Summary
# Long COVID RECOVERY NOW Act (H.R. 1114)
## WHAT THIS BILL DOES
This bill creates programs to help people with Long COVID receive better care and treatment. It directs the federal government to fund clinics, spread medical knowledge, track data, and support research on Long COVID, which is an ongoing health condition some people experience after having COVID-19.
## WHO IT AFFECTS
- People with Long COVID who need medical care
- Primary care doctors and specialty doctors
- Federally qualified health centers (community clinics serving low-income areas)
- Rural health clinics
- Hospitals and health systems
- State Medicaid programs (health insurance for low-income people)
- Pediatric (child) researchers and children's hospitals
- Mental health professionals treating Long COVID patients
## KEY PROVISIONS
- The Department of Health and Human Services must award grants to clinics and hospitals within one year to help them treat Long COVID patients with teams of multiple types of doctors and health professionals (Sec. 2(a)).
- Grantees cannot deny Long COVID treatment based on insurance type, when someone was diagnosed, or whether they were hospitalized (Sec. 2(e)).
- The government must create a federal website within six months with educational materials about Long COVID for both doctors and patients (Sec. 6).
- The government must award grants to support Long COVID patient registries (databases that track patient information) so researchers can better understand the condition (Sec. 7(a)).
- States can receive federal Medicaid funding to collect and report data on Long COVID cases, including patient race, language, and ethnicity (Sec. 10).
- The National Institutes of Health must award grants for research on Long COVID in children, focusing on immune system responses and brain development (Sec. 11(a)).
## WHAT CHANGES
Long COVID becomes an eligible condition for Medicaid Health Homes, meaning states can offer coordinated care programs to Medicaid patients with Long COVID (Sec. 8).
The federal government will fund mental health services specifically for Long COVID patients with diagnosed mental health conditions (Sec. 4).
States receive financial support to track Long COVID cases in their Medicaid programs using medical coding standards (Sec. 10).
## IMPORTANT DEFINITIONS
**Long COVID** means ongoing health problems some people experience after COVID-19 infection, diagnosed by a qualified health care provider. The bill references the Centers for Disease Control and Prevention's definition of "Post-COVID Conditions" from 2021 and any future updates (Sec. 2(g)).
**Multidisciplinary** means coordinated care from doctors and other professionals including specialty doctors, nurses, dietitians, social workers, therapists, and behavioral health professionals (Sec. 2(d)).
## EFFECTIVE DATE
Not specified in bill text
I
118TH CONGRESS
1ST SESSION H. R. 1114
To provide for optimized care, a coordinated Federal Government response,
public education, and insurance reimbursement guidance for Long
COVID, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
FEBRUARY 21, 2023
Ms. BLUNT ROCHESTER (for herself, Mr. BEYER, and Ms. PRESSLEY) intro-
duced the following bill; which was referred to the Committee on Energy
and Commerce
A BILL
To provide for optimized care, a coordinated Federal Govern-
ment response, public education, and insurance reim-
bursement guidance for Long COVID, and for other
purposes.
Be it enacted by the Senate and House of Representa-
1
tives of the United States of America in Congress assembled,
2
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
3
(a) SHORT TITLE.—This Act may be cited as
4
the‘‘Long COVID Response is Care Optimized and Vitally
5
Essential Resources that Yield New Opportunities for
6
Wellness Act’’ or the ‘‘Long COVID RECOVERY NOW
7
Act’’.
8
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(b) TABLE OF CONTENTS.—The table of contents for
1
this Act is as follows:
2
Sec. 1. Short title; table of contents.
Sec. 2. Targeting resources for equitable access to treatment of Long COVID.
Sec. 3. National Long COVID technical assistance dissemination program.
Sec. 4. Mental health and suicide prevention and treatment.
Sec. 5. ONC best practices for Long COVID data.
Sec. 6. Long COVID Education Website.
Sec. 7. Providing Support for Long COVID Registries.
Sec. 8. Medicaid Health Homes for Individuals with Long COVID.
Sec. 9. State health officials guidance.
Sec. 10. Support under Medicaid for State Collection of Long COVID Data.
Sec. 11. Grants for Pediatric Research on Long COVID.
SEC. 2. TARGETING RESOURCES FOR EQUITABLE ACCESS
3
TO TREATMENT OF LONG COVID.
4
(a) ESTABLISHMENT.—
5
(1) IN GENERAL.—Not later than 1 year after
6
the date of the enactment of this Act, the Secretary
7
of Health and Human Services shall award, subject
8
to subsection (f) and in accordance with the provi-
9
sions of this section, grants described in the fol-
10
lowing subsections to carry out the purposes de-
11
scribed in such subsections.
12
(2) ELIGIBILITY.—The Secretary may establish
13
a process for evaluating and determining the eligi-
14
bility of Federally qualified health centers and rural
15
health clinics for receiving a grant under this sec-
16
tion.
17
(b) GRANTS TO FQHCS AND RHCS.—For purposes
18
of subsection (a), the grants described in this subsection
19
are grants to Federally qualified health centers (as defined
20
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in section 1861(aa)(4) of the Social Security Act (42
1
U.S.C. 1395x(aa)(4)) and rural health clinics (as defined
2
in section 1861(aa)(2) of such Act (42 U.S.C.
3
1395x(aa)(2)) to—
4
(1) adopt evidence-based Long COVID clinical
5
practices that have been demonstrated to improve
6
the wellness of individuals with Long COVID, in-
7
cluding clinical validation of patient reported symp-
8
toms using established measures that yield struc-
9
tured, comparable data;
10
(2) establish or expand screening, referral, and
11
navigation processes for health-related social needs
12
that could interfere with Long COVID treatment,
13
including food insecurity, housing instability, trans-
14
portation needs, utility difficulties, and interpersonal
15
safety; and
16
(3) submit to the Secretary of Health and
17
Human Services (in a format consistent with the
18
standards and activities under the Data Moderniza-
19
tion Initiative of the Centers for Disease Control
20
and
Prevention)
standardized,
disaggregated,
21
deidentified data (as specified by the Secretary) on
22
the characteristics, diagnoses, and health care serv-
23
ice utilization of Long COVID patients served under
24
such grant, including disaggregated data on Long
25
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COVID patient characteristics, including patient
1
age, gender, race, ethnicity, language spoken, dis-
2
ability status, nature and duration of validated
3
symptoms, and other characteristics necessary to in-
4
form considerations for effective and equitable treat-
5
ment for patients with Long COVID.
6
(c) GRANTS TO PRIMARY CARE PRACTICES.—For
7
purposes of subsection (a), the grants described in this
8
subsection are grants to primary care practices (other
9
than Federally qualified health centers and rural health
10
clinics) that satisfy such criteria as may be established by
11
the Secretary to carry out the purposes described in para-
12
graphs (1) and (3) of subsection (b).
13
(d) GRANTS FOR MULTIDISCIPLINARY TREATMENT
14
AND COORDINATION.—
15
(1) IN GENERAL.—The Secretary of Health and
16
Human Services (in this section referred to as the
17
‘‘Secretary’’) shall award grants on a competitive
18
basis to eligible entities for the purpose of creating
19
or enhancing capacity to treat patients with Long
20
COVID through a multidisciplinary approach. The
21
term ‘‘multidisciplinary’’ in this section refers to the
22
coordinated work to provide care or treatment to a
23
patient by physicians and other professionals, such
24
as specialty or subspecialty providers, nurses and
25
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nurse care coordinators, dietitians, nutritionists, so-
1
cial workers, behavioral health professionals, phys-
2
ical and occupational therapists, speech pathologists,
3
or any professionals determined to be appropriate by
4
the State and approved by the Administrator of the
5
Centers for Medicare & Medicaid Services.
6
(2) USE OF FUNDS.—An eligible entity receiv-
7
ing a grant under this section shall use the grant,
8
for the purpose described in subsection (a), to—
9
(A) enhance the capacity of one or more
10
existing multidisciplinary Long COVID clinics
11
to serve the Long COVID population; or
12
(B) create one or more multidisciplinary
13
clinics to address the physical and mental
14
health needs of Long COVID patients.
15
(3) ELIGIBLE ENTITIES.—To be eligible to re-
16
ceive a grant under this section, an entity shall be
17
a health care provider, Federally qualified health
18
center (as defined in section 1861(aa) of the Social
19
Security Act (42 U.S.C. 1395x(aa))), rural health
20
clinic, urban Indian health center, or State or local
21
public health department, that—
22
(A)(i) operates an existing multidisci-
23
plinary Long COVID clinic or other specialized
24
Long COVID program; or
25
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(ii) is an existing health care provider with
1
experience providing care for individuals with
2
Long COVID and who demonstrates an intent
3
to create a multidisciplinary Long COVID clinic
4
or other specialized Long COVID program;
5
(B) submits to the Secretary an applica-
6
tion at such time, in such manner, and con-
7
taining such information and assurances as the
8
Secretary may require; and
9
(C) employs a framework that incentivizes
10
participants to attain the program’s goals to es-
11
tablish and disseminate best practices, and allo-
12
cates funds based on such attainment.
13
(4) SPECIAL RULE.—A physical clinical facility
14
is not a requirement for eligibility.
15
(5) PRIORITY.—In awarding grants under this
16
subsection, the Secretary shall give priority to eligi-
17
ble entities that—
18
(A) submit a plan to engage with medically
19
underserved communities, and with populations
20
disproportionately impacted by COVID–19;
21
(B) demonstrate capacity (or an intent to
22
build capacity) to provide personalized treat-
23
ment and facilitate patient access to multidisci-
24
plinary health care providers with expertise in
25
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treating Long COVID symptoms, including
1
such providers who are primary and specialty
2
care physicians (such as physiatrists, neurolo-
3
gists,
cardiologists,
immunologists,
and
4
pulmonologists), therapists, nurses, care coordi-
5
nators, social workers, nutritionists, and behav-
6
ioral health specialists; and
7
(C) submit a plan to ensure ongoing multi-
8
disciplinary continuing education on infection-
9
triggered conditions for—
10
(i) physicians treating Long COVID;
11
and
12
(ii) other physicians and health care
13
workers who are not treating Long
14
COVID, but are otherwise serving patients
15
in the community.
16
(e) EQUITABLE ACCESS.—In order to ensure equi-
17
table access treatment—
18
(1) no grantee under this section shall deny ac-
19
cess to treatment with respect to Long COVID
20
based on insurance coverage, date of diagnosis, or
21
previous hospitalization;
22
(2) a grantee under this section shall with re-
23
spect to Long COVID—
24
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(A) offer equity-centered resources (such
1
as the ability to offer resources in various lan-
2
guages), information, and training to safety net
3
health systems; and
4
(B) disseminate to individuals and organi-
5
zations that provide care best practices and
6
treatment approaches that enhance access to
7
high-quality care to everyone where they live;
8
and
9
(3) treatment for Long COVID shall be in-
10
cluded as a COVID–19 treatment, consistent with
11
the American Rescue Plan Act of 2021 (Public Law
12
117–2).
13
(f) DEVELOPMENT OF EVIDENCE-BASED STRATE-
14
GIES FOR HIGH-VALUE CARE FOR INDIVIDUALS WITH
15
LONG COVID.—
16
(1) IN GENERAL.—Not later than 1 year after
17
the date of the enactment of this Act, the Agency
18
for Healthcare Research and Quality shall, subject
19
to appropriations pursuant to subsection (i), award
20
multi-year grants to eligible entities meeting such
21
criteria as specified by the Secretary through rule-
22
making for the purposes of—
23
(A) supporting the generation of evidence
24
about how to deliver high quality, high-value
25
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health care for individuals with Long COVID
1
for the treatment of the condition;
2
(B) creating tools and strategies to help
3
health systems and hospitals, primary and spe-
4
cialty physicians, nurses, allied health care pro-
5
fessionals, and caregivers provide high-quality,
6
high-value care for individuals with Long
7
COVID; and
8
(C) providing educational materials for
9
health care providers, payers, and consumers on
10
high-value care for individuals with Long
11
COVID.
12
(2) ELIGIBILITY.—The Secretary shall, through
13
rulemaking, specify a process for evaluating and de-
14
termining the eligibility of primary care providers in-
15
cluding Federally qualified health centers and rural
16
health clinics; specialty care providers, hospitals,
17
health systems, academic medical centers; and other
18
entities for receiving a grant under this subsection.
19
Such rules shall prohibit grant funds from being
20
used to compensate or reimburse individuals or orga-
21
nizations excluded pursuant to section 1128 of the
22
Social Security Act (42 U.S.C. 1320a–7) from par-
23
ticipation under the Medicare program under title
24
XVIII of such Act.
25
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(g) LONG COVID DEFINED.—For purposes of this
1
Act, the term ‘‘Long COVID’’ (also referred to as ‘‘post-
2
acute sequelae of COVID–19’’, ‘‘post-COVID conditions’’,
3
or ‘‘persistent symptoms post-COVID’’) means the ongo-
4
ing sequelae of COVID–19 that some individuals experi-
5
ence after infection with the SARS–CoV–2 virus, as diag-
6
nosed by a qualified health care provider. Such sequelae
7
are defined as the ‘‘Post-COVID Conditions’’ identified
8
and defined by the Centers for Disease Control and Pre-
9
vention in 2021, or in subsequent revisions by the Centers
10
for Disease Control and Prevention.
11
(h) REPORTS.—
12
(1) ANNUAL REPORTS BY GRANTEES TO SEC-
13
RETARY.—On an annual basis, a recipient of a grant
14
under this section shall—
15
(A) submit to the Secretary, and make
16
publicly available, a report on the activities car-
17
ried out through the grant; and
18
(B) include evaluations of such activities,
19
including the experience of individuals who re-
20
ceived health care through such grant.
21
(2) ANNUAL REPORTS BY SECRETARY TO CON-
22
GRESS.—Not later than the end of each of fiscal
23
years 2024 through 2026, the Secretary shall submit
24
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to the Congress, and make publicly available, a re-
1
port that—
2
(A) summarizes the reports received under
3
paragraph (1);
4
(B) evaluates the effectiveness of grants
5
under this section; and
6
(C) makes recommendations with respect
7
to expanding coverage for clinical care for Long
8
COVID.
9
(i) AUTHORIZATION OF APPROPRIATIONS.—
10
(1) IN GENERAL.—To carry out this section,
11
there are authorized to be appropriated such sums
12
as may be necessary for each of fiscal years 2024
13
through 2026.
14
(2) ADMINISTRATIVE
EXPENSES.—Not more
15
than 15 percent of the amounts made available to
16
carry out this section for any fiscal year may be
17
used for administrative expenses to operate the
18
grants under this section.
19
SEC. 3. NATIONAL LONG COVID TECHNICAL ASSISTANCE
20
DISSEMINATION PROGRAM.
21
(a) IN GENERAL.—The Secretary of Health and
22
Human Services shall—
23
(1) establish a structured process to seek ongo-
24
ing input from medical societies representing pri-
25
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mary care, specialty care, and subspecialty care re-
1
garding the proven and promising practices for
2
treating individuals who are diagnosed with Long
3
C
[Text truncated for display. Full text available on Congress.gov.]