Bipartisan Health Care Act

[Congressional Bills 119th Congress] [From the U.S. Government Publishing Office] [S. 891 Introduced in Senate (IS)]

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119th CONGRESS 1st Session S. 891

To extend expiring health provisions and improve health care delivery.

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IN THE SENATE OF THE UNITED STATES

March 6, 2025

Mr. Wyden (for himself and Mr. Sanders) introduced the following bill; which was read twice and referred to the Committee on Finance

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A BILL

To extend expiring health provisions and improve health care delivery.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

(a) Short Title.--This Act may be cited as the ``Bipartisan Health Care Act''. (b) Table of Contents.--The table of contents for this Act is as follows:

Sec. 1. Short title; table of contents. TITLE I--MEDICAID

Sec. 101. Streamlined enrollment process for eligible out-of-state providers under Medicaid and CHIP. Sec. 102. Making certain adjustments to coverage of home or community- based services under Medicaid. Sec. 103. Removing certain age restrictions on Medicaid eligibility for working adults with disabilities. Sec. 104. Medicaid State plan requirement for determining residency and coverage for military families. Sec. 105. Ensuring the reliability of address information provided under the Medicaid program. Sec. 106. Codifying certain Medicaid provider screening requirements related to deceased providers. Sec. 107. Modifying certain State requirements for ensuring deceased individuals do not remain enrolled. Sec. 108. One-year delay of Medicaid and CHIP requirements for health screenings, referrals, and case management services for eligible juveniles in public institutions; State interim work plans. Sec. 109. State studies and HHS report on costs of providing maternity, labor, and delivery services. Sec. 110. Modifying certain disproportionate share hospital allotments. Sec. 111. Modifying certain limitations on disproportionate share hospital payment adjustments under the Medicaid program. Sec. 112. Ensuring accurate payments to pharmacies under Medicaid. Sec. 113. Preventing the use of abusive spread pricing in Medicaid. TITLE II--MEDICARE

Sec. 201. Extension of increased inpatient hospital payment adjustment for certain low-volume hospitals. Sec. 202. Extension of the Medicare-dependent hospital (MDH) program. Sec. 203. Extension of add-on payments for ambulance services. Sec. 204. Extending incentive payments for participation in eligible alternative payment models. Sec. 205. Temporary payment increase under the Medicare physician fee schedule to account for exceptional circumstances. Sec. 206. Extension of funding for quality measure endorsement, input, and selection. Sec. 207. Extension of funding outreach and assistance for low-income programs. Sec. 208. Extension of the work geographic index floor. Sec. 209. Extension of certain telehealth flexibilities. Sec. 210. Requiring modifier for use of telehealth to conduct face-to- face encounter prior to recertification of eligibility for hospice care. Sec. 211. Extending acute hospital care at home waiver flexibilities. Sec. 212. Enhancing certain program integrity requirements for DME under Medicare. Sec. 213. Guidance on furnishing services via telehealth to individuals with limited English proficiency. Sec. 214. In-home cardiopulmonary rehabilitation flexibilities. Sec. 215. Inclusion of virtual diabetes prevention program suppliers in MDPP Expanded Model. Sec. 216. Medication-induced movement disorder outreach and education. Sec. 217. Report on wearable medical devices. Sec. 218. Extension of temporary inclusion of authorized oral antiviral drugs as covered part D drugs. Sec. 219. Extension of adjustment to calculation of hospice cap amount. Sec. 220. Multiyear contracting authority for MedPAC and MACPAC. Sec. 221. Contracting parity for MedPAC and MACPAC. Sec. 222. Adjustments to Medicare part D cost-sharing reductions for low-income individuals. Sec. 223. Requiring Enhanced and Accurate Lists of (REAL) Health Providers Act. Sec. 224. Medicare coverage of multi-cancer early detection screening tests. Sec. 225. Medicare coverage of external infusion pumps and non-self- administrable home infusion drugs. Sec. 226. Assuring pharmacy access and choice for Medicare beneficiaries. Sec. 227. Modernizing and Ensuring PBM Accountability. Sec. 228. Requiring a separate identification number and an attestation for each off-campus outpatient department of a provider. Sec. 229. Medicare sequestration. Sec. 230. Medicare improvement fund. TITLE III--HUMAN SERVICES

Sec. 301. Sexual risk avoidance education extension. Sec. 302. Personal responsibility education extension. Sec. 303. Extension of funding for family-to-family health information centers. TITLE IV--PUBLIC HEALTH EXTENDERS

Subtitle A--Extensions

Sec. 401. Extension for community health centers, National Health Service Corps, and teaching health centers that operate GME programs. Sec. 402. Extension of special diabetes programs. Subtitle B--World Trade Center Health Program

Sec. 411. 9/11 responder and survivor health funding corrections. TITLE V--SUPPORT ACT REAUTHORIZATION

Sec. 501. Short title. Subtitle A--Prevention

Sec. 511. Prenatal and postnatal health. Sec. 512. Monitoring and education regarding infections associated with illicit drug use and other risk factors. Sec. 513. Preventing overdoses of controlled substances. Sec. 514. Support for individuals and families impacted by fetal alcohol spectrum disorder. Sec. 515. Promoting State choice in PDMP systems. Sec. 516. First responder training program. Sec. 517. Donald J. Cohen National Child Traumatic Stress Initiative. Sec. 518. Protecting suicide prevention lifeline from cybersecurity incidents. Sec. 519. Bruce's law. Sec. 520. Guidance on at-home drug disposal systems. Sec. 521. Assessment of opioid drugs and actions. Sec. 522. Grant program for State and Tribal response to opioid use disorders. Subtitle B--Treatment

Sec. 531. Residential treatment program for pregnant and postpartum women. Sec. 532. Improving access to addiction medicine providers. Sec. 533. Mental and behavioral health education and training grants. Sec. 534. Loan repayment program for substance use disorder treatment workforce. Sec. 535. Development and dissemination of model training programs for substance use disorder patient records. Sec. 536. Task force on best practices for trauma-informed identification, referral, and support. Sec. 537. Grants to enhance access to substance use disorder treatment. Sec. 538. State guidance related to individuals with serious mental illness and children with serious emotional disturbance. Sec. 539. Reviewing the scheduling of approved products containing a combination of buprenorphine and naloxone. Subtitle C--Recovery

Sec. 541. Building communities of recovery. Sec. 542. Peer support technical assistance center. Sec. 543. Comprehensive opioid recovery centers. Sec. 544. Youth prevention and recovery. Sec. 545. CAREER Act. Sec. 546. Addressing economic and workforce impacts of the opioid crisis. Subtitle D--Miscellaneous Matters

Sec. 551. Delivery of a controlled substance by a pharmacy to a prescribing practitioner. Sec. 552. Technical correction on controlled substances dispensing. Sec. 553. Required training for prescribers of controlled substances. Sec. 554. Extension of temporary order for fentanyl-related substances. TITLE VI--PANDEMIC AND ALL-HAZARDS PREPAREDNESS AND RESPONSE

Sec. 601. Short title. Subtitle A--State and Local Readiness and Response

Sec. 611. Temporary reassignment of State and local personnel during a public health emergency. Sec. 612. Public Health Emergency Preparedness program. Sec. 613. Hospital Preparedness Program. Sec. 614. Facilities and capacities of the Centers for Disease Control and Prevention to combat public health security threats. Sec. 615. Pilot program to support State medical stockpiles. Sec. 616. Enhancing domestic wastewater surveillance for pathogen detection. Sec. 617. Reauthorization of Mosquito Abatement for Safety and Health program. Subtitle B--Federal Planning and Coordination

Sec. 621. All-Hazards Emergency Preparedness and Response. Sec. 622. National Health Security Strategy. Sec. 623. Improving development and distribution of diagnostic tests. Sec. 624. Combating antimicrobial resistance. Sec. 625. Strategic National Stockpile and material threats. Sec. 626. Medical countermeasures for viral threats with pandemic potential. Sec. 627. Public Health Emergency Medical Countermeasures Enterprise. Sec. 628. Fellowship and training programs. Sec. 629. Regional biocontainment research laboratories. Sec. 629A. Limitation related to countries of concern conducting certain research. Subtitle C--Addressing the Needs of All Individuals

Sec. 631. Improving access to certain programs. Sec. 632. Supporting at-risk individuals during emergency responses. Sec. 633. National advisory committees. Sec. 634. National Academies study on prizes. Subtitle D--Additional Reauthorizations

Sec. 641. Medical countermeasure priority review voucher. Sec. 642. Epidemic Intelligence Service. Sec. 643. Monitoring and distribution of certain medical countermeasures. Sec. 644. Regional health care emergency preparedness and response systems. Sec. 645. Emergency system for advance registration of volunteer health professionals. Sec. 646. Ensuring collaboration and coordination in medical countermeasure development. Sec. 647. Military and civilian partnership for trauma readiness. Sec. 648. National Disaster Medical System. Sec. 649. Volunteer Medical Reserve Corps. Sec. 649A. Epidemiology-laboratory capacity. TITLE VII--PUBLIC HEALTH PROGRAMS

Sec. 701. Action for dental health. Sec. 702. PREEMIE. Sec. 703. Preventing maternal deaths. Sec. 704. Sickle cell disease prevention and treatment. Sec. 705. Traumatic brain injuries. Sec. 706. Lifespan respite care. Sec. 707. Dr. Lorna Breen health care provider protection. Sec. 708. SCREENS for Cancer. Sec. 709. DeOndra Dixon INCLUDE Project. Sec. 710. IMPROVE Initiative. Sec. 711. Organ Procurement and Transplantation Network. Sec. 712. Honor Our Living Donors. Sec. 713. Program for pediatric studies of drugs. TITLE VIII--FOOD AND DRUG ADMINISTRATION

Subtitle A--Give Kids a Chance

Sec. 801. Research into pediatric uses of drugs; additional authorities of Food and Drug Administration regarding molecularly targeted cancer drugs. Sec. 802. Ensuring completion of pediatric study requirements. Sec. 803. FDA report on PREA enforcement. Sec. 804. Extension of authority to issue priority review vouchers to encourage treatments for rare pediatric diseases. Sec. 805. Limitations on exclusive approval or licensure of orphan drugs. Subtitle B--United States-Abraham Accords Cooperation and Security

Sec. 811. Establishment of Abraham Accords Office within Food and Drug Administration. TITLE IX--LOWERING PRESCRIPTION DRUG COSTS

Sec. 901. Oversight of pharmacy benefit management services. Sec. 902. Full rebate pass through to plan; exception for innocent plan fiduciaries. Sec. 903. Increasing transparency in generic drug applications. Sec. 904. Title 35 amendments. TITLE X--MISCELLANEOUS

Sec. 1001. Extension of safe harbor for absence of deductible for telehealth.

TITLE I--MEDICAID

SEC. 101. STREAMLINED ENROLLMENT PROCESS FOR ELIGIBLE OUT-OF-STATE PROVIDERS UNDER MEDICAID AND CHIP.

(a) In General.--Section 1902(kk) of the Social Security Act (42 U.S.C. 1396a(kk)) is amended by adding at the end the following new paragraph: ``(10) Streamlined enrollment process for eligible out-of- state providers.-- ``(A) In general.--The State-- ``(i) adopts and implements a process to allow an eligible out-of-State provider to enroll under the State plan (or a waiver of such plan) to furnish items and services to, or order, prescribe, refer, or certify eligibility for items and services for, qualifying individuals without the imposition of screening or enrollment requirements by such State that exceed the minimum necessary for such State to provide payment to an eligible out-of-State provider under such State plan (or a waiver of such plan), such as the provider's name and National Provider Identifier (and such other information specified by the Secretary); and ``(ii) provides that an eligible out-of- State provider that enrolls as a participating provider in the State plan (or a waiver of such plan) through such process shall be so enrolled for a 5-year period, unless the provider is terminated or excluded from participation during such period. ``(B) Definitions.--In this paragraph: ``(i) Eligible out-of-state provider.--The term `eligible out-of-State provider' means, with respect to a State, a provider-- ``(I) that is located in any other State; ``(II) that-- ``(aa) was determined by the Secretary to have a limited risk of fraud, waste, and abuse for purposes of determining the level of screening to be conducted under section 1866(j)(2), has been so screened under such section 1866(j)(2), and is enrolled in the Medicare program under title XVIII; or ``(bb) was determined by the State agency administering or supervising the administration of the State plan (or a waiver of such plan) of such other State to have a limited risk of fraud, waste, and abuse for purposes of determining the level of screening to be conducted under paragraph (1) of this subsection, has been so screened under such paragraph (1), and is enrolled under such State plan (or a waiver of such plan); and ``(III) that has not been-- ``(aa) excluded from participation in any Federal health care program pursuant to section 1128 or 1128A; ``(bb) excluded from participation in the State plan (or a waiver of such plan) pursuant to part 1002 of title 42, Code of Federal Regulations (or any successor regulation), or State law; or ``(cc) terminated from participating in a Federal health care program or the State plan (or a waiver of such plan) for a reason described in paragraph (8)(A). ``(ii) Qualifying individual.--The term `qualifying individual' means an individual under 21 years of age who is enrolled under the State plan (or waiver of such plan). ``(iii) State.--The term `State' means 1 of the 50 States or the District of Columbia.''. (b) Conforming Amendments.-- (1) Section 1902(a)(77) of the Social Security Act (42 U.S.C. 1396a(a)(77)) is amended by inserting ``enrollment,'' after ``screening,''. (2) The subsection heading for section 1902(kk) of such Act (42 U.S.C. 1396a(kk)) is amended by inserting ``enrollment,'' after ``screening,''. (3) Section 2107(e)(1)(G) of such Act (42 U.S.C. 1397gg(e)(1)(G)) is amended by inserting ``enrollment,'' after ``screening,''. (c) Effective Date.--The amendments made by this section shall take effect on the date that is 3 years after the date of enactment of this Act.

SEC. 102. MAKING CERTAIN ADJUSTMENTS TO COVERAGE OF HOME OR COMMUNITY- BASED SERVICES UNDER MEDICAID.

(a) Increasing Transparency of HCBS Coverage Under Medicaid.-- (1) In general.--Section 1915(c) of the Social Security Act (42 U.S.C. 1396n(c)) is amended-- (A) in paragraph (2)-- (i) in subparagraph (E)-- (I) by inserting ``, not less frequently than'' before ``annually''; and (II) by inserting ``(including, with respect to such information provided on or after July 9, 2027, the information specified in paragraph (11))'' before the period at the end; and (ii) by adding at the end the following flush sentence: ``The Secretary shall make all information provided under subparagraph (E) on or after the date of the enactment of this sentence publicly available on the website of the Centers for Medicare & Medicaid Services.''; and (B) by adding at the end the following new paragraph: ``(11) For purposes of paragraph (2)(E), the information specified in this paragraph is the following: ``(A) In the case of a State that limits the number of individuals who may be provided home or community- based services under a waiver granted under this subsection and maintains a list of individuals waiting to enroll in such waiver, a description of how the State maintains such list, including-- ``(i) information on whether the State screens individuals on such list to determine whether such individuals are eligible to receive such services under such waiver; ``(ii) information on whether (and, if applicable, how often) the State periodically re-screens individuals on such list for eligibility; ``(iii) the number of people on such list of individuals waiting to enroll in such waiver; and ``(iv) the average amount of time that individuals newly enrolled in such waiver within the past 12 months were on such list of individuals waiting to enroll in such waiver. ``(B) With respect to homemaker services, home health aide services, personal care services, and habilitation services furnished under waivers under this subsection, by each such service type-- ``(i) for individuals newly receiving such services within the past 12 months, the average amount of time (which may be determined using statistically valid random sampling of such individuals) from when such services are initially approved for such an individual to when such individual begins receiving such services; and ``(ii) the percentage of authorized hours (which may be determined using statistically valid random sampling of individuals authorized to receive such services) that are provided within the past 12 months.''. (2) Conforming amendments.--Section 1915 of the Social Security Act (42 U.S.C. 1396n) is amended-- (A) in subsection (i) by adding at the end the following new paragraph: ``(8) Reporting requirement.--With respect to homemaker services, home health aide services, personal care services, and habilitation services provided under this subsection on or after July 9, 2027, the State, not less frequently than annually, shall provide to the Secretary the same information regarding such services as the State is required to provide under subsection (c)(11)(B).''; (B) in subsection (j)(2)(E), by inserting after the second sentence the following: ``With respect to any homemaker services, home health aide services, personal care services, and habilitation services provided under this subsection on or after July 9, 2027, the State, not less frequently than annually, shall provide to the Secretary the same information regarding such services as the State is required to provide under subsection (c)(11)(B).''; and (C) in subsection (k)(3)(E)-- (i) by striking ``and'' after ``the cost of such services and supports,''; and (ii) by inserting before the period, the following: ``, and with respect to homemaker services, home health aide services, personal care services, and habilitation services provided under this subsection on or after July 9, 2027, not less frequently than annually, the same information regarding such services as the State is required to provide under subsection (c)(11)(B)''. (b) Demonstration Program To Expand HCBS Coverage Under Section 1915(c) Waivers.--Section 1915(c) of the Social Security Act (42 U.S.C. 1396n(c)), as amended by subsection (a), is further amended-- (1) in paragraph (2)(E), by inserting ``, and the information specified in paragraph (12)(C)(v), when applicable'' after ``paragraph (11)''; and (2) by adding at the end the following new paragraph: ``(12) Demonstration program to expand coverage for home or community-based services.-- ``(A) In general.-- ``(i) Approval.--Not later than 24 months after the date on which the planning grants under subparagraph (B) are awarded, notwithstanding paragraph (1), the Secretary may approve a waiver that is standalone from any other waiver approved under this subsection for not more than 5 States, selected in accordance with clause (ii), to include as medical assistance under the State plan of such State, for the 3-year period beginning on the date of such approval, payment for part or all of the cost of home or community-based services (other than room and board (as described in paragraph (1))) approved by the Secretary which are provided pursuant to a written plan of care to individuals described in subparagraph (C)(iii). ``(ii) Selection criteria.--In selecting States for purposes of clause (i), the Secretary shall-- ``(I) only select States that received a planning grant under subparagraph (B); ``(II) only select States that meet the requirements specified in subparagraph (C) and such other requirements as the Secretary may determine appropriate; ``(III) select States in a manner that ensures geographic diversity; ``(IV) give preference to States with a higher percentage (relative to other States that apply to be selected for purposes of clause (i)) of the total State population residing in rural areas (as determined by the Secretary); ``(V) give preference to States that have demonstrated more progress in rebalancing long-term services and supports systems under this title, as determined based on the relative share of individuals who use home or community-based services (as defined by the Secretary) under this title as a percentage of total individuals who use long-term services and supports (as defined by the Secretary) under this title (in the most recent year for which such data is available); and ``(VI) give preference to States that pursue a waiver under this paragraph that incorporates the provision of mental health services for adults with serious mental illness, children with serious emotional disturbances, or individuals with substance use disorder. ``(B) Planning grants.-- ``(i) In general.-- ``(I) Approval.--Not later than 18 months after the date of the enactment of this paragraph, the Secretary shall award planning grants of not more than $5,000,000 each to not more than 10 States for purposes of preparing to submit a request for a waiver under this subsection (including for costs to implement the waiver or other activities to expand the provision of home or community-based services under this section) to provide home or community-based services to individuals described in subparagraph (C)(iii). ``(II) Selection criteria.--In awarding planning grants under subclause (I), the Secretary shall use the selection criteria specified in subclauses (III) through (VI) of subparagraph (A)(ii). ``(ii) Consultation.--A State that is awarded a planning grant under clause (i) shall, in preparing to submit a request for a waiver described in such clause, consult with-- ``(I) individuals in need of (and not receiving) home or community-based services, individuals receiving home or community-based services, and the caregivers of such individuals; ``(II) providers furnishing home or community-based services; and ``(III) such other stakeholders, as the Secretary may specify. ``(C) State requirements.--In addition to the requirements specified under this subsection (except for the requirements described in subparagraphs (C) and (D) of paragraph (2) and any other requirement the Secretary determines to be inapplicable in the context of a waiver relation to individuals who do not require the level of care described in paragraph (1)), the requirements specified in this paragraph are, with respect to a State, the following: ``(i) As of the date that such State requests a waiver under this subsection to provide home or community-based services to individuals described in clause (iii), all other waivers (if any) granted under this subsection to such State meet the requirements of this subsection. ``(ii) The State demonstrates to the Secretary that approval of a waiver under this subsection with respect to individuals described in clause (iii) will not result in a material increase of the average amount of time that individuals with respect to whom a determination described in paragraph (1) has been made will need to wait to receive home or community-based services under any waiver granted under this subsection, as determined by the Secretary. ``(iii) The State establishes needs-based criteria, subject to the approval of the Secretary, to identify individuals for whom a determination described in paragraph (1) is not applicable, who will be eligible for home or community-based services under a waiver approved under this paragraph, and specifies the home or community-based services such individuals so eligible will receive. ``(iv) The State established needs-based criteria for determining whether an individual described in clause (iii) requires the level of care provided in a hospital, nursing facility, or an intermediate care facility for individuals with developmental disabilities under the State plan or under any waiver of such plan that are more stringent than the needs-based criteria established under clause (iii) for determining eligibility for home or community-based services. ``(v) The State attests that the State's average per capita expenditure for medical assistance under the State plan (or waiver of such plan) provided with respect to such individuals enrolled in a waiver under this paragraph will not exceed the State's average per capita expenditures for medical assistance for individuals receiving institutional care under the State plan (or waiver of such plan) for the duration that the waiver under this paragraph is in effect. ``(vi) The State provides to the Secretary data (in such form and manner as the Secretary may specify) regarding the number of individuals described in clause (i) with respect to a State seeking approval of a waiver under this subsection, to whom the State will make such services available under such waiver. ``(vii) The State agrees to provide to the Secretary, not less frequently than annually, data for purposes of paragraph (2)(E) (in such form and manner as the Secretary may specify) regarding, with respect to each preceding year in which a waiver under this subsection to provide home and community-based services to individuals described in clause (iii) was in effect-- ``(I) the cost (as such term is defined by the Secretary) of such services furnished to individuals described in clause (iii), broken down by type of service; ``(II) with respect to each type of home and community-based service provided under the waiver, the length of time that such individuals have received such service; ``(III) a comparison between the data described in subclause (I) and any comparable data available with respect to individuals with respect to whom a determination described in paragraph (1) has been made and with respect to individuals receiving institutional care under this title; and ``(IV) the number of individuals who have received home and community- based services under the waiver during the preceding year.''. (c) Non-Application of the Paperwork Reduction Act.--Chapter 35 of title 44, United States Code (commonly referred to as the ``Paperwork Reduction Act of 1995''), shall not apply to the implementation of the amendments made by subsections (a) and (b). (d) CMS Guidance to States on Interim Coverage Under Section 1915 Home and Community-Based Services Authorities.--Not later than January 1, 2027, the Secretary of Health and Human Services shall issue guidance to the States to clarify how a State may provide, with respect to an individual who is eligible for home and community-based services under section 1915 of the Social Security Act (42 U.S.C. 1396n), coverage of such services pursuant to a provisional written plan of care, pending finalization, with respect to such individual. (e) Funding.-- (1) In general.--There are appropriated, out of any funds in the Treasury not otherwise obligated, $71,000,000 for fiscal year 2025, to remain available until expended, to the Secretary of Health and Human Services for purposes of carrying out subsection (d) and the amendments made by subsection (b). (2) Reservation for planning grants.--Of the amount appropriated under paragraph (1), the Secretary of Health and Human Services shall reserve $50,000,000 of such amount to award planning grants under the demonstration program established by the amendments made by subsection (b).

SEC. 103. REMOVING CERTAIN AGE RESTRICTIONS ON MEDICAID ELIGIBILITY FOR WORKING ADULTS WITH DISABILITIES.

(a) Modification of Optional Buy-In Groups.-- (1) In general.--Section 1902(a)(10)(A)(ii)(XV) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)(XV)) is amended by striking ``but less than 65,''. (2) Definition modification.--Section 1905(v)(1)(A) of the Social Security Act (42 U.S.C. 1396d(v)(1)(A)) is amended by striking ``, but less than 65,''. (b) Application to Certain States.--A State that, as of the date of enactment of this Act, provides for making medical assistance available to individuals described in subclause (XV) or (XVI) of section 1902(a)(10)(A)(ii) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)) shall not be regarded as failing to comply with the requirements of either such subclause (as amended by subsection (a)(1)) or with section 1905(v)(1)(A) of the Social Security Act (42 U.S.C. 1396d(v)(1)(A)) (as amended by subsection (a)(2)) before January 1, 2027.

SEC. 104. MEDICAID STATE PLAN REQUIREMENT FOR DETERMINING RESIDENCY AND COVERAGE FOR MILITARY FAMILIES.

(a) In General.--Section 1902 of the Social Security Act (42 U.S.C. 1396a) is amended-- (1) in subsection (a)-- (A) in paragraph (86), by striking ``and'' at the end; (B) in paragraph (87), by striking the period at the end and inserting ``; and''; and (C) by inserting after paragraph (87), the following new paragraph: ``(88) beginning January 1, 2028, provide, with respect to an active duty relocated individual (as defined in subsection (uu)(1))-- ``(A) that, for purposes of determining eligibility for medical assistance under the State plan (or waiver of such plan), such active duty relocated individual is treated as a resident of the State unless such individual voluntarily elects not to be so treated for such purposes; ``(B) that if, at the time of relocation (as described in subsection (uu)(1)), such active duty relocated individual is on a home and community-based services waiting list (as defined in subsection (uu)(2)), such individual remains on such list until-- ``(i) the State completes an assessment and renders a decision with respect to the eligibility of such individual to receive the relevant home and community-based services at the time a slot for such services becomes available and, in the case such decision is a denial of such eligibility, such individual has exhausted the individual's opportunity for a fair hearing; or ``(ii) such individual elects to be removed from such list; and ``(C) payment for medical assistance furnished under the State plan (or a waiver of the plan) on behalf of such active duty relocated individual in the military service relocation State (as referred to in subsection (uu)(1)(B)(i)), to the extent that such assistance is available in such military service relocation State in accordance with such guidance as the Secretary may issue to ensure access to such assistance.''; and (2) by adding at the end the following new subsection: ``(uu) Active Duty Relocated Individual; Home and Community-Based Services Waiting List.--For purposes of subsection (a)(88) and this subsection: ``(1) Active duty relocated individual.--The term `active duty relocated individual' means an individual-- ``(A) who-- ``(i) is enrolled under the State plan (or waiver of such plan); or ``(ii) with respect to an individual described in subparagraph (C)(ii), would be so enrolled pursuant to subsection (a)(10)(A)(ii)(VI) if such individual began receiving home and community-based services; ``(B) who-- ``(i) is a member of the Armed Forces engaged in active duty service and is relocated to another State (in this subsection referred to as the `military service relocation State') by reason of such service; ``(ii) would be described in clause (i) except that the individual stopped being engaged in active duty service (including by reason of retirement from such service) and the last day on which the individual was engaged in active duty service occurred not more than 12 months ago; or ``(iii) is a dependent (as defined by the Secretary) of a member described in clause (i) or (ii) who relocates to the military service relocation State with such member; and ``(C) who-- ``(i) was receiving home and community- based services (as defined in section 9817(a)(2)(B) of the American Rescue Plan Act of 2021) at the time of such relocation; or ``(ii) if the State maintains a home and community-based services waiting list, was on such home and community-based services waiting list at the time of such relocation. ``(2) Home and community-based services waiting list.--The term `home and community-based services waiting list' means, in the case of a State that has a limit on the number of individuals who may receive home and community-based services under section 1115(a), section 1915(c), or section 1915(j), a list maintained by such State of individuals who are requesting to receive such services under 1 or more such sections but for whom the State has not yet completed an assessment and rendered a decision with respect to the eligibility of such individuals to receive the relevant home and community-based services at the time a slot for such services becomes available due to such limit.''. (b) Implementation Funding.--There are appropriated, out of any funds in the Treasury not otherwise obligated, $1,000,000 for each of fiscal years 2025 through 2029, to remain available until expended, to the Secretary of Health and Human Services for purposes of implementing the amendments made by subsection (a).

SEC. 105. ENSURING THE RELIABILITY OF ADDRESS INFORMATION PROVIDED UNDER THE MEDICAID PROGRAM.

(a) In General.--Section 1902(a) of the Social Security Act (42 U.S.C. 1396a(a)), as previously amended by this title, is amended-- (1) in paragraph (87), by striking ``and'' at the end; (2) in paragraph (88), by striking the period at the end and inserting ``; and''; and (3) by inserting after paragraph (88) the following new paragraph: ``(89) beginning January 1, 2026, provide for a process to regularly obtain address information for individuals enrolled under such plan (or a waiver of such plan) from reliable data sources (as described in section 435.919(f)(1)(iii) of title 42, Code of Federal Regulations (or a successor regulation)) and act on any changes to such an address based on such information in accordance with such section (or successor regulation), except that this paragraph shall only apply in the case of the 50 States and the District of Columbia.''. (b) Application to CHIP.--Section 2107(e)(1) of the Social Security Act (42 U.S.C. 1397gg(e)(1)) is amended-- (1) by redesignating subparagraphs (H) through (U) as subparagraphs (I) through (V), respectively; and (2) by inserting after subparagraph (G) the following new subparagraph: ``(H) Section 1902(a)(89) (relating to regularly obtaining address information for enrollees).''. (c) Ensuring Transmission of Address Information From Managed Care Organizations.--Section 1932 of the Social Security Act (42 U.S.C. 1396u-2) is amended by adding at the end the following new subsection: ``(j) Transmission of Address Information.--Beginning January 1, 2026, each contract under a State plan with a managed care entity under section 1903(m) shall provide that the entity transmits to the State any address information for an individual enrolled with the entity that is provided to such entity directly from, or verified by such entity directly with, such individual.''.

SEC. 106. CODIFYING CERTAIN MEDICAID PROVIDER SCREENING REQUIREMENTS RELATED TO DECEASED PROVIDERS.

Section 1902(kk)(1) of the Social Security Act (42 U.S.C. 1396a(kk)(1)) is amended-- (1) by striking ``The State'' and inserting: ``(A) In general.--The State''; and (2) by adding at the end the following new subparagraph: ``(B) Additional provider screening.--Beginning January 1, 2027, as part of the enrollment (or reenrollment or revalidation of enrollment) of a provider or supplier under this title, and not less frequently than quarterly during the period that such provider or supplier is so enrolled, the State conducts a check of the Death Master File (as such term is defined in section 203(d) of the Bipartisan Budget Act of 2013) to determine whether such provider or supplier is deceased.''.

SEC. 107. MODIFYING CERTAIN STATE REQUIREMENTS FOR ENSURING DECEASED INDIVIDUALS DO NOT REMAIN ENROLLED.

Section 1902 of the Social Security Act (42 U.S.C. 1396a), as previously amended by this title, is amended-- (1) in subsection (a)-- (A) in paragraph (88), by striking ``; and'' and inserting a semicolon; (B) in paragraph (89), by striking the period at the end and inserting ``; and''; and (C) by inserting after paragraph (89) the following new paragraph: ``(90) provide that the State shall comply with the eligibility verification requirements under subsection (vv), except that this paragraph shall apply only in the case of the 50 States and the District of Columbia.''; and (2) by adding at the end the following new subsection: ``(vv) Verification of Certain Eligibility Criteria.-- ``(1) In general.--For purposes of subsection (a)(90), the eligibility verification requirements, beginning January 1, 2026, are as follows: ``(A) Quarterly screening to verify enrollee status.--The State shall, not less frequently than quarterly, review the Death Master File (as such term is defined in section 203(d) of the Bipartisan Budget Act of 2013) to determine whether any individuals enrolled for medical assistance under the State plan (or waiver of such plan) are deceased. ``(B) Disenrollment under state plan.--If the State determines, based on information obtained from the Death Master File, that an individual enrolled for medical assistance under the State plan (or waiver of such plan) is deceased, the State shall-- ``(i) treat such information as factual information confirming the death of a beneficiary for purposes of section 431.213(a) of title 42, Code of Federal Regulations (or any successor regulation); ``(ii) disenroll such individual from the State plan (or waiver of such plan); and ``(iii) discontinue any payments for medical assistance under this title made on behalf of such individual (other than payments for any items or services furnished to such individual prior to the death of such individual). ``(C) Reinstatement of coverage in the event of error.--If a State determines that an individual was misidentified as deceased based on information obtained from the Death Master File, and was erroneously disenrolled from medical assistance under the State plan (or waiver of such plan) based on such misidentification, the State shall immediately reenroll such individual under the State plan (or waiver of such plan), retroactive to the date of such disenrollment. ``(2) Rule of construction.--Nothing under this subsection shall be construed to preclude the ability of a State to use other electronic data sources to timely identify potentially deceased beneficiaries, so long as the State is also in compliance with the requirements of this subsection (and all other requirements under this title relating to Medicaid eligibility determination and redetermination).''.

SEC. 108. ONE-YEAR DELAY OF MEDICAID AND CHIP REQUIREMENTS FOR HEALTH SCREENINGS, REFERRALS, AND CASE MANAGEMENT SERVICES FOR ELIGIBLE JUVENILES IN PUBLIC INSTITUTIONS; STATE INTERIM WORK PLANS.

(a) In General.--Section 5121(d) of subtitle C of title V of division FF of the Consolidated Appropriations Act, 2023 (Public Law 117-328) is amended-- (1) by striking ``The amendments made by this section'' and inserting the following: ``(1) In general.--Subject to paragraph (2), the amendments made by this section''; and (2) by adding at the end the following new paragraph: ``(2) Delay of date by which states must comply with certain juvenile justice-related requirements.--A State shall not be regarded as failing to comply with the requirements of section 1902(a)(84)(D) or 2102(d)(2) of the Social Security Act (42 U.S.C. 1396a(a)(84)(D), 1397bb(d)(2)) before January 1, 2026.''. (b) Clarifying Nonapplication of Requirements to Individuals in Federal Custody.-- (1) Medicaid.-- (A) Subparagraph (D) of section 1902(a)(84) of the Social Security Act (42 U.S.C. 1396a(a)(84)), as added by section 5121 of subtitle C of title V of division FF of the Consolidated Appropriations Act, 2023 (Public Law 117-328), is amended by striking ``an individual who is an eligible juvenile'' and inserting ``an individual (other than an individual who is in Federal custody, including as an inmate in a Federal prison) who is an eligible juvenile''. (B) Section 5122(a) of subtitle C of title V of division FF of the Consolidated Appropriations Act, 2023 (Public Law 117-328) is amended-- (i) by striking ``paragraph (31)'' each place it appears and inserting ``the last numbered paragraph''; and (ii) in paragraph (1), by striking ``an individual who is an eligible juvenile'' and inserting ``an individual (other than an individual who is in Federal custody, including as an inmate in a Federal prison) who is an eligible juvenile''. (2) CHIP.-- (A) Subsection (d)(2) of section 2102 of the Social Security Act (42 U.S.C. 1397bb), as added by section 5121 of subtitle C of title V of division FF of the Consolidated Appropriations Act, 2023 (Public Law 117- 328), is amended by striking ``a targeted low-income child who'' and inserting ``a targeted low income child (other than a child who is in Federal custody, including as an inmate in a Federal prison) who''. (B) Section 5122(b)(2) of subtitle C of title V of division FF of the Consolidated Appropriations Act, 2023 (Public Law 117-328) is amended by striking ``a child who is'' and inserting ``a child (other than a child who is in Federal custody, including as an inmate in a Federal prison) who is''. (3) Effective date.--The amendments made by this subsection shall take effect as if enacted on December 29, 2022. (c) Interim Work Plan.--Not later than June 30, 2025, each State (as such term is defined in section 1101(a)(1) of the Social Security Act (42 U.S.C. 1301(a)(1)) for purposes of titles XIX and XXI of such Act) shall submit to the Secretary of Health and Human Services an interim work plan, in such form and containing such information as the Secretary may specify, describing the State's progress towards implementing, and its plans to come into compliance with, the requirements imposed by the amendments made by section 5121 of subtitle C of title V of division FF of the Consolidated Appropriations Act, 2023 (Public Law 117-328), consistent with the guidance issued by the Centers for Medicare & Medicaid Services in State Health Official Letter #24-004 on July 23, 2024.

SEC. 109. STATE STUDIES AND HHS REPORT ON COSTS OF PROVIDING MATERNITY, LABOR, AND DELIVERY SERVICES.

(a) State Study.-- (1) In general.--Not later than 24 months after the date of enactment of this Act, and every 5 years thereafter, each State (as such term is defined in section 1101(a)(1) of the Social Security Act (42 U.S.C. 1301(a)(1)) for purposes of titles XIX and XXI of such Act) shall conduct a study on the costs of providing maternity, labor, and delivery services in applicable hospitals (as defined in paragraph (3)) and submit the results of such study to the Secretary of Health and Human Services (referred to in this section as the ``Secretary''). (2) Content of study.--A State study required under paragraph (1) shall include the following information (to the extent practicable) with respect to maternity, labor, and delivery services furnished by applicable hospitals located in the State: (A) An estimate of the cost of providing maternity, labor, and delivery services at applicable hospitals, based on the expenditures a representative sample of such hospitals incurred for providing such services during the 2 most recent years for which data is available. (B) An estimate of the cost of providing maternity, labor, and delivery services at applicable hospitals that ceased providing labor and delivery services within the past 5 years, based on the expenditures a representative sample of such hospitals incurred for providing such services during the 2 most recent years for which data is available. (C) To the extent data allows, an analysis of the extent to which geographic location, community demographics, and local economic factors (as defined by the Secretary) affect the cost of providing maternity, labor, and delivery services at applicable hospitals, including the cost of services that support the provision of maternity, labor, and delivery services. (D) The amounts applicable hospitals are paid for maternity, labor, and delivery services, by geographic location and hospital size, under-- (i) Medicare; (ii) the State Medicaid program, including payment amounts for such services under fee- for-service payment arrangements and under managed care (as applicable); (iii) the State CHIP plan, including payment amounts for such services under fee- for-service payment arrangements and under managed care (as applicable); and (iv) private health insurance. (E) A comparative payment rate analysis-- (i) comparing payment rates for maternity, labor, and delivery services (inclusive of all payments received by applicable hospitals for furnishing maternity, labor, and delivery services) under the State Medicaid fee-for- service program to such payment rates for such services under Medicare (as described in section 447.203(b)(3) of title 42, Code of Federal Regulations), other Federally-funded or State-funded programs (including, to the extent data is available, Medicaid managed care rates), and to the payment rates for such services, to the extent data is available, of private health insurers within geographic areas of the State; and (ii) analyzing different payment methods for such services, such as the use of bundled payments, quality incentives, and low-volume adjustments. (F) An evaluation, using such methodology and parameters established by the Secretary, of whether each hospital located in the State that furnishes maternity, labor, and delivery services is expected to experience in the next 3 years significant changes in particular expenditures or types of reimbursement for maternity, labor, and delivery services. (3) Applicable hospital defined.--For purposes of this subsection, the term ``applicable hospital'' means any hospital located in a State that meets either of the following criteria: (A) The hospital provides labor and delivery services and more than 50 percent of the hospital's births (in the most recent year for which such data is available) are financed by the Medicaid program or CHIP. (B) The hospital-- (i) is located in a rural area (as defined by the Federal Office of Rural Health Policy for the purpose of rural health grant programs administered by such Office); (ii) based on the most recent 2 years of data available (as determined by the Secretary), furnished services for less than an average of 300 births per year; and (iii) provides labor and delivery services. (4) Assistance to small hospitals in compiling cost information.--There are appropriated to the Secretary for fiscal year 2025, $10,000,000 for the purpose of providing grants and technical assistance to a hospital described in paragraph (3)(B) to enable such hospital to compile detailed information for use in the State studies required under paragraph (1), to remain available until expended. (5) HHS report on state studies.--For each year in which a State is required to conduct a study under paragraph (1), the Secretary shall issue, not later than 12 months after the date on which the State submits to the Secretary the data described in such paragraph, a publicly available report that compiles and details the results of such study and includes the information described in paragraph (2). (b) HHS Report on National Data Collection Findings.--Not later than 3 years after the date of enactment of this Act, the Secretary shall submit to Congress, and make publicly available, a report analyzing the first studies conducted by States under subsection (a)(1), including recommendations for improving data collection on the cost of providing maternity, labor, and delivery services. (c) Implementation Funding.--In addition to the amount appropriated under subsection (a)(4), there are appropriated, out of any funds in the Treasury not otherwise obligated, $3,000,000 for fiscal year 2025, to remain available until expended, to the Secretary of Health and Human Services for purposes of implementing this section.

SEC. 110. MODIFYING CERTAIN DISPROPORTIONATE SHARE HOSPITAL ALLOTMENTS.

(a) Extending Tennessee DSH Allotments.--Section 1923(f)(6)(A)(vi) of the Social Security Act (42 U.S.C. 1396r-4(f)(6)(A)(vi)) is amended-- (1) in the heading, by striking ``2025'' and inserting ``2026 and for the 1st quarter of fiscal year 2027''; (2) by striking ``fiscal year 2025'' and inserting ``fiscal year 2026''; and (3) by inserting ``, and the DSH allotment for Tennessee for the 1st quarter of fiscal year 2027, shall be $13,275,000'' before the period. (b) Eliminating and Delaying DSH Allotment Reductions.--Section 1923(f) of the Social Security Act (42 U.S.C. 1396r-4(f)) is amended-- (1) in paragraph (7)(A)-- (A) in clause (i), in the matter preceding subclause (I), by striking ``April 1, 2025,'' and all that follows through ``2027'' and inserting ``January 1, 2027, and ending September 30, 2027, and for fiscal year 2028''; and (B) in clause (ii), by striking ``April 1, 2025,'' and all that follows through ``2027'' and inserting ``January 1, 2027, and ending September 30, 2027, and for fiscal year 2028''; and (2) in paragraph (8), by striking ``2027'' and inserting ``2028''.

SEC. 111. MODIFYING CERTAIN LIMITATIONS ON DISPROPORTIONATE SHARE HOSPITAL PAYMENT ADJUSTMENTS UNDER THE MEDICAID PROGRAM.

(a) In General.--Section 1923(g) of the Social Security Act (42 U.S.C. 1396r-4(g)) is amended-- (1) in paragraph (1)-- (A) in subparagraph (A)-- (i) in the matter preceding clause (i), by striking ``(other than a hospital described in paragraph (2)(B))''; (ii) in clause (i), by inserting ``with respect to such hospital and year'' after ``described in subparagraph (B)''; and (iii) in clause (ii)-- (I) in subclause (I), by striking ``and'' at the end; (II) in subclause (II), by striking the period and inserting ``; and''; and (III) by adding at the end the following new subclause: ``(III) payments made under title XVIII or by an applicable plan (as defined in section 1862(b)(8)(F)) for such services.''; and (B) in subparagraph (B)-- (i) in the matter preceding clause (i), by striking ``in this clause are'' and inserting ``in this subparagraph are, with respect to a hospital and a year,''; and (ii) by adding at the end the following new clause: ``(iii) Individuals who are eligible for medical assistance under the State plan or under a waiver of such plan and for whom the State plan or waiver is a payor for such services after application of benefits under title XVIII or under an applicable plan (as defined in section 1862(b)(8)(F)), but only if the hospital has in the aggregate incurred costs exceeding payments under such State plan, waiver, title XVIII, or applicable plan for such services furnished to such individuals during such year.''; (2) by striking paragraph (2); (3) by redesignating paragraph (3) as paragraph (2); and (4) in paragraph (2), as so redesignated, by striking ``Notwithstanding paragraph (2) of this subsection (as in effect on October 1, 2021), paragraph (2)'' and inserting ``Paragraph (2)''. (b) Effective Date.-- (1) In general.--Except as provided in paragraph (2), the amendments made by this section shall apply to payment adjustments made under section 1923 of the Social Security Act (42 U.S.C. 1396r-4) for Medicaid State plan rate years beginning on or after the date of enactment of this Act. (2) State option to distribute unspent dsh allotments from prior years up to modified cap.-- (A) In general.--If, for any Medicaid State plan rate year that begins on or after October 1, 2021, and before the date of enactment of this Act, a State did not spend the full amount of its Federal fiscal year allotment under section 1923 of the Social Security Act (42 U.S.C. 1396r-4) applicable to that State plan rate year, the State may use the unspent portion of such allotment to increase the amount of any payment adjustment made to a hospital for such rate year, provided that-- (i) such payment adjustment (as so increased) is consistent with subsection (g) of such section (as amended by this section); and (ii) the total amount of all payment adjustments for the State plan rate year (as so increased) does not exceed the disproportionate share hospital allotment for the State and applicable Federal fiscal year under subsection (f) of such section. (B) No recoupment of payments already made to hospitals.--A State shall not recoup any payment adjustment made by the State to a hospital for a Medicaid State plan rate year described in subparagraph (A) if such payment adjustment is consistent with section 1923(g) of such Act (42 U.S.C. 1396r-4(g)) as in effect on October 1, 2021. (C) Authority to permit retroactive modification of state plan amendments to allow for increases.-- (i) In general.--Subject to paragraph (2), solely for the purpose of allowing a State to increase the amount of a payment adjustment to a hospital for a Medicaid State plan rate year described in subparagraph (A) pursuant to this paragraph, a State may retroactively modify a provision of the Medicaid State plan, a waiver of such plan, or a State plan amendment that relates to such rate year and the Secretary may approve such modification. (ii) Deadline.--A State may not submit a request for approval of a retroactive modification to a provision of the Medicaid State plan, a waiver of such plan, or a State plan amendment for a Medicaid State plan rate year after the date by which the State is required to submit the independent certified audit for that State plan rate year as required under section 1923(j)(2) of the Social Security Act (42 U.S.C. 1396r-4(j)(2)). (D) Reporting.--If a State increases a payment adjustment made to a hospital for a Medicaid State plan rate year pursuant to this paragraph, the State shall include information on such increased payment adjustment as part of the next annual report submitted by the State under section 1923(j)(1) of the Social Security Act (42 U.S.C. 1396r-4(j)(1)).

SEC. 112. ENSURING ACCURATE PAYMENTS TO PHARMACIES UNDER MEDICAID.

(a) In General.--Section 1927(f) of the Social Security Act (42 U.S.C. 1396r-8(f)) is amended-- (1) in paragraph (1)(A)-- (A) by redesignating clause (ii) as clause (iii); and (B) by striking ``and'' after the semicolon at the end of clause (i) and all that precedes it through ``(1)'' and inserting the following: ``(1) Determining pharmacy actual acquisition costs.--The Secretary shall conduct a survey of retail community pharmacy drug prices and applicable non-retail pharmacy drug prices to determine national average drug acquisition cost benchmarks (as such term is defined by the Secretary) as follows: ``(A) Use of vendor.--The Secretary may contract services for-- ``(i) with respect to retail community pharmacies, the determination of retail survey prices of the national average drug acquisition cost for covered outpatient drugs that represent a nationwide average of consumer purchase prices for such drugs, net of all discounts, rebates, and other price concessions (to the extent any information with respect to such discounts, rebates, and other price concessions is available) based on a monthly survey of such pharmacies; ``(ii) with respect to applicable non- retail pharmacies-- ``(I) the determination of survey prices, separate from the survey prices described in clause (i), of the non- retail national average drug acquisition cost for covered outpatient drugs that represent a nationwide average of consumer purchase prices for such drugs, net of all discounts, rebates, and other price concessions (to the extent any information with respect to such discounts, rebates, and other price concessions is available) based on a monthly survey of such pharmacies; and ``(II) at the discretion of the Secretary, for each type of applicable non-retail pharmacy, the determination of survey prices, separate from the survey prices described in clause (i) or subclause (I) of this clause, of the national average drug acquisition cost for such type of pharmacy for covered outpatient drugs that represent a nationwide average of consumer purchase prices for such drugs, net of all discounts, rebates, and other price concessions (to the extent any information with respect to such discounts, rebates, and other price concessions is available) based on a monthly survey of such pharmacies; and''; (2) in subparagraph (B) of paragraph (1), by striking ``subparagraph (A)(ii)'' and inserting ``subparagraph (A)(iii)''; (3) in subparagraph (D) of paragraph (1), by striking clauses (ii) and (iii) and inserting the following: ``(ii) The vendor must update the Secretary no less often than monthly on the survey prices for covered outpatient drugs. ``(iii) The vendor must differentiate, in collecting and reporting survey data, for all cost information collected, whether a pharmacy is a retail community pharmacy or an applicable non-retail pharmacy, including whether such pharmacy is an affiliate (as defined in subsection (k)(14)), and, in the case of an applicable non-retail pharmacy, which type of applicable non-retail pharmacy it is using the relevant pharmacy type indicators included in the guidance required by subsection (d)(2) of section 112 of the Bipartisan Health Care Act.''; (4) by adding at the end of paragraph (1) the following: ``(F) Survey reporting.--In order to meet the requirement of section 1902(a)(54), a State shall require that any retail community pharmacy or applicable non-retail pharmacy in the State that receives any payment, reimbursement, administrative fee, discount, rebate, or other price concession related to the dispensing of covered outpatient drugs to individuals receiving benefits under this title, regardless of whether such payment, reimbursement, administrative fee, discount, rebate, or other price concession is received from the State or a managed care entity or other specified entity (as such terms are defined in section 1903(m)(9)(D)) directly or from a pharmacy benefit manager or another entity that has a contract with the State or a managed care entity or other specified entity (as so defined), shall respond to surveys conducted under this paragraph. ``(G) Survey information.--Information on national drug acquisition prices obtained under this paragraph shall be made publicly available in a form and manner to be determined by the Secretary and shall include at least the following: ``(i) The monthly response rate to the survey including a list of pharmacies not in compliance with subparagraph (F). ``(ii) The sampling methodology and number of pharmacies sampled monthly. ``(iii) Information on price concessions to pharmacies, including discounts, rebates, and other price concessions, to the extent that such information may be publicly released and has been collected by the Secretary as part of the survey. ``(H) Penalties.-- ``(i) In general.--Subject to clauses (ii), (iii), and (iv), the Secretary shall enforce the provisions of this paragraph with respect to a

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