[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 5182 Introduced in Senate (IS)]
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118th CONGRESS
2d Session
S. 5182
To amend title XIX of the Social Security Act to require the collection
of information regarding social determinants of health, and for other
purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
September 25, 2024
Mr. Sullivan (for himself and Ms. Cortez Masto) introduced the
following bill; which was read twice and referred to the Committee on
Finance
_______________________________________________________________________
A BILL
To amend title XIX of the Social Security Act to require the collection
of information regarding social determinants of health, 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 ``Utilizing National Data, Effectively
Reforming Standards and Tools, to Address Negative Determinates of
Health Act'' or the ``UNDERSTAND Act''.
SEC. 2. COLLECTION OF INFORMATION RELATED TO SOCIAL DETERMINANTS OF THE
HEALTH OF MEDICAID AND CHIP BENEFICIARIES.
(a) Reporting of Information.--Section 1946 of the Social Security
Act (42 U.S.C. 1396w-5) is amended by adding at the end the following:
``(d) Collection of Information Related to Social Determinants of
Health.--
``(1) Development of uniform reporting field.--
``(A) In general.--Not later than 18 months after
the date of enactment of this subsection, the
Secretary, in consultation with the States, shall
develop a model uniform reporting field through the
transformed Medicaid Statistical Information System (T-
MSIS), as approved by the Secretary, for collecting
standardized and aggregated State-level information
related to social determinants that may factor into the
health of beneficiaries under this title who are
eligible for medical assistance for which Federal
financial participation is available and beneficiaries
under title XXI who are eligible for child health
assistance for which Federal financial participation is
available which the States, notwithstanding section
1902(a)(7) and as a condition for meeting the
requirements of section 1902(a)(6) and section
2107(b)(1), shall use to annually report such
information.
``(B) Implementation.--In carrying out the
requirements of subparagraph (A), the Secretary shall--
``(i) determine the appropriate providers
and frequency with which such providers may
submit standardized information to States to be
used to complete the uniform reporting field
developed under such subparagraph;
``(ii) issue guidance for ensuring
compliance with applicable laws regarding
beneficiary informed consent, privacy, and
anonymity with respect to the information
collected through the uniform reporting field;
``(iii) with respect to the collection of
information relating to beneficiaries who are
children, issue guidance on the collection of
such information from a parent, legal guardian,
or any other person who is legally authorized
to share such information on behalf of the
child when the direct collection of such
information from children may not otherwise be
feasible or appropriate; and
``(iv) issue guidance on how to reduce
duplicative screenings of beneficiaries, or to
ensure that information collected from a
screening is entered into a beneficiary's
health record so that other providers who treat
that beneficiary can see that a screening has
been conducted for that beneficiary.
``(2) Social determinants of health defined.--
``(A) In general.--For purposes of this title and
title XXI, the term `social determinants of health'
means the standardized definitions developed in
accordance with paragraph (1) for identifying social
determinants of health needs identified in the ICD-10
diagnostic codes Z55 through Z63, Z65, and Z75 (as in
effect on the date of enactment of this subsection).
``(B) Incorporation measures of relative
severity.--The Secretary shall issue guidance relating
to incorporating measures for quantifying, with respect
to an individual, the relative severity of a social
determinant of health need of the individual as
identified by a diagnostic code referred to in
subparagraph (A).
``(3) Rules of construction.--
``(A) Federal privacy requirements.--Nothing in
this subsection shall be construed to supersede any
Federal privacy or confidentiality requirement,
including the regulations promulgated under section
264(c) of the Health Insurance Portability and
Accountability Act of 1996 and section 543 of the
Public Health Service Act and any regulations
promulgated thereunder.
``(B) No requirement for the provision of medical
assistance.--Nothing in this subsection shall be
construed as allowing for medical assistance for items
and services for which Federal financial participation
is not permitted under this title.
``(4) State requirement to collect information from
providers.--As a condition for meeting the requirements of
section 1902(a)(6) and section 2107(b)(1), a State shall ensure
that the providers identified by the Secretary under paragraph
(1)(B)(i) are conducting screenings for social needs and
submitting standardized information with appropriate frequency
(as identified by the Secretary under such paragraph).
``(5) Application to territories.--
``(A) In general.--To the extent that the Secretary
determines that it is not practicable for a State
specified in subparagraph (B) to report information in
accordance with the uniform reporting field made
available under paragraph (1), this subsection shall
not apply with respect to such State.
``(B) Territories specified.--The States specified
in this subparagraph are Puerto Rico, the Virgin
Islands, Guam, American Samoa, and the Northern Mariana
Islands.''.
(b) Report.--Section 1946(b)(2) of such Act (42 U.S.C. 1396w-
5(b)(2)) is amended--
(1) by striking ``Not later than'' and inserting the
following:
``(A) Initial reports.--Not later than''; and
(2) by adding at the end the following:
``(B) Report on collection of information related
to social determinants of health.--Not later than 4
years after the date of the enactment of this
subparagraph, the Secretary shall submit to Congress a
report that includes aggregate findings and trends
across respective beneficiary populations for improving
the identification of social determinants of health for
beneficiaries under this title who are eligible for
medical assistance for which Federal financial
participation is available and beneficiaries under
title XXI who are eligible for child health assistance
for which Federal financial participation is available
based on analyses of the data collected under
subsection (d).''.
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