(ii) RESPONDENT NOTICE.—The Di-
rector shall, not later than 30 days after 
receipt of such filing— 
(I) serve on the respondent a no-
tice of the complaint, together with a 
copy of the original complaint; and 
(II) advise the respondent of the 
procedural rights and obligations of 
respondents under this section. 
(iii) ANSWER.—The respondent may 
file, not later than 60 days after receipt of 
the notice from the Director, an answer to 
such complaint. 
(iv) INVESTIGATIVE DUTIES.—The Di-
rector shall— 
(I) make an investigation of the 
alleged inequitable provision of health 
care; and 
(II) complete such investigation 
within 180 days (unless it is impracti-
cable to complete such investigation 
within 180 days) after the filing of 
the complaint. 
(B) INVESTIGATIONS.— 
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(i) PATTERN
OR
PRACTICE.—In the 
course of investigating the complaint, the 
Director may seek records of care provided 
to patients other than the complainant if 
necessary to demonstrate or disprove an 
allegation of inequitable provision of health 
care or to determine whether there is a 
pattern or practice of such care. 
(ii) ACCOUNTING FOR SOCIAL DETER-
MINANTS
OF
HEALTH.—In investigating 
the complaint and reaching a determina-
tion on the validity of the complaint, the 
Director shall account for social deter-
minants of health and the effect of such 
social determinants on health care out-
comes. 
(iii) INABILITY TO COMPLETE INVES-
TIGATION.—If the Director is unable to 
complete (or finds it is impracticable to 
complete) the investigation within 180 
days after the filing of the complaint (or, 
if the Secretary takes further action under 
paragraph (6)(B) with respect to a com-
plaint, within 180 days after the com-
mencement of such further action), the Di-
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rector shall notify the complainant and re-
spondent in writing of the reasons in-
volved. 
(iv) REPORT
TO
STATE
LICENSING 
AUTHORITIES.—On concluding each inves-
tigation under this subparagraph, the Di-
rector shall provide to the State licensing 
authorities that were notified under sub-
paragraph (A), information specifying the 
results of the investigation. 
(C) REPORT.— 
(i) FINAL
REPORT.—On completing 
each investigation under this paragraph, 
the Director shall prepare a final investiga-
tive report. 
(ii) MODIFICATION
OF
REPORT.—A 
final report under this subparagraph may 
be modified if additional evidence is later 
discovered. 
(3) CONCILIATION.— 
(A) IN GENERAL.—During the period be-
ginning on the date on which a complaint is 
filed under this subsection and ending on the 
date of final disposition of such complaint (in-
cluding during an investigation under para-
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graph (2)(B)), the Director shall, to the extent 
feasible, engage in conciliation with respect to 
such complaint. 
(B) CONCILIATION
AGREEMENT.—A con-
ciliation agreement arising out of such concilia-
tion shall be an agreement between the re-
spondent and the complainant, and shall be 
subject to approval by the Director. 
(C) RIGHTS
PROTECTED.—The Director 
shall approve a conciliation agreement only if 
the agreement protects the rights of the com-
plainant and other persons similarly situated. 
(D) PUBLICLY AVAILABLE AGREEMENT.— 
(i) IN
GENERAL.—Subject to clause 
(ii), the Secretary shall make available to 
the public a copy of a conciliation agree-
ment entered into pursuant to this sub-
section unless the complainant and re-
spondent otherwise agree, and the Sec-
retary determines, that disclosure is not re-
quired to further the purposes of this sub-
section. 
(ii) 
LIMITATION.—A 
conciliation 
agreement that is made available to the 
public pursuant to clause (i) may not dis-
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close individually identifiable health infor-
mation. 
(4) FAILURE TO COMPLY WITH CONCILIATION 
AGREEMENT.—Whenever the Director has reason-
able cause to believe that a respondent has breached 
a conciliation agreement, the Director shall refer the 
matter to the Attorney General to consider filing a 
civil action to enforce such agreement. 
(5) WRITTEN
CONSENT
FOR
DISCLOSURE
OF 
INFORMATION.—Nothing said or done in the course 
of conciliation under this subsection may be made 
public, or used as evidence in a subsequent pro-
ceeding under this subsection, without the written 
consent of the parties to the conciliation. 
(6) PROMPT JUDICIAL ACTION.— 
(A) IN GENERAL.—If the Director deter-
mines at any time following the filing of a com-
plaint under this subsection that prompt judi-
cial action is necessary to carry out the pur-
poses of this subsection, the Director may rec-
ommend that the Attorney General promptly 
commence a civil action under subsection (d). 
(B) IMMEDIATE SUIT.—If the Director de-
termines at any time following the filing of a 
complaint under this subsection that the public 
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interest would be served by allowing the com-
plainant to bring a civil action under subsection 
(c) in a State or Federal court immediately, the 
Director shall certify that the administrative 
process has concluded and that the complainant 
may file such a suit immediately. 
(7) ANNUAL REPORT.—Not later than 1 year 
after the date of enactment of this Act, and annually 
thereafter, the Director shall make publicly available 
a report detailing the activities of the Office for Civil 
Rights and Health Equity under this subsection, in-
cluding— 
(A) the number of complaints filed and the 
basis on which the complaints were filed; 
(B) the number of investigations under-
taken as a result of such complaints; and 
(C) the disposition of all such investiga-
tions. 
(c) ENFORCEMENT BY PRIVATE PERSONS.— 
(1) IN GENERAL.— 
(A) CIVIL ACTION.— 
(i) IN
SUIT.—A complainant under 
subsection (b) may commence a civil action 
to obtain appropriate relief with respect to 
an alleged violation of subsection (a), or 
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for breach of a conciliation agreement 
under subsection (b), in an appropriate 
district court of the United States or State 
court— 
(I) not sooner than the earliest 
of— 
(aa) the date a conciliation 
agreement is reached under sub-
section (b); 
(bb) the date of a final dis-
position of a complaint under 
subsection (b); or 
(cc) 180 days after the first 
day of the alleged violation; and 
(II) not later than 2 years after 
the final day of the alleged violation. 
(ii) STATUTE OF LIMITATIONS.—The 
computation of such 2-year period shall 
not include any time during which an ad-
ministrative proceeding (including inves-
tigation or conciliation) under subsection 
(b) was pending with respect to a com-
plaint under such subsection. 
(B) BARRING SUIT.—If the Director has 
obtained a conciliation agreement under sub-
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section (b) regarding an alleged violation of 
subsection (a), no action may be filed under 
this paragraph by the complainant involved 
with respect to the alleged violation except for 
the purpose of enforcing the terms of such an 
agreement. 
(2) RELIEF WHICH MAY BE GRANTED.— 
(A) IN GENERAL.—In a civil action under 
paragraph (1), if the court finds that a viola-
tion of subsection (a) or breach of a conciliation 
agreement has occurred, the court may award 
to the plaintiff actual and punitive damages, 
and may grant as relief, as the court deter-
mines to be appropriate, any permanent or tem-
porary injunction, temporary restraining order, 
or other order (including an order enjoining the 
defendant from engaging in a practice violating 
subsection (a) or ordering such affirmative ac-
tion as may be appropriate). 
(B) FEES AND COSTS.—In a civil action 
under paragraph (1), the court, in its discre-
tion, may allow the prevailing party, other than 
the United States, a reasonable attorney’s fee 
and costs. The United States shall be liable for 
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such fees and costs to the same extent as a pri-
vate person. 
(3) INTERVENTION BY ATTORNEY GENERAL.— 
Upon timely application, the Attorney General may 
intervene in a civil action under paragraph (1), if 
the Attorney General certifies that the case is of 
general public importance. 
(d) ENFORCEMENT BY THE ATTORNEY GENERAL.— 
(1) COMMENCEMENT OF ACTIONS.— 
(A) PATTERN OR PRACTICE CASES.—The 
Attorney General may commence a civil action 
in any appropriate district court of the United 
States if the Attorney General has reasonable 
cause to believe that any health care provider 
covered by subsection (a)— 
(i) is engaged in a pattern or practice 
that violates such subsection; or 
(ii) is engaged in a violation of such 
subsection that raises an issue of signifi-
cant public importance. 
(B) CASES BY REFERRAL.—The Director 
may determine, based on a pattern of com-
plaints, a pattern of violations, a review of data 
reported by a health care provider covered by 
subsection (a), or any other means, that there 
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is reasonable cause to believe a health care pro-
vider is engaged in a pattern or practice that 
violates subsection (a). If the Director makes 
such a determination, the Director shall refer 
the related findings to the Attorney General. If 
the Attorney General finds that such reasonable 
cause exists, the Attorney General may com-
mence a civil action in any appropriate district 
court of the United States. 
(2) ENFORCEMENT OF SUBPOENAS.—The At-
torney General, on behalf of the Director, or another 
party at whose request a subpoena is issued under 
this subsection, may enforce such subpoena in ap-
propriate proceedings in the district court of the 
United States for the district in which the person to 
whom the subpoena was addressed resides, was 
served, or transacts business. 
(3) RELIEF WHICH MAY BE GRANTED IN CIVIL 
ACTIONS.— 
(A) IN GENERAL.—In a civil action under 
paragraph (1), the court— 
(i) may award such preventive relief, 
including a permanent or temporary in-
junction, temporary restraining order, or 
other order against the person responsible 
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for a violation of subsection (a) as is nec-
essary to assure the full enjoyment of the 
rights granted by this subsection; 
(ii) may award such other relief as the 
court determines to be appropriate, includ-
ing monetary damages, to aggrieved per-
sons; and 
(iii) may, to vindicate the public inter-
est, assess punitive damages against the 
respondent— 
(I) in an amount not exceeding 
$500,000, for a first violation; and 
(II) in an amount not exceeding 
$1,000,000, for any subsequent viola-
tion. 
(B) FEES AND COSTS.—In a civil action 
under this subsection, the court, in its discre-
tion, may allow the prevailing party, other than 
the United States, a reasonable attorney’s fee 
and costs. The United States shall be liable for 
such fees and costs to the extent provided by 
section 2412 of title 28, United States Code. 
(4) INTERVENTION IN CIVIL ACTIONS.—Upon 
timely application, any person may intervene in a 
civil action commenced by the Attorney General 
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under paragraphs (1) and (2) if the action involves 
an alleged violation of subsection (a) with respect to 
which such person is an aggrieved person (including 
a person who is a complainant under subsection (b)) 
or a conciliation agreement to which such person is 
a party. 
(e) DEFINITIONS.—In this section: 
(1) AGGRIEVED PERSON.—The term ‘‘aggrieved 
person’’ means— 
(A) a person who believes that the person 
was or will be injured in violation of subsection 
(a); or 
(B) the personal representative or estate of 
a deceased person who was injured in violation 
of subsection (a). 
(2) DIRECTOR.—The term ‘‘Director’’ refers to 
the Director for Civil Rights and Health Equity of 
the Department of Health and Human Services. 
(3) DISABILITY.—The term ‘‘disability’’ has the 
meaning given such term in section 3 of the Ameri-
cans with Disabilities Act of 1990 (42 U.S.C. 
12102). 
(4) CONCILIATION.—The term ‘‘conciliation’’ 
means the attempted resolution of issues raised by 
a complaint, or by the investigation of such com-
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plaint, through informal negotiations involving the 
complainant, the respondent, and the Secretary. 
(5) CONCILIATION
AGREEMENT.—The term 
‘‘conciliation agreement’’ means a written agreement 
setting forth the resolution of the issues in concilia-
tion. 
(6) INDIVIDUALLY IDENTIFIABLE HEALTH IN-
FORMATION.—The term ‘‘individually identifiable 
health information’’ means any information, includ-
ing demographic information collected from an indi-
vidual— 
(A) that is created or received by a health 
care provider covered by subsection (a), health 
plan, employer, or health care clearinghouse; 
(B) that relates to the past, present, or fu-
ture physical or mental health or condition of, 
the provision of health care to, or the past, 
present, or future payment for the provision of 
health care to, the individual; and 
(C)(i) that identifies the individual; or 
(ii) with respect to which there is a reason-
able basis to believe that the information can be 
used to identify the individual. 
(7) PROVISION
OF
INEQUITABLE
HEALTH 
CARE.—The term provision of inequitable health 
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care means the provision of any health care service, 
by a health care provider in a manner that— 
(A) fails to meet a high-quality care stand-
ard, meaning the health care provider fails to— 
(i) avoid harm to patients as a result 
of the health services that are intended to 
help the patient; 
(ii) provide health services based on 
scientific knowledge to all and to all pa-
tients who benefit; 
(iii) refrain from providing services to 
patients not likely to benefit; 
(iv) provide care that is responsive to 
patient preferences, needs, and values; and 
(v) avoids waits or delays in care; and 
(B) is discriminatory in intent or effect 
based at least in part on a basis specified in 
subsection (a). 
(8) RESPONDENT.—The term ‘‘respondent’’ 
means the person or other entity accused in a com-
plaint of a violation of subsection (a). 
(9) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
(10) SOCIAL DETERMINANTS OF HEALTH.—The 
term ‘‘social determinants of health’’ means condi-
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tions in the environments in which individuals live, 
work, attend school, and worship, that affect a wide 
range of health, functioning, and quality-of-life out-
comes and risks. 
(f) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed as repealing or limiting the effect 
of title VI of the Civil Rights Act of 1964 (42 U.S.C. 
2000b et seq.), section 1557 of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18116), section 504 of 
the Rehabilitation Act of 1973 (29 U.S.C. 794), or the 
Age Discrimination Act of 1975 (42 U.S.C. 6101 et seq.). 
SEC. 8. FEDERAL HEALTH EQUITY COMMISSION. 
(a) ESTABLISHMENT OF COMMISSION.— 
(1) IN
GENERAL.—There is established the 
Federal Health Equity Commission (hereinafter in 
this section referred to as the ‘‘Commission’’). 
(2) MEMBERSHIP.— 
(A) IN GENERAL.—The Commission shall 
be composed of— 
(i) 8 voting members appointed under 
subparagraph (B); and 
(ii) the nonvoting, ex officio members 
listed in subparagraph (C). 
(B) VOTING MEMBERS.—Not more than 4 
of the members described in subparagraph 
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(A)(i) shall at any one time be of the same po-
litical party. Such members shall have recog-
nized expertise in and personal experience with 
racial and ethnic health inequities, health care 
needs of vulnerable and marginalized popu-
lations, and health equity as a vehicle for im-
proving health status and health outcomes. 
Such members shall be appointed to the Com-
mission as follows: 
(i) Four members of the Commission 
shall be appointed by the President. 
(ii) Two members of the Commission 
shall be appointed by the President pro 
tempore of the Senate, upon the rec-
ommendations of the majority leader and 
the minority leader of the Senate. Each 
member appointed to the Commission 
under this clause shall be appointed from 
a different political party. 
(iii) Two members of the Commission 
shall be appointed by the Speaker of the 
House of Representatives upon the rec-
ommendations of the majority leader and 
the minority leader of the House of Rep-
resentatives. Each member appointed to 
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the Commission under this clause shall be 
appointed from a different political party. 
(C) EX OFFICIO MEMBER.—The Commis-
sion shall have the following nonvoting, ex offi-
cio members: 
(i) The Director for Civil Rights and 
Health Equity of the Department of 
Health and Human Services. 
(ii) The Deputy Assistant Secretary 
for Minority Health of the Department of 
Health and Human Services. 
(iii) The Director of the National In-
stitute on Minority Health and Health Dis-
parities. 
(iv) The Chairperson of the Advisory 
Committee on Minority Health established 
under section 1707(c) of the Public Health 
Service Act (42 U.S.C. 300u–6(c)). 
(3) TERMS.—The term of office of each mem-
ber appointed under paragraph (2)(B) of the Com-
mission shall be 6 years. 
(4) CHAIRPERSON; VICE CHAIRPERSON.— 
(A) CHAIRPERSON.—The President shall, 
with the concurrence of a majority of the mem-
bers of the Commission appointed under para-
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graph (2)(B), designate a Chairperson from 
among the members of the Commission ap-
pointed under such paragraph. 
(B) VICE CHAIRPERSON.— 
(i) DESIGNATION.—The Speaker of 
the House of Representatives shall, in con-
sultation with the majority leaders and the 
minority leaders of the Senate and the 
House of Representatives and with the 
concurrence of a majority of the members 
of the Commission appointed under para-
graph (2)(B), designate a Vice Chairperson 
from among the members of the Commis-
sion appointed under such paragraph. The 
Vice Chairperson may not be a member of 
the same political party as the Chair-
person. 
(ii) DUTY.—The Vice Chairperson 
shall act in place of the Chairperson in the 
absence of the Chairperson. 
(5) REMOVAL
OF
MEMBERS.—The President 
may remove a member of the Commission only for 
neglect of duty or malfeasance in office. 
(6) QUORUM.—A majority of members of the 
Commission appointed under paragraph (2)(B) shall 
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constitute a quorum of the Commission, but a lesser 
number of members may hold hearings. 
(b) DUTIES OF THE COMMISSION.— 
(1) IN GENERAL.—The Commission shall— 
(A) monitor and report on the implementa-
tion of this Act; and 
(B) investigate, monitor, and report on 
progress towards health equity and the elimi-
nation of health disparities. 
(2) 
ANNUAL
REPORT.—The 
Commission 
shall— 
(A) submit to the President and Congress 
at least one report annually on health equity 
and health disparities; and 
(B) include in such report— 
(i) a description of actions taken by 
the Department of Health and Human 
Services and any other Federal agency re-
lated to health equity or health disparities; 
and 
(ii) recommendations on ensuring eq-
uitable health care and eliminating health 
disparities. 
(c) POWERS.— 
(1) HEARINGS.— 
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(A) IN GENERAL.—The Commission or, at 
the direction of the Commission, any sub-
committee or member of the Commission, may, 
for the purpose of carrying out this section, as 
the Commission or the subcommittee or mem-
ber considers advisable— 
(i) hold such hearings, meet and act 
at such times and places, take such testi-
mony, receive such evidence, and admin-
ister such oaths; and 
(ii) require, by subpoena or otherwise, 
the attendance and testimony of such wit-
nesses and the production of such books, 
records, correspondence, memoranda, pa-
pers, documents, tapes, and materials. 
(B) 
LIMITATION
ON
HEARINGS.—The 
Commission may hold a hearing under subpara-
graph (A)(i) only if the hearing is approved— 
(i) by a majority of the members of 
the Commission appointed under sub-
section (a)(2)(B); or 
(ii) by a majority of such members 
present at a meeting when a quorum is 
present. 
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(2) ISSUANCE
AND
ENFORCEMENT
OF
SUB-
POENAS.— 
(A) ISSUANCE.—A subpoena issued under 
paragraph (1) shall— 
(i) bear the signature of the Chair-
person of the Commission; and 
(ii) be served by any person or class 
of persons designated by the Chairperson 
for that purpose. 
(B) ENFORCEMENT.—In the case of contu-
macy or failure to obey a subpoena issued 
under paragraph (1), the United States district 
court for the district in which the subpoenaed 
person resides, is served, or may be found may 
issue an order requiring the person to appear at 
any designated place to testify or to produce 
documentary or other evidence. 
(C) NONCOMPLIANCE.—Any failure to 
obey the order of the court may be punished by 
the court as a contempt of court. 
(3) WITNESS ALLOWANCES AND FEES.— 
(A) IN GENERAL.—Section 1821 of title 
28, United States Code, shall apply to a witness 
requested or subpoenaed to appear at a hearing 
of the Commission. 
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(B) EXPENSES.—The per diem and mile-
age allowances for a witness shall be paid from 
funds available to pay the expenses of the Com-
mission. 
(4) POSTAL SERVICES.—The Commission may 
use the United States mails in the same manner and 
under the same conditions as other agencies of the 
Federal Government. 
(5) GIFTS.—The Commission may accept, use, 
and dispose of gifts or donations of services or prop-
erty. 
(d) ADMINISTRATIVE PROVISIONS.— 
(1) STAFF.— 
(A) DIRECTOR.—There shall be a full-time 
staff director for the Commission who shall— 
(i) serve as the administrative head of 
the Commission; and 
(ii) be appointed by the Chairperson 
with the concurrence of the Vice Chair-
person. 
(B) OTHER
PERSONNEL.—The Commis-
sion may— 
(i) appoint such other personnel as it 
considers advisable, subject to the provi-
sions of title 5, United States Code, gov-
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erning appointments in the competitive 
service, and the provisions of chapter 51 
and subchapter III of chapter 53 of that 
title relating to classification and General 
Schedule pay rates; and 
(ii) may procure temporary and inter-
mittent services under section 3109(b) of 
title 5, United States Code, at rates for in-
dividuals not in excess of the daily equiva-
lent paid for positions at the maximum 
rate for GS–15 of the General Schedule 
under section 5332 of title 5, United 
States Code. 
(2) COMPENSATION OF MEMBERS.— 
(A) 
NON-FEDERAL
EMPLOYEES.—Each 
member of the Commission who is not an offi-
cer or employee of the Federal Government 
shall be compensated at a rate equal to the 
daily equivalent of the annual rate of basic pay 
prescribed for level IV of the Executive Sched-
ule under section 5315 of title 5, United States 
Code, for each day (including travel time) dur-
ing which the member is engaged in the per-
formance of the duties of the Commission. 
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(B) FEDERAL EMPLOYEES.—Each member 
of the Commission who is an officer or em-
ployee of the Federal Government shall serve 
without compensation in addition to the com-
pensation received for the services of the mem-
ber as an office or employee of the Federal 
Government. 
(C) TRAVEL EXPENSES.—A member of the 
Commission shall be allowed travel expenses, in-
cluding per diem in lieu of subsistence, at rates 
authorized for an employee of an agency under 
subchapter I of chapter 57 of title 5, United 
States Code, while away from the home or reg-
ular place of business of the member in the per-
formance of the duties of the Commission. 
(3) COOPERATION.—The Commission may se-
cure directly from any Federal department or agency 
such information as the Commission considers nec-
essary to carry out this Act. Upon request of the 
Chairman of the Commission, the head of such de-
partment or agency shall furnish such information to 
the Commission. 
(e) PERMANENT COMMISSION.—Section 14 of the 
Federal Advisory Committee Act (5 U.S.C. App.) shall not 
apply to the Commission. 
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(f) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated for fiscal year 2023 and 
each fiscal year thereafter such sums as may be necessary 
to carry out the duties of the Commission. 
SEC. 9. GRANTS FOR HOSPITALS TO PROMOTE EQUITABLE 
HEALTH CARE AND OUTCOMES. 
(a) IN GENERAL.—Not later than 180 days after the 
date of the enactment of this Act, the Secretary of Health 
and Human Services (in this section referred to as the 
‘‘Secretary’’) shall award grants to hospitals to promote 
equitable health care treatment and services, and reduce 
disparities in care and outcomes. 
(b) CONSULTATION.—In establishing the criteria for 
grants under this section and evaluating applications for 
such grants, the Secretary shall consult with the Director 
for Civil Rights and Health Equity of the Department of 
Health and Human Services. 
(c) USE OF FUNDS.—A hospital shall use funds re-
ceived from a grant under this section to establish or ex-
pand programs to provide equitable health care to all pa-
tients and to ensure equitable health care outcomes. Such 
uses may include— 
(1) providing explicit and implicit bias training 
to medical providers and staff; 
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(2) providing translation or interpretation serv-
ices for patients; 
(3) recruiting and training a diverse workforce; 
(4) tracking data related to care and outcomes; 
and 
(5) training on cultural sensitivity. 
(d) PRIORITY.—In awarding grants under this sec-
tion, the Secretary shall give priority to hospitals that 
have received disproportionate share hospital payments 
under section 1886(r) of the Social Security Act (42 
U.S.C. 1395ww(r)) or section 1923 of such Act (42 U.S.C. 
1396r–4) with respect to fiscal year 2021. 
(e) SUPPLEMENT, NOT SUPPLANT.—Grants awarded 
under this section shall be used to supplement, not sup-
plant, any nongovernment efforts, or other Federal, State, 
or local funds provided to a recipient. 
(f) EQUITABLE HEALTH CARE DEFINED.—The term 
‘‘equitable health care’’ has the meaning given such term 
in section 1886(b)(3)(B)(viii)(XIII)(cc) of the Social Secu-
rity Act (42 U.S.C. 1395ww(b)(3)(B)(viii)(XIII)(cc)), as 
added by section 4(a). 
(g) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
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such sums as may be necessary for each of fiscal years 
2023 through 2028. 
Æ 
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