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Union Calendar No. 325 

114TH CONGRESS 

2D SESSION H. R. 3821 

[Report No. 114–426] 

To amend title XIX to require the publication of a provider directory in 

the case of States providing for medical assistance on a fee-for-service 

basis or through a primary care case-management system, and for other 

purposes. 

IN THE HOUSE OF REPRESENTATIVES 

OCTOBER 23, 2015 

Mr. COLLINS of New York (for himself and Mr. TONKO) introduced the 

following bill; which was referred to the Committee on Energy and Commerce 

FEBRUARY 23, 2016 

Reported with an amendment, committed to the Committee of the Whole 

House on the State of the Union, and ordered to be printed 

[Strike out all after the enacting clause and insert the part printed in italic] 

[For text of introduced bill, see copy of bill as introduced on October 23, 2015] 


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A BILL 

To amend title XIX to require the publication of a provider 

directory in the case of States providing for medical 

assistance on a fee-for-service basis or through a primary 

care case-management system, and for other purposes. 


asabaliauskas on DSK5VPTVN1PROD with BILLS
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•HR 3821 RH

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Medicaid Directory of 

5 Caregivers Act’’ or the ‘‘Medicaid DOC Act’’. 

6 SEC. 2. REQUIRING PUBLICATION OF FEE-FOR-SERVICE 

7 PROVIDER DIRECTORY. 

8 (a) IN GENERAL.—Section 1902(a) of the Social Secu9 rity Act (42 U.S.C. 1396a(a)) is amended by inserting after 

10 paragraph (77) the following new paragraph: 

11 ‘‘(78) provide that, not later than 180 days after 

12 the date of the enactment of this paragraph, in the 

13 case of a State plan that provides medical assistance 

14 on a fee-for-service basis or through a primary care 

15 case-management system described in section 

16 1915(b)(1) (other than a primary care case manage17 ment entity (as defined by the Secretary)), the State 

18 shall publish (and update on at least an annual 

19 basis) on the public Website of the State agency ad20 ministering the State plan, a directory of the pro21 viders (including, at a minimum, primary and spe22 cialty care physicians) described in subsection (ll) 

23 that includes— 

24 ‘‘(A) with respect to each such provider— 

25 ‘‘(i) the name of the provider; 


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1 ‘‘(ii) the specialty of the provider; 

2 ‘‘(iii) the address of the provider; and 

3 ‘‘(iv) the telephone number of the pro4 vider; and 

5 ‘‘(B) with respect to any such provider par6 ticipating in such a primary care case-manage7 ment system, information regarding— 

8 ‘‘(i) whether the provider is accepting 

9 as new patients individuals who receive 

10 medical assistance under this title; and 

11 ‘‘(ii) the provider’s cultural and lin12 guistic capabilities, including the languages 

13 spoken by the provider or by the skilled 

14 medical interpreter providing interpretation 

15 services at the provider’s office;’’. 

16 (b) DIRECTORY PROVIDERS DESCRIBED.—Section 

17 1902 of the Social Security Act (42 U.S.C. 1396a) is 

18 amended by adding at the end the following new subsection: 

19 ‘‘(ll) DIRECTORY PROVIDERS DESCRIBED.—A pro20 vider described in this subsection is— 

21 ‘‘(1) in the case of a provider of a provider type 

22 for which the State agency, as a condition on receiv23 ing payment for items and services furnished by the 

24 provider to individuals eligible to receive medical as25 sistance under the State plan, requires the enrollment 


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1 of the provider with the State agency, a provider 

2 that— 

3 ‘‘(A) is enrolled with the agency as of the 

4 date on which the directory is published or up5 dated (as applicable) under subsection (a)(78); 

6 and 

7 ‘‘(B) received payment under the State plan 

8 in the 12-month period preceding such date; and 

9 ‘‘(2) in the case of a provider of a provider type 

10 for which the State agency does not require such en11 rollment, a provider that received payment under the 

12 State plan in the 12-month period preceding the date 

13 on which the directory is published or updated (as 

14 applicable) under subsection (a)(78).’’. 

15 (c) RULE OF CONSTRUCTION.— 

16 (1) IN GENERAL.—The amendment made by sub17 section (a) shall not be construed to apply in the case 

18 of a State in which all the individuals enrolled in the 

19 State plan under title XIX of the Social Security Act 

20 (or under a waiver of such plan), other than individ21 uals described in paragraph (2), are enrolled with a 

22 medicaid managed care organization (as defined in 

23 section 1903(m)(1)(A) of such Act (42 U.S.C. 

24 1396b(m)(1)(A))), including prepaid inpatient health 

25 plans and prepaid ambulatory health plans (as deVerDate Sep 11 2014 21:35 Feb 23, 2016 Jkt 059200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6203 E:\BILLS\H3821.RH H3821

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1 fined by the Secretary of Health and Human Serv2 ices). 

3 (2) INDIVIDUALS DESCRIBED.—An individual 

4 described in this paragraph is an individual who is 

5 an Indian (as defined in section 4 of the Indian 

6 Health Care Improvement Act (25 U.S.C. 1603)) or 

7 an Alaska Native. 

8 (d) EXCEPTION FOR STATE LEGISLATION.—In the case 

9 of a State plan under title XIX of the Social Security Act 

10 (42 U.S.C. 1396 et seq.), which the Secretary determines 

11 requires State legislation in order for the respective plan 

12 to meet one or more additional requirements imposed by 

13 amendments made by this section, the respective plan shall 

14 not be regarded as failing to comply with the requirements 

15 of such title solely on the basis of its failure to meet such 

16 an additional requirement before the first day of the first 

17 calendar quarter beginning after the close of the first reg18 ular session of the State legislature that begins after the 

19 date of enactment of this section. For purposes of the pre20 vious sentence, in the case of a State that has a 2-year legis21 lative session, each year of the session shall be considered 

22 to be a separate regular session of the State legislature. 


asabaliauskas on DSK5VPTVN1PROD with BILLS

asabaliauskas on DSK5VPTVN1PROD with BILLS
Union Calendar No. 325 

114TH CONGRESS 

2D SESSION H. R. 3821 

[Report No. 114–426] 

A BILL 

To amend title XIX to require the publication of a 

tem, and for other purposes. or through a primary care case-management sysfor medical assistance on a fee-for-service basis provider directory in the case of States providing 

FEBRUARY 23, 2016 

Reported with an amendment, committed to the Comand ordered to be printed mittee of the Whole House on the State of the Union, 


asabaliauskas on DSK5VPTVN1PROD with BILLS