[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7141 Introduced in House (IH)]
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118th CONGRESS
2d Session
H. R. 7141
To amend titles XIX and XXI of the Social Security Act and title XXVII
of the Public Health Service Act to require no-cost coverage of human
milk fortifier.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
January 30, 2024
Mr. McGarvey (for himself, Ms. DeLauro, and Mr. Krishnamoorthi)
introduced the following bill; which was referred to the Committee on
Energy and Commerce
_______________________________________________________________________
A BILL
To amend titles XIX and XXI of the Social Security Act and title XXVII
of the Public Health Service Act to require no-cost coverage of human
milk fortifier.
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 ``Supporting Premature Infant
Nutrition Act of 2024''.
SEC. 2. REQUIRING NO-COST COVERAGE OF HUMAN MILK FORTIFIER.
(a) Coverage Under Medicaid.--
(1) Mandatory coverage.--
(A) In general.--Section 1902(a)(10)(A) of the
Social Security Act (42 U.S.C. 1396a(a)(10)(A)) is
amended by striking ``and (30)'' and inserting ``(30),
and (31)''.
(B) Medically needy.--Section 1902(a)(10)(C)(iv) of
the Social Security Act (42 U.S.C. 1396a(a)(10)(C)(iv))
is amended by striking ``and (17)'' and inserting
``(17), and (31)''.
(C) Alternative benefit plans.--Section 1937(b) of
the Social Security Act (42 U.S.C. 1396u-7(b)) is
amended by adding at the end the following new
paragraph:
``(9) Human milk fortifier.--Notwithstanding the previous
provisions of this section, a State may not provide for medical
assistance through enrollment of an individual with benchmark
coverage or benchmark-equivalent coverage under this section
unless, beginning on January 1, 2025, such coverage includes
(and does not impose any deduction, cost sharing, or similar
charge for) human milk fortifier described in section
1905(a)(31).''.
(2) Inclusion as medical assistance.--Section 1905 of the
Social Security Act (42 U.S.C. 1396d) is amended--
(A) in subsection (a)--
(i) in paragraph (30), by striking ``and''
at the end;
(ii) by redesignating paragraph (31) as
paragraph (32); and
(iii) by inserting after paragraph (30) the
following new paragraph:
``(31) beginning January 1, 2025, human milk fortifier (as
described in subsection (jj)); and''; and
(B) by adding at the end the following new
subsection:
``(jj) Human Milk Fortifier.--
``(1) In general.--For purposes of subsection (a)(31), the
term `human milk fortifier' means a donor human milk-derived
product that is furnished to an infant under 1 year of age if a
specified professional determines that such donor human milk-
derived product is medically necessary for the infant because--
``(A) the infant's gestational age at birth was 34
weeks or less;
``(B) the infant--
``(i) had a birth weight of less than 1800
grams; or
``(ii) has a body weight below healthy
levels, as determined by the specified
professional; or
``(C) the infant has a congenital or acquired
condition and such donor human milk-derived product
will--
``(i) improve such condition; or
``(ii) aid in the recovery of the infant
with respect to such condition.
``(2) Definitions.--For purposes of this subsection, the
following definitions apply:
``(A) Donor human milk-derived product.--The term
`donor human milk-derived product' means a specialty
nutritional product made from donor human milk wherein
the donor human milk has been concentrated or one or
more components have been removed.
``(B) Specified professional.--The term `specified
professional' means a physician, nurse practitioner,
physician's assistant, registered dietician, or other
licensed professional authorized by State statute to
make the determination described in paragraph (1).''.
(3) Prohibition of cost sharing.--
(A) In general.--Section 1916 of the Social
Security Act (42 U.S.C. 1396o) is amended--
(i) in subsection (a)(2)--
(I) in subparagraph (I), by
striking at the end ``or'';
(II) in subparagraph (J), by
striking at the end ``; and'' and
inserting ``, or''; and
(III) by adding at the end the
following new subparagraph:
``(K) beginning January 1, 2025, human milk
fortifier (as described in section 1905(a)(31)); and'';
and
(ii) in subsection (b)(2)--
(I) in subparagraph (I), by
striking at the end ``or'';
(II) in subparagraph (J), by
striking at the end ``; and'' and
inserting ``, or''; and
(III) by adding at the end the
following new subparagraph:
``(K) beginning January 1, 2025, human milk
fortifier (as described in section 1905(a)(31)); and''.
(B) Application to alternative cost sharing.--
Section 1916A(b)(3)(B) of the Social Security Act (42
U.S.C. 1396o-1(b)(3)(B)) is amended by adding at the
end the following new clause:
``(xv) Beginning January 1, 2025, human
milk fortifier (as described in section
1905(a)(31)).''.
(b) Coverage Under the Children's Health Insurance Plan.--
(1) In general.--Section 2103 of the Social Security Act
(42 U.S.C. 1397cc) is amended--
(A) in subsection (a), by striking ``and (8)'' and
inserting ``, (8), and (13)''; and
(B) in subsection (c), by adding at the end the
following new paragraph:
``(13) Required coverage of human milk fortifier.--The
child health assistance provided to a targeted low-income child
shall include coverage of human milk fortifier (as described in
section 1905(a)(31)).''.
(2) Prohibition of cost sharing.--Section 2103(e)(2) of the
Social Security Act (42 U.S.C. 1397cc(e)(2)) is amended--
(A) in the paragraph heading, by inserting ``human
milk fortifier,'' before ``or pregnancy-related
assistance''; and
(B) by inserting ``human milk fortifier described
in section 1905(a)(31),'' before ``or for pregnancy-
related assistance''.
(3) Effective date.--
(A) In general.--Subject to subparagraph (B), the
amendments made by this subsection shall apply with
respect to child health assistance furnished on or
after January 1, 2025.
(B) Exception if state legislation required.--In
the case of a State child health plan for child health
assistance under title XXI of the Social Security Act
which the Secretary of Health and Human Services
determines requires State legislation (other than
legislation appropriating funds) in order for the plan
to meet the additional requirement imposed by the
amendments made by this subsection, the State child
health plan shall not be regarded as failing to comply
with the requirements of such title solely on the basis
of its failure to meet this additional requirement
before the first day of the first calendar quarter
beginning after the close of the first regular session
of the State legislature that begins after the date of
the enactment of this Act. For purposes of the previous
sentence, in the case of a State that has a 2-year
legislative session, each year of such session shall be
deemed to be a separate regular session of the State
legislature.
(c) Coverage Under Group Health Plans and Group and Individual
Health Insurance.--
(1) In general.--Subpart II of part A of title XXVII of the
Public Health Service Act (42 U.S.C. 300gg-11 et seq.) is
amended by adding at the end the following new section:
``SEC. 2730. NO-COST COVERAGE OF HUMAN MILK FORTIFIER.
``A group health plan, and a health insurance issuer offering group
or individual health insurance coverage, shall provide coverage for,
and shall not impose any cost sharing requirements for, human milk
fortifier (as described in section 1905(a)(jj) of the Social Security
Act).''.
(2) Effective date.--The amendments made by this subsection
shall apply to plan years beginning on or after January 1,
2025.
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