[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.
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