Summary
# Due Process Continuity of Care Act (S. 971) - Plain English Summary
## WHAT THIS BILL DOES
This bill removes a rule that prevents people in jail awaiting trial from getting Medicaid benefits (a government health insurance program for low-income people). States can now choose to cover medical care for people in custody waiting for their charges to be resolved. The bill also gives states money to plan how they will provide this healthcare.
## WHO IT AFFECTS
- People in jail waiting for their criminal cases to be decided
- State governments running Medicaid programs
- Healthcare providers who treat people in jails
- Medicaid managed care plans (companies that handle Medicaid benefits)
- Law enforcement and jail officials
## KEY PROVISIONS
- States have the option to use Medicaid to pay for medical care for people in custody pending disposition of charges (meaning awaiting trial or case resolution) (Sec. 2(a))
- The federal government will give planning grants to states to develop systems for providing this healthcare, including finding doctors and setting up billing systems (Sec. 3(a))
- States must prepare applications showing they reviewed barriers to finding healthcare providers and created plans to recruit doctors and increase behavioral health services, including substance use disorder treatment (Sec. 3(b)(3))
- States must consult with jails, law enforcement, healthcare providers, and patient advocates before completing their applications (Sec. 3(b)(4))
- The Secretary of Health and Human Services will choose states for grants in a way that spreads them across different geographic areas (Sec. 3(d))
## WHAT CHANGES
If this bill becomes law, states can decide to pay for healthcare through Medicaid for people sitting in jail waiting for their court cases to be resolved. Currently this is not allowed. States will also receive grant money to plan how to hire healthcare providers and set up the systems needed to deliver this care.
## IMPORTANT DEFINITIONS
- **Medicaid program:** A state's health insurance program under federal law, including any special agreements or experiments states make with the federal government (Sec. 3(f)(1))
- **Secretary:** The Secretary of Health and Human Services (Sec. 3(f)(2))
- **State:** States as defined under federal Medicaid law (Sec. 3(f)(3))
## EFFECTIVE DATE
The changes take effect on the first day of the first calendar quarter (three-month period) that begins 60 days or more after the president signs this bill into law (Sec. 2(c))
II
118TH CONGRESS
1ST SESSION
S. 971
To amend title XIX of the Social Security Act to remove the Medicaid
coverage exclusion for inmates in custody pending disposition of charges,
and for other purposes.
IN THE SENATE OF THE UNITED STATES
MARCH 23, 2023
Mr. CASSIDY (for himself, Mr. MERKLEY, Mr. MARKEY, and Mr. TILLIS) in-
troduced the following bill; which was read twice and referred to the Com-
mittee on Finance
A BILL
To amend title XIX of the Social Security Act to remove
the Medicaid coverage exclusion for inmates in custody
pending disposition of charges, 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.
3
This Act may be cited as the ‘‘Due Process Con-
4
tinuity of Care Act’’.
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SEC. 2. REMOVAL OF INMATE LIMITATION ON BENEFITS
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UNDER MEDICAID.
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(a) IN GENERAL.—The subdivision (A) of section
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1905(a) of the Social Security Act (42 U.S.C. 1396d(a))
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•S 971 IS
following the last numbered paragraph of such section is
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amended by inserting ‘‘, or, at the option of the State,
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while in custody pending disposition of charges’’ after ‘‘pa-
3
tient in a medical institution’’.
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(b) CONFORMING AMENDMENTS.—Section 5122 of
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division FF of the Consolidated Appropriations Act, 2023
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(Public Law 117–328) is amended—
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(1) in subsection (a), by striking ‘‘Medicaid’’
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and
all
that
follows
through
‘‘Section
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1902(a)(84)(A)’’ and inserting ‘‘MEDICAID.—Sec-
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tion 1902(a)(84)(A)’’; and
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(2) in subsection (c), by inserting ‘‘, except that
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if such date is later than the effective date described
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in section 2(c) of the Due Process Continuity of
14
Care Act then the amendment made by subsection
15
(a) shall take effect and apply to items and services
16
furnished for periods beginning on or after the effec-
17
tive date described in such section’’ before the pe-
18
riod.
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(c) EFFECTIVE DATE.—The amendments made by
20
subsections (a) and (b) shall take effect on the 1st day
21
of the 1st calendar quarter that begins on or after the
22
date that is 60 days after the date of the enactment of
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this Act and shall apply to items and services furnished
24
for periods beginning on or after such date.
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•S 971 IS
SEC. 3. PLANNING GRANTS.
1
(a) IN GENERAL.—The Secretary shall award plan-
2
ning grants to States to support providing medical assist-
3
ance under the State Medicaid program to individuals who
4
are eligible for such assistance as a result of the amend-
5
ment made by section 2(a). The grants shall be used to
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prepare an application that meets the requirements of sub-
7
section (b).
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(b) APPLICATION REQUIREMENTS.—In order to be
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awarded a planning grant under this section, a State shall
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submit an application to the Secretary at such time and
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in such form and manner as the Secretary shall require,
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that includes the following information along with such
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additional information, provisions, and assurances, as the
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Secretary may require:
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(1) A proposed process for carrying out each of
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the activities described in subsection (c) in the State.
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(2) A review of State policies regarding the
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population of individuals who are eligible for medical
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assistance under the State Medicaid program as a
20
result of the amendment made by section 2(a) with
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respect to whether such policies may create barriers
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to increasing the number of health care providers
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who can provide items and services for that popu-
24
lation.
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(3) The development of a plan, taking into ac-
1
count activities described in subsection (c)(2), that
2
will ensure a sustainable number of Medicaid-en-
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rolled providers under the State Medicaid program
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that can offer a full array of treatment and services
5
to the patient population described in paragraph (2)
6
as needed. Such plan shall include the following:
7
(A) Specific activities to increase the num-
8
ber of providers that will offer physical health
9
treatment, as well as services related to behav-
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ioral health treatment, including substance use
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disorder treatment, recovery, or support serv-
12
ices (including short-term detoxification serv-
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ices, outpatient substance use disorder services,
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and evidence-based peer recovery services).
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(B) Milestones and timeliness for imple-
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menting activities set forth in the plan.
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(C) Specific measurable targets for in-
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creasing the number of providers under the
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State Medicaid program who will treat the pa-
20
tient population described in paragraph (2).
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(4) An assurance that the State consulted with
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relevant stakeholders, including the State agency re-
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sponsible for administering the State Medicaid pro-
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gram, Medicaid managed care plans, health care
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•S 971 IS
providers, law enforcement personnel, officials from
1
jails, and Medicaid beneficiary advocates, with re-
2
spect to the preparation and completion of the appli-
3
cation and a description of such consultation.
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(c) ACTIVITIES DESCRIBED.—For purposes of sub-
5
section (b)(1), the activities described in this subsection
6
are the following:
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(1) Activities that support the development of
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an initial assessment of the health treatment needs
9
of patients who are in custody pending disposition of
10
charges to determine the extent to which providers
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are needed (including the types of such providers
12
and geographic area of need) to improve the number
13
of providers that will treat patients in custody pend-
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ing disposition of charges under the State Medicaid
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program, including the following:
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(A) An estimate of the number of individ-
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uals enrolled under the State Medicaid program
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who are in custody pending disposition of
19
charges.
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(B) Information on the capacity of pro-
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viders to provide treatment or services to such
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individuals enrolled under the State Medicaid
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program, including information on providers
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•S 971 IS
who provide such services and their participa-
1
tion under the State Medicaid program.
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(C) Information on the health care services
3
provided under programs other than the State
4
Medicaid program in jails to individuals who
5
are in custody pending disposition of charges.
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(2) Activities that, taking into account the re-
7
sults of the assessment described in paragraph (1)
8
with respect to the provision of treatment or services
9
under the State Medicaid program, support the de-
10
velopment of State infrastructure to recruit or con-
11
tract with prospective health care providers, provide
12
training and technical assistance to such providers,
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and secure a process for an electronic health record
14
system for billing to reimburse for services provided
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by the correctional facility, outpatient providers,
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medical vendors, and contracted telehealth service
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providers to patients who are in custody pending dis-
18
position of charges that are compliant with applica-
19
ble requirements and regulations for State Medicaid
20
programs.
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(3) Activities that ensure the quality of care for
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patients who are in custody pending disposition of
23
charges, including formal reporting mechanisms for
24
patient outcomes, and activities that promote par-
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ticipation in learning collaboratives among providers
1
treating this population.
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(d) GEOGRAPHIC DIVERSITY.—The Secretary shall
3
select States for planning grants under this section in a
4
manner that ensures geographic diversity.
5
(e) FUNDING.—There are authorized to be appro-
6
priated $50,000,000 to carry out this section.
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(f) DEFINITIONS.—In this section:
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(1) MEDICAID PROGRAM.—The term ‘‘Medicaid
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program’’ means, with respect to a State, the State
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program under title XIX of the Social Security Act
11
(42 U.S.C. 1396 et seq.) including any waiver or
12
demonstration under such title or under section
13
1115 of such Act (42 U.S.C. 1315) relating to such
14
title.
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(2) SECRETARY.—The term ‘‘Secretary’’ means
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the Secretary of Health and Human Services.
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(3) STATE.—The term ‘‘State’’ has the mean-
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ing given that term for purposes of title XIX of the
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Social Security Act (42 U.S.C. 1396 et seq.) in sec-
20
tion 1101(a)(1) of such Act (42 U.S.C. 1301(a)(1)).
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Æ
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