Sec. 401 Required coverage of preventive services under the Medicaid program
Mandatory coverage— Section 1905 of the Social Security Act (42 U.S.C. 1396d), as amended by section 4107(a)(1) of the Patient Protection and Affordable Care Act (Public Law 111–148), is amended—
in subsection (a)(4)—
by striking “and” before “(D)”; and
by inserting before the semicolon at the end the following new subparagraph: “; and (E) preventive services described in subsection (ee);”; and
by adding at the end the following new subsection:
“(ee) Preventive Services—For purposes of subsection (a)(4)(E), the preventive services described in this subsection are diagnostic, screening, preventive, and rehabilitative services not otherwise described in subsection (a) or (r) that the Secretary determines are appropriate for individuals entitled to medical assistance under this title, including—
“(1) evidence-based services that are assigned a grade of A or B by the United States Preventive Services Task Force; and
“(2) with respect to an adult individual, approved vaccines recommended for routine use by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention.”
Elimination of cost-Sharing—
Subsections (a)(2)(D) and (b)(2)(D) of section 1916 of the Social Security Act (42 U.S.C. 1396o) are each amended by inserting “preventive services described in section 1905(ee),” after “emergency services (as defined by the Secretary),”.
Section 1916A(a)(1) of such Act (42 U.S.C. 1396o–1(a)(1)) is amended by inserting “, preventive services described in section 1905(ee),” after “subsection (c)”.
Conforming amendment— Effective as if included in the enactment of the Patient Protection and Affordable Care Act (Public Law 111–148), the provisions of, and amendments made by, section 4106 of such Act are repealed.
Interval period for inclusion of new recommendations in State plans— With respect to a recommendation issued on or after the date of enactment of this Act by an organization described in subsection (ee) of section 1905 of the Social Security Act for a preventive service included under such subsection, the Secretary of Health and Human Services shall establish a minimum interval period, which shall be not less than 12 months, between the date on which the recommendation is issued and the plan year for which a State plan for medical assistance under title XIX of the Social Security Act shall be required to include such preventive service.
Effective date—
In general— Except as provided in paragraph (2), the amendments made by subsections (a) and (b) take effect on the date of enactment of this Act.
Extension of effective date for state law amendment— In the case of a State plan under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) which the Secretary of Health and Human Services determines requires State legislation or State regulation in order for the plan to meet the additional requirements imposed by the amendments made by subsections (a) and (b), the State plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet these additional requirements 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 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 the session is considered to be a separate regular session of the State legislature.