Title: Equality in Medicare and Medicaid Treatment Act of 2019
Policy area: Health

Summary:
Equality in Medicare and Medicaid Treatment Act of 2019
This bill requires the Center for Medicare and Medicaid Innovation to test a payment model that addresses social determinants of health and health disparities, particularly with respect to minorities, underserved areas, and high-risk individuals. The bill also generally incorporates consideration of such factors into the selection, implementation, and evaluation of other models, including the decision as to whether to expand a model's duration and scope.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3910 Introduced in House (IH)]

<DOC>






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 
 Alabama, Mr. Doggett, Mr. Evans, Mr. Pascrell, Mr. Gomez, Mr. Suozzi, 
 and Ms. Sanchez) 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 subsequently 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 Representatives 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''.

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 
                                Secretary 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 consideration 
                                address health disparities and social 
                                determinants of health as appropriate 
                                for populations to be cared for under 
                                the model.'';
                                    (II) by inserting ``, as well as 
                                improving access to care received by 
                                individuals 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 December 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 potential 
                        to produce reductions in minority and rural 
                        health disparities.''; and
                            (iii) by adding at the end the following 
                        new subparagraph:
                    ``(D) Social determinants of health payment 
                model.--
                            ``(i) In general.--The social determinants 
                        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 delivery 
                        innovations described.--For purposes of clause 
                        (i), the payment and service delivery 
                        innovations described in this clause are the 
                        following:
                                    ``(I) Payment and service delivery 
                                innovations for behavioral health 
                                services, focusing on gathering 
                                actionable data to address the higher 
                                costs associated with beneficiaries 
                                with diagnosed behavioral conditions.
                                    ``(II) Payment and service delivery 
                                innovations targeting conditions or 
                                comorbidities of individuals entitled 
                                or enrolled under the Medicare program 
                                under title XVIII and enrolled under a 
                                State plan under the Medicaid program 
                                under title XIX to increase capacity in 
                                underserved areas.
                                    ``(III) Payment and service 
                                delivery innovations targeted on 
                                Medicaid-eligible pregnant and 
                                postpartum women, up to one year after 
                                delivery.''; and
                    (B) in paragraph (4)(A)--
                            (i) in clause (i) at the end, by striking 
                        ``and'';
                            (ii) in clause (ii), at the end, by 
                        striking the period and inserting ``; and''; 
                        and
                            (iii) by adding at the end the following 
                        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'';
                    (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 Centers 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 period 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 inserting ``, 
                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 subsequent 
                year, each such report shall include information on the 
                following:
            ``(1) The extent and severity of minority and rural health 
        disparities in Medicare and Medicaid beneficiaries.
            ``(2) The interventions that address social determinants of 
        health in payment models selected by the Center for Medicare 
        and Medicaid Innovation for testing.
            ``(3) The 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 interventions in mitigating 
        negative health outcomes and higher costs associated 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 underserved areas that are 
        attributable to provider and supplier participation in a Phase 
        II model.
            ``(6) In consultation with the Comptroller General of the 
        United States, estimated Federal savings achieved through the 
        reduction of rural and minority health disparities.
            ``(7) Other areas determined appropriate by the 
        Secretary.''.
                                 <all>