Sen. Thomas R. Carper

Mental Health Access Improvement Act of 2021 This bill provides for coverage of marriage and family therapist services and mental health counselor services under Medicare. It also excludes such services from the skilled nursing facility prospective payment system, and authorizes marriage and family therapists and mental health counselors to develop discharge plans for post-hospital services.

Huntington's Disease Disability Insurance Access Act of 2021 This bill expedites payment of Social Security Disability Insurance (SSDI) benefits and eligibility for Medicare coverage for those with Huntington's disease. This is an inherited disorder that causes brain cells to die, including in areas of the brain that help to control voluntary movement. Specifically, the bill eliminates the 5-month waiting period for SSDI benefits and the subsequent 24-month waiting period for Medicare coverage for individuals with Huntington's disease. Under current law, individuals generally must wait five months after the onset of disability to begin receiving SSDI benefits and an additional 24 months to become eligible for Medicare.

Periodically Listing Updates to Management Act or the PLUM Act This bill replaces the congressional publication entitled United States Government Policy and Supporting Positions , commonly known as the PLUM Book , with an online public directory. The PLUM Book contains personnel information for federal civil service leadership and support positions in the legislative and executive branches that may be subject to noncompetitive appointment, including heads of agencies and policy executives. The book is used to identify presidentially appointed positions and is published every four years (after each presidential election) by certain congressional committees. The bill requires the Office of Personnel Management (OPM) to publish the information contained in the PLUM Book on a public website in a format that is easily searchable and that otherwise meets certain data standards. Agencies must upload updated information to the website on a monthly basis; OPM must verify the accuracy of the information twice a year in coordination with the White House Office of Presidential Personnel. The bill terminates publication of the PLUM Book in its current form on January 1, 2024.

Federal Firefighter Flexibility and Fairness Act This bill provides that any hours worked by a firefighter under a qualified trade-of-time arrangement shall be disregarded for purposes of determining eligibility for, or the amount of, any overtime pay. The bill defines qualified trade-of-time arrangement as an arrangement under which two firefighters who are employed by the same agency agree, solely at their option and with the approval of their employing agency, to substitute for one another during scheduled work hours in the performance of work in the same capacity.

Connected Maternal Online Monitoring Act or the Connected MOM Act This bill requires the Centers for Medicare & Medicaid Services to report, and provide resources for states, on coverage of remote physiologic devices and related services (e.g., blood glucose monitors) under Medicaid, so as to improve maternal and child health outcomes for pregnant and postpartum women.

Monarch and Pollinator Highway Act of 2021 or the MPH Act of 20 21 This bill requires the Department of Transportation to provide grants to states, Indian tribes, and federal land management agencies to carry out pollinator-friendly practices on roadsides and highway rights-of-way, including the planting and seeding of native, locally-appropriate grasses, wildflowers, and milkweed.

Ensuring Lasting Smiles Act This bill requires private health insurance plans to cover diagnosis and treatment of congenital anomalies and birth defects, such as reconstructive services and items. Coverage must include services and items that functionally improve, repair, or restore any body part that is medically necessary for normal bodily functions or appearance, as determined by the treating physician. Coverage limits and cost-sharing requirements for such services and items may not be more restrictive than those applicable to all medical and surgical benefits under the plan.

This bill waives certain eligibility requirements for hospitals participating in the 340B drug discount program (i.e., a program that allows entities to receive covered outpatient drugs at reduced prices from manufacturers) during the COVID-19 (i.e., coronavirus disease 2019) public health emergency. Specifically, the bill waives the required minimum proportion of low-income patients served for hospitals that began participating in the program during or prior to the COVID-19 emergency.

Responsibility for Unaccompanied Minors Act This bill amends provisions relating to responsibilities of the Department of Health and Human Services (HHS) for the care of unaccompanied alien children. The Office of Refugee Resettlement of HHS may provide care for an unaccompanied alien child until the conclusion of the child's immigration proceedings or the child reaching 18 years of age, whichever occurs first. Before placing an unaccompanied alien child with a sponsor, the office shall evaluate the child's future need for follow-up services. Before placing an accompanied alien child, HHS shall (1) require the proposed sponsor to execute a sponsor care agreement, (2) notify the welfare agency of the state where the child will be placed, and (3) conduct a background check of the sponsor and all adults living in the household in which the child will reside. Under the care agreement, each sponsor shall agree to (1) provide for the child's physical and mental well-being, and (2) ensure the child's presence at immigration proceedings and compliance with all court and agency orders. HHS shall assume physical custody of a child if the non-parent or legal guardian sponsor fails to comply with the care agreement. HHS shall periodically report to Congress on instances where a sponsor failed to comply with a care agreement. The Department of Justice shall increase the number of immigration judge teams by at least 225.

Protecting Americans with Pre-Existing Conditions Act of 2021 This bill nullifies specified guidance and final rule provisions pertaining to Section 1332 waivers (also known as State Innovation Waivers or State Relief and Empowerment Waivers) issued by the Department of the Treasury and the Department of Health and Human Services. The provisions allow states to forego certain requirements of the Patient Protection and Affordable Care Act in order to implement experimental plans for health care coverage, as long as the resulting coverage meets certain statutory criteria. The provisions, which supersede earlier guidance from 2015, alter agency interpretation of how states may satisfy the statutory criteria for waiver approval. For example, the provisions (1) redefine acceptable coverage under such waivers to include short-term, limited-duration insurance and association health plans; (2) allow the comprehensiveness and affordability of coverage under such waivers to be assessed based on projected availability, rather than enrollment; and (3) allow the level of coverage to be assessed based on the effects over the entire course of the waiver, rather than per year.