I 

118TH CONGRESS 

2D SESSION H. R. 9446 

To provide payment for patient navigator services under title XIX of the 

Social Security Act, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

SEPTEMBER 3, 2024 

Mr. DESAULNIER introduced the following bill; which was referred to the 

Committee on Energy and Commerce 

A BILL 

To provide payment for patient navigator services under title 

XIX of the Social Security Act, 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 ‘‘Patient Navigation As5 sistance Act’’. 

6 SEC. 2. MEDICAID COVERAGE FOR PATIENT NAVIGATOR 

7 SERVICES. 

8 (a) IN GENERAL.—Section 1902(a) of the Social Se9 curity Act (42 U.S.C. 1396a(a)) is amended— 


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1 (1) in paragraph (86), by striking ‘‘and’’ at the 

2 end; 

3 (2) in paragraph (87), by striking at the end 

4 the period and inserting ‘‘; and’’; 

5 (3) by inserting after paragraph (87) the fol6 lowing new paragraph: 

7 ‘‘(88) provide that the State shall reimburse an 

8 eligible entity (as defined in subsection (tt)(1)) for 

9 any patient navigator service (as defined in sub10 section (tt)(3)) that is provided— 

11 ‘‘(A) to an individual who is eligible for 

12 medical assistance under the State plan; and 

13 ‘‘(B) by a patient navigator (as defined in 

14 subsection (tt)(2)) through the eligible entity.’’; 

15 and 

16 (4) by adding at the end the following new sub17 section: 

18 ‘‘(tt) PATIENT NAVIGATOR SERVICES DEFINI19 TIONS.—For purposes of this section: 

20 ‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible en21 tity’ means an entity that— 

22 ‘‘(A) is an eligible entity (as defined in 

23 subsection (l)(1) of section 340A of the Public 

24 Health Service Act); and 


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1 ‘‘(B) complies with the following require2 ments of such section (insofar as they apply to 

3 a grant recipient under such section): 

4 ‘‘(i) Subsection (b) (relating to patient 

5 navigator duties and community knowl6 edge). 

7 ‘‘(ii) Subsection (c) (relating to prohi8 bitions). 

9 ‘‘(iii) Subsection (e) (relating to appli10 cations). 

11 ‘‘(iv) Subsection (j)(3) (relating to re12 ports). 

13 ‘‘(2) PATIENT NAVIGATOR.— 

14 ‘‘(A) IN GENERAL.—The term ‘patient 

15 navigator’ means an individual who— 

16 ‘‘(i) is employed by a health care or 

17 community-based organization and pro18 vides individualized education and re19 sources to facilitate informed decision-mak20 ing and timely access to quality health and 

21 psychosocial care; and 

22 ‘‘(ii) has obtained and complies with 

23 education, licensure, or certification, in24 cluding at least— 


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1 ‘‘(I) a bachelor’s degree in nurs2 ing from an accredited university, 

3 master’s degree in social work from 

4 an accredited university, or bachelor’s 

5 degree in a health-related field from 

6 an accredited university; 

7 ‘‘(II) licensing and certification 

8 requirements for a registered nurse, 

9 social work, or clinical practitioner, as 

10 applicable, and scope of practice re11 quirements, as defined by the State or 

12 jurisdiction in which the individual is 

13 licensed or certified; 

14 ‘‘(III) completion of competency15 based navigation training sessions or 

16 courses for clinical or non-clinical pro17 fessionals, as applicable; or 

18 ‘‘(IV) subject to subparagraph 

19 (B), completion of a training program 

20 approved by the Secretary for pur21 poses of section 340A(l)(3) of the 

22 Public Health Service Act. 

23 ‘‘(B) TRANSITIONAL LIMITATION.—The 

24 training described in subclause (IV) of subpara25 graph (A)(ii) shall not satisfy the requirement 


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1 of subparagraph (A)(ii) after the date that is 3 

2 years after the date on which the provisions of 

3 this subsection apply to patient navigator serv4 ices pursuant to section 2(c) of the Patient 

5 Navigator Assistance Act. 

6 ‘‘(3) PATIENT NAVIGATOR SERVICES.—The 

7 term ‘patient navigator service’ means a service pro8 vided by a patient navigator to an individual, includ9 ing— 

10 ‘‘(A) referrals and related activities to help 

11 the individual obtain needed services, including 

12 activities that help link the individual with med13 ical, social, logistical, financial, or other pro14 grams or services to address identified or speci15 fied needs of the individual; 

16 ‘‘(B) services specified under paragraphs 

17 (1) through (6) of subsection (b) of section 

18 340A of the Public Health Service Act; and 

19 ‘‘(C) other services specified by the Sec20 retary.’’. 

21 (b) TREATMENT AS MEDICAL ASSISTANCE FOR PUR22 POSES OF FMAP.—Section 1905(a) of the Social Security 

23 Act (42 U.S.C. 1396d(a)) is amended— 

24 (1) in paragraph (30), by striking ‘‘and’’ at the 

25 end; 


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1 (2) by redesignating paragraph (31) as para2 graph (32); and 

3 (3) by inserting after paragraph (30) the fol4 lowing new paragraph: 

5 ‘‘(31) patient navigator services (as defined in 

6 section 1902(tt)(3)) that are provided in a manner 

7 that meets the requirements of section 1902(a)(88); 

8 and’’. 

9 (c) EFFECTIVE DATE.— 

10 (1) IN GENERAL.—Subject to paragraph (2), 

11 the amendments made by this section shall apply to 

12 patient navigator services provided after the first 

13 day of the first calendar year that begins after the 

14 date of enactment of this Act. 

15 (2) EXCEPTION FOR STATE LEGISLATION.—In 

16 the case of a State plan under title XIX of the So17 cial Security Act, which the Secretary of Health and 

18 Human Services determines requires State legisla19 tion in order for the respective plan to meet any re20 quirement imposed by amendments made by this 

21 Act, the respective plan shall not be regarded as fail22 ing to comply with the requirements of such title 

23 solely on the basis of its failure to meet such an ad24 ditional requirement before the first day of the first 

25 calendar quarter beginning after the close of the 


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1 first regular session of the State legislature that be2 gins after the date of enactment of this Act. For 

3 purposes of the previous sentence, in the case of a 

4 State that has a 2-year legislative session, each year 

5 of the session shall be considered to be a separate 

6 regular session of the State legislature. 

Æ 


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