[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8890 Introduced in House (IH)]
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117th CONGRESS
2d Session
H. R. 8890
To amend title XVIII of the Social Security Act to establish exceptions
for certain physician wellness programs, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 19, 2022
Mr. Ruiz (for himself, Mr. Bucshon, Mr. Beyer, and Mr. Murphy of North
Carolina) introduced the following bill; which was referred to the
Committee on Energy and Commerce, and in addition to the Committee on
Ways and Means, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to establish exceptions
for certain physician wellness programs, 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 ``Physician Wellness Program Act of
2022''.
SEC. 2. EXCEPTION FOR PHYSICIAN WELLNESS PROGRAMS.
(a) Exception for Physician Wellness Programs.--
(1) In general.--Section 1877(e) of the Social Security Act
(42 U.S.C. 1395nn(e)) is amended by adding at the end the
following:
``(9) Physician wellness programs.--A bona fide mental
health or behavioral health improvement or maintenance program
offered to a physician by an entity, if--
``(A) such program--
``(i) consists of counseling, mental health
services, a suicide prevention program, or a
substance use disorder prevention and treatment
program;
``(ii) is made available to a physician for
the primary purpose of preventing suicide,
improving mental health and resiliency, or
providing training in appropriate strategies to
promote the mental health and resiliency of
such physician;
``(iii) is set out in a written policy,
approved in advance of the operation of the
program by the governing body of the entity
providing such program, that includes--
``(I) a description of the content
and duration of the program;
``(II) a description of the
evidence-based support for the design
of the program;
``(III) the estimated cost of the
program;
``(IV) the personnel (including the
qualifications of such personnel)
implementing the program; and
``(V) the method by which such
entity will evaluate the use and
success of the program;
``(iv) is offered by an entity with a
formal medical staff to all physicians who
practice in the geographic area served by such
entity, including physicians who hold bona fide
appointments to the medical staff of such
entity or otherwise have clinical privileges at
such entity;
``(v) is offered to all such physicians on
the same terms and conditions and without
regard to the volume or value of referrals or
other business generated by a physician for
such entity;
``(vi) is evidence-based and conducted by a
qualified health professional; and
``(vii) meets such other requirements the
Secretary may impose by regulation as needed to
protect against program or patient abuse;
``(B) such entity is--
``(i) a hospital;
``(ii) an ambulatory surgical center;
``(iii) a community health center;
``(iv) a rural emergency hospital;
``(v) a rural health clinic;
``(vi) a skilled nursing facility; or
``(vii) a similar entity, as determined by
the Secretary; and
``(C) neither the provision of such program, nor
the value of such program, are contingent upon the
number or value of referrals made by a physician to
such entity.''.
(2) Regulation.--Not later than 1 year after the date of
enactment of this Act, the Secretary of Health and Human
Services shall promulgate such regulations as are necessary to
carry out the amendment made by paragraph (1).
(b) Exception Under the Anti-Kickback Statute.--Section 1128B(b)(3)
of the Social Security Act (42 U.S.C. 1320a-7b(b)(3)) is amended--
(1) in subparagraph (J), by striking ``and'' at the end;
(2) in subparagraph (K), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(L) a bona fide mental health or behavioral health
improvement or maintenance program, if--
``(i) such program--
``(I) consists of counseling, mental health
services, a suicide prevention program, or a
substance use disorder prevention and treatment
program;
``(II) is made available to a physician and
other clinicians for the primary purpose of
preventing suicide, improving mental health and
resiliency, or providing training in
appropriate strategies to promote the mental
health and resiliency of such physician;
``(III) is set out in a written policy,
approved in advance of the operation of the
program by the governing body of the entity
providing such program, that includes--
``(aa) a description of the content
and duration of the program;
``(bb) a description of the
evidence-based support for the design
of the program;
``(cc) the estimated cost of the
program;
``(dd) the personnel (including the
qualifications of such personnel)
implementing the program; and
``(ee) the method by which such
entity will evaluate the use and
success of the program;
``(IV) is offered by an entity with a
formal medical staff to all physicians and
other clinicians who practice in the geographic
area served by such entity, including
physicians who hold bona fide appointments to
the medical staff of such entity or otherwise
have clinical privileges at such entity;
``(V) is offered to all such physicians and
clinicians on the same terms and conditions and
without regard to the volume or value of
referrals or other business generated by a
physician or clinician for such entity;
``(VI) is evidence-based and conducted by a
qualified health professional; and
``(VII) meets such other requirements the
Secretary may impose by regulation as needed to
protect against program or patient abuse;
``(ii) such entity is--
``(I) a hospital;
``(II) an ambulatory surgical center;
``(III) a community health center;
``(IV) a rural emergency hospital;
``(V) a skilled nursing facility; or
``(VI) any similar entity, as determined by
the Secretary; and
``(iii) neither the provision of such program, nor
the value of such program, are contingent upon the
number or value of referrals made by a physician or
other clinician to such entity.''.
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