[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 2840 Introduced in Senate (IS)]

<DOC>






118th CONGRESS
  1st Session
                                S. 2840

To improve access to and the quality of primary health care, expand the 
               health workforce, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           September 19, 2023

  Mr. Sanders (for himself and Mr. Marshall) introduced the following 
  bill; which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
To improve access to and the quality of primary health care, expand the 
               health workforce, 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 ``Bipartisan Primary 
Care and Health Workforce Act''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
 TITLE I--EXTENSION FOR COMMUNITY HEALTH CENTERS, THE NATIONAL HEALTH 
  SERVICE CORPS, AND TEACHING HEALTH CENTERS THAT OPERATE GME PROGRAMS

Sec. 101. Programs of payments to teaching health centers that operate 
                            graduate medical education programs.
Sec. 102. Community health centers.
Sec. 103. National Health Service Corps.
Sec. 104. GAO report.
Sec. 105. OIG report.
Sec. 106. Application of provisions.
             TITLE II--SUPPORTING THE HEALTH CARE WORKFORCE

Sec. 201. Rural residency planning and development program.
Sec. 202. Primary care training and enhancement program.
Sec. 203. Telehealth technology-enabled learning program.
Sec. 204. Expanding the number of primary care doctors.
Sec. 205. Nurse education, practice, quality, and retention grants.
Sec. 206. Nurse faculty loan program.
Sec. 207. Nurse faculty demonstration program.
Sec. 208. Nurse corps scholarship and loan repayment program.
Sec. 209. Grants for primary care nurse residency training programs.
Sec. 210. State oral health workforce improvement grant program.
Sec. 211. Oral health training programs.
Sec. 212. Allied health professionals.
Sec. 213. Budgetary treatment.
           TITLE III--REDUCING HEALTH CARE COSTS FOR PATIENTS

Sec. 301. Banning anticompetitive terms in facility and insurance 
                            contracts that limit access to higher 
                            quality, lower cost care.
Sec. 302. Honest billing requirements applicable to providers.
Sec. 303. Banning facility fees for certain services.
Sec. 304. Prevention and Public Health Fund.

 TITLE I--EXTENSION FOR COMMUNITY HEALTH CENTERS, THE NATIONAL HEALTH 
  SERVICE CORPS, AND TEACHING HEALTH CENTERS THAT OPERATE GME PROGRAMS

SEC. 101. PROGRAMS OF PAYMENTS TO TEACHING HEALTH CENTERS THAT OPERATE 
              GRADUATE MEDICAL EDUCATION PROGRAMS.

    (a) Funding.--Section 340H(g)(1) of the Public Health Service Act 
(42 U.S.C. 256h(g)(1)) is amended--
            (1) by striking ``such sums as may be necessary, not to 
        exceed'';
            (2) by striking ``2017, and'' and inserting ``2017,''; and
            (3) by inserting ``and $300,000,000 for each of fiscal 
        years 2024 through 2028,'' after ``2023,''.
    (b) Per Resident Amount.--Section 340H(a)(2) of the Public Health 
Service Act (42 U.S.C. 256h(a)(2)) is amended by adding at the end the 
following: ``Beginning in fiscal year 2024, in accordance with 
paragraph (1), but notwithstanding the capped amount referenced in 
subsections (b)(2) and (d)(2), the qualified teaching health center per 
resident amount for a fiscal year shall be not less than such amount 
for the previous fiscal year.''.
    (c) Amount of Payments.--Section 340H of the Public Health Service 
Act (42 U.S.C. 256h) is amended--
            (1) in subsection (b)(2)--
                    (A) in subparagraph (A), by striking ``amount of 
                funds appropriated under subsection (g) for such 
                payments for that fiscal year'' and inserting ``total 
                amount of funds available under subsection (g) and any 
                amounts recouped under subsection (f)''; and
                    (B) in subparagraph (B), by striking ``appropriated 
                in a fiscal year under subsection (g)'' and inserting 
                ``available under subsection (g) and any amounts 
                recouped under subsection (f)''; and
            (2) in subsection (d)(2)(B), by striking ``amount 
        appropriated for such expenses as determined in subsection 
        (g)'' and inserting ``total amount of funds available under 
        subsection (g) and any amounts recouped under subsection (f)''.
    (d) Priority Payments.--Section 340H(a)(3) of Public Health Service 
Act (42 U.S.C. 256h(a)(3)) is amended--
            (1) in subparagraph (A), by striking ``; or'' and inserting 
        a semicolon;
            (2) in subparagraph (B), by striking the period and 
        inserting ``; or''; and
            (3) by adding at the end the following:
                    ``(C) are located in a State that does not already 
                have a qualified teaching health center receiving 
                funding under this section.''.
    (e) Reporting Requirements.--Section 340H(h)(1) of the Public 
Health Service Act (42 U.S.C. 256h(h)(1)) is amended--
            (1) by redesignating subparagraph (H) as subparagraph (I); 
        and
            (2) by inserting after subparagraph (G) the following:
                    ``(H) Of the number of residents described in 
                paragraph (4) who completed their residency training, 
                the number practicing primary care (meaning any of the 
                areas of practice listed in the definition of a primary 
                care residency program in section 749A) 5 years 
                following completion of such training.''.
    (f) Guidance.--The Secretary shall update guidance and relevant 
information regarding States described in subparagraph (C) of section 
340H(a)(3) of the Public Health Service Act (42 U.S.C. 256h(a)(3)), as 
amended by subsection (d), and make available model templates to assist 
health centers in such States to establish a teaching health center.

SEC. 102. COMMUNITY HEALTH CENTERS.

    (a) Community Health Center Fund.--Section 10503 of the Patient 
Protection and Affordable Care Act (42 U.S.C. 254b-2) is amended--
            (1) in subsection (b)(1)(F)--
                    (A) by striking ``2018 and'' and inserting 
                ``2018,''; and
                    (B) by inserting before the semicolon the 
                following: ``, and $5,800,000,000 for each of fiscal 
                years 2024 through 2026''; and
            (2) by adding at the end the following:
    ``(f) Priority Use of Funds.--For fiscal years 2024 through 2026, 
with respect to $1,800,000,000 of the amount appropriated under 
subsection (b)(1)(F), the Secretary shall prioritize awards to entities 
for purposes of--
            ``(1) increasing the number of low-income patients not 
        enrolled in a group health plan or group or individual health 
        insurance coverage who are served by health centers, including 
        through Health Center Program New Access Points described in 
        section 330(e)(6) of the Public Health Service Act, including 
        school-based service sites;
            ``(2) increasing the required primary health services 
        described in paragraph (1)(A)(i) of section 330(b) of the 
        Public Health Service Act and additional health services (as 
        defined in paragraph (2) of such section) offered by health 
        centers; and
            ``(3) increasing patient case management, enabling 
        services, and education services, as described in clauses (iii) 
        through (v) of section 330(b)(1)(A) of the Public Health 
        Service Act.''.
    (b) Authorization of Appropriations.--Section 330(r)(1) of the 
Public Health Service Act (42 U.S.C. 254b(r)(1)) is amended--
            (1) in subparagraph (G), by striking ``fiscal year 2016, 
        and each subsequent fiscal year'' and inserting ``each of 
        fiscal years 2016 through 2023''; and
            (2) by adding at the end the following:
                    ``(H) For each of fiscal years 2024 through 2026, 
                $2,200,000,000.
                    ``(I) For fiscal year 2027, and each subsequent 
                fiscal year, the amount appropriated for the preceding 
                fiscal year adjusted by the product of--
                            ``(i) one plus the average percentage 
                        increase in costs incurred per patient served; 
                        and
                            ``(ii) one plus the average percentage 
                        increase in the total number of patients 
                        served.''.
    (c) Allocation of Funds.--Section 10503 of the Patient Protection 
and Affordable Care Act (42 U.S.C. 254b-2), as amended by subsection 
(a), is further amended by adding at the end the following:
    ``(g) Allocation of Funds.--For each of fiscal years 2024 through 
2026, of the amounts appropriated under subsection (b)(1)(F) for a 
fiscal year, the Secretary shall use--
            ``(1) at least $245,000,000 for awards to support health 
        centers in each State that are receiving awards under section 
        330 of the Public Health Service Act in extending operating 
        hours, in an amount determined pursuant to a formula and 
        eligibility criteria developed by the Secretary, for the 
        purposes of increasing access to services;
            ``(2) at least $55,000,000 for awards under this section 
        for health centers to expand school-based services and 
        establish new school-based service sites; and
            ``(3) such sums as may be necessary for purposes of 
        increasing the amount awarded pursuant to grants or cooperative 
        agreements under section 330 of the Public Health Service Act 
        so that each recipient of such an award receives--
                    ``(A) for fiscal year 2024, at least 15 percent 
                more than such recipient received for fiscal year 2023; 
                and
                    ``(B) for each of fiscal years 2025 and 2026, the 
                amount received in the previous year adjusted by--
                            ``(i) the percent increase in the medical 
                        component of the consumer price index for the 
                        most recent 12-month period for which 
                        applicable data is available; plus
                            ``(ii) one percent.''.
    (d) Capital Funding.--Section 10503(c) of the Patient Protection 
and Affordable Care Act (42 U.S.C. 254b-2(c)) is amended--
            (1) in the subsection heading, by inserting ``, Capital 
        Funding'' after ``Construction'';
            (2) by striking ``There is'' and inserting the following:
            ``(1) Construction.--There is''; and
            (3) by adding at the end the following:
            ``(2) Capital funding.--For the alteration, renovation, 
        construction, equipment, and other capital costs of health 
        centers that receive funding under section 330 of the Public 
        Health Service Act (42 U.S.C. 254b), in addition to amounts 
        otherwise made available for such purpose, there is 
        appropriated to the Secretary of Health and Human Services, out 
        of amounts in the Treasury not otherwise appropriated, 
        $3,000,000,000 for fiscal year 2024, to remain available until 
        September 30, 2026. In awarding amounts appropriated under this 
        paragraph, the Secretary shall prioritize awards related to 
        increasing access to dental and behavioral health services.''.
    (e) Strategic Plan To Improve Health Outcomes Through Nutrition.--
            (1) In general.--Not later than one year after the date of 
        enactment of this Act, the Secretary of Health and Human 
        Services, in consultation with the Secretary of Agriculture, 
        shall submit to the Committee on Health, Education, Labor, and 
        Pensions of the Senate and the Committee on Energy and Commerce 
        of the House of Representatives a 5-year strategic plan to 
        improve health outcomes through nutrition for low-income or 
        uninsured patient populations with severe, complex chronic 
        conditions and one or more diet-related conditions.
            (2) Report.--In carrying out paragraph (1), the Secretary 
        of Health and Human Services shall--
                    (A) conduct an evaluation of previous and current 
                federally-funded efforts of the Department of Health 
                and Human Services to improve patient outcomes through 
                nutrition interventions, such as medically tailored 
                meals and nutrition counseling; and
                    (B) include in the strategic report recommendations 
                for--
                            (i) reducing the financial impact of 
                        obesity and preventable chronic conditions 
                        resulting from obesity;
                            (ii) empowering federally-funded community 
                        health centers, rural health clinics, and other 
                        relevant federally-funded facilities to provide 
                        produce prescriptions, medically tailored 
                        groceries, and medically tailored meals;
                            (iii) promoting long-term adoption of 
                        improved nutrition habits, including through 
                        increased culinary education and consumer 
                        nutrition aligned with the most recent Dietary 
                        Guidelines for Americans published under 
                        section 301 of the National Nutrition 
                        Monitoring and Related Research Act of 1990 (7 
                        U.S.C. 5341) and incorporating behavioral 
                        modeling or other novel methods across Federal 
                        programs;
                            (iv) developing performance and quality 
                        metrics related to the delivery of produce 
                        prescriptions, medically tailored groceries, 
                        and medically tailored meals across relevant 
                        Federal payers to aid in reimbursement 
                        strategies;
                            (v) developing payment models for novel 
                        obesity care therapies for the treatment of 
                        diabetes that include behavioral and 
                        nutritional and dietary services and education;
                            (vi) improving coordination of care and 
                        integrating nutrition services and resources 
                        within federally-funded community health 
                        centers, rural health clinics, and other 
                        federally-funded primary care facilities;
                            (vii) bolstering partnerships with State 
                        and local governments and nongovernmental 
                        organizations; and
                            (viii) addressing geographic disparities in 
                        access to nutrition services and resources.
    (f) Required Primary Health Services.--
            (1) In general.--Section 330 of the Public Health Service 
        Act (42 U.S.C. 254b) is amended--
                    (A) in subsection (b)(1)(A)--
                            (i) in clause (i)--
                                    (I) in subclause (IV), by striking 
                                ``; and'' and inserting a semicolon;
                                    (II) in subclause (V), by adding 
                                ``and'' after the semicolon; and
                                    (III) by adding at the end the 
                                following:
                                    ``(VI) appropriate nutritional and 
                                dietary services;'';
                            (ii) in clause (ii), by inserting ``and 
                        nutrition services'' after ``mental health 
                        services''; and
                            (iii) in clause (iii), by inserting 
                        ``nutritional,'' after ``educational,''; and
                    (B) in subsection (d)(1)(A), by inserting ``or one 
                or more diet-related conditions'' before the semicolon.
            (2) Implementation of new required primary health 
        service.--Paragraph (4) of section 330(e) of the Public Health 
        Service Act (42 U.S.C. 254b(e)) is amended to read as follows:
            ``(4) Limitation.--Not more than 2 grants may be made under 
        paragraph (1)(B) for the same entity, except that such 
        limitation shall not apply for the period of 2 years beginning 
        on the date of enactment of the Bipartisan Primary Care and 
        Health Workforce Act, in any case where the only basis upon 
        which paragraph (1)(B) applies to a health center is that the 
        health center is not in noncompliance with the requirements 
        under subsection (b)(1)(A)(i)(VI) to provide appropriate 
        nutritional and dietary services.''.
    (g) Increase the Use of Provider Tools To Improve Health 
Outcomes.--Not later than one year after the date of enactment of this 
Act, the Secretary of Health and Human Services, in consultation with 
the Secretary of Agriculture, shall submit to Congress a report that 
includes--
            (1) recommendations for States to support the coordination 
        of federally-funded nutrition programs and services provided by 
        health care professionals in community health centers; and
            (2) data on the number of individuals enrolled in 
        federally-subsidized health insurance coverage who are also 
        enrolled in or eligible for federally-subsidized nutrition and 
        food programs.

SEC. 103. NATIONAL HEALTH SERVICE CORPS.

    Section 10503(b)(2) of the Patient Protection and Affordable Care 
Act (42 U.S.C. 254b-2(b)(2)) is amended--
            (1) in subparagraph (G), by striking ``; and'' and 
        inserting a semicolon;
            (2) in subparagraph (H), by striking the period and 
        inserting ``; and''; and
            (3) by adding at the end the following:
                    ``(I) $950,000,000 for each of fiscal years 2024 
                through 2026.''.

SEC. 104. GAO REPORT.

    (a) In General.--Not later than one year after the date of 
enactment of this Act, the Comptroller General of the United States 
shall submit to the Committee on Health, Education, Labor, and Pensions 
of the Senate and the Committee on Energy and Commerce of the House of 
Representatives a report assessing the effectiveness of the National 
Health Service Corps (referred to in this section as the ``NHSC'') at 
attracting health care professionals to health professional shortage 
areas designated under section 332 of the Public Health Service Act (42 
U.S.C. 254e) (referred to in this section as ``HPSAs''), such as by--
            (1) assessing the metrics used by the Health Resources and 
        Services Administration in evaluating the program;
            (2) comparing the retention rates of NHSC participants in 
        the HPSAs where they completed their period of obligated 
        service to the retention rate of non-NHSC participants in the 
        corresponding HPSAs;
            (3) comparing the retention rates of NHSC participants in 
        the HPSAs where they completed their period of obligated 
        service to the retention rates of NHSC participants in HPSAs 
        other than those where they completed their period of obligated 
        service;
            (4) identifying factors that influence a NHSC participant's 
        decision to practice in a HPSA other than the HPSA where they 
        completed their period of obligated service;
            (5) identifying factors other than participation in the 
        National Health Service Corps Scholarship and Loan Repayment 
        Programs that attract health care professionals to a HPSA;
            (6) assessing the impact the NHSC has on wages for health 
        care professionals in a HPSA; and
            (7) comparing the distribution of NHSC participants across 
        HPSAs, including a comparison of rural versus non-rural HPSAs.
    (b) Definition.--In this section, the term ``NHSC participant'' 
means a National Health Service Corps member participating in the 
National Health Service Corps Scholarship or Loan Repayment Program 
under subpart III of part D of title III of the Public Health Service 
Act (42 U.S.C. 254l et seq.).

SEC. 105. OIG REPORT.

    Not later than 2 years after the date of enactment of this Act, the 
Inspector General of the Department of Health and Human Services shall 
submit to Congress a report on integrity efforts of the Health 
Resources and Services Administration with respect to programs carried 
out by the Health Resources and Services Administration. Such report 
shall include an assessment of--
            (1) the ways in which the Administrator of the Health 
        Resources and Services Administration (referred to in this 
        section as the ``Administrator'') determines reasonable efforts 
        are continuously made to establish and maintain collaborative 
        relationships with health care providers;
            (2) the ways in which the Administrator ensures quality and 
        continuity of care for underserved areas; and
            (3) the extent to which the Administrator validates the 
        financial responsibility of and use of grant funding by 
        community health centers.

SEC. 106. APPLICATION OF PROVISIONS.

    (a) In General.--Amounts appropriated pursuant to the amendments 
made by this title shall be subject to the requirements contained in 
Public Law 117-328 for funds for programs authorized under sections 330 
through 340 of the Public Health Service Act (42 U.S.C. 254b through 
256).
    (b) Conforming Amendment.--Paragraph (4) of section 3014(h) of 
title 18, United States Code, ``and section 301(d) of division BB of 
the Consolidated Appropriations Act, 2021.'' and inserting ``section 
301(d) of division BB of the Consolidated Appropriations Act, 2021, and 
section 106(a) of the Bipartisan Primary Care and Health Workforce 
Act''.

             TITLE II--SUPPORTING THE HEALTH CARE WORKFORCE

SEC. 201. RURAL RESIDENCY PLANNING AND DEVELOPMENT PROGRAM.

    Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) 
is amended by inserting after section 330A-2 the following:

``SEC. 330A-3. RURAL RESIDENCY PLANNING AND DEVELOPMENT PROGRAM AND 
              RURAL RESIDENCY PLANNING AND DEVELOPMENT TECHNICAL 
              ASSISTANCE PROGRAM.

    ``(a) Definition of Rural Residency Program.--In this section, the 
term `rural residency program' means a physician residency program, 
including a rural track program, accredited by the Accreditation 
Council for Graduate Medical Education (or a similar body) that--
            ``(1) trains residents in rural areas (as defined by the 
        Secretary) for more than 50 percent of the total time of their 
        residency; and
            ``(2) primarily focuses on producing physicians who will 
        practice in rural areas, as defined by the Secretary.
    ``(b) Rural Residency Planning and Development Program.--
            ``(1) Definition of eligible entity.--In this subsection, 
        the term `eligible entity'--
                    ``(A) means--
                            ``(i) a domestic public or private 
                        nonprofit or for-profit entity;
                            ``(ii) an Indian Tribe, Tribal health 
                        program, Tribal organization, or Urban Indian 
                        organization (as such terms are defined in 
                        section 4 of the Indian Health Care Improvement 
                        Act); or
                            ``(iii) a Native Hawaiian Health 
                        organization as defined in section 12 of the 
                        Native Hawaiian Health Care Improvement; and
                    ``(B) may include faith-based or community-based 
                organizations, rural hospitals, rural community-based 
                ambulatory patient care centers (including rural health 
                clinics), health centers operated by a Native Hawaiian 
                Health organization (defined as described in 
                subparagraph (A)(iii)), an Indian Tribe, a Tribal 
                health program, a Tribal organization, or an Urban 
                Indian organization (defined as described in 
                subparagraph (A)(ii)), graduate medical education 
                consortiums (including institutions of higher 
                education, such as schools of allopathic medicine, 
                schools of osteopathic medicine, or historically Black 
                colleges or universities (as defined by the term `part 
                B institution' in section 322 of the Higher Education 
                Act of 1965 or described in section 326(e)(1) of the 
                Higher Education Act of 1965) or other minority-serving 
                institutions (as described in section 371(a) of the 
                Higher Education Act of 1965), or other organizations 
                as determined appropriate by the Secretary.
            ``(2) Grants.--
                    ``(A) In general.--The Secretary may award grants 
                to eligible entities to create new rural residency 
                programs (including adding new rural training sites to 
                existing rural track programs).
                    ``(B) Funding.--Grants awarded under this 
                subsection may be fully funded at the time of the 
                award.
                    ``(C) Term.--The term of a grant under this 
                subsection shall be 4 years and may be extended at the 
                discretion of the Secretary.
            ``(3) Applications.--
                    ``(A) In general.--To be eligible to receive a 
                grant under this subsection, an eligible entity shall 
                prepare and submit to the Secretary an application at 
                such time, in such manner, and containing such 
                information as the Secretary may require, including a 
                description of the pathway of the rural residency 
                program as described in subparagraph (B).
                    ``(B) Pathway.--A pathway of a rural residency 
                program supported under this subsection shall be for--
                            ``(i) general primary care and high-need 
                        specialty care, including family medicine, 
                        internal medicine, preventive medicine, 
                        psychiatry, or general surgery;
                            ``(ii) maternal health and obstetrics, 
                        which may be obstetrics and gynecology or 
                        family medicine with enhanced obstetrical 
                        training; or
                            ``(iii) any other pathway as determined 
                        appropriate by the Secretary.
    ``(c) Rural Residency Planning and Development Technical 
Assistance.--
            ``(1) Definition of eligible entity.--In this subsection, 
        the term `eligible entity' means--
                    ``(A) a domestic public or private nonprofit or 
                for-profit entity; or
                    ``(B) an Indian Tribe or Tribal organization (as 
                such terms are defined in section 4 of the Indian 
                Health Care Improvement Act).
            ``(2) Grants.--
                    ``(A) In general.--The Secretary may award grants 
                to eligible entities to provide technical assistance to 
                awardees of and potential applicants of the program 
                described in subsection (b).
                    ``(B) Funding.--Grants awarded under this 
                subsection may be fully funded at the time of the 
                award.
                    ``(C) Term.--The term of a grant under this 
                subsection shall be 4 years and may be extended at the 
                discretion of the Secretary.
            ``(3) Applications.--To be eligible to receive a grant 
        under this subsection, an eligible entity shall prepare and 
        submit to the Secretary an application at such time, in such 
        manner, and containing such information as the Secretary may 
        require.
    ``(d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $13,000,000 for fiscal year 
2024, $13,500,00 for fiscal year 2025, and $14,000,000 for fiscal year 
2026, to remain available until expended.''.

SEC. 202. PRIMARY CARE TRAINING AND ENHANCEMENT PROGRAM.

    Section 747(c)(1) of the Public Health Service Act (42 U.S.C. 
293k(c)(1)) is amended--
            (1) by striking ``$48,924,000 for each of fiscal years 2021 
        through 2025'' and inserting ``$49,250,000 for fiscal year 
        2024, $49,500,000 for fiscal year 2025, and $50,000,000 for 
        fiscal year 2026''; and
            (2) by striking ``subsection (b)(1)(B)'' and inserting 
        ``subsections (b)(1)(B) and (c)''.

SEC. 203. TELEHEALTH TECHNOLOGY-ENABLED LEARNING PROGRAM.

    Section 330N(k) of the Public Health Service Act (42 U.S.C. 254c-
20(k)) is amended by striking ``2026'' and inserting ``2025, and 
$11,000,000 for each of fiscal years 2026 through 2028, to remain 
available until expended''.

SEC. 204. EXPANDING THE NUMBER OF PRIMARY CARE DOCTORS.

    Section 747 of the Public Health Service Act (42 U.S.C. 293k), as 
amended by section 202, is further amended--
            (1) by redesignating subsection (c) as subsection (d); and
            (2) by inserting after subsection (b) the following:
    ``(c) Expanding the Number of Primary Care Doctors.--
            ``(1) In general.--The Secretary shall award grants to 
        eligible medical schools described in paragraph (2) for the 
        purpose of graduating more physicians who will practice a 
        primary care discipline. Funds awarded under this subsection 
        may be used for costs associated with faculty, construction and 
        capital improvements, clinical support, research support, 
        student supports, and any other costs, as determined by the 
        Secretary.
            ``(2) Eligibility.--To be eligible to receive a grant under 
        this subsection, a medical school shall--
                    ``(A) be a nonprofit school of medicine or 
                osteopathic medicine that is accredited by a nationally 
                recognized accrediting agency or association; and
                    ``(B) demonstrate in the grant application of the 
                medical school--
                            ``(i) that not less than 33 percent of 
                        graduates from the medical school enter primary 
                        care and are, as of the date of the 
                        application, practicing primary care, as 
                        calculated by dividing--
                                    ``(I) the number of physicians who 
                                graduated during such time period as is 
                                specified by the Secretary who are 
                                practicing primary care; by
                                    ``(II) the total number of 
                                physicians who graduated during such 
                                time period; and
                            ``(ii) a plan to expand the number of 
                        graduates of the medical school who are 
                        practicing primary care; and
                            ``(iii) a commitment to use grant funds to 
                        supplement, not supplant, such school's 
                        investment in primary care medical education.
            ``(3) Expanding the number of minority primary care 
        doctors.--Of the amounts appropriated under paragraph (6)(C), 
        the Secretary shall awards not less than 20 percent to eligible 
        medical schools described in paragraph (2) that are 
        historically Black colleges and universities (as defined by the 
        term `part B institution' in section 322 of the Higher 
        Education Act of 1965 (20 U.S.C. 1061) or described in section 
        326(e)(1) of such Act (20 U.S.C. 1063b(e)(1))) or other 
        minority-serving institutions (as described in section 371(a) 
        of the Higher Education Act of 1965 (20 U.S.C. 1067q(a))).
            ``(4) Grant amounts; geographic distribution.--
                    ``(A) Grant amounts.--The Secretary shall determine 
                the amount of each grant awarded under this subsection, 
                which shall be based on the scope of the plan submitted 
                by the medical school under paragraph (2)(B)(ii), and 
                other appropriate factors.
                    ``(B) Geographic distribution.--In awarding grants 
                under this subsection, the Secretary shall ensure, to 
                the greatest extent practicable, that such grants are 
                equitably distributed among the geographic regions of 
                the United States.
            ``(5) Primary care.--In this subsection, the term `primary 
        care' means health care services related to family medicine, 
        internal medicine, pediatrics, obstetrics, gynecology, 
        geriatrics, or psychiatry.
            ``(6) Account to address the primary care physician 
        shortage.--
                    ``(A) Establishment of account.--There is 
                established in the Treasury an account, to be known as 
                the `Account to Address the Primary Care Physician 
                Shortage' (referred to in this subsection as the 
                `Account'), for purposes of carrying out this 
                subsection.
                    ``(B) Transfer of direct spending.--
                            ``(i) In general.--The Secretary of the 
                        Treasury shall transfer, from the general fund 
                        of the Treasury, to the Account $300,000,000 
                        for fiscal year 2024.
                            ``(ii) Amounts deposited.--Any amounts 
                        transferred under clause (i) shall remain 
                        unavailable in the Account until such amounts 
                        are appropriated pursuant to subparagraph (C).
                    ``(C) Appropriations.--
                            ``(i) Authorization of appropriations.--For 
                        the period of fiscal years 2024 through 2026, 
                        there is authorized to be appropriated from the 
                        Account to the Secretary, for the purpose of 
                        carrying out the activities under this 
                        subsection, an amount not to exceed the total 
                        amount transferred to the Account under 
                        subparagraph (B)(i).
                            ``(ii) Offsetting future appropriations.--
                        For fiscal years 2024 through 2026, for any 
                        discretionary appropriation under the heading 
                        `Account to Address the Primary Care Physician 
                        Shortage' provided to the Secretary pursuant to 
                        the authorization of appropriations under 
                        clause (i) for the purpose of carrying out this 
                        subsection, the total amount of such 
                        appropriations for the applicable fiscal year 
                        (not to exceed the total amount remaining in 
                        the Account) shall be subtracted from the 
                        estimate of discretionary budget authority and 
                        the resulting outlays for any estimate under 
                        the Congressional Budget and Impoundment 
                        Control Act of 1974 or the Balanced Budget and 
                        Emergency Deficit Control Act of 1985, and the 
                        amount transferred to the Account shall be 
                        reduced by the same amount.
            ``(7) Annual reports.--Not later than October 1 of fiscal 
        years 2025 through 2027, the Secretary shall submit to the 
        Committee on Health, Education, Labor, and Pensions and the 
        Committee on Appropriations of the Senate and the Committee on 
        Energy and Commerce and the Committee on Appropriations of the 
        House of Representatives, a report including a description of 
        any use of funds provided pursuant to the authorization of 
        appropriations under paragraph (6)(C).
            ``(8) Limitations.--Notwithstanding any transfer authority 
        authorized by this subsection or any appropriations Act, any 
        funds made available pursuant to the authorization of 
        appropriations under paragraph (6)(C) may not be used for any 
        purpose other than the program established under paragraph (1).
            ``(9) Sunset.--Amounts remaining unappropriated in the 
        Account under this subsection shall be transferred back to the 
        general fund of the Treasury on October 1, 2026.''.

SEC. 205. NURSE EDUCATION, PRACTICE, QUALITY, AND RETENTION GRANTS.

    (a) Reauthorization.--Section 831 of the Public Health Service Act 
(42 U.S.C. 296p) is amended by adding at the end the following:
    ``(g) Authorization of Appropriations.--To carry out this section 
(other than subsection (e)), in addition to amounts made available 
under section 871(a), there are authorized to be appropriated 
$59,413,000 for each of fiscal years 2024 through 2026, to remain 
available until expended.''.
    (b) Expanding Associate Degree Nursing Programs.--Section 831 of 
the Public Health Service Act (42 U.S.C. 296p), as amended by 
subsection (a), is further amended--
            (1) by redesignating subsections (e) through (g) as 
        subsections (f) through (h), respectively; and
            (2) by inserting after subsection (d) the following:
    ``(e) Supplemental Appropriations Expanding Associate Degree 
Nursing Programs.--
            ``(1) Authorization.--The Secretary shall award grants to 
        institutions of higher education (as defined in section 101 of 
        the Higher Education Act of 1965) offering an accredited 
        registered nursing program at the associate degree level for 
        the purpose of expanding the number of students enrolled in 
        each such program.
            ``(2) Use of funds.--A recipient of a grant under this 
        subsection shall use the grant funds to expand the number of 
        students enrolled in the recipient's accredited registered 
        nursing program, which may include increasing nurse faculty and 
        nurse faculty salaries, expanding the number of qualified 
        preceptors at clinical rotations sites, providing direct 
        support for students, supporting partnerships with health 
        facilities for clinical training, purchasing and training 
        faculty to use distance learning technologies and simulation 
        equipment, alteration, renovation, construction, equipment, and 
        other capital improvement costs, and other projects determined 
        appropriate by the Secretary.
            ``(3) Determination of number of students and 
        application.--Each institution of higher education that offers 
        a program described in paragraph (1) that desires to receive a 
        grant under this subsection shall--
                    ``(A) provide documentation from the last 4 
                academic years, or number of academic years the program 
                has been accredited if less than 4, demonstrating the 
                average percentage of individuals who graduated from 
                the nursing degree program with an associate degree 
                within 150 percent of the expected completion time 
                designated for the program; and
                    ``(B) submit an application to the Secretary at 
                such time, in such manner, and accompanied by such 
                information as the Secretary may require, including the 
                average percent of individuals determined under 
                subparagraph (A).
            ``(4) Definition.--For purposes of this subsection, the 
        term `health facility' means an Indian health service center, a 
        Native Hawaiian health center, a Federally qualified health 
        center, a rural health clinic, a nursing home, a home health 
        agency, a hospice program, a public health clinic, a State or 
        local department of public health, a skilled nursing facility, 
        or an ambulatory surgical center.
            ``(5) Account to address the nursing workforce shortage.--
                    ``(A) Establishment of account.--There is 
                established in the Treasury an account, to be known as 
                the `Account to Address the Nursing Workforce Shortage' 
                (referred to in this subsection as the `Account'), for 
                purposes of carrying out this subsection, in addition 
                to amounts otherwise made available, including under 
                section 871(a).
                    ``(B) Transfer of direct spending.--
                            ``(i) In general.--The Secretary of the 
                        Treasury shall transfer, from the general fund 
                        of the Treasury, to the Account $240,000,000 
                        for each of fiscal years 2024 through 2028.
                            ``(ii) Amounts deposited.--Any amounts 
                        transferred under clause (i) shall remain 
                        unavailable in the Account until such amounts 
                        are appropriated pursuant to subparagraph (C).
                    ``(C) Appropriations.--
                            ``(i) Authorization of appropriations.--For 
                        each of fiscal years 2024 through 2028, there 
                        is authorized to be appropriated from the 
                        Account to the Secretary, for the purpose of 
                        carrying out the activities under this 
                        subsection, in addition to amounts otherwise 
                        made available for such purpose, an amount not 
                        to exceed the total amount transferred to the 
                        Account under subparagraph (B)(i).
                            ``(ii) Offsetting future appropriations.--
                        For any of fiscal years 2024 through 2028, for 
                        any discretionary appropriation under the 
                        heading `Account to Address the Nursing 
                        Workforce Shortage' provided to the Secretary 
                        pursuant to the authorization of appropriations 
                        under clause (i) for an additional amount for 
                        carrying out this subsection, the total amount 
                        of such appropriations for the applicable 
                        fiscal year (not to exceed the total amount 
                        remaining in the Account) shall be subtracted 
                        from the estimate of discretionary budget 
                        authority and the resulting outlays for any 
                        estimate under the Congressional Budget and 
                        Impoundment Control Act of 1974 or the Balanced 
                        Budget and Emergency Deficit Control Act of 
                        1985, and the amount transferred to the Account 
                        shall be reduced by the same amount.
            ``(6) Annual reports.--Not later than October 1 of fiscal 
        years 2025 through 2029, the Secretary shall submit to the 
        Committee on Health, Education, Labor, and Pensions and the 
        Committee on Appropriations of the Senate and the Committee on 
        Energy and Commerce and the Committee on Appropriations of the 
        House of Representatives, a report including a description of 
        any use of funds provided pursuant to the authorization of 
        appropriations under paragraph (5)(C).
            ``(7) Limitations.--Notwithstanding any transfer authority 
        authorized by this subsection or any appropriations Act, any 
        funds made available pursuant to the authorization of 
        appropriations under paragraph (5)(C) may not be used for any 
        purpose other than the program established under paragraph (1).
            ``(8) Sunset.--Amounts remaining unappropriated in the 
        Account under this subsection shall be transferred back to the 
        general fund of the Treasury on October 1, 2028.''.

SEC. 206. NURSE FACULTY LOAN PROGRAM.

    Section 846A of the Public Health Service Act (42 U.S.C. 297n-1), 
as amended by section 207, is amended by inserting after subsection (b) 
the following:
    ``(c) Funding.--
            ``(1) Authorization of appropriations.--
                    ``(A) In general.--To carry out this section (other 
                than subsection (d)), in addition to amounts otherwise 
                made available, including under section 871(b) and 
                paragraph (2), there are authorized to be appropriated 
                $28,500,000 for each of fiscal years 2024 through 2026, 
                to remain available until expended.
            ``(2) Account to address the nurse faculty workforce 
        shortage.--
                    ``(A) Establishment of account.--There is 
                established in the Treasury an account, to be known as 
                the `Account to Address the Nurse Faculty Shortage' 
                (referred to in this paragraph as the `Account'), for 
                purposes of carrying out this section (other than 
                subsection (d)) in addition to amounts otherwise made 
                available, including under section 871(b) and paragraph 
                (1).
                    ``(B) Transfer of direct spending.--
                            ``(i) In general.--The Secretary of the 
                        Treasury shall transfer, from the general fund 
                        of the Treasury, to the Account $57,000,000 for 
                        each of fiscal years 2024 through 2026.
                            ``(ii) Amounts deposited.--Any amounts 
                        transferred under clause (i) shall remain 
                        unavailable in the Account until such amounts 
                        are appropriated pursuant to subparagraph (C).
                    ``(C) Appropriations.--
                            ``(i) Authorization of appropriations.--For 
                        each of fiscal years 2024 through 2026, there 
                        is authorized to be appropriated from the 
                        Account to the Secretary, for the purpose of 
                        carrying out the activities under this section, 
                        in addition to amounts otherwise made available 
                        for such purpose, an amount not to exceed the 
                        total amount transferred to the Account under 
                        subparagraph (B)(i).
                            ``(ii) Offsetting future appropriations.--
                        For any of fiscal years 2024 through 2026, for 
                        any discretionary appropriation under the 
                        heading `Account to Address the Nurse Faculty 
                        Shortage' provided to the Secretary pursuant to 
                        the authorization of appropriations under 
                        clause (i) for an additional amount for 
                        carrying out this section, the total amount of 
                        such appropriations for the applicable fiscal 
                        year (not to exceed the total amount remaining 
                        in the Account) shall be subtracted from the 
                        estimate of discretionary budget authority and 
                        the resulting outlays for any estimate under 
                        the Congressional Budget and Impoundment 
                        Control Act of 1974 or the Balanced Budget and 
                        Emergency Deficit Control Act of 1985, and the 
                        amount transferred to the Account shall be 
                        reduced by the same amount.
                    ``(D) Annual reports.--Not later than October 1 of 
                fiscal years 2025 through 2027, the Secretary shall 
                submit to the Committee on Health, Education, Labor, 
                and Pensions and the Committee on Appropriations of the 
                Senate and the Committee on Energy and Commerce and the 
                Committee on Appropriations of the House of 
                Representatives, a report including a description of 
                any use of funds provided pursuant to the authorization 
                of appropriations under subparagraph (C).
                    ``(E) Limitations.--Notwithstanding any transfer 
                authority authorized by this paragraph or any 
                appropriations Act, any funds made available pursuant 
                to the authorization of appropriations under 
                subparagraph (C) may not be used for any purpose other 
                than the program under this section.
                    ``(F) Sunset.--Amounts remaining unappropriated in 
                the Account under this paragraph shall be transferred 
                back to the general fund of the Treasury on October 1, 
                2026.''.

SEC. 207. NURSE FACULTY DEMONSTRATION PROGRAM.

    Section 846A of the Public Health Service Act (42 U.S.C. 297n-1) is 
amended--
            (1) by amending subsection (a) to read as follows:
    ``(a) In General.--To increase the number of qualified nursing 
faculty, the Secretary may--
            ``(1) enter into an agreement with any accredited school of 
        nursing for the establishment and operation of a student loan 
        fund in accordance with subsection (b); and
            ``(2) award nurse faculty grants in accordance with 
        subsection (d).'';
            (2) in subsection (b)--
                    (A) by redesignating subparagraphs (A) through (D) 
                of paragraph (2) as clauses (i) through (iv), 
                respectively, and adjusting the margins accordingly;
                    (B) by redesignating paragraphs (1) through (5) as 
                subparagraphs (A) through (E), respectively, and 
                adjusting the margins accordingly;
                    (C) in subparagraph (C), as so redesignated, by 
                striking ``subsection (c)'' and inserting ``paragraph 
                (2)''; and
                    (D) by striking ``(b) Agreements--Each agreement 
                entered into under subsection (a) shall--'' and 
                inserting the following:
    ``(b) School of Nursing Student Loan Fund.--
            ``(1) In general.--Each agreement entered into under 
        subsection (a)(1) shall--'';
            (3) in subsection (c)--
                    (A) by striking ``subsection (a)'' each place it 
                appears and inserting ``subsection (a)(1)'';
                    (B) in paragraph (3), by redesignating 
                subparagraphs (A) and (B) as clauses (i) and (ii), 
                respectively, and adjusting the margins accordingly;
                    (C) in paragraph (6), by redesignating 
                subparagraphs (A) and (B) as clauses (i) and (ii), 
                respectively, and adjusting the margins accordingly;
                    (D) by redesignating paragraphs (1) through (6) as 
                subparagraphs (A) through (F), respectively, and 
                adjusting the margins accordingly; and
                    (E) in subparagraph (F)(ii), as so redesignated, by 
                striking ``subsection (e)'' and inserting ``paragraph 
                (4)'';
            (4) in subsection (e), by striking ``subsection (c)(6)(B)'' 
        and inserting ``paragraph (2)(F)(ii)'';
            (5) by redesignating subsections (c) through (e) (before 
        application of the amendment made by section 206) as paragraphs 
        (2) through (4), respectively, and adjusting the margins 
        accordingly; and
            (6) by adding after subsection (c), as added by section 
        206, the following:
    ``(d) Nurse Faculty Demonstration Program.--
            ``(1) In general.--The Secretary shall establish and carry 
        out a demonstration program described in subsection (a)(2) 
        under which eligible schools of nursing receive a grant for 
        purposes of supplementing the salaries of eligible nursing 
        faculty members to enhance recruitment and retention of nursing 
        faculty members.
            ``(2) Eligible entities.--To be eligible to receive a grant 
        under this subsection, an entity shall--
                    ``(A) be an accredited school of nursing; and
                    ``(B) submit an application to the Secretary, at 
                such time, in such manner, and containing such 
                information as the Secretary may require, including--
                            ``(i)(I) to the extent such information is 
                        available to the school of nursing, the salary 
                        history of nursing faculty at such school who 
                        previously were nurses in clinical practice, 
                        for the most recent 3-year period ending on the 
                        date of application, adjusted for inflation as 
                        appropriate and broken down by credentials, 
                        experience, and levels of education of such 
                        nurses; or
                            ``(II) if the information described in 
                        subclause (I) is not available, information on 
                        the average local salary of nurses in clinical 
                        practice, adjusted for inflation as appropriate 
                        and broken down by credentials, experience, and 
                        levels of education of the individual nurses, 
                        in accordance with such requirements as the 
                        Secretary may specify;
                            ``(ii) an attestation of the average 
                        nursing faculty salary at the school of nursing 
                        during the most recent 3-year period prior to 
                        the date of application, adjusted for 
                        inflation, as appropriate, broken down by 
                        credentials, experience, and levels of 
                        education of such faculty members;
                            ``(iii) the number of nursing faculty 
                        member vacancies at the entity at the time of 
                        application, and the entity's projection of 
                        such vacancies over the ensuing 5-year period; 
                        and
                            ``(iv) a description of the entity's plans 
                        to identify funding sources to sustainably 
                        continue, after the 2-year grant period, the 
                        salary available to the eligible nursing 
                        faculty member pursuant to the program under 
                        this subsection during such grant program and 
                        to retain eligible nursing faculty members 
                        after the end of the grant period.
            ``(3) Awards.--A grant awarded under this subsection, with 
        respect to supporting eligible nursing faculty members, shall--
                    ``(A) be awarded to the school of nursing to 
                supplement the salaries of eligible faculty members at 
                the school of nursing, annually, for up to a 2-year 
                period, in an amount equal to, for each eligible 
                nursing faculty member at the eligible entity during 
                the grant period, the difference between--
                            ``(i) the average salary of nurses in 
                        clinical practice submitted under subclause (I) 
                        or (II) of paragraph (2)(B)(i); and
                            ``(ii) the greater of--
                                    ``(I) the salary for the eligible 
                                nursing faculty member at the school of 
                                nursing; or
                                    ``(II) the average nursing faculty 
                                salary submitted under paragraph 
                                (2)(B)(ii) for faculty members with the 
                                same or similar credentials and level 
                                of education;
                    ``(B) notwithstanding section 803(a), be used in 
                its entirety to supplement the eligible faculty 
                member's salary; and
                    ``(C) be conditioned upon the school of nursing 
                maintaining, for each year in which the award is made 
                as described in subparagraph (A), a salary for such 
                faculty member at a level that is not less than the 
                greater of the amount under subclause (I) or (II) of 
                subparagraph (A)(ii).
            ``(4) Priority.--In awarding grants under this subsection, 
        the Secretary shall ensure the equitable geographic 
        distribution of awards, and shall give priority to applications 
        from schools of nursing that demonstrate--
                    ``(A) the greatest need for such grant, which may 
                be based upon the financial circumstances of the school 
                of nursing, eligible nurse faculty members, the planned 
                number of students to be trained or admitted off a wait 
                list;
                    ``(B) training or partnerships to serve vulnerable 
                patient populations, such as through the location or 
                activity of a school in a health professional shortage 
                area (as defined in section 332);
                    ``(C) recruitment and retention of faculty from 
                underrepresented populations; or
                    ``(D) other particular need for such grant, 
                including public institutions of higher education that 
                offer 4-year degrees but at which the predominant 
                degree awarded is an associate degree.
            ``(5) Rule of construction.--Nothing in this subsection 
        precludes a school of nursing or an eligible nursing faculty 
        member receiving an award under this section from obtaining or 
        receiving any other form of Federal support or funding.
            ``(6) Report.--Not later than 3 years after the date of 
        enactment of the Bipartisan Primary Care and Health Workforce 
        Act, the Secretary shall submit to the Committee on Finance and 
        the Committee on Health, Education, Labor, and Pensions of the 
        Senate and the Committee on Ways and Means and the Committee on 
        Energy and Commerce of the House of Representatives, a report 
        that evaluates the program established under this subsection, 
        including--
                    ``(A) the impact of such program on recruitment and 
                retention rates of nursing faculty, as available, and 
                specifically for each faculty member participating in 
                the program; and
                    ``(B) recommendations and considerations for 
                Congress on continuing the program under this 
                subsection.
            ``(7) Definitions.--In this subsection:
                    ``(A) Eligible nursing faculty member.--The term 
                `eligible nursing faculty member' means a nursing 
                faculty member who--
                            ``(i) was hired by a school of nursing 
                        within the 2-year period preceding the 
                        submission of an application under paragraph 
                        (2), or a prospective nursing faculty member;
                            ``(ii) is currently employed at the school 
                        of nursing and who demonstrates the need for 
                        such support;
                            ``(iii) previously worked as a nurse in 
                        clinical practice or as a nurse faculty member 
                        at another school of nursing; or
                            ``(iv) may work on a part-time basis as a 
                        nursing faculty member, for whom such award 
                        amounts described in paragraph (3) shall be 
                        prorated relative to the amount of time 
                        participating in part-time teaching.
                    ``(B) Inflation.--The term `inflation' means the 
                Consumer Price Index for all urban consumers (all 
                items; U.S. city average).
            ``(8) Authorization of appropriations.--To carry out this 
        subsection, in addition to amounts otherwise available, 
        including under section 871(b), there is authorized to be 
        appropriated $15,000,000 for each of fiscal years 2024 and 
        2025.''.

SEC. 208. NURSE CORPS SCHOLARSHIP AND LOAN REPAYMENT PROGRAM.

    Section 846 of the Public Health Service Act (42 U.S.C. 297n) is 
amended by adding at the end the following:
    ``(j) Authorization of Appropriations.--To carry out this section, 
in addition to amounts otherwise made available, including under 
section 871(b), there are authorized to be appropriated $93,600,000 for 
fiscal year 2024, $94,600,000 for fiscal year 2025, and $95,600,000 for 
fiscal year 2026, to remain available until expended.''.

SEC. 209. GRANTS FOR PRIMARY CARE NURSE RESIDENCY TRAINING PROGRAMS.

    Section 5316 of the Patient Protection and Affordable Care Act (42 
U.S.C. 296j-1) is amended--
            (1) in the section heading, by striking ``demonstration'';
            (2) in subsection (a), by striking ``demonstration'';
            (3) in subsection (d)--
                    (A) in paragraph (1)(B), by striking ``and'' at the 
                end;
                    (B) by redesignating paragraph (2) as paragraph 
                (3); and
                    (C) by inserting after paragraph (1) the following:
            ``(2)(A) in the case of an entity that does not have an 
        established residency program for nurse practitioners at the 
        time of the application, demonstrate plans to establish a new 
        residency program for nurse practitioners; or
            ``(B) in the case of an entity that has an established 
        residency program for nurse practitioners at the time of the 
        application, demonstrate plans to use the grant under this 
        section to offer not fewer than 4 additional residency 
        positions for new nurse practitioners to participate in such 
        program; and''; and
            (4) in subsection (i), by striking ``such sums as may be 
        necessary for each of fiscal years 2011 through 2014'' and 
        inserting ``$30,000,000 for each of fiscal years 2024 through 
        2026''.

SEC. 210. STATE ORAL HEALTH WORKFORCE IMPROVEMENT GRANT PROGRAM.

    Subsection (f) of section 340G of the Public Health Service Act (42 
U.S.C. 256g) is amended by striking ``$13,903,000 for each of fiscal 
years 2019 through 2023'' and inserting ``$15,200,000 for fiscal year 
2024, $15,500,000 for fiscal year 2025, and $15,800,000 for fiscal year 
2026, to remain available until expended''.

SEC. 211. ORAL HEALTH TRAINING PROGRAMS.

    Subsection (f) of section 748 of the Public Health Service Act (42 
U.S.C. 293k-2) is amended to read as follows:
    ``(f) Authorization of Appropriations.--
            ``(1) In general.--To carry out this section, there is 
        authorized to be appropriated $28,500,000 for fiscal year 2026, 
        to remain available until expended.
            ``(2) Geographic distribution.--In awarding grants under 
        this section, the Secretary shall ensure, to the greatest 
        extent practicable, that such grants are equitably distributed 
        among the geographical regions of the United States.''.

SEC. 212. ALLIED HEALTH PROFESSIONALS.

    (a) Supporting Dual or Concurrent Enrollment in the Allied Health 
Projects Program.--Section 755(b)(1) of the Public Health Service Act 
(42 U.S.C. 294e(b)(1)) is amended--
            (1) in subparagraph (B), by striking ``to individuals who 
        have baccalaureate degrees in health-related sciences'';
            (2) in the flush text at the end of subparagraph (I), by 
        striking ``; and'' and inserting a semicolon;
            (3) in subparagraph (J), by striking the period and 
        inserting ``; and''; and
            (4) by adding at the end the following:
                    ``(K) those that establish or support a dual or 
                concurrent enrollment program (as defined in section 
                8101 of the Elementary and Secondary Education Act of 
                1965) if the dual or concurrent enrollment program--
                            ``(i) provides outreach on allied health 
                        careers requiring an industry-recognized 
                        credential, a certificate, or an associate 
                        degree, to all high schools served by the local 
                        educational agency that is a partner in the 
                        partnership offering the dual or concurrent 
                        enrollment program;
                            ``(ii) provides information to high school 
                        students about the training requirements and 
                        expected salary of allied health professions; 
                        and
                            ``(iii) provides academic and financial aid 
                        counseling to students who participate in the 
                        dual or concurrent enrollment program.''.
    (b) Supporting Dual or Concurrent Enrollment in the Health Careers 
Opportunity Program.--Section 739(a)(2) of the Public Health Service 
Act (42 U.S.C. 293c(a)(2)) is amended--
            (1) in subparagraph (H), by striking ``and'' after the 
        semicolon;
            (2) in subparagraph (I), by striking the period at the end 
        and inserting ``; and''; and
            (3) by adding at the end the following:
                    ``(J) providing academic and financial aid 
                counseling to support participation in a dual or 
                concurrent enrollment program (as defined in section 
                8101 of the Elementary and Secondary Education Act of 
                1965) that leads to an industry-recognized credential, 
                a certificate, or an associate degree in the health 
                professions or academic credits that can be 
                transferred, as indicated through an articulation 
                agreement between 2 or more community colleges or 
                universities, to obtain an industry-recognized 
                credential, a certificate, or a degree in the health 
                professions.''.
    (c) Health Care Workforce Innovation Program.--Section 755(b) of 
the Public Health Service Act (42 U.S.C. 294e(b)) is amended by adding 
at the end the following:
            ``(5)(A) Supporting and developing new innovative, 
        community-driven approaches for the education and training of 
        allied health professionals, including those described in 
        subparagraph (F)(i), with an emphasis on expanding the supply 
        of such professionals located in, and meeting the needs of, 
        underserved communities and rural areas. Grants under this 
        paragraph shall be awarded through a new program (referred to 
        as the `Health Care Workforce Innovation Program' or in this 
        paragraph as the `Program').
            ``(B) To be eligible to receive a grant under the Program 
        an entity shall--
                    ``(i) be a Federally qualified health center (as 
                defined in section 1905(l)(2)(B) of the Social Security 
                Act), a State-level association or other consortium 
                that represents and is comprised of Federally qualified 
                health centers, or a certified rural health clinic that 
                meets the requirements of section 334; and
                    ``(ii) submit to the Secretary an application that, 
                at a minimum, contains--
                            ``(I) a description of how all trainees 
                        will be trained in accredited training programs 
                        either directly or through partnerships with 
                        public or nonprofit private entities;
                            ``(II) a description of the community-
                        driven health care workforce innovation model 
                        to be carried out under the grant, including 
                        the specific professions to be funded;
                            ``(III) the geographic service area that 
                        will be served, including quantitative data, if 
                        available, showing that such particular area 
                        faces a shortage of health professionals and 
                        lacks access to health care;
                            ``(IV) a description of the benefits 
                        provided to each health care professional 
                        trained under the proposed model during the 
                        education and training phase;
                            ``(V) a description of the experience that 
                        the applicant has in the recruitment, 
                        retention, and promotion of the well-being of 
                        workers and volunteers;
                            ``(VI) a description of how the funding 
                        awarded under the Program will supplement 
                        rather than supplant existing funding;
                            ``(VII) a description of the scalability 
                        and replicability of the community-driven 
                        approach to be funded under the Program;
                            ``(VIII) a description of the 
                        infrastructure, outreach and communication plan 
                        and other program support costs required to 
                        operationalize the proposed model; and
                            ``(IX) any other information, as the 
                        Secretary determines appropriate.
            ``(C)(i) An entity shall use amounts received under a grant 
        awarded under the Program to carry out the innovative, 
        community-driven model described in the application under 
        subparagraph (B). Such amounts may be used for launching new or 
        expanding existing innovative health care professional 
        partnerships, including the following specific uses:
                    ``(I) Establishing or expanding a partnership 
                between an eligible entity and 1 or more high schools, 
                accredited public or nonprofit private vocational-
                technical schools, accredited public or nonprofit 
                private 2-year colleges, area health education centers, 
                and entities with clinical settings for the provision 
                of education and training opportunities not available 
                at the grantee's facilities.
                    ``(II) Providing education and training programs to 
                improve allied health professionals' readiness in 
                settings that serve underserved communities and rural 
                areas; encouraging students from underserved and 
                disadvantaged backgrounds and former patients to 
                consider careers in health care, and better reflecting 
                and meeting community needs; providing education and 
                training programs for individuals to work in patient-
                centered, team-based, community-driven health care 
                models that include integration with other clinical 
                practitioners and training in cultural and linguistic 
                competence; providing pre-apprenticeship and 
                apprenticeship programs for health care technical, 
                support, and entry-level occupations, particularly for 
                those enrolled in dual or concurrent enrollment 
                programs; building a preceptorship training-to-practice 
                model for medical, behavioral health, oral health, and 
                public health disciplines in an integrated, community-
                driven setting; providing and expanding internships, 
                career ladders, and development opportunities for 
                health care professionals, including new and existing 
                staff; or investing in training equipment, supplies, 
                and limited renovations or retrofitting of training 
                space needed for grantees to carry out their particular 
                model.
            ``(ii) Amounts received under a grant awarded under the 
        Program shall not be used to support construction costs or to 
        supplant funding from existing programs that support the 
        applicant's health workforce.
            ``(iii) Models funded under the Program shall be for a 
        duration of at least 3 years.
            ``(D) In awarding grants under the Program, the Secretary 
        may give priority to applicants that will use grant funds to 
        support workforce innovation models that increase the number of 
        individuals from underserved and disadvantaged backgrounds 
        working in such health care professions, improve access to 
        health care (including medical, behavioral health and oral 
        health) in underserved communities, or demonstrate that the 
        model can be replicated in other underserved communities in a 
        cost-efficient and effective manner to achieve the purposes of 
        the Program.
            ``(E) An entity that receives a grant under the Program 
        shall provide periodic reports to the Secretary detailing the 
        findings and outcomes of the innovative, community-driven model 
        carried out under the grant. Such reports shall contain 
        information in a manner and at such times as determined 
        appropriate by the Secretary.
            ``(F) In this paragraph:
                    ``(i) The term `allied health care professional' 
                includes individuals who provide clinical support 
                services, including medical assistants, dental 
                assistants, dental hygienists, pharmacy technicians, 
                physical therapists and health care interpreters; 
                individuals providing non-clinical support, such as 
                billing and coding professionals and health information 
                technology professionals; dieticians; medical 
                technologists; emergency medical technicians; community 
                health workers; public health personnel; and peer 
                support workers.
                    ``(ii) The term `rural area' has the meaning given 
                such term by the Administrator of the Health Resources 
                and Services Administration.
                    ``(iii) The term `underserved communities' means 
                areas, population groups, and facilities designated as 
                health professional shortage areas under section 332, 
                medically underserved areas as defined under section 
                330I(a)), or medically underserved populations as 
                defined under section 330(b)(3).
            ``(G)(i) There are authorized to be appropriated 
        $100,000,000 for each of fiscal years 2024 through 2026, to 
        carry out this section, to remain available until expended.
            ``(ii) A grant provided under the Program shall not exceed 
        $2,500,000 for a grant period.''.

SEC. 213. BUDGETARY TREATMENT.

    (a) Statutory Paygo Scorecards.--The budgetary effects of section 
302 (including the amendments made by such section), up to 
$1,671,000,000, shall not be entered on either PAYGO scorecard 
maintained pursuant to section 4(d) of the Statutory Pay As-You-Go Act 
of 2010 (2 U.S.C. 933(d)).
    (b) Senate Paygo Scorecards.--The budgetary effects of section 302 
(including the amendments made by such section), up to $1,671,000,000, 
shall not be entered on any PAYGO scorecard maintained for purposes of 
section 4106 of H. Con. Res. 71 (115th Congress).
    (c) Reservation of Savings.--None of the funds in the Account to 
Address the Primary Care Physician Shortage (established under section 
747(c)(6) of the Public Health Service Act, as amended by section 204), 
the Account to Address the Nursing Workforce Shortage (established 
under section 831(e)(5) of the Public Health Service Act, as amended by 
section 205), or the Account to Address the Nurse Faculty Shortage 
(established under section 846A(c)(2) of the Public Health Service Act, 
as amended by section 206) shall be made available except to the extent 
provided in advance in appropriations Acts, and legislation or an Act 
that rescinds or reduces amounts in such accounts shall not be 
estimated as a reduction in direct spending under the Congressional 
Budget and Impoundment Control Act of 1974 or the Balanced Budget and 
Emergency Deficit Control Act of 1985.

           TITLE III--REDUCING HEALTH CARE COSTS FOR PATIENTS

SEC. 301. BANNING ANTICOMPETITIVE TERMS IN FACILITY AND INSURANCE 
              CONTRACTS THAT LIMIT ACCESS TO HIGHER QUALITY, LOWER COST 
              CARE.

    (a) In General.--
            (1) Public health service act.--Section 2799A-9 of the 
        Public Health Service Act (42 U.S.C. 300gg-119) is amended--
                    (A) by adding at the end the following:
    ``(b) Protecting Health Plans Network Design Flexibility.--
            ``(1) In general.--A group health plan or a health 
        insurance issuer offering group or individual health insurance 
        coverage shall not enter into an agreement with a provider, 
        network or association of providers, or other service provider 
        offering access to a network of service providers if such 
        agreement, directly or indirectly--
                    ``(A) restricts the group health plan or health 
                insurance issuer from--
                            ``(i) directing or steering enrollees to 
                        other health care providers; or
                            ``(ii) offering incentives to encourage 
                        enrollees to utilize specific health care 
                        providers;
                    ``(B) requires the group health plan or health 
                insurance issuer to enter into any additional contract 
                with an affiliate of the provider as a condition of 
                entering into a contract with such provider;
                    ``(C) requires the group health plan or health 
                insurance issuer to agree to payment rates or other 
                terms for any affiliate not party to the contract of 
                the provider involved; or
                    ``(D) restricts other group health plans or health 
                insurance issuers not party to the contract from paying 
                a lower rate for items or services than the contracting 
                plan or issuer pays for such items or services.
            ``(2) Additional requirement for self-insured plans.--A 
        self-insured group health plan shall not enter into an 
        agreement with a provider, network or association of providers, 
        third-party administrator, or other service provider offering 
        access to a network of providers if such agreement directly or 
        indirectly requires the group health plan to certify, attest, 
        or otherwise confirm in writing that the group health plan is 
        bound by restrictive contracting terms between the service 
        provider and a third-party administrator that the group health 
        plan is not party to, without a disclosure that such terms 
        exist.
            ``(3) Exception for plans and issuers.--Paragraph (1)(A) 
        shall not apply to a group health plan or health insurance 
        issuer offering group or individual health insurance coverage 
        with respect to--
                    ``(A) a health maintenance organization (as defined 
                in section 2791(b)(3)), if such health maintenance 
                organization operates primarily through exclusive 
                contracts with multi-specialty physician groups, nor to 
                any arrangement between such a health maintenance 
                organization and its affiliates; or
                    ``(B) a value-based network arrangement, such as an 
                exclusive provider network, accountable care 
                organization, center of excellence, a provider 
                sponsored health insurance issuer that operates 
                primarily through aligned multi-specialty physician 
                group practices or integrated health systems, or such 
                other similar network arrangements as determined by the 
                Secretary through rulemaking.
            ``(4) Attestation.--A group health plan or health insurance 
        issuer offering group or individual health insurance coverage 
        shall annually submit to, as applicable, the applicable 
        authority described in section 2723 or the Secretary of Labor 
        or the Secretary of the Treasury, an attestation that such plan 
        or issuer is in compliance with the requirements of this 
        subsection.
            ``(5) Rule of construction.--Nothing in this subsection 
        shall be construed to limit network design or cost or quality 
        initiatives by a group health plan or health insurance issuer, 
        including accountable care organizations, exclusive provider 
        organizations, networks that tier providers by cost or quality 
        or steer enrollees to centers of excellence, or other pay-for-
        performance programs.
            ``(6) Compliance with respect to antitrust laws.--
        Compliance with this subsection does not constitute compliance 
        with the antitrust laws, as defined in subsection (a) of the 
        first section of the Clayton Act (15 U.S.C. 12(a)).
            ``(7) Grandfathering.--An applicable State authority may 
        make a determination that the prohibitions under paragraph (1) 
        (with respect to conditions that would direct or steer to, or 
        offer incentives to encourage enrollees to use, other health 
        care providers) will not apply in the State with respect to any 
        specified agreement that is executed before the date of 
        enactment of the Bipartisan Primary Care and Health Workforce 
        Act, for a maximum length of nonapplicability of up to 10 years 
        from the date of execution of the contract if the applicable 
        State authority determines that the contract is unlikely to 
        significantly lessen competition. With respect to a specified 
        agreement for which an applicable State authority has made a 
        determination under the preceding sentence an applicable State 
        authority may determine whether renewal of the contract, within 
        the applicable 10-year period, is allowed.''; and
                    (B) by redesignating paragraph (5) of subsection 
                (a) as subsection (c), adjusting the margin of such 
                subsection accordingly, and transferring such 
                subsection (c) to appear after subsection (b), as added 
                by subparagraph (A).
            (2) Employee retirement income security act of 1974.--
        Section 724 of the Employee Retirement Income Security Act of 
        1974 (29 U.S.C. 1185m) is amended--
                    (A) by adding at the end the following:
    ``(b) Protecting Health Plans Network Design Flexibility.--
            ``(1) In general.--A group health plan or a health 
        insurance issuer offering group health insurance coverage shall 
        not enter into an agreement with a provider, network or 
        association of providers, or other service provider offering 
        access to a network of service providers if such agreement, 
        directly or indirectly--
                    ``(A) restricts the group health plan or health 
                insurance issuer from--
                            ``(i) directing or steering enrollees to 
                        other health care providers; or
                            ``(ii) offering incentives to encourage 
                        enrollees to utilize specific health care 
                        providers;
                    ``(B) requires the group health plan or health 
                insurance issuer to enter into any additional contract 
                with an affiliate of the provider as a condition of 
                entering into a contract with such provider;
                    ``(C) requires the group health plan or health 
                insurance issuer to agree to payment rates or other 
                terms for any affiliate not party to the contract of 
                the provider involved; or
                    ``(D) restricts other group health plans or health 
                insurance issuers not party to the contract from paying 
                a lower rate for items or services than the contracting 
                plan or issuer pays for such items or services.
            ``(2) Additional requirement for self-insured plans.--A 
        self-insured group health plan shall not enter into an 
        agreement with a provider, network or association of providers, 
        third-party administrator, or other service provider offering 
        access to a network of providers if such agreement directly or 
        indirectly requires the group health plan to certify, attest, 
        or otherwise confirm in writing that the group health plan is 
        bound by restrictive contracting terms between the service 
        provider and a third-party administrator that the group health 
        plan is not party to, without a disclosure that such terms 
        exist.
            ``(3) Exception for plans and issuers.--Paragraph (1)(A) 
        shall not apply to a group health plan or health insurance 
        issuer offering group health insurance coverage with respect 
        to--
                    ``(A) a health maintenance organization (as defined 
                in section 733(b)(3)), if such health maintenance 
                organization operates primarily through exclusive 
                contracts with multi-specialty physician groups, nor to 
                any arrangement between such a health maintenance 
                organization and its affiliates; or
                    ``(B) a value-based network arrangement, such as an 
                exclusive provider network, accountable care 
                organization, center of excellence, a provider 
                sponsored health insurance issuer that operates 
                primarily through aligned multi-specialty physician 
                group practices or integrated health systems, or such 
                other similar network arrangements as determined by the 
                Secretary through rulemaking.
            ``(4) Attestation.--A group health plan or health insurance 
        issuer offering group health insurance coverage shall annually 
        submit to, as applicable, the applicable authority described in 
        section 2723 of the Public Health Service Act or the Secretary 
        of Labor or the Secretary of the Treasury, an attestation that 
        such plan or issuer is in compliance with the requirements of 
        this subsection.
            ``(5) Rule of construction.--Nothing in this subsection 
        shall be construed to limit network design or cost or quality 
        initiatives by a group health plan or health insurance issuer, 
        including accountable care organizations, exclusive provider 
        organizations, networks that tier providers by cost or quality 
        or steer enrollees to centers of excellence, or other pay-for-
        performance programs.
            ``(6) Compliance with respect to antitrust laws.--
        Compliance with this subsection does not constitute compliance 
        with the antitrust laws, as defined in subsection (a) of the 
        first section of the Clayton Act (15 U.S.C. 12(a)).
            ``(7) Grandfathering.--An applicable State authority may 
        make a determination that the prohibitions under paragraph (1) 
        (with respect to conditions that would direct or steer to, or 
        offer incentives to encourage enrollees to use, other health 
        care providers) will not apply in the State with respect to any 
        specified agreement that is executed before the date of 
        enactment of the Bipartisan Primary Care and Health Workforce 
        Act, for a maximum length of nonapplicability of up to 10 years 
        from the date of execution of the contract if the applicable 
        State authority determines that the contract is unlikely to 
        significantly lessen competition. With respect to a specified 
        agreement for which an applicable State authority has made a 
        determination under the preceding sentence an applicable State 
        authority may determine whether renewal of the contract, within 
        the applicable 10-year period, is allowed.''; and
                    (B) by redesignating paragraph (4) of subsection 
                (a) as subsection (c), adjusting the margin of such 
                subsection accordingly, and transferring such 
                subsection (c) to appear after subsection (b), as added 
                by subparagraph (A).
            (3) Internal revenue code of 1986.--Section 9824 of the 
        Internal Revenue Code of 1986 is amended--
                    (A) by adding at the end the following:
    ``(b) Protecting Health Plans Network Design Flexibility.--
            ``(1) In general.--A group health plan shall not enter into 
        an agreement with a provider, network or association of 
        providers, or other service provider offering access to a 
        network of service providers if such agreement, directly or 
        indirectly--
                    ``(A) restricts the group health plan from--
                            ``(i) directing or steering enrollees to 
                        other health care providers; or
                            ``(ii) offering incentives to encourage 
                        enrollees to utilize specific health care 
                        providers;
                    ``(B) requires the group health plan to enter into 
                any additional contract with an affiliate of the 
                provider as a condition of entering into a contract 
                with such provider;
                    ``(C) requires the group health plan to agree to 
                payment rates or other terms for any affiliate not 
                party to the contract of the provider involved; or
                    ``(D) restricts other group health plans not party 
                to the contract from paying a lower rate for items or 
                services than the contracting plan pays for such items 
                or services.
            ``(2) Additional requirement for self-insured plans.--A 
        self-insured group health plan shall not enter into an 
        agreement with a provider, network or association of providers, 
        third-party administrator, or other service provider offering 
        access to a network of providers if such agreement directly or 
        indirectly requires the group health plan to certify, attest, 
        or otherwise confirm in writing that the group health plan is 
        bound by restrictive contracting terms between the service 
        provider and a third-party administrator that the group health 
        plan is not party to, without a disclosure that such terms 
        exist.
            ``(3) Exception for certain plans.--Paragraph (1)(A) shall 
        not apply to a group health plan with respect to--
                    ``(A) a health maintenance organization (as defined 
                in section 9832(b)(3)), if such health maintenance 
                organization operates primarily through exclusive 
                contracts with multi-specialty physician groups, nor to 
                any arrangement between such a health maintenance 
                organization and its affiliates; or
                    ``(B) a value-based network arrangement, such as an 
                exclusive provider network, accountable care 
                organization, center of excellence, a provider 
                sponsored health insurance issuer that operates 
                primarily through aligned multi-specialty physician 
                group practices or integrated health systems, or such 
                other similar network arrangements as determined by the 
                Secretary through rulemaking.
            ``(4) Attestation.--A group health plan shall annually 
        submit to, as applicable, the applicable authority described in 
        section 2723 of the Public Health Service Act or the Secretary 
        of Labor or the Secretary of the Treasury, an attestation that 
        such plan is in compliance with the requirements of this 
        subsection.
            ``(5) Rule of construction.--Nothing in this subsection 
        shall be construed to limit network design or cost or quality 
        initiatives by a group health plan, including accountable care 
        organizations, exclusive provider organizations, networks that 
        tier providers by cost or quality or steer enrollees to centers 
        of excellence, or other pay-for-performance programs.
            ``(6) Compliance with respect to antitrust laws.--
        Compliance with this subsection does not constitute compliance 
        with the antitrust laws, as defined in subsection (a) of the 
        first section of the Clayton Act (15 U.S.C. 12(a)).
            ``(7) Grandfathering.--An applicable State authority may 
        make a determination that the prohibitions under paragraph (1) 
        (with respect to conditions that would direct or steer to, or 
        offer incentives to encourage enrollees to use, other health 
        care providers) will not apply in the State with respect to any 
        specified agreement that is executed before the date of 
        enactment of the Bipartisan Primary Care and Health Workforce 
        Act, for a maximum length of nonapplicability of up to 10 years 
        from the date of execution of the contract if the applicable 
        State authority determines that the contract is unlikely to 
        significantly lessen competition. With respect to a specified 
        agreement for which an applicable State authority has made a 
        determination under the preceding sentence an applicable State 
        authority may determine whether renewal of the contract, within 
        the applicable 10-year period, is allowed.''; and
                    (B) by redesignating paragraph (4) of subsection 
                (a) as subsection (c), adjusting the margin of such 
                subsection accordingly, and transferring such 
                subsection (c) to appear after subsection (b), as added 
                by subparagraph (A).
    (b) Regulations.--Not later than 1 year after the date of enactment 
of this Act, the Secretary of Health and Human Services, the Secretary 
of Labor, and the Secretary of the Treasury, jointly, shall promulgate 
regulations to carry out section 2799A-9(b) of the Public Health 
Service Act, section 724(b) of the Employee Retirement Income Security 
Act of 1974, and section 9824(b) of the Internal Revenue Code of 1986, 
as added by subsection (a).
    (c) Effective Date.--Subsection (b) of section 2799A-9 of the 
Public Health Service Act, subsection (b) of section 724 of the 
Employee Retirement Income Security Act of 1974, and subsection (b) of 
section 9824 of the Internal Revenue Code of 1986 (as added by 
paragraphs (1), (2), and (3), respectively, of subsection (a)) shall 
apply with respect to any contract entered into on or after the date 
that is 18 months after the date of enactment of this Act. With respect 
to an applicable contract that is in effect on the date of enactment of 
this Act, such subsection (b) shall apply on the earlier of the date of 
renewal of such contract or 3 years after such date of enactment.

SEC. 302. HONEST BILLING REQUIREMENTS APPLICABLE TO PROVIDERS.

    (a) Group Health Plan and Health Insurance Issuer Requirements.--
            (1) Public health service act.--Part D of title XXVII of 
        the Public Health Service Act (42 U.S.C. 300gg-111 et seq.) is 
        amended by adding at the end the following:

``SEC. 2799A-11. HONEST BILLING REQUIREMENTS APPLICABLE TO PLANS AND 
              ISSUERS.

    ``A group health plan or health insurance issuer offering group or 
individual health insurance coverage may not pay a claim for items and 
services furnished on or after January 1, 2026, to an individual at an 
off-campus outpatient department of a provider (as defined in section 
2799B-10(b))) submitted by a health care provider or facility unless 
such claim submitted by such provider or facility includes a separate 
unique health identifier for the department where items and services 
were furnished, in accordance with section 2799B-10.''.
            (2) Employee retirement income security act of 1974.--
                    (A) In general.--Subpart B of part 7 of subtitle B 
                of title I of the Employee Retirement Income Security 
                Act of 1974 (29 U.S.C. 1185 et seq.) is amended by 
                adding at the end the following:

``SEC. 726. HONEST BILLING REQUIREMENTS APPLICABLE TO PLANS AND 
              ISSUERS.

    ``A group health plan or health insurance issuer offering group 
health insurance coverage may not pay a claim for items and services 
furnished on or after January 1, 2026, to an individual at an off-
campus outpatient department of a provider (as defined in section 
2799B-10(b)) of the Public Health Service Act) submitted by a health 
care provider or facility unless such claim submitted by such provider 
or facility includes a separate unique health identifier for the 
department where items and services were furnished, in accordance with 
section 2799B-10 of such Act.''.
                    (B) Clerical amendment.--The table of contents in 
                section 1 of the Employee Retirement Income Security 
                Act of 1974 (29 U.S.C. 1001 et seq.) is amended by 
                inserting after the item relating to section 725 the 
                following new item:

``Sec. 726. Honest billing requirements applicable to plans and 
                            issuers.''.
            (3) Internal revenue code of 1986.--
                    (A) In general.--Subchapter B of chapter 100 of the 
                Internal Revenue Code of 1986 is amended by adding at 
                the end the following:

``SEC. 9826. HONEST BILLING REQUIREMENTS APPLICABLE TO PLANS.

    ``A group health plan may not pay a claim for items and services 
furnished on or after January 1, 2026, to an individual at an off-
campus outpatient department of a provider (as defined in section 
2799B-10(b)) of the Public Health Service Act) submitted by a health 
care provider or facility unless such claim submitted by such provider 
or facility includes a separate unique health identifier for the 
department where items and services were furnished, in accordance with 
section 2799B-10 of such Act.''.
                    (B) Clerical amendment.--The table of sections for 
                subchapter B of chapter 100 of the Internal Revenue 
                Code of 1986 is amended by adding at the end the 
                following new item:

``Sec. 9826. Honest billing requirements applicable to plans.''.
    (b) Requiring a Separate Identification Number and an Attestation 
for Each Off-Campus Outpatient Department of a Provider.--
            (1) In general.--Part E of title XXVII of the Public Health 
        Service Act (42 U.S.C. 300gg-131 et seq.) is amended by adding 
        at the end the following:

``SEC. 2799B-10. HONEST BILLING REQUIREMENTS APPLICABLE TO PROVIDERS.

    ``(a) Requirements Relating to Unique Health Identifiers.--For 
items and services furnished, on or after January 1, 2026, at an off-
campus outpatient department of a provider to a participant, 
beneficiary, or enrollee with benefits under a group health plan or 
group or individual health insurance coverage offered by a health 
insurance issuer, a health care provider or facility may not submit a 
claim to the group health plan or health insurance issuer, bill the 
participant, beneficiary, or enrollee, or hold liable the participant, 
beneficiary, or enrollee, unless--
            ``(1) such provider or facility obtains a separate unique 
        health identifier established for such department pursuant to 
        section 1173(b) of the Social Security Act; and
            ``(2) such items and services are billed using the separate 
        unique health identifier established for such department 
        pursuant to paragraph (1).
    ``(b) Off-Campus Outpatient Department of a Provider.--The term 
`off-campus outpatient department of a provider' means a department of 
a provider (as defined in section 413.65(a)(2) of title 42 of the Code 
of Federal Regulations, as in effect on the date of the enactment of 
the Bipartisan Primary Care and Health Workforce Act) that is not 
located--
            ``(1) on the campus (as defined in such section 
        413.65(a)(2)) of such provider; or
            ``(2) within the distance (described in such definition of 
        campus) from a remote location of a hospital (as defined in 
        such section 413.65(a)(2)).
    ``(c) Process for Reporting Suspected Violations.--The Secretary 
shall establish a process under which a suspected violation of this 
section may be reported to such Secretary.
    ``(d) Penalties.--The Secretary may assess a civil monetary penalty 
against a hospital for a violation under this section in an amount--
            ``(1) in the case of a hospital with not more than 30 beds 
        (as determined under section 180.90(c)(2)(ii)(D) of title 45, 
        Code of Federal Regulations, as in effect on the date of the 
        enactment of the Bipartisan Primary Care and Health Workforce 
        Act (or any successor regulations)), not to exceed $300 per day 
        that the violation is ongoing, as determined by the Secretary; 
        and
            ``(2) in the case of a hospital with more than 30 beds (as 
        so determined), not to exceed $5,500 per day that the violation 
        is ongoing, as determined by the Secretary.''.
            (2) Conforming amendment.--Section 2799B-4(a)(1) of the 
        Public Health Service Act (42 U.S.C. 300gg-134(a)(1)) is 
        amended by inserting ``(other than section 2799B-10)'' after 
        ``this part''.

SEC. 303. BANNING FACILITY FEES FOR CERTAIN SERVICES.

    Part E of title XXVII of the Public Health Service Act (42 U.S.C. 
300gg-131 et seq.), as amended by section 302(b), is further amended by 
adding at the end the following:

``SEC. 2799B-11. BANNING FACILITY FEES FOR CERTAIN SERVICES.

    ``(a) In General.--With respect to applicable items and services 
furnished to an individual on or after January 1, 2026, a health care 
provider or facility may not charge a facility fee (regardless of how 
the fee is labeled) to a group health plan, a health insurance issuer 
offering group or individual health insurance coverage, a participant, 
beneficiary, or enrollee in such a plan or coverage, or an individual 
patient who is not covered by a group health plan, health insurance 
coverage, or a Federal health care program (as defined in section 
1128(f) of the Social Security Act).
    ``(b) Applicable Items and Services.--In this section, the term 
`applicable items and services' means--
            ``(1) evaluation and management services described in 
        section 1833(cc)(1)(B)(i) of the Social Security Act;
            ``(2) outpatient behavioral health services (not including 
        partial hospitalizations, intensive outpatient program 
        services, and other services not typically provided in an 
        office setting (as the Secretary may determine)); and
            ``(3) any items and services (including the items and 
        services described in paragraphs (1) and (2)) furnished via 
        telehealth.''.

SEC. 304. PREVENTION AND PUBLIC HEALTH FUND.

    Section 4002(b) of the Patient Protection and Affordable Care Act 
(42 U.S.C. 300u-11(b)) is amended by striking paragraphs (8) through 
(10) and inserting the following:
            ``(8) for each of fiscal years 2026 and 2027, 
        $1,425,000,000;
            ``(9) for each of fiscal years 2028 and 2029, 
        $1,495,000,000;
            ``(10) for fiscal year 2030, $1,680,000,000; and
            ``(11) for fiscal year 2031 and each fiscal year 
        thereafter, $2,000,000,000.''.
                                 <all>