Sickle Cell Disease Comprehensive Care Act
This bill allows state Medicaid programs to cover home health services for those with sickle cell disease.
States that choose to provide these services must report on the quality of health care provided to these individuals, their access to care, and the associated costs. The Centers for Medicare & Medicaid Services must issue best practices for states with respect to these services.
[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7432 Introduced in House (IH)]
<DOC>
118th CONGRESS
2d Session
H. R. 7432
To amend title XIX of the Social Security Act to enable State Medicaid
programs to provide comprehensive, coordinated care through a health
home to individuals with sickle cell disease.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 23, 2024
Mr. Burgess (for himself and Mr. Davis of Illinois) 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 enable State Medicaid
programs to provide comprehensive, coordinated care through a health
home to individuals with sickle cell disease.
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 ``Sickle Cell Disease Comprehensive
Care Act''.
SEC. 2. ENABLING STATE MEDICAID PROGRAMS TO PROVIDE CARE THROUGH HEALTH
HOMES TO INDIVIDUALS WITH SICKLE CELL DISEASE.
Section 1945 of the Social Security Act (42 U.S.C. 1396w-4) is
amended--
(1) in subsection (a), by inserting ``(and, beginning
January 1, 2025, to eligible individuals with sickle cell
disease (as described under subsection (c)(5)))'' after
``chronic conditions''; and
(2) in subsection (c)--
(A) in paragraph (1), by inserting ``and each
eligible individual with sickle cell disease'' after
``chronic conditions''; and
(B) by adding at the end the following new
paragraph:
``(5) Special rule relating to sickle cell disease health
homes.--
``(A) In general.--Beginning January 1, 2025, the
Secretary may approve a State plan amendment under this
section that is designed to provide health home
services primarily to eligible individuals with sickle
cell disease (in this section referred to as a `sickle
cell disease-focused State plan amendment').
``(B) Report requirements.--In the case of a State
with a sickle cell disease-focused State plan
amendment, such State shall, at the end of the first 8
fiscal year quarters that such State plan amendment is
in effect, submit to the Secretary a report on the
following, with respect to eligible individuals with
sickle cell disease provided health home services under
such State plan amendment:
``(i) The quality of health care provided
to such individuals, with a focus on outcomes
relevant to the recovery of each such
individual.
``(ii) The access of such individuals to
health care.
``(iii) The total expenditures of such
individuals for health care.
For purposes of this subparagraph, the Secretary shall
specify all applicable measures for determining
quality, access, and expenditures.
``(C) Best practices.--Not later than June 30,
2025, the Secretary shall make publicly available on
the internet website of the Centers for Medicare &
Medicaid Services best practices for designing and
implementing a sickle cell disease-focused State plan
amendment, based on clinical practice guidelines for
sickle cell diseases developed by medical specialty
societies and in consultation with sickle cell disease
providers and patient advocacy organizations.
``(D) Definitions.--For purposes of this section:
``(i) Eligible individual with sickle cell
disease.--The term `eligible individual with
sickle cell disease' means, with respect to a
State, an individual who satisfies all of the
following:
``(I) The individual is eligible
for medical assistance under the State
plan or under a waiver of such plan.
``(II) The individual has sickle
cell disease.
``(III) The individual may or may
not have previously received health
home services under any other State
plan amendment approved for the State
under this section by the Secretary.
``(ii) Sickle cell disease.--The term
`sickle cell disease' means an inherited blood
disorder affecting red blood cells that occurs
when an individual has inherited a sickle cell
gene from each parent, as identified by a
newborn screening or other genetic test.''; and
(3) in subsection (h)--
(A) in paragraph (4)(A)--
(i) by striking the period at the end and
inserting ``; and'';
(ii) by striking ``means comprehensive''
and inserting ``means--
``(i) with respect to eligible individuals
with chronic conditions, comprehensive''; and
(iii) by adding at the end the following
new clause:
``(ii) in the case of a State that provides
for dental services and vision services (as
defined by such State), with respect to
eligible individuals with sickle cell disease,
the services described in clause (i), dental
services, and vision services.''; and
(B) in paragraph (5), by inserting ``or a health
home for eligible individuals with sickle cell
disease'' after ``chronic conditions''.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
Referred to the Subcommittee on Health.
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