Title: Protecting Patients Transportation to Care Act
Policy area: Health

Summary:
Protecting Patients Transportation to Care Act
This bill provides statutory authority for the requirement that state Medicaid programs cover nonemergency transportation to medically necessary services. The bill also requires programs, as a condition of federal payment for such transportation services, to have a prior authorization or utilization management requirement for such services.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3935 Introduced in House (IH)]

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116th CONGRESS
  1st Session
                                H. R. 3935

   To amend title XIX of the Social Security Act to provide for the 
      continuing requirement of Medicaid coverage of nonemergency 
            transportation to medically necessary services.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 24, 2019

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

_______________________________________________________________________

                                 A BILL


 
   To amend title XIX of the Social Security Act to provide for the 
      continuing requirement of Medicaid coverage of nonemergency 
            transportation to medically necessary services.

    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 ``Protecting Patients Transportation 
to Care Act''.

SEC. 2. CONTINUING REQUIREMENT OF MEDICAID COVERAGE OF NONEMERGENCY 
              TRANSPORTATION TO MEDICALLY NECESSARY SERVICES.

    (a) Requirement.--Section 1902(a)(10) of the Social Security Act 
(42 U.S.C. 1396a(a)(10)) is amended--
            (1) in subparagraph (A), in the matter preceding clause 
        (i), by striking ``and (21)'' and inserting ``, (21), and 
        (30)''; and
            (2) in subparagraph (C)(iv), by striking ``and (17)'' and 
        inserting ``, (17), and (30)''.
    (b) Description of Services.--Section 1905 of such Act (42 U.S.C. 
1396d) is amended--
            (1) in subsection (a)--
                    (A) in paragraph (29), by striking ``and'' at the 
                end;
                    (B) by redesignating paragraph (30) as paragraph 
                (31) and by striking the comma at the end and inserting 
                a semicolon; and
                    (C) by inserting after paragraph (29) the following 
                new paragraph:
            ``(30) subject to subsection (ff), nonemergency 
        transportation to medically necessary services, consistent with 
        the requirement of section 431.53 of title 42, Code of Federal 
        Regulations, as in effect as of June 1, 2019; and''; and
            (2) by adding at the end the following new subsection:
    ``(ff) Nonemergency Transportation to Medically Necessary 
Services.--
            ``(1) Limitation on federal financial participation.--
        Notwithstanding any other provision of this title, to be 
        eligible for federal financial participation under this title 
        for expenses incurred as medical assistance or as an 
        administrative expense for nonemergency transportation to 
        medically necessary services described in subsection (a)(30), 
        the State Medicaid agency of such State must have in place a 
        prior authorization or utilization management requirement for 
        such services.
            ``(2) Prior authorization defined.--For purposes of 
        paragraph (1), the term `prior authorization' means a process 
        through which a request for provisional affirmation of coverage 
        is submitted for review before the service involved is 
        furnished and before a claim is submitted for payment for such 
        service.''.
    (c) Effective Date.--The amendments made by this section shall take 
effect on the date of the enactment of this Act and shall apply to 
transportation on or after such date.
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