Strengthening the Vaccines for Children Program Act of 2021

I 117TH CONGRESS 1ST SESSION H. R. 2347 To amend title XIX of the Social Security Act to ensure adequate access to vaccines under the Medicaid program and the Vaccines for Children program, and for other purposes. IN THE HOUSE OF REPRESENTATIVES APRIL 1, 2021 Ms. SCHRIER (for herself, Mr. JOYCE of Pennsylvania, Mr. BUTTERFIELD, and Mr. MCKINLEY) 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 adequate access to vaccines under the Medicaid program and the Vaccines for Children program, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Strengthening the Vac- 4 cines for Children Program Act of 2021’’. 5 VerDate Sep 11 2014 04:54 Jun 02, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2347.IH H2347 pbinns on DSKJLVW7X2PROD with BILLS 2 •HR 2347 IH SEC. 2. ENSURING ADEQUATE ACCESS TO VACCINES 1 UNDER THE MEDICAID PROGRAM AND THE 2 VACCINES FOR CHILDREN PROGRAM. 3 (a) ENCOURAGING INVOLVEMENT OF PROVIDERS.— 4 Paragraph (3) of section 1928(c) of the Social Security 5 Act (42 U.S.C. 1396s(c)) is amended— 6 (1) by redesignating subparagraphs (A) and 7 (B) as clauses (i) and (ii), respectively, and moving 8 the margins of each such clause, as so redesignated, 9 2 ems to the right; 10 (2) by striking ‘‘PROVIDERS’’ and all that fol- 11 lows through ‘‘Each program’’ and inserting ‘‘PRO- 12 VIDERS.— 13 ‘‘(A) IN GENERAL.—Each program’’; and 14 (3) by adding at the end the following: 15 ‘‘(B) INCENTIVE PAYMENTS.— 16 ‘‘(i) IN GENERAL.—The Secretary 17 shall pay to each provider that requests 18 payment under this subparagraph and that 19 is a program-registered provider under this 20 section for the duration of the period be- 21 ginning on the date of the enactment of 22 this subparagraph, and ending on Decem- 23 ber 31, 2022— 24 ‘‘(I) an amount equal to $5,000, 25 to be paid as soon as practicable after 26 VerDate Sep 11 2014 04:54 Jun 02, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2347.IH H2347 pbinns on DSKJLVW7X2PROD with BILLS 3 •HR 2347 IH the date of the enactment of this sub- 1 paragraph; 2 ‘‘(II) an amount equal to $2,500, 3 to be paid as soon as practicable after 4 January 1, 2022; and 5 ‘‘(III) an amount equal to 6 $2,500, to be paid as soon as prac- 7 ticable after January 1, 2023. 8 ‘‘(ii) USE OF FUNDS.—Payments 9 made under clause (i) may only be used by 10 a provider for purposes of carrying out the 11 program under this section (including any 12 operational expenses associated with the 13 furnishing of vaccines under such program, 14 as specified by the Secretary). 15 ‘‘(iii) RECOUPMENT OF PAYMENTS.— 16 The Secretary may conduct reviews of pro- 17 viders receiving payments under this sub- 18 paragraph to ensure that such payments 19 are used in accordance with clause (ii) and 20 recoup from such providers any such pay- 21 ments not so used in accordance with such 22 clause.’’. 23 (b) EXPANSION OF DEFINITION OF FEDERALLY VAC- 24 CINE-ELIGIBLE CHILD.—Paragraph (2) of section 25 VerDate Sep 11 2014 04:54 Jun 02, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2347.IH H2347 pbinns on DSKJLVW7X2PROD with BILLS 4 •HR 2347 IH 1928(b) of the Social Security Act (42 U.S.C. 1396s(b)) 1 is amended— 2 (1) in subparagraph (A)— 3 (A) in clause (iii), by striking ‘‘A child 4 who’’ and all that follows through the period at 5 the end and inserting ‘‘A child who is adminis- 6 tered a qualified pediatric vaccine and is not in- 7 sured with respect to such vaccine.’’; and 8 (B) by adding at the end the following new 9 clause: 10 ‘‘(v) A child who is enrolled for child 11 health assistance under a State child 12 health plan approved under title XXI.’’; 13 and 14 (2) in subparagraph (B)(ii)(II), by striking ‘‘for 15 purposes of subparagraph (A)(iii)(II)’’ and inserting 16 ‘‘for purposes of subparagraph (A)(iii)’’. 17 (c) MINIMUM PAYMENT REQUIREMENT FOR VACCINE 18 ADMINISTRATION SERVICES.— 19 (1) IN GENERAL.—Section 1902(a)(13) of the 20 Social Security Act (42 U.S.C. 1396a(a)(13)) is 21 amended— 22 (A) in subparagraph (B), by striking 23 ‘‘and’’ at the end; 24 VerDate Sep 11 2014 04:54 Jun 02, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2347.IH H2347 pbinns on DSKJLVW7X2PROD with BILLS 5 •HR 2347 IH (B) in subparagraph (C), by striking the 1 semicolon and inserting ‘‘; and’’; and 2 (C) by adding at the end the following new 3 subparagraph: 4 ‘‘(D) for payment for vaccine administra- 5 tion services (including vaccine counseling and 6 educational services) furnished by a provider 7 during the period beginning on the date of the 8 enactment of this subparagraph, and ending on 9 December 31, 2022 (including, notwithstanding 10 subsection (c)(2)(C)(ii) of section 1928, any 11 such services furnished with respect to a vac- 12 cine furnished under the program established 13 by the State pursuant to such section to a med- 14 icaid-eligible child (as defined in subsection 15 (b)(2)(B)(i) of such section)), at a rate not less 16 than 100 percent of the payment rate that ap- 17 plies to such services and provider under part 18 B of title XVIII;’’. 19 (2) MANAGED CARE PLANS.—Section 1932(f) 20 of the Social Security Act (42 U.S.C. 1396u–2(f)) is 21 amended— 22 (A) in the header, by striking ‘‘PAYMENT 23 FOR PRIMARY CARE SERVICES’’ and inserting 24 ‘‘PAYMENTS’’; 25 VerDate Sep 11 2014 04:54 Jun 02, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2347.IH H2347 pbinns on DSKJLVW7X2PROD with BILLS 6 •HR 2347 IH (B) by striking ‘‘section 1902(a)(13)(C)’’ 1 and inserting ‘‘subparagraph (C) of section 2 1902(a)(13) and vaccine administration services 3 described in subparagraph (D) of such section’’; 4 (C) by striking ‘‘such section’’ and insert- 5 ing ‘‘such subparagraph (C) or (D), respec- 6 tively’’; and 7 (D) by adding at the end the following new 8 sentence: ‘‘The provisions of the preceding sen- 9 tence shall apply to contracts entered into with, 10 and payments made by, other specified entities 11 (as defined in section 1903(m)(9)(D)(iii)) in the 12 same manner as such provisions apply with re- 13 spect to contracts entered into with, and pay- 14 ments made by, medicaid managed care organi- 15 zations.’’. 16 (3) CHIP.—Section 2103(c) of the Social Secu- 17 rity Act (42 U.S.C. 1397cc(c)) is amended by add- 18 ing at the end the following new paragraph: 19 ‘‘(11) VACCINE ADMINISTRATION SERVICES.— 20 The child health assistance provided to a targeted 21 low-income child shall include payment for vaccine 22 administration services (including vaccine counseling 23 and educational services) furnished by a provider 24 during the period beginning on the date of the en- 25 VerDate Sep 11 2014 04:54 Jun 02, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2347.IH H2347 pbinns on DSKJLVW7X2PROD with BILLS 7 •HR 2347 IH actment of this paragraph, and ending on December 1 31, 2022 (including, notwithstanding subsection 2 (c)(2)(C)(ii) of section 1928, any such services fur- 3 nished to such child with respect to a vaccine fur- 4 nished under the program established by the State 5 pursuant to such section), at a rate not less than 6 100 percent of the payment rate that applies to such 7 services and provider under part B of title XVIII.’’. 8 (d) COVERAGE OF VACCINE COUNSELING AND EDU- 9 CATIONAL SERVICES UNDER MEDICAID.— 10 (1) IN GENERAL.—Section 1905(a) of the So- 11 cial Security Act (42 U.S.C. 1396d) is amended— 12 (A) in paragraph (29), by striking ‘‘and’’ 13 at the end; 14 (B) by redesignating paragraph (30) as 15 paragraph (31); and 16 (C) by inserting after paragraph (29) the 17 following new paragraph: 18 ‘‘(30) vaccine counseling and educational serv- 19 ices furnished to children under the age of 19 on or 20 after the date of the enactment of this paragraph, 21 including any such services furnished as part of a 22 multiple component vaccine (identified as of October 23 1, 2020, by CPT code 90461) and including any 24 such services furnished under the program estab- 25 VerDate Sep 11 2014 04:54 Jun 02, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2347.IH H2347 pbinns on DSKJLVW7X2PROD with BILLS 8 •HR 2347 IH lished by the State pursuant to section 1928 to a 1 medicaid-eligible child (as defined in subsection (b) 2 of such section),’’. 3 (2) MANDATORY BENEFIT.—Section 4 1902(a)(10)(A) of the Social Security Act (42 5 U.S.C. 1396a(a)(10)(A)) is amended by striking 6 ‘‘and (29)’’ and inserting ‘‘(29), and (30)’’. 7 (e) CLARIFICATION OF COVERAGE OF PEDIATRIC 8 VACCINES AND VACCINE COUNSELING AND EDUCATIONAL 9 SERVICES UNDER THE VACCINES FOR CHILDREN PRO- 10 GRAM.—Section 1928(c)(2)(C)(ii) of the Social Security 11 Act (42 U.S.C. 1396s(c)(2)(C)(ii)) is amended to read as 12 follows: 13 ‘‘(ii) The provider may impose— 14 ‘‘(I) in the case of a qualified pedi- 15 atric vaccine not described in subclause 16 (II), a fee for the administration of and 17 counseling for such vaccine so long as the 18 fee in the case of a federally vaccine-eligi- 19 ble child does not exceed the costs of such 20 administration and counseling (as deter- 21 mined by the Secretary based on actual re- 22 gional costs for such administration and 23 counseling); and 24 VerDate Sep 11 2014 04:54 Jun 02, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H2347.IH H2347 pbinns on DSKJLVW7X2PROD with BILLS 9 •HR 2347 IH ‘‘(II) in the case of a qualified pedi- 1 atric vaccine that is a multiple component 2 vaccine, a separate charge for the adminis- 3 tration of and counseling for each compo- 4 nent of such vaccine so long as the charge 5 in the case of a federally vaccine-eligible 6 child does not exceed— 7 ‘‘(aa) with respect to the first 8 component of such vaccine, the costs 9 of such administration and counseling 10 for such component (as determined by 11 the Secretary based on actual regional 12 costs for such administration and 13 counseling for such first component); 14 and 15 ‘‘(bb) with respect to a subse- 16 quent component of such vaccine, the 17 payment rate that applies to such ad- 18 ministration and counseling for such 19 component and provider under part B 20 of title XVIII.’’. 21 (f) INCREASE IN FEDERAL MEDICAL ASSISTANCE 22 PERCENTAGE.— 23 (1) IN GENERAL.—Subject to paragraph (2), 24 for each calendar quarter occurring during the pe- 25 VerDate Sep 11 2014 04:54 Jun 02, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H2347.IH H2347 pbinns on DSKJLVW7X2PROD with BILLS 10 •HR 2347 IH riod beginning on January 1, 2021, and ending on 1 December 31, 2022, the Federal medical assistance 2 percentage determined for each State, including the 3 District of Columbia, American Samoa, Guam, the 4 Commonwealth of the Northern Mariana Islands, 5 Puerto Rico, and the United States Virgin Islands, 6 under section 1905(b) of the Social Security Act (42 7 U.S.C. 1396d(b)), after application of section 6008 8 of the Families First Coronavirus Response Act 9 (Public Law 116–127) (if applicable), shall be in- 10 creased by 1 percentage point. 11 (2) REQUIREMENTS.— 12 (A) IN GENERAL.—A State described in 13 paragraph (1) may not receive the increase de- 14 scribed in such paragraph in the Federal med- 15 ical assistance percentage for such State, with 16 respect to a quarter, if such State does not en- 17 sure culturally competent and effective mes- 18 sages for vaccination outreach to child popu- 19 lations, which may include the dissemination of 20 information highlighting— 21 (i) advancements in research and vac- 22 cine development that have saved millions 23 of individuals from death and disability 24 from now-preventable diseases; 25 VerDate Sep 11 2014 04:54 Jun 02, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H2347.IH H2347 pbinns on DSKJLVW7X2PROD with BILLS 11 •HR 2347 IH (ii) information on how individuals 1 across the lifespan benefit from immuniza- 2 tions, including those who cannot be vac- 3 cinated and rely on community immunity; 4 (iii) information on the dangers of not 5 being vaccinated, including the potential 6 for infectious disease outbreaks within 7 communities; and 8 (iv) information on vaccine safety and 9 the systems in place to monitor vaccine 10 safety. 11 (B) REQUIREMENT FOR CERTAIN 12 STATES.—Section 1905(cc) of the Social Secu- 13 rity Act (42 U.S.C. 1396d(cc)) is amended— 14 (i) by inserting ‘‘and section 2(e) of 15 the Strengthening the Vaccines for Chil- 16 dren Program Act of 2021’’ before ‘‘, ex- 17 cept that in applying’’; and 18 (ii) by inserting ‘‘, and in applying 19 such treatments to the increases in the 20 Federal medical assistance percentage 21 under section 2(e) of the Strengthening the 22 Vaccines for Children Program Act of 23 2021, the reference to ‘December 31, 24 2009’ shall be deemed to be a reference to 25 VerDate Sep 11 2014 04:54 Jun 02, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H2347.IH H2347 pbinns on DSKJLVW7X2PROD with BILLS 12 •HR 2347 IH ‘December 31, 2020’ ’’ before the period at 1 the end. 2 (g) TRIBAL EPIDEMIOLOGY CENTER DATA AC- 3 CESS.—With respect to data access for tribal epidemiology 4 centers established under section 214 of the Indian Health 5 Care Improvement Act (25 U.S.C. 1621m), the Director 6 of the Centers for Disease control and Prevention may cre- 7 ate a data sharing strategy that ensures such centers have 8 access to data, data sets, monitoring systems, delivery sys- 9 tems, and other protected health information with respect 10 to health care and public health surveillance systems of 11 child and adolescent health necessary to accomplish such 12 centers’ public health authority responsibilities described 13 in such section or section 164.501 of title 45, Code of Fed- 14 eral Regulations. 15 (h) REPORTS.— 16 (1) IN GENERAL.—For each of fiscal years 17 2021 and 2022, the Director of the Centers for Dis- 18 ease Control and Prevention, in coordination with 19 each State that has established a pediatric vaccine 20 distribution program under section 1928 of the So- 21 cial Security Act (42 U.S.C. 1396s), shall publish on 22 the public internet website of the Centers for Dis- 23 ease Control and Prevention, in such manner as de- 24 termined appropriate by the Director, information 25 VerDate Sep 11 2014 04:54 Jun 02, 2021 Jkt 019200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H2347.IH H2347 pbinns on DSKJLVW7X2PROD with BILLS 13 •HR 2347 IH on vaccination rates under each such program dur- 1 ing such year, includi [Text truncated for display. Full text available on Congress.gov.]