[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3910 Introduced in House (IH)]
<DOC>
116th CONGRESS
1st Session
H. R. 3910
To amend title XI of the Social Security Act to improve access to care
for all Medicare and Medicaid beneficiaries through models tested under
the Center for Medicare and Medicaid Innovation, and for other
purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 23, 2019
Mr. Lewis (for himself, Mr. Larson of Connecticut, Ms. Sewell of
Alabama, Mr. Doggett, Mr. Evans, Mr. Pascrell, Mr. Gomez, Mr. Suozzi,
and Ms. Sanchez) introduced the following bill; which was referred to
the Committee on Energy and Commerce, and in addition to the Committee
on Ways and Means, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend title XI of the Social Security Act to improve access to care
for all Medicare and Medicaid beneficiaries through models tested under
the Center for Medicare and Medicaid Innovation, and for other
purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Equality in Medicare and Medicaid
Treatment Act of 2019''.
SEC. 2. IMPROVING ACCESS TO CARE FOR MEDICARE AND MEDICAID
BENEFICIARIES.
Section 1115A of the Social Security Act (42 U.S.C. 1315a) is
amended--
(1) in subsection (a)(3)--
(A) by inserting ``, the causes of health
disparities and social determinants of health,'' after
``medicine''; and
(B) by inserting ``, the Office of Minority Health
of the Centers for Medicare & Medicaid Services, the
Office of Rural Health Policy, and the Office on
Women's Health'';
(2) in subsection (b)--
(A) in paragraph (2)--
(i) in subparagraph (A)--
(I) by inserting after the first
sentence, the following new sentence:
``Prior to model selection, the
Secretary shall consult with the Office
of Minority Health of the Centers for
Medicare & Medicaid Services, the
Federal Office of Rural Health Policy,
and the Office on Women's Health to
ensure that models under consideration
address health disparities and social
determinants of health as appropriate
for populations to be cared for under
the model.'';
(II) by inserting ``, as well as
improving access to care received by
individuals receiving benefits under
such title,'' after ``title''; and
(III) by adding at the end the
following new sentence: ``The models
selected under this subparagraph shall
include the social determinants of
health payment model described in
subparagraph (D), the testing of which
shall begin not later than December 31,
2020.'';
(ii) in subparagraph (C), by adding at the
end the following new clauses:
``(ix) Whether the model will affect access
to care from providers and suppliers caring for
high risk patients or operating in underserved
areas.
``(x) Whether the model has the potential
to produce reductions in minority and rural
health disparities.''; and
(iii) by adding at the end the following
new subparagraph:
``(D) Social determinants of health payment
model.--
``(i) In general.--The social determinants
of health payment model described in this
subparagraph is a payment model that tests each
of the payment and service delivery innovations
described in clause (ii) in a region determined
appropriate by the Secretary.
``(ii) Payment and service delivery
innovations described.--For purposes of clause
(i), the payment and service delivery
innovations described in this clause are the
following:
``(I) Payment and service delivery
innovations for behavioral health
services, focusing on gathering
actionable data to address the higher
costs associated with beneficiaries
with diagnosed behavioral conditions.
``(II) Payment and service delivery
innovations targeting conditions or
comorbidities of individuals entitled
or enrolled under the Medicare program
under title XVIII and enrolled under a
State plan under the Medicaid program
under title XIX to increase capacity in
underserved areas.
``(III) Payment and service
delivery innovations targeted on
Medicaid-eligible pregnant and
postpartum women, up to one year after
delivery.''; and
(B) in paragraph (4)(A)--
(i) in clause (i) at the end, by striking
``and'';
(ii) in clause (ii), at the end, by
striking the period and inserting ``; and'';
and
(iii) by adding at the end the following
new clause:
``(iii) the extent to which the model
improves access to care or the extent to which
the model improves care for high risk patients,
patients from racial or ethnic minorities, or
patients in underserved areas.'';
(3) in subsection (c)--
(A) in paragraph (2), by striking at the end
``and'';
(B) by redesignating paragraph (3) as paragraph
(4);
(C) by inserting after paragraph (2) the following
new paragraph:
``(3) the Office of Minority Health of the Centers for
Medicare & Medicaid Services certifies that such expansion will
not reduce access to care for low-income, minority, or rural
beneficiaries; and'';
(D) in paragraph (4), as redesignated by
subparagraph (B), by inserting before the period at the
end the following: ``nor increase health disparities
experienced by low-income, minority, or rural
beneficiaries''; and
(E) in the matter following paragraph (4), as
redesignated by subparagraph (B), by inserting ``,
improve access to care,'' after ``care''; and
(4) in subsection (g)--
(A) by inserting ``(or, beginning with 2021, once
every year thereafter)'' after ``thereafter''; and
(B) by adding at the end the following new
sentence: ``For reports for 2021 and each subsequent
year, each such report shall include information on the
following:
``(1) The extent and severity of minority and rural health
disparities in Medicare and Medicaid beneficiaries.
``(2) The interventions that address social determinants of
health in payment models selected by the Center for Medicare
and Medicaid Innovation for testing.
``(3) The interventions that address social determinants of
health in payment models not selected by the Center for
Medicare and Medicaid Innovation for testing.
``(4) The effectiveness of interventions in mitigating
negative health outcomes and higher costs associated with
social determinants of health within models selected by the
Center for Medicare and Medicaid Innovation for testing.
``(5) Changes in disparities among minorities and Medicare
and Medicaid beneficiaries in underserved areas that are
attributable to provider and supplier participation in a Phase
II model.
``(6) In consultation with the Comptroller General of the
United States, estimated Federal savings achieved through the
reduction of rural and minority health disparities.
``(7) Other areas determined appropriate by the
Secretary.''.
<all>
Equality in Medicare and Medicaid Treatment Act of 2019
#3910 | HR Congress #116
Policy Area: Health
Last Action: Referred to the Subcommittee on Health. (7/24/2019)
Bill Text Source: Congress.gov
Summary and Impacts
Original Text