I 
117TH CONGRESS 
2D SESSION 
H. R. 7585 
To improve the health of minority individuals, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 26, 2022 
Ms. KELLY
of Illinois (for herself, Ms. ADAMS, Ms. NORTON, Mr. 
BUTTERFIELD, Ms. WILSON of Florida, Mr. PAYNE, Mr. BROWN of 
Maryland, Ms. SCHAKOWSKY, Mr. KAHELE, Mr. DANNY K. DAVIS of Illi-
nois, Ms. UNDERWOOD, Mr. TAKANO, Ms. MENG, Mr. GOMEZ, Mrs. 
HAYES, Mr. CARTER of Louisiana, Mr. HORSFORD, Ms. LEE of Cali-
fornia, Ms. MOORE of Wisconsin, Mr. LAWSON of Florida, Ms. JAYAPAL, 
Mrs. WATSON COLEMAN, Ms. TITUS, Mrs. LAWRENCE, Ms. CHU, Mr. 
JOHNSON of Georgia, Ms. VELA´ZQUEZ, Mr. EVANS, Mr. LOWENTHAL, 
Ms. BROWN of Ohio, Ms. PRESSLEY, Mr. RUSH, Mrs. BEATTY, Mr. 
CARBAJAL, Mr. CARSON, Ms. BARRAGA´N, Ms. BLUNT ROCHESTER, Ms. 
BONAMICI, Mr. CA´RDENAS, Mrs. CHERFILUS-MCCORMICK, Mr. CASTRO 
of Texas, Mrs. NAPOLITANO, Mr. SCHIFF, Ms. JOHNSON of Texas, Ms. 
SA´NCHEZ, Ms. STRICKLAND, Mr. LIEU, Mr. GREEN of Texas, Mr. 
MCEACHIN, Mr. SMITH of Washington, Mr. GALLEGO, Ms. CLARK of 
Massachusetts, Mr. SIRES, Mr. SAN NICOLAS, Ms. CLARKE of New York, 
Mr. GRIJALVA, Mr. RUIZ, Ms. PLASKETT, and Mr. MEEKS) introduced 
the following bill; which was referred to the Committee on Energy and 
Commerce, and in addition to the Committees on Agriculture, Oversight 
and Reform, Ways and Means, Education and Labor, the Judiciary, the 
Budget, Veterans’ Affairs, Natural Resources, Armed Services, Homeland 
Security, Financial Services, and Transportation and Infrastructure, for 
a period to be subsequently determined by the Speaker, in each case for 
consideration of such provisions as fall within the jurisdiction of the com-
mittee concerned 
A BILL 
To improve the health of minority individuals, and for other 
purposes. 
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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 ‘‘Health Equity and 
Accountability Act of 2022’’. 
SEC. 2. TABLE OF CONTENTS. 
The table of contents of this Act is as follows: 
Sec. 1. Short title. 
Sec. 2. Table of contents. 
Sec. 3. Findings. 
TITLE I—DATA COLLECTION AND REPORTING 
Sec. 1001. Strengthening data collection, improving data analysis, and expand-
ing data reporting. 
Sec. 1002. Elimination of prerequisite of direct appropriations for data collec-
tion and analysis. 
Sec. 1003. Collection of data for the Medicare program. 
Sec. 1004. Revision of HIPAA claims standards. 
Sec. 1005. National Center for Health Statistics. 
Sec. 1006. Disparities data collected by the Federal Government. 
Sec. 1007. Data collection and analysis grants to minority-serving institutions. 
Sec. 1008. Safety and effectiveness of drugs with respect to racial and ethnic 
background. 
Sec. 1009. Improving health data regarding Native Hawaiians and Pacific Is-
landers. 
Sec. 1010. Clarification of simplified administrative reporting requirement. 
Sec. 1011. Data collection regarding pandemic preparedness, testing, infections, 
and deaths. 
Sec. 1012. Commission on Ensuring Data for Health Equity. 
Sec. 1013. Task Force on Preventing Bias in AI and Algorithms. 
TITLE II—CULTURALLY AND LINGUISTICALLY APPROPRIATE 
HEALTH AND HEALTH CARE 
Sec. 2001. Definitions; findings. 
Sec. 2002. Improving access to services for individuals with limited English 
proficiency. 
Sec. 2003. Ensuring standards for culturally and linguistically appropriate 
services in health care. 
Sec. 2004. Culturally and linguistically appropriate health care in the Public 
Health Service Act. 
Sec. 2005. Pilot program for improvement and development of State medical 
interpreting services. 
Sec. 2006. Training tomorrow’s doctors for culturally and linguistically appro-
priate care: graduate medical education. 
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Sec. 2007. Federal reimbursement for culturally and linguistically appropriate 
services under the Medicare, Medicaid, and State Children’s 
Health Insurance Programs. 
Sec. 2008. Increasing understanding of and improving health literacy. 
Sec. 2009. Requirements for health programs or activities receiving Federal 
funds. 
Sec. 2010. Report on Federal efforts to provide culturally and linguistically ap-
propriate health care services. 
Sec. 2011. English instruction for individuals with limited English proficiency. 
Sec. 2012. Implementation. 
Sec. 2013. Language access services. 
Sec. 2014. Medically underserved populations. 
TITLE III—HEALTH WORKFORCE DIVERSITY 
Sec. 3001. Amendment to the Public Health Service Act. 
Sec. 3002. Hispanic-serving institutions, historically Black colleges and univer-
sities, historically Black professional or graduate institutions, 
Asian American and Native American Pacific Islander-serving 
institutions, Tribal Colleges, regional community-based organi-
zations, and national minority medical associations. 
Sec. 3003. Loan repayment program of Centers for Disease Control and Pre-
vention. 
Sec. 3004. Allied health workforce diversity. 
Sec. 3005. Cooperative agreements for online degree programs at schools of 
public health and schools of allied health. 
Sec. 3006. National Health Care Workforce Commission. 
Sec. 3007. Scholarship and fellowship programs. 
Sec. 3008. McNair Postbaccalaureate Achievement Program. 
Sec. 3009. Rules for determination of full-time equivalent residents for cost-re-
porting periods. 
Sec. 3010. Developing and implementing strategies for local health equity. 
Sec. 3011. Health Professions Workforce Fund. 
Sec. 3012. Future advancement of academic nursing. 
Sec. 3013. Findings; sense of Congress relating to graduate medical education. 
Sec. 3014. Career support for skilled, internationally educated health profes-
sionals. 
Sec. 3015. Study and report on strategies for increasing diversity. 
Sec. 3016. Conrad State 30 program; physician retention. 
Sec. 3017. National Hispanic Nurses Day. 
Sec. 3018. Expanding medical education. 
TITLE IV—IMPROVING HEALTH CARE ACCESS AND QUALITY 
Sec. 4000. Definition. 
Subtitle A—Reducing Barriers to Accessing Care 
Sec. 4001. Protecting protected areas. 
Sec. 4002. Repeal of requirement for documentation evidencing citizenship or 
nationality under the Medicaid program. 
Sec. 4003. Availability of basic assistance to lawfully present noncitizens. 
Sec. 4004. Improve affordability and reduce premium costs of health insurance 
for consumers. 
Sec. 4005. Removing citizenship and immigration barriers to access to afford-
able health care under the ACA. 
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Sec. 4006. Removing barriers to access to affordable health care for lawfully re-
siding immigrants under Medicaid and CHIP. 
Sec. 4007. Consistency in health insurance coverage for individuals with feder-
ally authorized presence, including deferred action. 
Sec. 4008. Study on the uninsured. 
Sec. 4009. Medicaid fallback coverage program for low-income adults in non- 
expansion States. 
Sec. 4010. Increase and extension of temporary enhanced FMAP for States 
which begin to expend amounts for certain mandatory individ-
uals. 
Subtitle B—Improvement of Coverage 
Sec. 4101. Medicaid in the territories. 
Sec. 4102. Extension of the supplemental security income program to Puerto 
Rico, the United States Virgin Islands, Guam, and American 
Samoa. 
Sec. 4103. Extension of Medicare secondary payer. 
Sec. 4104. Indian defined in title I of the Patient Protection and Affordable 
Care Act. 
Sec. 4105. Removing Medicare barrier to health care. 
Sec. 4106. Lowering Medicare premiums and prescription drug costs. 
Sec. 4107. Reducing cost-sharing, aligning income and resource eligibility tests, 
simplifying enrollment, and other program improvements for 
low-income beneficiaries. 
Sec. 4108. 100 percent FMAP for medical assistance provided by urban Indian 
organizations. 
Sec. 4109. 100 percent FMAP for medical assistance provided to a Native Ha-
waiian through a federally qualified health center or a Native 
Hawaiian health care system under the Medicaid program. 
Sec. 4110. Repeal of requirement for estate recovery under the Medicaid pro-
gram. 
Sec. 4111. Allow for suspension of Medicare benefits and premium liability for 
individuals who are incarcerated and provide a special enroll-
ment period around the date of release. 
Sec. 4112. Federal Employee Health Benefit Plans. 
Sec. 4113. Continuation of Medicaid income eligibility standard for pregnant 
individuals and infants. 
Subtitle C—Expansion of Access 
PART 1—GENERAL PROVISIONS 
Sec. 4201. Amendment to the Public Health Service Act. 
Sec. 4202. Border health grants. 
Sec. 4203. Critical access hospital improvements. 
Sec. 4204. Medicare remote monitoring pilot projects. 
Sec. 4205. Community health center collaborative access expansion. 
Sec. 4206. Facilitating the provision of telehealth services across State lines. 
Sec. 4207. Scoring of preventive health savings. 
Sec. 4208. Sense of Congress on Maintenance of Effort Provisions Regarding 
Children’s Health. 
Sec. 4209. Protection of the HHS Offices of Minority Health. 
Sec. 4210. Office of Minority Health in Veterans Health Administration of De-
partment of Veterans Affairs. 
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Sec. 4211. Study of DSH payments to ensure hospital access for low-income 
patients. 
Sec. 4212. Reauthorization of the Native Hawaiian Health Care Improvement 
Act. 
PART 2—RURAL 
Sec. 4221. Establishment of Rural Community Hospital (RCH) Program. 
Sec. 4222. Rural Health Quality Advisory Commission and demonstration 
projects. 
Sec. 4223. Rural health care services. 
PART 3—INDIAN COMMUNITIES 
Sec. 4231. Assistant Secretary of the Indian Health Service. 
Sec. 4232. Extension of full Federal medical assistance percentage to Indian 
health care providers. 
Sec. 4233. Conferring with urban Indian organizations. 
PART 4—PROVIDERS 
Sec. 4241. Availability of non-English language speaking providers. 
Sec. 4242. Access to essential community providers. 
Sec. 4243. Provider network adequacy in communities of color. 
PART 5—DENTAL 
Sec. 4251. Improving access to dental care. 
Sec. 4252. Oral health literacy and awareness campaign. 
Subtitle D—Advancing Health Equity Through Payment and Delivery Reform 
Sec. 4301. Sense of Congress. 
Sec. 4302. Centers for Medicare & Medicaid Services reporting and value-based 
programs. 
Sec. 4303. Development and testing of disparity reducing delivery and payment 
models. 
Sec. 4304. Diversity in Centers for Medicare and Medicaid consultation. 
Sec. 4305. Supporting safety net and community-based providers to compete in 
value-based payment systems. 
Subtitle E—Health Empowerment Zones 
Sec. 4401. Designation of health empowerment zones. 
Sec. 4402. Assistance to those seeking designation. 
Sec. 4403. Benefits of designation. 
Sec. 4404. Definition of Secretary. 
Sec. 4405. Authorization of appropriations. 
Subtitle F—Equitable Health Care For All 
Sec. 4501. Findings. 
Sec. 4502. Data collection and reporting. 
Sec. 4503. Requiring equitable health care in the hospital value-based pur-
chasing program. 
Sec. 4504. Provision of inequitable health care as a basis for permissive exclu-
sion from medicare and State health care programs. 
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Sec. 4505. Office for Civil Rights and Health Equity of the Department of 
Health and Human Services. 
Sec. 4506. Prohibiting discrimination in health care. 
Sec. 4507. Federal Health Equity Commission. 
Sec. 4508. Grants for hospitals to promote equitable health care and outcomes. 
Subtitle G—Investing in Equity 
Sec. 4601. Definitions. 
Sec. 4602. Strategy to incentivize health equity. 
Sec. 4603. Pay for Equity Advisory Council. 
TITLE V—IMPROVING HEALTH OUTCOMES FOR WOMEN, 
CHILDREN, AND FAMILIES 
Subtitle A—In General 
Sec. 5001. Grants to promote health for underserved communities. 
Subtitle B—Pregnancy Screening 
Sec. 5101. Pregnancy intention screening initiative demonstration program. 
Sec. 5102. Birth defects prevention, risk reduction, and awareness. 
Subtitle C—Pregnancy-Related Care 
Sec. 5201. Mothers and Offspring Mortality and Morbidity Awareness. 
Sec. 5202. MOMMIES. 
Sec. 5203. Justice for Incarcerated Moms. 
Sec. 5204. IMPACT to Save Moms Act. 
Sec. 5205. Protecting moms and babies against climate change. 
Sec. 5206. Tech to Save Moms. 
Sec. 5207. Social Determinants for Moms. 
Sec. 5208. Data to Save Moms. 
Sec. 5209. Kira Johnson Act. 
Sec. 5210. Moms Matter. 
Sec. 5211. Taskforce Recommending Improvements for Unaddressed Mental 
Perinatal & Postpartum Health (TRIUMPH) for New Moms. 
Sec. 5212. Protect Moms from Domestic Violence. 
Sec. 5213. Perinatal workforce. 
Sec. 5214. Midwives schools and programs expansion. 
Sec. 5215. Gestational diabetes. 
Sec. 5216. Consumer education campaign. 
Sec. 5217. Bibliographic database of systematic reviews for care of childbearing 
individuals and newborns. 
Sec. 5218. Development of interprofessional maternity care educational models 
and tools. 
Sec. 5219. Dissemination of the quality family planning guidelines. 
Subtitle D—Federal Agency Coordination on Maternal Health 
Sec. 5301. Interagency Coordinating Committee on the Promotion of Optimal 
Maternity Outcomes. 
Sec. 5302. Expansion of CDC Prevention Research Centers Program to include 
Centers on Optimal Maternity Outcomes. 
Sec. 5303. Expanding models to be tested by Center for Medicare and Medicaid 
Innovation to explicitly include maternity care and children’s 
health models. 
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Sec. 5304. Interagency update to the quality family planning guidelines. 
Subtitle E—Reproductive and Sexual Health 
Sec. 5401. Findings; sense of Congress on urgent barriers to abortion access 
and vital solutions. 
Sec. 5402. Emergency contraception education and information programs. 
Sec. 5403. Access to birth control duties of pharmacies to ensure provision of 
FDA-approved contraception. 
Sec. 5404. Real Education and Access for Healthy Youth. 
Sec. 5405. Compassionate assistance for rape emergencies. 
Sec. 5406. Menstrual Equity For All Act of 2021. 
Sec. 5407. Additional focus area for the Office on Women’s Health. 
Sec. 5408. Including services furnished by certain students, interns, and resi-
dents supervised by certified nurse midwives or certified mid-
wives within inpatient hospital services under Medicare. 
Sec. 5409. Grants to professional organizations and minority-serving institu-
tions to increase diversity in maternal, reproductive, and sexual 
health professionals. 
Subtitle F—Children’s Health 
Sec. 5501. CARING for Kids Act. 
Sec. 5502. End Diaper Need Act of 2021. 
Sec. 5503. Decreasing the risk factors for sudden unexpected infant death and 
sudden unexplained death in childhood. 
Subtitle G—Nutrition for Women, Children, Families 
Sec. 5601. Removing barriers to health care and nutrition assistance for chil-
dren, pregnant persons, and lawfully present individuals. 
Sec. 5602. Closing the meal gap. 
Sec. 5603. Repeal of denial of Supplemental Nutrition Assistance Program ben-
efits. 
Subtitle H—Universal School Meals Program 
Sec. 5701. Short title. 
Sec. 5702. Effective date. 
Sec. 5703. Free school breakfast program. 
Sec. 5704. Apportionment to States. 
Sec. 5705. Nutritional and other program requirements. 
Sec. 5706. Special assistance program. 
Sec. 5707. Price for a paid lunch. 
Sec. 5708. Summer food service program for children. 
Sec. 5709. Summer Electronic Benefit Transfer for Children Program. 
Sec. 5710. Child and adult care food program. 
Sec. 5711. Meals and supplements for children in afterschool care. 
Sec. 5712. Access to local foods: farm to school program. 
Sec. 5713. Fresh fruit and vegetable program. 
Sec. 5714. Training, technical assistance, and Food Service Management Insti-
tute. 
Sec. 5715. Reimbursement of school meal delinquent debt program. 
Sec. 5716. Conforming amendments. 
Sec. 5717. Measure of poverty. 
Sec. 5718. Supplemental nutrition assistance program. 
Sec. 5719. Higher Education Act of 1965. 
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Sec. 5720. Elementary and Secondary Education Act of 1965. 
Sec. 5721. America COMPETES Act. 
Sec. 5722. Workforce Innovation and Opportunity Act. 
Sec. 5723. National Science Foundation Authorization Act of 2002. 
Sec. 5724. Child care and development block grant. 
Sec. 5725. Children’s Health Act of 2000. 
Sec. 5726. Juvenile justice and delinquency prevention. 
Subtitle I—Elder Care 
Sec. 5801. Expenses for household and elder care services necessary for gainful 
employment. 
Subtitle J—Miscellaneous Provisions 
Sec. 5901. Clarification supporting permissible use of funds for stillbirth pre-
vention activities. 
TITLE VI—MENTAL HEALTH AND SUBSTANCE USE DISORDERS 
Sec. 6001. Mental health findings. 
Sec. 6002. Sense of Congress. 
Subtitle A—Access to Care and Funding Streams 
Sec. 6011. Coverage of marriage and family therapist services, mental health 
counselor services, substance abuse counselor services, and peer 
support specialist services under part B of the Medicare pro-
gram. 
Sec. 6012. Reauthorization of Minority Fellowship Program. 
Sec. 6013. Additional funds for National Institutes of Health. 
Sec. 6014. Additional funds for National Institute on Minority Health and 
Health Disparities. 
Sec. 6015. Grants for increasing racial and ethnic minority access to high-qual-
ity trauma support services and mental health care. 
Sec. 6016. Grants for unarmed 9–1–1 response programs. 
Subtitle B—Interprofessional Care 
Sec. 6021. Health professions competencies to address racial and ethnic mental 
health inequities. 
Sec. 6022. Interprofessional health care teams for behavioral health care. 
Sec. 6023. Integrated Health Care Demonstration Program. 
Subtitle C—Workforce Development 
Sec. 6031. Building an effective workforce in mental health. 
Sec. 6032. Pilot program to increase language access at Federally qualified 
health centers. 
Sec. 6033. Health professions competencies to address racial and ethnic minor-
ity mental health disparities. 
Subtitle D—Children’s Mental Health 
Sec. 6041. Pediatric behavioral health care. 
Sec. 6042. Mental health in schools. 
Sec. 6043. Additional support for youth and young adult mental health service 
provision. 
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Sec. 6044. Early intervention and prevention programs for transition-age 
youth. 
Sec. 6045. Strategies to increase access to telehealth under Medicaid and Chil-
dren’s Health Insurance Program. 
Sec. 6046. Youth and young adult mental health promotion, prevention, inter-
vention, and treatment. 
Sec. 6047. Study on the Effects of Smartphone and Social Media Use on Ado-
lescents. 
Subtitle E—Community-Based Care 
Sec. 6051. Mental health at the border. 
Sec. 6052. Asian American, African American, Native Hawaiian, Pacific Is-
lander, Indigenous, Middle Eastern and North African, and 
Hispanic and Latino behavioral and mental health outreach 
and education strategy. 
Subtitle F—Reports 
Sec. 6061. Addressing racial and ethnic mental health inequities research gaps. 
Sec. 6062. Research on adverse health effects associated with interactions with 
law enforcement. 
Sec. 6063. Geoaccess study. 
Sec. 6064. Cooccurring conditions. 
Sec. 6065. Technical correction. 
Subtitle G—Miscellaneous Provisions 
Sec. 6071. Children’s Mental Health Infrastructure Act. 
Sec. 6072. Mental Health for Latinos. 
Sec. 6073. Strengthening Mental Health Supports for BIPOC Communities. 
Sec. 6074. STRONG Support for Children. 
Sec. 6075. Improving access to mental health. 
Sec. 6076. Mental Health in Schools Excellence Program. 
Sec. 6077. School Social Workers Improving Student Success. 
Sec. 6078. Opioid grants to support caregivers, kinship care families, and kin-
ship caregivers. 
Sec. 6079. Advancing Student Services In Schools Today Act (ASSIST Act). 
TITLE VII—ADDRESSING HIGH IMPACT MINORITY DISEASES 
Subtitle A—Cancer 
Sec. 7001. Lung cancer mortality reduction. 
Sec. 7002. Expanding prostate cancer research, outreach, screening, testing, 
access, and treatment effectiveness. 
Sec. 7003. Prostate Research, Imaging, and Men’s Education (PRIME). 
Sec. 7004. Prostate cancer detection research and education. 
Sec. 7005. National Prostate Cancer Council. 
Sec. 7006. Improved Medicaid coverage for certain breast and cervical cancer 
patients in the territories. 
Sec. 7007. Cancer prevention and treatment demonstration for ethnic and ra-
cial minorities. 
Sec. 7008. Reducing cancer disparities within Medicare. 
Subtitle B—Viral Hepatitis and Liver Cancer Control and Prevention 
Sec. 7051. Viral hepatitis and liver cancer control and prevention. 
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Sec. 7052. Liver cancer and disease prevention, awareness, and patient track-
ing grants. 
Subtitle C—Acquired Bone Marrow Failure Diseases 
Sec. 7101. Acquired bone marrow failure diseases. 
Subtitle D—Cardiovascular Disease, Chronic Disease, Obesity, and Other 
Disease Issues 
Sec. 7151. Guidelines for disease screening for minority patients. 
Sec. 7152. CDC Wisewoman Screening Program. 
Sec. 7153. Report on cardiovascular care for women and minorities. 
Sec. 7154. Coverage of comprehensive tobacco cessation services in Medicaid, 
CHIP, and private health insurance. 
Sec. 7155. Clinical research funding for oral health. 
Sec. 7156. Guide on evidence-based strategies for public health department obe-
sity prevention programs. 
Sec. 7157. Stephanie Tubbs Jones Uterine Fibroid Research and Education 
Act. 
Subtitle E—HIV/AIDS 
Sec. 7201. Statement of policy. 
Sec. 7202. Findings. 
Sec. 7203. Additional funding for AIDS drug assistance program treatments. 
Sec. 7204. Enhancing the national HIV surveillance system. 
Sec. 7205. Evidence-based strategies for improving linkage to, and retention in, 
appropriate care. 
Sec. 7206. Improving entry into, and retention in, care and antiretroviral ad-
herence for persons with HIV. 
Sec. 7207. Services to reduce HIV/AIDS in racial and ethnic minority commu-
nities. 
Sec. 7208. Minority AIDS initiative. 
Sec. 7209. Health care professionals treating individuals with HIV. 
Sec. 7210. HIV/AIDS provider loan repayment program. 
Sec. 7211. Dental education loan repayment program. 
Sec. 7212. Reducing new HIV infections among injecting drug users. 
Sec. 7213. Report on impact of HIV/AIDS in vulnerable populations. 
Sec. 7214. National HIV/AIDS observance days. 
Sec. 7215. Review of all Federal and State laws, policies, and regulations re-
garding the criminal prosecution of individuals for HIV-related 
offenses. 
Sec. 7216. Expanding support for condoms in prisons. 
Sec. 7217. Automatic reinstatement or enrollment in Medicaid for people who 
test positive for HIV before reentering communities. 
Sec. 7218. Stop HIV in prison. 
Sec. 7219. Transfer of funds for implementation of Ending the HIV Epidemic: 
A Plan for America. 
Sec. 7220. PrEP access and coverage. 
Subtitle F—Diabetes 
Sec. 7251. Research, treatment, and education. 
Sec. 7252. Research, education, and other activities. 
Sec. 7253. Programs to educate health providers on the causes and effects of 
diabetes in minority populations. 
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Sec. 7254. Research, education, and other activities regarding diabetes in 
American Indian populations. 
Sec. 7255. Updated report on health disparities. 
Subtitle G—Lung Disease 
Sec. 7301. National asthma burden. 
Sec. 7302. Asthma-related activities of the Centers for Disease Control and 
Prevention. 
Sec. 7303. Influenza and pneumonia vaccination campaign. 
Sec. 7304. Chronic obstructive pulmonary disease. 
Subtitle H—Tuberculosis 
Sec. 7351. Elimination of all forms of tuberculosis. 
Sec. 7352. Additional funding for States in combating and eliminating tuber-
culosis. 
Sec. 7353. Strengthening clinical research funding for tuberculosis. 
Subtitle I—Osteoarthritis and Musculoskeletal Diseases 
Sec. 7401. Findings. 
Sec. 7402. Osteoarthritis and other musculoskeletal health-related activities of 
the Centers for Disease Control and Prevention. 
Sec. 7403. Grants for comprehensive osteoarthritis and musculoskeletal disease 
health education within health professions schools. 
Subtitle J—Sleep and Circadian Rhythm Disorders 
Sec. 7451. Short title; findings. 
Sec. 7452. Sleep and circadian rhythm disorders research activities of the Na-
tional Institutes of Health. 
Sec. 7453. Sleep and circadian rhythm health disparities-related activities of 
the Centers for Disease Control and Prevention. 
Sec. 7454. Grants for comprehensive sleep and circadian health education with-
in health professions schools. 
Sec. 7455. Report on impact of sleep and circadian health disorders in vulner-
able and racial/ethnic populations. 
Subtitle K—Kidney Disease Research, Surveillance, Prevention, and 
Treatment 
Sec. 7501. Kidney disease, research, surveillance, prevention, and treatment. 
Sec. 7502. Kidney disease research in minority populations. 
Sec. 7503. Kidney disease action plan. 
Sec. 7504. Home dialysis and increasing end-stage renal disease treatment mo-
dalities in minority communities action plan. 
Sec. 7505. Increasing kidney transplants in minority populations. 
Sec. 7506. Environmental and occupational health programs. 
Sec. 7507. Understanding the treatment patterns associated with providing 
care and treatment of kidney failure in minority populations. 
Sec. 7508. Improving access in underserved areas. 
Sec. 7509. The Jack Reynolds Memorial Medigap Expansion Act; Medigap cov-
erage for beneficiaries with end-stage renal disease. 
Subtitle L—Diversity in Clinical Trials 
Sec. 7551. FDA review of clinical trial best practices. 
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Sec. 7552. Diversifying Investigations Via Equitable Research Studies for Ev-
eryone Trials Act. 
Sec. 7553. Clinical trial diversity. 
Sec. 7554. Patient experience data. 
Subtitle M—Additional Provisions Addressing High Impact Minority Diseases 
Sec. 7601. Medicare coverage of multi-cancer early detection screening tests. 
Sec. 7602. Amputation Reduction and Compassion Act. 
Sec. 7603. Eliminating the coinsurance requirement for certain colorectal can-
cer screening tests furnished under the Medicare program. 
Sec. 7604. Expanding the availability of medical nutrition therapy services 
under the Medicare program. 
Sec. 7605. Encouraging the development and use of DISARM antimicrobial 
drugs. 
Sec. 7606. Treat and Reduce Obesity Act. 
Sec. 7607. Incentives, improvements, and outreach to increase diversity in Alz-
heimer’s disease research. 
TITLE VIII—HEALTH INFORMATION TECHNOLOGY 
Sec. 8001. Definitions. 
Subtitle A—Reducing Health Disparities Through Health IT 
Sec. 8101. HRSA assistance to health centers for promotion of Health IT. 
Sec. 8102. Assessment of impact of Health IT on racial and ethnic minority 
communities; outreach and adoption of Health IT in such com-
munities. 
Sec. 8103. Nondiscrimination and health equity in health information tech-
nology. 
Sec. 8104. Language access in health information technology. 
Subtitle B—Modifications To Achieve Parity in Existing Programs 
Sec. 8201. Extending funding to strengthen the Health IT infrastructure in ra-
cial and ethnic minority communities. 
Sec. 8202. Extending competitive grants for the development of loan programs 
to facilitate adoption of certified EHR technology by providers 
serving racial and ethnic minority groups. 
Sec. 8203. Authorization of appropriations. 
Subtitle C—Additional Research and Studies 
Sec. 8301. Data collection and assessments conducted in coordination with mi-
nority-serving institutions. 
Sec. 8302. Study of health information technology in medically underserved 
communities. 
Sec. 8303. Assessment of use and misuse of de-identified health data. 
Subtitle D—Closing Gaps in Funding To Adopt Certified EHRs 
Sec. 8401. Extending Medicaid EHR incentive payments to rehabilitation facili-
ties, long-term care facilities, and home health agencies. 
Sec. 8402. Extending physician assistant eligibility for Medicaid electronic 
health record incentive payments. 
Subtitle E—Expanding Access to Telehealth Services 
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Sec. 8501. Removing geographic requirements for telehealth services. 
Sec. 8502. Expanding originating sites. 
TITLE IX—ACCOUNTABILITY AND EVALUATION 
Sec. 9001. Prohibition on discrimination in Federal assisted health care serv-
ices and research on the basis of sex (including sexual orienta-
tion, gender identity, and pregnancy, including termination of 
pregnancy), race, color, national origin, marital status, familial 
status, or disability status. 
Sec. 9002. Treatment of Medicare payments under title VI of the Civil Rights 
Act of 1964. 
Sec. 9003. Accountability and transparency within the Department of Health 
and Human Services. 
Sec. 9004. United States Commission on Civil Rights. 
Sec. 9005. Sense of Congress concerning full funding of activities to eliminate 
racial and ethnic health disparities. 
Sec. 9006. GAO and NIH reports. 
Sec. 9007. Investigative and enforcement actions. 
Sec. 9008. Federal Health Equity Commission. 
TITLE X—ADDRESSING SOCIAL DETERMINANTS AND IMPROVING 
ENVIRONMENTAL JUSTICE 
Subtitle A—In General 
Sec. 10001. Definitions. 
Sec. 10002. Findings. 
Sec. 10003. Health impact assessments. 
Sec. 10004. Grant program to conduct environmental health improvement ac-
tivities and to improve social determinants of health. 
Sec. 10005. Additional research on the relationship between the built environ-
ment and the health of community residents. 
Sec. 10006. Environment and public health restoration. 
Sec. 10007. GAO report on health effects of Deepwater Horizon oil rig explo-
sion in the Gulf Coast. 
Sec. 10008. Establish an interagency counsel and grant programs on social de-
terminants of health. 
Sec. 10009. Correcting Hurtful and Alienating Names in Government Expres-
sion (CHANGE). 
Sec. 10010. Andrew Kearse Accountability for Denial of Medical Care. 
Sec. 10011. Investing in community healing. 
Sec. 10012. Environmental justice mapping and data collection. 
Sec. 10013. Antiracism in public health. 
Sec. 10014. LGBTQ essential data. 
Sec. 10015. Social determinants accelerator. 
Sec. 10016. Improving social determinants of health. 
Subtitle B—Gun Violence 
Sec. 10101. Reaffirming research authority of the Centers for Disease Control 
and Prevention. 
Sec. 10102. National Violent Death Reporting System. 
Sec. 10103. Report on effects of gun violence on public health. 
Sec. 10104. Report on effects of gun violence on mental health in minority 
communities. 
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SEC. 3. FINDINGS. 
The Congress finds as follows: 
(1) The population of racial and ethnic minori-
ties is expected to increase over the next few dec-
ades, yet racial and ethnic minorities have the poor-
est health status and face substantial cultural, so-
cial, and economic barriers to obtaining high-quality 
health care. 
(2) Health disparities are a function of not only 
access to health care, but also the social deter-
minants of health—including the environment, the 
physical structure of communities, nutrition and 
food options, educational attainment, employment, 
race, ethnicity, sex, geography, language preference, 
immigrant or citizenship status, sexual orientation, 
gender identity, socioeconomic status, or disability 
status—that directly and indirectly affect the health, 
health care, and wellness of individuals and commu-
nities. 
(3) Over the next few decades, the United 
States will face a shortage of health care providers 
and allied health workers. 
(4) All efforts to reduce health disparities and 
barriers to high-quality health services require better 
and more consistent data, and better and more con-
sistent collection of and access to data. 
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(5) A full range of culturally and linguistically 
appropriate health care and public health services 
must be available and accessible in every community. 
(6) Racial and ethnic minorities and under-
served populations must be included early and equi-
tably in health reform innovations. 
(7) Efforts to improve minority health have 
been limited by inadequate resources in funding, 
staffing, stewardship, and accountability. Targeted 
investments that are focused on disparities elimi-
nation must be made in providing care and services 
that are community-based, including prevention and 
policies addressing social determinants of health. 
(8) In 2011, the Department of Health and 
Human Services developed the HHS Action Plan to 
Reduce Racial and Ethnic Health Disparities and 
the National Stakeholder Strategy for Achieving 
Health Equity, which are 2 strategic plans that rep-
resent the first coordinated roadmap in the United 
States to reducing health disparities. These com-
prehensive plans, along with the National Prevention 
Strategy issued by the National Prevention Council 
of the Department of Health and Human Services, 
Healthy People 2030, and the National Quality 
Strategy of the Agency for Healthcare Research and 
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Quality, as well as critical resources such as the 
2012 National Healthcare Quality and Disparities 
Reports, will work to increase the number of people 
in the United States who are healthy at every stage 
of life. 
(9) The Secretary of Health and Human Serv-
ices has also reviewed and advanced updated clinical 
guidelines and developed other strategic planning 
documents to combat health disparities with a high 
impact on minority populations and to provide high- 
quality family planning services. Such guidelines and 
documents include the National HIV/AIDS Strategy, 
the Action Plan for the Prevention, Care, and Treat-
ment of Viral Hepatitis, and recommendations of the 
Centers for Disease Control and Prevention and the 
Office of Population Affairs. 
(10) The Patient Protection and Affordable 
Care Act (Public Law 111–148), as amended by the 
Health Care and Education Reconciliation Act (Pub-
lic Law 111–152), represents the biggest advance-
ment for minority health in the 40 years imme-
diately preceding the enactment of this Act. 
(11) The Health Information Technology for 
Educational and Clinical Health Act of 2009, part 
of the American Recovery and Reinvestment Act of 
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2009 (Public Law 111–5), provides that the nation-
wide health information exchange infrastructure be 
developed and used to reduce health disparities, 
among other purposes. 
TITLE I—DATA COLLECTION 
AND REPORTING 
SEC. 1001. STRENGTHENING DATA COLLECTION, IMPROV-
ING DATA ANALYSIS, AND EXPANDING DATA 
REPORTING. 
(a) AMENDMENTS TO THE PUBLIC HEALTH SERVICE 
ACT.— 
(1) PURPOSE.—The purpose of the amend-
ments made by this subsection is to promote cul-
turally and linguistically appropriate data collection, 
analysis, and reporting by race, ethnicity, sex, pri-
mary language, sexual orientation, disability status, 
gender identity, age, and socioeconomic status in 
federally supported health programs. 
(2) AHRQ GENERAL
AUTHORITIES.—Section 
902(a) of the Public Health Service Act (42 U.S.C. 
299a(a)) is amended— 
(A) in paragraph (8), by striking ‘‘and’’ at 
the end; 
(B) in paragraph (9), by striking the pe-
riod at the end and inserting ‘‘; and’’; and 
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(C) by adding at the end the following: 
‘‘(10) cultural and linguistic competence of 
health care services and of data collection activities 
described under section 3101.’’. 
(3) OFFICE
OF
MINORITY
HEALTH.—Section 
1707(g)(1) of the Public Health Service Act (42 
U.S.C. 300u–6(g)(1)) is amended by inserting ‘‘Mid-
dle 
Easterners 
and 
North 
Africans;’’ 
after 
‘‘Blacks;’’. 
(4) OFFICE OF THE NATIONAL COORDINATOR 
FOR HEALTH INFORMATION TECHNOLOGY.—Section 
3001 of the Public Health Service Act (42 U.S.C. 
300jj–11) is amended— 
(A) in subsection (b)— 
(i) in paragraph (10), by striking 
‘‘and’’ at the end; 
(ii) in paragraph (11), by striking the 
period at the end and inserting ‘‘; and’’; 
and 
(iii) by adding at the end the fol-
lowing: 
‘‘(12) ensures the interoperability of health in-
formation systems among federally conducted or 
supported health care or public health programs, 
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State health agencies, and social service agencies.’’; 
and 
(B) by amending clause (vii) in subsection 
(c)(3)(A) to read as follows: 
‘‘(vii) Strategies to enhance the use of 
health information technology in improving 
the quality of health care; reducing medical 
errors; reducing health disparities and en-
suring the provision of equitable health 
services; improving public health; increas-
ing prevention and coordination with com-
munity resources; ensuring interoperability 
among federally conducted or supported 
health care or public health programs, 
State health agencies, and social service 
agencies; and improving the continuity of 
care among health care settings.’’. 
(5) DATA COLLECTION, ANALYSIS, AND QUAL-
ITY.—Section 3101 of the Public Health Service Act 
(42 U.S.C. 300kk) is amended— 
(A) in subsections (a)(1)(A), (a)(1)(C), 
(a)(2)(B), and (a)(2)(E), by inserting ‘‘sexual 
orientation, gender identity, age,’’ before ‘‘and 
disability status’’; 
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(B) in subsection (a)(1), by amending sub-
paragraph (D) to read as follows: 
‘‘(D) data for additional population groups 
if such groups can be aggregated into the data 
collection standards described under paragraph 
(2).’’; 
(C) in subsection (a)(2)— 
(i) in subparagraph (C)— 
(I) in clause (i), by striking 
‘‘and’’ at the end; 
(II) in clause (ii)— 
(aa) by striking ‘‘is a minor 
or legally incapacitated’’ and in-
serting ‘‘is a minor, requires as-
sistance with communication in 
speech or writing, or is legally in-
capacitated’’; and 
(bb) by striking the semi-
colon at the end and inserting ‘‘; 
and’’; and 
(III) by adding at the end the 
following: 
‘‘(iii) collects data in a manner that is 
culturally and linguistically appropriate;’’; 
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(ii) in subparagraph (D)(iii), by strik-
ing ‘‘and’’ at the end; 
(iii) in subparagraph (E), by striking 
the period at the end and inserting ‘‘; 
and’’; and 
(iv) by adding at the end the fol-
lowing: 
‘‘(F) use, where practicable, the standards 
developed by the Health and Medicine Division 
of the National Academies of Sciences, Engi-
neering, and Medicine (formerly known as the 
‘Institute of Medicine’) in the 2009 publication 
titled ‘Race, Ethnicity, and Language Data: 
Standardization for Health Care Quality Im-
provement’.’’; and 
(D) in subsection (a)(3), by amending sub-
paragraph (B) to read as follows: 
‘‘(B) develop interoperability and security 
systems for data management among federally 
conducted and supported health care and public 
health programs, State health agencies, and so-
cial service agencies.’’. 
(b) COROLLARY PROVISIONS.— 
(1) RECOMMENDATIONS BY THE DATA COUN-
CIL.—The Data Council of the Department of 
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Health and Human Services, in consultation with 
the Director of the National Center for Health Sta-
tistics, the Deputy Assistant Secretary for Minority 
Health, the Deputy Assistant Secretary for Women’s 
Health, the Administrator of the Centers for Medi-
care & Medicaid, the head of the Office of the Na-
tional Coordinator for Health Information Tech-
nology, and other appropriate public and private en-
tities and officials, shall make recommendations to 
the Secretary of Health and Human Services con-
cerning how to— 
(A) implement the amendments made by 
this section, while minimizing the cost and ad-
ministrative burdens of data collection and re-
porting on all parties, including patients and 
providers; 
(B) expand awareness among Federal 
agencies, States, territories, Indian Tribes, 
counties, municipalities, health providers, health 
plans, and the general public that data collec-
tion, analysis, and reporting by race, ethnicity, 
sex, primary language, sexual orientation, gen-
der identity, age, socioeconomic status, and dis-
ability status is legal and necessary to ensure 
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equity and nondiscrimination in the quality of 
health care services; 
(C) ensure that future patient record sys-
tems follow Federal standards promulgated 
under the HITECH Act (42 U.S.C. 201 note) 
for the collection and meaningful use of elec-
tronic health data on race, ethnicity, sex, pri-
mary language, sexual orientation, gender iden-
tity, age, socioeconomic status, and disability 
status; 
(D) improve health and health care data 
collection and analysis for more population 
groups if such groups can be aggregated into 
minimum race and ethnicity categories, includ-
ing exploring the feasibility of enhancing collec-
tion efforts in States, counties, and municipali-
ties for racial and ethnic groups that comprise 
a significant proportion of the population of the 
State, county, or municipality; 
(E) provide researchers with greater access 
to racial, ethnic, primary language, sex, sexual 
orientation, gender identity, age, socioeconomic 
status, and disability status data, subject to all 
applicable privacy and confidentiality require-
ments, including HIPAA privacy and security 
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law as defined in section 3009 of the Public 
Health Service Act (42 U.S.C. 300jj–19); 
(F) ensure the cultural and linguistic com-
petence of entities that receive Federal support 
to collect and report data pursuant to the 
amendments made by subsection (a); and 
(G) safeguard and prevent the misuse of 
data collected under section 3101 of the Public 
Health Service Act (42 U.S.C. 300kk), as 
amended by subsection (a)(5). 
(2) RULES
OF
CONSTRUCTION.—Nothing in 
this section shall be construed to— 
(A) permit the use of information collected 
under this section or any provision amended by 
this section in a manner that would adversely 
affect any individual providing any such infor-
mation; or 
(B) diminish any requirements on health 
care providers to collect data, including such re-
quirements in effect on or after the date of en-
actment of this Act. 
(3) TECHNICAL ASSISTANCE FOR THE ANALYSIS 
OF
HEALTH
DISPARITY
DATA.—The Secretary of 
Health and Human Services, acting through the Di-
rector of the Agency for Healthcare Research and 
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Quality, and in coordination with the Assistant Sec-
retary for Planning and Evaluation, the Adminis-
trator of the Centers for Medicare & Medicaid Serv-
ices, the Director of the National Center for Health 
Statistics, the Director of the National Institutes of 
Health, and the head of the Office of the National 
Coordinator for Health Information Technology, 
shall provide technical assistance to agencies of the 
Department of Health and Human Services in meet-
ing Federal standards for health disparity data col-
lection and for analysis of racial, ethnic, and other 
disparities in health and health care in programs 
conducted or supported by such agencies by— 
(A) identifying appropriate quality assur-
ance mechanisms to monitor for health dispari-
ties; 
(B) specifying the clinical, diagnostic, or 
therapeutic measures which should be mon-
itored; 
(C) developing new quality measures relat-
ing to racial and ethnic disparities and their 
overlap with other disparity factors in health 
and health care; 
(D) identifying the level at which data 
analysis should be conducted; 
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(E) sharing data with external organiza-
tions for research and quality improvement pur-
poses; and 
(F) identifying and addressing issues relat-
ing to the interoperability of Federal- and 
State-level health information systems which 
undermine the ability of health-related pro-
grams collecting data under this section to 
achieve the purpose described in subsection 
(a)(1). 
(4) REFERENCES.—Except as otherwise speci-
fied, any reference to the term ‘‘racial and ethnic 
minority group’’ in any Federal regulation, guid-
ance, order, or document for establishment or imple-
mentation of any federally conducted or supported 
health care or public health program, activity, or 
survey shall be treated as having the definition given 
to such term in section 1707(g) of the Public Health 
Service Act (42 U.S.C. 300u–6(g)). 
(5) AUTHORIZATION OF APPROPRIATIONS.—To 
carry out this subsection, subsection (a), and the 
amendments made by subsection (a), there are au-
thorized to be appropriated such sums as may be 
necessary for each of fiscal years 2023 through 
2027. 
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(c) ADDITIONS TO THE PUBLIC HEALTH SERVICE 
ACT.—Title XXXIV of the Public Health Service Act, as 
added by titles II and III of this Act, is further amended 
by inserting after subtitle B the following: 
‘‘Subtitle 
C—Strengthening 
Data 
Collection, 
Improving 
Data 
Analysis, and Expanding Data 
Reporting 
‘‘SEC. 3431. ESTABLISHING GRANTS FOR DATA COLLECTION 
IMPROVEMENT ACTIVITIES. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Agency for Healthcare Research and 
Quality and in consultation with the Deputy Assistant 
Secretary for Minority Health, the Director of the Na-
tional Institutes of Health, the Assistant Secretary for 
Planning and Evaluation, the head of the Office of the 
National Coordinator for Health Information Technology, 
and the Director of the National Center for Health Statis-
tics, shall establish a technical assistance program under 
which the Secretary provides grants to eligible entities to 
assist such entities in complying with section 3101 of the 
Public Health Service Act. 
‘‘(b) TYPES
OF ASSISTANCE.—A grant provided 
under this section may be used to— 
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‘‘(1) enhance or upgrade computer technology 
that will facilitate collection, analysis, and reporting 
of racial, ethnic, primary language, sexual orienta-
tion, sex, gender identity, socioeconomic status, and 
disability status data; 
‘‘(2) improve methods for health data collection 
and analysis, including additional population groups 
if such groups can be aggregated into the race and 
ethnicity categories outlined by standards developed 
under section 3101; 
‘‘(3) develop mechanisms for submitting col-
lected data subject to any applicable privacy and 
confidentiality regulations; 
‘‘(4) develop educational programs to inform 
health plans, health providers, health-related agen-
cies, and the general public that data collection and 
reporting by race, ethnicity, primary language, sex-
ual orientation, sex, gender identity, disability sta-
tus, and socioeconomic status are legal and essential 
for eliminating health and health care disparities; 
and 
‘‘(5) develop educational programs to train 
health providers, health care organizations, health 
plans, health-related agencies, and frontline health 
care workers on how to collect and report 
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