Title: Patient Navigation Assistance Act
Policy area: Health

Summary:
Patient Navigation Assistance Act
This bill requires state Medicaid programs to cover patient navigator services. Patient navigators help individuals who are seeking prevention and treatment services for chronic diseases (e.g., cancer) to access appropriate services, obtain relevant information, and otherwise navigate the health care system.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4830 Introduced in House (IH)]

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116th CONGRESS
  1st Session
                                H. R. 4830

 To provide payment for patient navigator services under title XIX of 
            the Social Security Act, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 23, 2019

 Mr. DeSaulnier (for himself and Mr. Carter of Georgia) introduced the 
   following bill; which was referred to the Committee on Energy and 
                                Commerce

_______________________________________________________________________

                                 A BILL


 
 To provide payment for patient navigator services under title XIX of 
            the Social Security Act, 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 ``Patient Navigation Assistance Act''.

SEC. 2. MEDICAID COVERAGE FOR PATIENT NAVIGATOR SERVICES.

    (a) In General.--Section 1902(a) of the Social Security Act (42 
U.S.C. 1396a(a)) is amended--
            (1) in paragraph (82), by striking ``and'' at the end;
            (2) in paragraph (83), by striking at the end the period 
        and inserting ``; and''; and
            (3) by inserting after paragraph (83) the following new 
        paragraph:
            ``(84) provide that the State shall reimburse an eligible 
        entity (as defined in subsection (nn)(1)) for any patient 
        navigator service (as defined in subsection (nn)(3)) that is 
        provided--
                    ``(A) to an individual who is eligible for medical 
                assistance under the State plan; and
                    ``(B) by a patient navigator (as defined in 
                subsection (nn)(2)) through the eligible entity.''; and
            (4) by adding at the end the following new subsection:
    ``(nn) Patient Navigator Services Definitions.--For purposes of 
this section:
            ``(1) Eligible entity.--The term `eligible entity' means an 
        entity that--
                    ``(A) is an eligible entity (as defined in 
                subsection (l)(1) of section 340A of the Public Health 
                Service Act); and
                    ``(B) complies with the following requirements of 
                such section (insofar as they apply to a grant 
                recipient under such section):
                            ``(i) Subsection (b) (relating to patient 
                        navigator duties and community knowledge).
                            ``(ii) Subsection (c) (relating to 
                        prohibitions).
                            ``(iii) Subsection (e) (relating to 
                        applications).
                            ``(iv) Subsection (j)(3) (relating to 
                        reports).
            ``(2) Patient navigator.--
                    ``(A) In general.--The term `patient navigator' has 
                the meaning given such term in section 340A(l)(3) of 
                the Public Health Service Act.
                    ``(B) Consultation with advisory committee.--
                            ``(i) In general.--The Secretary shall 
                        consult with the patient navigation advisory 
                        committee to the extent necessary to further 
                        clarify the definition of the term `patient 
                        navigator' for purposes of this section, 
                        including establishing requirements to ensure 
                        adequate training for such navigators, such as 
                        developing a training curriculum and 
                        determining required qualifications and 
                        maintenance of qualifications.
                            ``(ii) Membership.--The Secretary shall 
                        convene a patient navigation advisory 
                        committee. The members of such committee shall 
                        include--
                                    ``(I) representatives from relevant 
                                Federal departments and agencies, 
                                including the National Institutes of 
                                Health, the Centers for Disease Control 
                                and Prevention, the Health Resources 
                                and Services Administration, the 
                                Centers for Medicare & Medicaid 
                                Services, the Indian Health Service, 
                                and the Office of Rural Health Policy 
                                of the Department of Health and Human 
                                Services; and
                                    ``(II) physicians, nurses, 
                                stakeholder groups, and other 
                                individuals and representatives of 
                                public and private organizations with 
                                expertise in patient navigation.
            ``(3) Patient navigator services.--The term `patient 
        navigator service' means a service that is a duty specified 
        under paragraphs (1) through (6) of subsection (b) of section 
        340A of the Public Health Service Act and that is provided by a 
        patient navigator through an eligible entity.''.
    (b) Treatment as Medical Assistance for Purposes of FMAP.--Section 
1905(a) of the Social Security Act (42 U.S.C. 1396d(a)) is amended--
            (1) in paragraph (28), by striking ``and'' at the end;
            (2) by redesignating paragraph (29) as paragraph (30); and
            (3) by inserting after paragraph (28) the following new 
        paragraph:
            ``(29) patient navigator services (as defined in section 
        1902(nn)(3)) that are provided in a manner that meets the 
        requirements of section 1902(a)(84); and''.
    (c) Effective Date.--
            (1) In general.--Subject to paragraph (2), the amendments 
        made by this section shall apply to patient navigator services 
        provided after the first day of the first calendar year that 
        begins after the date of enactment of this Act.
            (2) Exception for state legislation.--In the case of a 
        State plan under title XIX of the Social Security Act, which 
        the Secretary of Health and Human Services determines requires 
        State legislation in order for the respective plan to meet any 
        requirement imposed by amendments made by this Act, the 
        respective plan shall not be regarded as failing to comply with 
        the requirements of such title solely on the basis of its 
        failure to meet such an additional requirement before the first 
        day of the first calendar quarter beginning after the close of 
        the first regular session of the State legislature that begins 
        after the date of enactment of this Act. For purposes of the 
        previous sentence, in the case of a State that has a 2-year 
        legislative session, each year of the session shall be 
        considered to be a separate regular session of the State 
        legislature.
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