II 

117TH CONGRESS 

1ST SESSION S. 201 

To establish a program ensuring access to accredited continuing medical 

education for primary care physicians and other health care providers 

at Federally-qualified health centers and rural health clinics, to provide 

training and clinical support for primary care providers to practice at 

their full scope and improve access to care for patients in underserved 

areas. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 3, 2021 

Ms. ROSEN (for herself and Ms. MURKOWSKI) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To establish a program ensuring access to accredited continuing medical education for primary care physicians 

and other health care providers at Federally-qualified 

health centers and rural health clinics, to provide training and clinical support for primary care providers to 

practice at their full scope and improve access to care 

for patients in underserved areas. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Improving Access to 

3 Health Care in Rural and Underserved Areas Act’’. 

4 SEC. 2. PRIMARY CARE ACCREDITED CONTINUING MED5 ICAL EDUCATION PROGRAM. 

6 Subpart 1 of part D of title III of the Public Health 

7 Service Act (42 U.S.C. 254b et seq.) is amended by adding 

8 at the end the following: 

9 ‘‘SEC. 330O. PRIMARY CARE ACCREDITED CONTINUING 

10 MEDICAL EDUCATION PROGRAM. 

11 ‘‘(a) IN GENERAL.—The Secretary, acting through 

12 the Administrator of the Health Resources and Services 

13 Administration, shall establish a program to award not 

14 more than 100 grants to Federally-qualified health centers 

15 or rural health clinics, or organizations affiliated with such 

16 clinics, for the purpose of ensuring access to accredited 

17 continuing medical education by board-certified specialist 

18 physicians, including family and internal medicine physi19 cians, with teaching or high-volume patient experience, 

20 and other licensed medical providers who have clinical ex21 perience and are certified in accordance with regulations 

22 issued by the Secretary, to primary care physicians and 

23 medical providers employed by Federally-qualified health 

24 centers or rural health clinics, to increase the primary care 

25 providers’ knowledge and capacity to practice within their 


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1 full scope and increase access to care for patients in rural 

2 and underserved areas. 

3 ‘‘(b) SCOPE OF TRAINING.— 

4 ‘‘(1) IN GENERAL.—Accredited continuing med5 ical education programs offered under this section— 

6 ‘‘(A) shall be designed to be flexible to 

7 meet the needs of the patients and providers 

8 served and offer a variety of schedules, with a 

9 minimum of 1-day training per month, per spe10 cialty area; 

11 ‘‘(B) shall involve clinical practice for at 

12 least 50 percent of the training (based on a 3- 

13 month average), involving direct care for pa14 tients with a scheduled visit with the primary 

15 care provider, and who could benefit from a 

16 concurrent visit with both the primary care pro17 vider and a specialist; 

18 ‘‘(C) shall not impose additional cost-shar19 ing with respect to the concurrent visits de20 scribed in subparagraph (B); and 

21 ‘‘(D) may involve specialists and faculty 

22 who participate in the program via telemedicine, 

23 as the program determines appropriate. 

24 ‘‘(2) TRAINING.—Accredited continuing medical 

25 education programs offered under this section may 


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1 provide training to primary and behavioral care phy2 sicians and health care providers on— 

3 ‘‘(A) endocrinology (including diabetes 

4 care); 

5 ‘‘(B) palliative care and pain management; 

6 ‘‘(C) dermatology; 

7 ‘‘(D) obstetrics and gynecology; 

8 ‘‘(E) pediatric primary care and pediatric 

9 subspecialties; 

10 ‘‘(F) gastroenterology; 

11 ‘‘(G) mental and behavioral health, and 

12 substance use treatment; 

13 ‘‘(H) preventive care and nutrition; 

14 ‘‘(I) geriatric medicine; 

15 ‘‘(J) infectious disease; 

16 ‘‘(K) cardiology; 

17 ‘‘(L) rural health and training to improve 

18 outcomes for populations experiencing health 

19 disparities; 

20 ‘‘(M) wound care; 

21 ‘‘(N) disease management for patients with 

22 multiple comorbidities; 

23 ‘‘(O) health information technology; and 

24 ‘‘(P) other topics, as the Secretary deter25 mines appropriate. 


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1 ‘‘(3) PARTICIPATING CENTERS OR CLINICS.— 

2 ‘‘(A) IN GENERAL.—To be eligible for a 

3 grant under this section a Federally-qualified 

4 health center or rural health clinic, or an orga5 nization affiliated with any such health clinic 

6 acting on behalf of multiple such clinics, shall— 

7 ‘‘(i) submit an application to the Sec8 retary at such time, in such manner, and 

9 containing such information as the Sec10 retary may require; 

11 ‘‘(ii) ensure that training under the 

12 program under the grant is provided to the 

13 physicians and primary care providers em14 ployed by such center or clinic, as well as 

15 peer-to-peer training; 

16 ‘‘(iii) include in the application a 

17 needs assessment describing how participa18 tion in the program under the grant will 

19 meet both patient needs and skills training 

20 needs for their primary care providers; and 

21 ‘‘(iv) include in the application a de22 scription of the expected patient target for 

23 how many patients would be directly 

24 served by activities under the grant and an 

25 assurance that data and reports will be 


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1 provided annually on the number of pa2 tients served and the accrediting entity 

3 used for purposes of subsection (c)(2)(B). 

4 ‘‘(B) USE OF GRANT.—A Federally-quali5 fied health center, rural health clinic, or affili6 ated organization receiving a grant under this 

7 section may use grant funds for— 

8 ‘‘(i) compensation for medical pro9 viders participating in teaching at program 

10 sessions; 

11 ‘‘(ii) part-time administration support 

12 for the program; 

13 ‘‘(iii) compensation for the center for 

14 the nonclinical training time of the center’s 

15 primary care or behavioral health care pro16 viders; 

17 ‘‘(iv) technology and equipment need18 ed to facilitate clinical visits for the pro19 gram; 

20 ‘‘(v) transportation costs for medical 

21 providers participating in teaching under 

22 the program to travel to center sites if 

23 such sites are located more than 35 miles 

24 from their primary residences and their 

25 participation is in-person; and 


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1 ‘‘(vi) other purposes related to ex2 penses incurred in the planning and deliv3 ery of the educational program and associ4 ated clinical visits, as the Secretary deter5 mines appropriate. 

6 ‘‘(C) TERM.—A grant under this section 

7 shall be for a period of 5-years. 

8 ‘‘(D) RURAL AREAS.—The Secretary shall 

9 ensure that at least half of the recipients of a 

10 grant under this section are eligible Federally11 qualified health centers located in a rural area 

12 or rural health clinics, or affiliated organiza13 tions acting on behalf of such centers. 

14 ‘‘(c) PHYSICIAN PARTICIPATION IN PROGRAM.— 

15 ‘‘(1) ELIGIBILITY.—To be eligible to participate 

16 in an accredited continuing medical education pro17 gram offered under this section, a physician or other 

18 primary care or behavioral health care provider shall 

19 be a primary care provider— 

20 ‘‘(A) who is employed by the grantee; and 

21 ‘‘(B) who serves patients in a medically 

22 underserved population (as defined in section 

23 330(b)(3)). 

24 ‘‘(2) CME CREDIT.— 


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1 ‘‘(A) IN GENERAL.—The Secretary shall 

2 require a grantee under this section to identify 

3 an accrediting body that the grantee will work 

4 with to certify the program under the grant in 

5 a manner that provides continuing medical edu6 cation credits to providers participating in the 

7 program. Such certification shall include mate8 rial with respect to specific skills development. 

9 ‘‘(B) REPORTING.—As part of the annual 

10 reporting under subsection (b)(3)(A)(iv) a 

11 grantee shall provide to the Secretary informa12 tion to confirm the accredited continuing med13 ical education entity used by the grantee. 

14 ‘‘(C) SUSPENSION OF FUNDING FOR NON15 COMPLIANCE.—The Secretary may suspend 

16 grant funding if the grantee fails to provide for 

17 accredited continuing medical education within 

18 the first year of the grant. Such grant funding 

19 may be reinstated by the Secretary once the 

20 grantee certifies that accredited continuing 

21 medical education is provided. 

22 ‘‘(d) ANNUAL REPORTING.—Beginning 1 year after 

23 the date of enactment of the Improving Access to Health 

24 Care in Rural and Underserved Areas Act, and every year 


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1 thereafter, the Secretary shall submit to Congress a report 

2 on the program under this section, including— 

3 ‘‘(1) the number of physicians who participate 

4 in the program each year and the specialties of such 

5 physicians; 

6 ‘‘(2) a breakdown of specialist time spent di7 rectly with patients, with patients through telemedi8 cine, and with primary care providers in classroom 

9 or other non-clinical setting during the program ses10 sions; 

11 ‘‘(3) a comparison of measures under the Uni12 form Data System of the Health Resources and 

13 Services Administration, or similar program, rel14 evant to patient care improvements, between the 

15 year prior to the implementation of the program 

16 under this section and the most recent year in the 

17 program; 

18 ‘‘(4) a summary of any clinical practice changes 

19 or notable improvements in patient care; 

20 ‘‘(5) patient referrals from health centers that 

21 participate in the program to outside specialist care, 

22 and any patient care provided at the health center 

23 that, prior to the program, would have been referred 

24 to outside specialists; 


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1 ‘‘(6) retention rates of physicians at partici2 pating health centers; and 

3 ‘‘(7) satisfaction rates of physicians with the 

4 education program at participating health centers. 

5 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—To 

6 carry out this section, there are authorized to be appro7 priated $20,000,000 for each of fiscal years 2021 through 

8 2025.’’. 

Æ 


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