I 
116TH CONGRESS 
1ST SESSION H. R. 4830 
To provide payment for patient navigator services under title XIX of the 
Social Security Act, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 23, 2019 
Mr. DESAULNIER (for himself and Mr. CARTER of Georgia) introduced the 
following bill; which was referred to the Committee on Energy and Commerce 
A BILL 
To provide payment for patient navigator services under title 
XIX of the Social Security Act, and for other purposes. 
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 ‘‘Patient Navigation As-
sistance Act’’. 
SEC. 2. MEDICAID COVERAGE FOR PATIENT NAVIGATOR 
SERVICES. 
(a) IN GENERAL.—Section 1902(a) of the Social Se-
curity Act (42 U.S.C. 1396a(a)) is amended— 
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(1) in paragraph (82), by striking ‘‘and’’ at the 
end; 
(2) in paragraph (83), by striking at the end 
the period and inserting ‘‘; and’’; and 
(3) by inserting after paragraph (83) the fol-
lowing new paragraph: 
‘‘(84) provide that the State shall reimburse an 
eligible entity (as defined in subsection (nn)(1)) for 
any patient navigator service (as defined in sub-
section (nn)(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 (nn)(2)) through the eligible entity.’’; 
and 
(4) by adding at the end the following new sub-
section: 
‘‘(nn) PATIENT
NAVIGATOR
SERVICES
DEFINI-
TIONS.—For purposes of this section: 
‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible en-
tity’ means an entity that— 
‘‘(A) is an eligible entity (as defined in 
subsection (l)(1) of section 340A of the Public 
Health Service Act); and 
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‘‘(B) complies with the following require-
ments of such section (insofar as they apply to 
a grant recipient under such section): 
‘‘(i) Subsection (b) (relating to patient 
navigator duties and community knowl-
edge). 
‘‘(ii) Subsection (c) (relating to prohi-
bitions). 
‘‘(iii) Subsection (e) (relating to appli-
cations). 
‘‘(iv) Subsection (j)(3) (relating to re-
ports). 
‘‘(2) PATIENT NAVIGATOR.— 
‘‘(A) IN
GENERAL.—The term ‘patient 
navigator’ has the meaning given such term in 
section 340A(l)(3) of the Public Health Service 
Act. 
‘‘(B) CONSULTATION WITH ADVISORY COM-
MITTEE.— 
‘‘(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’ for purposes of this sec-
tion, including establishing requirements to 
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ensure adequate training for such naviga-
tors, such as developing a training cur-
riculum and determining required quali-
fications and maintenance of qualifications. 
‘‘(ii) MEMBERSHIP.—The Secretary 
shall convene a patient navigation advisory 
committee. The members of such com-
mittee shall include— 
‘‘(I) representatives from relevant 
Federal departments and agencies, in-
cluding the National Institutes of 
Health, the Centers for Disease Con-
trol and Prevention, the Health Re-
sources and Services Administration, 
the Centers for Medicare & Medicaid 
Services, the Indian Health Service, 
and the Office of Rural Health Policy 
of the Department of Health and 
Human Services; and 
‘‘(II) physicians, nurses, stake-
holder groups, and other individuals 
and representatives of public and pri-
vate organizations with expertise in 
patient navigation. 
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‘‘(3) PATIENT
NAVIGATOR
SERVICES.—The 
term ‘patient navigator service’ means a service that 
is a duty specified under paragraphs (1) through (6) 
of subsection (b) of section 340A of the Public 
Health Service Act and that is provided by a patient 
navigator through an eligible entity.’’. 
(b) TREATMENT AS MEDICAL ASSISTANCE FOR PUR-
POSES OF FMAP.—Section 1905(a) of the Social Security 
Act (42 U.S.C. 1396d(a)) is amended— 
(1) in paragraph (28), by striking ‘‘and’’ at the 
end; 
(2) by redesignating paragraph (29) as para-
graph (30); and 
(3) by inserting after paragraph (28) the fol-
lowing new paragraph: 
‘‘(29) patient navigator services (as defined in 
section 1902(nn)(3)) that are provided in a manner 
that meets the requirements of section 1902(a)(84); 
and’’. 
(c) EFFECTIVE DATE.— 
(1) IN GENERAL.—Subject to paragraph (2), 
the amendments made by this section shall apply to 
patient navigator services provided after the first 
day of the first calendar year that begins after the 
date of enactment of this Act. 
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(2) EXCEPTION FOR STATE LEGISLATION.—In 
the case of a State plan under title XIX of the So-
cial Security Act, which the Secretary of Health and 
Human Services determines requires State legisla-
tion in order for the respective plan to meet any re-
quirement imposed by amendments made by this 
Act, the respective plan shall not be regarded as fail-
ing to comply with the requirements of such title 
solely on the basis of its failure to meet such an ad-
ditional requirement before the first day of the first 
calendar quarter beginning after the close of the 
first regular session of the State legislature that be-
gins 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. 
Æ 
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