[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 3194 Introduced in Senate (IS)]
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116th CONGRESS
2d Session
S. 3194
To establish a program ensuring access to accredited continuing medical
education for primary care physicians and other health care providers
at Federally-qualified health centers and rural health clinics, to
provide training and clinical support for primary care providers to
practice at their full scope and improve access to care for patients in
underserved areas.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
January 15, 2020
Ms. Rosen (for herself and Ms. Murkowski) introduced the following
bill; which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To establish a program ensuring access to accredited continuing medical
education for primary care physicians and other health care providers
at Federally-qualified health centers and rural health clinics, to
provide training and clinical support for primary care providers to
practice at their full scope and improve access to care for patients in
underserved areas.
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 ``Improving Access to Health Care in
Rural and Underserved Areas Act''.
SEC. 2. PRIMARY CARE ACCREDITED CONTINUING MEDICAL EDUCATION PROGRAM.
Subpart 1 of part D of title III of the Public Health Service Act
(42 U.S.C. 254b et seq.) is amended by adding at the end the following:
``SEC. 330N. PRIMARY CARE ACCREDITED CONTINUING MEDICAL EDUCATION
PROGRAM.
``(a) In General.--The Secretary, acting through the Administrator
of the Health Resources and Services Administration, shall establish a
program to award not more than 100 grants to Federally-qualified health
centers or rural health clinics, or organizations affiliated with such
clinics, for the purpose of ensuring access to accredited continuing
medical education by board-certified specialist physicians, including
family and internal medicine physicians, with teaching or high-volume
patient experience, and other licensed medical providers who have
clinical experience and are certified in accordance with regulations
issued by the Secretary, to primary care physicians and medical
providers employed by Federally-qualified health centers or rural
health clinics, to increase the primary care providers' knowledge and
capacity to practice within their full scope and increase access to
care for patients in rural and underserved areas.
``(b) Scope of Training.--
``(1) In general.--Accredited continuing medical education
programs offered under this section--
``(A) shall be designed to be flexible to meet the
needs of the patients and providers served and offer a
variety of schedules, with a minimum of 1-day training
per month, per specialty area;
``(B) shall involve clinical practice for at least
50 percent of the training (based on a 3-month
average), involving direct care for patients with a
scheduled visit with the primary care provider, and who
could benefit from a concurrent visit with both the
primary care provider and a specialist;
``(C) shall not impose additional cost-sharing with
respect to the concurrent visits described in
subparagraph (B);
``(D) may involve specialists and faculty who
participate in the program via telemedicine for up to
50 percent of the clinical time, not to exceed 75
percent of the total program time over a 3-month
average; and
``(E) with respect to rural and frontier Federally-
qualified health centers or rural health clinics, may
permit a waiver of subparagraph (D) (upon request to
the Health Resources and Services Administration) to
permit 100 percent telemedicine participation.
``(2) Training.--Accredited continuing medical education
programs offered under this section may provide training to
primary and behavioral care physicians and health care
providers on--
``(A) endocrinology (including diabetes care);
``(B) palliative care and pain management;
``(C) dermatology;
``(D) obstetrics and gynecology;
``(E) pediatric primary care and pediatric
subspecialties;
``(F) gastroenterology;
``(G) mental and behavioral health, and substance
use treatment;
``(H) preventive care and nutrition;
``(I) geriatric medicine;
``(J) infectious disease;
``(K) cardiology;
``(L) rural health and training to improve outcomes
for populations experiencing health disparities;
``(M) wound care;
``(N) disease management for patients with multiple
comorbidities;
``(O) health information technology; and
``(P) other topics, as the Secretary determines
appropriate.
``(3) Participating centers or clinics.--
``(A) In general.--To be eligible for a grant under
this section a Federally-qualified health center or
rural health clinic, or an organization affiliated with
any such health clinic acting on behalf of multiple
such clinics, shall--
``(i) submit an application to the
Secretary at such time, in such manner, and
containing such information as the Secretary
may require;
``(ii) ensure that training under the
program under the grant is provided to the
physicians and primary care providers employed
by such center or clinic, as well as peer-to-
peer training;
``(iii) include in the application a needs
assessment describing how participation in the
program under the grant will meet both patient
needs and skills training needs for their
primary care providers; and
``(iv) include in the application a
description of the expected patient target for
how many patients would be directly served by
activities under the grant and an assurance
that data and reports will be provided on the
number of patients served and the accrediting
entity used for purposes of subsection (c).
``(B) Use of grant.--A Federally-qualified health
center, rural health clinic, or affiliated organization
receiving a grant under this section may use grant
funds for--
``(i) compensation for medical providers
participating in teaching at program sessions;
``(ii) part-time administration support for
the program;
``(iii) compensation for the center for the
nonclinical training time of the center's
primary care or behavioral health care
providers;
``(iv) technology and equipment needed to
facilitate clinical visits for the program;
``(v) transportation costs for medical
providers participating in teaching under the
program to travel to center sites if such sites
are located more than 35 miles from their
primary residences; and
``(vi) other purposes related to expenses
incurred in the planning and delivery of the
educational program and associated clinical
visits, as the Secretary determines
appropriate.
``(C) Term.--A grant under this section shall be
for a period of 5-years.
``(D) Rural areas.--The Secretary shall ensure that
at least half of the recipients of a grant under this
section are eligible Federally-qualified health centers
located in a rural area or rural health clinics, or
affiliated organizations acting on behalf of such
centers.
``(c) Physician Participation in Program.--
``(1) Eligibility.--To be eligible to participate in an
accredited continuing medical education program offered under
this section, a physician or other primary care or behavioral
health care provider shall be a primary care provider--
``(A) who is employed by the grantee; and
``(B) who serves patients in a medically
underserved population (as defined in section
330(b)(3)).
``(2) CME credit.--
``(A) In general.--The Secretary shall require a
grantee under this section to identify an accrediting
body that the grantee will work with to certify the
program under the grant in a manner that provides
continuing medical education credits to providers
participating in the program. Such certification shall
include material with respect to specific skills
development.
``(B) Reporting.--As part of the annual reporting
provided under subsection (b)(3)(A)(iv) a grantee shall
provide information to confirm the accredited
continuing medical education entity used by the
grantee. The Secretary may suspend grant funding if the
grantee fails to provide for accredited continuing
medical education within the first year of the grant.
Such grant funding may be reinstated by the Secretary
once the grantee certifies that accredited continuing
medical education is provided.
``(d) Annual Reporting.--Beginning 1 year after the date of
enactment of the Improving Access to Health Care in Rural and
Underserved Areas Act, and every year thereafter, the Secretary shall
submit to Congress a report on the program under this section,
including--
``(1) the number of physicians who participate in the
program each year and the specialties of such physicians;
``(2) a breakdown of specialist time spent directly with
patients, with patients through telemedicine, and with primary
care providers in classroom or other non-clinical setting
during the program sessions;
``(3) a comparison of measures under the Uniform Data
System of the Health Resources and Services Administration, or
similar program, relevant to patient care improvements, between
the year prior to the implementation of the program under this
section and the most recent year in the program;
``(4) a summary of any clinical practice changes or notable
improvements in patient care;
``(5) patient referrals from health centers that
participate in the program to outside specialist care, and any
patient care provided at the health center that, prior to the
program, would have been referred to outside specialists;
``(6) retention rates of physicians at participating health
centers; and
``(7) satisfaction rates of physicians with the education
program at participating health centers.
``(e) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated $20,000,000 for each of fiscal
years 2020 through 2024.''.
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