(v) the time limits for coverage of a child under the State plan, (vi) the State's choice of health benefits coverage and other methods used for providing child health assistance, and (vii) the sources of non-Federal funding used in the State plan. (C) An assessment of the effectiveness of other public and private programs in the State in increasing the availability of affordable quality individual and family health insurance for children. (D) A review and assessment of State activities to coordinate the plan under this title with other public and private programs providing health care and health care financing, including medicaid and maternal and child health services. (E) An analysis of changes and trends in the State that affect the provision of accessible, affordable, quality health insurance and health care to children. (F) A description of any plans the State has for improving the availability of health insurance and health care for children. (G) Recommendations for improving the program under this title. (H) Any other matters the State and the Secretary consider appropriate. (2) REPORT OF THE SECRETARY.-The Secretary_shall submit to Congress and make available to the public by December 31, 2001, a report based on the evaluations submitted by States under paragraph (1), containing any conclusions and recommendations the Secretary considers appropriate. MISCELLANEOUS PROVISIONS SEC. 2109. [42 U.S.C. 1397ii] (a) RELATION TO OTHER LAWS.— (1) HIPAA-Health benefits coverage provided under section 2101(a)(1) (and coverage provided under a waiver under sec on 2105(c)(2)(B)) shall be treated as creditable coverage for purposes of part 7 of subtitle B of title II of the Employee Retirement Income Security Act of 1974, title XXVII of the Public Health Service Act, and subtitle K of the Internal Revenue Code of 1986. (2) ERISA.-Nothing in this title shall be construed as affecting or modifying section 514 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1144) with respect to a group health plan (as defined in section 2791(a)(1) of the Public Health Service Act (42 U.S.C. 300gg- 91(a)(1)). DEFINITIONS SEC. 2110. [42 U.S.C. 1397jj] (a) CHILD HEALTH ASSISTANCE.— For purposes of this title, the term "child health assistance" means payment for part or all of the cost of health benefits coverage for targeted low-income children that includes any of the following (and includes, in the case described in section 2105(a)(2)(A), payment for part or all of the cost of providing any of the following), as specified under the State plan: (1) Inpatient hospital services. (2) Outpatient hospital services. (3) Physician services. (4) Surgical services. (5) Clinic services (including health center services) and other ambulatory health care services. (6) Prescription drugs and biologicals and the administration of such drugs and biologicals, only if such drugs and biologicals are not furnished for the purpose of causing, or assisting in causing, the death, suicide, euthanasia, or mercy killing of a person. (7) Over-the-counter medications. (8) Laboratory and radiological services. (9) Prenatal care and prepregnancy family planning services and supplies. (10) Inpatient mental health services, other than services described in paragraph (18) but including services furnished in a State-operated mental hospital and including residential or other 24-hour therapeutically planned structured services. (11) Outpatient mental health services, other than services described in paragraph (19) but including services furnished in a State-operated mental hospital and including communitybased services. (12) Durable medical equipment and other medically-related or remedial devices (such as prosthetic devices, implants, eyeglasses, hearing aids, dental devices, and adaptive devices). (13) Disposable medical supplies. (14) Home and community-based health care services and related supportive services (such as home health nursing services, home health aide services, personal care, assistance with activities of daily living, chore services, day care services, respite care services, training for family members, and minor modifications to the home). (15) Nursing care services (such as nurse practitioner services, nurse midwife services, advanced practice nurse services, private duty nursing care, pediatric nurse services, and respiratory care services) in a home, school, or other setting. (16) Abortion only if necessary to save the life of the mother or if the pregnancy is the result of an act of rape or incest. (17) Dental services. (18) Inpatient substance abuse treatment services and residential substance abuse treatment services. (19) Outpatient substance abuse treatment services. (20) Case management services. (21) Care coordination services. (22) Physical therapy, occupational therapy, and services for individuals with speech, hearing, and language disorders. (23) Hospice care. (24) Any other medical, diagnostic, screening, preventive, restorative, remedial, therapeutic, or rehabilitative services (whether in a facility, home, school, or other setting) if recognized by State law and only if the service is (A) prescribed by or furnished by a physician or other licensed or registered practitioner within the scope of practice as defined by State law, (B) performed under the general supervision or at the direction of a physician, or (C) furnished by a health care facility that is operated by a State or local government or is licensed under State law and operating within the scope of the license. (25) Premiums for private health care insurance coverage. (26) Medical transportation. (27) Enabling services (such as transportation, translation, and outreach services) only if designed to increase the accessibility of primary and preventive health care services for eligible low-income individuals. (28) Any other health care services or items specified by the Secretary and not excluded under this section. (b) TARGETED LOW-INCOME CHILD DEFINED.-For purposes of this title (1) IN GENERAL. Subject to paragraph (2), the term “targeted low-income child” means a child— (A) who has been determined eligible by the State for child health assistance under the State plan; (B)(i) who is a low-income child, or (ii) is a child (I) whose family income (as determined under the State child health plan) exceeds the medicaid applicable income level (as defined in paragraph (4)), but does not exceed 50 percentage points above the medicaid applicable income level; (II) whose family income (as so determined) does not exceed the medicaid applicable income level (as defined in paragraph (4) but determined as if “June 1, 1997" were substituted for "March 31, 1997"); or (III) who resides in a State that does not have a medicaid applicable income level (as defined in paragraph (4)); and 14 (C) who is not found to be eligible for medical assistance under title XIX or covered under a group health plan or under health insurance coverage (as such terms are defined in section 2791 of the Public Health Service Act). (2) CHILDREN EXCLUDED.-Such term does not include (A) a child who is an inmate of a public institution or a patient in an institution for mental diseases; or (B) a child who is a member of a family that is eligible for health benefits coverage under a State health benefits plan on the basis of a family member's employment with a public agency in the State. (3) SPECIAL RULE.-A child shall not be considered to be described in paragraph (1)(C) notwithstanding that the child is covered under a health insurance coverage program that has been in operation since before July 1, 1997, and that is offered by a State which receives no Federal funds for the program's operation. (4) MEDICAID APPLICABLE INCOME LEVEL.-The term "medicaid applicable income level" means, with respect to a child, the effective income level (expressed as a percent of the poverty line) that has been specified under the State plan under title XIX (including under a waiver authorized by the Secretary or 14 P.L. 105-100, §162(3)(A), amended clause (ii) in its entirety, effective as if included in the enactment of P.L. 105-33, August 5, 1997. For clause (ii) as it formerly read, see Vol. II, Superseded Provisions, P.L. 105–100. under section 1902(r)(2)), as of March 31, 1997 15, for the child to be eligible for medical assistance under section 1902(1)(2) or 1905(n)(2) (as selected by a State) 16 for the age of such child. (c) ADDITIONAL DEFINITIONS.-For purposes of this title: (1) CHILD. The term child means an individual under 19 years of age. (2) CREDITABLE HEALTH COVERAGE.-The term "creditable health coverage” has the meaning given the term "creditable coverage" under section 2701(c) of the Public Health Service Act (42 U.S.C. 300gg(c)) and includes coverage that meets the requirements of section 2103 provided to a targeted low-income child under this title or under a waiver approved under section 2105(c)(2)(B) (relating to a direct service waiver). (3) GROUP HEALTH PLAN; HEALTH INSURANCE COVERAGE; ETC.-The terms "group health plan", "group health insurance coverage", and "health insurance coverage" have the meanings given such terms in section 2791 17 of the Public Health Service Act. (4) LOW-INCOME.-The term "low-income child" means a child whose family income is at or below 200 percent of the poverty line for a family of the size involved. (5) POVERTY LINE DEFINED.-The term "poverty line" has the meaning given such term in section 673(2) of the Community Services Block Grant Act (42 U.S.C. 9902(2)), including any revision required by such section. (6) PREEXISTING CONDITION EXCLUSION.-The term "preexisting condition exclusion" has the meaning given such term in section 2701(b)(1)(A) of the Public Health Service Act (42 U.S.C. 300gg(b)(1)(A)). (7) STATE CHILD HEALTH PLAN; PLAN.-Unless the context otherwise requires, the terms "State child health plan" and "plan" mean a State child health plan approved under section 2106. (8) UNCOVERED CHILD.-The term "uncovered child" means a child that does not have creditable health coverage. 15 P.L. 105-100, §162(3)(B)((i), struck out “June 1, 1997" and substituted "March 31, 1997", effective as if included in the enactment of P.L. 105–33, August 5, 1997. 16 P.L. 105-100, §162(3)(B)(ii), inserted "or 1905(n)(2) (as selected by a State)”, effective as if included in the enactment of P.L. 105-33, August 5, 1997. 17 P.L. 105–100, §162(9), struck out "2191" and substituted "2791". SELECTED PROVISIONS OF THE INTERNAL REVENUE CODE OF 19861 (P.L. 83-591, Approved August 16, 1954) Beginning after: SEC. 1401. RATE OF TAX. (a) OLD-AGE, SURVIVORS, AND DISABILITY INSURANCE.—In addition to other taxes, there shall be imposed for each taxable year, on the self-employment income of every individual, a tax equal to the following percent of the amount of the self-employment income for such taxable year: In the case of a taxable year January 1, 1988 Percent: 11.40 12.12 12.40* *As in original. No punctuation. (b) HOSPITAL INSURANCE.—In addition to the tax imposed by the preceding subsection, there shall be imposed for each taxable year, on the self-employment income of every individual, a tax equal to the following percent of the amount of the self-employment income for such taxable year: To locate in U.S. Code, look for identical section number in Title 26, Internal Revenue Code. P.L. 99-514, §2(a), provides that the Internal Revenue Title enacted August 14, 1954, may be cited as the "Internal Revenue Code of 1986" and §2(b) provides, except when inappropriate, any reference to the Internal Revenue Code of 1954 shall include a reference to the Internal Revenue Code of 1986 and any reference to the Internal Revenue Code of 1986 shall include a reference to the provisions of the Internal Revenue Code of 1954. |