Physician Wellness Program Act of 2022
Bill: H.R.8890 | Sponsor: Rep. Ruiz, Raul (D-CA)
Policy area: Health

Summary:
Physician Wellness Program Act of 2022
This bill exempts wellness programs that provide certain mental or behavioral health services for physicians from restrictions under the Stark law (i.e., the Physician Self-Referral Law) and federal anti-kickback laws.

To amend title XVIII of the Social Security Act to establish exceptions 
    for certain physician wellness programs, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Physician Wellness Program Act of 
2022''.

SEC. 2. EXCEPTION FOR PHYSICIAN WELLNESS PROGRAMS.

    (a) Exception for Physician Wellness Programs.--
            (1) In general.--Section 1877(e) of the Social Security Act 
        (42 U.S.C. 1395nn(e)) is amended by adding at the end the 
        following:
            ``(9) Physician wellness programs.--A bona fide mental 
        health or behavioral health improvement or maintenance program 
        offered to a physician by an entity, if--
                    ``(A) such program--
                            ``(i) consists of counseling, mental health 
                        services, a suicide prevention program, or a 
                        substance use disorder prevention and treatment 
                        program;
                            ``(ii) is made available to a physician for 
                        the primary purpose of preventing suicide, 
                        improving mental health and resiliency, or 
                        providing training in appropriate strategies to 
                        promote the mental health and resiliency of 
                        such physician;
                            ``(iii) is set out in a written policy, 
                        approved in advance of the operation of the 
                        program by the governing body of the entity 
                        providing such program, that includes--
                                    ``(I) a description of the content 
                                and duration of the program;
                                    ``(II) a description of the 
                                evidence-based support for the design 
                                of the program;
                                    ``(III) the estimated cost of the 
                                program;
                                    ``(IV) the personnel (including the 
                                qualifications of such personnel) 
                                implementing the program; and
                                    ``(V) the method by which such 
                                entity will evaluate the use and 
                                success of the program;
                            ``(iv) is offered by an entity with a 
                        formal medical staff to all physicians who 
                        practice in the geographic area served by such 
                        entity, including physicians who hold bona fide 
                        appointments to the medical staff of such 
                        entity or otherwise have clinical privileges at 
                        such entity;
                            ``(v) is offered to all such physicians on 
                        the same terms and conditions and without 
                        regard to the volume or value of referrals or 
                        other business generated by a physician for 
                        such entity;
                            ``(vi) is evidence-based and conducted by a 
                        qualified health professional; and
                            ``(vii) meets such other requirements the 
                        Secretary may impose by regulation as needed to 
                        protect against program or patient abuse;
                    ``(B) such entity is--
                            ``(i) a hospital;
                            ``(ii) an ambulatory surgical center;
                            ``(iii) a community health center;
                            ``(iv) a rural emergency hospital;
                            ``(v) a rural health clinic;
                            ``(vi) a skilled nursing facility; or
                            ``(vii) a similar entity, as determined by 
                        the Secretary; and
                    ``(C) neither the provision of such program, nor 
                the value of such program, are contingent upon the 
                number or value of referrals made by a physician to 
                such entity.''.
            (2) Regulation.--Not later than 1 year after the date of 
        enactment of this Act, the Secretary of Health and Human 
        Services shall promulgate such regulations as are necessary to 
        carry out the amendment made by paragraph (1).
    (b) Exception Under the Anti-Kickback Statute.--Section 1128B(b)(3) 
of the Social Security Act (42 U.S.C. 1320a-7b(b)(3)) is amended--
            (1) in subparagraph (J), by striking ``and'' at the end;
            (2) in subparagraph (K), by striking the period at the end 
        and inserting ``; and''; and
            (3) by adding at the end the following:
            ``(L) a bona fide mental health or behavioral health 
        improvement or maintenance program, if--
                    ``(i) such program--
                            ``(I) consists of counseling, mental health 
                        services, a suicide prevention program, or a 
                        substance use disorder prevention and treatment 
                        program;
                            ``(II) is made available to a physician and 
                        other clinicians for the primary purpose of 
                        preventing suicide, improving mental health and 
                        resiliency, or providing training in 
                        appropriate strategies to promote the mental 
                        health and resiliency of such physician;
                            ``(III) is set out in a written policy, 
                        approved in advance of the operation of the 
                        program by the governing body of the entity 
                        providing such program, that includes--
                                    ``(aa) a description of the content 
                                and duration of the program;
                                    ``(bb) a description of the 
                                evidence-based support for the design 
                                of the program;
                                    ``(cc) the estimated cost of the 
                                program;
                                    ``(dd) the personnel (including the 
                                qualifications of such personnel) 
                                implementing the program; and
                                    ``(ee) the method by which such 
                                entity will evaluate the use and 
                                success of the program;
                            ``(IV) is offered by an entity with a 
                        formal medical staff to all physicians and 
                        other clinicians who practice in the geographic 
                        area served by such entity, including 
                        physicians who hold bona fide appointments to 
                        the medical staff of such entity or otherwise 
                        have clinical privileges at such entity;
                            ``(V) is offered to all such physicians and 
                        clinicians on the same terms and conditions and 
                        without regard to the volume or value of 
                        referrals or other business generated by a 
                        physician or clinician for such entity;
                            ``(VI) is evidence-based and conducted by a 
                        qualified health professional; and
                            ``(VII) meets such other requirements the 
                        Secretary may impose by regulation as needed to 
                        protect against program or patient abuse;
                    ``(ii) such entity is--
                            ``(I) a hospital;
                            ``(II) an ambulatory surgical center;
                            ``(III) a community health center;
                            ``(IV) a rural emergency hospital;
                            ``(V) a skilled nursing facility; or
                            ``(VI) any similar entity, as determined by 
                        the Secretary; and
                    ``(iii) neither the provision of such program, nor 
                the value of such program, are contingent upon the 
                number or value of referrals made by a physician or 
                other clinician to such entity.''.
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