[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3821 Reported in House (RH)]
<DOC>
Union Calendar No. 325
114th CONGRESS
2d Session
H. R. 3821
[Report No. 114-426]
To amend title XIX to require the publication of a provider directory
in the case of States providing for medical assistance on a fee-for-
service basis or through a primary care case-management system, and for
other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
October 23, 2015
Mr. Collins of New York (for himself and Mr. Tonko) introduced the
following bill; which was referred to the Committee on Energy and
Commerce
February 23, 2016
Reported with an amendment, committed to the Committee of the Whole
House on the State of the Union, and ordered to be printed
[Strike out all after the enacting clause and insert the part printed
in italic]
[For text of introduced bill, see copy of bill as introduced on October
23, 2015]
_______________________________________________________________________
A BILL
To amend title XIX to require the publication of a provider directory
in the case of States providing for medical assistance on a fee-for-
service basis or through a primary care case-management system, 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.
This Act may be cited as the ``Medicaid Directory of Caregivers
Act'' or the ``Medicaid DOC Act''.
SEC. 2. REQUIRING PUBLICATION OF FEE-FOR-SERVICE PROVIDER DIRECTORY.
(a) In General.--Section 1902(a) of the Social Security Act (42
U.S.C. 1396a(a)) is amended by inserting after paragraph (77) the
following new paragraph:
``(78) provide that, not later than 180 days after the date
of the enactment of this paragraph, in the case of a State plan
that provides medical assistance on a fee-for-service basis or
through a primary care case-management system described in
section 1915(b)(1) (other than a primary care case management
entity (as defined by the Secretary)), the State shall publish
(and update on at least an annual basis) on the public Website
of the State agency administering the State plan, a directory
of the providers (including, at a minimum, primary and
specialty care physicians) described in subsection (ll) that
includes--
``(A) with respect to each such provider--
``(i) the name of the provider;
``(ii) the specialty of the provider;
``(iii) the address of the provider; and
``(iv) the telephone number of the
provider; and
``(B) with respect to any such provider
participating in such a primary care case-management
system, information regarding--
``(i) whether the provider is accepting as
new patients individuals who receive medical
assistance under this title; and
``(ii) the provider's cultural and
linguistic capabilities, including the
languages spoken by the provider or by the
skilled medical interpreter providing
interpretation services at the provider's
office;''.
(b) Directory Providers Described.--Section 1902 of the Social
Security Act (42 U.S.C. 1396a) is amended by adding at the end the
following new subsection:
``(ll) Directory Providers Described.--A provider described in this
subsection is--
``(1) in the case of a provider of a provider type for
which the State agency, as a condition on receiving payment for
items and services furnished by the provider to individuals
eligible to receive medical assistance under the State plan,
requires the enrollment of the provider with the State agency,
a provider that--
``(A) is enrolled with the agency as of the date on
which the directory is published or updated (as
applicable) under subsection (a)(78); and
``(B) received payment under the State plan in the
12-month period preceding such date; and
``(2) in the case of a provider of a provider type for
which the State agency does not require such enrollment, a
provider that received payment under the State plan in the 12-
month period preceding the date on which the directory is
published or updated (as applicable) under subsection
(a)(78).''.
(c) Rule of Construction.--
(1) In general.--The amendment made by subsection (a) shall
not be construed to apply in the case of a State in which all
the individuals enrolled in the State plan under title XIX of
the Social Security Act (or under a waiver of such plan), other
than individuals described in paragraph (2), are enrolled with
a medicaid managed care organization (as defined in section
1903(m)(1)(A) of such Act (42 U.S.C. 1396b(m)(1)(A))),
including prepaid inpatient health plans and prepaid ambulatory
health plans (as defined by the Secretary of Health and Human
Services).
(2) Individuals described.--An individual described in this
paragraph is an individual who is an Indian (as defined in
section 4 of the Indian Health Care Improvement Act (25 U.S.C.
1603)) or an Alaska Native.
(d) Exception for State Legislation.--In the case of a State plan
under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.),
which the Secretary determines requires State legislation in order for
the respective plan to meet one or more additional requirements imposed
by amendments made by this section, the respective plan shall not be
regarded as failing to comply with the requirements of such title
solely on the basis of its failure to meet such an 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 enactment of this section.
For purposes of the previous sentence, in the case of a State that has
a 2-year legislative session, each year of the session shall be
considered to be a separate regular session of the State legislature.
Union Calendar No. 325
114th CONGRESS
2d Session
H. R. 3821
[Report No. 114-426]
_______________________________________________________________________
A BILL
To amend title XIX to require the publication of a provider directory
in the case of States providing for medical assistance on a fee-for-
service basis or through a primary care case-management system, and for
other purposes.
_______________________________________________________________________
February 23, 2016
Reported with an amendment, committed to the Committee of the Whole
House on the State of the Union, and ordered to be printed