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<PRE>[DOCID: f:h1793ih.txt]






107th CONGRESS
  1st Session
                                H. R. 1793

To amend title XIX of the Social Security Act to permit a State waiver 
 authority to provide medical assistance in cases of congenital heart 
                                defects.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 10, 2001

  Mrs. Morella (for herself, Mr. Wynn, and Mr. Putnam) 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 permit a State waiver 
 authority to provide medical assistance in cases of congenital heart 
                                defects.

    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 ``Melissa Froelich Medicaid Congenital 
Heart Defect Waiver Act of 2001''.

SEC. 2. MEDICAID WAIVER TO PROVIDE MEDICAL ASSISTANCE IN CASE OF 
              INDIVIDUALS WITH CONGENITAL HEART DEFECTS.

    Section 1915 of the Social Security Act (42 U.S.C. 1396n) is 
amended--
            (1) by redesignating subsection (h) as subsection (i); and
            (2) by inserting after subsection (g) the following new 
        subsection:
    ``(h)(1)(A) Subject to paragraph (2), the Secretary shall by waiver 
provide that a State plan approved under this title may include as 
`medical assistance' under such plan payment for part or all of the 
costs of nursing care (including home health nursing care), respite 
care, physicians' services, prescribed drugs (including physician 
ordered dietary supplements), medical devices and supplies, home 
modifications required to accommodate the individual, transportation 
services (including medical transport costs of life-saving flights to 
treating hospitals as well as transportation to access highly 
specialized care which does not exist in the area of residence), 
payment for the set aside fund for placement on the National Organ 
Waiting List, and such other services related to the treatment of the 
congenital heart defect or defects requested by the State as the 
Secretary may approve which are provided pursuant to a written plan of 
care to an individual described in subparagraph (B). Such payment shall 
be made (in a manner consistent with section 1902(a)(25)) for costs of 
covered benefits that are not reimbursed under group health plan, other 
insurance coverage, or other third party liability.
    ``(B) Individuals described in this subparagraph are individuals 
who at the time of birth had one or more congenital heart defects which 
require surgical intervention.
    ``(2) A waiver shall not be granted under this subsection unless 
the State provides assurances satisfactory to the Secretary that--
            ``(A) necessary safeguards (including adequate standards 
        for provider participation) have been taken to protect the 
        health and welfare of individuals provided services under the 
        waiver and to assure financial accountability for funds 
        expended with respect to such services;
            ``(B) under such waiver, the State, in any fiscal year will 
        be the secondary payor of the medical assistance as required 
        under section 1902(a)(25);
            ``(C) individuals described in paragraph (1)(B) shall be 
        eligible for medical assistance at the time they have exhausted 
        (either on a lifetime basis or based upon an annual limitation 
        on benefits) all other health insurance benefits, without 
        regard to the assets or resources of the individual or the 
        individual's family;
            ``(D) the State will provide to the Secretary annually, 
        consistent with a data collection plan designed by the 
        Secretary, information on the impact of the waiver granted 
        under this subsection on the type and amount of medical 
        assistance provided under the State plan and on the health and 
        welfare of recipients.
    ``(3) The provisions of paragraphs (3) and (4) of subsection (e) 
shall apply under this subsection in the same manner as they apply 
under such subsection.''.
                                 &lt;all&gt;

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