
participation.--Not later than 2 years after the date of the
enactment of this Act, the Comptroller General of the United
States shall submit to Congress a report containing an analysis
of the effects of the provisions of, and the amendments made
by, this Act on--
(A) vaccination rates under the pediatric vaccine
distribution program under section 1928 of the Social
Security Act (42 U.S.C. 1396s); and
(B) provider participation in such program.
<all>