[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1114 Introduced in House (IH)]
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118th CONGRESS
1st Session
H. R. 1114
To provide for optimized care, a coordinated Federal Government
response, public education, and insurance reimbursement guidance for
Long COVID, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 21, 2023
Ms. Blunt Rochester (for herself, Mr. Beyer, and Ms. Pressley)
introduced the following bill; which was referred to the Committee on
Energy and Commerce
_______________________________________________________________________
A BILL
To provide for optimized care, a coordinated Federal Government
response, public education, and insurance reimbursement guidance for
Long COVID, 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; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the``Long COVID Response
is Care Optimized and Vitally Essential Resources that Yield New
Opportunities for Wellness Act'' or the ``Long COVID RECOVERY NOW
Act''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Targeting resources for equitable access to treatment of Long
COVID.
Sec. 3. National Long COVID technical assistance dissemination program.
Sec. 4. Mental health and suicide prevention and treatment.
Sec. 5. ONC best practices for Long COVID data.
Sec. 6. Long COVID Education Website.
Sec. 7. Providing Support for Long COVID Registries.
Sec. 8. Medicaid Health Homes for Individuals with Long COVID.
Sec. 9. State health officials guidance.
Sec. 10. Support under Medicaid for State Collection of Long COVID
Data.
Sec. 11. Grants for Pediatric Research on Long COVID.
SEC. 2. TARGETING RESOURCES FOR EQUITABLE ACCESS TO TREATMENT OF LONG
COVID.
(a) Establishment.--
(1) In general.--Not later than 1 year after the date of
the enactment of this Act, the Secretary of Health and Human
Services shall award, subject to subsection (f) and in
accordance with the provisions of this section, grants
described in the following subsections to carry out the
purposes described in such subsections.
(2) Eligibility.--The Secretary may establish a process for
evaluating and determining the eligibility of Federally
qualified health centers and rural health clinics for receiving
a grant under this section.
(b) Grants to FQHCs and RHCs.--For purposes of subsection (a), the
grants described in this subsection are grants to Federally qualified
health centers (as defined in section 1861(aa)(4) of the Social
Security Act (42 U.S.C. 1395x(aa)(4)) and rural health clinics (as
defined in section 1861(aa)(2) of such Act (42 U.S.C. 1395x(aa)(2))
to--
(1) adopt evidence-based Long COVID clinical practices that
have been demonstrated to improve the wellness of individuals
with Long COVID, including clinical validation of patient
reported symptoms using established measures that yield
structured, comparable data;
(2) establish or expand screening, referral, and navigation
processes for health-related social needs that could interfere
with Long COVID treatment, including food insecurity, housing
instability, transportation needs, utility difficulties, and
interpersonal safety; and
(3) submit to the Secretary of Health and Human Services
(in a format consistent with the standards and activities under
the Data Modernization Initiative of the Centers for Disease
Control and Prevention) standardized, disaggregated,
deidentified data (as specified by the Secretary) on the
characteristics, diagnoses, and health care service utilization
of Long COVID patients served under such grant, including
disaggregated data on Long COVID patient characteristics,
including patient age, gender, race, ethnicity, language
spoken, disability status, nature and duration of validated
symptoms, and other characteristics necessary to inform
considerations for effective and equitable treatment for
patients with Long COVID.
(c) Grants to Primary Care Practices.--For purposes of subsection
(a), the grants described in this subsection are grants to primary care
practices (other than Federally qualified health centers and rural
health clinics) that satisfy such criteria as may be established by the
Secretary to carry out the purposes described in paragraphs (1) and (3)
of subsection (b).
(d) GRANTS For Multidisciplinary Treatment and Coordination.--
(1) In general.--The Secretary of Health and Human Services
(in this section referred to as the ``Secretary'') shall award
grants on a competitive basis to eligible entities for the
purpose of creating or enhancing capacity to treat patients
with Long COVID through a multidisciplinary approach. The term
``multidisciplinary'' in this section refers to the coordinated
work to provide care or treatment to a patient by physicians
and other professionals, such as specialty or subspecialty
providers, nurses and nurse care coordinators, dietitians,
nutritionists, social workers, behavioral health professionals,
physical and occupational therapists, speech pathologists, or
any professionals determined to be appropriate by the State and
approved by the Administrator of the Centers for Medicare &
Medicaid Services.
(2) Use of funds.--An eligible entity receiving a grant
under this section shall use the grant, for the purpose
described in subsection (a), to--
(A) enhance the capacity of one or more existing
multidisciplinary Long COVID clinics to serve the Long
COVID population; or
(B) create one or more multidisciplinary clinics to
address the physical and mental health needs of Long
COVID patients.
(3) Eligible entities.--To be eligible to receive a grant
under this section, an entity shall be a health care provider,
Federally qualified health center (as defined in section
1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa))),
rural health clinic, urban Indian health center, or State or
local public health department, that--
(A)(i) operates an existing multidisciplinary Long
COVID clinic or other specialized Long COVID program;
or
(ii) is an existing health care provider with
experience providing care for individuals with Long
COVID and who demonstrates an intent to create a
multidisciplinary Long COVID clinic or other
specialized Long COVID program;
(B) submits to the Secretary an application at such
time, in such manner, and containing such information
and assurances as the Secretary may require; and
(C) employs a framework that incentivizes
participants to attain the program's goals to establish
and disseminate best practices, and allocates funds
based on such attainment.
(4) Special rule.--A physical clinical facility is not a
requirement for eligibility.
(5) Priority.--In awarding grants under this subsection,
the Secretary shall give priority to eligible entities that--
(A) submit a plan to engage with medically
underserved communities, and with populations
disproportionately impacted by COVID-19;
(B) demonstrate capacity (or an intent to build
capacity) to provide personalized treatment and
facilitate patient access to multidisciplinary health
care providers with expertise in treating Long COVID
symptoms, including such providers who are primary and
specialty care physicians (such as physiatrists,
neurologists, cardiologists, immunologists, and
pulmonologists), therapists, nurses, care coordinators,
social workers, nutritionists, and behavioral health
specialists; and
(C) submit a plan to ensure ongoing
multidisciplinary continuing education on infection-
triggered conditions for--
(i) physicians treating Long COVID; and
(ii) other physicians and health care
workers who are not treating Long COVID, but
are otherwise serving patients in the
community.
(e) Equitable Access.--In order to ensure equitable access
treatment--
(1) no grantee under this section shall deny access to
treatment with respect to Long COVID based on insurance
coverage, date of diagnosis, or previous hospitalization;
(2) a grantee under this section shall with respect to Long
COVID--
(A) offer equity-centered resources (such as the
ability to offer resources in various languages),
information, and training to safety net health systems;
and
(B) disseminate to individuals and organizations
that provide care best practices and treatment
approaches that enhance access to high-quality care to
everyone where they live; and
(3) treatment for Long COVID shall be included as a COVID-
19 treatment, consistent with the American Rescue Plan Act of
2021 (Public Law 117-2).
(f) Development of Evidence-Based Strategies for High-Value Care
for Individuals With Long COVID.--
(1) In general.--Not later than 1 year after the date of
the enactment of this Act, the Agency for Healthcare Research
and Quality shall, subject to appropriations pursuant to
subsection (i), award multi-year grants to eligible entities
meeting such criteria as specified by the Secretary through
rulemaking for the purposes of--
(A) supporting the generation of evidence about how
to deliver high quality, high-value health care for
individuals with Long COVID for the treatment of the
condition;
(B) creating tools and strategies to help health
systems and hospitals, primary and specialty
physicians, nurses, allied health care professionals,
and caregivers provide high-quality, high-value care
for individuals with Long COVID; and
(C) providing educational materials for health care
providers, payers, and consumers on high-value care for
individuals with Long COVID.
(2) Eligibility.--The Secretary shall, through rulemaking,
specify a process for evaluating and determining the
eligibility of primary care providers including Federally
qualified health centers and rural health clinics; specialty
care providers, hospitals, health systems, academic medical
centers; and other entities for receiving a grant under this
subsection. Such rules shall prohibit grant funds from being
used to compensate or reimburse individuals or organizations
excluded pursuant to section 1128 of the Social Security Act
(42 U.S.C. 1320a-7) from participation under the Medicare
program under title XVIII of such Act.
(g) Long COVID Defined.--For purposes of this Act, the term ``Long
COVID'' (also referred to as ``post-acute sequelae of COVID-19'',
``post-COVID conditions'', or ``persistent symptoms post-COVID'') means
the ongoing sequelae of COVID-19 that some individuals experience after
infection with the SARS-CoV-2 virus, as diagnosed by a qualified health
care provider. Such sequelae are defined as the ``Post-COVID
Conditions'' identified and defined by the Centers for Disease Control
and Prevention in 2021, or in subsequent revisions by the Centers for
Disease Control and Prevention.
(h) Reports.--
(1) Annual reports by grantees to secretary.--On an annual
basis, a recipient of a grant under this section shall--
(A) submit to the Secretary, and make publicly
available, a report on the activities carried out
through the grant; and
(B) include evaluations of such activities,
including the experience of individuals who received
health care through such grant.
(2) Annual reports by secretary to congress.--Not later
than the end of each of fiscal years 2024 through 2026, the
Secretary shall submit to the Congress, and make publicly
available, a report that--
(A) summarizes the reports received under paragraph
(1);
(B) evaluates the effectiveness of grants under
this section; and
(C) makes recommendations with respect to expanding
coverage for clinical care for Long COVID.
(i) Authorization of Appropriations.--
(1) In general.--To carry out this section, there are
authorized to be appropriated such sums as may be necessary for
each of fiscal years 2024 through 2026.
(2) Administrative expenses.--Not more than 15 percent of
the amounts made available to carry out this section for any
fiscal year may be used for administrative expenses to operate
the grants under this section.
SEC. 3. NATIONAL LONG COVID TECHNICAL ASSISTANCE DISSEMINATION PROGRAM.
(a) In General.--The Secretary of Health and Human Services shall--
(1) establish a structured process to seek ongoing input
from medical societies representing primary care, specialty
care, and subspecialty care regarding the proven and promising
practices for treating individuals who are diagnosed with Long
COVID to support their wellness and recovery; and
(2) enter into a memorandum of understanding with one or
more organizations with specific medical knowledge on Long
COVID or experience providing care and medical treatment to
individuals with Long COVID to support the ongoing
dissemination to the broader medical community of existing open
source evidence, tools and strategies.
(b) Organization Described.--For purposes of subsection (a), and
organization described in this paragraph is an organization that
satisfies at least the following:
(1) The organization has clinical expertise related to the
treatment of Long COVID.
(2) The organization has a robust understanding of clinical
and business practices.
(3) The organization has the ability to convene groups and
disseminate information nationally.
(4) The organization consults with medical specialty
associations for purposes of developing and distributing
clinical best practices for Long COVID diagnosis and treatment.
SEC. 4. MENTAL HEALTH AND SUICIDE PREVENTION AND TREATMENT.
Section 1911(b)(1) of the Public Health Service Act (42 U.S.C.
300x(b)(1)) is amended by inserting ``and, for each of fiscal years
2024 through 2026, individuals with Long COVID (as defined in section 2
of the Long COVID RECOVERY NOW Act) who have also been diagnosed with a
mental health condition (such as a serious mental illness or a serious
emotional disturbance)'' after ``1912(c)''.
SEC. 5. ONC BEST PRACTICES FOR LONG COVID DATA.
(a) In General.--Not later than 6 months after the date of the
enactment of this Act, the Secretary of Health and Human Services,
acting through the National Coordinator for Health Information
Technology, shall convene health care stakeholders to identify
potential best practices for collecting, aggregating, and disseminating
to health care researchers deidentified data that promotes learning
about Long COVID and supports the further research of the
characteristics of individuals diagnosed with Long COVID.
(b) Report.--Not later than 160 days after the first meeting of
such stakeholders pursuant to subsection (a), the Secretary shall
submit to Congress (and make publicly available on the website of the
Office of the National Coordinator of Health Information Technology) a
report summarizing the meetings and findings of the stakeholders as
well as any recommendations, including recommendations on ways that
federal health care policy can better support an understanding of the
etiology, characteristics, care and potential treatments for
individuals Long COVID to support individuals' recovery and wellness.
Such recommendations shall--
(1) take into account the perspectives of health data
scientists, health services researchers, medical providers,
health plans, hospitals and health systems, epidemiologists,
public health experts, patient representatives and groups,
health information technology companies, and other
stakeholders; and
(2) be informed by public and private sector efforts to
characterize Long COVID, aggregate and disaggregate data, and
promote data standardization, data standards, or open data
access for furthering a greater understanding of Long COVID.
SEC. 6. LONG COVID EDUCATION WEBSITE.
Not later than 6 months after the date of the enactment of this
Act, the Secretary of Health and Human Services shall, in consultation
with medical societies representing the perspectives of primary care,
specialty care, mental health professionals, medical researchers
(including through the National Institutes of Health), public health
experts (including the Centers for Disease Control and Prevention), and
patient advocates, implement a Federal website (which may be
implemented through an existing public website of the Department of
Health and Human Services) that--
(1) collects, and curates educational materials for health
care providers and consumers about Long COVID (as defined in
section 2(e)) symptoms, diagnosis, characteristics, treatment,
and access to care; and
(2) includes, or provides a link to, comprehensive
educational resources for health care providers, such as the
interim guidance (and subsequent updates) for health care
providers published by the Centers for Disease Control and
Prevention on how to treat individuals with Long COVID.
SEC. 7. PROVIDING SUPPORT FOR LONG COVID REGISTRIES.
(a) In General.--Not later than one year after the date of the
enactment of this Act, the Secretary of Health and Human Services,
acting through the Director of the Agency for Healthcare Research and
Quality shall, subject to appropriations pursuant to subsection (d),
award multi-year grants to eligible entities described in subsection
(b) for the purposes of--
(1) supporting existing or creating new Longitudinal
registries of patients with Long COVID (as defined in section
2(g));
(2) establishing voluntary standards for such registries
that include common data elements and clear data definitions to
enable the comparability and synchronization of data by
researchers;
(3) utilize data from such registries to help inform
understanding regarding the efficacy of care, diagnostics,
therapeutics, care pathways, behavioral health interventions,
and other dynamics regarding individuals with Long COVID; and
(4) informing health care providers' efforts related to
improving equitable access to health care by collecting data
through such registries from individuals with Long COVID,
including social needs, medical history, race and ethnicity,
language, gender, and disability status, as specified by the
Secretary of Health and Human Services.
(b) Eligible Entities.--
(1) In general.--To be eligible for a grant under
subsection (a) an entity shall--
(A) submit an application to the Secretary in such
form and manner as the Secretary may require;
(B) agree to adhere to such data definitions and
standards as the Secretary may require, including
privacy and security requirements, requirements to make
findings of the organization, and the use of open-
source technology to promote the dissemination of
information related to Long COVID;
(C) agree to make any information collected or
produced by the entity pursuant to the grant available
to the public through secure, non-proprietary means
without a paywall or fee;
(D) demonstrate to the Secretary, in a form and
manner specified by the Secretary, that the entity has
in place appropriate standards for handling
proprietary, confidential, and medical information
securely and in a manner that is compliant with
applicable law;
(E) have in place and demonstrate to the Secretary
the adequacy of a plan for the Longer-term financial
sustainability of such registry; and
(F) be an organization described in paragraph (2).
(2) Organizations.--For purposes of paragraph (1), an
organization described in this paragraph is any of the
following:
(A) A non-profit organization representative of
individuals with Long COVID.
(B) An organization of health care providers, such
as health systems and hospitals.
(C) An organization of data scientists.
(D) Multi-sector groups that consist of
organizations described in 2 or more of the preceding
subparagraphs that meet such standards as the Secretary
may require.
(c) Consideration.--In carrying out the purposes described in
subsection (a), an eligible entity shall take into consideration the
report made available under section 4(b).
(d) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $10,000,000 for each of fiscal
years 2024 through 2028.
SEC. 8. MEDICAID HEALTH HOMES FOR INDIVIDUALS WITH LONG COVID.
(a) Health Homes for Individuals With Chronic Conditions.--Section
1945(h)(1)(A)(ii) of the Social Security Act (42 U.S.C. 1396w-
4(h)(1)(A)(ii)) is amended--
(1) in subclause (II), by striking at the end ``or'';
(2) in subclause (III), by striking at the end the period
and inserting ``; or''; and
(3) by adding at the end the following new subclause:
``(IV) Long COVID (as defined in
section 2(g) of the Long COVID RECOVERY
NOW Act).''.
(b) Health Homes for Children With Medically Complex Conditions.--
Section 1945A(i)(1)(A)(ii) of the Social Security Act (42 U.S.C. 1396w-
4a(i)(1)(A)(ii)) is amended--
(1) in subclause (I), by striking at the end ``or'';
(2) in subclause (II), by striking at the end the period
and inserting ``; or''; and
(3) by adding at the end the following new subclause:
``(III) Long COVID (as defined in
section 2(g) of the Long COVID RECOVERY
NOW Act).''.
SEC. 9. STATE HEALTH OFFICIALS GUIDANCE.
Not later than 18 months after the date of the enactment of this
Act, the Secretary of Health and Human Services shall issue guidance to
State health officials specifying tools and strategies that may help
States improve the health and wellness of individuals enrolled under
the Medicaid program under title XIX of the Social Security Act or the
Children's Health Insurance Program under title XXI of such Act who
have been diagnosed with Long COVID by facilitating strong primary care
and supporting linkages to specialists, relevant social supports, or
community-based organizations at the local level, that can help support
the recovery and wellness of such individuals.
SEC. 10. SUPPORT UNDER MEDICAID FOR STATE COLLECTION OF LONG COVID
DATA.
Section 1903(a)(3) of the Social Security Act (42 U.S.C.
1396b(a)(3)) is amended by adding at the end the following new
subparagraph:
``(I) 75 percent of the sums expended during a fiscal year
quarter in 2024, 2025, or 2026 as are attributable to the
collection and reporting of claims and encounter data on Long
COVID (including identification of race, language, ethnicity,
and duration of treatment) using the ICD-10 code U09.9 post
COVID-19 condition, unspecified (or any successor to such
code);''.
SEC. 11. GRANTS FOR PEDIATRIC RESEARCH ON LONG COVID.
(a) In General.--The Secretary of Health and Human Services, acting
through the Director of the National Institutes of Health (in this
section, referred to as the ``Secretary''), shall award grants to
eligible entities to conduct research on Long COVID in pediatric
populations.
(b) Use of Funds.--An eligible entity selected to receive a grant
under this subsection may use funds received through the grant to
conduct research described in subsection (a), with a focus on pediatric
immune system responses and neurodevelopment.
(c) Eligible Entity Defined.--In this section, the term ``eligible
entity'' means a children's hospital, pediatric researcher,
pediatrician, academic medical center, or other organization determined
appropriate by the Secretary.
(d) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated such sums as may be necessary
for each of fiscal years 2024 through 2026.
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