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<bill bill-stage="Introduced-in-House" dms-id="H07FD3D0BCD5948F4A7BE5588E18AFA14" public-private="public" key="H" bill-type="olc">
<metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
<dublinCore>
<dc:title>117 HR 4554 IH: Care That’s Fair Act</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2021-07-20</dc:date>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
</dublinCore>
</metadata>
<form>
<distribution-code display="yes">I</distribution-code>
<congress display="yes">117th CONGRESS</congress><session display="yes">1st Session</session>
<legis-num display="yes">H. R. 4554</legis-num>
<current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber>
<action display="yes">
<action-date date="20210720">July 20, 2021</action-date>
<action-desc><sponsor name-id="B001251">Mr. Butterfield</sponsor> (for himself and <cosponsor name-id="J000302">Mr. Joyce of Pennsylvania</cosponsor>) introduced the following bill; which was referred to the <committee-name committee-id="HIF00">Committee on Energy and Commerce</committee-name></action-desc>
</action>
<legis-type>A BILL</legis-type>
<official-title display="yes">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.</official-title>
</form>
<legis-body id="H4F58788198DB445585E0FC9CF5B92F99" style="OLC">
<section id="H21B472FD26A645BDAD0A81CA053D3833" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Care That’s Fair Act</short-title></quote>.</text></section> <section id="H1DAC2608F4F24DECA65BBB01F8E222F0"><enum>2.</enum><header>Grants to support for States to identify and act on racial disparities under Medicaid</header><text display-inline="no-display-inline">Section 1946 of the Social Security Act (42 U.S.C. is amended by adding the following new subsection:</text>
<quoted-block id="H21C3299DE5C4474EAFF9B36110945C53" style="OLC">
<subsection id="H94C365ACD2524B56A86944EA56966B00"><enum>(d)</enum><header>Support for States To identify and act on racial disparities</header>
<paragraph id="HDA8322E67EB8451CB2351F1753B40A6D"><enum>(1)</enum><header>In general</header><text>The Administrator is authorized to award grants to States in accordance with this section to analyze Medicaid claims and clinical data to study—</text> <subparagraph id="H1F840514F8364C0A97A939BADEEF5513"><enum>(A)</enum><text>variation in Medicaid health outcomes and health care service utilization that are correlated to race and ethnicity for clinically similar patients; or</text></subparagraph>
<subparagraph id="HF68C75D7F6D04CCF8F99864189E9B49F"><enum>(B)</enum><text>the contributing clinical and social factors to poor infant and maternal health outcomes in Medicaid.</text></subparagraph></paragraph> <paragraph id="HF27A9B7CAA984889A113598C60952883"><enum>(2)</enum><header>State application</header><text>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.</text></paragraph>
<paragraph id="H07F24FD7958F42F08D272D7C4BC591AE"><enum>(3)</enum><header>Limitations</header><text>No State shall receive—</text> <subparagraph id="HF0211FB83B9344EB833814491A5D2D3E"><enum>(A)</enum><text>more than one grant in any fiscal year; or</text></subparagraph>
<subparagraph id="HDB70A64AC5074821986E71B07F06B372"><enum>(B)</enum><text>a grant that exceeds $500,000.</text></subparagraph></paragraph> <paragraph id="H37A5D0945E3F417BA8055A9F9F74F1EE"><enum>(4)</enum><header>Action report</header><text>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 &amp; 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.</text></paragraph>
<paragraph id="H3A48A099ECF94D38B363087F43B6F1DF"><enum>(5)</enum><header>Definitions</header><text>For purposes of this section:</text> <subparagraph id="H65171E9E5F714B53AAE8A548494437BA"><enum>(A)</enum><header>Administrator</header><text>The term <term>Administrator</term> means the Administrator for the Center for Medicare and Medicaid Services.</text></subparagraph>
<subparagraph id="HA115E54852674D83A95E2F7BC82EBF6C"><enum>(B)</enum><header>State</header><text>The term <term>State</term> means any of the 50 States or the District of Columbia.</text></subparagraph> <subparagraph id="H9D43D547982840AB87B208DDD918671A"><enum>(C)</enum><header>Clinically Similar</header><text>The term <term>clinically similar</term> 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.</text></subparagraph>
<subparagraph id="H52EDE390147F438D943206660E708409"><enum>(D)</enum><header>Health Outcomes</header><text>The term <term>health outcomes</term> means, with respect to a State Medicaid program, a change in health status for a Medicaid enrollee as a result of care interventions.</text></subparagraph> <subparagraph id="H51D45432968D405A8AC996B7C9842A1F"><enum>(E)</enum><header>Health Care Service Utilization</header><text>The term <term>health care service utilization</term> means, with respect to a State Medicaid program, the rate of use of a particular health care service, procedure, test, process, or care intervention.</text></subparagraph>
<subparagraph id="HA304A8F7570E4D55960E1C18F7305039"><enum>(F)</enum><header>Social Factors</header><text>The term <term>social factors</term> may include, but is not limited to—</text> <clause id="H27E8EC88F7674D27B9692793DE52535F"><enum>(i)</enum><text>housing;</text></clause>
<clause id="HB842BA14FFF6408FB538F9026DC81A61"><enum>(ii)</enum><text>transportation;</text></clause> <clause id="H926B8154ED6345C2901D3DB9689CBE72"><enum>(iii)</enum><text>food insecurity;</text></clause>
<clause id="HF6EC7CA123C9458BA0D0AD7157F4D0F8"><enum>(iv)</enum><text>environmental conditions;</text></clause> <clause id="H7F484CFAC1CD4388824B05668CC7EC3D"><enum>(v)</enum><text>economic insecurity;</text></clause>
<clause id="H96526A82FC414C9CB2CA2693F6AA9E73"><enum>(vi)</enum><text>health literacy;</text></clause> <clause id="H66F7A130BA05491DA18EE24F6BED1945"><enum>(vii)</enum><text>family and community instability; and</text></clause>
<clause id="H15D17554FBE348C7933E207943BB8304"><enum>(viii)</enum><text>interpersonal violence.</text></clause></subparagraph> <subparagraph id="H7950A8938F6C4358B875524AD24E7109"><enum>(G)</enum><header>Action Report</header><text>The term <term>action report</term> means, with respect to a State Medicaid program—</text>
<clause id="H339427C3A4654946A05A9B60B8CD92F0"><enum>(i)</enum><text>a summary at the aggregate level of the results from the State analysis performed under paragraph (1);</text></clause> <clause id="HC779E550F964451A83900DBF834C568E"><enum>(ii)</enum><text>a summary of the characteristics of the study, including population included, time period covered, methodologies used, and any limitations encountered;</text></clause>
<clause id="HFC81E39183FD4586A9BCBD936043C35B"><enum>(iii)</enum><text>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</text></clause> <clause id="HDB30D72002074EA892E83C04DCD7C0DA"><enum>(iv)</enum><text>what regulatory barriers exist in enacting the steps under clause (ii).</text></clause></subparagraph></paragraph>
<paragraph id="H4BCE51A017204C9C9F2923272AA8B366"><enum>(6)</enum><header>Appropriations</header><text>In general, there are appropriated, from any funds in the Treasury not otherwise appropriated, for grants to carry out this section—</text> <subparagraph id="H682403E2168F4530B69D1585527C6589"><enum>(A)</enum><text>$5,000,000 for fiscal year 2021;</text></subparagraph>
<subparagraph id="HECBEE85EE1D845E18E336F73275E77A0"><enum>(B)</enum><text>$10,000,000 for fiscal year 2022; and</text></subparagraph> <subparagraph id="HA149F067CDD5402FB6879325D20C3C10"><enum>(C)</enum><text>$10,000,000 for fiscal year 2023.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></section>
</legis-body>
</bill> 


