I 

116TH CONGRESS 

1ST SESSION H. R. 3910 

To amend title XI of the Social Security Act to improve access to care 

for all Medicare and Medicaid beneficiaries through models tested under 

the Center for Medicare and Medicaid Innovation, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 23, 2019 

Mr. LEWIS (for himself, Mr. LARSON of Connecticut, Ms. SEWELL of Alabama, Mr. DOGGETT, Mr. EVANS, Mr. PASCRELL, Mr. GOMEZ, Mr. 

SUOZZI, and Ms. SA ́NCHEZ) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to 

the Committee on Ways and Means, 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 title XI of the Social Security Act to improve 

access to care for all Medicare and Medicaid beneficiaries 

through models tested under the Center for Medicare 

and Medicaid Innovation, 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 ‘‘Equality in Medicare 

5 and Medicaid Treatment Act of 2019’’. 


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1 SEC. 2. IMPROVING ACCESS TO CARE FOR MEDICARE AND 

2 MEDICAID BENEFICIARIES. 

3 Section 1115A of the Social Security Act (42 U.S.C. 

4 1315a) is amended— 

5 (1) in subsection (a)(3)— 

6 (A) by inserting ‘‘, the causes of health 

7 disparities and social determinants of health,’’ 

8 after ‘‘medicine’’; and 

9 (B) by inserting ‘‘, the Office of Minority 

10 Health of the Centers for Medicare & Medicaid 

11 Services, the Office of Rural Health Policy, and 

12 the Office on Women’s Health’’; 

13 (2) in subsection (b)— 

14 (A) in paragraph (2)— 

15 (i) in subparagraph (A)— 

16 (I) by inserting after the first 

17 sentence, the following new sentence: 

18 ‘‘Prior to model selection, the Sec19 retary shall consult with the Office of 

20 Minority Health of the Centers for 

21 Medicare & Medicaid Services, the 

22 Federal Office of Rural Health Policy, 

23 and the Office on Women’s Health to 

24 ensure that models under consider25 ation address health disparities and 

26 social determinants of health as apVerDate Sep 11 2014 02:51 Jul 31, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3910.IH H3910

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1 propriate for populations to be cared 

2 for under the model.’’; 

3 (II) by inserting ‘‘, as well as im4 proving access to care received by in5 dividuals receiving benefits under such 

6 title,’’ after ‘‘title’’; and 

7 (III) by adding at the end the 

8 following new sentence: ‘‘The models 

9 selected under this subparagraph shall 

10 include the social determinants of 

11 health payment model described in 

12 subparagraph (D), the testing of 

13 which shall begin not later than De14 cember 31, 2020.’’; 

15 (ii) in subparagraph (C), by adding at 

16 the end the following new clauses: 

17 ‘‘(ix) Whether the model will affect 

18 access to care from providers and suppliers 

19 caring for high risk patients or operating 

20 in underserved areas. 

21 ‘‘(x) Whether the model has the po22 tential to produce reductions in minority 

23 and rural health disparities.’’; and 

24 (iii) by adding at the end the fol25 lowing new subparagraph: 


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1 ‘‘(D) SOCIAL DETERMINANTS OF HEALTH

2 PAYMENT MODEL.— 

3 ‘‘(i) IN GENERAL.—The social deter4 minants of health payment model described 

5 in this subparagraph is a payment model 

6 that tests each of the payment and service 

7 delivery innovations described in clause (ii) 

8 in a region determined appropriate by the 

9 Secretary. 

10 ‘‘(ii) PAYMENT AND SERVICE DELIV11 ERY INNOVATIONS DESCRIBED.—For pur12 poses of clause (i), the payment and serv13 ice delivery innovations described in this 

14 clause are the following: 

15 ‘‘(I) Payment and service delivery 

16 innovations for behavioral health serv17 ices, focusing on gathering actionable 

18 data to address the higher costs asso19 ciated with beneficiaries with diag20 nosed behavioral conditions. 

21 ‘‘(II) Payment and service deliv22 ery innovations targeting conditions or 

23 comorbidities of individuals entitled or 

24 enrolled under the Medicare program 

25 under title XVIII and enrolled under 


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1 a State plan under the Medicaid pro2 gram under title XIX to increase ca3 pacity in underserved areas. 

4 ‘‘(III) Payment and service deliv5 ery innovations targeted on Medicaid6 eligible pregnant and postpartum 

7 women, up to one year after deliv8 ery.’’; and 

9 (B) in paragraph (4)(A)— 

10 (i) in clause (i) at the end, by striking 

11 ‘‘and’’; 

12 (ii) in clause (ii), at the end, by strik13 ing the period and inserting ‘‘; and’’; and 

14 (iii) by adding at the end the fol15 lowing new clause: 

16 ‘‘(iii) the extent to which the model 

17 improves access to care or the extent to 

18 which the model improves care for high 

19 risk patients, patients from racial or ethnic 

20 minorities, or patients in underserved 

21 areas.’’; 

22 (3) in subsection (c)— 

23 (A) in paragraph (2), by striking at the 

24 end ‘‘and’’; 


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1 (B) by redesignating paragraph (3) as 

2 paragraph (4); 

3 (C) by inserting after paragraph (2) the 

4 following new paragraph: 

5 ‘‘(3) the Office of Minority Health of the Cen6 ters for Medicare & Medicaid Services certifies that 

7 such expansion will not reduce access to care for 

8 low-income, minority, or rural beneficiaries; and’’; 

9 (D) in paragraph (4), as redesignated by 

10 subparagraph (B), by inserting before the pe11 riod at the end the following: ‘‘nor increase 

12 health disparities experienced by low-income, 

13 minority, or rural beneficiaries’’; and 

14 (E) in the matter following paragraph (4), 

15 as redesignated by subparagraph (B), by insert16 ing ‘‘, improve access to care,’’ after ‘‘care’’; 

17 and 

18 (4) in subsection (g)— 

19 (A) by inserting ‘‘(or, beginning with 2021, 

20 once every year thereafter)’’ after ‘‘thereafter’’; 

21 and 

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

23 sentence: ‘‘For reports for 2021 and each sub24 sequent year, each such report shall include in25 formation on the following: 


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1 ‘‘(1) The extent and severity of minority and 

2 rural health disparities in Medicare and Medicaid 

3 beneficiaries. 

4 ‘‘(2) The interventions that address social de5 terminants of health in payment models selected by 

6 the Center for Medicare and Medicaid Innovation for 

7 testing. 

8 ‘‘(3) The interventions that address social de9 terminants of health in payment models not selected 

10 by the Center for Medicare and Medicaid Innovation 

11 for testing. 

12 ‘‘(4) The effectiveness of interventions in miti13 gating negative health outcomes and higher costs as14 sociated with social determinants of health within 

15 models selected by the Center for Medicare and 

16 Medicaid Innovation for testing. 

17 ‘‘(5) Changes in disparities among minorities 

18 and Medicare and Medicaid beneficiaries in under19 served areas that are attributable to provider and 

20 supplier participation in a Phase II model. 

21 ‘‘(6) In consultation with the Comptroller Gen22 eral of the United States, estimated Federal savings 

23 achieved through the reduction of rural and minority 

24 health disparities. 


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1 ‘‘(7) Other areas determined appropriate by the 

2 Secretary.’’. 

Æ 


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