‘‘(B) UNIFIED GRIEVANCES AND APPEALS 
PROCESS.— 
‘‘(i) IN
GENERAL.—Not later than 
April 1, 2020, the Secretary shall establish 
procedures, to the extent feasible as deter-
mined by the Secretary, unifying griev-
ances and appeals procedures under sec-
tions 
1852(f), 
1852(g), 
1902(a)(3), 
1902(a)(5), and 1932(b)(4) for items and 
services provided by specialized MA plans 
for special needs individuals described in 
subsection (b)(6)(B)(ii) under this title 
and title XIX. The Secretary shall solicit 
comment in developing such procedures 
from States, plans, beneficiaries and their 
representatives, and other relevant stake-
holders. With respect to items and services 
described in the previous sentence, appeals 
procedures established under this clause 
shall apply in place of otherwise applicable 
appeals procedures. 
‘‘(ii) PROCEDURES.—The procedures 
established under clause (i) shall be in-
cluded in the plan contract under para-
graph (3)(D) and shall— 
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‘‘(I) adopt the provisions for the 
enrollee that are most protective for 
the enrollee and, to the extent feasible 
as determined by the Secretary, are 
compatible with unified timeframes 
and consolidated access to external re-
view under an integrated process; 
‘‘(II) take into account dif-
ferences in State plans under title 
XIX to the extent necessary; 
‘‘(III) be easily navigable by an 
enrollee; and 
‘‘(IV) include the elements de-
scribed in clause (iii), as applicable. 
‘‘(iii) ELEMENTS
DESCRIBED.—Both 
unified appeals and unified grievance pro-
cedures shall include, as applicable, the fol-
lowing elements described in this clause: 
‘‘(I) Single written notification of 
all applicable grievances and appeal 
rights under this title and title XIX. 
For purposes of this subparagraph, 
the Secretary may waive the require-
ments under section 1852(g)(1)(B) 
when the specialized MA plan covers 
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items or services under this part or 
under title XIX. 
‘‘(II) Single pathways for resolu-
tion of any grievance or appeal related 
to a particular item or service pro-
vided by specialized MA plans for spe-
cial needs individuals described in 
subsection (b)(6)(B)(ii) under this 
title and title XIX. 
‘‘(III) Notices written in plain 
language and available in a language 
and format that is accessible to the 
enrollee, including in non-English lan-
guages that are prevalent in the serv-
ice area of the specialized MA plan. 
‘‘(IV) Unified timeframes for 
grievances and appeals processes, 
such as an individual’s filing of a 
grievance or appeal, a plan’s acknowl-
edgment and resolution of a grievance 
or appeal, and notification of decisions 
with respect to a grievance or appeal. 
‘‘(V) Requirements for how the 
plan must process, track, and resolve 
grievances and appeals, to ensure 
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beneficiaries are notified on a timely 
basis of decisions that are made 
throughout the grievance or appeals 
process and are able to easily deter-
mine the status of a grievance or ap-
peal. 
‘‘(iv) CONTINUATION
OF
BENEFITS 
PENDING APPEAL.—The unified procedures 
under clause (i) shall, with respect to all 
benefits under parts A and B and title 
XIX subject to appeal under such proce-
dures, incorporate provisions under current 
law and implementing regulations that pro-
vide continuation of benefits pending ap-
peal under this title and title XIX. 
‘‘(C) REQUIREMENT FOR UNIFIED GRIEV-
ANCES AND APPEALS.—For 2022 and subse-
quent years, the contract of a specialized MA 
plan for special needs individuals described in 
subsection (b)(6)(B)(ii) with a State Medicaid 
agency under paragraph (3)(D) shall require 
the use of unified grievances and appeals proce-
dures as described in subparagraph (B). 
‘‘(D) REQUIREMENTS FOR FULL INTEGRA-
TION FOR CERTAIN DUAL SNPS.— 
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‘‘(i) REQUIREMENT.—For 2021 and 
subsequent years, a specialized MA plan 
for special needs individuals described in 
subsection (b)(6)(B)(ii) shall meet one or 
more of the following requirements for in-
tegration of benefits under this title and 
title XIX: 
‘‘(I) Meet the requirements of a 
fully integrated plan described in sec-
tion 1853(a)(1)(B)(iv)(II) (other than 
the requirement that the plan have 
similar average levels of frailty, as de-
termined by the Secretary, as the 
PACE program). 
‘‘(II) Enter into a capitated con-
tract with the State Medicaid agency 
to provide long-term services and sup-
ports or behavioral health services, or 
both. 
‘‘(III) To the extent the State 
does not allow for or require such a 
specialized MA plan to enter into a 
capitated contract described in sub-
clause (II), enter into another type of 
integration arrangement, as deter-
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mined appropriate by the Secretary 
after consultation with stakeholders, 
such as by— 
‘‘(aa) entering into a con-
tract with the State that requires 
notifying the State in a timely 
manner of hospitalizations, emer-
gency room visits, and hospital or 
nursing home discharges of en-
rollees or otherwise requires shar-
ing data that would benefit the 
coordination of items and serv-
ices under this title and the State 
plan under title XIX; or 
‘‘(bb) being offered by a 
parent organization that also of-
fers a Medicaid managed care 
plan 
that 
provides 
long-term 
services and supports or behav-
ioral health services to the same 
enrollees as under such special-
ized MA plan. 
‘‘(ii) SANCTIONS.—For 2021 and sub-
sequent years, if the Secretary determines 
that a specialized MA plan fails to comply 
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with clause (i), the Secretary may provide 
for the application against the Medicare 
Advantage organization offering the plan 
any of the remedies described in section 
1857(g)(2).’’. 
(2) CONFORMING
AMENDMENT
TO
RESPON-
SIBILITIES
OF
FEDERAL
COORDINATED
HEALTH 
CARE OFFICE.—Section 2602(d) of Public Law 111– 
148 (42 U.S.C. 1315b(d)) is amended by adding at 
the end the following new paragraphs: 
‘‘(6) To act as a designated contact for States 
under subsection (f)(8)(A) of section 1859 of the So-
cial Security Act (42 U.S.C. 1395w–28) with respect 
to the integration of specialized MA plans for special 
needs 
individuals 
described 
in 
subsection 
(b)(6)(B)(ii) of such section. 
‘‘(7) To be responsible for developing regula-
tions and guidance related to the implementation of 
a unified grievance and appeals process as described 
in subparagraphs (B) and (C) of section 1859(f)(8) 
of the Social Security Act (42 U.S.C. 1395w– 
28(f)(8)). 
‘‘(8) To be responsible for developing regula-
tions and guidance related to the integration or 
alignment of policy and oversight under the Medi-
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care program under title XVIII of such Act and 
Medicaid program under title XIX of such Act re-
garding specialized MA plans for special needs indi-
viduals described in subsection (b)(6)(B)(ii) of such 
section 1859.’’. 
(c) IMPROVEMENTS
TO
SEVERE
OR
DISABLING 
CHRONIC CONDITION SNPS.— 
(1) CARE MANAGEMENT REQUIREMENTS.—Sec-
tion 1859(f)(5) of the Social Security Act (42 
U.S.C. 1395w–28(f)(5)) is amended— 
(A) by redesignating subparagraphs (A) 
and (B) as clauses (i) and (ii), respectively, and 
indenting appropriately; 
(B) in clause (ii), as redesignated by sub-
paragraph (B), by redesignating clauses (i) 
through (iii) as subclauses (I) through (III), re-
spectively, and indenting appropriately; 
(C) by striking ‘‘ALL SNPS.—The require-
ments’’ and inserting ‘‘ALL SNPS.— 
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (B), the requirements’’; and 
(D) by adding at the end the following new 
subparagraph: 
‘‘(B) IMPROVEMENTS
TO
CARE
MANAGE-
MENT
REQUIREMENTS
FOR
SEVERE
OR
DIS-
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ABLING CHRONIC CONDITION SNPS.—For 2020 
and subsequent years, in the case of a special-
ized MA plan for special needs individuals de-
scribed in subsection (b)(6)(B)(iii), the require-
ments described in this paragraph include the 
following: 
‘‘(i) The interdisciplinary team under 
subparagraph (A)(ii)(III) includes a team 
of providers with demonstrated expertise, 
including training in an applicable spe-
cialty, in treating individuals similar to the 
targeted population of the plan. 
‘‘(ii) Requirements developed by the 
Secretary to provide face-to-face encoun-
ters with individuals enrolled in the plan 
not less frequently than on an annual 
basis. 
‘‘(iii) As part of the model of care 
under clause (i) of subparagraph (A), the 
results of the initial assessment and an-
nual reassessment under clause (ii)(I) of 
such subparagraph of each individual en-
rolled in the plan are addressed in the indi-
vidual’s individualized care plan under 
clause (ii)(II) of such subparagraph. 
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‘‘(iv) As part of the annual evaluation 
and approval of such model of care, the 
Secretary shall take into account whether 
the plan fulfilled the previous year’s goals 
(as required under the model of care). 
‘‘(v) The Secretary shall establish a 
minimum benchmark for each element of 
the model of care of a plan. The Secretary 
shall only approve a plan’s model of care 
under this paragraph if each element of 
the model of care meets the minimum 
benchmark applicable under the preceding 
sentence.’’. 
(2) REVISIONS TO THE DEFINITION OF A SE-
VERE OR DISABLING CHRONIC CONDITIONS SPECIAL-
IZED NEEDS INDIVIDUAL.— 
(A) 
IN
GENERAL.—Section 
1859(b)(6)(B)(iii) of the Social Security Act 
(42 U.S.C. 1395w–28(b)(6)(B)(iii)) is amend-
ed— 
(i) by striking ‘‘who have’’ and insert-
ing ‘‘who— 
‘‘(I) before January 1, 2022, 
have’’; 
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(ii) in subclause (I), as added by 
clause (i), by striking the period at the end 
and inserting ‘‘; and’’; and 
(iii) by adding at the end the fol-
lowing new subclause: 
‘‘(II) on or after January 1, 
2022, have one or more capitated and 
medically complex chronic conditions 
that is life threatening or significantly 
limits overall health or function, have 
a high risk of hospitalization or other 
adverse health outcomes, and require 
intensive care coordination and that is 
listed under subsection (f)(9)(A).’’. 
(B) PANEL OF CLINICAL ADVISORS.—Sec-
tion 1859(f) of the Social Security Act (42 
U.S.C. 1395w–28(f)), as amended by subsection 
(b), is amended by adding at the end the fol-
lowing new paragraph: 
‘‘(9) LIST OF CONDITIONS FOR CLARIFICATION 
OF THE DEFINITION OF A SEVERE OR DISABLING 
CHRONIC
CONDITIONS
SPECIALIZED
NEEDS
INDI-
VIDUAL.— 
‘‘(A) IN
GENERAL.—Not later than De-
cember 31, 2020, and every 5 years thereafter, 
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the Secretary shall convene a panel of clinical 
advisors to establish and update a list of condi-
tions that meet each of the following criteria: 
‘‘(i) Conditions that meet the defini-
tion of a severe or disabling chronic condi-
tion under subsection (b)(6)(B)(iii) on or 
after January 1, 2022. 
‘‘(ii) Conditions that require prescrip-
tion drugs, providers, and models of care 
that are unique to the specific population 
of enrollees in a specialized MA plan for 
special needs individuals described in such 
subsection on or after such date and— 
‘‘(I) as a result of such special 
needs individuals with such a condi-
tion having access to and being en-
rolled in such a plan, as compared to 
access to and enrollment in other 
Medicare Advantage plans under this 
part, it is projected that such individ-
uals would improve health outcomes 
with respect to such condition, that 
such individuals would have reduced 
overall costs under this title, and that 
there would not be any increase in ex-
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penditures under this title for such in-
dividuals; or 
‘‘(II) have a low prevalence in the 
general population of beneficiaries 
under this title or a disproportionally 
high per-beneficiary cost under this 
title. 
‘‘(B) GAO STUDY ON HEALTH OUTCOMES 
OF
INDIVIDUALS
ENROLLED
IN
SPECIALIZED 
MA PLANS.—Not later than the date that is 3 
years after the date of the enactment of this 
paragraph, the Comptroller General of the 
United States shall conduct a study and submit 
to Congress a report on the extent to which 
health outcomes can be compared across spe-
cialized MA plans for special needs individuals 
(as defined in section 1859(b)(6)) and other 
Medicare Advantage plans under this part 
across similar populations, using existing meas-
ures and that identifies any potential limita-
tions where new measures may need to be de-
veloped for such population.’’. 
(d) QUALITY MEASUREMENT AT THE PLAN LEVEL 
FOR SNPS AND DETERMINATION OF FEASIBILITY OF 
QUALITY MEASUREMENT AT THE PLAN LEVEL FOR ALL 
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MA PLANS.—Section 1853(o) of the Social Security Act 
(42 U.S.C. 1395w–23(o)) is amended by adding at the end 
the following new paragraphs: 
‘‘(6) QUALITY
MEASUREMENT
AT
THE
PLAN 
LEVEL FOR SNPS.— 
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (B), the Secretary may require reporting 
of data under section 1852(e) for, and apply 
under this subsection, quality measures at the 
plan level for specialized MA plans for special 
needs individuals instead of at the contract 
level. 
‘‘(B) CONSIDERATIONS.—Prior to applying 
quality measurement at the plan level under 
this paragraph, the Secretary shall— 
‘‘(i) take into consideration the min-
imum number of enrollees in a specialized 
MA plan for special needs individuals in 
order to determine if a statistically signifi-
cant or valid measurement of quality at 
the plan level is possible under this para-
graph; 
‘‘(ii) if quality measures are reported 
at the plan level, ensure that MA plans are 
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not required to provide duplicative infor-
mation; and 
‘‘(iii) ensure that such reporting does 
not interfere with the collection of encoun-
ter data submitted by MA organizations or 
the administration of any changes to the 
program under this part as a result of the 
collection of such data. 
‘‘(C) APPLICATION.—If the Secretary ap-
plies quality measurement at the plan level 
under this paragraph— 
‘‘(i) such quality measurement may 
include Medicare Health Outcomes Survey 
(HOS), Healthcare Effectiveness Data and 
Information Set (HEDIS), Consumer As-
sessment of Healthcare Providers and Sys-
tems (CAHPS) measures and quality 
measures under part D; and 
‘‘(ii) the Secretary shall consider ap-
plying administrative actions, such as rem-
edies described in section 1857(g)(2), to 
the plan level. 
‘‘(7) DETERMINATION
OF
FEASIBILITY
OF 
QUALITY MEASUREMENT AT THE PLAN LEVEL FOR 
ALL MA PLANS.— 
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‘‘(A) DETERMINATION OF FEASIBILITY.— 
The Secretary shall determine the feasibility of 
requiring reporting of data under section 
1852(e) for, and applying under this subsection, 
quality measures at the plan level for all MA 
plans under this part. 
‘‘(B) CONSIDERATION OF CHANGE.—After 
making a determination under subparagraph 
(A), the Secretary shall consider requiring such 
reporting and applying such quality measures 
at the plan level as described in such subpara-
graph.’’. 
(e) GAO STUDY AND REPORT ON STATE-LEVEL IN-
TEGRATION BETWEEN DUAL SNPS AND MEDICAID.— 
(1) STUDY.—The Comptroller General of the 
United States (in this paragraph referred to as the 
‘‘Comptroller General’’) shall conduct a study on 
State-level integration between specialized MA plans 
for special needs individuals described in subsection 
(b)(6)(B)(ii) of section 1859 of the Social Security 
Act (42 U.S.C. 1395w–28) and the Medicaid pro-
gram under title XIX of such Act (42 U.S.C. 1396 
et seq.). Such study shall include an analysis of the 
following: 
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(A) The characteristics of States in which 
the State agency responsible for administering 
the State plan under such title XIX has a con-
tract with such a specialized MA plan and that 
delivers long-term services and supports under 
the State plan under such title XIX through a 
managed care program, including the require-
ments under such State plan with respect to 
long-term services and supports. 
(B) The types of such specialized MA 
plans, which may include the following: 
(i) A plan described in section 
1853(a)(1)(B)(iv)(II) of such Act (42 
U.S.C. 1395w–23(a)(1)(B)(iv)(II)). 
(ii) A plan that meets the require-
ments described in subsection (f)(3)(D) of 
such section 1859. 
(iii) A plan described in clause (ii) 
that also meets additional requirements es-
tablished by the State. 
(C) The characteristics of individuals en-
rolled in such specialized MA plans. 
(D) As practicable, the following with re-
spect to State programs for the delivery of long- 
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term services and supports under such title 
XIX through a managed care program: 
(i) Which populations of individuals 
are eligible to receive such services and 
supports. 
(ii) Whether all such services and sup-
ports are provided on a capitated basis or 
if any of such services and supports are 
carved out and provided through fee-for- 
service. 
(E) As, practicable, how the availability 
and variation of integration arrangements of 
such specialized MA plans offered in States af-
fects spending, service delivery options, access 
to community-based care, and utilization of 
care. 
(F) Barriers and opportunities for making 
further progress on dual integration, as well as 
recommend legislation to expedite or refine 
pathways toward fully integrated care. 
(2) REPORT.—Not later than 2 years after the 
date of the enactment of this Act, the Comptroller 
General shall submit to Congress a report containing 
the results of the study conducted under paragraph 
(1), together with recommendations for such legisla-
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tion and administrative action as the Comptroller 
General determines appropriate. 
SEC. 209. EXPANDING SUPPLEMENTAL BENEFITS TO MEET 
THE NEEDS OF CHRONICALLY ILL MEDICARE 
ADVANTAGE ENROLLEES. 
(a) IN GENERAL.—Section 1852(a)(3) of the Social 
Security Act (42 U.S.C. 1395w–22(a)(3)) is amended— 
(1) in subparagraph (A), by striking ‘‘Each’’ 
and inserting ‘‘Subject to subparagraph (D), each’’; 
and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(D) EXPANDING
SUPPLEMENTAL
BENE-
FITS TO MEET THE NEEDS OF CHRONICALLY 
ILL ENROLLEES.— 
‘‘(i) IN
GENERAL.—For plan year 
2020 and subsequent plan years, in addi-
tion to any supplemental health care bene-
fits otherwise provided under this para-
graph, an MA plan, including a specialized 
MA plan for special needs individuals de-
scribed in subsection (b)(6) of section 
1859, may provide supplemental benefits 
described in clause (ii) to a chronically ill 
enrollee (as defined in clause (iii)). 
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‘‘(ii) SUPPLEMENTAL
BENEFITS
DE-
SCRIBED.— 
‘‘(I) IN GENERAL.—Supplemental 
benefits described in this clause are 
supplemental benefits that, with re-
spect to a chronically ill enrollee, have 
a reasonable expectation of improving 
or maintaining the health or overall 
function of the chronically ill enrollee 
and may not be limited to being pri-
marily health related benefits. 
‘‘(II) AUTHORITY TO WAIVE UNI-
FORMITY
REQUIREMENTS.—The Sec-
retary may, with respect to supple-
mental benefits provided to a chron-
ically ill enrollee under this subpara-
graph, waive the uniformity require-
ment, as determined appropriate by 
the Secretary. 
‘‘(iii) CHRONICALLY
ILL
ENROLLEE 
DEFINED.—In this subparagraph, the term 
‘chronically ill enrollee’ means an enrollee 
in an MA plan that the Secretary deter-
mines— 
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‘‘(I) has one or more comorbid 
and medically complex chronic condi-
tions that is life threatening or signifi-
cantly limits the overall health or 
function of the enrollee; 
‘‘(II) has a high risk of hos-
pitalization or other adverse health 
outcomes; or 
‘‘(III) requires intensive care co-
ordination.’’. 
(b) GAO STUDY AND REPORT.— 
(1) STUDY.—The Comptroller General of the 
United States (in this subsection referred to as the 
‘‘Comptroller General’’) shall conduct a study on 
supplemental benefits provided to enrollees in Medi-
care Advantage plans under part C of title XVIII of 
the Social Security Act, including specialized MA 
plans for special needs individuals described in sec-
tion 1859(b)(6) of such Act (42 U.S.C. 1395w– 
28(b)(6)). Such study shall be conducted in con-
sultation with the Centers for Medicare & Medicaid 
Services and Medicare Advantage plans as necessary 
and, to the extent data is available, shall include an 
analysis of the following: 
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(A) The type of supplemental benefits pro-
vided to such enrollees, the total number of en-
rollees receiving each supplemental benefit, and 
whether the supplemental benefit is covered by 
the standard benchmark cost of the benefit or 
with an additional premium. 
(B) The frequency in which supplemental 
benefits are utilized by such enrollees. 
(C) The impact supplemental benefits have 
on— 
(i) indicators of the quality of care re-
ceived by such enrollees, including overall 
health and function of the enrollees; 
(ii) the utilization of items and serv-
ices for which benefits are available under 
the original Medicare fee-for-service pro-
gram option under parts A and B of such 
title XVIII by such enrollees; and 
(iii) the amount of the bids submitted 
by Medicare Advantage Organizations for 
Medicare Advantage plans under such part 
C. 
(2) REPORT.—Not later than 5 years after the 
date of the enactment of this Act, the Comptroller 
General shall submit to Congress a report containing 
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the results of the study conducted under paragraph 
(1), together with recommendations for such legisla-
tion and administrative action as the Comptroller 
General determines appropriate. 
SEC. 210. EXTENSION OF CONSENSUS-BASED ENTITY FUND-
ING. 
Section 1890(d)(2) of the Social Security Act (42 
U.S.C. 1395aaa(d)(2)) is amended by striking ‘‘2017’’ 
and inserting ‘‘2019’’. 
SEC. 211. EXTENSION OF CERTAIN MIPPA FUNDING PROVI-
SIONS. 
Section 119 of the Medicare Improvements for Pa-
tients and Providers Act of 2008 (42 U.S.C. 1395b–3 
note) is amended— 
(1) in subsection (a)(1)(B)— 
(A) in clause (vi), by striking ‘‘and’’ at the 
end; 
(B) in clause (vii), by striking the period 
at the end and inserting ‘‘; and’’; and 
(C) by inserting after clause (vii) the fol-
lowing new clause: 
‘‘(viii) for each of fiscal years 2018 
through 2019, of $13,000,000.’’; 
(2) in subsection (b)(1)(B)— 
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(A) in clause (vi), by striking ‘‘and’’ at the 
end; 
(B) in clause (vii), by striking the period 
at the end and inserting ‘‘; and’’; and 
(C) by inserting after clause (vii) the fol-
lowing new clause: 
‘‘(viii) for each of fiscal years 2018 
through 2019, of $7,500,000.’’; 
(3) in subsection (c)(1)(B)— 
(A) in clause (vi), by striking ‘‘and’’ at the 
end; 
(B) in clause (vii), by striking the period 
at the end and inserting ‘‘; and’’; and 
(C) by inserting after clause (vii) the fol-
lowing new clause: 
‘‘(viii) for each of fiscal years 2018 
through 2019, of $5,000,000.’’; and 
(4) in subsection (d)(2)— 
(A) in clause (vi), by striking ‘‘and’’ at the 
end; 
(B) in clause (vii), by striking the period 
at the end and inserting ‘‘; and’’; and 
(C) by inserting after clause (vii) the fol-
lowing new clause: 
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‘‘(viii) for each of fiscal years 2018 
through 2019, of $12,000,000.’’. 
SEC. 212. EXTENSION OF HOME HEALTH RURAL ADD-ON. 
Section 421(a) of the Medicare Prescription Drug, 
Improvement, and Modernization Act of 2003 (Public Law 
108–173; 117 Stat. 2283; 42 U.S.C. 1395fff note), as 
amended by section 5201(b) of the Deficit Reduction Act 
of 2005 (Public Law 109–171; 120 Stat. 46), section 
3131(c) of the Patient Protection and Affordable Care Act 
(Public Law 111–148; 124 Stat. 428), and section 210 
of the Medicare Access and CHIP Reauthorization Act of 
2015 (Public Law 114–10), is further amended by strik-
ing ‘‘January 1, 2018’’ and inserting ‘‘January 1, 2020’’ 
each place it appears. 
Subtitle B—Medicaid and Public 
Health Extenders 
SEC. 221. EXTENSION FOR COMMUNITY HEALTH CENTERS 
AND 
THE 
NATIONAL 
HEALTH 
SERVICE 
CORPS. 
(a) COMMUNITY HEALTH CENTERS FUNDING.—Sec-
tion 10503(b)(1) of the Patient Protection and Affordable 
Care Act (42 U.S.C. 254b–2(b)(1)), as amended by sec-
tion 3101 of Public Law 115–96, is amended by amending 
subparagraph (F) to read as follows: 
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‘‘(F) $3,600,000,000 for each of fiscal 
years 2018 and 2019.’’. 
(b) OTHER COMMUNITY HEALTH CENTERS PROVI-
SIONS.—Section 330 of the Public Health Service Act (42 
U.S.C. 254b) is amended— 
(1) in subsection (b)(1)(A)(ii), by striking 
‘‘abuse’’ and inserting ‘‘use disorder’’; 
(2) in subsection (b)(2)(A), by striking ‘‘abuse’’ 
and inserting ‘‘use disorder’’; 
(3) in subsection (c)— 
(A) in paragraph (1), by striking subpara-
graphs (B) through (D); 
(B) by striking ‘‘(1) IN GENERAL’’ and all 
that follows through ‘‘The Secretary’’ and in-
serting the following: 
‘‘(1) CENTERS.—The Secretary’’; and 
(C) in paragraph (1), as amended, by re-
designating clauses (i) through (v) as subpara-
graphs (A) through (E) and moving the margin 
of each of such redesignated subparagraph 2 
ems to the left; 
(4) by striking subsection (d) and inserting the 
following: 
‘‘(d) IMPROVING QUALITY OF CARE.— 
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‘‘(1) SUPPLEMENTAL AWARDS.—The Secretary 
may award supplemental grant funds to health cen-
ters funded under this section to implement evi-
dence-based models for increasing access to high- 
quality primary care services, which may include 
models related to— 
‘‘(A) improving the delivery of care for in-
dividuals with multiple chronic conditions; 
‘‘(B) workforce configuration; 
‘‘(C) reducing the cost of care; 
‘‘(D) enhancing care coordination; 
‘‘(E) expanding the use of telehealth and 
technology-enabled collaborative learning and 
capacity building models; 
‘‘(F) care integration, including integration 
of behavioral health, mental health, or sub-
stance use disorder services; and 
‘‘(G) addressing emerging public health or 
substance use disorder issues to meet the health 
needs of the population served by the health 
center. 
‘‘(2) 
SUSTAINABILITY.—In 
making 
supple-
mental awards under this subsection, the Secretary 
may consider whether the health center involved has 
submitted a plan for continuing the activities funded 
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under this subsection after supplemental funding is 
expended. 
‘‘(3) SPECIAL CONSIDERATION.—The Secretary 
may give special consideration to applications for 
supplemental funding under this subsection that 
seek to address significant barriers to access to care 
in areas with a greater shortage of health care pro-
viders and health services relative to the national av-
erage.’’; 
(5) in subsection (e)(1)— 
(A) in subparagraph (B)— 
(i) by striking ‘‘2 years’’ and inserting 
‘‘1 year’’; and 
(ii) by adding at the end the fol-
lowing: ‘‘The Secretary shall not make a 
grant under this paragraph unless the ap-
plicant provides assurances to the Sec-
retary that within 120 days of receiving 
grant funding for the operation of the 
health center, the applicant will submit, for 
approval by the Secretary, an implementa-
tion plan to meet the requirements of sub-
section (l)(3). The Secretary may extend 
such 120-day period for achieving compli-
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ance upon a demonstration of good cause 
by the health center.’’; and 
(B) in subparagraph (C)— 
(i) in the subparagraph heading, by 
striking ‘‘AND PLANS’’; 
(ii) by striking ‘‘or plan (as described 
in subparagraphs (B) and (C) of sub-
section (c)(1))’’; 
(iii) by striking ‘‘or plan, including 
the purchase’’ and inserting the following: 
‘‘including— 
‘‘(i) the purchase’’; 
(iv) by inserting ‘‘, which may include 
data and information systems’’ after ‘‘of 
equipment’’; 
(v) by striking the period at the end 
and inserting a semicolon; and 
(vi) by adding at the end the fol-
lowing: 
‘‘(ii) the provision of training and 
technical assistance; and 
‘‘(iii) other activities that— 
‘‘(I) reduce costs associated with 
the provision of health services; 
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‘‘(II) improve access to, and 
availability of, health services provided 
to individuals served by the centers; 
‘‘(III) enhance the quality and 
coordination of health services; or 
‘‘(IV) improve the health status 
of communities.’’; 
(6) in subsection (e)(5)(B)— 
(A) in the heading of subparagraph (B), by 
striking ‘‘AND PLANS’’; and 
(B) by striking ‘‘and subparagraphs (B) 
and (C) of subsection (c)(1) to a health center 
or to a network or plan’’ and inserting ‘‘to a 
health center or to a network’’; 
(7) by striking subsection (s); 
(8) by redesignating subsections (g) through (r) 
as subsections (h) through (s), respectively; 
(9) by inserting after subsection (f), the fol-
lowing: 
‘‘(g) NEW ACCESS POINTS AND EXPANDED SERV-
ICES.— 
‘‘(1) APPROVAL OF NEW ACCESS POINTS.— 
‘‘(A) IN
GENERAL.—The Secretary may 
approve applications for grants under subpara-
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