I 
115TH CONGRESS 
2D SESSION 
H. R. 6601 
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 26, 2018 
Mr. LEWIS of Georgia (for himself and Mr. LEVIN) introduced the following 
bill; which was referred to the Committee on Energy and Commerce, and 
in addition to the Committee on Ways and Means, for a period to be sub-
sequently determined 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 2018’’. 
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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), by inserting ‘‘, the 
causes of health disparities and social determinants 
of health,’’ after ‘‘medicine’’; 
(2) in subsection (b)— 
(A) in paragraph (2)(A), by inserting ‘‘, as 
well as improving access to care received by in-
dividuals receiving benefits under such title,’’ 
after ‘‘title’’; 
(B) in paragraph (2)(C), by adding at the 
end the following new clauses: 
‘‘(ix) Whether the model will discour-
age providers of services and supplies from 
treating high risk patients, patients from 
minority or rural communities, or women. 
‘‘(x) Whether the model demonstrates 
reductions in minority and rural health 
disparities.’’; and 
(C) 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 
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(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 discourages providers 
from caring for high risk patients, women, 
patients from racial or ethnic minorities, or 
patients from rural communities.’’; 
(3) in subsection (c)— 
(A) in paragraph (2), by striking at the 
end ‘‘and’’; 
(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 
women, 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 women, low-in-
come, minority, or rural beneficiaries’’; and 
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(E) in the matter following paragraph (4), 
as redesignated by subparagraph (B), by insert-
ing ‘‘, improve access to care,’’ after ‘‘care’’. 
SEC. 3. UNDERSTANDING SOCIAL DETERMINANTS OF 
HEALTH IN MEDICARE AND MEDICAID POPU-
LATIONS. 
The Secretary of Health and Human Services shall, 
for each fiscal year (beginning not later than fiscal year 
2019), submit to Congress an annual report that analyzes 
the following: 
(1) The extent and severity of minority and 
rural health disparities in Medicare and Medicaid 
beneficiaries. 
(2) The prevalence of interventions that address 
social determinants of health in payment models se-
lected by the Center for Medicare and Medicaid In-
novation for testing. 
(3) The prevalence of interventions that address 
social determinants of health in payment models not 
selected by the Center for Medicare and Medicaid 
Innovation for testing. 
(4) The effectiveness of payment models se-
lected by the Center for Medicare and Medicaid In-
novation for testing in mitigating negative health 
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