[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4554 Introduced in House (IH)]

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117th CONGRESS
  1st Session
                                H. R. 4554

  To amend title XIX of the Social Security Act to provide grants for 
 support for States to identify and act on racial disparities, and for 
                            other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 20, 2021

Mr. Butterfield (for himself and Mr. Joyce of Pennsylvania) introduced 
 the following bill; which was referred to the Committee on Energy and 
                                Commerce

_______________________________________________________________________

                                 A BILL


 
  To amend title XIX of the Social Security Act to provide grants for 
 support for States to identify and act on racial disparities, 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 ``Care That's Fair Act''.

SEC. 2. GRANTS TO SUPPORT FOR STATES TO IDENTIFY AND ACT ON RACIAL 
              DISPARITIES UNDER MEDICAID.

    Section 1946 of the Social Security Act (42 U.S.C. is amended by 
adding the following new subsection:
    ``(d) Support for States To Identify and Act on Racial 
Disparities.--
            ``(1) In general.--The Administrator is authorized to award 
        grants to States in accordance with this section to analyze 
        Medicaid claims and clinical data to study--
                    ``(A) variation in Medicaid health outcomes and 
                health care service utilization that are correlated to 
                race and ethnicity for clinically similar patients; or
                    ``(B) the contributing clinical and social factors 
                to poor infant and maternal health outcomes in 
                Medicaid.
            ``(2) State application.--A State seeking approval of a 
        grant shall submit an application to the Administrator, after 
        April 1, 2021, and prior to September 1, 2024, in such format 
        as the Administrator requires.
            ``(3) Limitations.--No State shall receive--
                    ``(A) more than one grant in any fiscal year; or
                    ``(B) a grant that exceeds $500,000.
            ``(4) Action report.--Each State receiving a grant under 
        this subsection must submit to the Administrator an action 
        report no later than 2 fiscal years after being awarded the 
        grant, which the Administrator must make public on the Centers 
        for Medicare & Medicaid Services website and provide analysis 
        comparing the results of the action reports across each 
        grantee, taking into account variation in the demographics and 
        clinical needs in each State.
            ``(5) Definitions.--For purposes of this section:
                    ``(A) Administrator.--The term `Administrator' 
                means the Administrator for the Center for Medicare and 
                Medicaid Services.
                    ``(B) State.--The term `State' means any of the 50 
                States or the District of Columbia.
                    ``(C) Clinically similar.--The term `clinically 
                similar' means, with respect to a State Medicaid 
                program, Medicaid enrollees that have the same health 
                status, burden of illness, comorbid conditions, and 
                need for services.
                    ``(D) Health outcomes.--The term `health outcomes' 
                means, with respect to a State Medicaid program, a 
                change in health status for a Medicaid enrollee as a 
                result of care interventions.
                    ``(E) Health care service utilization.--The term 
                `health care service utilization' means, with respect 
                to a State Medicaid program, the rate of use of a 
                particular health care service, procedure, test, 
                process, or care intervention.
                    ``(F) Social factors.--The term `social factors' 
                may include, but is not limited to--
                            ``(i) housing;
                            ``(ii) transportation;
                            ``(iii) food insecurity;
                            ``(iv) environmental conditions;
                            ``(v) economic insecurity;
                            ``(vi) health literacy;
                            ``(vii) family and community instability; 
                        and
                            ``(viii) interpersonal violence.
                    ``(G) Action report.--The term `action report' 
                means, with respect to a State Medicaid program--
                            ``(i) a summary at the aggregate level of 
                        the results from the State analysis performed 
                        under paragraph (1);
                            ``(ii) a summary of the characteristics of 
                        the study, including population included, time 
                        period covered, methodologies used, and any 
                        limitations encountered;
                            ``(iii) the actions the State plans to take 
                        or would like to take under the State Medicaid 
                        program in the next 5 years to address 
                        paragraph (1)(A) or (1)(B); and
                            ``(iv) what regulatory barriers exist in 
                        enacting the steps under clause (ii).
            ``(6) Appropriations.--In general, there are appropriated, 
        from any funds in the Treasury not otherwise appropriated, for 
        grants to carry out this section--
                    ``(A) $5,000,000 for fiscal year 2021;
                    ``(B) $10,000,000 for fiscal year 2022; and
                    ``(C) $10,000,000 for fiscal year 2023.''.
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