[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1114 Introduced in House (IH)]

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118th CONGRESS
  1st Session
                                H. R. 1114

    To provide for optimized care, a coordinated Federal Government 
 response, public education, and insurance reimbursement guidance for 
                  Long COVID, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 21, 2023

    Ms. Blunt Rochester (for herself, Mr. Beyer, and Ms. Pressley) 
 introduced the following bill; which was referred to the Committee on 
                          Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
    To provide for optimized care, a coordinated Federal Government 
 response, public education, and insurance reimbursement guidance for 
                  Long COVID, 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; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the``Long COVID Response 
is Care Optimized and Vitally Essential Resources that Yield New 
Opportunities for Wellness Act'' or the ``Long COVID RECOVERY NOW 
Act''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Targeting resources for equitable access to treatment of Long 
                            COVID.
Sec. 3. National Long COVID technical assistance dissemination program.
Sec. 4. Mental health and suicide prevention and treatment.
Sec. 5. ONC best practices for Long COVID data.
Sec. 6. Long COVID Education Website.
Sec. 7. Providing Support for Long COVID Registries.
Sec. 8. Medicaid Health Homes for Individuals with Long COVID.
Sec. 9. State health officials guidance.
Sec. 10. Support under Medicaid for State Collection of Long COVID 
                            Data.
Sec. 11. Grants for Pediatric Research on Long COVID.

SEC. 2. TARGETING RESOURCES FOR EQUITABLE ACCESS TO TREATMENT OF LONG 
              COVID.

    (a) Establishment.--
            (1) In general.--Not later than 1 year after the date of 
        the enactment of this Act, the Secretary of Health and Human 
        Services shall award, subject to subsection (f) and in 
        accordance with the provisions of this section, grants 
        described in the following subsections to carry out the 
        purposes described in such subsections.
            (2) Eligibility.--The Secretary may establish a process for 
        evaluating and determining the eligibility of Federally 
        qualified health centers and rural health clinics for receiving 
        a grant under this section.
    (b) Grants to FQHCs and RHCs.--For purposes of subsection (a), the 
grants described in this subsection are grants to Federally qualified 
health centers (as defined in section 1861(aa)(4) of the Social 
Security Act (42 U.S.C. 1395x(aa)(4)) and rural health clinics (as 
defined in section 1861(aa)(2) of such Act (42 U.S.C. 1395x(aa)(2)) 
to--
            (1) adopt evidence-based Long COVID clinical practices that 
        have been demonstrated to improve the wellness of individuals 
        with Long COVID, including clinical validation of patient 
        reported symptoms using established measures that yield 
        structured, comparable data;
            (2) establish or expand screening, referral, and navigation 
        processes for health-related social needs that could interfere 
        with Long COVID treatment, including food insecurity, housing 
        instability, transportation needs, utility difficulties, and 
        interpersonal safety; and
            (3) submit to the Secretary of Health and Human Services 
        (in a format consistent with the standards and activities under 
        the Data Modernization Initiative of the Centers for Disease 
        Control and Prevention) standardized, disaggregated, 
        deidentified data (as specified by the Secretary) on the 
        characteristics, diagnoses, and health care service utilization 
        of Long COVID patients served under such grant, including 
        disaggregated data on Long COVID patient characteristics, 
        including patient age, gender, race, ethnicity, language 
        spoken, disability status, nature and duration of validated 
        symptoms, and other characteristics necessary to inform 
        considerations for effective and equitable treatment for 
        patients with Long COVID.
    (c) Grants to Primary Care Practices.--For purposes of subsection 
(a), the grants described in this subsection are grants to primary care 
practices (other than Federally qualified health centers and rural 
health clinics) that satisfy such criteria as may be established by the 
Secretary to carry out the purposes described in paragraphs (1) and (3) 
of subsection (b).
    (d) GRANTS For Multidisciplinary Treatment and Coordination.--
            (1) In general.--The Secretary of Health and Human Services 
        (in this section referred to as the ``Secretary'') shall award 
        grants on a competitive basis to eligible entities for the 
        purpose of creating or enhancing capacity to treat patients 
        with Long COVID through a multidisciplinary approach. The term 
        ``multidisciplinary'' in this section refers to the coordinated 
        work to provide care or treatment to a patient by physicians 
        and other professionals, such as specialty or subspecialty 
        providers, nurses and nurse care coordinators, dietitians, 
        nutritionists, social workers, behavioral health professionals, 
        physical and occupational therapists, speech pathologists, or 
        any professionals determined to be appropriate by the State and 
        approved by the Administrator of the Centers for Medicare & 
        Medicaid Services.
            (2) Use of funds.--An eligible entity receiving a grant 
        under this section shall use the grant, for the purpose 
        described in subsection (a), to--
                    (A) enhance the capacity of one or more existing 
                multidisciplinary Long COVID clinics to serve the Long 
                COVID population; or
                    (B) create one or more multidisciplinary clinics to 
                address the physical and mental health needs of Long 
                COVID patients.
            (3) Eligible entities.--To be eligible to receive a grant 
        under this section, an entity shall be a health care provider, 
        Federally qualified health center (as defined in section 
        1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa))), 
        rural health clinic, urban Indian health center, or State or 
        local public health department, that--
                    (A)(i) operates an existing multidisciplinary Long 
                COVID clinic or other specialized Long COVID program; 
                or
                    (ii) is an existing health care provider with 
                experience providing care for individuals with Long 
                COVID and who demonstrates an intent to create a 
                multidisciplinary Long COVID clinic or other 
                specialized Long COVID program;
                    (B) submits to the Secretary an application at such 
                time, in such manner, and containing such information 
                and assurances as the Secretary may require; and
                    (C) employs a framework that incentivizes 
                participants to attain the program's goals to establish 
                and disseminate best practices, and allocates funds 
                based on such attainment.
            (4) Special rule.--A physical clinical facility is not a 
        requirement for eligibility.
            (5) Priority.--In awarding grants under this subsection, 
        the Secretary shall give priority to eligible entities that--
                    (A) submit a plan to engage with medically 
                underserved communities, and with populations 
                disproportionately impacted by COVID-19;
                    (B) demonstrate capacity (or an intent to build 
                capacity) to provide personalized treatment and 
                facilitate patient access to multidisciplinary health 
                care providers with expertise in treating Long COVID 
                symptoms, including such providers who are primary and 
                specialty care physicians (such as physiatrists, 
                neurologists, cardiologists, immunologists, and 
                pulmonologists), therapists, nurses, care coordinators, 
                social workers, nutritionists, and behavioral health 
                specialists; and
                    (C) submit a plan to ensure ongoing 
                multidisciplinary continuing education on infection-
                triggered conditions for--
                            (i) physicians treating Long COVID; and
                            (ii) other physicians and health care 
                        workers who are not treating Long COVID, but 
                        are otherwise serving patients in the 
                        community.
    (e) Equitable Access.--In order to ensure equitable access 
treatment--
            (1) no grantee under this section shall deny access to 
        treatment with respect to Long COVID based on insurance 
        coverage, date of diagnosis, or previous hospitalization;
            (2) a grantee under this section shall with respect to Long 
        COVID--
                    (A) offer equity-centered resources (such as the 
                ability to offer resources in various languages), 
                information, and training to safety net health systems; 
                and
                    (B) disseminate to individuals and organizations 
                that provide care best practices and treatment 
                approaches that enhance access to high-quality care to 
                everyone where they live; and
            (3) treatment for Long COVID shall be included as a COVID-
        19 treatment, consistent with the American Rescue Plan Act of 
        2021 (Public Law 117-2).
    (f) Development of Evidence-Based Strategies for High-Value Care 
for Individuals With Long COVID.--
            (1) In general.--Not later than 1 year after the date of 
        the enactment of this Act, the Agency for Healthcare Research 
        and Quality shall, subject to appropriations pursuant to 
        subsection (i), award multi-year grants to eligible entities 
        meeting such criteria as specified by the Secretary through 
        rulemaking for the purposes of--
                    (A) supporting the generation of evidence about how 
                to deliver high quality, high-value health care for 
                individuals with Long COVID for the treatment of the 
                condition;
                    (B) creating tools and strategies to help health 
                systems and hospitals, primary and specialty 
                physicians, nurses, allied health care professionals, 
                and caregivers provide high-quality, high-value care 
                for individuals with Long COVID; and
                    (C) providing educational materials for health care 
                providers, payers, and consumers on high-value care for 
                individuals with Long COVID.
            (2) Eligibility.--The Secretary shall, through rulemaking, 
        specify a process for evaluating and determining the 
        eligibility of primary care providers including Federally 
        qualified health centers and rural health clinics; specialty 
        care providers, hospitals, health systems, academic medical 
        centers; and other entities for receiving a grant under this 
        subsection. Such rules shall prohibit grant funds from being 
        used to compensate or reimburse individuals or organizations 
        excluded pursuant to section 1128 of the Social Security Act 
        (42 U.S.C. 1320a-7) from participation under the Medicare 
        program under title XVIII of such Act.
    (g) Long COVID Defined.--For purposes of this Act, the term ``Long 
COVID'' (also referred to as ``post-acute sequelae of COVID-19'', 
``post-COVID conditions'', or ``persistent symptoms post-COVID'') means 
the ongoing sequelae of COVID-19 that some individuals experience after 
infection with the SARS-CoV-2 virus, as diagnosed by a qualified health 
care provider. Such sequelae are defined as the ``Post-COVID 
Conditions'' identified and defined by the Centers for Disease Control 
and Prevention in 2021, or in subsequent revisions by the Centers for 
Disease Control and Prevention.
    (h) Reports.--
            (1) Annual reports by grantees to secretary.--On an annual 
        basis, a recipient of a grant under this section shall--
                    (A) submit to the Secretary, and make publicly 
                available, a report on the activities carried out 
                through the grant; and
                    (B) include evaluations of such activities, 
                including the experience of individuals who received 
                health care through such grant.
            (2) Annual reports by secretary to congress.--Not later 
        than the end of each of fiscal years 2024 through 2026, the 
        Secretary shall submit to the Congress, and make publicly 
        available, a report that--
                    (A) summarizes the reports received under paragraph 
                (1);
                    (B) evaluates the effectiveness of grants under 
                this section; and
                    (C) makes recommendations with respect to expanding 
                coverage for clinical care for Long COVID.
    (i) Authorization of Appropriations.--
            (1) In general.--To carry out this section, there are 
        authorized to be appropriated such sums as may be necessary for 
        each of fiscal years 2024 through 2026.
            (2) Administrative expenses.--Not more than 15 percent of 
        the amounts made available to carry out this section for any 
        fiscal year may be used for administrative expenses to operate 
        the grants under this section.

SEC. 3. NATIONAL LONG COVID TECHNICAL ASSISTANCE DISSEMINATION PROGRAM.

    (a) In General.--The Secretary of Health and Human Services shall--
            (1) establish a structured process to seek ongoing input 
        from medical societies representing primary care, specialty 
        care, and subspecialty care regarding the proven and promising 
        practices for treating individuals who are diagnosed with Long 
        COVID to support their wellness and recovery; and
            (2) enter into a memorandum of understanding with one or 
        more organizations with specific medical knowledge on Long 
        COVID or experience providing care and medical treatment to 
        individuals with Long COVID to support the ongoing 
        dissemination to the broader medical community of existing open 
        source evidence, tools and strategies.
    (b) Organization Described.--For purposes of subsection (a), and 
organization described in this paragraph is an organization that 
satisfies at least the following:
            (1) The organization has clinical expertise related to the 
        treatment of Long COVID.
            (2) The organization has a robust understanding of clinical 
        and business practices.
            (3) The organization has the ability to convene groups and 
        disseminate information nationally.
            (4) The organization consults with medical specialty 
        associations for purposes of developing and distributing 
        clinical best practices for Long COVID diagnosis and treatment.

SEC. 4. MENTAL HEALTH AND SUICIDE PREVENTION AND TREATMENT.

    Section 1911(b)(1) of the Public Health Service Act (42 U.S.C. 
300x(b)(1)) is amended by inserting ``and, for each of fiscal years 
2024 through 2026, individuals with Long COVID (as defined in section 2 
of the Long COVID RECOVERY NOW Act) who have also been diagnosed with a 
mental health condition (such as a serious mental illness or a serious 
emotional disturbance)'' after ``1912(c)''.

SEC. 5. ONC BEST PRACTICES FOR LONG COVID DATA.

    (a) In General.--Not later than 6 months after the date of the 
enactment of this Act, the Secretary of Health and Human Services, 
acting through the National Coordinator for Health Information 
Technology, shall convene health care stakeholders to identify 
potential best practices for collecting, aggregating, and disseminating 
to health care researchers deidentified data that promotes learning 
about Long COVID and supports the further research of the 
characteristics of individuals diagnosed with Long COVID.
    (b) Report.--Not later than 160 days after the first meeting of 
such stakeholders pursuant to subsection (a), the Secretary shall 
submit to Congress (and make publicly available on the website of the 
Office of the National Coordinator of Health Information Technology) a 
report summarizing the meetings and findings of the stakeholders as 
well as any recommendations, including recommendations on ways that 
federal health care policy can better support an understanding of the 
etiology, characteristics, care and potential treatments for 
individuals Long COVID to support individuals' recovery and wellness. 
Such recommendations shall--
            (1) take into account the perspectives of health data 
        scientists, health services researchers, medical providers, 
        health plans, hospitals and health systems, epidemiologists, 
        public health experts, patient representatives and groups, 
        health information technology companies, and other 
        stakeholders; and
            (2) be informed by public and private sector efforts to 
        characterize Long COVID, aggregate and disaggregate data, and 
        promote data standardization, data standards, or open data 
        access for furthering a greater understanding of Long COVID.

SEC. 6. LONG COVID EDUCATION WEBSITE.

    Not later than 6 months after the date of the enactment of this 
Act, the Secretary of Health and Human Services shall, in consultation 
with medical societies representing the perspectives of primary care, 
specialty care, mental health professionals, medical researchers 
(including through the National Institutes of Health), public health 
experts (including the Centers for Disease Control and Prevention), and 
patient advocates, implement a Federal website (which may be 
implemented through an existing public website of the Department of 
Health and Human Services) that--
            (1) collects, and curates educational materials for health 
        care providers and consumers about Long COVID (as defined in 
        section 2(e)) symptoms, diagnosis, characteristics, treatment, 
        and access to care; and
            (2) includes, or provides a link to, comprehensive 
        educational resources for health care providers, such as the 
        interim guidance (and subsequent updates) for health care 
        providers published by the Centers for Disease Control and 
        Prevention on how to treat individuals with Long COVID.

SEC. 7. PROVIDING SUPPORT FOR LONG COVID REGISTRIES.

    (a) In General.--Not later than one year after the date of the 
enactment of this Act, the Secretary of Health and Human Services, 
acting through the Director of the Agency for Healthcare Research and 
Quality shall, subject to appropriations pursuant to subsection (d), 
award multi-year grants to eligible entities described in subsection 
(b) for the purposes of--
            (1) supporting existing or creating new Longitudinal 
        registries of patients with Long COVID (as defined in section 
        2(g));
            (2) establishing voluntary standards for such registries 
        that include common data elements and clear data definitions to 
        enable the comparability and synchronization of data by 
        researchers;
            (3) utilize data from such registries to help inform 
        understanding regarding the efficacy of care, diagnostics, 
        therapeutics, care pathways, behavioral health interventions, 
        and other dynamics regarding individuals with Long COVID; and
            (4) informing health care providers' efforts related to 
        improving equitable access to health care by collecting data 
        through such registries from individuals with Long COVID, 
        including social needs, medical history, race and ethnicity, 
        language, gender, and disability status, as specified by the 
        Secretary of Health and Human Services.
    (b) Eligible Entities.--
            (1) In general.--To be eligible for a grant under 
        subsection (a) an entity shall--
                    (A) submit an application to the Secretary in such 
                form and manner as the Secretary may require;
                    (B) agree to adhere to such data definitions and 
                standards as the Secretary may require, including 
                privacy and security requirements, requirements to make 
                findings of the organization, and the use of open-
                source technology to promote the dissemination of 
                information related to Long COVID;
                    (C) agree to make any information collected or 
                produced by the entity pursuant to the grant available 
                to the public through secure, non-proprietary means 
                without a paywall or fee;
                    (D) demonstrate to the Secretary, in a form and 
                manner specified by the Secretary, that the entity has 
                in place appropriate standards for handling 
                proprietary, confidential, and medical information 
                securely and in a manner that is compliant with 
                applicable law;
                    (E) have in place and demonstrate to the Secretary 
                the adequacy of a plan for the Longer-term financial 
                sustainability of such registry; and
                    (F) be an organization described in paragraph (2).
            (2) Organizations.--For purposes of paragraph (1), an 
        organization described in this paragraph is any of the 
        following:
                    (A) A non-profit organization representative of 
                individuals with Long COVID.
                    (B) An organization of health care providers, such 
                as health systems and hospitals.
                    (C) An organization of data scientists.
                    (D) Multi-sector groups that consist of 
                organizations described in 2 or more of the preceding 
                subparagraphs that meet such standards as the Secretary 
                may require.
    (c) Consideration.--In carrying out the purposes described in 
subsection (a), an eligible entity shall take into consideration the 
report made available under section 4(b).
    (d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $10,000,000 for each of fiscal 
years 2024 through 2028.

SEC. 8. MEDICAID HEALTH HOMES FOR INDIVIDUALS WITH LONG COVID.

    (a) Health Homes for Individuals With Chronic Conditions.--Section 
1945(h)(1)(A)(ii) of the Social Security Act (42 U.S.C. 1396w-
4(h)(1)(A)(ii)) is amended--
            (1) in subclause (II), by striking at the end ``or'';
            (2) in subclause (III), by striking at the end the period 
        and inserting ``; or''; and
            (3) by adding at the end the following new subclause:
                                    ``(IV) Long COVID (as defined in 
                                section 2(g) of the Long COVID RECOVERY 
                                NOW Act).''.
    (b) Health Homes for Children With Medically Complex Conditions.--
Section 1945A(i)(1)(A)(ii) of the Social Security Act (42 U.S.C. 1396w-
4a(i)(1)(A)(ii)) is amended--
            (1) in subclause (I), by striking at the end ``or'';
            (2) in subclause (II), by striking at the end the period 
        and inserting ``; or''; and
            (3) by adding at the end the following new subclause:
                                    ``(III) Long COVID (as defined in 
                                section 2(g) of the Long COVID RECOVERY 
                                NOW Act).''.

SEC. 9. STATE HEALTH OFFICIALS GUIDANCE.

    Not later than 18 months after the date of the enactment of this 
Act, the Secretary of Health and Human Services shall issue guidance to 
State health officials specifying tools and strategies that may help 
States improve the health and wellness of individuals enrolled under 
the Medicaid program under title XIX of the Social Security Act or the 
Children's Health Insurance Program under title XXI of such Act who 
have been diagnosed with Long COVID by facilitating strong primary care 
and supporting linkages to specialists, relevant social supports, or 
community-based organizations at the local level, that can help support 
the recovery and wellness of such individuals.

SEC. 10. SUPPORT UNDER MEDICAID FOR STATE COLLECTION OF LONG COVID 
              DATA.

    Section 1903(a)(3) of the Social Security Act (42 U.S.C. 
1396b(a)(3)) is amended by adding at the end the following new 
subparagraph:
            ``(I) 75 percent of the sums expended during a fiscal year 
        quarter in 2024, 2025, or 2026 as are attributable to the 
        collection and reporting of claims and encounter data on Long 
        COVID (including identification of race, language, ethnicity, 
        and duration of treatment) using the ICD-10 code U09.9 post 
        COVID-19 condition, unspecified (or any successor to such 
        code);''.

SEC. 11. GRANTS FOR PEDIATRIC RESEARCH ON LONG COVID.

    (a) In General.--The Secretary of Health and Human Services, acting 
through the Director of the National Institutes of Health (in this 
section, referred to as the ``Secretary''), shall award grants to 
eligible entities to conduct research on Long COVID in pediatric 
populations.
    (b) Use of Funds.--An eligible entity selected to receive a grant 
under this subsection may use funds received through the grant to 
conduct research described in subsection (a), with a focus on pediatric 
immune system responses and neurodevelopment.
    (c) Eligible Entity Defined.--In this section, the term ``eligible 
entity'' means a children's hospital, pediatric researcher, 
pediatrician, academic medical center, or other organization determined 
appropriate by the Secretary.
    (d) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for each of fiscal years 2024 through 2026.
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