I 
116TH CONGRESS 
2D SESSION 
H. R. 6637 
To improve the health of minority individuals, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 28, 2020 
Mr. GARCI´A of Illinois (for himself, Ms. PRESSLEY, Ms. JUDY CHU of Cali-
fornia, Mr. RICHMOND, Mr. ESPAILLAT, Mr. VELA, Mr. VARGAS, Ms. 
BARRAGA´N, Ms. ROYBAL-ALLARD, Mr. SOTO, Ms. TLAIB, Mr. HIGGINS 
of New York, Mr. HUFFMAN, Mr. GREEN of Texas, Ms. NORTON, Ms. 
GARCIA of Texas, Mr. TAKANO, Mr. SERRANO, Ms. JACKSON LEE, Mrs. 
BEATTY, Mr. BISHOP of Georgia, Mr. THOMPSON of Mississippi, Mr. 
LEWIS, Ms. WILSON of Florida, Ms. SEWELL of Alabama, Mr. GOMEZ, 
Ms. MOORE, Mr. CARSON of Indiana, Ms. LEE of California, Mrs. DAVIS 
of California, Mr. SABLAN, Mrs. HAYES, Mrs. NAPOLITANO, Ms. 
BONAMICI, Ms. CLARKE of New York, Ms. KELLY of Illinois, Mrs. WAT-
SON COLEMAN, Mr. DOGGETT, Ms. OMAR, Ms. BLUNT ROCHESTER, Mrs. 
TRAHAN, Ms. OCASIO-CORTEZ, Ms. SA´NCHEZ, Ms. ESCOBAR, Mr. 
CARBAJAL, Mr. CASTRO of Texas, Mr. CA´RDENAS, Mr. GRIJALVA, Ms. 
CASTOR of Florida, Mr. MCNERNEY, Mr. CORREA, Ms. MENG, Mr. 
RUSH, Ms. VELA´ZQUEZ, Ms. JAYAPAL, Mr. EVANS, Mr. CASTEN of Illi-
nois, Mr. GALLEGO, Mr. SARBANES, Mr. MEEKS, Ms. JOHNSON of Texas, 
Mr. BROWN of Maryland, Ms. LOFGREN, Mr. BUTTERFIELD, Mr. NAD-
LER, Mr. ENGEL, Mr. KENNEDY, Mr. MCGOVERN, Mr. HASTINGS, Mrs. 
CAROLYN B. MALONEY of New York, Mr. MCEACHIN, Mr. SIRES, Mr. 
PAYNE, Mr. SCHIFF, Mr. JOHNSON of Georgia, Mr. KHANNA, Mr. 
HORSFORD, Mr. SAN NICOLAS, Ms. BASS, and Mr. DANNY K. DAVIS of 
Illinois) introduced the following bill; which was referred to the Com-
mittee 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, and Homeland Security, for a period to be subsequently 
determined by the Speaker, in each case for consideration of such provi-
sions as fall within the jurisdiction of the committee concerned 
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A BILL 
To improve the health of minority individuals, and for other 
purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Health Equity and 
Accountability Act of 2020’’. 
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. 101. Amendment to the Public Health Service Act. 
Sec. 102. Elimination of prerequisite of direct appropriations for data collection 
and analysis. 
Sec. 103. Collection of data for the Medicare program. 
Sec. 104. Revision of HIPAA claims standards. 
Sec. 105. National Center for Health Statistics. 
Sec. 106. Disparities data collected by the Federal Government. 
Sec. 107. Data collection and analysis grants to minority-serving institutions. 
Sec. 108. Standards for measuring sexual orientation, gender identity, and so-
cioeconomic status in collection of health data. 
Sec. 109. Safety and effectiveness of drugs with respect to racial and ethnic 
background. 
Sec. 110. Improving health data regarding Native Hawaiians and other Pacific 
Islanders. 
Sec. 111. Clarification of simplified administrative reporting requirement. 
TITLE II—CULTURALLY AND LINGUISTICALLY APPROPRIATE 
HEALTH AND HEALTH CARE 
Sec. 201. Definitions; findings. 
Sec. 202. Improving access to services for individuals with limited English pro-
ficiency. 
Sec. 203. Ensuring standards for culturally and linguistically appropriate serv-
ices in health care. 
Sec. 204. Culturally and linguistically appropriate health care in the Public 
Health Service Act. 
Sec. 205. Pilot program for improvement and development of State medical in-
terpreting services. 
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Sec. 206. Training tomorrow’s doctors for culturally and linguistically appro-
priate care: graduate medical education. 
Sec. 207. Federal reimbursement for culturally and linguistically appropriate 
services under the Medicare, Medicaid, and State Children’s 
Health Insurance Programs. 
Sec. 208. Increasing understanding of and improving health literacy. 
Sec. 209. Requirements for health programs or activities receiving Federal 
funds. 
Sec. 210. Report on Federal efforts to provide culturally and linguistically ap-
propriate health care services. 
Sec. 211. English for speakers of other languages. 
Sec. 212. Implementation. 
Sec. 213. Language access services. 
Sec. 214. Medically underserved populations. 
TITLE III—HEALTH WORKFORCE DIVERSITY 
Sec. 301. Amendment to the Public Health Service Act. 
Sec. 302. Hispanic-serving institutions, historically Black colleges and univer-
sities, Asian American and Native American Pacific Islander- 
serving institutions, Tribal Colleges, regional community-based 
organizations, and national minority medical associations. 
Sec. 303. Loan repayment program of Centers for Disease Control and Preven-
tion. 
Sec. 304. Cooperative agreements for online degree programs at schools of pub-
lic health and schools of allied health. 
Sec. 305. Sense of Congress on the mission of the National Health Care Work-
force Commission. 
Sec. 306. Scholarship and fellowship programs. 
Sec. 307. McNair Postbaccalaureate Achievement Program. 
Sec. 308. Rules for determination of full-time equivalent residents for cost-re-
porting periods. 
Sec. 309. Developing and implementing strategies for local health equity. 
Sec. 310. Loan forgiveness for mental and behavioral health social workers. 
Sec. 311. Health Professions Workforce Fund. 
Sec. 312. Findings; sense of Congress relating to graduate medical education. 
Sec. 313. Career support for skilled, internationally educated health profes-
sionals. 
Sec. 314. Study and report on strategies for increasing diversity. 
Sec. 315. Conrad State 30 and physician retention. 
TITLE IV—IMPROVING HEALTH CARE ACCESS AND QUALITY 
Subtitle A—Improvement of Coverage 
Sec. 401. Repeal of requirement for documentation evidencing citizenship or 
nationality under the Medicaid program. 
Sec. 402. Removing citizenship and immigration barriers to access to affordable 
health care under ACA. 
Sec. 403. Study on the uninsured. 
Sec. 404. Medicaid in the territories. 
Sec. 405. Extension of Medicare secondary payer. 
Sec. 406. Indian defined in title I of the Patient Protection and Affordable 
Care Act. 
Sec. 407. Removing Medicare barrier to health care. 
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Sec. 408. 100 percent FMAP for medical assistance provided by urban Indian 
health centers. 
Sec. 409. 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. 410. Medicaid coverage for citizens of freely associated states. 
Sec. 411. At-risk youth Medicaid protection. 
Subtitle B—Expansion of Access 
Sec. 412. Amendment to the Public Health Service Act. 
Sec. 413. Protecting sensitive locations. 
Sec. 414. Grants for racial and ethnic approaches to community health. 
Sec. 415. Border health grants. 
Sec. 416. Critical access hospital improvements. 
Sec. 417. Establishment of Rural Community Hospital (RCH) Program. 
Sec. 418. Medicare remote monitoring pilot projects. 
Sec. 419. Rural Health Quality Advisory Commission and demonstration 
projects. 
Sec. 420. Rural health care services. 
Sec. 421. Community health center collaborative access expansion. 
Sec. 422. Facilitating the provision of telehealth services across State lines. 
Sec. 423. Scoring of preventive health savings. 
Sec. 424. Sense of Congress on maintenance of effort provisions regarding chil-
dren’s health. 
Sec. 425. Protection of the HHS Offices of Minority Health. 
Sec. 426. Office of Minority Health in Veterans Health Administration of De-
partment of Veterans Affairs. 
Sec. 427. Study of DSH payments to ensure hospital access for low-income pa-
tients. 
Sec. 428. Assistant Secretary of the Indian Health Service. 
Sec. 429. Reauthorization of the Native Hawaiian Health Care Improvement 
Act. 
Sec. 430. Availability of non-English language speaking providers. 
Sec. 431. Access to essential community providers. 
Sec. 432. Provider network adequacy in communities of color. 
Sec. 433. Improving access to dental care. 
Sec. 434. Providing for a special enrollment period for pregnant individuals. 
Sec. 435. Coverage of maternity care for dependent children. 
Sec. 436. Federal employee health benefit plans. 
Sec. 437. Continuation of Medicaid income eligibility standard for pregnant in-
dividuals and infants. 
Subtitle C—Advancing Health Equity Through Payment and Delivery Reform 
Sec. 441. Sense of Congress. 
Sec. 442. Centers for Medicare & Medicaid Services reporting and value-based 
programs. 
Sec. 443. Development and testing of disparity reducing delivery and payment 
models. 
Sec. 444. Diversity in Centers for Medicare & Medicaid consultation. 
Sec. 445. Supporting safety net and community-based providers to compete in 
value-based payment systems. 
Subtitle D—Health Empowerment Zones 
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Sec. 451. Short title. 
Sec. 452. Findings. 
Sec. 453. Designation of health empowerment zones. 
Sec. 454. Assistance to those seeking designation. 
Sec. 455. Benefits of designation. 
Sec. 456. Definition of Secretary. 
Sec. 457. Authorization of appropriations. 
TITLE V—IMPROVING HEALTH OUTCOMES FOR WOMEN, 
CHILDREN, AND FAMILIES 
Subtitle A—In General 
Sec. 501. Grants to promote health for underserved communities. 
Sec. 502. Removing barriers to health care and nutrition assistance for chil-
dren, pregnant persons, and lawfully present individuals. 
Sec. 503. Repeal of denial of benefits. 
Sec. 504. Birth defects prevention, risk reduction, and awareness. 
Sec. 505. MOMMA’s Act. 
Sec. 506. Rural maternal and obstetric modernization of services. 
Sec. 507. Decreasing the risk factors for sudden unexpected infant death and 
sudden unexplained death in childhood. 
Sec. 508. Reducing unintended teenage pregnancies. 
Sec. 509. Gestational diabetes. 
Sec. 510. Emergency contraception education and information programs. 
Sec. 511. Comprehensive sex education programs. 
Sec. 512. Compassionate assistance for rape emergencies. 
Sec. 513. Access to birth control duties of pharmacies to ensure provision of 
FDA-approved contraception. 
Sec. 514. Additional focus area for the Office on Women’s Health. 
Sec. 515. Interagency coordinating committee on the promotion of optimal ma-
ternity outcomes. 
Sec. 516. Consumer education campaign. 
Sec. 517. Bibliographic database of systematic reviews for care of childbearing 
individuals and newborns. 
Sec. 518. Expansion of CDC prevention research centers program to include 
centers on optimal maternity outcomes. 
Sec. 519. Expanding models allowed to be tested by Center for Medicare & 
Medicaid Innovation to include maternity care models. 
Sec. 520. Development of interprofessional maternity care educational models 
and tools. 
Sec. 521. Including services furnished by certain students, interns, and resi-
dents supervised by certified nurse midwives within inpatient 
hospital services under Medicare. 
Sec. 522. Grants to professional organizations to increase diversity in maternal, 
reproductive, and sexual health professionals. 
Sec. 523. Interagency update to the quality family planning guidelines. 
Sec. 524. Dissemination of the quality family planning guidelines. 
Subtitle B—Pregnancy Screening 
Sec. 531. Pregnancy intention screening initiative demonstration program. 
TITLE VI—MENTAL HEALTH 
Sec. 601. Mental health findings. 
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Sec. 602. Coverage of marriage and family therapist services, mental health 
counselor services, and substance abuse counselor services 
under part B of the Medicare program. 
Sec. 603. Integrated Health Care Demonstration Program. 
Sec. 604. Addressing racial and ethnic mental health disparities research gaps. 
Sec. 605. Health professions competencies to address racial and ethnic mental 
health disparities. 
Sec. 606. Geoaccess study. 
Sec. 607. Asian American, Native Hawaiian, Pacific Islander, and Hispanic and 
Latino behavioral and mental health outreach and education 
strategies. 
Sec. 608. Mental health in schools. 
Sec. 609. Building an effective workforce in mental health. 
Sec. 610. Mental health at the border. 
TITLE VII—ADDRESSING HIGH-IMPACT MINORITY DISEASES 
Subtitle A—Cancer 
Sec. 701. Lung cancer mortality reduction. 
Sec. 702. Expanding prostate cancer research, outreach, screening, testing, ac-
cess, and treatment effectiveness. 
Sec. 703. Prostate research, imaging, and men’s education (PRIME). 
Sec. 704. Prostate cancer detection research and education. 
Sec. 705. National Prostate Cancer Council. 
Sec. 706. Improved Medicaid coverage for certain breast and cervical cancer pa-
tients in the territories. 
Sec. 707. Cancer prevention and treatment demonstration for ethnic and racial 
minorities. 
Sec. 708. Reducing cancer disparities within Medicare. 
Sec. 709. Cancer clinical trials. 
Subtitle B—Viral Hepatitis and Liver Cancer Control and Prevention 
Sec. 711. Viral hepatitis and liver cancer control and prevention. 
Subtitle C—Acquired Bone Marrow Failure Diseases 
Sec. 721. Acquired bone marrow failure diseases. 
Subtitle D—Cardiovascular Disease, Chronic Disease, Obesity, and Other 
Disease Issues 
Sec. 731. Guidelines for disease screening for minority patients. 
Sec. 732. CDC Wisewoman Screening Program. 
Sec. 733. Report on cardiovascular care for women and minorities. 
Sec. 734. Coverage of comprehensive tobacco cessation services in Medicaid and 
private health insurance. 
Sec. 735. Clinical research funding for oral health. 
Sec. 736. Participation by Medicaid beneficiaries in approved clinical trials. 
Sec. 737. Guide on evidence-based strategies for public health department obe-
sity prevention programs. 
Subtitle E—HIV/AIDS 
Sec. 741. Statement of policy. 
Sec. 742. Findings. 
Sec. 743. Additional funding for AIDS drug assistance program treatments. 
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Sec. 744. Enhancing the national HIV surveillance system. 
Sec. 745. Evidence-based strategies for improving linkage to and retention in 
appropriate care. 
Sec. 746. Improving entry into and retention in care and antiretroviral adher-
ence for persons with HIV. 
Sec. 747. Services to reduce HIV/AIDS in racial and ethnic minority commu-
nities. 
Sec. 748. Minority AIDS initiative. 
Sec. 749. Health care professionals treating individuals with HIV. 
Sec. 750. HIV/AIDS provider loan repayment program. 
Sec. 751. Dental education loan repayment program. 
Sec. 752. Reducing new HIV infections among injecting drug users. 
Sec. 753. Report on impact of HIV/AIDS in vulnerable populations. 
Sec. 754. National HIV/AIDS observance days. 
Sec. 755. Review of all Federal and State laws, policies, and regulations regard-
ing the criminal prosecution of individuals for HIV-related of-
fenses. 
Sec. 756. Expanding support for condoms in prisons. 
Sec. 757. Automatic reinstatement or enrollment in Medicaid for people who 
test positive for HIV before reentering communities. 
Sec. 758. Stop HIV in prison. 
Sec. 759. Support data system review and indicators for monitoring HIV care. 
Sec. 760. Transfer of funds for implementation of ending the HIV epidemic: a 
plan for America. 
Subtitle F—Diabetes 
Sec. 771. Research, treatment, and education. 
Sec. 772. Research, education, and other activities. 
Sec. 773. Research, education, and other activities. 
Sec. 774. Research, education, and other activities. 
Sec. 775. Updated report on health disparities. 
Subtitle G—Lung Disease 
Sec. 776. Expansion of the National Asthma Education and Prevention Pro-
gram. 
Sec. 777. Asthma-related activities of the Centers for Disease Control and Pre-
vention. 
Sec. 778. Influenza and pneumonia vaccination campaign. 
Sec. 779. Chronic obstructive pulmonary disease action plan. 
Subtitle H—Tuberculosis 
Sec. 781. Elimination of all forms of tuberculosis. 
Sec. 782. Additional funding for States in combating and eliminating tuber-
culosis. 
Sec. 783. Strengthening clinical research funding for tuberculosis. 
Subtitle I—Osteoarthritis and Musculoskeletal Diseases 
Sec. 785. Findings. 
Sec. 786. Osteoarthritis and other musculoskeletal health-related activities of 
the Centers for Disease Control and Prevention. 
Sec. 787. Grants for comprehensive osteoarthritis and musculoskeletal disease 
health education within health professions schools. 
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Subtitle J—Sleep and Circadian Rhythm Disorders 
Sec. 791. Short title; findings. 
Sec. 792. Sleep and circadian rhythm disorders research activities of the Na-
tional Institutes of Health. 
Sec. 793. Sleep and circadian rhythm health disparities-related activities of the 
Centers for Disease Control and Prevention. 
Sec. 794. Grants for comprehensive sleep and circadian health education within 
health professions schools. 
Sec. 795. 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. 797. Kidney disease, research, surveillance, prevention, and treatment. 
Sec. 798. Kidney disease research in minority populations. 
Sec. 799. Kidney disease action plan. 
Sec. 799A. Home dialysis and increasing end-stage renal disease treatment mo-
dalities in minority communities action plan. 
Sec. 799B. Increasing kidney transplants in minority communities. 
Sec. 799C. Environmental and occupational health programs. 
Sec. 799D. Understanding the treatment patterns associated with providing 
care and treatment of kidney failure in minority populations. 
Sec. 799E. Improving access in underserved areas. 
TITLE VIII—HEALTH INFORMATION TECHNOLOGY 
Sec. 800. Definitions. 
Subtitle A—Reducing Health Disparities Through Health IT 
Sec. 801. HRSA assistance to health centers for promotion of Health IT. 
Sec. 802. Assessment of impact of Health IT on racial and ethnic minority 
communities; outreach and adoption of Health IT in such com-
munities. 
Sec. 803. Nondiscrimination and health equity in health information tech-
nology. 
Sec. 804. Language access in health information technology. 
Subtitle B—Modifications To Achieve Parity in Existing Programs 
Sec. 811. Extending funding to strengthen the Health IT infrastructure in ra-
cial and ethnic minority communities. 
Sec. 812. 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. 813. Authorization of appropriations. 
Subtitle C—Additional Research and Studies 
Sec. 821. Data collection and assessments conducted in coordination with mi-
nority-serving institutions. 
Sec. 822. Study of health information technology in medically underserved com-
munities. 
Sec. 823. Assessment of use and misuse of de-identified health data. 
Subtitle D—Closing Gaps in Funding To Adopt Certified EHRs 
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Sec. 831. Extending Medicaid EHR incentive payments to rehabilitation facili-
ties, long-term care facilities, and home health agencies. 
Sec. 832. Extending physician assistant eligibility for Medicaid electronic health 
record incentive payments. 
TITLE IX—ACCOUNTABILITY AND EVALUATION 
Sec. 901. Prohibition on discrimination in Federal assisted health care services 
and research programs on the basis of sex (including sex ori-
entation, gender identity, and pregnancy, including termination 
of pregnancy), race, color, national origin, marital status, fa-
milial status, sexual orientation, gender identity, or disability 
status. 
Sec. 902. Treatment of Medicare payments under title VI of the Civil Rights 
Act of 1964. 
Sec. 903. Accountability and transparency within the Department of Health 
and Human Services. 
Sec. 904. United States Commission on Civil Rights. 
Sec. 905. Sense of Congress concerning full funding of activities to eliminate 
racial and ethnic health disparities. 
Sec. 906. GAO and NIH reports. 
TITLE X—ADDRESSING SOCIAL DETERMINANTS AND IMPROVING 
ENVIRONMENTAL JUSTICE 
Subtitle A—In General 
Sec. 1001. Definitions. 
Sec. 1002. Findings. 
Sec. 1003. Health impact assessments. 
Sec. 1004. Implementation of recommendations by Environmental Protection 
Agency. 
Sec. 1005. Grant program to conduct environmental health improvement activi-
ties and to improve social determinants of health. 
Sec. 1006. Additional research on the relationship between the built environ-
ment and the health of community residents. 
Sec. 1007. Environment and public health restoration. 
Sec. 1008. GAO report on health effects of Deepwater Horizon oil rig explosion 
in the Gulf Coast. 
Sec. 1009. Establish an interagency counsel and grant programs on social de-
terminants of health. 
Sec. 1010. Correcting hurtful and alienating names in government expression 
(CHANGE). 
Subtitle B—Gun Violence 
Sec. 1011. Findings. 
Sec. 1012. Reaffirming research authority of the Centers for Disease Control 
and Prevention. 
Sec. 1013. National violent death reporting system. 
Sec. 1014. Report on effects of gun violence on public health. 
Sec. 1015. Report on effects of gun violence on mental health in minority com-
munities. 
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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 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 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. 101. AMENDMENT TO THE PUBLIC HEALTH SERVICE 
ACT. 
(a) PURPOSE.—It is the purpose of the amendment 
made by this section to promote data collection, analysis, 
and reporting by race, ethnicity, sex, primary language, 
sexual orientation, disability status, gender identity, age, 
and socioeconomic status among federally supported 
health programs. 
(b) AMENDMENT.—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. HEALTH DISPARITY DATA. 
‘‘(a) REQUIREMENTS.— 
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‘‘(1) IN
GENERAL.—Each health-related pro-
gram shall— 
‘‘(A) require the collection, by the agency 
or program involved, of data on the race, eth-
nicity, sex, primary language, sexual orienta-
tion, disability status, gender identity, age, and 
socioeconomic status of each applicant for and 
recipient of health-related assistance under such 
program, including— 
‘‘(i) using, at a minimum, standards 
for data collection on race, ethnicity, sex, 
primary language, sexual orientation, gen-
der identity, age, socioeconomic status, and 
disability status as each are developed 
under section 3101; 
‘‘(ii) collecting data for additional 
population groups if such groups can be 
aggregated into the race and ethnicity cat-
egories outlined by standards developed 
under section 3101; 
‘‘(iii) using, where practicable, the 
standards developed by the Health and 
Medicine Division of the National Acad-
emies of Sciences, Engineering, and Medi-
cine (formerly known as the ‘Institute of 
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Medicine’) in the 2009 publication, entitled 
‘Race, Ethnicity, and Language Data: 
Standardization for Health Care Quality 
Improvement’; and 
‘‘(iv) where practicable, collecting 
such data through self-reporting; 
‘‘(B) with respect to the collection of the 
data described in subparagraph (A), for appli-
cants and recipients who are minors, require 
communication assistance in speech or writing, 
and for applicants and recipients who are other-
wise legally incapacitated, require that— 
‘‘(i) such data be collected from the 
parent or legal guardian of such an appli-
cant or recipient; and 
‘‘(ii) the primary language of the par-
ent or legal guardian of such an applicant 
or recipient be collected; 
‘‘(C) systematically analyze such data 
using the smallest appropriate units of analysis 
feasible to detect racial and ethnic disparities, 
as well as disparities along the lines of primary 
language, sex, disability status, sexual orienta-
tion, gender identity, age, and socioeconomic 
status in health and health care, and report the 
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results of such analysis to the Secretary, the 
Director of the Office for Civil Rights, each 
agency listed in section 3101(c)(1), the Com-
mittee on Health, Education, Labor, and Pen-
sions and the Committee on Finance of the 
Senate, and the Committee on Energy and 
Commerce and the Committee on Ways and 
Means of the House of Representatives; 
‘‘(D) provide such data to the Secretary on 
at least an annual basis; and 
‘‘(E) ensure that the provision of assist-
ance to an applicant or recipient of assistance 
is not denied or otherwise adversely affected be-
cause of the failure of the applicant or recipient 
to provide race, ethnicity, primary language, 
sex, sexual orientation, disability status, gender 
identity, age, and socioeconomic status data. 
‘‘(2) RULES
OF
CONSTRUCTION.—Nothing in 
this subsection shall be construed to— 
‘‘(A) permit the use of information col-
lected under this subsection in a manner that 
would adversely affect any individual providing 
any such information; or 
‘‘(B) diminish any requirements, including 
such requirements in effect on or after the date 
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of enactment of this section, on health care pro-
viders to collect data. 
‘‘(3) NO COMPELLED DISCLOSURE OF DATA.— 
This title does not authorize any health care pro-
vider, Federal official, or other entity to compel the 
disclosure of any data collected under this title. The 
disclosure of any such data by an individual pursu-
ant to this title shall be strictly voluntary. 
‘‘(b) PROTECTION OF DATA.—The Secretary shall 
ensure (through the promulgation of regulations or other-
wise) that all data collected pursuant to subsection (a) are 
protected— 
‘‘(1) under the same privacy protections as the 
Secretary applies to other health data under the reg-
ulations promulgated under section 264(c) of the 
Health Insurance Portability and Accountability Act 
of 1996 relating to the privacy of individually identi-
fiable health information and other protections; and 
‘‘(2) from all inappropriate internal use by any 
entity that collects, stores, or receives the data, in-
cluding use of such data in determinations of eligi-
bility (or continued eligibility) in health plans, and 
from other inappropriate uses, as defined by the 
Secretary. 
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‘‘(c) NATIONAL PLAN OF THE DATA COUNCIL.—The 
Secretary shall develop and implement a national plan to 
ensure the collection of data in a culturally and linguis-
tically appropriate manner, to improve the collection, anal-
ysis, and reporting of racial, ethnic, sex, primary lan-
guage, sexual orientation, disability status, gender iden-
tity, age, and socioeconomic status data at the Federal, 
State, territorial, Tribal, and local levels, including data 
to be collected under subsection (a), and to ensure that 
data collection activities carried out under this section are 
in compliance with standards developed under section 
3101. The Data Council of the Department of Health and 
Human Services, in consultation with the National Com-
mittee on Vital Health Statistics, the Office of Minority 
Health, Office on Women’s Health, and other appropriate 
public and private entities, shall make recommendations 
to the Secretary concerning the development, implementa-
tion, and revision of the national plan. Such plan shall 
include recommendations on how to— 
‘‘(1) implement subsection (a) while minimizing 
the cost and administrative burdens of data collec-
tion and reporting; 
‘‘(2) expand knowledge among Federal agen-
cies, States, territories, Indian Tribes, counties, mu-
nicipalities, health providers, health plans, and the 
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general public that data collection, analysis, and re-
porting by race, ethnicity, sex, primary language, 
sexual orientation, gender identity, age, socio-
economic status, and disability status is legal and 
necessary to assure equity and nondiscrimination in 
the quality of health care services; 
‘‘(3) ensure that future patient record systems 
follow Federal standards promulgated under the 
Health Information Technology for Economic and 
Clinical Health Act for the collection and meaningful 
use of electronic health data on race, ethnicity, sex, 
primary language, sexual orientation, gender iden-
tity, age, socioeconomic status, and disability status; 
‘‘(4) improve health and health care data collec-
tion and analysis for more population groups if such 
groups can be aggregated into the minimum race 
and ethnicity categories, including exploring the fea-
sibility of enhancing collection efforts in States, 
counties, and municipalities for racial and ethnic 
groups that comprise a significant proportion of the 
population of the State, county, or municipality; 
‘‘(5) provide researchers with greater access to 
racial, ethnic, primary language, sex, sexual orienta-
tion, gender identity, age, socioeconomic status data, 
and disability status data, subject to all applicable 
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privacy and confidentiality requirements, including 
HIPAA privacy and security law as defined in sec-
tion 3009; and 
‘‘(6) safeguard and prevent the misuse of data 
collected under subsection (a). 
‘‘(d) COMPLIANCE WITH STANDARDS.—Data col-
lected under subsection (a) shall be obtained, maintained, 
and presented (including for reporting purposes) in ac-
cordance with standards developed under section 3101. 
‘‘(e) ANALYSIS OF HEALTH DISPARITY DATA.—The 
Secretary, acting through the Director of the Agency for 
Healthcare Research and Quality and in coordination with 
the Assistant Secretary for Planning and Evaluation, the 
Administrator of the Centers for Medicare & Medicaid 
Services, the Director of the National Center for Health 
Statistics, and the Director of the National Institutes of 
Health, shall provide technical assistance to agencies of 
the Department of Health and Human Services in meeting 
Federal standards for health disparity data collection and 
for analysis of racial, ethnic, and other disparities in 
health and health care in programs conducted or sup-
ported by such agencies by— 
‘‘(1) identifying appropriate quality assurance 
mechanisms to monitor for health disparities; 
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‘‘(2) specifying the clinical, diagnostic, or thera-
peutic measures which should be monitored; 
‘‘(3) developing new quality measures relating 
to racial and ethnic disparities and their overlap 
with other disparity factors in health and health 
care; 
‘‘(4) identifying the level at which data analysis 
should be conducted; and 
‘‘(5) sharing data with external organizations 
for research and quality improvement purposes. 
‘‘(f) DEFINITIONS.—In this section— 
‘‘(1) the term ‘health-related program’ means a 
program that is operated by the Secretary, or that 
receives funding or reimbursement, in whole or in 
part, either directly or indirectly from the Sec-
retary— 
‘‘(A) for activities under the Social Secu-
rity Act for health care services; or 
‘‘(B) for providing Federal financial assist-
ance for health care, biomedical research, or 
health services research or for otherwise im-
proving the health of the public; 
‘‘(2) the term ‘primary language data’ includes 
spoken and written primary language data; and 
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‘‘(3) the term ‘primary language data collection 
activities’ includes identifying, collecting, storing, 
tracking, and analyzing primary language data and 
information on the methods used to meet the lan-
guage access needs of individuals with limited 
English proficiency. 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as may be necessary for each of fiscal years 
2021 through 2025. 
‘‘SEC. 3432. 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, and the Director of the National 
Center for Health Statistics, shall establish a technical as-
sistance program under which the Secretary provides 
grants to eligible entities to assist such entities in com-
plying with section 3431. 
‘‘(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; and 
‘‘(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. 
‘‘(c) ELIGIBLE ENTITY.—To be eligible for grants 
under this section, an entity shall be a State, territory, 
Indian Tribe, municipality, county, health provider, health 
care organization, or health plan making a demonstrated 
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