Sec. 301. Strengthened cost-sharing protections under CHIP
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Section 2103(e) of the Social Security Act ( 42 U.S.C. 1397cc(e) ) is amended— in paragraph (3)(B)— by inserting , including with respect to benefits for dental services, after State child health plan ; by striking annual aggregate cost-sharing and inserting aggregate cost-sharing ; and by striking for the year involved and inserting , as applied on a quarterly or monthly basis (as specified by the State) ; and by adding at the end the following new paragraph: Except as provided in subparagraph (B), in the case of a State child health plan that imposes premiums, deductibles, cost sharing, or similar charges that could (as determined by the Secretary) cause families that include a targeted low-income child or a targeted low-income pregnant woman to have out-of-pocket expenses that exceed the limit imposed under paragraph (3)(B) for a month or quarter (as applicable under the State plan), the State child health plan shall— establish an electronic process for tracking such expenses that does not rely on documentation provided by the targeted low-income child, the targeted low-income pregnant woman, or the family; and notify each such family— of the aggregate monthly or quarterly limits on out-of-pocket expenses applicable to the family imposed under paragraph (3)(B); and that no premiums, deductibles, cost sharing, or similar charges shall be imposed on any targeted low-income child or targeted low-income pregnant woman in the family for the remainder of any month or quarter with respect to which the family has reached the aggregate monthly or quarterly family limit imposed under such paragraph applicable to the family.
In the case of a State child health plan that provides child health assistance through managed care entities or organizations, the entities or organizations shall, with respect to families described in subparagraph (A)— establish an electronic process described in subparagraph (A)(i); and coordinate with the State agency responsible for implementing the State child health plan under this title to ensure that any premiums, deductibles, cost sharing, or similar charges imposed on such a family are included in the aggregate limit applicable to the family under paragraph (3)(B). .
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Sec. 301
Strengthened cost-sharing protections under CHIP
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