[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3227 Introduced in House (IH)]
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118th CONGRESS
1st Session
H. R. 3227
To amend titles XVIII and XIX of the Social Security Act with respect
to nursing facility requirements, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 11, 2023
Mr. Estes (for himself and Mr. Connolly) 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 titles XVIII and XIX of the Social Security Act with respect
to nursing facility requirements, 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 ``Ensuring Seniors' Access to Quality
Care Act''.
SEC. 2. TRAINING AND COMPETENCY EVALUATION PROGRAMS.
(a) Medicare.--Section 1819(f)(2) of the Social Security Act (42
U.S.C. 1395i-3(f)(2)) is amended--
(1) in subparagraph (A)(iv)(I), by striking ``(unless the
facility is described in subparagraph (B)(iii)(I))'';
(2) in subparagraph (B)--
(A) in clause (i)--
(i) by striking ``(subject to clause
(iii))''; and
(ii) by inserting ``and'' after the
semicolon;
(B) in clause (ii), by striking ``; and'' and
inserting a period; and
(C) by striking clause (iii);
(3) by striking ``A State may not delegate (through
subcontract or otherwise) its responsibility under clause
(iii)(II) to the skilled nursing facility.'';
(4) by striking subparagraphs (C) and (D); and
(5) by adding at the end the following:
``(C) Disapproval of nurse aide training and
competency evaluation programs and nurse aide
competency evaluation programs.--
``(i) In general.--With respect to a State,
the Secretary shall, in consultation with such
State, disapprove, for a period not to exceed 2
years, a nurse aide training and competency
evaluation program or a nurse aide competency
evaluation program offered by or in a skilled
nursing facility if such facility--
``(I) has been assessed a civil
monetary penalty under subsection
(h)(2)(B)(ii) or section
1919(h)(2)(A)(ii) of not less than
$10,697 for providing substandard
quality of care; and
``(II) has not, in the
determination of the Secretary,
corrected the deficiencies in quality
of care for which such civil monetary
penalty was assessed.
``(ii) Rescission of disapproval.--The
Secretary shall rescind a disapproval under
clause (i) upon demonstration by a skilled
nursing facility that--
``(I) all deficiencies for which
the civil monetary penalty described in
clause (i)(I) was assessed have been
remedied;
``(II) the facility has not
received deficiencies related to direct
patient harm for substandard quality of
care deficiencies in the prior 2 years;
and
``(III) the Secretary certifies
that the civil monetary penalty
assessed under clause (i)(I) did not
result in immediate jeopardy for direct
patient harm or injury related to an
abuse or neglect deficiency.
For purposes of rescinding disapproval under
this clause, the Secretary may require
additional oversight of the skilled nursing
facility for a period not to exceed the period
of disapproval imposed under clause (i) with
respect to such facility.''.
(b) Medicaid.--Section 1919(f)(2) of the Social Security Act (42
U.S.C. 1396r(f)(2)) is amended--
(1) in subparagraph (A)(iv)(I), by striking ``(unless the
facility is described in subparagraph (B)(iii)(I))'';
(2) in subparagraph (B)--
(A) in clause (i), by inserting ``and'' after the
semicolon;
(B) in clause (ii), by striking ``; and'' and
inserting a period;
(C) by striking clause (iii); and
(D) by striking ``A State may not delegate (through
subcontract or otherwise) its responsibility under
clause (iii)(II) to the nursing facility.'';
(3) by striking subparagraphs (C) and (D); and
(4) by adding at the end the following:
``(C) Disapproval of nurse aide training and
competency evaluation programs and nurse aide
competency evaluation programs.--
``(i) In general.--With respect to a State,
the Secretary shall, in consultation with such
State, disapprove, for a period not to exceed 2
years, a nurse aide training and competency
evaluation program or a nurse aide competency
evaluation program offered by or in a nursing
facility if such facility--
``(I) has been assessed a civil
monetary penalty under section
1819(h)(2)(B)(ii) or subsection
(h)(2)(A)(ii) of not less than $10,697
for providing substandard quality of
care; and
``(II) has not, in the
determination of the Secretary,
corrected the deficiencies in quality
of care for which such civil monetary
penalty was assessed.
``(ii) Rescission of disapproval.--The
Secretary shall rescind a disapproval under
clause (i) upon demonstration by a nursing
facility that--
``(I) all deficiencies for which
the civil monetary penalty described in
clause (i)(I) was assessed have been
remedied;
``(II) the facility has not
received deficiencies related to direct
patient harm for substandard quality of
care deficiencies in the prior 2 years;
and
``(III) the Secretary certifies
that the civil monetary penalty
assessed under clause (i)(I) did not
result in immediate jeopardy for direct
patient harm or injury related to an
abuse or neglect deficiency.
For purposes of rescinding disapproval under
this clause, the Secretary may require
additional oversight of the nursing facility
for a period not to exceed the period of
disapproval imposed under clause (i) with
respect to such facility.''.
(c) Regulations.--Not later than 180 days after the date of
enactment of this Act, the Secretary of Health and Human Services shall
promulgate regulations as necessary to implement the amendments made by
this section.
(d) Applicability.--
(1) In general.--
(A) Timing of determinations.--The amendments made
by subsections (a)(4) and (b)(4) of this section shall
apply only to a civil monetary penalty if the relevant
covered determination was made on or after the date of
enactment of this Act.
(B) Covered determination defined.--The term
``covered determination'' means, with respect to a
skilled nursing facility or a nursing facility in a
State, a determination by the State or the Secretary of
Health and Human Services that the facility has
provided a substandard quality of care for which a
civil monetary penalty described in section
1819(f)(2)(C)(i)(I) or 1919(f)(2)(C)(i)(I) of the
Social Security Act (as such sections have been amended
by this Act) may be assessed.
(2) Previously prohibited programs.--
(A) Waiver.--With respect to a skilled nursing
facility or a nursing facility subject, on the day
before the date of enactment of this Act, to a
prohibition under item (a) of either section
1819(f)(2)(B)(iii)(I) or section 1919(f)(2)(B)(iii)(I)
of the Social Security Act (as in effect on the day
before such date of enactment), such prohibition shall
no longer apply to the facility on or after such date
of enactment.
(B) Survey or civil monetary penalty.--With respect
to a skilled nursing facility or a nursing facility
subject, on the day before the date of enactment of
this Act, to a prohibition under item (b) or (c) of
either section 1819(f)(2)(B)(iii)(I) or section
1919(f)(2)(B)(iii)(I) of the Social Security Act (as in
effect on the day before such date of enactment), such
prohibition shall no longer apply to the facility on or
after such date of enactment upon a determination by
the Secretary of Health and Human Services that the
facility has corrected the issue that resulted in such
prohibition.
SEC. 3. PERMITTING MEDICARE AND MEDICAID PROVIDERS TO ACCESS THE
NATIONAL PRACTITIONER DATA BANK TO CONDUCT EMPLOYEE
BACKGROUND CHECKS.
Section 1921(b)(6) of the Social Security Act (42 U.S.C. 1396r-
2(b)(6)) is amended--
(1) by striking ``and other health care entities (as
defined in section 431 of the Health Care Quality Improvement
Act of 1986)'' and inserting ``, other health care entities (as
defined in section 431 of the Health Care Quality Improvement
Act of 1986), providers of services (as defined in section
1861(u)), suppliers (as defined in section 1861(d)), and
providers of items or services under a State plan under this
title (or a waiver of such a plan)''; and
(2) by striking ``such hospitals or other health care
entities'' and inserting ``such hospitals, health care
entities, providers, or suppliers''.
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