I 
118TH CONGRESS 
2D SESSION 
H. R. 8244 
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 addi-
tion to the Committee on Energy and Commerce, for a period to be sub-
sequently 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 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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Ensuring Seniors’ Ac-
cess to Quality Care Act’’. 
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SEC. 2. ENSURING APPROPRIATE APPROVAL FOR CERTAIN 
SKILLED NURSING FACILITY AND NURSING 
FACILITY 
NURSING 
AIDE 
TRAINING 
AND 
COMPETENCY 
EVALUATION 
PROGRAMS 
UNDER THE MEDICARE AND MEDICAID PRO-
GRAM. 
(a) MEDICARE.—Section 1819(f)(2) of the Social Se-
curity Act (42 U.S.C. 1395i–3(f)(2)) is amended— 
(1) in subparagraph (B)(iii)— 
(A) by striking ‘‘subparagraphs (C) and 
(D)’’ and inserting ‘‘subparagraph (C)’’; and 
(B) in subclause (I)— 
(i) in item (b), by striking ‘‘or’’ at the 
end; 
(ii) by amending item (c) to read as 
follows: 
‘‘(c) has been assessed a 
civil money penalty described in 
subsection (h)(2)(B)(ii) or sec-
tion 1919(h)(2)(A)(ii) of not less 
than $12,924 and has been cited 
for a deficiency relating to the 
quality of care provided to resi-
dents of the facility; or’’; and 
(iii) by adding at the end the fol-
lowing new item: 
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‘‘(d) has been subject to a 
remedy described in clause (i) or 
(iii) of subsection (h)(2)(B), sub-
section 
(h)(4), 
section 
1919(h)(1)(B)(i), or in clause (i), 
(iii), 
or 
(iv) 
of 
section 
1919(h)(2)(A), or’’; and 
(2) by striking subparagraph (D). 
(b) MEDICAID.—Section 1919(f)(2) of the Social Se-
curity Act (42 U.S.C. 1396r(f)(2)) is amended— 
(1) in subparagraph (B)(iii)— 
(A) in the matter preceding subclause (I), 
by striking ‘‘subparagraphs (C) and (D)’’ and 
inserting ‘‘subparagraph (C)’’; and 
(B) in subclause (I)— 
(i) in item (b), by striking ‘‘or’’ at the 
end; 
(ii) by amending item (c) to read as 
follows: 
‘‘(c) has been assessed a 
civil money penalty described in 
subsection (h)(2)(A)(ii) or section 
1819(h)(2)(B)(ii) of not less than 
$12,924 and has been cited for a 
deficiency relating to the quality 
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of care provided to residents of 
the facility; or’’; and 
(iii) by adding at the end the fol-
lowing new item: 
‘‘(d) has been subject to a 
remedy described in subsection 
(h)(1)(B)(i), clauses (i), (iii), or 
(iv) 
of 
subsection 
(h)(2)(A), 
clauses (i) or (iii) of section 
1819(h)(2)(B), 
or 
section 
1819(h)(4), or’’; and 
(2) by striking subparagraph (D). 
Æ 
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