I 

118TH CONGRESS 

2D SESSION H. R. 8244 

To amend titles XVIII and XIX of the Social Security Act ensure appropriate 

approval for certain skilled nursing facility and nursing facility nursing 

aide training and competency evaluation programs under the Medicare 

and Medicaid program. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 6, 2024 

Mr. ESTES (for himself and Mr. CONNOLLY) introduced the following bill; 

which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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 titles XVIII and XIX of the Social Security Act 

ensure appropriate approval for certain skilled nursing 

facility and nursing facility nursing aide training and 

competency evaluation programs under the Medicare and 

Medicaid program. 

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 ‘‘Ensuring Seniors’ Ac5 cess to Quality Care Act’’. 


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1 SEC. 2. ENSURING APPROPRIATE APPROVAL FOR CERTAIN 

2 SKILLED NURSING FACILITY AND NURSING 

3 FACILITY NURSING AIDE TRAINING AND 

4 COMPETENCY EVALUATION PROGRAMS 

5 UNDER THE MEDICARE AND MEDICAID PRO6 GRAM. 

7 (a) MEDICARE.—Section 1819(f)(2) of the Social Se8 curity Act (42 U.S.C. 1395i–3(f)(2)) is amended— 

9 (1) in subparagraph (B)(iii)— 

10 (A) by striking ‘‘subparagraphs (C) and 

11 (D)’’ and inserting ‘‘subparagraph (C)’’; and 

12 (B) in subclause (I)— 

13 (i) in item (b), by striking ‘‘or’’ at the 

14 end; 

15 (ii) by amending item (c) to read as 

16 follows: 

17 ‘‘(c) has been assessed a 

18 civil money penalty described in 

19 subsection (h)(2)(B)(ii) or sec20 tion 1919(h)(2)(A)(ii) of not less 

21 than $12,924 and has been cited 

22 for a deficiency relating to the 

23 quality of care provided to resi24 dents of the facility; or’’; and 

25 (iii) by adding at the end the fol26 lowing new item: 


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1 ‘‘(d) has been subject to a 

2 remedy described in clause (i) or 

3 (iii) of subsection (h)(2)(B), sub4 section (h)(4), section 

5 1919(h)(1)(B)(i), or in clause (i), 

6 (iii), or (iv) of section 

7 1919(h)(2)(A), or’’; and 

8 (2) by striking subparagraph (D). 

9 (b) MEDICAID.—Section 1919(f)(2) of the Social Se10 curity Act (42 U.S.C. 1396r(f)(2)) is amended— 

11 (1) in subparagraph (B)(iii)— 

12 (A) in the matter preceding subclause (I), 

13 by striking ‘‘subparagraphs (C) and (D)’’ and 

14 inserting ‘‘subparagraph (C)’’; and 

15 (B) in subclause (I)— 

16 (i) in item (b), by striking ‘‘or’’ at the 

17 end; 

18 (ii) by amending item (c) to read as 

19 follows: 

20 ‘‘(c) has been assessed a 

21 civil money penalty described in 

22 subsection (h)(2)(A)(ii) or section 

23 1819(h)(2)(B)(ii) of not less than 

24 $12,924 and has been cited for a 

25 deficiency relating to the quality 


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1 of care provided to residents of 

2 the facility; or’’; and 

3 (iii) by adding at the end the fol4 lowing new item: 

5 ‘‘(d) has been subject to a 

6 remedy described in subsection 

7 (h)(1)(B)(i), clauses (i), (iii), or 

8 (iv) of subsection (h)(2)(A), 

9 clauses (i) or (iii) of section 

10 1819(h)(2)(B), or section 

11 1819(h)(4), or’’; and 

12 (2) by striking subparagraph (D). 

Æ 


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