140 
(5) share data with external organizations for 
research and quality improvement purposes, in com-
pliance with applicable Federal privacy laws. 
(h) REPORT.—Not later than 2 years after the date 
of enactment of this Act, and biennially thereafter, the 
Secretary shall submit to the appropriate committees of 
Congress a report on the effectiveness of data collection, 
analysis, and reporting on race, ethnicity, and primary 
language under the programs administered through title 
XVIII of the Social Security Act. The report shall evaluate 
the progress made with respect to the plan under sub-
section (c) or subsequent revisions thereto. 
(i) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section, 
such sums as may be necessary for each of fiscal years 
2008 through 2012. 
SEC. 232. ENSURING EFFECTIVE COMMUNICATION IN MEDI-
CARE. 
(a) ENSURING EFFECTIVE COMMUNICATION BY THE 
CENTERS FOR MEDICARE & MEDICAID SERVICES.— 
(1) STUDY ON MEDICARE PAYMENTS FOR LAN-
GUAGE
SERVICES.—The Secretary of Health and 
Human Services shall conduct a study that examines 
ways that Medicare should develop payment systems 
VerDate Aug 31 2005 
05:18 Jul 25, 2007
Jkt 059200
PO 00000
Frm 00140
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.IH
H3162
bajohnson on PROD1PC77 with BILLS
141 
for language services using the results of the dem-
onstration program conducted under section 233. 
(2) ANALYSES.— The study shall include an 
analysis of each of the following: 
(A) How to develop and structure appro-
priate payment systems for language services 
for all Medicare service providers. 
(B) The feasibility of adopting a payment 
methodology for on-site interpreters, including 
interpreters who work as independent contrac-
tors and interpreters who work for agencies 
that provide on-site interpretation, pursuant to 
which such interpreters could directly bill Medi-
care for services provided in support of physi-
cian office services for an LEP Medicare pa-
tient. 
(C) The feasibility of Medicare contracting 
directly with agencies that provide off-site inter-
pretation including telephonic and video inter-
pretation pursuant to which such contractors 
could directly bill Medicare for the services pro-
vided in support of physician office services for 
an LEP Medicare patient. 
(D) The feasibility of modifying the exist-
ing Medicare resource-based relative value scale 
VerDate Aug 31 2005 
05:18 Jul 25, 2007
Jkt 059200
PO 00000
Frm 00141
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.IH
H3162
bajohnson on PROD1PC77 with BILLS
142 
(RBRVS) by using adjustments (such as multi-
pliers or add-ons) when a patient is LEP. 
(E) How each of options described in a 
previous paragraph would be funded and how 
such funding would affect physician payments, 
a physician’s practice, and beneficiary cost- 
sharing. 
(3) VARIATION
IN
PAYMENT
SYSTEM
DE-
SCRIBED.—The payment systems described in sub-
section (b) may allow variations based upon types of 
service providers, available delivery methods, and 
costs for providing language services including such 
factors as— 
(A) the type of language services provided 
(such as provision of health care or health care 
related services directly in a non-English lan-
guage by a bilingual provider or use of an inter-
preter); 
(B) type of interpretation services provided 
(such as in-person, telephonic, video interpreta-
tion); 
(C) the methods and costs of providing 
language services (including the costs of pro-
viding language services with internal staff or 
VerDate Aug 31 2005 
05:18 Jul 25, 2007
Jkt 059200
PO 00000
Frm 00142
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.IH
H3162
bajohnson on PROD1PC77 with BILLS
143 
through contract with external independent con-
tractors and/or agencies); 
(D) providing services for languages not 
frequently encountered in the United States; 
and 
(E) providing services in rural areas. 
(4) REPORT.—The Secretary shall submit a re-
port on the study conducted under subsection (a) to 
appropriate committees of Congress not later than 1 
year after the expiration of the demonstration pro-
gram conducted under section 3. 
(b) HEALTH PLANS.—Section 1857(g)(1) of the So-
cial Security Act (42 U.S.C. 1395w–27(g)(1)) is amend-
ed— 
(1) by striking ‘‘or’’ at the end of subparagraph 
(F); 
(2) by adding ‘‘and’’ at the end of subpara-
graph (G); and 
(3) by inserting after subparagraph (G) the fol-
lowing new subparagraph: 
‘‘(H) fails substantially to provide lan-
guage services to limited English proficient 
beneficiaries enrolled in the plan that are re-
quired under law;’’. 
VerDate Aug 31 2005 
05:18 Jul 25, 2007
Jkt 059200
PO 00000
Frm 00143
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.IH
H3162
bajohnson on PROD1PC77 with BILLS
144 
SEC. 233. DEMONSTRATION TO PROMOTE ACCESS FOR 
MEDICARE BENEFICIARIES WITH LIMITED 
ENGLISH PROFICIENCY BY PROVIDING REIM-
BURSEMENT FOR CULTURALLY AND LINGUIS-
TICALLY APPROPRIATE SERVICES. 
(a) IN GENERAL.—Within one year after the date of 
the enactment of this Act the Secretary, acting through 
the Centers for Medicare & Medicaid Services, shall award 
24 3-year demonstration grants to eligible Medicare serv-
ice providers to improve effective communication between 
such providers and Medicare beneficiaries who are limited 
English proficient. The Secretary shall not authorize a 
grant larger than $500,000 over three years for any grant-
ee. 
(b) ELIGIBILITY; PRIORITY.— 
(1) ELIGIBILITY.—To be eligible to receive a 
grant under subsection (1) an entity shall— 
(A) be— 
(i) a provider of services under part A 
of title XVIII of the Social Security Act; 
(ii) a service provider under part B of 
such title; 
(iii) a part C organization offering a 
Medicare part C plan under part C of such 
title; or 
VerDate Aug 31 2005 
05:18 Jul 25, 2007
Jkt 059200
PO 00000
Frm 00144
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.IH
H3162
bajohnson on PROD1PC77 with BILLS
145 
(iv) a PDP sponsor of a prescription 
drug plan under part D of such title; and 
(B) prepare and submit to the Secretary 
an application, at such time, in such manner, 
and accompanied by such additional informa-
tion as the Secretary may require. 
(2) PRIORITY.— 
(A) DISTRIBUTION.—To the extent fea-
sible, in awarding grants under this section, the 
Secretary shall award— 
(i) 6 grants to providers of services 
described in paragraph (1)(A)(i); 
(ii) 6 grants to service providers de-
scribed in paragraph (1)(A)(ii); 
(iii) 6 grants to organizations de-
scribed in paragraph (1)(A)(iii); and 
(iv) 6 grants to sponsors described in 
paragraph (1)(A)(iv). 
(B) FOR
COMMUNITY
ORGANIZATIONS.— 
The Secretary shall give priority to applicants 
that have developed partnerships with commu-
nity organizations or with agencies with experi-
ence in language access. 
(C) VARIATION IN GRANTEES.—The Sec-
retary shall also ensure that the grantees under 
VerDate Aug 31 2005 
05:18 Jul 25, 2007
Jkt 059200
PO 00000
Frm 00145
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.IH
H3162
bajohnson on PROD1PC77 with BILLS