I 

114TH CONGRESS 

1ST SESSION H. R. 3821 

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 

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. 

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’’. 


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

2 PROVIDER DIRECTORY. 

3 (a) IN GENERAL.—Section 1902(a) of the Social Se4 curity Act (42 U.S.C. 1396a(a)) is amended by inserting 

5 after paragraph (77) the following new paragraph: 

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

7 after the date of the enactment of this paragraph, 

8 in the case of a State plan that provides medical as9 sistance on a fee-for-service basis or through a pri10 mary care case-management system described in sec11 tion 1915(b)(1) (other than a primary care case 

12 management entity (as defined by the Secretary)), 

13 the State shall publish (and update on at least an 

14 annual basis) on the public Website of the State 

15 agency administering the State plan, a directory of 

16 the providers (including, at a minimum, primary and 

17 specialty care physicians) that received payment 

18 under the State plan in the preceding 12-month pe19 riod that includes— 

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

21 ‘‘(i) the name of the provider; 

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

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

24 ‘‘(iv) the telephone number of the pro25 vider; and 


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1 ‘‘(B) with respect to any such provider 

2 participating in such a primary care case-man3 agement system, information regarding— 

4 ‘‘(i) whether the provider is accepting 

5 as new patients individuals who receive 

6 medical assistance under this title; and 

7 ‘‘(ii) the provider’s cultural and lin8 guistic capabilities, including the languages 

9 spoken by the provider or by the skilled 

10 medical interpreter providing interpreta11 tion services at the provider’s office.’’. 

12 (b) RULE OF CONSTRUCTION.— 

13 (1) IN GENERAL.—The amendment made by 

14 subsection (a) shall not be construed to apply in the 

15 case of a State in which all the individuals enrolled 

16 in the State plan under title XIX of the Social Secu17 rity Act (or under a waiver of such plan), other than 

18 individuals described in paragraph (2), are enrolled 

19 with a medicaid managed care organization (as de20 fined in section 1903(m)(1)(A) of such Act (42 

21 U.S.C. 1396b(m)(1)(A))), including prepaid inpa22 tient health plans and prepaid ambulatory health 

23 plans (as defined by the Secretary). 

24 (2) INDIVIDUALS DESCRIBED.—An individual 

25 described in this paragraph is an individual who is 


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

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

3 an Alaska Native. 

4 (c) EXCEPTION FOR STATE LEGISLATION.—In the 

5 case of a State plan under title XIX of the Social Security 

6 Act (42 U.S.C. 1396 et seq.), which the Secretary deter7 mines requires State legislation in order for the respective 

8 plan to meet one or more additional requirements imposed 

9 by amendments made by this section, the respective plan 

10 shall not be regarded as failing to comply with the require11 ments of such title solely on the basis of its failure to meet 

12 such an additional requirement before the first day of the 

13 first calendar quarter beginning after the close of the first 

14 regular session of the State legislature that begins after 

15 the date of enactment of this section. For purposes of the 

16 previous sentence, in the case of a State that has a 2- 

17 year legislative session, each year of the session shall be 

18 considered to be a separate regular session of the State 

19 legislature. 

Æ 


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