[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2779 Introduced in House (IH)]

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115th CONGRESS
  1st Session
                                H. R. 2779

  To amend title XI of the Social Security Act to provide through the 
   Center for Medicare and Medicaid Innovation (CMMI) for a Medicaid 
   payment model demonstration project on Medicaid reimbursement for 
    physicians' services in counties with a disproportionately high 
                   proportion of Medicaid enrollees.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              June 6, 2017

Mr. Denham (for himself and Mr. Valadao) introduced the following bill; 
       which was referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
  To amend title XI of the Social Security Act to provide through the 
   Center for Medicare and Medicaid Innovation (CMMI) for a Medicaid 
   payment model demonstration project on Medicaid reimbursement for 
    physicians' services in counties with a disproportionately high 
                   proportion of Medicaid enrollees.

    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 ``Assessing Critical Care Efforts to 
Strengthen Services (ACCESS) Act of 2017''.

SEC. 2. CMMI MEDICAID PAYMENT MODEL DEMONSTRATION PROJECT ON MEDICAID 
              REIMBURSEMENT FOR PHYSICIANS' SERVICES IN COUNTIES WITH A 
              DISPROPORTIONATELY HIGH PROPORTION OF MEDICAID ENROLLEES.

    Section 1115A(b) of the Social Security Act (42 U.S.C. 1315a(b)) is 
amended--
            (1) in paragraph (2)(B), by adding at the end the following 
        new clause:
                            ``(xxv) Focusing on payment models under 
                        title XIX for recruiting and retaining 
                        physicians to serve low-income applicable 
                        individuals residing in disproportionate share 
                        counties (as defined in paragraph (5)(D)).''; 
                        and
            (2) by adding at the end the following new paragraph:
            ``(5)  Medicaid physicians' service model for low-income 
        individuals in disproportionate share counties.--
                    ``(A) Selection.--Beginning not later than 6 months 
                after the date of the enactment of this paragraph, the 
                Secretary shall select for testing one or more models 
                described in paragraph (2)(B)(xxv).
                    ``(B) Design.--In selecting, and designing the 
                testing for, such a model under this subsection, CMI 
                shall--
                            ``(i) review the most successful models for 
                        recruiting and retaining physicians to serve 
                        low-income applicable individuals residing in a 
                        disproportionate share county (as defined in 
                        subparagraph (D)); and
                            ``(ii) incorporate lessons from successful 
                        strategies that take into account how access to 
                        physicians' services has improved for such 
                        individuals.
                    ``(C) Evaluation.--In evaluating the performance of 
                such a model under paragraph (4), CMI shall--
                            ``(i) evaluate the applicability and 
                        expansion of the model to inform national 
                        strategies to best leverage funds under title 
                        XIX to improve access to physicians' services 
                        for low-income applicable individuals residing 
                        in a disproportionate share county; and
                            ``(ii) examine the degree to which Medicaid 
                        payment strategies (such as the use of primary 
                        case management, medical homes, and palliative 
                        care, the use of payment rates for physicians' 
                        services that are not less than the Medicare 
                        payment rates that apply to such care and 
                        services under part B of title XVIII, and 
                        allowing Federally-qualified health centers to 
                        contract with specialty physicians to be paid 
                        at Federally-qualified health center payment 
                        rates for services furnished in a physician's 
                        office), including such strategies as modified 
                        through such a model, improve access, outcomes, 
                        and patient satisfaction for such individuals 
                        and reduce emergency department utilization by 
                        such individuals.
                    ``(D) Disproportionate share county defined.--In 
                this paragraph, the term `disproportionate share 
                county' means a county in which at least 35 percent of 
                the residents of the county are enrolled under the 
                State plan under title XIX (or under a waiver of such 
                plan).''.
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