Health Equity and Accountability Act of 2020

II 116TH CONGRESS 2D SESSION S. 4819 To improve the health of minority individuals, and for other purposes. IN THE SENATE OF THE UNITED STATES OCTOBER 20 (legislative day, OCTOBER 19), 2020 Ms. HIRONO (for herself, Mrs. GILLIBRAND, Mr. MERKLEY, Ms. DUCKWORTH, Mr. BLUMENTHAL, Mr. SANDERS, Mr. BOOKER, Mr. CARDIN, and Mr. KAINE) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To improve the health of minority individuals, 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 ‘‘Health Equity and 4 Accountability Act of 2020’’. 5 SEC. 2. TABLE OF CONTENTS. 6 The table of contents of this Act is as follows: 7 Sec. 1. Short title. Sec. 2. Table of contents. Sec. 3. Findings. TITLE I—DATA COLLECTION AND REPORTING VerDate Sep 11 2014 23:11 Dec 01, 2020 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6211 E:\BILLS\S4819.IS S4819 khammond on DSKJM1Z7X2PROD with BILLS 2 •S 4819 IS Sec. 101. Amendment to the Public Health Service Act. Sec. 102. Elimination of prerequisite of direct appropriations for data collection and analysis. Sec. 103. Collection of data for the Medicare program. Sec. 104. Revision of HIPAA claims standards. Sec. 105. National Center for Health Statistics. Sec. 106. Disparities data collected by the Federal Government. Sec. 107. Data collection and analysis grants to minority-serving institutions. Sec. 108. Standards for measuring sexual orientation, gender identity, and so- cioeconomic status in collection of health data. Sec. 109. Safety and effectiveness of drugs with respect to racial and ethnic background. Sec. 110. Improving health data regarding Native Hawaiians and other Pacific Islanders. Sec. 111. Clarification of simplified administrative reporting requirement. TITLE II—CULTURALLY AND LINGUISTICALLY APPROPRIATE HEALTH AND HEALTH CARE Sec. 201. Definitions; findings. Sec. 202. Improving access to services for individuals with limited English pro- ficiency. Sec. 203. Ensuring standards for culturally and linguistically appropriate serv- ices in health care. Sec. 204. Culturally and linguistically appropriate health care in the Public Health Service Act. Sec. 205. Pilot program for improvement and development of State medical in- terpreting services. Sec. 206. Training tomorrow’s doctors for culturally and linguistically appro- priate care: graduate medical education. Sec. 207. Federal reimbursement for culturally and linguistically appropriate services under the Medicare, Medicaid, and State Children’s Health Insurance Programs. Sec. 208. Increasing understanding of and improving health literacy. Sec. 209. Requirements for health programs or activities receiving Federal funds. Sec. 210. Report on Federal efforts to provide culturally and linguistically ap- propriate health care services. Sec. 211. English for speakers of other languages. Sec. 212. Implementation. Sec. 213. Language access services. Sec. 214. Medically underserved populations. TITLE III—HEALTH WORKFORCE DIVERSITY Sec. 301. Amendment to the Public Health Service Act. Sec. 302. Hispanic-serving institutions, historically black colleges and univer- sities, Asian American and Native American Pacific Islander- serving institutions, Tribal colleges, regional community-based organizations, and national minority medical associations. Sec. 303. Loan repayment program of Centers for Disease Control and Preven- tion. Sec. 304. Cooperative agreements for online degree programs at schools of pub- lic health and schools of allied health. Sec. 305. Sense of Congress on the mission of the National Health Care Work- force Commission. VerDate Sep 11 2014 23:11 Dec 01, 2020 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6211 E:\BILLS\S4819.IS S4819 khammond on DSKJM1Z7X2PROD with BILLS 3 •S 4819 IS Sec. 306. Scholarship and fellowship programs. Sec. 307. McNair Postbaccalaureate Achievement Program. Sec. 308. Rules for determination of full-time equivalent residents for cost-re- porting periods. Sec. 309. Developing and implementing strategies for local health equity. Sec. 310. Loan forgiveness for mental and behavioral health social workers. Sec. 311. Health Professions Workforce Fund. Sec. 312. Findings; sense of Congress relating to graduate medical education. Sec. 313. Career support for skilled, internationally educated health profes- sionals. Sec. 314. Study and report on strategies for increasing diversity. Sec. 315. Conrad State 30 program; physician retention. TITLE IV—IMPROVING HEALTH CARE ACCESS AND QUALITY Subtitle A—Improvement of Coverage Sec. 401. Repeal of requirement for documentation evidencing citizenship or nationality under the Medicaid program. Sec. 402. Removing citizenship and immigration barriers to access to affordable health care under ACA. Sec. 403. Study on the uninsured. Sec. 404. Medicaid in the territories. Sec. 405. Extension of Medicare secondary payer. Sec. 406. Indian defined in title I of the Patient Protection and Affordable Care Act. Sec. 407. Removing Medicare barrier to health care. Sec. 408. 100 percent FMAP for medical assistance provided by urban Indian health centers. Sec. 409. 100 percent FMAP for medical assistance provided to a Native Ha- waiian through a federally qualified health center or a Native Hawaiian health care system under the Medicaid program. Sec. 410. Medicaid coverage for citizens of freely associated states. Subtitle B—Expansion of Access Sec. 412. Amendment to the Public Health Service Act. Sec. 413. Protecting sensitive locations. Sec. 414. Grants for racial and ethnic approaches to community health. Sec. 415. Border health grants. Sec. 416. Critical access hospital improvements. Sec. 417. Establishment of Rural Community Hospital (RCH) Program. Sec. 418. Medicare remote monitoring pilot projects. Sec. 419. Rural Health Quality Advisory Commission and demonstration projects. Sec. 420. Rural health care services. Sec. 421. Community health center collaborative access expansion. Sec. 422. Facilitating the provision of telehealth services across State lines. Sec. 423. Scoring of preventive health savings. Sec. 424. Sense of Congress on Maintenance of Effort Provisions Regarding Children’s Health. Sec. 425. Protection of the HHS Offices of Minority Health. Sec. 426. Office of Minority Health in Veterans Health Administration of De- partment of Veterans Affairs. Sec. 427. Study of DSH payments to ensure hospital access for low-income pa- tients. VerDate Sep 11 2014 23:11 Dec 01, 2020 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6211 E:\BILLS\S4819.IS S4819 khammond on DSKJM1Z7X2PROD with BILLS 4 •S 4819 IS Sec. 428. Assistant Secretary of the Indian Health Service. Sec. 429. Reauthorization of the Native Hawaiian Health Care Improvement Act. Sec. 430. Availability of non-English language speaking providers. Sec. 431. Access to essential community providers. Sec. 432. Provider network adequacy in communities of color. Sec. 433. Improving access to dental care. Sec. 434. Providing for a special enrollment period for pregnant individuals. Sec. 435. Coverage of maternity care for dependent children. Sec. 436. Federal Employee Health Benefit Plans. Sec. 437. Continuation of Medicaid income eligibility standard for pregnant in- dividuals and infants. Subtitle C—Advancing Health Equity Through Payment and Delivery Reform Sec. 441. Sense of Congress. Sec. 442. Centers for Medicare & Medicaid Services reporting and value based programs. Sec. 443. Development and testing of disparity reducing delivery and payment models. Sec. 444. Diversity in Centers for Medicare and Medicaid consultation. Sec. 445. Supporting safety net and community-based providers to compete in value-based payment systems. Subtitle D—Health Empowerment Zones Sec. 451. Short title. Sec. 452. Findings. Sec. 453. Designation of health empowerment zones. Sec. 454. Assistance to those seeking designation. Sec. 455. Benefits of designation. Sec. 456. Definition of Secretary. Sec. 457. Authorization of appropriations. TITLE V—IMPROVING HEALTH OUTCOMES FOR WOMEN, CHILDREN, AND FAMILIES Subtitle A—In General Sec. 501. Grants to promote health for underserved communities. Sec. 502. Removing barriers to health care and nutrition assistance for chil- dren, pregnant persons, and lawfully present individuals. Sec. 503. Repeal of denial of SNAP benefits. Sec. 504. Birth defects prevention, risk reduction, and awareness. Sec. 505. MOMMA’s Act. Sec. 506. Rural maternal and obstetric modernization of services. Sec. 507. Decreasing the risk factors for sudden unexpected infant death and sudden unexplained death in childhood. Sec. 508. Reducing unintended teenage pregnancies. Sec. 509. Gestational diabetes. Sec. 510. Emergency contraception education and information programs. Sec. 511. Comprehensive sex education programs. Sec. 512. Compassionate assistance for rape emergencies. Sec. 513. Access to birth control duties of pharmacies to ensure provision of FDA-approved contraception. Sec. 514. Additional focus area for the Office on Women’s Health. VerDate Sep 11 2014 23:11 Dec 01, 2020 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6211 E:\BILLS\S4819.IS S4819 khammond on DSKJM1Z7X2PROD with BILLS 5 •S 4819 IS Sec. 515. Interagency Coordinating Committee on the Promotion of Optimal Maternity Outcomes. Sec. 516. Consumer education campaign. Sec. 517. Bibliographic database of systematic reviews for care of childbearing individuals and newborns. Sec. 518. Expansion of CDC Prevention Research Centers Program to include Centers on Optimal Maternity Outcomes. Sec. 519. Expanding models allowed to be tested by Center for Medicare & Medicaid Innovation to include maternity care models. Sec. 520. Development of interprofessional maternity care educational models and tools. Sec. 521. Including services furnished by certain students, interns, and resi- dents supervised by certified nurse midwives within inpatient hospital services under Medicare. Sec. 522. Grants to professional organizations to increase diversity in maternal, reproductive, and sexual health professionals. Sec. 523. Interagency update to the quality family planning guidelines. Sec. 524. Dissemination of the quality family planning guidelines. Subtitle B—Pregnancy Screening Sec. 531. Pregnancy intention screening initiative demonstration program. TITLE VI—MENTAL HEALTH Sec. 601. Mental health findings. Sec. 602. Coverage of marriage and family therapist services, mental health counselor services, substance abuse counselor services, and peer support specialist services under part B of the Medicare pro- gram. Sec. 603. Integrated Health Care Demonstration Program. Sec. 604. Addressing racial and ethnic mental health disparities research gaps. Sec. 605. Health professions competencies to address racial and ethnic mental health disparities. Sec. 606. Geoaccess study. Sec. 607. Asian American, Native Hawaiian, Pacific Islander, and Hispanic and Latino behavioral and mental health outreach and education strategies. Sec. 608. Mental health in schools. Sec. 609. Building an effective workforce in mental health. Sec. 610. Mental health at the border. TITLE VII—ADDRESSING HIGH IMPACT MINORITY DISEASES Subtitle A—Cancer Sec. 701. Lung cancer mortality reduction. Sec. 702. Expanding prostate cancer research, outreach, screening, testing, ac- cess, and treatment effectiveness. Sec. 703. Prostate research, imaging, and men’s education (PRIME). Sec. 704. Prostate cancer detection research and education. Sec. 705. National Prostate Cancer Council. Sec. 706. Improved Medicaid coverage for certain breast and cervical cancer pa- tients in the territories. Sec. 707. Cancer prevention and treatment demonstration for ethnic and racial minorities. Sec. 708. Reducing cancer disparities within Medicare. VerDate Sep 11 2014 23:11 Dec 01, 2020 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6211 E:\BILLS\S4819.IS S4819 khammond on DSKJM1Z7X2PROD with BILLS 6 •S 4819 IS Sec. 709. Cancer clinical trials. Subtitle B—Viral Hepatitis and Liver Cancer Control and Prevention Sec. 711. Viral hepatitis and liver cancer control and prevention. Subtitle C—Acquired Bone Marrow Failure Diseases Sec. 721. Acquired bone marrow failure diseases. Subtitle D—Cardiovascular Disease, Chronic Disease, Obesity, and Other Disease Issues Sec. 731. Guidelines for disease screening for minority patients. Sec. 732. CDC Wisewoman Screening Program. Sec. 733. Report on cardiovascular care for women and minorities. Sec. 734. Coverage of comprehensive tobacco cessation services in Medicaid and private health insurance. Sec. 735. Clinical research funding for oral health. Sec. 736. Participation by Medicaid beneficiaries in approved clinical trials. Sec. 737. Guide on evidence-based strategies for public health department obe- sity prevention programs. Subtitle E—HIV/AIDS Sec. 741. Statement of policy. Sec. 742. Findings. Sec. 743. Additional funding for AIDS drug assistance program treatments. Sec. 744. Enhancing the national HIV surveillance system. Sec. 745. Evidence-based strategies for improving linkage to and retention in appropriate care. Sec. 746. Improving entry into and retention in care and antiretroviral adher- ence for persons with HIV. Sec. 747. Services to reduce HIV/AIDS in racial and ethnic minority commu- nities. Sec. 748. Minority AIDS initiative. Sec. 749. Health care professionals treating individuals with HIV. Sec. 750. HIV/AIDS provider loan repayment program. Sec. 751. Dental education loan repayment program. Sec. 752. Reducing new HIV infections among injecting drug users. Sec. 753. Report on impact of HIV/AIDS in vulnerable populations. Sec. 754. National HIV/AIDS observance days. Sec. 755. Review of all Federal and State laws, policies, and regulations regard- ing the criminal prosecution of individuals for HIV-related of- fenses. Sec. 756. Expanding support for condoms in prisons. Sec. 757. Automatic reinstatement or enrollment in Medicaid for people who test positive for HIV before reentering communities. Sec. 758. Stop HIV in prison. Sec. 759. Support data system review and indicators for monitoring HIV care. Sec. 760. Transfer of funds for implementation of ending the HIV epidemic: a plan for America. Subtitle F—Diabetes Sec. 771. Research, treatment, and education. Sec. 772. Research, education, and other activities. VerDate Sep 11 2014 23:11 Dec 01, 2020 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6211 E:\BILLS\S4819.IS S4819 khammond on DSKJM1Z7X2PROD with BILLS 7 •S 4819 IS Sec. 773. Programs to educate health providers on the causes and effects of di- abetes in minority populations. [Text truncated for display. Full text available on Congress.gov.]