[Congressional Record Volume 166, Number 163 (Monday, September 21, 2020)]
[House]
[Pages H4626-H4627]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




             PROTECTING PATIENTS TRANSPORTATION TO CARE ACT

  Mrs. DINGELL. Madam Speaker, I move to suspend the rules and pass the 
bill (H.R. 3935) to amend title XIX of the Social Security Act to 
provide for the continuing requirement of Medicaid coverage of 
nonemergency transportation to medically necessary services, as 
amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 3935

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Protecting Patients 
     Transportation to Care Act''.

     SEC. 2. MEDICAID COVERAGE OF CERTAIN MEDICAL TRANSPORTATION.

       (a) Continuing Requirement of Medicaid Coverage of 
     Necessary Transportation.--
       (1) Requirement.--Section 1902(a)(4) of the Social Security 
     Act (42 U.S.C. 1396a(a)(4)) is amended--
       (A) by striking ``and including provision for utilization'' 
     and inserting ``including provision for utilization''; and
       (B) by inserting after ``supervision of administration of 
     the plan'' the following: ``, and, subject to section 
     1903(i), including a specification that the single State 
     agency described in paragraph (5) will ensure necessary 
     transportation for beneficiaries under the State plan to and 
     from providers and a description of the methods that such 
     agency will use to ensure such transportation''.
       (2) Application with respect to benchmark benefit packages 
     and benchmark equivalent coverage.--Section 1937(a)(1) of the 
     Social Security Act (42 U.S.C. 1396u-7(a)(1)) is amended--
       (A) in subparagraph (A), by striking ``subsection (E)'' and 
     inserting ``subparagraphs (E) and (F)''; and
       (B) by adding at the end the following new subparagraph:
       ``(F) Necessary transportation.--Notwithstanding the 
     preceding provisions of this paragraph, a State may not 
     provide medical assistance through the enrollment of an 
     individual with benchmark coverage or benchmark equivalent 
     coverage described in subparagraph (A)(i) unless, subject to 
     section 1903(i)(9) and in accordance with section 1902(a)(4), 
     the benchmark benefit package or benchmark equivalent 
     coverage (or the State)--
       ``(i) ensures necessary transportation for individuals 
     enrolled under such package or coverage to and from 
     providers; and
       ``(ii) provides a description of the methods that will be 
     used to ensure such transportation.''.
       (3) Limitation on federal financial participation.--Section 
     1903(i) of the Social Security Act (42 U.S.C. 1396b(i)) is 
     amended by inserting after paragraph (8) the following new 
     paragraph:
       ``(9) with respect to any amount expended for non-emergency 
     transportation authorized under section 1902(a)(4), unless 
     the State plan provides for the methods and procedures 
     required under section 1902(a)(30)(A); or''.
       (4) Effective date.--The amendments made by this subsection 
     shall take effect on the date of the enactment of this Act 
     and shall apply to transportation furnished on or after such 
     date.
       (b) Medicaid Program Integrity Measures Related to Coverage 
     of Nonemergency Medical Transportation.--
       (1) Gao study.--Not later than two years after the date of 
     the enactment of this Act, the Comptroller General of the 
     United States shall conduct a study, and submit to Congress, 
     a report on coverage under the Medicaid program under title 
     XIX of the Social Security Act of nonemergency transportation 
     to medically necessary services. Such study shall take into 
     account the 2009 report of the Office of the Inspector 
     General of the Department of Health and Human Services, 
     titled ``Fraud and Abuse Safeguards for Medicaid Nonemergency 
     Medical Transportation'' (OEI-06-07-003200). Such report 
     shall include the following:
       (A) An examination of the 50 States and the District of 
     Columbia to identify safeguards to prevent and detect fraud 
     and abuse with respect to coverage under the Medicaid program 
     of nonemergency transportation to medically necessary 
     services.
       (B) An examination of transportation brokers to identify 
     the range of safeguards against such fraud and abuse to 
     prevent improper payments for such transportation.
       (C) Identification of the numbers, types, and outcomes of 
     instances of fraud and abuse, with respect to coverage under 
     the Medicaid program of such transportation, that State 
     Medicaid Fraud Control Units have investigated in recent 
     years.
       (D) Identification of commonalities or trends in program 
     integrity, with respect to such coverage, to inform risk 
     management strategies of States and the Centers for Medicare 
     & Medicaid Services.
       (2) Stakeholder working group.--
       (A) In general.--Not later than one year after the date of 
     the enactment of this Act, the Secretary of Health and Human 
     Services, through the Centers for Medicare & Medicaid 
     Services, shall convene a series of meetings to obtain input 
     from appropriate stakeholders to facilitate discussion and 
     shared learning about the leading practices for improving 
     Medicaid program integrity, with respect to coverage of 
     nonemergency transportation to medically necessary services.
       (B) Topics.--The meetings convened under subparagraph (A) 
     shall--
       (i) focus on ongoing challenges to Medicaid program 
     integrity as well as leading practices to address such 
     challenges; and
       (ii) address specific challenges raised by stakeholders 
     involved in coverage under the Medicaid program of 
     nonemergency transportation to medically necessary services, 
     including unique considerations for specific groups of 
     Medicaid beneficiaries meriting particular attention, such as 
     American Indians and tribal land issues or accommodations for 
     individuals with disabilities.
       (C) Stakeholders.--Stakeholders described in subparagraph 
     (A) shall include individuals from State Medicaid programs, 
     brokers for nonemergency transportation to medically 
     necessary services that meet the criteria described in 
     section 1902(a)(70)(B) of the Social Security Act (42 U.S.C. 
     1396a(a)(70)(B)), providers (including transportation network 
     companies), Medicaid patient advocates, and such other 
     individuals specified by the Secretary.
       (3) Guidance review.--Not later than 18 months after the 
     date of the enactment of this Act, the Secretary of Health 
     and Human Services, through the Centers for Medicare & 
     Medicaid Services, shall assess guidance issued to States by 
     the Centers for Medicare & Medicaid Services relating to 
     Federal requirements for nonemergency transportation to 
     medically necessary services under the Medicaid program under 
     title XIX of the Social Security Act and update such guidance 
     as necessary to ensure States have appropriate and current 
     guidance in designing and administering coverage under the 
     Medicaid program of nonemergency transportation to medically 
     necessary services.
       (4) Nemt transportation provider and driver requirements.--
       (A) State plan requirement.--Section 1902(a) of the Social 
     Security Act (42 U.S.C. 1396a(a)) is amended--
       (i) by striking ``and'' at the end of paragraph (85);
       (ii) by striking the period at the end of paragraph (86) 
     and inserting ``; and''; and
       (iii) by inserting after paragraph (86) the following new 
     paragraph:
       ``(87) provide for a mechanism, which may include 
     attestation, that ensures that, with respect to any provider 
     (including a transportation network company) or individual 
     driver of nonemergency transportation to medically necessary 
     services receiving payments under such plan (but excluding 
     any public transit authority), at a minimum--

[[Page H4627]]

       ``(A) each such provider and individual driver is not 
     excluded from participation in any Federal health care 
     program (as defined in section 1128B(f)) and is not listed on 
     the exclusion list of the Inspector General of the Department 
     of Health and Human Services;
       ``(B) each such individual driver has a valid driver's 
     license;
       ``(C) each such provider has in place a process to address 
     any violation of a State drug law; and
       ``(D) each such provider has in place a process to disclose 
     to the State Medicaid program the driving history, including 
     any traffic violations, of each such individual driver 
     employed by such provider, including any traffic 
     violations.''.
       (B) Effective date.--
       (i) In general.--Except as provided in clause (ii), the 
     amendments made by subparagraph (A) shall take effect on the 
     date of the enactment of this Act and shall apply to services 
     furnished on or after the date that is one year after the 
     date of the enactment of this Act.
       (ii) Exception if state legislation required.--In the case 
     of a State plan for medical assistance under title XIX of the 
     Social Security Act which the Secretary of Health and Human 
     Services determines requires State legislation (other than 
     legislation appropriating funds) in order for the plan to 
     meet the additional requirement imposed by the amendments 
     made by subparagraph (A), the State plan shall not be 
     regarded as failing to comply with the requirements of such 
     title solely on the basis of its failure to meet this 
     additional requirement before the first day of the first 
     calendar quarter beginning after the close of the first 
     regular session of the State legislature that begins after 
     the date of the enactment of this Act. For purposes of the 
     previous sentence, in the case of a State that has a 2-year 
     legislative session, each year of such session shall be 
     deemed to be a separate regular session of the State 
     legislature.
       (5) Analysis of t-msis data.--Not later than one year after 
     the date of the enactment of this Act, the Secretary of 
     Health and Human Services, through the Centers for Medicare & 
     Medicaid Services, shall analyze, and submit to Congress a 
     report on, the nation-wide data set under the Transformed 
     Medicaid Statistical Information System to identify 
     recommendations relating to coverage under the Medicaid 
     program under title XIX of the Social Security Act of 
     nonemergency transportation to medically necessary services.

  The SPEAKER pro tempore. Pursuant to the rule, the gentlewoman from 
Michigan (Mrs. Dingell) and the gentleman from Montana (Mr. Gianforte) 
each will control 20 minutes.
  The Chair recognizes the gentlewoman from Michigan.


                             General Leave

  Mrs. DINGELL. Madam Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and include extraneous material on H.R. 3935.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from Michigan?
  There was no objection.
  Mrs. DINGELL. Madam Speaker, I yield myself such time as I may 
consume.
  Madam Speaker, I rise in support of H.R. 3935, Protecting Patients 
Transportation to Care Act. This legislation will add nonemergency 
medical transportation services for individuals without other means of 
transportation to the list of benefits required by law under Medicaid.
  NEMT, N-E-M-T, benefits have been a mandatory Medicaid benefit by 
regulation since the program's beginning in 1966, and the benefits are 
clear. Transportation is one of the most common barriers to care for 
low-income patients, and reliable transportation to and from medical 
appointments is a cornerstone of healthcare access.
  NEMT provides over 100 million rides to Medicaid beneficiaries each 
year, and this lifeline is critical to patients with chronic conditions 
like kidney disease or diabetes.
  Additionally, it allows seniors and Americans to remain in their 
homes and continue to live independently.
  The NEMT benefit is especially critical to beneficiaries seeking care 
during this current public health crisis, which has placed additional 
burdens and barriers to care.
  The Protecting Patients Transportation to Care Act will codify this 
benefit and maintain robust program integrity protections.
  In addition to safeguarding the lifesaving NEMT benefit, the 
legislation is scored as having no cost by the Congressional Budget 
Office.
  I would like to thank Representatives Carter, Cardenas, Graves and 
Bishop of Georgia for leading this bipartisan effort and urge my 
colleagues to support its passage.
  I reserve the balance of my time.

                              {time}  1815

  Mr. GIANFORTE. Madam Speaker, I yield myself such time as I may 
consume.
  Madam Speaker, I rise today in support of H.R. 3935, the Protecting 
Patients Transportation to Care Act, introduced by Representatives 
Carter and Cardenas, and Representatives Graves and Bishop of Georgia.
  This legislation would require Medicaid to cover nonemergency medical 
transportation, or NEMT. This can help rural Medicaid patients get to 
dialysis, preventive care, and substance abuse treatment.
  Covering this transport can ensure these patients get the care they 
need, improving outcomes and reducing the need for expensive emergency 
room visits and hospitalizations.
  In my home State of Montana, it can take 2 hours or more to get to a 
specialist. This important legislation will help ensure rural patients 
have the ability to get to their providers.
  H.R. 3935 would also require States to ensure that NEMT providers are 
not on the excluded providers list; that each individual driver has a 
valid driver's license; and that providers report and address 
violations of State law, including traffic violations.
  It would require the Comptroller General to conduct a study on 
coverages of NEMT by State Medicaid programs, including the policies 
and program integrity measures in place to prevent waste, fraud, and 
abuse.
  Finally, the bill would require the Secretary to analyze any NEMT 
data and report to Congress on his or her findings within one year of 
the date of enactment.
  The legislation also requires State Medicaid programs to develop a 
utilization management process for the benefit.
  Madam Speaker, I urge adoption of this important legislation, and I 
yield back the balance of my time.
  Mrs. DINGELL. Madam Speaker, I, too, urge adoption of this important 
piece of legislation to remove barriers so people are able to go to the 
doctor, and I urge my colleagues to support this bill.
  I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentlewoman from Michigan (Mrs. Dingell) that the House suspend the 
rules and pass the bill, H.R. 3935, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

                          ____________________