698 
(2) in clause (ii), by striking the period at the 
end and inserting a semicolon; and 
(3) by inserting after clause (ii) the following 
new clauses: 
‘‘(iii) a rehabilitation facility (as defined in sec-
tion 1886(j)(1)) that furnishes acute or subacute re-
habilitation services; 
‘‘(iv) a long-term care hospital (as defined in 
section 1886(d)(1)(B)(iv)(I)); or 
‘‘(v) a home health agency (as defined in sec-
tion 1861(o)).’’. 
SEC. 842. EXTENDING PHYSICIAN ASSISTANT ELIGIBILITY 
FOR 
MEDICAID 
ELECTRONIC 
HEALTH 
RECORD INCENTIVE PAYMENTS. 
(a) IN GENERAL.—Section 1903(t)(3)(B)(v) of the 
Social Security Act (42 U.S.C. 1396b(t)(3)(B)(v)) is 
amended to read as follows: 
‘‘(v) physician assistant, in the case that 
the assistant is a primary care provider, includ-
ing an assistant who practices in a rural health 
clinic that is led by a physician assistant or 
practices in a federally qualified health center 
that is so led.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply with respect to amounts ex-
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pended under section 1903(a)(3)(F) of the Social Security 
Act (42 U.S.C. 1396b(a)(3)(F)) for calendar quarters be-
ginning on or after the date of the enactment of this Act. 
TITLE IX—ACCOUNTABILITY 
AND EVALUATION 
SEC. 901. PROHIBITION ON DISCRIMINATION IN FEDERAL 
ASSISTED HEALTH CARE SERVICES AND RE-
SEARCH PROGRAMS ON THE BASIS OF SEX, 
RACE, COLOR, NATIONAL ORIGIN, MARITAL 
STATUS, FAMILIAL STATUS, SEXUAL ORI-
ENTATION, 
GENDER 
IDENTITY, 
OR 
DIS-
ABILITY STATUS. 
(a) IN GENERAL.—No person in the United States 
shall, on the basis of sex, race, color, national origin, mar-
ital status, familial status, sexual orientation, gender iden-
tity, or disability status, be excluded from participation 
in, be denied the benefits of, or be subjected to discrimina-
tion under any health program or activity, including any 
health research program or activity, receiving Federal fi-
nancial assistance. 
(b) DEFINITION.—In this section, the term ‘‘familial 
status’’ means, with respect to one or more individuals— 
(1) being domiciled with any individual related 
by blood or affinity whose close association with the 
individual is the equivalent of a family relationship; 
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(2) being in the process of securing legal cus-
tody of any individual; or 
(3) being pregnant. 
SEC. 902. TREATMENT OF MEDICARE PAYMENTS UNDER 
TITLE VI OF THE CIVIL RIGHTS ACT OF 1964. 
A payment to a provider of services, physician, or 
other supplier under part B, C, or D of title XVIII of 
the Social Security Act shall be deemed a grant, and not 
a contract of insurance or guaranty, for the purposes of 
title VI of the Civil Rights Act of 1964. 
SEC. 903. ACCOUNTABILITY AND TRANSPARENCY WITHIN 
THE DEPARTMENT OF HEALTH AND HUMAN 
SERVICES. 
Title XXXIV of the Public Health Service Act, as 
amended by titles I, II, and III of this Act, is further 
amended by inserting after subtitle B the following: 
‘‘Subtitle C—Strengthening 
Accountability 
‘‘SEC. 3441. ELEVATION OF THE OFFICE OF CIVIL RIGHTS. 
‘‘(a) IN GENERAL.—The Secretary shall establish 
within the Office for Civil Rights an Office of Health Dis-
parities, which shall be headed by a director to be ap-
pointed by the Secretary. 
‘‘(b) PURPOSE.—The Office of Health Disparities 
shall ensure that the health programs, activities, and oper-
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ations of health entities which receive Federal financial as-
sistance are in compliance with title VI of the Civil Rights 
Act, which prohibits discrimination on the basis of race, 
color, or national origin. The activities of the Office shall 
include the following: 
‘‘(1) The development and implementation of 
an action plan to address racial and ethnic health 
care disparities, which shall address concerns relat-
ing to the Office for Civil Rights as released by the 
United States Commission on Civil Rights in the re-
port entitled ‘Health Care Challenge: Acknowledging 
Disparity, Confronting Discrimination, and Ensur-
ing Equity’ (September 1999) in conjunction with 
the reports by the Institute of Medicine entitled ‘Un-
equal Treatment: Confronting Racial and Ethnic 
Disparities in Health Care’, ‘Crossing the Quality 
Chasm: A New Health System for the 21st Cen-
tury’, ‘In the Nation’s Compelling Interest: Ensur-
ing Diversity in the Health Care Workforce’, ‘The 
National Partnership for Action to End Health Dis-
parities’, and ‘The Health of Lesbian, Gay, Bisexual, 
and Transgender People’, and other related reports 
by the Institute of Medicine. This plan shall be pub-
licly disclosed for review and comment and the final 
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plan shall address any comments or concerns that 
are received by the Office. 
‘‘(2) Investigative and enforcement actions 
against intentional discrimination and policies and 
practices that have a disparate impact on minorities. 
‘‘(3) The review of racial, ethnic, gender iden-
tity, sexual orientation, sex, disability status, socio-
economic status, and primary language health data 
collected by Federal health agencies to assess health 
care disparities related to intentional discrimination 
and policies and practices that have a disparate im-
pact on minorities. 
‘‘(4) Outreach and education activities relating 
to compliance with title VI of the Civil Rights Act. 
‘‘(5) The provision of technical assistance for 
health entities to facilitate compliance with title VI 
of the Civil Rights Act. 
‘‘(6) Coordination and oversight of activities of 
the civil rights compliance offices established under 
section 3442. 
‘‘(7) Ensuring— 
‘‘(A) at a minimum, compliance with the 
1997 Office of Management and Budget Stand-
ards for Maintaining, Collecting, and Pre-
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