[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3821 Reported in House (RH)]

<DOC>





                                                 Union Calendar No. 325
114th CONGRESS
  2d Session
                                H. R. 3821

                          [Report No. 114-426]

 To amend title XIX to require the publication of a provider directory 
  in the case of States providing for medical assistance on a fee-for-
service basis or through a primary care case-management system, and for 
                            other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 23, 2015

  Mr. Collins of New York (for himself and Mr. Tonko) introduced the 
   following bill; which was referred to the Committee on Energy and 
                                Commerce

                           February 23, 2016

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]
[For text of introduced bill, see copy of bill as introduced on October 
                               23, 2015]


_______________________________________________________________________

                                 A BILL


 
 To amend title XIX to require the publication of a provider directory 
  in the case of States providing for medical assistance on a fee-for-
service basis or through a primary care case-management system, and for 
                            other purposes.


 


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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicaid Directory of Caregivers 
Act'' or the ``Medicaid DOC Act''.

SEC. 2. REQUIRING PUBLICATION OF FEE-FOR-SERVICE PROVIDER DIRECTORY.

    (a) In General.--Section 1902(a) of the Social Security Act (42 
U.S.C. 1396a(a)) is amended by inserting after paragraph (77) the 
following new paragraph:
            ``(78) provide that, not later than 180 days after the date 
        of the enactment of this paragraph, in the case of a State plan 
        that provides medical assistance on a fee-for-service basis or 
        through a primary care case-management system described in 
        section 1915(b)(1) (other than a primary care case management 
        entity (as defined by the Secretary)), the State shall publish 
        (and update on at least an annual basis) on the public Website 
        of the State agency administering the State plan, a directory 
        of the providers (including, at a minimum, primary and 
        specialty care physicians) described in subsection (ll) that 
        includes--
                    ``(A) with respect to each such provider--
                            ``(i) the name of the provider;
                            ``(ii) the specialty of the provider;
                            ``(iii) the address of the provider; and
                            ``(iv) the telephone number of the 
                        provider; and
                    ``(B) with respect to any such provider 
                participating in such a primary care case-management 
                system, information regarding--
                            ``(i) whether the provider is accepting as 
                        new patients individuals who receive medical 
                        assistance under this title; and
                            ``(ii) the provider's cultural and 
                        linguistic capabilities, including the 
                        languages spoken by the provider or by the 
                        skilled medical interpreter providing 
                        interpretation services at the provider's 
                        office;''.
    (b) Directory Providers Described.--Section 1902 of the Social 
Security Act (42 U.S.C. 1396a) is amended by adding at the end the 
following new subsection:
    ``(ll) Directory Providers Described.--A provider described in this 
subsection is--
            ``(1) in the case of a provider of a provider type for 
        which the State agency, as a condition on receiving payment for 
        items and services furnished by the provider to individuals 
        eligible to receive medical assistance under the State plan, 
        requires the enrollment of the provider with the State agency, 
        a provider that--
                    ``(A) is enrolled with the agency as of the date on 
                which the directory is published or updated (as 
                applicable) under subsection (a)(78); and
                    ``(B) received payment under the State plan in the 
                12-month period preceding such date; and
            ``(2) in the case of a provider of a provider type for 
        which the State agency does not require such enrollment, a 
        provider that received payment under the State plan in the 12-
        month period preceding the date on which the directory is 
        published or updated (as applicable) under subsection 
        (a)(78).''.
    (c) Rule of Construction.--
            (1) In general.--The amendment made by subsection (a) shall 
        not be construed to apply in the case of a State in which all 
        the individuals enrolled in the State plan under title XIX of 
        the Social Security Act (or under a waiver of such plan), other 
        than individuals described in paragraph (2), are enrolled with 
        a medicaid managed care organization (as defined in section 
        1903(m)(1)(A) of such Act (42 U.S.C. 1396b(m)(1)(A))), 
        including prepaid inpatient health plans and prepaid ambulatory 
        health plans (as defined by the Secretary of Health and Human 
        Services).
            (2) Individuals described.--An individual described in this 
        paragraph is an individual who is an Indian (as defined in 
        section 4 of the Indian Health Care Improvement Act (25 U.S.C. 
        1603)) or an Alaska Native.
    (d) Exception for State Legislation.--In the case of a State plan 
under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.), 
which the Secretary determines requires State legislation in order for 
the respective plan to meet one or more additional requirements imposed 
by amendments made by this section, 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 section. 
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.
                                                 Union Calendar No. 325

114th CONGRESS

  2d Session

                               H. R. 3821

                          [Report No. 114-426]

_______________________________________________________________________

                                 A BILL

 To amend title XIX to require the publication of a provider directory 
  in the case of States providing for medical assistance on a fee-for-
service basis or through a primary care case-management system, and for 
                            other purposes.

_______________________________________________________________________

                           February 23, 2016

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed