II 

116TH CONGRESS 

2D SESSION S. 4182 

To provide nursing homes with resources for responding to the COVID– 

19 public health emergency to protect the health and safety of residents 

and workers, to reauthorize funding for programs under the Elder Justice 

Act of 2009, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JULY 2, 2020 

Mr. GRASSLEY (for himself, Mr. DAINES, and Ms. MCSALLY) introduced the 

following bill; which was read twice and referred to the Committee on Finance 

A BILL 

To provide nursing homes with resources for responding to 

the COVID–19 public health emergency to protect the 

health and safety of residents and workers, to reauthorize funding for programs under the Elder Justice Act 

of 2009, 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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Emergency Support for Nursing Homes and Elder Jus6 tice Reform Act of 2020’’. 


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1 (b) TABLE OF CONTENTS.—The table of contents for 

2 this Act is as follows: 

Sec. 1. Short title; table of contents. 

Sec. 2. Definitions. 

Sec. 3. Providing resources for personal protective equipment and testing. 

Sec. 4. Promoting transparency about COVID–19-related cases and fatalities 

and staffing levels in long-term care facilities. 

Sec. 5. Establishing strike teams. 

Sec. 6. Promoting identification and reporting of potential abuse or neglect in 

long-term care facilities. 

Sec. 7. Promoting quality of life of long-term care facility residents through 

televisitation. 

Sec. 8. Upgrading nursing home compare and the Five-Star rating system. 

Sec. 9. Enhancing Federal oversight of nursing homes participating in Medicare or Medicaid. 

Sec. 10. Continuing funding for programs to prevent and prosecute elder abuse 

and neglect. 

Sec. 11. Increasing resources to investigate abuse or neglect and extend services 

to victims. 

Sec. 12. Protecting Americans with dementia. 

Sec. 13. Reducing racial and ethnic disparities in long-term care facilities. 

Sec. 14. Establishing reciprocity with Drug Enforcement Administration to address improper prescribing of controlled substances. 

3 SEC. 2. DEFINITIONS. 

4 In this Act: 

5 (1) COVID–19 PUBLIC HEALTH EMERGENCY

6 PERIOD.—The term ‘‘COVID–19 public health emer7 gency period’’ means the period beginning on the 

8 first day of the emergency period defined in para9 graph (1)(B) of section 1135(g) of the Social Secu10 rity Act (42 U.S.C. 1320b–5(g)) and ending on the 

11 last day of the calendar quarter in which the last 

12 day of such emergency period occurs. 

13 (2) INDIAN TRIBE.—The term ‘‘Indian tribe’’ 

14 has the meaning given that term in section 4 of the 


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1 Indian Self-Determination and Education Assistance 

2 Act (25 U.S.C. 5304). 

3 (3) LONG-TERM CARE FACILITY.—The term 

4 ‘‘long-term care facility’’ has the meaning given that 

5 term in section 2011(15) of the Social Security Act 

6 (42 U.S.C. 1397j(15)). 

7 (4) NURSING FACILITY.—The term ‘‘nursing 

8 facility’’ has the meaning given that term in section 

9 1919(a) of the Social Security Act (42 U.S.C. 

10 1396r(a)). 

11 (5) PARTICIPATING PROVIDER.—The term 

12 ‘‘participating provider’’ means a skilled nursing fa13 cility or a nursing facility that has been assigned a 

14 national provider identifier number by the Secretary 

15 and has executed an agreement to participate in the 

16 Medicare program established under title XVIII of 

17 the Social Security Act (42 U.S.C. 1395 et seq.) or 

18 the Medicaid program established under title XIX of 

19 such Act (42 U.S.C. 1396 et seq.). 

20 (6) SECRETARY.—The term ‘‘Secretary’’ means 

21 the Secretary of Health and Human Services. 

22 (7) SKILLED NURSING FACILITY.—The term 

23 ‘‘skilled nursing facility’’ has the meaning given that 

24 term in section 1819(a) of the Social Security Act 

25 (42 U.S.C. 1395i–3(a)). 


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1 (8) STATE.—Except as otherwise provided, the 

2 term ‘‘State’’ has the meaning given such term for 

3 purposes of title XIX of the Social Security Act (42 

4 U.S.C. 1396 et seq.). 

5 (9) TRIBAL ORGANIZATION.—The term ‘‘tribal 

6 organization’’ has the meaning given that term in 

7 section 4 of the Indian Self-Determination and Edu8 cation Assistance Act (25 U.S.C. 5304). 

9 (10) OTHER TERMS.—Each other term has the 

10 meaning given the term for purposes of subtitle B 

11 of title XX of the Social Security Act (42 U.S.C. 

12 1397j et seq.). 

13 SEC. 3. PROVIDING RESOURCES FOR PERSONAL PROTEC14 TIVE EQUIPMENT AND TESTING. 

15 (a) IN GENERAL.—A portion of any payments re16 ceived or funds made available on or after July 1, 2020, 

17 for responding to the public health or fiscal impacts re18 lated to the Coronavirus Disease (COVID–19) under Fed19 eral legislation enacted on or after that date which pri20 marily makes appropriations for the coronavirus response 

21 and related activities, shall be used for the purposes de22 scribed in subsection (b), notwithstanding the original 

23 purpose for which the amounts were appropriated to make 

24 such payments or funds available, or any other provision 

25 of law restricting the use of such payments or funds. 


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1 (b) PURPOSES DESCRIBED.—The purposes described 

2 in this subsection are the following: 

3 (1) To establish and maintain a supply of per4 sonal protective equipment at a level that is suffi5 cient, as determined by the Centers for Disease Con6 trol and Prevention, in collaboration with the Sec7 retary and the Administrator of the Federal Emer8 gency Management Agency, to provide for the safety 

9 of— 

10 (A) personnel employed by participating 

11 providers and long-term care facilities, includ12 ing licensed assisted living or residential care 

13 facilities, during the COVID–19 public health 

14 emergency period; and 

15 (B) State survey agency personnel who 

16 conduct audits or investigations of participating 

17 providers and long-term care facilities, includ18 ing licensed assisted living or residential care 

19 facilities, during the COVID–19 public health 

20 emergency period. 

21 (2) To provide regular COVID–19 testing for 

22 personnel and residents of participating providers 

23 and long-term care facilities, including licensed as24 sisted living or residential care facilities (at no cost 

25 to such personnel and residents), at a level that is 


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1 sufficient, based on the needs of the locality and its 

2 circumstances, as determined by the Director of the 

3 Centers for Disease Control and Prevention, in col4 laboration with the Secretary and the Administrator 

5 of the Federal Emergency Management Agency, to 

6 provide for the safety of such personnel and resi7 dents. A State shall provide such testing during the 

8 90-day period that begins on the date on which the 

9 Secretary, after consultation with the Director of the 

10 Centers for Disease Control and Prevention, deter11 mines the State is able to conduct such testing at 

12 such level and notifies the State of the date on 

13 which the testing period is to start. 

14 (c) STANDARDS AND GUIDANCE.—Not later than 30 

15 days after the date of enactment of this Act, the Director 

16 of the Centers for Disease Control and Prevention, in col17 laboration with the Secretary and the Administrator of the 

18 Federal Emergency Management Agency, shall issue de19 tailed guidance to States on compliance with the require20 ments of this section as it relates to participating pro21 viders and long-term care facilities, including licensed as22 sisted living or residential care facilities. 


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1 SEC. 4. PROMOTING TRANSPARENCY ABOUT COVID–19-RE2 LATED CASES AND FATALITIES AND STAFF3 ING LEVELS IN LONG-TERM CARE FACILI4 TIES. 

5 (a) COLLECTION AND REPORTING OF STAFFING

6 DATA BY PARTICIPATING PROVIDERS.—The Secretary 

7 shall develop a plan for ensuring that participating pro8 viders shall resume compliance with the requirement, 

9 under section 1128I(g) of the Social Security Act (42 

10 U.S.C. 1320a–7j(g)), to electronically submit direct care 

11 staffing information based on payroll and other auditable 

12 data (including measures to ensure that the submitted 

13 data includes direct care staffing information for the en14 tire duration of the emergency period). 

15 (b) COLLECTION AND REPORTING OF DATA RE16 LATED TO COVID–19 BY PARTICIPATING PROVIDERS

17 AND LONG-TERM CARE FACILITIES.— 

18 (1) IN GENERAL.— 

19 (A) REPORTING OF COVID–19 CASES AND

20 FATALITIES BY PARTICIPATING PROVIDERS AND

21 LONG-TERM CARE FACILITIES.—The Secretary 

22 shall ensure that participating providers and 

23 long-term care facilities report all suspected and 

24 confirmed cases of COVID–19 among personnel 

25 and residents of the provider or facility, all 

26 COVID–19-related fatalities among personnel 


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1 and residents of the provider or facility, and all 

2 fatalities among personnel and residents of the 

3 provider or facility, whether related to COVID– 

4 19 or unrelated to COVID–19, for the period 

5 beginning on January 1, 2020, to the Sec6 retary. 

7 (B) TIMING AND MANNER OF REPORT8 ING.—Such data shall be reported to the Sec9 retary by participating providers and long-term 

10 care facilities in a format and manner that is 

11 consistent with any data that the Secretary has 

12 directed participating providers to furnish to 

13 the Centers for Disease Control and Prevention 

14 on or after May 8, 2020, and, beginning on the 

15 date that is 15 days after the date of enactment 

16 of this Act, shall be collected and reported to 

17 the Secretary by participating providers and 

18 long-term care facilities on a daily basis. 

19 (C) PUBLICATION OF DATA.—Not later 

20 than 15 days after the date of enactment of 

21 this Act, the Secretary shall make the data col22 lected under this paragraph publicly available 

23 and shall update such data on a daily basis. 

24 (2) COLLECTION AND REPORTING OF DEMO25 GRAPHIC DATA.—The Secretary shall post the folVerDate Sep 11 2014 17:28 Jul 14, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S4182.IS S4182

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1 lowing information with respect to participating pro2 viders and long-term care facilities on the official 

3 internet website of the Federal Government for 

4 Medicare beneficiaries (commonly referred to as the 

5 ‘‘Nursing Home Compare’’ Medicare website) (or a 

6 successor website) aggregated by State: 

7 (A) The age, gender, race, ethnicity, dis8 ability, and preferred language of the residents 

9 of participating providers with suspected or 

10 confirmed COVID–19 infections. 

11 (B) With respect to residents of partici12 pating providers and long-term care facilities 

13 who died on or after January 1, 2020, the age, 

14 gender, race, ethnicity, disability, and preferred 

15 language of— 

16 (i) all of such residents; and 

17 (ii) all of such residents whose deaths 

18 are related to COVID–19. 

19 (3) CONFIDENTIALITY.—Any information re20 ported under this subsection that is made available 

21 to the public shall be made so available in a manner 

22 that protects the identity of residents of partici23 pating providers and long-term care facilities. 


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1 SEC. 5. ESTABLISHING STRIKE TEAMS. 

2 (a) IN GENERAL.—A portion of any payments re3 ceived or funds made available on or after July 1, 2020, 

4 for responding to the public health or fiscal impacts re5 lated to the Coronavirus Disease (COVID–19) under Fed6 eral legislation enacted on or after that date which pri7 marily makes appropriations for the coronavirus response 

8 and related activities, shall be used to establish and sup9 port the operation of statewide or regional strike teams 

10 that meet the requirements of subsection (b) to respond 

11 to COVID–19-related crises in participating providers, 

12 notwithstanding the original purpose for which the 

13 amounts were appropriated to make such payments or 

14 funds available, or any other provision of law restricting 

15 the use of such payments or funds. 

16 (b) STRIKE TEAM REQUIREMENTS.—The require17 ments of this section with respect to a strike team of a 

18 State are the following: 

19 (1) Strike teams may include assessment, test20 ing, and clinical teams, and the State shall establish 

21 a mission for each such team by written directive, 

22 which may include performing medical examinations, 

23 conducting COVID–19 testing, and assisting partici24 pating providers with the implementation of quar25 antine, isolation, or disinfection procedures. 


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1 (2) Each strike team shall be comprised of indi2 viduals who have relevant skills, qualifications, and 

3 experience to serve as members of 1 or more of the 

4 assessment, testing, and clinical teams described in 

5 paragraph (1), such as employees of the State or 

6 any of its political subdivisions, members of the mili7 tia on State activity duty, members of COVID–19 

8 response teams sent to the State by the Secretary, 

9 or other individuals designated by the State agency 

10 with primary responsibility for promoting resident 

11 and employee safety in participating providers. 

12 (3) Strike teams and members of such teams 

13 shall be subject to the State’s oversight and direc14 tion and team members shall receive a State-issued 

15 letter of authorization describing— 

16 (A) the individual’s designation to serve on 

17 1 or more teams under an emergency proclama18 tion; 

19 (B) the mission of the team; 

20 (C) the authority of the individual to per21 form the team mission on the State’s behalf; 

22 (D) the individual’s authority to access 

23 places, persons, and materials necessary for the 

24 team member’s performance of the team’s mis25 sion; and 


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1 (E) the requirement that team members 

2 maintain the confidentiality of patient informa3 tion shared with such individuals by the facility. 

4 (4) The State may, at any time, disband any 

5 strike team and rescind the letter of authorization 

6 for any team member. 

7 (5) A team and team member may not use the 

8 letter of authorization described in paragraph (3) for 

9 any purpose except in connection with the team’s 

10 mission of acting in good faith to promote resident 

11 and employee safety in participating providers in 

12 which COVID–19 is confirmed to be present. 

13 (6) The State shall establish protocols and pro14 cedures for requesting the assistance of a strike 

15 team established under this section and any other 

16 procedures deemed necessary for the team’s oper17 ation. 

18 (7) If a strike team finds consistent quality of 

19 care deficiencies with respect to a participating pro20 vider and such deficiencies immediately jeopardize 

21 the health or safety of residents of the participating 

22 provider, the team shall, within 18 hours of making 

23 such finding, alert the State survey agency (which 

24 may take immediate enforcement action to remove 

25 the jeopardy and correct the deficiencies through the 


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1 remedies specified in section 1819(h)(2)(B)(iii) or 

2 1919(h)(2)(A)(iii) of the Social Security Act (42 

3 U.S.C. 1395i–3(h)(2)(B)(iii), 1396r(h)(2)(A)(iii)), 

4 the long-term care ombudsman of the State, and the 

5 Medicaid fraud control unit of such State). 

6 SEC. 6. PROMOTING IDENTIFICATION AND REPORTING OF 

7 POTENTIAL ABUSE OR NEGLECT IN LONG8 TERM CARE FACILITIES. 

9 (a) USE OF CLAIMS DATA TO IDENTIFY INSTANCES

10 OF POTENTIAL ABUSE OR NEGLECT IN FACILITIES.— 

11 Section 1128I of the Social Security Act (42 U.S.C. 

12 1320a–7j) is amended by adding at the end the following 

13 new subsection: 

14 ‘‘(i) USE OF CLAIMS DATA TO IDENTIFY INSTANCES

15 OF POTENTIAL ABUSE OR NEGLECT.— 

16 ‘‘(1) COMPILATION OF CODES.—Not later than 

17 1 year after the date of the enactment of this sub18 section, the Secretary, in collaboration with the In19 spector General of the Department of Health and 

20 Human Services, shall— 

21 ‘‘(A) compile a comprehensive list of diag22 nosis codes that may indicate potential physical 

23 or sexual abuse or neglect of the elderly; and 

24 ‘‘(B) develop a plan for reliance on data 

25 from claims under titles XVIII and XIX that 


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1 contain 1 or more of those codes, for the pur2 pose of identifying instances of potential phys3 ical or sexual abuse or neglect in facilities re4 ceiving reimbursement under such titles. 

5 ‘‘(2) AVAILABILITY TO STATES.—Not later than 

6 2 years after the date of the enactment of this sub7 section, the Secretary shall make such claims data 

8 available to State survey agencies to help verify com9 pliance with Federal and State mandatory reporting 

10 laws.’’. 

11 (b) REQUIRED TRAINING ON SIGNS AND SYMPTOMS

12 OF POTENTIAL ABUSE OR NEGLECT.—Section 1128I of 

13 the Social Security Act (42 U.S.C. 1320a–7j), as amended 

14 by subsection (a), is amended by adding at the end the 

15 following new subsection: 

16 ‘‘(j) REQUIRED TRAINING ON SIGNS AND SYMPTOM

17 OF POTENTIAL ABUSE OR NEGLECT.—Beginning not 

18 later than 1 year after the date of the enactment of this 

19 subsection, a facility shall ensure that any staff of the fa20 cility who provide direct care (as defined in section 2011) 

21 to residents of the facility receive training on the signs 

22 and symptoms of potential abuse or neglect of the elder23 ly.’’. 


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1 (c) EVALUATION AND REPORT ON PROTOCOLS TO

2 ENCOURAGE PROMPT REPORTING OF SUSPECTED INCI3 DENTS OF POTENTIAL ABUSE OR NEGLECT.— 

4 (1) EVALUATION AND IMPLEMENTATION OF

5 PROTOCOLS.—The Secretary, in collaboration with 

6 the Attorney General, shall evaluate the effectiveness 

7 of current protocols and, if warranted, recommend 

8 and implement improvements in those protocols, to 

9 encourage prompt reporting of suspected incidents of 

10 potential abuse or neglect to the appropriate law en11 forcement officials or adult protective services office, 

12 by State and Federal surveyors of Medicare and 

13 Medicaid covered entities. 

14 (2) REPORT.—Not later than 180 days after 

15 the completion of the evaluation under paragraph 

16 (1), the Secretary shall submit to Congress a report 

17 containing the results of such evaluation, together 

18 with recommendations for improvements, including 

19 such legislation and administrative action as the 

20 Secretary determines appropriate. 

21 (d) ISSUANCE OF GUIDANCE TO DETER SOCIAL

22 MEDIA ABUSE IN FACILITIES.— 

23 (1) IN GENERAL.—Not later than 1 year after 

24 the date of enactment of this Act, the Secretary 

25 shall— 


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1 (A) update guidance, and, as necessary, 

2 issue new guidance to clarify for State survey 

3 and certification agencies the requirements ap4 plicable to facilities (as defined in section 483.5 

5 of title 42, Code of Federal Regulations (or any 

6 successor regulations)) under part 483 of title 

7 42, Code of Federal Regulations (or any suc8 cessor regulations), to protect resident privacy 

9 and prohibit mental abuse or exploitation, spe10 cifically as it relates to exploitative photo11 graphs, audio and video recordings, and posting 

12 or sharing of such photographs or recordings on 

13 social media networks or through multimedia 

14 messages; and 

15 (B) establish procedures to ensure that 

16 violations of the safety and privacy require17 ments applicable to facilities (as so defined) 

18 under part 483 of title 42, Code of Federal 

19 Regulations (or any successor regulations), 

20 which prohibit misuse of photographs, audio 

21 and video recordings, and the inappropriate 

22 posting or sharing of such photographs or re23 cordings on social media networks or through 

24 multimedia messages, are reported by State 

25 survey agencies to law enforcement agencies, 


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1 adult protective service agencies, and other rel2 evant agencies and that such violations are re3 corded and tracked in the Automated Survey 

4 Processing Environment (‘‘ASPEN’’) and the 

5 ASPEN Complaints/Incident Tracking System 

6 (‘‘ACTS’’). 

7 (2) CLARIFICATION.—The guidance issued 

8 under paragraph (1) shall clarify that enforcement 

9 penalties do not apply to the posting or sharing of 

10 such photographs or recordings that occurred solely 

11 for the purpose of documenting and promptly report12 ing, to the appropriate authorities, a case of abuse 

13 in a facility. 

14 SEC. 7. PROMOTING QUALITY OF LIFE OF LONG-TERM 

15 CARE FACILITY RESIDENTS THROUGH TELE16 VISITATION. 

17 (a) PROMOTING TELEVISITATION FOR RESIDENTS.— 

18 (1) IN GENERAL.—Sections 1819(c)(3) and 

19 1919(c)(3) of the Social Security Act (42 U.S.C. 

20 1395i–3(c)(3), 1396r(c)(3)) are each amended— 

21 (A) in subparagraph (D), by striking 

22 ‘‘and’’ at the end; 

23 (B) in subparagraph (E), by striking the 

24 period and inserting ‘‘; and’’; and 


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1 (C) by adding at the end the following new 

2 subparagraph: 

3 ‘‘(F) provide for access to telecommuni4 cations devices and use of the internet, includ5 ing assistance from facility staff in the use of 

6 such technology, if necessary or requested by 

7 the resident or a family member, to support 

8 telecommunication, including but not limited to 

9 audio, visual, text communication, video10 conference, and two-way audio/video options, by 

11 residents of such facility with family members 

12 and other individuals.’’. 

13 (2) ACCESS DURING COVID–19 PUBLIC HEALTH

14 EMERGENCY PERIOD.— 

15 (A) IN GENERAL.—Not later than 30 days 

16 after the date of enactment of this Act, the Sec17 retary shall take steps necessary to ensure that 

18 the residents of each participating provider and 

19 licensed assisted living or residential care facil20 ity have access to telecommunications devices 

21 and use of the internet (to the extent prac22 ticable), including assistance from facility staff 

23 in the use of such technology, if necessary or 

24 requested by the resident or a family member, 

25 to support telecommunication, including but not 


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1 limited to audio, visual, text communication, 

2 videoconference and two-way audio/video op3 tions, by residents of such provider or facility 

4 with family members and other individuals. 

5 (B) REQUIREMENTS.—In taking such 

6 steps, the Secretary shall address— 

7 (i) notification to residents, family 

8 members, and other individuals of access 

9 to televisitation described in subparagraph 

10 (A); 

11 (ii) how such a provider or facility will 

12 ensure or enable installation and access to 

13 a device purchased by, or for the use or 

14 benefit of, individual residents; and 

15 (iii) operational issues and steps to 

16 avoid unnecessary barriers to the timely 

17 deployment of such televisitation. 

18 (b) FUNDING.—A participating provider may use a 

19 portion of any emergency funding that the provider re20 ceives (prior to and after the date of enactment of this 

21 Act) from the Secretary related to the COVID–19 public 

22 health emergency period to purchase any technology, in23 cluding telecommunications devices and internet service, 

24 or any other items or services as necessary to implement 

25 the televisitation described in the provisions of, and 


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1 amendments made by, subsection (a), notwithstanding any 

2 other provision of law restricting the use of such funding. 

3 SEC. 8. UPGRADING NURSING HOME COMPARE AND THE 

4 FIVE-STAR RATING SYSTEM. 

5 (a) COMPREHENSIVE REVIEW OF FIVE-STAR QUAL6 ITY RATING SYSTEM.—Sections 1819 and 1919 of the So7 cial Security Act (42 U.S.C. 1395i–3, 1396r) are each 

8 amended— 

9 (1) by redesignating subsection (j) as sub10 section (k); and 

11 (2) by inserting after subsection (i) the fol12 lowing new subsection: 

13 ‘‘(j) COMPREHENSIVE REVIEW AND MODIFICATION

14 OF FIVE-STAR QUALITY RATING SYSTEM.— 

15 ‘‘(1) IN GENERAL.—The Secretary shall con16 duct a comprehensive review of the system main17 tained by the Secretary to measure and publicly re18 port the quality of skilled nursing facilities and nurs19 ing facilities (commonly referred to as the ‘Five-Star 

20 Quality Rating System’). 

21 ‘‘(2) TIMING.—The Secretary shall conduct 

22 such review not later than 1 year after the end of 

23 the COVID–19 public health emergency period and 

24 shall implement modifications to the Five-Star Qual25 ity Rating System (or its successor system) not later 


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1 than 180 days after the release of the report that is 

2 required under paragraph (4). 

3 ‘‘(3) REQUIREMENTS.—The review of the sys4 tem under this subsection shall include an evaluation 

5 of the relative weight accorded to each of the fol6 lowing: 

7 ‘‘(A) The adequacy of the facility’s proce8 dures for preventing and reporting infection. 

9 ‘‘(B) The adequacy of the facility’s proce10 dures for preventing and reporting incidents of 

11 abuse, neglect, mistreatment, or exploitation of 

12 residents of the facility. 

13 ‘‘(C) Deficiencies identified in the facility’s 

14 most recent standard survey and the extent to 

15 which the facility corrected such deficiencies 

16 since the date of the most recent survey. 

17 ‘‘(D) The number, type, severity, and out18 come of substantiated complaints. 

19 ‘‘(E) The number of adjudicated instances 

20 of criminal violations by a facility or the em21 ployees of a facility. 

22 ‘‘(F) The number of civil monetary pen23 alties levied against the facility, employees, con24 tractors, and other agents of the facility. 


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1 ‘‘(G) Selected quality measures (such as 

2 the percentages of long-stay residents who expe3 rience pressure ulcers, are physically restrained, 

4 experience falls with major injury, or received 

5 antipsychotic medication). 

6 ‘‘(H) Whether a facility is connected to an 

7 assisted living facility and whether such facili8 ties should be rated separately from facilities 

9 that are standalone skilled nursing facilities or 

10 nursing facilities. 

11 ‘‘(I) Other items determined appropriate 

12 by the Secretary. 

13 ‘‘(4) REPORT.—Not later than 180 days after 

14 the completion of the review under paragraph (1), 

15 the Secretary shall submit to the Committee on Fi16 nance of the Senate and the Committee on Ways 

17 and Means of the House of Representatives a final 

18 report that includes such findings and recommenda19 tions as the Secretary considers appropriate based 

20 on the review, including recommended actions to be 

21 taken to implement the specific recommendations in 

22 such report. 

23 ‘‘(5) CONSULTATION.—In conducting such re24 view and implementing modifications of the system, 


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1 the Secretary shall consult with each of the fol2 lowing: 

3 ‘‘(A) State long-term care ombudsman pro4 grams. 

5 ‘‘(B) Adult protective services agencies. 

6 ‘‘(C) Consumer advocacy and other non7 profit organizations whose mission is to pro8 mote the health, safety, and well being of older 

9 Americans. 

10 ‘‘(D) Provider stakeholder groups. 

11 ‘‘(E) Statewide provider agencies and ad12 vocacy groups with relevant expertise. 

13 ‘‘(F) Any other representatives of pro14 grams or groups the Secretary determines ap15 propriate. 

16 ‘‘(6) COVID–19 PUBLIC HEALTH EMERGENCY

17 PERIOD.—In this subsection, the term ‘COVID–19 

18 public health emergency period’ means the period 

19 beginning on the first day of the emergency period 

20 defined in paragraph (1)(B) of section 1135(g) and 

21 ending on the last day of the calendar quarter in 

22 which the last day of such emergency period oc23 curs.’’. 

24 (b) TRANSPARENCY.—The Secretary shall publicly 

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1 forcement actions with respect to deficiencies or statutory 

2 violations that have been reported to the Centers for Medi3 care & Medicaid Services, corrective actions, if any, that 

4 were recommended to resolve such deficiencies or statu5 tory violations, and the status of implementation of each 

6 such recommended corrective action by the participating 

7 provider involved. 

8 (c) FUNDING.—The Secretary shall transfer to the 

9 Centers for Medicare & Medicaid Services Program Man10 agement Account, from the Federal Hospital Insurance 

11 Trust Fund established under section 1817 of the Social 

12 Security Act (42 U.S.C. 1395i) a one-time allocation of 

13 $20,000,000, to be used to carry out sections 1819(j) and 

14 1919(j) of the Social Security Act (42 U.S.C. 1395i–3, 

15 1396r) (as added by subsection (a) and subsection (b)). 

16 The amount shall be available on the date of the enact17 ment of this Act and shall remain available until expended. 

18 SEC. 9. ENHANCING FEDERAL OVERSIGHT OF NURSING 

19 HOMES PARTICIPATING IN MEDICARE OR 

20 MEDICAID. 

21 (a) IDENTIFICATION OF FACILITIES INCLUDED IN, 

22 OR CANDIDATES FOR, THE SPECIAL FOCUS FACILITY

23 PROGRAM.—Not later than 60 days after the date of en24 actment of this Act, the Secretary shall publish the fol25 lowing lists on the official internet website of the Federal 


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1 Government for Medicare beneficiaries (commonly re2 ferred to as the ‘‘Nursing Home Compare’’ Medicare 

3 website) (or a successor website): 

4 (1) A list of all participating providers that are 

5 included in the special focus facility program con6 ducted under sections 1819(f)(8) and 1919(f)(10) of 

7 the Social Security Act (42 U.S.C. 1395i–3(f)(8), 

8 1396r(f)(10)). 

9 (2) A list of all participating providers that 

10 have been identified as candidates for such program, 

11 based on the most recent survey of the facility. 

12 (b) REGULARLY PUBLISHED UPDATES.—The Sec13 retary shall publish periodic updates of the lists published 

14 under subsection (a) no less often than once every 30 days. 

15 (c) DATA COLLECTION.—To the extent that the Sec16 retary maintains a system to collect certification defi17 ciencies and licensure violations relating to participating 

18 providers (such as the Automated Survey Processing Envi19 ronment ‘‘ASPEN’’ or a successor system), the Secretary 

20 shall develop methods to separately track reports of con21 firmed incidents of abuse or neglect in such providers on 

22 survey forms through such system. 

23 (d) GUIDANCE ON THE MEANING OF TERMS.—Not 

24 later than 18 months after the date of enactment of this 

25 Act, the Secretary, after consultation with staff of particiVerDate Sep 11 2014 17:28 Jul 14, 2020 Jkt 099200 PO 00000 Frm 00025 Fmt 6652 Sfmt 6201 E:\BILLS\S4182.IS S4182

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1 pating providers and other long-term care facilities that 

2 receive provider payments under the Medicare or Medicaid 

3 programs, shall issue guidance for such participating pro4 viders and other long-term care facilities to clarify the 

5 meaning of certain terms, such as ‘‘suspicious’’, ‘‘injuries 

6 of unknown source’’, and ‘‘mistreatment’’, when used in 

7 the statutory and regulatory requirements for such pro8 viders relating to reporting and tracking incidents of 

9 abuse, sexual abuse, neglect, mistreatment, or exploitation 

10 of residents of such providers by facility staff, including 

11 on social media. 

12 SEC. 10. CONTINUING FUNDING FOR PROGRAMS TO PRE13 VENT AND PROSECUTE ELDER ABUSE AND 

14 NEGLECT. 

15 (a) LONG-TERM CARE OMBUDSMAN PROGRAM

16 GRANTS AND TRAINING.—Section 2043 of the Social Se17 curity Act (42 U.S.C. 1397m–2) is amended— 

18 (1) in subsection (a)(2)— 

19 (A) in subparagraph (B), by striking 

20 ‘‘and’’ after the semicolon; 

21 (B) in subparagraph (C), by striking the 

22 period at the end and inserting ‘‘; and’’; and 

23 (C) by adding at the end the following: 

24 ‘‘(D) for each of fiscal years 2020 through 

25 2023, $12,000,000.’’; and 


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1 (2) in subsection (b)(2), by inserting before the 

2 period the following: ‘‘, and for each of fiscal years 

3 2020 through 2023, $12,000,000’’. 

4 (b) ELDER ABUSE, NEGLECT, AND EXPLOITATION

5 FORENSIC CENTERS.—Section 2031(f) of the Social Secu6 rity Act (42 U.S.C. 1397l(f)) is amended— 

7 (1) in paragraph (2), by striking ‘‘and’’ after 

8 the semicolon; 

9 (2) in paragraph (3), by striking the period at 

10 the end and inserting ‘‘; and’’; and 

11 (3) by adding at the end the following: 

12 ‘‘(4) for each of fiscal years 2020 through 

13 2023, $10,000,000.’’. 

14 (c) ELDER JUSTICE COORDINATING COUNCIL.— 

15 (1) MEMBERSHIP.—Section 2021(b)(1) of the 

16 Social Security Act (42 U.S.C. 1397k(b)(1)) is 

17 amended— 

18 (A) by redesignating subparagraph (C) as 

19 subparagraph (D); and 

20 (B) by inserting after subparagraph (B), 

21 the following: 

22 ‘‘(C) The Administrator of the Federal 

23 Emergency Management Agency.’’. 

24 (2) DUTIES.—Section 2021(f)(1) of such Act 

25 (42 U.S.C. 1397k(f)(1)) is amended by inserting 


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1 ‘‘the Federal Emergency Management Agency,’’ 

2 after ‘‘Justice,’’. 

3 (d) ADULT PROTECTIVE SERVICES FUNCTIONS AND

4 GRANT PROGRAMS.—Section 2042 of the Social Security 

5 Act (42 U.S.C. 1397m–1) is amended— 

6 (1) in subsection (a)(2), by striking 

7 ‘‘$3,000,000’’ and all that follows through the pe8 riod and inserting ‘‘$5,000,000 for each of fiscal 

9 years 2020 through 2023.’’; 

10 (2) in subsection (b)(5), by striking 

11 ‘‘$100,000,000’’ and all that follows through the pe12 riod and inserting ‘‘$120,000,000 for each of fiscal 

13 years 2020 through 2023.’’; and 

14 (3) in subsection (c)(6), by striking 

15 ‘‘$25,000,000’’ and all that follows through the pe16 riod and inserting ‘‘$30,000,000 for each of fiscal 

17 years 2020 through 2023.’’. 

18 (e) TECHNICAL AMENDMENT.—Section 2011(12)(A) 

19 of the Social Security Act (42 U.S.C. 1397j(12)(A)) is 

20 amended by striking ‘‘450b’’ and inserting ‘‘5304’’. 


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1 SEC. 11. INCREASING RESOURCES TO INVESTIGATE ABUSE 

2 OR NEGLECT AND EXTEND SERVICES TO VIC3 TIMS. 

4 (a) FUNDING FOR ADULT PROTECTIVE SERVICES

5 DURING THE COVID–19 PUBLIC HEALTH EMER6 GENCY.— 

7 (1) IN GENERAL.—A total of $60,000,000 of 

8 the amounts appropriated to make payments or 

9 funds available on or after July 1, 2020, for re10 sponding to the public health or fiscal impacts re11 lated to the Coronavirus Disease (COVID–19) under 

12 Federal legislation enacted on or after that date 

13 which primarily makes appropriations for the 

14 coronavirus response and related activities, shall be 

15 transferred and made available to the Secretary to 

16 make direct payments under this subsection to the 

17 agency of each State with primary responsibility for 

18 adult protective services and to tribally operated 

19 adult protective services agencies, notwithstanding 

20 the original purpose for which the amounts were ap21 propriated to make such payments or funds avail22 able, or any other provision of law restricting the 

23 use of such payments or funds. 

24 (2) PAYMENTS.— 


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1 (A) IN GENERAL.—From the funds trans2 ferred and made available under paragraph (1), 

3 the Secretary shall— 

4 (i) reserve 3 percent of such funds for 

5 making payments to tribally operated adult 

6 protective services agencies in such man7 ner, and based on such information, as the 

8 Secretary shall specify; and 

9 (ii) make allotments to States from 

10 the remainder of such funds (after the ap11 plication of clause (i)), in the same manner 

12 as amounts are allotted to States for fiscal 

13 year 2020 under section 2003(b) of the 

14 Social Security Act (42 U.S.C. 1397b(b)). 

15 (B) DIRECT PAYMENTS.—The Secretary 

16 shall make direct payment from the amounts 

17 reserved under subparagraph (A) to tribally op18 erated adult protective services agencies and 

19 from the amounts allotted under that subpara20 graph to the agency of each State with primary 

21 responsibility for adult protective services. 

22 (3) OTHER REQUIREMENTS.— 

23 (A) NO MATCH.—No cash or in-kind 

24 matching requirement shall apply to the pay25 ments made under this subsection. 


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1 (B) DEADLINE.—The Secretary shall make 

2 the payments required under this subsection 

3 not later than 60 days after the date on which 

4 funds are transferred and made available under 

5 paragraph (1). 

6 (C) USE OF FUNDS.—Each agency that re7 ceives funds from a payment made under this 

8 subsection shall use the funds to provide adult 

9 protective services during the COVID–19 public 

10 health emergency period. 

11 (D) PROHIBITION.—No funds from a pay12 ment made under this subsection shall be used 

13 to satisfy any requirement of a federally funded 

14 program relating to State or local matching 

15 funds or in-kind contributions. 

16 (4) DEFINITIONS.—In this subsection: 

17 (A) ADULT PROTECTIVE SERVICES.—The 

18 term ‘‘adult protective services’’ has the mean19 ing given that term in section 2011(2) of the 

20 Social Security Act (42 U.S.C. 1397j(2)). 

21 (B) INDIAN COUNTRY.—The term ‘‘Indian 

22 country’’ has the meaning given that term in 

23 section 1151 of title 18, United States Code. 

24 (C) STATE.—The term ‘‘State’’ has the 

25 meaning given that term in section 1101(a)(1) 


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1 of the Social Security Act (42 U.S.C. 

2 1301(a)(1)) for purposes of title XX of such 

3 Act. 

4 (D) TRIBALLY OPERATED ADULT PROTEC5 TIVE SERVICES AGENCY.—The term ‘‘tribally 

6 operated adult protective services agency’’ 

7 means an agency of the recognized governing 

8 body of any Indian or Alaska Native Tribe, 

9 band, Nation, pueblo, village, community, com10 ponent band, or component reservation, individ11 ually identified (including parenthetically) in 

12 the list published most recently as of the date 

13 of enactment of this Act pursuant to section 

14 104 of the Federally Recognized Indian Tribe 

15 List Act of 1994 (25 U.S.C. 5131) whose pri16 mary purpose is to protect any vulnerable adult 

17 who is the victim of an alleged or substantiated 

18 incident of abuse, neglect, or exploitation in In19 dian Country. 

20 (b) AUTHORITY FOR TRANSFERS FROM THE CRIME

21 VICTIMS FUND.—Section 1402(d)(3) of the Victims of 

22 Crime Act of 1984 (34 U.S.C. 20101(d)(3)) is amended 

23 by adding at the end the following: 

24 ‘‘(C)(i) Notwithstanding subparagraph 

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1 cent of the amount to be distributed from the 

2 Fund under this paragraph in a particular fis3 cal year to provide and improve services for vic4 tims of elder abuse, neglect, or exploitation by 

5 a department or agency of the Federal Govern6 ment other than the Department of Justice.’’. 

7 SEC. 12. PROTECTING AMERICANS WITH DEMENTIA. 

8 (a) ALZHEIMER’S DISEASE BEST PRACTICES AND

9 REPORTING.— 

10 (1) ADDRESSING ALZHEIMER’S DISEASE IN

11 BEST PRACTICES.— 

12 (A) IN GENERAL.—Section 101(b) of the 

13 Elder Abuse Prevention and Prosecution Act 

14 (34 U.S.C. 21711(b)) is amended— 

15 (i) by redesignating subparagraphs 

16 (A), (B), and (C) of paragraph (2) as 

17 clauses (i), (ii), and (iii), respectively, and 

18 adjusting the margin accordingly; 

19 (ii) by redesignating paragraphs (1), 

20 (2), and (3) as subparagraphs (A), (B), 

21 and (C), respectively, and adjusting the 

22 margin accordingly; 

23 (iii) by striking ‘‘Not later than’’ and 

24 inserting the following: 

25 ‘‘(1) IN GENERAL.—Not later than’’; 


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1 (iv) in paragraph (1)(B), as so redes2 ignated— 

3 (I) in clause (ii), by inserting ‘‘, 

4 including witnesses who have Alz5 heimer’s disease and related demen6 tias’’ after ‘‘other legal issues’’; and 

7 (II) in clause (iii), by striking 

8 ‘‘elder abuse cases,’’ and inserting 

9 ‘‘elder abuse cases (including victims 

10 and witnesses who have Alzheimer’s 

11 disease and related dementias),’’; and 

12 (v) by adding at the end the following: 

13 ‘‘(2) TRAINING MATERIALS.— 

14 ‘‘(A) IN GENERAL.—In creating or com15 piling replication guides and training materials 

16 under paragraph (1)(B), the Elder Justice Co17 ordinator shall consult with the Secretary of 

18 Health and Human Services, State, local, and 

19 Tribal adult protective services, aging, social, 

20 and human services agencies, Federal, State, 

21 local, and Tribal law enforcement agencies, and 

22 nationally recognized nonprofit associations 

23 with relevant expertise, as appropriate. 

24 ‘‘(B) UPDATING.—The Elder Justice Coor25 dinator shall— 


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1 ‘‘(i) review the best practices identi2 fied and replication guides and training 

3 materials created or compiled under para4 graph (1)(B) to determine if the replica5 tion guides or training materials require 

6 updating; and 

7 ‘‘(ii) perform any necessary updating 

8 of the replication guides or training mate9 rials.’’. 

10 (B) APPLICABILITY.—The amendments 

11 made by subparagraph (A) shall— 

12 (i) take effect on the date of enact13 ment of this Act; and 

14 (ii) apply on and after the date that 

15 is 1 year after the date of enactment of 

16 this Act. 

17 (2) REPORT ON OUTREACH.— 

18 (A) IN GENERAL.—Section 101(c)(2) of 

19 the Elder Abuse Prevention and Prosecution 

20 Act (34 U.S.C. 21711(c)(2)) is amended— 

21 (i) by redesignating subparagraphs 

22 (A) through (D) as clauses (i) through 

23 (iv), respectively, and adjusting the margin 

24 accordingly; 


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1 (ii) by striking ‘‘a report detailing’’ 

2 and inserting the following: ‘‘a report— 

3 ‘‘(A) detailing’’; and 

4 (iii) by adding at the end the fol5 lowing: 

6 ‘‘(B) with respect to the report by the At7 torney General, including a link to the publicly 

8 available best practices identified under sub9 section (b)(1)(B) and the replication guides and 

10 training materials created or compiled under 

11 such subsection.’’. 

12 (B) APPLICABILITY.—The amendments 

13 made by subparagraph (A) shall apply with re14 spect to the report under section 101(c)(2) of 

15 the Elder Abuse Prevention and Prosecution 

16 Act (34 U.S.C. 21711(c)(2)) submitted during 

17 the second year beginning after the date of en18 actment of this Act, and each year thereafter. 

19 (b) PROMOTING ACCOUNTABILITY OF COURT-AP20 POINTED GUARDIANS.—Section 2042(c) of the Social Se21 curity Act (42 U.S.C. 1397m–1(c)) is amended— 

22 (1) in paragraph (1), by striking ‘‘paragraph 

23 (2)(E)’’ and inserting ‘‘subparagraphs (E), (F), (G), 

24 and (H) of paragraph (2)’’; 

25 (2) in paragraph (2)— 


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1 (A) in the matter preceding subparagraph 

2 (A)— 

3 (i) by striking ‘‘Funds’’ and inserting 

4 ‘‘Subject to paragraph (7), funds’’; and 

5 (ii) by striking ‘‘subparagraph (E)’’ 

6 and inserting ‘‘subparagraphs (E), (F), 

7 (G), and (H)’’; 

8 (B) in subparagraph (E), by striking ‘‘or’’ 

9 at the end; 

10 (C) by redesignating subparagraph (F) as 

11 subparagraph (I); and 

12 (D) by inserting after subparagraph (E) 

13 the following new paragraphs: 

14 ‘‘(F) methods to assess State guardianship 

15 statistics such as the creation of State data16 bases to collect information about the number 

17 and characteristics of guardianship arrange18 ments, guardians, and individuals subject to 

19 guardianship; 

20 ‘‘(G) the use of trained court visitors to 

21 improve court administration of guardianship 

22 arrangements, including the appointment and 

23 oversight of guardians; 

24 ‘‘(H) methods for collecting, storing, and 

25 making available to the appropriate individuals, 


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1 organizations, and entities information on pro2 spective, current, and previously appointed 

3 guardians, which may include— 

4 ‘‘(i) contact and identifying informa5 tion; 

6 ‘‘(ii) information relating to back7 ground check investigations; 

8 ‘‘(iii) court decisions regarding peti9 tions for appointment as a guardian, in10 cluding the rationale for such decisions; 

11 and 

12 ‘‘(iv) information relating to the cause 

13 for removal of the guardian or termination 

14 of the guardianship arrangement; or’’; 

15 (3) in paragraph (4), by striking ‘‘paragraph 

16 (2)(E)’’ and inserting ‘‘subparagraphs (E), (F), (G), 

17 and (H) of paragraph (2)’’; 

18 (4) in paragraph (5), by striking ‘‘paragraph 

19 (2)(E)’’ each place it appears and inserting ‘‘sub20 paragraphs (E), (F), (G), and (H) of paragraph 

21 (2)’’; and 

22 (5) by adding at the end the following new 

23 paragraph: 

24 ‘‘(7) ENSURING DEMONSTRATION PROGRAM

25 FUNDING FOR THE HIGHEST COURTS OF STATES.— 


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1 The Secretary shall ensure that up to 5 percent of 

2 the total of any funds made available to carry out 

3 this subsection in a fiscal year (beginning with fiscal 

4 year 2020) is awarded under grants to the highest 

5 courts of States for purposes of conducting dem6 onstration programs described in subparagraphs 

7 (E), (F), (G), and (H) of paragraph (2).’’. 

8 SEC. 13. REDUCING RACIAL AND ETHNIC DISPARITIES IN 

9 LONG-TERM CARE FACILITIES. 

10 (a) TASK FORCE.—The Secretary shall establish a 

11 task force, to be known as the ‘‘Ethnic and Racial Dispari12 ties in Long-Term Care Facilities Task Force’’ (referred 

13 to in this section as the ‘‘task force’’), to gather data on 

14 racial and ethnic disparities in long-term care facilities 

15 and provide recommendations to Federal, State, local, and 

16 Tribal policymakers on ways to reduce such disparities. 

17 (b) MEMBERSHIP.—The task force shall be composed 

18 of the Secretary, the Surgeon General, other Federal, 

19 State, and local government officials, and individuals ap20 pointed by the Secretary with firsthand knowledge of, or 

21 expertise relating to, disparities in access to quality care 

22 for residents of long-term care facilities who are members 

23 of racial or ethnic minority groups. In appointing such in24 dividuals, the Secretary shall ensure the individuals ap25 pointed provide ample representation with respect to the 


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1 demographics of residents and caregivers of such facilities, 

2 particularly with respect to residents and caregivers of 

3 such facilities who are members of racial or ethnic minor4 ity groups. 

5 (c) ADMINISTRATION.— 

6 (1) CHAIRPERSON.—The Secretary shall serve 

7 as the chairperson of the task force. The Surgeon 

8 General shall serve as the vice chairperson. 

9 (2) STAFF.—The task force shall have 2 full10 time staff members. 

11 (3) MEETINGS.—The task force shall convene 

12 at least monthly, with the first meeting to occur 

13 within 60 days after the enactment of this Act. 

14 (d) REPORTING AND RECOMMENDATIONS.— 

15 (1) MONTHLY REPORTS.—Not later than 45 

16 days after the 1st meeting of the task force, and 

17 monthly thereafter, the task force shall submit to 

18 Congress and the Federal Emergency Management 

19 Agency a report that includes— 

20 (A) recommended methodologies for im21 proving Federal data collection on resident out22 comes in long-term care facilities with dis23 proportionately high rates of admission of indi24 viduals who are members of racial or ethnic mi25 nority groups; 


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1 (B) the identification of long-term care fa2 cilities evidencing racial or ethnic disparities in 

3 psychotropic drug usage, infection prevention 

4 and control deficiencies, hospitalization rates, 

5 infectious disease rates, injury rates, abuse 

6 rates, neglect rates, fatality rates, and any ad7 ditional areas, as determined by the task force 

8 based on available public health data (or, if no 

9 such data are available, on the basis of such 

10 other publicly available data or information as 

11 the task force may determine); 

12 (C) the identification of factors, including 

13 Federal and State policies, that have contrib14 uted to racial or ethnic health disparities in 

15 resident outcomes in long-term care facilities, 

16 and actions Congress (and if appropriate, other 

17 entities) can take to address these factors; and 

18 (D) recommendations for best practices to 

19 promote improvements in long-term care facili20 ties evidencing racial or ethnic disparities in 

21 psychotropic drug usage, infection prevention 

22 and control deficiencies, hospitalization rates, 

23 infectious disease rates, injury rates, abuse and 

24 neglect rates, fatality rates, or any additional 

25 areas determined by the task force. 


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1 (2) CONSULTATION WITH INDIAN TRIBES.—In 

2 submitting reports and recommendations under this 

3 subsection, the task force shall consult with Indian 

4 Tribes and Tribal organizations. 

5 (3) SUNSET.—The task force shall terminate on 

6 December 31, 2021. 

7 SEC. 14. ESTABLISHING RECIPROCITY WITH DRUG EN8 FORCEMENT ADMINISTRATION TO ADDRESS 

9 IMPROPER PRESCRIBING OF CONTROLLED 

10 SUBSTANCES. 

11 (a) NOTIFICATION OF THE ATTORNEY GENERAL BY

12 THE SECRETARY OF HEALTH AND HUMAN SERVICES IN

13 CASES OF IMPROPER PRESCRIBING OF CONTROLLED

14 SUBSTANCES.— 

15 (1) IN GENERAL.—Section 1866(j) of the Social 

16 Security Act (42 U.S.C. 1395cc(j)) is amended by 

17 adding at the end the following new paragraph: 

18 ‘‘(10) NOTIFICATION OF ATTORNEY GEN19 ERAL.— 

20 ‘‘(A) IN GENERAL.—If the Secretary 

21 makes a determination described in subpara22 graph (B) with respect to improper prescribing 

23 of a controlled substance (as defined in section 

24 102(6) of the Controlled Substances Act), the 


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1 Secretary shall notify the Attorney General in 

2 accordance with subparagraph (C). 

3 ‘‘(B) DETERMINATION BY SECRETARY.—A 

4 determination described in this subparagraph is 

5 a determination by the Secretary under 

6 which— 

7 ‘‘(i) the enrollment of a provider of 

8 services or supplier under this title is re9 voked, based in whole or in part on a find10 ing by the Secretary under section 

11 424.535(a)(14) of title 42, Code of Federal 

12 Regulations (or any successor regulation), 

13 as applied to improper prescribing of con14 trolled substances; or 

15 ‘‘(ii) a provider of services or supplier 

16 is placed on the preclusion list as defined 

17 under sections 422.2 and 423.100 of such 

18 title 42 (or any successor regulation), 

19 based in whole or in part on a finding by 

20 the Secretary that such provider or sup21 plier has engaged in conduct, in connection 

22 with prescribing of controlled substances, 

23 that would be considered improper pre24 scribing under such section 


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1 424.535(a)(14), if the provider of services 

2 or supplier were enrolled under this title. 

3 ‘‘(C) NOTIFICATION.—If the Secretary re4 vokes an enrollment or makes a preclusion list 

5 placement as described in subparagraph (B), 

6 the Secretary shall notify the Attorney General 

7 of such revocation or placement, no later than 

8 30 days after— 

9 ‘‘(i) the affirmation of such Secre10 tarial action, in response to a request for 

11 reconsideration by the provider of services 

12 or supplier involved under section 

13 424.545(a) or part 498 of such title 42, as 

14 applicable (or any successor regulations); 

15 or 

16 ‘‘(ii) absent such a request for recon17 sideration, expiration of the time period 

18 during which such a request may be filed. 

19 ‘‘(D) SUBSEQUENT NOTIFICATION.—In the 

20 case that a revocation of enrollment or a pre21 clusion list placement as described in subpara22 graph (B) is reversed under proceedings subse23 quent to the appropriate notification under sub24 paragraph (C), the Secretary shall inform the 

25 Attorney General of such reversal (and as appliVerDate Sep 11 2014 17:28 Jul 14, 2020 Jkt 099200 PO 00000 Frm 00044 Fmt 6652 Sfmt 6201 E:\BILLS\S4182.IS S4182

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1 cable, reinstatement of such enrollment or re2 moval from the preclusion list).’’. 

3 (2) TECHNICAL CORRECTION TO CITATION FOR

4 APPEALS PROVISION.—Section 1866(j)(5)(B) of the 

5 Social Security Act (42 U.S.C. 1395cc(j)(5)(B)) is 

6 amended by striking ‘‘paragraph (7)’’ and inserting 

7 ‘‘paragraph (9)’’. 

8 (b) REVOCATION OF REGISTRATION UNDER THE

9 CONTROLLED SUBSTANCES ACT.—Section 304 of the 

10 Controlled Substances Act (21 U.S.C. 824) is amended 

11 by adding at the end the following: 

12 ‘‘(h)(1) Upon receipt of a notification from the Sec13 retary under section 1866(j)(10)(C) of the Social Security 

14 Act (42 U.S.C. 1395cc(j)(10)(C)) of a determination of 

15 the Secretary to revoke an enrollment or make a pre16 clusion list placement, the Attorney General shall revoke 

17 the registration granted under section 303 of this Act of 

18 the registrant that is the subject of such revocation or 

19 placement. 

20 ‘‘(2) After revocation of a registration under para21 graph (1), if the Attorney General receives information 

22 from the Secretary under section 1866(j)(10)(D) of the 

23 Social Security Act (42 U.S.C. 1395cc(j)(10)(D)) that the 

24 determination of the Secretary described in paragraph (1) 

25 has been reversed, the Attorney General may reverse the 


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1 revocation of the registration if the Attorney General de2 termines such reversal is appropriate.’’. 

Æ 


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