I 

116TH CONGRESS 

1ST SESSION H. R. 3935 

To amend title XIX of the Social Security Act to provide for the continuing 

requirement of Medicaid coverage of nonemergency transportation to 

medically necessary services. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 24, 2019 

Mr. CARTER of Georgia (for himself, Mr. CA ́RDENAS, Mr. GRAVES of Georgia, 

and Mr. BISHOP of Georgia) introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend title XIX of the Social Security Act to provide 

for the continuing requirement of Medicaid coverage of 

nonemergency transportation to medically necessary services. 

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 ‘‘Protecting Patients 

5 Transportation to Care Act’’. 


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1 SEC. 2. CONTINUING REQUIREMENT OF MEDICAID COV2 ERAGE OF NONEMERGENCY TRANSPOR3 TATION TO MEDICALLY NECESSARY SERV4 ICES. 

5 (a) REQUIREMENT.—Section 1902(a)(10) of the So6 cial Security Act (42 U.S.C. 1396a(a)(10)) is amended— 

7 (1) in subparagraph (A), in the matter pre8 ceding clause (i), by striking ‘‘and (21)’’ and insert9 ing ‘‘, (21), and (30)’’; and 

10 (2) in subparagraph (C)(iv), by striking ‘‘and 

11 (17)’’ and inserting ‘‘, (17), and (30)’’. 

12 (b) DESCRIPTION OF SERVICES.—Section 1905 of 

13 such Act (42 U.S.C. 1396d) is amended— 

14 (1) in subsection (a)— 

15 (A) in paragraph (29), by striking ‘‘and’’ 

16 at the end; 

17 (B) by redesignating paragraph (30) as 

18 paragraph (31) and by striking the comma at 

19 the end and inserting a semicolon; and 

20 (C) by inserting after paragraph (29) the 

21 following new paragraph: 

22 ‘‘(30) subject to subsection (ff), nonemergency 

23 transportation to medically necessary services, con24 sistent with the requirement of section 431.53 of 

25 title 42, Code of Federal Regulations, as in effect as 

26 of June 1, 2019; and’’; and 


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1 (2) by adding at the end the following new sub2 section: 

3 ‘‘(ff) NONEMERGENCY TRANSPORTATION TO MEDI4 CALLY NECESSARY SERVICES.— 

5 ‘‘(1) LIMITATION ON FEDERAL FINANCIAL PAR6 TICIPATION.—Notwithstanding any other provision 

7 of this title, to be eligible for federal financial par8 ticipation under this title for expenses incurred as 

9 medical assistance or as an administrative expense 

10 for nonemergency transportation to medically nec11 essary services described in subsection (a)(30), the 

12 State Medicaid agency of such State must have in 

13 place a prior authorization or utilization manage14 ment requirement for such services. 

15 ‘‘(2) PRIOR AUTHORIZATION DEFINED.—For 

16 purposes of paragraph (1), the term ‘prior author17 ization’ means a process through which a request for 

18 provisional affirmation of coverage is submitted for 

19 review before the service involved is furnished and 

20 before a claim is submitted for payment for such 

21 service.’’. 

22 (c) EFFECTIVE DATE.—The amendments made by 

23 this section shall take effect on the date of the enactment 


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1 of this Act and shall apply to transportation on or after 

2 such date. 

Æ 


kjohnson on DSK79L0C42 with BILLS