John Lewis Equality in Medicare and Medicaid Treatment Act of 2023

I 118TH CONGRESS 1ST SESSION H. R. 3069 To amend title XI of the Social Security Act to improve access to care for all Medicare and Medicaid beneficiaries through models tested under the Center for Medicare and Medicaid Innovation, and for other purposes. IN THE HOUSE OF REPRESENTATIVES MAY 2, 2023 Ms. SEWELL (for herself, Ms. STRICKLAND, Mr. DOGGETT, Mr. EVANS, Mr. GOMEZ, Mr. CARTER of Louisiana, and Mrs. CHERFILUS-MCCORMICK) introduced the following bill; which was referred to the Committee on En- ergy 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 jurisdic- tion of the committee concerned A BILL To amend title XI of the Social Security Act to improve access to care for all Medicare and Medicaid beneficiaries through models tested under the Center for Medicare and Medicaid Innovation, 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 ‘‘John Lewis Equality 4 in Medicare and Medicaid Treatment Act of 2023’’. 5 VerDate Sep 11 2014 03:10 May 13, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H3069.IH H3069 pbinns on DSKJLVW7X2PROD with $$_JOB 2 •HR 3069 IH SEC. 2. IMPROVING ACCESS TO CARE FOR MEDICARE AND 1 MEDICAID BENEFICIARIES. 2 Section 1115A of the Social Security Act (42 U.S.C. 3 1315a) is amended— 4 (1) in subsection (a)— 5 (A) in paragraph (1), by inserting ‘‘ad- 6 vance health equity and’’ before ‘‘improve the 7 coordination’’; and 8 (B) in paragraph (3)— 9 (i) by inserting ‘‘(including the Office 10 of Minority Health of the Centers for 11 Medicare & Medicaid Services, the Office 12 of Rural Health Policy of the Health Re- 13 sources and Services Administration, and 14 the Office on Women’s Health of the De- 15 partment of Health and Human Services)’’ 16 after ‘‘relevant Federal agencies’’; and 17 (ii) by striking ‘‘experts with expertise 18 in medicine’’ and inserting ‘‘experts with 19 expertise in medicine, the causes of health 20 disparities and the social determinants of 21 health,’’; 22 (2) in subsection (b)— 23 (A) in paragraph (2)— 24 (i) in subparagraph (A)— 25 VerDate Sep 11 2014 03:10 May 13, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3069.IH H3069 pbinns on DSKJLVW7X2PROD with $$_JOB 3 •HR 3069 IH (I) by inserting the following 1 after the first sentence: ‘‘Prior to se- 2 lecting a model under this paragraph, 3 the Secretary shall consult with the 4 Office of Minority Health of the Cen- 5 ters for Medicare & Medicaid Services, 6 the Office of Rural Health Policy of 7 the Health Resources and Services 8 Administration, and the Office on 9 Women’s Health of the Department of 10 Health and Human Services to ensure 11 that models under consideration ad- 12 dress health disparities and social de- 13 terminants of health as appropriate 14 for populations to be cared for under 15 the model.’’; 16 (II) by inserting ‘‘and, for models 17 for which testing begins on or after 18 January 1, 2024, address health eq- 19 uity as well as improving access to 20 care received by individuals receiving 21 benefits under such title’’ after ‘‘appli- 22 cable title’’; and 23 (III) by adding at the end the 24 following: ‘‘The models selected under 25 VerDate Sep 11 2014 03:10 May 13, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3069.IH H3069 pbinns on DSKJLVW7X2PROD with $$_JOB 4 •HR 3069 IH this subparagraph shall include the 1 social determinants of health payment 2 model described in subsection (h), the 3 testing of which shall begin not later 4 than December 31, 2024.’’; and 5 (ii) in subparagraph (C), by adding at 6 the end the following new clauses: 7 ‘‘(ix) Whether the model will affect 8 access to care from providers and suppliers 9 caring for high risk patients or operating 10 in underserved areas. 11 ‘‘(x) Whether the model has the po- 12 tential to reduce health disparities, includ- 13 ing minority and rural health disparities.’’; 14 (B) in paragraph (3)(B)— 15 (i) in clause (i), by inserting ‘‘or 16 health equity’’ after ‘‘quality of care’’; 17 (ii) in clause (ii), by inserting ‘‘or in- 18 creasing health inequities’’ after ‘‘quality 19 of care’’; and 20 (iii) in clause (iii), by inserting ‘‘or 21 health equity’’ after ‘‘quality of care’’; and 22 (C) in paragraph (4)(A)— 23 (i) in clause (i), by striking ‘‘; and’’ 24 and inserting a semicolon; 25 VerDate Sep 11 2014 03:10 May 13, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H3069.IH H3069 pbinns on DSKJLVW7X2PROD with $$_JOB 5 •HR 3069 IH (ii) in clause (ii), by striking the pe- 1 riod and inserting ‘‘; and’’; and 2 (iii) by adding at the end the fol- 3 lowing new clause: 4 ‘‘(iii) for models for which testing be- 5 gins on or after January 1, 2024, the ex- 6 tent to which the model improves health 7 equity.’’; 8 (3) in subsection (c)— 9 (A) in paragraph (1)— 10 (i) in subparagraph (A), by inserting 11 ‘‘or, beginning on or after January 1, 12 2024, increasing health inequities’’ before 13 the semicolon; and 14 (ii) in subparagraph (B), by inserting 15 ‘‘or, beginning on or after January 1, 16 2024, health equity’’ after ‘‘patient care’’; 17 and 18 (B) in paragraph (3), by inserting ‘‘or in- 19 crease health disparities experienced by bene- 20 ficiaries, including low-income, minority, or 21 rural beneficiaries, or that such expansion 22 would improve health equity’’ before the period; 23 (4) in subsection (g), by adding at the end the 24 following: ‘‘For reports submitted after the date of 25 VerDate Sep 11 2014 03:10 May 13, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H3069.IH H3069 pbinns on DSKJLVW7X2PROD with $$_JOB 6 •HR 3069 IH enactment of the John Lewis Equality in Medicare 1 and Medicaid Treatment Act of 2023, each such re- 2 port shall include information on the following: 3 ‘‘(1) The interventions that address social de- 4 terminants of health, health disparities, or health eq- 5 uity in payment models selected by the CMI for test- 6 ing under this section. 7 ‘‘(2) Estimated Federal savings achieved 8 through reducing disparities, including rural and mi- 9 nority health disparities, improving health equity, or 10 addressing social determinants of health. 11 ‘‘(3) The effectiveness of interventions in miti- 12 gating negative health outcomes and higher costs as- 13 sociated with social determinants of health within 14 models selected by the Center for Medicare and 15 Medicaid Innovation for testing. 16 ‘‘(4) Other areas determined appropriate by the 17 Secretary.’’; and 18 (5) by adding at the end the following new sub- 19 section: 20 ‘‘(h) SOCIAL DETERMINANTS OF HEALTH PAYMENT 21 MODEL.— 22 ‘‘(1) IN GENERAL.—The social determinants of 23 health payment model described in this subsection is 24 a payment model that tests each of the payment and 25 VerDate Sep 11 2014 03:10 May 13, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H3069.IH H3069 pbinns on DSKJLVW7X2PROD with $$_JOB 7 •HR 3069 IH service delivery innovations described in paragraph 1 (2) in a region determined appropriate by the Sec- 2 retary. 3 ‘‘(2) PAYMENT AND SERVICE DELIVERY INNO- 4 VATIONS DESCRIBED.—For purposes of paragraph 5 (1), the payment and service delivery innovations de- 6 scribed in this clause are the following: 7 ‘‘(A) Payment and service delivery innova- 8 tions for behavioral health services, focusing on 9 gathering actionable data to address the higher 10 costs associated with beneficiaries with diag- 11 nosed behavioral conditions. 12 ‘‘(B) Payment and service delivery innova- 13 tions targeting conditions or comorbidities of 14 individuals entitled or enrolled under the Medi- 15 care program under title XVIII and enrolled 16 under a State plan under the Medicaid program 17 under title XIX to increase capacity in under- 18 served areas. 19 ‘‘(C) Payment and service delivery innova- 20 tions targeting conditions or comorbidities of 21 applicable individuals to increase capacity in 22 underserved areas. 23 ‘‘(D) Payment and service delivery innova- 24 tions targeted on Medicaid eligible pregnant 25 VerDate Sep 11 2014 03:10 May 13, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H3069.IH H3069 pbinns on DSKJLVW7X2PROD with $$_JOB 8 •HR 3069 IH and postpartum women, up to one year after 1 delivery.’’. 2 Æ VerDate Sep 11 2014 03:10 May 13, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6301 E:\BILLS\H3069.IH H3069 pbinns on DSKJLVW7X2PROD with $$_JOB