Title: Equal Health Care for All Act
Policy area: Health

Summary:
Equal Health Care for All Act
This bill prohibits discrimination in health care based on race, ethnicity, and other characteristics. It also revises reporting requirements, adds equity-related measures to certain Medicare programs, and makes other changes to reduce health disparities.
To enforce the prohibition, the Department of Health and Human Services (HHS) must establish an administrative process to resolve complaints about inequitable health care. HHS must investigate these complaints and mediate agreements to resolve issues. In the event of noncompliance with a mediated agreement, an aggrieved individual may bring a civil action.
Health care providers must also report data in formats that allow disaggregation by demographic factors. HHS must issue proposed regulations to carry out this requirement within 90 days.
Additionally, the Centers for Medicare & Medicaid Services (CMS) must include measures related to equitable health care in the Medicare value-based purchasing program for hospitals. This program provides incentive payments based on quality of care. The CMS may also exclude providers that furnish inequitable health care from its programs.
In addition, the bill establishes the Federal Health Equity Commission to monitor implementation of the bill and establishes a grant program for hospitals to promote equitable health care.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8436 Introduced in House (IH)]

<DOC>






116th CONGRESS
  2d Session
                                H. R. 8436

To prohibit discrimination in health care and require the provision of 
             equitable health care, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 29, 2020

   Mr. Schiff (for himself, Ms. Bass, Mr. Grijalva, Mr. Cooper, Mrs. 
Hayes, Mr. Khanna, Ms. Scanlon, Ms. Norton, and Ms. Lee of California) 
 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 prohibit discrimination in health care and require the provision of 
             equitable health care, 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 ``Equal Health Care for All Act''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) In 1966, Martin Luther King, Jr., said, ``Of all the 
        forms of inequality, injustice in health care is the most 
        shocking and inhuman because it often results in physical 
        death.''.
            (2) Inequality in health care remains a persistent and 
        devastating reality for many communities, but, in particular, 
        communities of color.
            (3) Unequal health care has complex causes, many stemming 
        from systemic inequality in access to health care, housing, 
        nutrition, economic opportunity, education, and other factors.
            (4) Health care outcomes for African-American communities 
        in particular lag far behind those of the population as a 
        whole.
            (5) Dr. Anthony Fauci, director of the National Institute 
        of Allergy and Infectious Diseases, said on April 7, 2020, the 
        coronavirus outbreak is ``shining a bright light'' on 
        ``unacceptable'' health disparities in the African-American 
        community.
            (6) A contributing factor in health disparities is explicit 
        and implicit bias in the delivery of health care, resulting in 
        inferior care and poorer outcomes for some patients on the 
        basis of race or ethnicity.
            (7) The Institute of Medicine issued a report in 2002 
        titled ``Unequal Treatment'', finding that racial and ethnic 
        minorities receive lower-quality health care than Whites do, 
        even when insurance status, income, age, and severity of 
        condition is comparable.
            (8) Just as Congress has sought to eliminate bias, both 
        explicit and implicit, in employment, housing, and other parts 
        of our society, the elimination of bias and the legacy of 
        structural racism in health care is of paramount importance.

SEC. 3. DATA COLLECTION AND REPORTING.

    (a) Required Reporting.--
            (1) In general.--The Secretary of Health and Human 
        Services, in consultation with Director of the National 
        Institutes of Health, the Director of the Centers for Medicare 
        & Medicaid Services, the Director of the Agency for Healthcare 
        Research and Quality, the Deputy Assistant Secretary for 
        Minority Health, and the Director of the National Center for 
        Health Statistics, shall by regulation require all health care 
        providers and facilities that are required under other 
        provisions of law to report data on health outcomes to the 
        Department of Health and Human Services to disaggregate such 
        data by demographic characteristics, including by race, 
        ethnicity, sex, sexual orientation, disability status, gender 
        identity, age, and any other factor that the Secretary 
        determines would be useful for determining a pattern of 
        inequitable health care.
            (2) Proposed regulations.--Not later than 90 days after the 
        date of enactment of this Act, the Secretary of Health and 
        Human Services shall issue proposed regulations to carry out 
        paragraph (1).
    (b) Repository.--The Secretary of Health and Human Services shall--
            (1) not later than 1 year after the date of enactment of 
        this Act, establish a repository of the disaggregated data 
        reported pursuant to subsection (a);
            (2) subject to paragraph (3), make the data in such 
        repository publicly available; and
            (3) ensure that such repository does not contain any data 
        that is individually identifiable.

SEC. 4. REQUIRING EQUITABLE HEALTH CARE IN THE HOSPITAL VALUE-BASED 
              PURCHASING PROGRAM.

    (a) Equitable Health Care as Value Measurement.--Section 
1886(b)(3)(B)(viii) of the Social Security Act (42 U.S.C. 
1395ww(b)(3)(B)(viii)) is amended by adding at the end the following 
new subclause:
                                    ``(XIII)(aa) Effective for payments 
                                beginning with fiscal year 2022, in 
                                expanding the number of measures under 
                                subclause (III), the Secretary shall 
                                adopt measures that relate to equitable 
                                health care furnished by hospitals in 
                                inpatient settings.
                                    ``(bb) In carrying out this 
                                subclause, the Secretary shall solicit 
                                input and recommendations from 
                                individuals and groups representing 
                                communities of color and ensure 
                                measures adopted pursuant to this 
                                subclause account for social 
                                determinants of health care outcomes.
                                    ``(cc) For purposes of this 
                                subclause, the term `equitable health 
                                care' refers to the principle that 
                                quality of care provided to an 
                                individual shall not vary on account of 
                                the real or perceived race, ethnicity, 
                                sex, sexual orientation, disability 
                                status, gender identity, or age of such 
                                individual.''.
    (b) Inclusion of Equitable Health Care Measures.--Section 
1886(o)(2)(B) of the Social Security Act (42 U.S.C. 1395ww(o)(2)(B)) is 
amended by adding at the end the following new clause:
                            ``(iv) Inclusion of equitable health care 
                        measures.--Beginning in fiscal year 2021, 
                        measures selected under subparagraph (A) shall 
                        include the equitable health care measures 
                        described under subsection 
                        (b)(3)(B)(viii)(XIII).''.

SEC. 5. PROVISION OF INEQUITABLE HEALTH CARE AS A BASIS FOR PERMISSIVE 
              EXCLUSION FROM MEDICARE AND STATE HEALTH CARE PROGRAMS.

    Section 1128(b) of the Social Security Act (42 U.S.C. 1320a-7(b)) 
is amended by adding at the end the following new paragraph:
            ``(18) Provision of inequitable health care.--Any 
        individual or entity that the Secretary determines has engaged 
        in a pattern of providing inequitable health care (as defined 
        in section 7 of the Equality in Health Care for All Act) on the 
        basis of race, ethnicity, sex, sexual orientation, disability 
        status, gender identity, age, or any other protected class.''.

SEC. 6. OFFICE OF CIVIL RIGHTS AND HEALTH EQUITY OF THE DEPARTMENT OF 
              HEALTH AND HUMAN SERVICES.

    (a) Name of Office.--The Office for Civil Rights of the Department 
of Health and Human Services shall, beginning on the date of enactment 
of this Act, be known as the Office of Civil Rights and Health Equity. 
Any reference to the Office for Civil Rights in any law, regulation, 
map, document, record, or other paper of the United States shall be 
deemed to be a reference to the Office of Civil Rights and Health 
Equity.
    (b) Head of Office.--The head of the Office of Civil Rights and 
Health Equity shall be the Assistant Secretary for Civil Rights and 
Health Equity, to be appointed by the President with advice and consent 
of the Senate. Any reference to the head of the Office for Civil Rights 
of the Department of Health and Human Services in any law, regulation, 
map, document, record, or other paper of the United States shall be 
deemed to be a reference to the Assistant Secretary for Civil Rights 
and Health Equity.

SEC. 7. PROHIBITING DISCRIMINATION IN HEALTH CARE.

    (a) In General.--No health care provider or entity providing health 
care may, on the basis of race, ethnicity, sex, sexual orientation, 
disability status, gender identity, age, subject another to inequitable 
health care.
    (b) Definition.--In this section, the term ``inequitable health 
care'' means any service provided by a health care provider or entity 
providing health care that--
            (1) is discriminatory in intent or effect; and
            (2) results in a disparate outcome for an individual based 
        at least in part on their membership in a protected class.

SEC. 8. ADMINISTRATIVE COMPLAINT AND CONCILIATION PROCESS.

    (a) Complaints and Answers.--
            (1) In general.--An aggrieved person may, not later than 
        one year after an alleged violation of section 7 has occurred 
        or terminated, file a complaint with the Assistant Secretary 
        alleging discriminatory health care by a health care provider.
            (2) Complaint.--A complaint submitted pursuant to paragraph 
        (1) shall be in writing and shall contain such information and 
        be in such form as the Assistant Secretary requires.
            (3) Procedure.--Upon the filing of such a complaint--
                    (A) the Assistant Secretary shall serve notice upon 
                the aggrieved person acknowledging receipt of such 
                filing and advising the aggrieved person of the time 
                limits and procedures provided under this section and 
                sections 9 and 10;
                    (B) the Assistant Secretary shall, not later than 
                10 days after receipt of such filing serve on the 
                respondent alleged to have provided discriminatory care 
                a notice of the complaint and advise the provider of 
                the procedural rights and obligations of respondents 
                under this section and sections 9 and 10, together with 
                a copy of the original complaint;
                    (C) a respondent may file, not later than 30 days 
                after receipt of notice from the Assistant Secretary, 
                an answer to such complaint;
                    (D) the Assistant Secretary shall make an 
                investigation of the alleged discriminatory health care 
                practice and complete such investigation within 100 
                days after the filing of the complaint, unless it is 
                impracticable to do so; and
                    (E) the Assistant Secretary shall notify State 
                licensing authorities with authority over the 
                respondent of the complaint and provide a copy of the 
                complaint and the final disposition of the complaint.
            (4) Investigation.--If the Assistant Secretary is unable to 
        complete the investigation within 100 days after the filing of 
        the complaint (or, when the Secretary takes further action 
        under subsection (f)(2) with respect to a complaint, within 100 
        days after the commencement of such further action), the 
        Assistant Secretary shall notify the complainant and respondent 
        in writing of the reasons for not doing so.
            (5) Oath or affirmation.--Complaints and answers shall be 
        under oath or affirmation, and may be reasonably and fairly 
        modified at any time.
            (6) Pattern of care.--In the course of investigating a 
        complaint, the Assistant Secretary may seek records of care 
        provided to patients other than the complainant if necessary to 
        demonstrate or disprove an allegation of inequitable health 
        care.
            (7) Accounting for social determinants of health.--In 
        investigating a complaint and reaching a determination, the 
        Assistant Secretary shall account for social determinants of 
        health and their effect on health care outcomes.
    (b) Investigative Report and Conciliation.--
            (1) Conciliation.--During the period beginning with the 
        filing of such complaint and ending with the resolution of a 
        complaint or a dismissal by the Assistant Secretary, the 
        Assistant Secretary shall, to the extent feasible, engage in 
        conciliation with respect to such complaint.
            (2) Conciliation agreement.--A conciliation agreement 
        arising out of such conciliation shall be an agreement between 
        the respondent and the complainant, and shall be subject to 
        approval by the Assistant Secretary.
            (3) Rights protected.--The Assistant Secretary shall 
        approve a conciliation agreement only if it protects the rights 
        of the aggrieved person and other persons similarly situated.
            (4) Publicly available.--
                    (A) In general.--Subject to subparagraph (B), a 
                redacted copy of a conciliation agreement entered into 
                pursuant to this section shall be made available to the 
                public unless the complainant and respondent otherwise 
                agree, and the Secretary determines, that disclosure is 
                not required to further the purposes of this section.
                    (B) Limitation.--A conciliation agreement that is 
                made available to the public pursuant to subparagraph 
                (A) may not disclose personally identifiable 
                information or individually identifiable health 
                information.
            (5) Report.--
                    (A) Final report.--At the end of each investigation 
                under this section, the Assistant Secretary shall 
                prepare a final investigative report.
                    (B) Modification of report.--A final report under 
                this paragraph may be modified if additional evidence 
                is later discovered.
    (c) Failure To Comply With Conciliation Agreement.--Whenever the 
Assistant Secretary has reasonable cause to believe that a health care 
provider has breached a conciliation agreement, the Assistant Secretary 
shall refer the matter to the Attorney General for consideration of the 
filing of a civil action for the enforcement of such agreement.
    (d) Prohibitions and Requirements With Respect to Disclosure of 
Information.--
            (1) Written consent for disclosure.--Nothing said or done 
        in the course of conciliation under this section may be made 
        public or used as evidence in a subsequent proceeding under 
        this section or section 9 or 10 without the written consent of 
        the persons concerned.
            (2) Investigation disclosures.--Notwithstanding paragraph 
        (1), the Assistant Secretary shall make available to the 
        aggrieved person and the respondent, at any time, upon request 
        following completion of the Assistant Secretary's 
        investigation, information derived from an investigation and 
        any final investigative report relating to that investigation.
    (e) Prompt Judicial Action.--
            (1) In general.--If the Assistant Secretary concludes at 
        any time following the filing of a complaint that prompt 
        judicial action is necessary to carry out the purposes of this 
        section or section 9 or 10, the Assistant Secretary may 
        recommend that the Attorney General promptly commence an 
        action.
            (2) Immediate suit.--If the Assistant Secretary determines 
        that the public interest would be served by allowing the 
        complainant to bring a civil action in a State or Federal court 
        immediately, the Assistant Secretary shall certify that the 
        administrative process has concluded and that the complainant 
        may file such a suit immediately.
    (f) Annual Report.--Not later than 1 year after the date of the 
enactment of this Act, and annually thereafter, the Assistant Secretary 
shall make publicly available a report detailing the activities of the 
Office under this section, including--
            (1) the number of complaints filed and the basis on which 
        they were filed;
            (2) the number of investigations undertaken as a result of 
        such complaints; and
            (3) the disposition of all investigations.
    (g) Definitions.--In this section and sections 9 and 10:
            (1) Assistant secretary.--The term ``Assistant Secretary'' 
        refers to the Assistant Secretary of Health and Human Services 
        for Civil Rights and Health Equity.
            (2) Aggrieved person.--The term ``aggrieved person'' means 
        a person who believes that they were injured by a violation of 
        section 7, or the personal representative or estate of the 
        deceased person.
            (3) Conciliation.--The term ``conciliation'' means the 
        attempted resolution of issues raised by a complaint, or by the 
        investigation of such complaint, through informal negotiations 
        involving the aggrieved person, the respondent, and the 
        Secretary.
            (4) Conciliation agreement.--The term ``conciliation 
        agreement'' means a written agreement setting forth the 
        resolution of the issues in conciliation.
            (5) Individually identifiable health information.--The term 
        ``individually identifiable health information'' means any 
        information, including demographic information collected from 
        an individual, that--
                    (A) is created or received by a health care 
                provider, health plan, employer, or health care 
                clearinghouse; and
                    (B) relates to the past, present, or future 
                physical or mental health or condition of an 
                individual, the provision of health care to an 
                individual, or the past, present, or future payment for 
                the provision of health care to an individual, and--
                            (i) identifies the individual; or
                            (ii) with respect to which there is a 
                        reasonable basis to believe that the 
                        information can be used to identify the 
                        individual.
            (6) Inequitable health care.--The term ``inequitable health 
        care'' has the meaning given the term under section 7.
            (7) Personally identifiable information.--The term 
        ``personally identifiable information'' has the meaning given 
        such term under the regulations promulgated under section 
        264(c) of the Health Insurance Portability and Accountability 
        Act of 1996.
            (8) Respondent.--The term ``respondent'' means the person 
        or other entity accused in a complaint of a violation of 
        section 7.

SEC. 9. ENFORCEMENT BY PRIVATE PERSONS.

    (a) In General.--
            (1) Civil action.--
                    (A) In suit.--An aggrieved person may commence a 
                civil action to obtain appropriate relief with respect 
                to an alleged violation of section 7 or an enforcement 
                action for breach of a conciliation agreement in an 
                appropriate United States district court or State 
                court--
                            (i) not later than 2 years after the 
                        occurrence or termination of the alleged 
                        violation; and
                            (ii) not sooner than the earlier of the 
                        conclusion of the administrative process and 
                        180 days after the alleged violation.
                    (B) Statute of limitations.--The computation of 
                such 2-year period shall not include any time during 
                which an administrative proceeding under section 8 was 
                pending with respect to a complaint under such section.
            (2) Barring suit.--If the Assistant Secretary has obtained 
        a conciliation agreement with the consent of an aggrieved 
        person, no action may be filed under this subsection by such 
        aggrieved person with respect to the alleged violation of 
        section 7 except for the purpose of enforcing the terms of such 
        an agreement.
    (b) Relief Which May Be Granted.--
            (1) In general.--In a civil action under subsection (a), if 
        the court finds that a violation of section 7 or breach of a 
        conciliation agreement has occurred, the court may award to the 
        plaintiff actual and punitive damages, and may grant as relief, 
        as the court deems appropriate, any permanent or temporary 
        injunction, temporary restraining order, or other order 
        (including an order enjoining the defendant from engaging in 
        such practice or ordering such affirmative action as may be 
        appropriate).
            (2) Fees and costs.--In a civil action under subsection 
        (a), the court, in its discretion, may allow the prevailing 
        party, other than the United States, a reasonable attorney's 
        fee and costs. The United States shall be liable for such fees 
        and costs to the same extent as a private person.
    (c) Intervention by Attorney General.--Upon timely application, the 
Attorney General may intervene in such civil action, if the Attorney 
General certifies that the case is of general public importance.

SEC. 10. ENFORCEMENT BY THE ATTORNEY GENERAL.

    (a) Pattern or Practice Cases.--Whenever the Attorney General has 
reasonable cause to believe that any person or entity is engaged in a 
pattern or practice that denies the rights specified in section 7 and 
such denial raises an issue of general public importance, the Attorney 
General may commence a civil action in any appropriate United States 
district court.
    (b) Consultation.--The Assistant Secretary may determine, based on 
a pattern of complaints, a pattern of violations, a review of data 
reported by a health care provider, or any others mean, that there is 
reasonable cause to believe a health care provider is engaged in a 
pattern or practice that denies the rights specified in section 7. If 
the Assistant Secretary makes such a determination, they shall refer 
their findings to the Attorney General.
    (c) Enforcement of Subpoenas.--The Attorney General, on behalf of 
the Assistant Secretary, or other party at whose request a subpoena is 
issued, under this section, may enforce such subpoena in appropriate 
proceedings in the United States district court for the district in 
which the person to whom the subpoena was addressed resides, was 
served, or transacts business.
    (d) Relief Which May Be Granted in Civil Actions Under Subsections 
(a) and (b).--
            (1) In general.--In a civil action under subsection (a) or 
        (b), the court--
                    (A) may award such preventive relief, including a 
                permanent or temporary injunction, restraining order, 
                or other order against the person responsible for a 
                violation of section 7 as is necessary to assure the 
                full enjoyment of the rights granted by this section 
                and sections 8 and 9;
                    (B) may award such other relief as the court deems 
                appropriate, including monetary damages to persons 
                aggrieved; and
                    (C) may, to vindicate the public interest, assess a 
                civil penalty against the respondent--
                            (i) in an amount not exceeding $500,000, 
                        for a first violation; and
                            (ii) in an amount not exceeding $1,000,000, 
                        for any subsequent violation.
            (2) Fees and costs.--In a civil action under this section, 
        the court, in its discretion, may allow the prevailing party, 
        other than the United States, a reasonable attorney's fee and 
        costs. The United States shall be liable for such fees and 
        costs to the extent provided by section 2412 of title 28, 
        United States Code.
    (e) Intervention in Civil Actions.--Upon timely application, any 
person may intervene in a civil action commenced by the Attorney 
General under subsection (a) or (b) which involves an alleged violation 
of section 7 with respect to which such person is an aggrieved person 
or a conciliation agreement to which such person is a party.

SEC. 11. FEDERAL HEALTH EQUITY COMMISSION.

    (a) Establishment of Commission.--
            (1) In general.--There is established the Federal Health 
        Equity Commission (hereinafter in this section referred to as 
        the ``Commission'').
            (2) Membership.--The Commission shall be composed of 8 
        members. Not more than 4 of the members shall at any one time 
        be of the same political party. Members shall have recognized 
        expertise in and personal experience with racial and ethnic 
        health disparities, health care needs of vulnerable and 
        marginalized populations, and health equity as a vehicle for 
        improving health status and health outcomes. Members shall be 
        appointed to the commission as follows:
                    (A) Four members of the Commission shall be 
                appointed by the President.
                    (B) Two members of the Commission shall be 
                appointed by the President pro tempore of the Senate, 
                upon the recommendations of the majority leader and the 
                minority leader of the Senate, and of the members 
                appointed pursuant to this subparagraph not more than 
                one shall be appointed from the same political party.
                    (C) Two members of the Commission shall be 
                appointed by the Speaker of the House of 
                Representatives upon the recommendations of the 
                majority leader and the minority leader of the House of 
                Representatives, and of the members appointed pursuant 
                to this subparagraph not more than one shall be 
                appointed from the same political party.
            (3) Terms.--The term of office of each member of the 
        Commission shall be 6 years.
            (4) Chairperson; vice chairperson.--
                    (A) Chairperson.--The President shall, with the 
                concurrence of a majority of the Commission's members, 
                designate a Chairperson from among the Commission's 
                members.
                    (B) Vice chairperson.--
                            (i) Designation.--The Speaker of the House 
                        of Representatives shall, in consultation with 
                        the majority leader and the minority leader of 
                        the House of Representatives and with the 
                        concurrence of a majority of the Commission's 
                        members, designate a Vice Chairperson from 
                        among the Commission's members. The Vice 
                        Chairperson may not be a member of the same 
                        political party as the Chairperson.
                            (ii) Duty.--The Vice Chairperson shall act 
                        in place of the Chairperson in the absence of 
                        the Chairperson.
            (5) Removal of members.--The President may remove a member 
        of the Commission only for neglect of duty or malfeasance in 
        office.
            (6) Quorum.--Five members of the Commission constitute a 
        quorum of the Commission.
            (7) Ex-officio members.--In addition to the members 
        appointed under paragraph (2), the Commission shall have the 
        following nonvoting ex officio members:
                    (A) The Assistant Secretary for Civil Rights and 
                Health Equity of the Department of Health and Human 
                Services.
                    (B) The Deputy Assistant Secretary for Minority 
                Health of the Department of Health and Human Services.
                    (C) The Director of the National Institute for 
                Minority Health and Health Disparities.
                    (D) The Chairperson of the Advisory Committee on 
                Minority Health established under section 1707 of the 
                Public Health Service Act (42 U.S.C. 300u-6).
    (b) Duties of the Commission.--
            (1) In general.--The Commission shall--
                    (A) monitor and report on the implementation of the 
                Equality in Health Care for All Act; and
                    (B) investigate, monitor, and report on progress 
                towards health equity and the elimination of health 
                disparities.
            (2) Annual report.--The Commission shall--
                    (A) submit to the President and Congress at least 
                one report annually on health equity and health 
                disparities; and
                    (B) include in such report--
                            (i) a description of actions taken by the 
                        Department of Health and Human Services and any 
                        other Federal agency related to health equity 
                        or health disparities; and
                            (ii) recommendations on ensuring equal 
                        health care and eliminating health disparities.
            (3) Hearings and authorities.--
                    (A) Power to hold hearings.--The Commission may, 
                for the purpose of carrying out this section, hold such 
                hearings as the Commission deems advisable. Each member 
                of the Commission shall have the power to administer 
                oaths and affirmations in connection with the 
                proceedings of the Commission. The Commission may hold 
                a hearing only if the hearing is approved by a majority 
                of the Commission, or by a majority of the members 
                present at a meeting when a quorum is present.
                    (B) Power to issue subpoenas.--The Commission may 
                issue subpoenas for the attendance of witnesses and the 
                production of written or other matter.
                    (C) Witness fees.--A witness attending any 
                proceeding of the Commission shall be paid the same 
                fees and mileage that are paid witnesses in the courts 
                of the United States.
                    (D) Depositions and interrogatories.--The 
                Commission may use depositions and written 
                interrogatories to obtain information and testimony 
                about matters that are the subject of a Commission 
                hearing or report.
    (c) Administrative Provisions.--
            (1) Staff.--
                    (A) Director.--There shall be a full-time staff 
                director for the Commission who shall--
                            (i) serve as the administrative head of the 
                        Commission; and
                            (ii) be appointed by the Chairperson with 
                        the concurrence of the Vice Chairperson.
                    (B) Other personnel.--The Commission may--
                            (i) appoint such other personnel as it 
                        deems advisable, subject to the provisions of 
                        title 5, United States Code, governing 
                        appointments in the competitive service, and 
                        the provisions of chapter 51 and subchapter III 
                        of chapter 53 of that title relating to 
                        classification and General Schedule pay rates; 
                        and
                            (ii) may procure temporary and intermittent 
                        services under section 3109(b) of title 5, 
                        United States Code, at rates for individuals 
                        not in excess of the daily equivalent paid for 
                        positions at the maximum rate for GS-15 of the 
                        General Schedule under section 5332 of title 5, 
                        United States Code.
            (2) Compensation of members.--
                    (A) In general.--Each member of the Commission who 
                is not otherwise in the service of the Government of 
                the United States shall receive a sum equivalent to the 
                compensation paid at level IV of the Executive Schedule 
                under section 5315 of title 5, United States Code, 
                prorated on a daily basis for time spent in the work of 
                the Commission.
                    (B) Persons otherwise in government service.--Each 
                member of the Commission who is otherwise in the 
                service of the Government of the United States shall 
                serve without compensation in addition to that received 
                for such other service, but while engaged in the work 
                of the Commission shall be paid actual travel expenses 
                and per diem in lieu of subsistence expenses when away 
                from such member's usual place of residence, under 
                subchapter I of chapter 57 of title 5, United States 
                Code.
            (3) Rules.--The Commission may make such rules as are 
        necessary to carry out the purposes of this section.
            (4) Cooperation.--All Federal agencies shall cooperate 
        fully with the Commission to the end that it may effectively 
        carry out its functions and duties.
    (d) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as may be necessary to carry out the duties of 
the Commission for each of fiscal years 2021 through 2025.

SEC. 12. GRANTS FOR HOSPITALS TO PROMOTE EQUITABLE HEALTH CARE AND 
              OUTCOMES.

    (a) In General.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Health and Human Services (in 
this section referred to as the ``Secretary'') shall award grants to 
hospitals to promote equitable health care and reduce disparities in 
care and outcomes.
    (b) Consultation.--In establishing the criteria for grants under 
this section and evaluating applications for such grants, the Secretary 
shall consult with the Assistant Secretary for Civil Rights and Health 
Equity of the Department of Health and Human Services.
    (c) Use of Funds.--A hospital shall use funds received from a grant 
under this section to establish or expand programs to provide equal 
care to all patients and to ensure equitable health care outcomes. Such 
uses may include--
            (1) providing explicit and implicit bias training to 
        medical providers and staff;
            (2) providing translation or interpretation services for 
        patients;
            (3) recruiting and training a diverse workforce;
            (4) tracking data related to care and outcomes; and
            (5) training on cultural sensitivity.
    (d) Priority.--In awarding grants under this section, the Secretary 
shall give priority to hospitals that have received disproportionate 
share hospital payments under section 1886(r) of the Social Security 
Act (42 U.S.C. 1395ww) or section 1925 of such Act (42 U.S.C. 1396r-6) 
with respect to fiscal year 2020.
    (e) Supplement, Not Supplant.--Grants awarded under this section 
shall be used to supplement, not supplant, any other Federal funds 
provided to a recipient.
    (f) Equitable Health Care Defined.--The term ``equitable health 
care'' has the meaning given the term in section 
1886(b)(3)(B)(viii)(XIII)(cc) of the Social Security Act (42 U.S.C. 
1395ww(b)(3)(B)(viii)(XIII)(cc)), as amended by this Act.
    (g) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for fiscal years 2021 through 2026.
                                 <all>