[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6521 Introduced in House (IH)]

112th CONGRESS
  2d Session
                                H. R. 6521

 To provide payment for patient navigator services under title XIX of 
                        the Social Security Act.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 21, 2012

    Mr. Israel (for himself, Mr. Rangel, Mr. Lewis of Georgia, Mr. 
 Ackerman, Mrs. McCarthy of New York, Mr. Serrano, Ms. Slaughter, Mr. 
  Owens, Mrs. Christensen, Mrs. Lowey, Mr. Crowley, Mr. Bishop of New 
York, and Mr. Deutch) introduced the following bill; which was referred 
                to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
 To provide payment for patient navigator services under title XIX of 
                        the Social Security Act.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. MEDICAID COVERAGE FOR PATIENT NAVIGATOR SERVICES.

    (a) State Plan Requirement.--Section 1902(a) of the Social Security 
Act (42 U.S.C. 1396a(a)) is amended--
            (1) in paragraph (82)(C), by striking ``and'' at the end;
            (2) in paragraph (83), by striking the period at the end 
        and inserting ``; and''; and
            (3) by inserting after paragraph (83) the following:
            ``(84) provide that the State shall reimburse an eligible 
        entity (as such term is defined in subsection (ll)(1)) for any 
        patient navigator service (as such term is defined in 
        subsection (ll)(3)) that is--
                    ``(A) provided to an individual who is eligible for 
                medical assistance under the State plan; and
                    ``(B) provided by a patient navigator (as such term 
                is defined in subsection (ll)(2)) through the eligible 
                entity.''.
    (b) Patient Navigator Services Definitions.--Section 1902 of the 
Social Security Act is amended by adding at the end the following:
    ``(ll) Patient Navigator Services Definitions.--For purposes of 
subsection (a)(84):
            ``(1) Eligible entity.--The term `eligible entity' means an 
        entity that--
                    ``(A) is an eligible entity (as such term is 
                defined in section 340A(l)(1) of the Public Health 
                Service Act); and
                    ``(B) complies with the following requirements of 
                section 340A of the Public Health Service Act:
                            ``(i) Subsection (b) (relating to patient 
                        navigator duties and community knowledge).
                            ``(ii) Subsection (c) (relating to 
                        prohibitions).
                            ``(iii) Subsection (e) (relating to 
                        applications).
                            ``(iv) Subsection (j)(3) (relating to 
                        reports).
            ``(2) Patient navigator.--
                    ``(A) In general.--The term `patient navigator' has 
                the meaning given such term in section 340A(l)(3) of 
                the Public Health Service Act.
                    ``(B) Consultation.--
                            ``(i) In general.--The Secretary shall 
                        consult with the patient navigation advisory 
                        committee to the extent necessary to further 
                        clarify the definition of the term `patient 
                        navigator' for purposes of subsection (a)(84), 
                        including establishing requirements to ensure 
                        adequate training for such navigators, such as 
                        developing a training curriculum.
                            ``(ii) Membership.--The Secretary shall 
                        convene a patient navigation advisory committee 
                        and the members of such committee shall 
                        include--
                                    ``(I) representatives from relevant 
                                Federal departments and agencies, 
                                including the National Institutes of 
                                Health, the Centers for Disease Control 
                                and Prevention, the Health Resources 
                                and Services Administration, and the 
                                Centers for Medicare & Medicaid 
                                Services; and
                                    ``(II) individuals and 
                                representatives of public and private 
                                organizations with expertise in patient 
                                navigation.
            ``(3) Patient navigator services.--The term `patient 
        navigator service' means a service that is a duty specified 
        under paragraphs (1) through (6) of subsection (b) of section 
        340A of the Public Health Service Act and that is provided by a 
        patient navigator (as defined in section 340A(l)(3) of the 
        Public Health Service Act), through an eligible entity.''.
    (c) Treatment as Medical Assistance for Purposes of FMAP.--Section 
1905(a) of the Social Security Act (42 U.S.C. 1396d(a)) is amended--
            (1) in paragraph (28), by striking ``and'' at the end;
            (2) by redesignating paragraph (29) as paragraph (30); and
            (3) by inserting after paragraph (28) the following:
            ``(29) patient navigator services (as such term is defined 
        in section 1902(ll)(3)) that are provided in a manner that 
        meets the requirements of section 1902(a)(84); and''.
    (d) Effective Date.--
            (1) In general.--Subject to paragraph (2), the amendments 
        made this section shall apply to patient navigator services 
        provided after the first day of the first calendar year that 
        begins after the date of enactment of this Act.
            (2) Exception for state legislation.--In the case of a 
        State plan under title XIX of the Social Security Act, which 
        the Secretary of Health and Human Services determines requires 
        State legislation in order for the respective plan to meet any 
        requirement imposed by amendments made by this Act, the 
        respective plan shall not be regarded as failing to comply with 
        the requirements of such title solely on the basis of its 
        failure to meet such an additional requirement before the first 
        day of the first calendar quarter beginning after the close of 
        the first regular session of the State legislature that begins 
        after the date of enactment of this Act. For purposes of the 
        previous sentence, in the case of a State that has a 2-year 
        legislative session, each year of the session shall be 
        considered to be a separate regular session of the State 
        legislature.
                                 <all>