Child Health Assurance Act of 1979

Summary

Child Health Assurance Act of 1979 - Amends title XIX (Medicaid) of the Social Security Act to require the State plan for medical assistance required by such title to provide for making "medical assistance" available to: (1) any individual who is under the age of 18 or, at the option of the State, to any individual over the age of 17 and under 21; and (2) any woman for the period of her pregnancy and for 60 days following the termination of her pregnancy, and to any child born as the result of such pregnancy, if the resources and income of such individual or woman meet the resource and income tests of eligibility set forth in this Act. Stipulates that no enrollment fee or charge will be imposed for any such individual or woman. Includes as "medical assistance": (1) inpatient hospital services; (2) outpatient hospital services; (3) laboratory and x-ray services; (4) skilled nursing facility services; (5) child health assessment services and continuing care services; (6) immunizations clinic services, diagnosis and treatment of vision and hearing problems, (including hearing aids and eyeglasses, prescribed drugs and insulin, prosthetic devices, home health services, physical therapy), and rehabilitative services; (7) ambulatory mental health services delivered in centers funded under the Community Mental Health Centers Act; (8) emergency crisis intervention inpatient mental health services; (9) routine dental care; (10) family planning services and supplies to certain individuals; (11) prenatal and postnatal services; and (12) physicians' services. Directs the Secretary of Health, Education, and Welfare to establish a national child health assurance program (CHAP) income standard and a national maternal income standard for the purpose of establishing the eligibility of, and extent of medical assistance provided to, certain children and pregnant women. Sets the national child health assurance program income standard at two-thirds of the nonfarm income official poverty line and the national maternal income standard at 80 percent of the nonfarm income official poverty line. Requires a State Medicaid plan to assure the provision of outreach to pregnant women eligible for medical assistance. Defines "outreach" to mean the identification and location of pregnant women eligible for assistance and the informing of such women of the services available to them. Requires the provider of a child health assessment to: (1) provide timely and appropriate child health assessments to individuals under 21 who are eligible for Medicaid; (2) provide basic diagnostic and treatment services; (3) provide routine dental care; and (4) be reasonably accessible on a continuing basis to individuals whom it has assessed. Sets forth provisions concerning payments for CHAP services, including payments to health maintenance organizations for those who choose to have such services provided by such an organization. Directs the State agency to assure the compliance of providers with this Act. Requires a State Medicaid plan to develop, with substantial public input, a plan for the implementation of a CHAP which meets certain minimum levels of acceptable performance. Sets forth methods of determining Federal matching percentages and performance standards for the programs established under this Act. Directs the Secretary to report to Congress: (1) the level of performance of each State in implementing its CHAP; (2) the ratio of individuals under the age of 21 enrolled for Medicaid to the number of individuals under 21 whose income is below the nonfarm income official poverty line; and (3) the effectiveness of the performance standards established by this Act. Requires a State to submit a plan for outreach services to certain individuals eligible under the Medicaid program if the ratio of individuals under 21 enrolled in a State's Medicaid program to the number of individuals under 21 in families in that State whose income is below the nonfarm income official poverty line is significantly less than the national average. Requires a State, under part A (Aid to Families with Dependent Children) of title IV of the Act, to inform all families in the State receiving AFDC of the availability of child health assurance services available under title XIX. Prohibits a State's Medicaid plan from excluding aliens lawfully admitted for permanent residence. Directs the Secretary to conduct a study to determine the extent to which other Federal programs duplicate the health services provided under the Medicaid program to children and pregnant women. Directs the Secretary to study and, if necessary, conduct demonstration projects in order to evaluate (1) the participation of health care providers in the CHAP and (2) methods of improving their level of participation in such programs. Directs the Secretary to develop and carry out demonstration projects designed to determine the effect of payment on a capitation basis for services provided under a CHAP. Directs the Secretary to report to Congress on the studies and projects conducted pursuant to this paragraph. Directs the Secretary to study and report to Congress on the effectiveness of the CHAP. Stipulates that certain individuals under the age of 21 shall remain eligible for Medicaid while inmates in certain juvenile institutions.

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Documents

3 official files

• Passed House amended

  summary · EN · 11 December 1979

  Open at official source

• Reported to House with amendment(s)

  summary · EN · 26 October 1979

  Open at official source

• Introduced in House

  summary · EN · 25 July 1979

  Open at official source

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