CARING for Social Determinants Act of 2019

I 116TH CONGRESS 1ST SESSION H. R. 4621 To require the Secretary of Health and Human Services to issue and dissemi- nate guidance to States to clarify strategies to address social deter- minants of health under the Medicaid program and the Children’s Health Insurance Program, and for other purposes. IN THE HOUSE OF REPRESENTATIVES OCTOBER 8, 2019 Ms. BLUNT ROCHESTER (for herself and Mr. BILIRAKIS) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To require the Secretary of Health and Human Services to issue and disseminate guidance to States to clarify strategies to address social determinants of health under the Medicaid program and the Children’s Health Insur- ance Program, 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 ‘‘Collecting and Ana- 4 lyzing Resources Integral and Necessary for Guidance for 5 Social Determinants Act of 2019’’ or the ‘‘CARING for 6 Social Determinants Act of 2019’’. 7 VerDate Sep 11 2014 22:21 Oct 08, 2019 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H4621.IH H4621 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 4621 IH SEC. 2. FINDINGS; PURPOSE. 1 (a) FINDINGS.—Congress makes the following find- 2 ings: 3 (1) Social determinants of health are the condi- 4 tions in which people are born, grow, live, play, work 5 and age; they include factors like socioeconomic sta- 6 tus, education, housing, transportation, nutrition 7 and literacy. 8 (2) Research has shown that addressing social 9 determinants of health is important for improving 10 overall health and reducing health inequities. 11 (3) Social determinants that negatively impact 12 health can have harmful neurodevelopmental and bi- 13 ological consequences that develop in childhood and 14 manifest in adulthood. 15 (4) There is a growing body of evidence sug- 16 gesting that policies that specifically address social 17 needs, including policies targeting children and fami- 18 lies, can improve community health outcomes and 19 have the potential to reduce health care spending. 20 (5) Some State Medicaid programs have begun 21 testing innovative delivery and payment models de- 22 signed to improve health outcomes and reduce costs 23 by implementing strategies to address social deter- 24 minants of health under existing Medicaid authori- 25 ties as well as through the use of waivers, though 26 VerDate Sep 11 2014 22:21 Oct 08, 2019 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H4621.IH H4621 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 4621 IH payment incentives linked to social determinant of 1 health are not common. 2 (6) Despite a growing focus on social deter- 3 minants of health in State managed care contracts, 4 most States do not provide necessary guidance for 5 managed care organizations as to how they may use 6 existing authority under Federal law to provide pa- 7 tients with services that can improve health by ad- 8 dressing social determinants. 9 (7) Centers for Medicare & Medicaid Services 10 guidance and technical assistance are critical tools 11 that could increase adoption of strategies to address 12 social determinants of health among State Medicaid 13 agencies. 14 (b) PURPOSES.—It is the purpose of this Act to pro- 15 vide States with additional operational clarity and exam- 16 ples of the strategies they can leverage through existing 17 authority and waivers to address social determinants of 18 health for the Medicaid population. 19 VerDate Sep 11 2014 22:21 Oct 08, 2019 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H4621.IH H4621 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 4621 IH SEC. 3. REQUIREMENT TO ISSUE GUIDANCE TO CLARIFY 1 STRATEGIES TO ADDRESS SOCIAL DETER- 2 MINANTS OF HEALTH IN THE MEDICAID PRO- 3 GRAM AND THE CHILDREN’S HEALTH INSUR- 4 ANCE PROGRAM. 5 Not later than 2 years after the date of the enact- 6 ment of this Act, the Secretary of Health and Human 7 Services shall issue and disseminate guidance to States to 8 clarify strategies to address social determinants of health 9 under the Medicaid program and the Children’s Health 10 Insurance Program. Such guidance shall include the fol- 11 lowing: 12 (1) Guidance and technical assistance to State 13 Medicaid agencies regarding the strategies that 14 States can implement under existing authorities 15 under title XI, XIX, or XXI of the Social Security 16 Act, or through waivers, to address social deter- 17 minants of health in the provision of health care, in- 18 cluding strategies specifically targeting the pediatric 19 population. 20 (2) Guidance and technical assistance on how 21 States can encourage and incentivize managed care 22 organizations to address social determinants of 23 health through contracts with such organizations. 24 (3) A compendium of examples from States 25 with respect to how States are currently addressing 26 VerDate Sep 11 2014 22:21 Oct 08, 2019 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H4621.IH H4621 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 4621 IH social determinants of health in the provision of 1 health care under the Medicaid program and the 2 Children’s Health Insurance Program, including 3 through payment models. 4 Æ VerDate Sep 11 2014 22:21 Oct 08, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\H4621.IH H4621 pamtmann on DSKBC07HB2PROD with BILLS