H. R. 3590—877 
(d) Section 738(a)(3) of the Public Health Service Act (42 U.S.C. 
293b(a)(3)) is amended by inserting ‘‘schools offering physician 
assistant education programs,’’ after ‘‘public health,’’. 
(e) Subtitle D of title V of this Act is amended by adding 
at the end the following: 
‘‘SEC. 5316. DEMONSTRATION GRANTS FOR FAMILY NURSE PRACTI-
TIONER TRAINING PROGRAMS. 
‘‘(a) ESTABLISHMENT OF PROGRAM.—The Secretary of Health 
and Human Services (referred to in this section as the ‘Secretary’) 
shall establish a training demonstration program for family nurse 
practitioners (referred to in this section as the ‘program’) to employ 
and provide 1-year training for nurse practitioners who have grad-
uated from a nurse practitioner program for careers as primary 
care providers in Federally qualified health centers (referred to 
in this section as ‘FQHCs’) and nurse-managed health clinics 
(referred to in this section as ‘NMHCs’). 
‘‘(b) PURPOSE.—The purpose of the program is to enable each 
grant recipient to— 
‘‘(1) provide new nurse practitioners with clinical training 
to enable them to serve as primary care providers in FQHCs 
and NMHCs; 
‘‘(2) train new nurse practitioners to work under a model 
of primary care that is consistent with the principles set forth 
by the Institute of Medicine and the needs of vulnerable popu-
lations; and 
‘‘(3) create a model of FQHC and NMHC training for nurse 
practitioners that may be replicated nationwide. 
‘‘(c) GRANTS.—The Secretary shall award 3-year grants to 
eligible entities that meet the requirements established by the 
Secretary, for the purpose of operating the nurse practitioner pri-
mary care programs described in subsection (a) in such entities. 
‘‘(d) ELIGIBLE ENTITIES.—To be eligible to receive a grant under 
this section, an entity shall— 
‘‘(1)(A) be a FQHC as defined in section 1861(aa) of the 
Social Security Act (42 U.S.C. 1395x(aa)); or 
‘‘(B) be a nurse-managed health clinic, as defined in section 
330A–1 of the Public Health Service Act (as added by section 
5208 of this Act); and 
‘‘(2) submit to the Secretary an application at such time, 
in such manner, and containing such information as the Sec-
retary may require. 
‘‘(e) PRIORITY IN AWARDING GRANTS.—In awarding grants under 
this section, the Secretary shall give priority to eligible entities 
that— 
‘‘(1) demonstrate sufficient infrastructure in size, scope, 
and capacity to undertake the requisite training of a minimum 
of 3 nurse practitioners per year, and to provide to each awardee 
12 full months of full-time, paid employment and benefits con-
sistent with the benefits offered to other full-time employees 
of such entity; 
‘‘(2) will assign not less than 1 staff nurse practitioner 
or physician to each of 4 precepted clinics; 
‘‘(3) will provide to each awardee specialty rotations, 
including specialty training in prenatal care and women’s 
health, adult and child psychiatry, orthopedics, geriatrics, and 
at least 3 other high-volume, high-burden specialty areas;
H. R. 3590—878 
‘‘(4) provide sessions on high-volume, high-risk health prob-
lems and have a record of training health care professionals 
in the care of children, older adults, and underserved popu-
lations; and 
‘‘(5) collaborate with other safety net providers, schools, 
colleges, and universities that provide health professions 
training. 
‘‘(f) ELIGIBILITY OF NURSE PRACTITIONERS.— 
‘‘(1) IN GENERAL.—To be eligible for acceptance to a pro-
gram funded through a grant awarded under this section, an 
individual shall— 
‘‘(A) be licensed or eligible for licensure in the State 
in which the program is located as an advanced practice 
registered nurse or advanced practice nurse and be eligible 
or board-certified as a family nurse practitioner; and 
‘‘(B) demonstrate commitment to a career as a primary 
care provider in a FQHC or in a NMHC. 
‘‘(2) PREFERENCE.—In selecting awardees under the pro-
gram, each grant recipient shall give preference to bilingual 
candidates that meet the requirements described in paragraph 
(1). 
‘‘(3) DEFERRAL
OF
CERTAIN
SERVICE.—The starting date 
of required service of individuals in the National Health Service 
Corps Service program under title II of the Public Health 
Service Act (42 U.S.C. 202 et seq.) who receive training under 
this section shall be deferred until the date that is 22 days 
after the date of completion of the program. 
‘‘(g) GRANT AMOUNT.—Each grant awarded under this section 
shall be in an amount not to exceed $600,000 per year. A grant 
recipient may carry over funds from 1 fiscal year to another without 
obtaining approval from the Secretary. 
‘‘(h) TECHNICAL
ASSISTANCE
GRANTS.—The Secretary may 
award technical assistance grants to 1 or more FQHCs or NMHCs 
that have demonstrated expertise in establishing a nurse practi-
tioner residency training program. Such technical assistance grants 
shall be for the purpose of providing technical assistance to other 
recipients of grants under subsection (c). 
‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—To carry out this sec-
tion, there is authorized to be appropriated such sums as may 
be necessary for each of fiscal years 2011 through 2014.’’. 
(f)(1) Section 399W of the Public Health Service Act, as added 
by section 5405, is redesignated as section 399V–1. 
(2) Section 399V–1 of the Public Health Service Act, as so 
redesignated, is amended in subsection (b)(2)(A) by striking ‘‘and 
the departments of 1 or more health professions schools in the 
State that train providers in primary care’’ and inserting ‘‘and 
the departments that train providers in primary care in 1 or more 
health professions schools in the State’’. 
(3) Section 934 of the Public Health Service Act, as added 
by section 3501, is amended by striking ‘‘399W’’ each place such 
term appears and inserting ‘‘399V–1’’. 
(4) Section 935(b) of the Public Health Service Act, as added 
by section 3503, is amended by striking ‘‘399W’’ and inserting 
‘‘399V–1’’. 
(g) Part P of title III of the Public Health Service Act 42 
U.S.C. 280g et seq.), as amended by section 10411, is amended 
by adding at the end the following:
H. R. 3590—879 
‘‘SEC. 399V–3. NATIONAL DIABETES PREVENTION PROGRAM. 
‘‘(a) IN GENERAL.—The Secretary, acting through the Director 
of the Centers for Disease Control and Prevention, shall establish 
a national diabetes prevention program (referred to in this section 
as the ‘program’) targeted at adults at high risk for diabetes in 
order to eliminate the preventable burden of diabetes. 
‘‘(b) PROGRAM ACTIVITIES.—The program described in sub-
section (a) shall include— 
‘‘(1) a grant program for community-based diabetes preven-
tion program model sites; 
‘‘(2) a program within the Centers for Disease Control 
and Prevention to determine eligibility of entities to deliver 
community-based diabetes prevention services; 
‘‘(3) a training and outreach program for lifestyle interven-
tion instructors; and 
‘‘(4) evaluation, monitoring and technical assistance, and 
applied research carried out by the Centers for Disease Control 
and Prevention. 
‘‘(c) ELIGIBLE ENTITIES.—To be eligible for a grant under sub-
section (b)(1), an entity shall be a State or local health department, 
a tribal organization, a national network of community-based non- 
profits focused on health and wellbeing, an academic institution, 
or other entity, as the Secretary determines. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of 
carrying out this section, there are authorized to be appropriated 
such sums as may be necessary for each of fiscal years 2010 through 
2014.’’. 
(h) The provisions of, and amendment made by, section 5501(c) 
of this Act are repealed. 
(i)(1) The provisions of, and amendments made by, section 
5502 of this Act are repealed. 
(2)(A) Section 1861(aa)(3)(A) of the Social Security Act (42 
U.S.C. 1395w(aa)(3)(A)) is amended to read as follows: 
‘‘(A) services of the type described in subparagraphs (A) 
through (C) of paragraph (1) and preventive services (as defined 
in section 1861(ddd)(3)); and’’. 
(B) The amendment made by subparagraph (A) shall apply 
to services furnished on or after January 1, 2011. 
(3)(A) Section 1834 of the Social Security Act (42 U.S.C. 1395m), 
as amended by section 4105, is amended by adding at the end 
the following new subsection: 
‘‘(o) DEVELOPMENT AND IMPLEMENTATION OF PROSPECTIVE PAY-
MENT SYSTEM.— 
‘‘(1) DEVELOPMENT.— 
‘‘(A) IN
GENERAL.—The Secretary shall develop a 
prospective payment system for payment for Federally 
qualified health center services furnished by Federally 
qualified health centers under this title. Such system shall 
include a process for appropriately describing the services 
furnished by Federally qualified health centers and shall 
establish payment rates for specific payment codes based 
on such appropriate descriptions of services. Such system 
shall be established to take into account the type, intensity, 
and duration of services furnished by Federally qualified 
health centers. Such system may include adjustments, 
including geographic adjustments, determined appropriate 
by the Secretary.
H. R. 3590—880 
‘‘(B) COLLECTION OF DATA AND EVALUATION.—By not 
later than January 1, 2011, the Secretary shall require 
Federally qualified health centers to submit to the Sec-
retary such information as the Secretary may require in 
order to develop and implement the prospective payment 
system under this subsection, including the reporting of 
services using HCPCS codes. 
‘‘(2) IMPLEMENTATION.— 
‘‘(A) 
IN
GENERAL.—Notwithstanding 
section 
1833(a)(3)(A), the Secretary shall provide, for cost reporting 
periods beginning on or after October 1, 2014, for payments 
of prospective payment rates for Federally qualified health 
center services furnished by Federally qualified health cen-
ters under this title in accordance with the prospective 
payment system developed by the Secretary under para-
graph (1). 
‘‘(B) PAYMENTS.— 
‘‘(i) INITIAL PAYMENTS.—The Secretary shall imple-
ment such prospective payment system so that the 
estimated aggregate amount of prospective payment 
rates (determined prior to the application of section 
1833(a)(1)(Z)) under this title for Federally qualified 
health center services in the first year that such system 
is implemented is equal to 100 percent of the estimated 
amount of reasonable costs (determined without the 
application of a per visit payment limit or productivity 
screen and prior to the application of section 
1866(a)(2)(A)(ii)) that would have occurred for such 
services under this title in such year if the system 
had not been implemented. 
‘‘(ii) PAYMENTS IN SUBSEQUENT YEARS.—Payment 
rates in years after the year of implementation of 
such system shall be the payment rates in the previous 
year increased— 
‘‘(I) in the first year after implementation of 
such system, by the percentage increase in the 
MEI (as defined in section 1842(i)(3)) for the year 
involved; and 
‘‘(II) in subsequent years, by the percentage 
increase in a market basket of Federally qualified 
health center goods and services as promulgated 
through regulations, or if such an index is not 
available, by the percentage increase in the MEI 
(as defined in section 1842(i)(3)) for the year 
involved. 
‘‘(C) PREPARATION FOR PPS IMPLEMENTATION.—Notwith-
standing any other provision of law, the Secretary may 
establish and implement by program instruction or other-
wise the payment codes to be used under the prospective 
payment system under this section.’’. 
(B) Section 1833(a)(1) of the Social Security Act (42 U.S.C. 
1395l(a)(1)), as amended by section 4104, is amended— 
(i) by striking ‘‘and’’ before ‘‘(Y)’’; and 
(ii) by inserting before the semicolon at the end the fol-
lowing: ‘‘, and (Z) with respect to Federally qualified health 
center services for which payment is made under section 
1834(o), the amounts paid shall be 80 percent of the lesser