I 
116TH CONGRESS 
1ST SESSION H. R. 3910 
To amend title XI of the Social Security Act to improve access to care 
for all Medicare and Medicaid beneficiaries through models tested under 
the Center for Medicare and Medicaid Innovation, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 23, 2019 
Mr. LEWIS (for himself, Mr. LARSON of Connecticut, Ms. SEWELL of Ala-
bama, Mr. DOGGETT, Mr. EVANS, Mr. PASCRELL, Mr. GOMEZ, Mr. 
SUOZZI, and Ms. SA´NCHEZ) introduced the following bill; which was re-
ferred to the Committee on Energy and Commerce, and in addition to 
the Committee on Ways and Means, for a period to be subsequently de-
termined by the Speaker, in each case for consideration of such provisions 
as fall within the jurisdiction of the committee concerned 
A BILL 
To amend title XI of the Social Security Act to improve 
access to care for all Medicare and Medicaid beneficiaries 
through models tested under the Center for Medicare 
and Medicaid Innovation, 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 ‘‘Equality in Medicare 
and Medicaid Treatment Act of 2019’’. 
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SEC. 2. IMPROVING ACCESS TO CARE FOR MEDICARE AND 
MEDICAID BENEFICIARIES. 
Section 1115A of the Social Security Act (42 U.S.C. 
1315a) is amended— 
(1) in subsection (a)(3)— 
(A) by inserting ‘‘, the causes of health 
disparities and social determinants of health,’’ 
after ‘‘medicine’’; and 
(B) by inserting ‘‘, the Office of Minority 
Health of the Centers for Medicare & Medicaid 
Services, the Office of Rural Health Policy, and 
the Office on Women’s Health’’; 
(2) in subsection (b)— 
(A) in paragraph (2)— 
(i) in subparagraph (A)— 
(I) by inserting after the first 
sentence, the following new sentence: 
‘‘Prior to model selection, the Sec-
retary shall consult with the Office of 
Minority Health of the Centers for 
Medicare & Medicaid Services, the 
Federal Office of Rural Health Policy, 
and the Office on Women’s Health to 
ensure that models under consider-
ation address health disparities and 
social determinants of health as ap-
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propriate for populations to be cared 
for under the model.’’; 
(II) by inserting ‘‘, as well as im-
proving access to care received by in-
dividuals receiving benefits under such 
title,’’ after ‘‘title’’; and 
(III) by adding at the end the 
following new sentence: ‘‘The models 
selected under this subparagraph shall 
include the social determinants of 
health payment model described in 
subparagraph (D), the testing of 
which shall begin not later than De-
cember 31, 2020.’’; 
(ii) in subparagraph (C), by adding at 
the end the following new clauses: 
‘‘(ix) Whether the model will affect 
access to care from providers and suppliers 
caring for high risk patients or operating 
in underserved areas. 
‘‘(x) Whether the model has the po-
tential to produce reductions in minority 
and rural health disparities.’’; and 
(iii) by adding at the end the fol-
lowing new subparagraph: 
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‘‘(D) SOCIAL DETERMINANTS OF HEALTH 
PAYMENT MODEL.— 
‘‘(i) IN GENERAL.—The social deter-
minants of health payment model described 
in this subparagraph is a payment model 
that tests each of the payment and service 
delivery innovations described in clause (ii) 
in a region determined appropriate by the 
Secretary. 
‘‘(ii) PAYMENT AND SERVICE DELIV-
ERY INNOVATIONS DESCRIBED.—For pur-
poses of clause (i), the payment and serv-
ice delivery innovations described in this 
clause are the following: 
‘‘(I) Payment and service delivery 
innovations for behavioral health serv-
ices, focusing on gathering actionable 
data to address the higher costs asso-
ciated with beneficiaries with diag-
nosed behavioral conditions. 
‘‘(II) Payment and service deliv-
ery innovations targeting conditions or 
comorbidities of individuals entitled or 
enrolled under the Medicare program 
under title XVIII and enrolled under 
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a State plan under the Medicaid pro-
gram under title XIX to increase ca-
pacity in underserved areas. 
‘‘(III) Payment and service deliv-
ery innovations targeted on Medicaid- 
eligible 
pregnant 
and 
postpartum 
women, up to one year after deliv-
ery.’’; and 
(B) in paragraph (4)(A)— 
(i) in clause (i) at the end, by striking 
‘‘and’’; 
(ii) in clause (ii), at the end, by strik-
ing the period and inserting ‘‘; and’’; and 
(iii) by adding at the end the fol-
lowing new clause: 
‘‘(iii) the extent to which the model 
improves access to care or the extent to 
which the model improves care for high 
risk patients, patients from racial or ethnic 
minorities, or patients in underserved 
areas.’’; 
(3) in subsection (c)— 
(A) in paragraph (2), by striking at the 
end ‘‘and’’; 
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(B) by redesignating paragraph (3) as 
paragraph (4); 
(C) by inserting after paragraph (2) the 
following new paragraph: 
‘‘(3) the Office of Minority Health of the Cen-
ters for Medicare & Medicaid Services certifies that 
such expansion will not reduce access to care for 
low-income, minority, or rural beneficiaries; and’’; 
(D) in paragraph (4), as redesignated by 
subparagraph (B), by inserting before the pe-
riod at the end the following: ‘‘nor increase 
health disparities experienced by low-income, 
minority, or rural beneficiaries’’; and 
(E) in the matter following paragraph (4), 
as redesignated by subparagraph (B), by insert-
ing ‘‘, improve access to care,’’ after ‘‘care’’; 
and 
(4) in subsection (g)— 
(A) by inserting ‘‘(or, beginning with 2021, 
once every year thereafter)’’ after ‘‘thereafter’’; 
and 
(B) by adding at the end the following new 
sentence: ‘‘For reports for 2021 and each sub-
sequent year, each such report shall include in-
formation on the following: 
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‘‘(1) The extent and severity of minority and 
rural health disparities in Medicare and Medicaid 
beneficiaries. 
‘‘(2) The interventions that address social de-
terminants of health in payment models selected by 
the Center for Medicare and Medicaid Innovation for 
testing. 
‘‘(3) The interventions that address social de-
terminants of health in payment models not selected 
by the Center for Medicare and Medicaid Innovation 
for testing. 
‘‘(4) The effectiveness of interventions in miti-
gating negative health outcomes and higher costs as-
sociated with social determinants of health within 
models selected by the Center for Medicare and 
Medicaid Innovation for testing. 
‘‘(5) Changes in disparities among minorities 
and Medicare and Medicaid beneficiaries in under-
served areas that are attributable to provider and 
supplier participation in a Phase II model. 
‘‘(6) In consultation with the Comptroller Gen-
eral of the United States, estimated Federal savings 
achieved through the reduction of rural and minority 
health disparities. 
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‘‘(7) Other areas determined appropriate by the 
Secretary.’’. 
Æ 
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