Medicaid DOC Act

Medicaid Directory of Caregivers Act or the Medicaid DOC Act

(Sec. 2) This bill amends title XIX (Medicaid) of the Social Security Act to require a state to publish and annually update a directory of providers that participate in the state plan for medical assistance on a fee-for-service basis or through a primary care case-management system. The directory must include each provider's name, specialty, address, and telephone number. In addition, with respect to a provider that participates in a primary care case-management system, the directory must specify: (1) the provider's language capabilities, and (2) whether the provider is accepting new Medicaid patients.

[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3821 Introduced in House (IH)]

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114th CONGRESS
  1st Session
                                H. R. 3821

 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

_______________________________________________________________________

                                 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) that received payment under the 
        State plan in the preceding 12-month period 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) 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).
            (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.
    (c) 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.
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