IB 

Union Calendar No. 805 

118TH CONGRESS 

2D SESSION H. R. 8244 

[Report No. 118–956, Part I] 

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 

DECEMBER 27, 2024 

Additional sponsors: Mr. FEENSTRA, Mrs. FISCHBACH, Mr. GROTHMAN, Mr. 

DAVIS of North Carolina, and Mr. VAN ORDEN

DECEMBER 27, 2024 

Reported from the Committee on Ways and Means with an amendment 

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

DECEMBER 27, 2024 

Committee on Energy and Commerce discharged; committed to the Committee 

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

[For text of introduced bill, see copy of bill as introduced on May 6, 2024] 


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•HR 8244 RH

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. 


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•HR 8244 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 ‘‘Ensuring Seniors’ Ac5 cess to Quality Care Act’’. 

6 SEC. 2. ENSURING APPROPRIATE APPROVAL FOR CERTAIN 

7 SKILLED NURSING FACILITY AND NURSING 

8 FACILITY NURSING AIDE TRAINING AND COM9 PETENCY EVALUATION PROGRAMS UNDER 

10 THE MEDICARE AND MEDICAID PROGRAM. 

11 (a) MEDICARE.—Section 1819(f)(2) of the Social Secu12 rity Act (42 U.S.C. 1395i–3(f)(2)) is amended— 

13 (1) in subparagraph (B)(iii)— 

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

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

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

17 (B) in subclause (I)— 

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

19 end; 

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

21 follows: 

22 ‘‘(c) has been assessed a civil 

23 money penalty described in sub24 section (h)(2)(B)(ii) or section 

25 1919(h)(2)(A)(ii) of not less than 


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•HR 8244 RH

1 $12,924 and has been cited for a 

2 deficiency relating to the quality 

3 of care provided to residents of the 

4 facility; or’’; and 

5 (iii) by adding at the end the following 

6 new item: 

7 ‘‘(d) has been subject to a 

8 remedy described in clause (i) or 

9 (iii) of subsection (h)(2)(B), sub10 section (h)(4), section 

11 1919(h)(1)(B)(i), or in clause (i), 

12 (iii), or (iv) of section 

13 1919(h)(2)(A), or’’; and 

14 (2) by striking subparagraph (D). 

15 (b) MEDICAID.—Section 1919(f)(2) of the Social Secu16 rity Act (42 U.S.C. 1396r(f)(2)) is amended— 

17 (1) in subparagraph (B)(iii)— 

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

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

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

21 (B) in subclause (I)— 

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

23 end; 

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

25 follows: 


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•HR 8244 RH

1 ‘‘(c) has been assessed a civil 

2 money penalty described in sub3 section (h)(2)(A)(ii) or section 

4 1819(h)(2)(B)(ii) of not less than 

5 $12,924 and has been cited for a 

6 deficiency relating to the quality 

7 of care provided to residents of the 

8 facility; or’’; and 

9 (iii) by adding at the end the following 

10 new item: 

11 ‘‘(d) has been subject to a 

12 remedy described in subsection 

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

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

15 clauses (i) or (iii) of section 

16 1819(h)(2)(B), or section 

17 1819(h)(4), or’’; and 

18 (2) by striking subparagraph (D). 


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Union Calendar No. 805 

118TH CONGRESS 

2D SESSION H. R. 8244 

[Report No. 118–956, Part I] 

A BILL 

To amend titles XVIII and XIX of the Social Secugram. grams under the Medicare and Medicaid pro- ing aide training and competency evaluation pro- skilled nursing facility and nursing facility nurs- rity Act ensure appropriate approval for certain 

DECEMBER 27, 2024 

Reported from the Committee on Ways and Means with 

an amendment 

DECEMBER 27, 2024 

Committee on Energy and Commerce discharged; comState of the Union and ordered to be printed mitted to the Committee of the Whole House on the 


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