Patient Navigation Assistance Act of 2016

To provide payment for patient navigator services under title XIX of the Social Security Act, and for other purposes. 1. Short title This Act may be cited as the Patient Navigation Assistance Act of 2016 2. Medicaid coverage for patient navigator services (a) In general Section 1902(a) of the Social Security Act ( 42 U.S.C. 1396a(a) (1) by inserting after paragraph (77) the following new paragraph: (78) provide that the State shall reimburse an eligible entity (as defined in subsection (ll)(1)) for any patient navigator service (as defined in subsection (ll)(3)) that is provided— (A) to an individual who is eligible for medical assistance under the State plan; and (B) by a patient navigator (as defined in subsection (ll)(2)) through the eligible entity. ; and (2) by adding at the end the following new subsection: (ll) Patient navigator services definitions For purposes of this section: (1) Eligible entity The term eligible entity (A) is an eligible entity (as defined in subsection (l)(1) of section 340A of the Public Health Service Act); and (B) complies with the following requirements of such section (insofar as they apply to a grant recipient under such section): (i) Subsection (b) (relating to patient navigator duties and community knowledge). (ii) Subsection (c) (relating to prohibitions). (iii) Subsection (e) (relating to applications). (iv) Subsection (j)(3) (relating to reports). (2) Patient navigator (A) In general The term patient navigator (B) Consultation with advisory committee (i) In general The Secretary shall consult with the patient navigation advisory committee to the extent necessary to further clarify the definition of the term patient navigator (ii) Membership The Secretary shall convene a patient navigation advisory committee. The members of such committee shall include— (I) representatives from relevant Federal departments and agencies, including the National Institutes of Health, the Centers for Disease Control and Prevention, the Health Resources and Services Administration, and the Centers for Medicare & Medicaid Services; and (II) individuals and representatives of public and private organizations with expertise in patient navigation. (3) Patient navigator services The term patient navigator service . (b) Treatment as medical assistance for purposes of FMAP Section 1905(a) of the Social Security Act ( 42 U.S.C. 1396d(a) (1) in paragraph (28), by striking and (2) by redesignating paragraph (29) as paragraph (30); and (3) by inserting after paragraph (28) the following new paragraph: (29) patient navigator services (as defined in section 1902(ll)(3)) that are provided in a manner that meets the requirements of section 1902(a)(78); and . (c) Effective date (1) In general Subject to paragraph (2) (2) Exception for State legislation In the case of a State plan under title XIX of the Social Security Act, which the Secretary of Health and Human Services determines requires State legislation in order for the respective plan to meet any requirement imposed by amendments made by this Act, the respective plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such an additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session shall be considered to be a separate regular session of the State legislature.

Summary: Patient Navigation Assistance Act of 2016 This bill amends title XIX (Medicaid) of the Social Security Act to require state Medicaid programs to provide medical assistance for patient navigator services. ("Patient navigators" are individuals who are trained to facilitate the care of other individuals and who have direct knowledge of the communities they serve.)