for achieving the ability to systematically and inter-
nally track the following: 
(A) When, how, and by whom services are 
identified for review. 
(B) When services are reviewed or re-
viewed or when new services are added. 
(C) The resources, evidence, data, and rec-
ommendations used in reviews. 
(D) When relative values are adjusted. 
(E) The rationale for final relative value 
decisions. 
(d) FREQUENCY OF REVIEW.—Section 1848(c)(2) of 
the Social Security Act (42 U.S.C. 1395w–4(c)(2)) is 
amended— 
(1) in subparagraph (B)(i), by striking ‘‘5’’ and 
inserting ‘‘4’’; and 
(2) in subparagraph (K)(i)(I), by striking ‘‘peri-
odically’’ and inserting ‘‘annually’’. 
(e) CONSULTATION WITH MEDICARE PAYMENT AD-
VISORY COMMISSION.— 
(1) IN
GENERAL.—Section 1848(c)(2) of the 
Social Security Act (42 U.S.C. 1395w–4(c)(2)) is 
amended— 
(A) in subparagraph (B)(i), by inserting 
‘‘in consultation with the Medicare Payment 
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Advisory Commission,’’ after ‘‘The Secretary,’’; 
and 
(B) in subparagraph (K)(i)(I), as amended 
by subsection (d)(2), by inserting ‘‘, in coordi-
nation with the Medicare Payment Advisory 
Commission,’’ after ‘‘annually’’. 
(2) CONFORMING AMENDMENTS.—Section 1805 
of the Social Security Act (42 U.S.C. 1395b–6) is 
amended— 
(A) in subsection (b)(1)(A), by inserting 
the following before the semicolon at the end: 
‘‘and including coordinating with the Secretary 
in accordance with section 1848(c)(2) to sys-
tematically review the relative values established 
for physicians’ services, identify potentially 
misvalued services, and propose adjustments to 
the relative values for physicians’ services’’; and 
(B) in subsection (e)(1), in the second sen-
tence, by inserting ‘‘or the Ranking Minority 
Member’’ after ‘‘the Chairman’’. 
(f) PERIODIC AUDIT BY THE COMPTROLLER GEN-
ERAL.—Section 1848(c)(2) of the Social Security Act (42 
U.S.C. 1395w–4(c)(2)), as amended by subsection (a), is 
amended by adding at the end the following new subpara-
graph: 
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‘‘(Q) PERIODIC
AUDIT
BY
THE
COMP-
TROLLER GENERAL.— 
‘‘(i) IN
GENERAL.—The Comptroller 
General of the United States (in this sub-
section referred to as the ‘Comptroller 
General’) shall periodically audit the review 
by the Secretary of relative values estab-
lished under this paragraph for physicians’ 
services. 
‘‘(ii) ACCESS TO INFORMATION.—The 
Comptroller General shall have unre-
stricted access to all deliberations, records, 
and data related to the activities carried 
out under this paragraph, in a timely man-
ner, upon request.’’. 
SEC. 614. PAYMENT PROHIBITIONS; CAPITAL EXPENDI-
TURES; SPECIAL PROJECTS. 
(a) SENSE OF CONGRESS.—It is the sense of Con-
gress that tens of millions of people in the United States 
do not receive healthcare services while billions of dollars 
that could be spent on providing health care are diverted 
to profit. There is a moral imperative to correct the mas-
sive deficiencies in our current health system and to elimi-
nate profit from the provision of health care. 
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(b) PROHIBITIONS.—Payments to providers under 
this Act may not take into account, include any process 
for the provision of funding for, or be used by a provider 
for— 
(1) marketing of the provider; 
(2) the profit or net revenue of the provider, or 
increasing the profit or net revenue of the provider; 
(3) incentive payments, bonuses, or other com-
pensation based on patient utilization of items and 
services or any financial measure applied with re-
spect to the provider (or any group practice, inte-
grated health care delivery system, or other provider 
with which the provider contracts or has a pecuniary 
interest), including any value-based payment or em-
ployment-based compensation; 
(4) any agreement or arrangement described in 
section 203(a)(4) of the Labor-Management Report-
ing and Disclosure Act of 1959 (29 U.S.C. 
433(a)(4)); or 
(5) political or contributions prohibited under 
section 317 of the Federal Elections Campaign Act 
of 1971 (52 U.S.C. 30119(a)(1)). 
(c) PAYMENTS FOR CAPITAL EXPENDITURES.— 
(1) IN
GENERAL.—The Secretary shall pay, 
from amounts made available for capital expendi-
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tures pursuant to section 601(a)(2)(B), such sums 
determined appropriate by the Secretary to providers 
who have submitted an application to the regional 
director of the region or regions in which the pro-
vider operates or seeks to operate in a time and 
manner specified by the Secretary for purposes of 
funding capital expenditures of such providers. 
(2) PRIORITY.—The Secretary shall prioritize 
allocation of funding under paragraph (1) to 
projects that propose to use such funds to improve 
service in a medically underserved area (as defined 
in section 330(b)(3) of the Public Health Service 
Act (42 U.S.C. 254b(b)(3))) or to address health 
disparities, including racial, ethnic, national origin, 
primary language use, age, disability, sex (including 
gender identity and sexual orientation), geography, 
or socioeconomic health disparities. 
(3) LIMITATION.—The Secretary shall not 
grant funding for capital expenditures under this 
subsection for capital projects that are financed di-
rectly or indirectly through the diversion of private 
or other non-Medicare for All Program funding that 
results in reductions in care to patients, including 
reductions in registered nursing staffing patterns 
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and changes in emergency room or primary care 
services or availability. 
(4) CAPITAL
ASSETS
NOT
FUNDED
BY
THE 
MEDICARE FOR ALL PROGRAM.—Operating expenses 
and funds shall not be used by an institutional pro-
vider receiving payment for capital expenditures 
under this subsection for a capital asset that was 
not funded by the Medicare for All program without 
the approval of the regional director or directors of 
the region or regions where the capital asset is lo-
cated. 
(d) PROHIBITION AGAINST CO-MINGLING OPER-
ATING AND CAPITAL FUNDS.—Providers that receive pay-
ment under this title shall be prohibited from using, with 
respect to funds made available under this Act— 
(1) funds designated for operating expenditures 
for capital expenditures or for profit; or 
(2) funds designated for capital expenditures 
for operating expenditures. 
(e) PAYMENTS FOR SPECIAL PROJECTS.— 
(1) IN GENERAL.—The Secretary shall allocate 
to each regional director, from amounts made avail-
able for special projects pursuant to section 
601(a)(2)(C), such sums determined appropriate by 
the Secretary for purposes of funding projects de-
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scribed in such section, including the construction, 
renovation, or staffing of health care facilities, in 
rural, underserved, or health professional or medical 
shortage areas within such region and to address 
health disparities, including racial, ethnic, national 
origin, primary language use, age, disability, sex, in-
cluding gender identity and sexual orientation, geog-
raphy, or socioeconomic health disparities. Each re-
gional director shall, prior to distributing such funds 
in accordance with paragraph (2), present a budget 
describing how such funds will be distributed to the 
Secretary. 
(2) DISTRIBUTION.—A regional director shall 
distribute funds to providers operating in the region 
of such director’s jurisdiction in a manner deter-
mined appropriate by the director. 
(f) 
PROHIBITION
ON
FINANCIAL
INCENTIVE 
METRICS
IN
PAYMENT
DETERMINATIONS.—The Sec-
retary may not utilize any quality metrics or standards 
for the purposes of establishing provider payment meth-
odologies, programs, modifiers, or adjustments for pro-
vider payments under this title. 
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SEC. 615. OFFICE OF HEALTH EQUITY. 
Title XVII of the Public Health Service Act (42 
U.S.C. 300u et seq.) is amended by adding at the end 
the following: 
‘‘SEC. 1712. OFFICE OF HEALTH EQUITY. 
‘‘(a) IN GENERAL.—There is established, in the Of-
fice of the Secretary of Health and Human Services, an 
Office of Health Equity, to be headed by a Director, to 
ensure coordination and collaboration across the programs 
and activities of the Department of Health and Human 
Services with respect to ensuring health equity. 
‘‘(b) MONITORING, TRACKING, AND AVAILABILITY OF 
DATA.— 
‘‘(1) IN GENERAL.—In carrying out subsection 
(a), the Director of the Office of Health Equity shall 
monitor, track, and make publicly available data 
on— 
‘‘(A) the disproportionate burden of dis-
ease and death among people of color, 
disaggregated by race, major ethnic group, 
Tribal affiliation, national origin, primary lan-
guage use, English proficiency status, immigra-
tion status, length of stay in the United States 
age, disability, sex (including gender identity 
and sexual orientation), incarceration, home-
lessness, geography, and socioeconomic status; 
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‘‘(B) barriers to health, including such 
barriers relating to income, education, housing, 
food insecurity (including availability, access, 
utilization, and stability), employment status, 
working conditions, and conditions related to 
the physical environment (including pollutants 
and population density); 
‘‘(C) barriers to health care access, includ-
ing— 
‘‘(i) lack of trust and awareness; 
‘‘(ii) lack of transportation; 
‘‘(iii) geography; 
‘‘(iv) hospital and service closures; 
‘‘(v) lack of health care infrastructure 
and facilities; and 
‘‘(vi) lack of health care professional 
staffing and recruitment; 
‘‘(D) disparities in quality of care received, 
including discrimination in health care settings 
and the use of racially-biased practice guide-
lines and algorithms; and 
‘‘(E) disparities in utilization of care. 
‘‘(2) ANALYSIS OF CROSS-SECTIONAL INFORMA-
TION.—The Director of the Office of Health Equity 
shall ensure that the data collection and reporting 
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process under paragraph (1) allows for the analysis 
of cross-sectional information on people’s identities. 
‘‘(c) POLICIES.—In carrying out subsection (a), the 
Director of the Office of Health Equity shall develop, co-
ordinate, and promote policies that enhance health equity, 
including by— 
‘‘(1) providing recommendations on— 
‘‘(A) cultural competence, implicit bias, 
and ethics training with respect to health care 
workers; 
‘‘(B) increasing diversity in the health care 
workforce; and 
‘‘(C) ensuring sufficient health care profes-
sionals and facilities; and 
‘‘(2) ensuring adequate public health funding at 
the local and State levels to address health dispari-
ties. 
‘‘(d) CONSULTATION.—In carrying out subsection 
(a), the Director of the Office of Health Equity, in coordi-
nation with the Director of the Indian Health Service, 
shall consult with Indian Tribes and with Urban Indian 
organizations on data collection, reporting, and implemen-
tation of policies. 
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100 
than amounts attributable to any pre-
miums under such title). 
(ii) The Medicaid program under 
State plans approved under title XIX of 
such Act. 
(iii) The Federal Employees Health 
Benefits program, under chapter 89 of title 
5, United States Code. 
(iv) The purchased care component of 
the TRICARE program, under chapter 55 
of title 10, United States Code (other than 
amounts appropriated for the purchased 
care component of the TRICARE Overseas 
Program). 
(v) The maternal and child health 
program (under title V of the Social Secu-
rity Act), vocational rehabilitation pro-
grams, programs for drug abuse and men-
tal health services under the Public Health 
Service Act, programs providing general 
hospital or medical assistance, and any 
other Federal program identified by the 
Secretary, in consultation with the Sec-
retary of the Treasury, to the extent the 
programs provide for payment for health 
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