[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 912 Introduced in House (IH)]
112th CONGRESS
1st Session
H. R. 912
To amend the Public Health Service Act to establish a national
screening program at the Centers for Disease Control and Prevention and
to amend title XIX of the Social Security Act to provide States the
option to increase screening in the United States population for the
prevention, early detection, and timely treatment of colorectal cancer.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 3, 2011
Ms. Granger introduced the following bill; which was referred to the
Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to establish a national
screening program at the Centers for Disease Control and Prevention and
to amend title XIX of the Social Security Act to provide States the
option to increase screening in the United States population for the
prevention, early detection, and timely treatment of colorectal cancer.
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 ``Colorectal Cancer Prevention, Early
Detection, and Treatment Act''.
SEC. 2. PREVENTIVE HEALTH MEASURES WITH RESPECT TO COLORECTAL CANCER.
Part B of title III of the Public Health Service Act (42 U.S.C. 243
et seq.) is amended by inserting after section 317T the following new
section:
``SEC. 317U. PREVENTIVE HEALTH MEASURES WITH RESPECT TO COLORECTAL
CANCER.
``(a) Grant Program Authorization.--
``(1) In general.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention, may
make grants to eligible entities for the purpose of carrying
out a program described in subsection (b). An eligible entity
that is a recipient of a grant under this subsection may use
such grant to carry out such programs directly or through
grants to, or contracts with, public and not-for-profit private
entities.
``(2) Eligible entity defined.--For purposes of this
section, the term `eligible entity' includes the following:
``(A) A State, including, in addition to the
several States, the District of Columbia, Guam, the
Commonwealth of Puerto Rico, the Northern Mariana
Islands, the Virgin Islands, American Samoa, and the
Trust Territory of the Pacific Islands.
``(B) An Indian tribe or tribal organization, as
such terms are defined in section 4 of the Indian Self-
Determination and Education Assistance Act.
``(b) Programs Described.--
``(1) In general.--Subject to paragraph (2), a program
described in this subsection shall use evidence-based
strategies and population-based public health approaches,
including public education and outreach, professional training
and development, quality assurance monitoring, surveillance,
and evaluation, to increase quality colorectal cancer screening
in the population aged 50 years and older, or for individuals
under 50 who are at high risk. A program described in this
subsection is a program for planning or implementing each of
the following:
``(A) Providing evidence-based, recommended
screenings for colorectal cancer to individuals who--
``(i) are 50 years of age or older; or
``(ii)(I) are under 50 years of age; and
``(II) are at high risk for such cancer, as
determined in accordance with subsection
(e)(2).
``(B) Providing appropriate case management and
referrals for medical treatment of individuals screened
pursuant to subparagraph (A).
``(C) Ensuring (directly or through coordination or
an arrangement with health care providers or programs)
the full continuum of follow-up and cancer care for
individuals so screened, including appropriate follow-
up for abnormal tests, diagnostic services, therapeutic
services, and treatment of detected cancers and
management of unanticipated medical complications.
``(D) Carrying out activities to improve the
education, training, and skills of health professionals
(including allied health professionals) to ensure the
use of evidence-based recommended and quality screening
and follow up in the prevention, detection, and control
of colorectal cancer, which activities are carried out
pursuant to the participation of the health
professionals in the program.
``(E) Establishing mechanisms through which the
eligible entity involved can monitor the quality of
screening and diagnostic follow-up procedures for
colorectal cancer, including the interpretation of such
procedures.
``(F) Evaluating the activities described in this
subsection through appropriate surveillance and program
monitoring activities.
``(G) Developing and disseminating findings derived
through such evaluations and the collection of data on
outcomes.
``(H) Developing and disseminating public
information and education programs for the prevention,
detection, and control of colorectal cancer and
promoting the benefits of receiving screenings to
populations recommended for screening.
``(2) Supplement not supplant.--In the case of an eligible
entity that implements a universal colorectal screening program
under which the eligible entity makes available funds for
activities described in subparagraph (A), (B), or (C) of
paragraph (1), such entity shall be able to receive grant funds
under subsection (a) only for purposes of--
``(A) carrying out those activities under this
subsection that are not so funded; or
``(B) supplementing (and not supplanting) funds
made available by the entity for such funded program.
``(c) Priority for Low-Income, Uninsured and Underinsured
Individuals.--A grant may be made under subsection (a) to an eligible
entity only if the eligible entity agrees that, in providing screenings
under subsection (b)(1)(A), the eligible entity will give priority to
low-income individuals who lack adequate coverage, as determined by the
Secretary, under health insurance and health plans with respect to
screenings for colorectal cancer.
``(d) Special Consideration for Certain Applicants.--In making
grants under subsection (a) for a fiscal year, the Secretary shall give
special consideration to the following eligible entities:
``(1) In the case of services under such subsection for
women, to such entities that, for such year, are grantees under
title XV.
``(2) In the case of services under such subsection for
men, to such entities that, for such year, are grantees under
section 317D.
``(3) To such entities that coordinate with other Federal,
State, and local colorectal cancer programs.
``(4) To such entities with an existing program to provide
cancer screening to individuals.
``(e) Use of Certain Standards Under Medicare Program.--A grant may
be made under subsection (a) to an eligible entity only if the eligible
entity provides, as applicable, assurances as follows:
``(1) Screenings under subsection (b)(1)(A) will be carried
out as preventive health measures in accordance with evidence-
based screening guidelines and procedures and in accordance
with the standard of care required for purposes of title XVIII
of the Social Security Act to carry out colorectal screening
tests defined in section 1861(pp)(1) of such Act.
``(2) An individual will be considered high risk for
purposes of subsection (b)(1)(A)(ii) only if the individual is
high risk within the meaning of section 1861(pp)(2) of such
Act.
``(3) The payment made from the grant for a screening
procedure under subsection (b)(1)(A) will not exceed the amount
that would be paid under part B of title XVIII of such Act if
payment were made under such part for furnishing the procedure
to an individual enrolled under such part.
``(f) Relationship to Items and Services Under Other Programs.--A
grant under subsection (a) may be made to an eligible entity only if
the eligible entity, as applicable, provides assurances that the grant
will not be expended to make payment for any item or service to the
extent that payment has been made, or can reasonably be expected to be
made, with respect to such item or service--
``(1) under any State compensation program, under an
insurance policy, or under any Federal or State health benefits
program; or
``(2) by an entity that provides health services on a
prepaid basis.
``(g) Records and Audits.--A grant under subsection (a) may be made
to an eligible entity only if the eligible entity provides assurances
that the eligible entity will--
``(1) establish such fiscal control and fund accounting
procedures as may be necessary to ensure proper disbursal of,
and accounting for, amounts received under subsection (a); and
``(2) upon request, provide records maintained pursuant to
paragraph (1) to the Secretary or the Comptroller General of
the United States for purposes of auditing the expenditures of
the grant by the eligible entity.
``(h) Requirement of Matching Funds.--
``(1) In general.--The Secretary may not make a grant under
subsection (a) to an eligible entity for a fiscal year unless
the eligible entity agrees, with respect to the costs to be
incurred by the eligible entity for such fiscal year in
carrying out the activities described in subsection (b), to
make available non-Federal contributions (in cash or in kind
under paragraph (2)) toward such costs in an amount equal to
not less than $1 for each $3 of Federal funds provided in the
grant for such fiscal year. Such contributions may be made
directly or through donations from public or private entities.
``(2) Determination of amount of non-federal
contribution.--
``(A) In general.--Non-Federal contributions
required in paragraph (1) may be in cash or in kind,
fairly evaluated, including equipment or services (and
excluding indirect or overhead costs). Amounts provided
by the Federal Government, or services assisted or
subsidized to any significant extent by the Federal
Government, may not be included in determining the
amount of such non-Federal contributions.
``(B) Maintenance of effort.--In making a
determination of the amount of non-Federal
contributions for purposes of paragraph (1), the
Secretary may include only non-Federal contributions in
excess of the average amount of non-Federal
contributions made by the eligible entity involved
toward the activities described in subsection (b) for
the 2-year period preceding the first fiscal year for
which the eligible entity is applying to receive a
grant under subsection (a).
``(C) Inclusion of relevant non-federal
contributions for medicaid.--In making a determination
of the amount of non-Federal contributions for purposes
of paragraph (1), the Secretary shall, subject to
subparagraphs (A) and (B) of this paragraph, include
any non-Federal amounts expended pursuant to title XIX
of the Social Security Act by the eligible entity
involved toward the activities described in
subparagraphs (A) and (B) of subsection (b)(1).
``(i) Additional Requirements.--
``(1) Limitation on administrative expenses.--The Secretary
may not make a grant to an eligible entity under subsection (a)
unless the eligible entity provides assurances that not more
than 10 percent of the grant will be expended for
administrative expenses with respect to the activities funded
by the grant.
``(2) Statewide provision of services.--
``(A) In general.--Subject to subparagraph (B), the
Secretary may not make a grant under subsection (a) to
an eligible entity unless the eligible entity provides
assurances that any program funded by such grant will
be made available throughout the State, including
availability to members of an Indian tribe or tribal
organization (as such terms are defined in section 4 of
the Indian Self-Determination and Education Assistance
Act).
``(B) Waiver.--The Secretary may waive the
requirement under subparagraph (A) for an eligible
entity if the Secretary determines that compliance by
the eligible entity with the requirement would result
in an inefficient allocation of resources with respect
to carrying out the purposes described in subsection
(a).
``(j) Technical Assistance and Provision of Supplies and Services
in Lieu of Grant Funds.--
``(1) Technical assistance.--The Secretary may provide
training and technical assistance with respect to the planning,
development, and operation of any program funded by a grant
under subsection (a). The Secretary may provide such technical
assistance directly to eligible entities or through grants to,
or contracts with, public and private entities.
``(2) Provision of supplies and services in lieu of grant
funds.--
``(A) In general.--Subject to subparagraph (B),
upon the request of an eligible entity receiving a
grant under subsection (a), the Secretary for the
purpose of aiding the eligible entity to carry out a
program under subsection (b)--
``(i) may provide supplies, equipment, and
services to the eligible entity; and
``(ii) may detail to the eligible entity
any officer or employee of the Department of
Health and Human Services.
``(B) Corresponding reduction in payments.--With
respect to a request made by an eligible entity under
subparagraph (A), the Secretary shall reduce the amount
of payments made under the grant under subsection (a)
to the eligible entity by an amount equal to the fair
market value of any supplies, equipment, or services
provided by the Secretary and the costs of detailing
personnel (including pay, allowances, and travel
expenses) under subparagraph (A). The Secretary shall,
for the payment of expenses incurred in complying with
such request, expend the amounts withheld.
``(k) Reports.--A grant under subsection (a) may be made only if
the applicant involved agrees to submit to the Secretary such reports
as the Secretary may require with respect to the grant.
``(l) Authorization of Appropriations.--
``(1) In general.--For the purpose of carrying out this
section, there are authorized to be appropriated $120,000,000
for each of fiscal years 2012 through 2016.
``(2) Set-aside for technical assistance and provision of
supplies and services.--Of the amount appropriated under
paragraph (1) for a fiscal year, the Secretary shall reserve
not to exceed 20 percent for carrying out subsection (j).''.
SEC. 3. OPTIONAL MEDICAID COVERAGE OF CERTAIN PERSONS SCREENED AND
FOUND TO HAVE COLORECTAL CANCER.
(a) Coverage as Optional Categorically Needy Group.--
(1) In general.--Section 1902(a)(10)(A)(ii) of the Social
Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)) is amended--
(A) in subclause (XXI), by striking ``or'' at the
end;
(B) in subclause (XXII), by adding ``or'' at the
end; and
(C) by adding at the end the following:
``(XXIII) who are described in
subsection (ll) (relating to certain
persons screened and found to need
treatment from complications from
screening or have colorectal
cancer);''.
(2) Group described.--Section 1902 of the Social Security
Act (42 U.S.C. 1396a) is amended by adding at the end the
following:
``(ll) Individuals described in this subsection are individuals
who--
``(1) are not described in subsection (a)(10)(A)(i);
``(2) have not attained age 65;
``(3) have been screened for colorectal cancer and need
treatment for complications due to screening or colorectal
cancer; and
``(4) are not otherwise covered under creditable coverage,
as defined in section 2704(c) of the Public Health Service
Act.''.
(3) Limitation on benefits.--Section 1902(a)(10) of the
Social Security Act (42 U.S.C. 1396a(a)(10)) is amended in the
matter following subparagraph (G)--
(A) by striking ``(XV)'' and inserting ``, (XV)'';
(B) by striking ``setting and (XVI)'' and inserting
``setting, (XVII)''; and
(C) by inserting ``, and (XVIII) the medical
assistance made available to an individual described in
subsection (ll) who is eligible for medical assistance
only because of subparagraph (A)(10)(ii)(XXIII) shall
be limited to medical assistance provided during the
period in which such an individual requires treatment
for complications due to screening or colorectal
cancer'' before the semicolon.
(4) Conforming amendments.--Section 1905(a) of the Social
Security Act (42 U.S.C. 1396d(a)) is amended in the matter
preceding paragraph (1)--
(A) in clause (xvi), by striking ``or'' at the end;
(B) in clause (xvii), by adding ``or'' at the end;
and
(C) by inserting after clause (xvii) the following:
``(xviii) individuals described in section
1902(ll),''.
(b) Presumptive Eligibility.--
(1) In general.--Title XIX of the Social Security Act (42
U.S.C. 1396 et seq.) is amended by inserting after section
1920C the following:
``optional application of presumptive eligibility provisions for
certain persons with colorectal cancer
``Sec. 1920D. A State may elect to apply the provisions of section
1920B to individuals described in section 1902(ll) (relating to certain
colorectal cancer patients) in the same manner as such section applies
to individuals described in section 1902(aa) (relating to certain
breast or cervical cancer patients).''.
(2) Conforming amendments.--
(A) Section 1902(a)(47) of the Social Security Act
(42 U.S.C. 1396a(a)(47)), as amended by sections
2202(a) and 2303(b)(2) of Public Law 111-148, is
amended--
(i) by inserting before the first semicolon
the following: `` and provide for making
medical assistance available to individuals
described in section 1920D during a presumptive
eligibility period in accordance with such
section''; and
(ii) effective as of January 1, 2014, in
subparagraph (B), by striking ``or 1920C'' and
inserting ``1920C, or 1920D''.
(B) Section 1903(u)(1)(D)(v) of such Act (42 U.S.C.
1396b(u)(1)(d)(v)) is amended by inserting ``, or for
medical assistance provided to an individual described
in section 1920D during a presumptive eligibility
period under such section'' after ``1920B during a
presumptive eligibility period under such section''.
(c) Enhanced Match.--The first sentence of section 1905(b) of the
Social Security Act (42 U.S.C. 1396d(b)) is amended--
(1) by striking ``and'' before ``(4)''; and
(2) by inserting before the period at the end the
following: ``, and (5) the Federal medical assistance
percentage shall be equal to the enhanced FMAP described in
section 2105(b) with respect to medical assistance provided to
individuals who are eligible for such assistance only on the
basis of section 1902(a)(10)(A)(ii)(XXIII)''.
(d) Effective Date.--The amendments made by this section apply to
medical assistance for items and services furnished on or after October
1, 2011, without regard to whether final regulations to carry out such
amendments have been promulgated by such date.
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