End Valley Fever Now Act
This bill provides various supports to address the occurrence of valley fever, which is an infection caused by the fungus Coccidioides that is commonly found in the southwestern United States as well as parts of Mexico, Central America, and South America.
[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5438 Introduced in House (IH)]
<DOC>
116th CONGRESS
1st Session
H. R. 5438
To direct the Secretary of Health and Human Services, acting through
the Director of the Centers for Disease Control and Prevention, to
award grants to develop programs to increase health care providers'
awareness of Valley fever, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
December 16, 2019
Mr. Cox of California (for himself, Mr. Harder of California, Mr.
Costa, Mr. Gallego, Mr. O'Halleran, Mrs. Kirkpatrick, Mr. Panetta, and
Mr. Grijalva) 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 direct the Secretary of Health and Human Services, acting through
the Director of the Centers for Disease Control and Prevention, to
award grants to develop programs to increase health care providers'
awareness of Valley fever, 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 ``End Valley Fever Now Act''.
SEC. 2. GRANTS TO DEVELOP PROGRAMS TO INCREASE HEALTH CARE PROVIDERS'
AWARENESS OF VALLEY FEVER.
Part P of title III of the Public Health Service Act (42 U.S.C.
280g et seq.) is amended by adding at the end the following:
``SEC. 399V-7. GRANTS TO DEVELOP PROGRAMS TO INCREASE HEALTH CARE
PROVIDERS' AWARENESS OF VALLEY FEVER.
``(a) In General.--The Secretary, acting through the Administrator
of the Health Resources and Services Administration and in consultation
with the Director of the Centers for Disease Control and Prevention,
shall make awards of grants or cooperative agreements to eligible
entities to establish and carry out programs--
``(1) to increase health care providers' awareness of
Valley fever; and
``(2) to educate and train health care providers on the
diagnosis and treatment of Valley fever.
``(b) Use of Funds.--An eligible entity selected to receive a grant
or contract under this section shall use amounts awarded under such a
grant or contract to provide innovative supportive activities (which
may include activities that do not rely on the use of broadband
services) to enhance education through distance learning, continuing
educational activities, collaborative conferences, and electronic and
telelearning activities.
``(c) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $1,000,000 for the period of
fiscal years 2021 through 2023, to remain available until expended.
``(d) Condition.--A recipient of a grant under this section shall,
as a condition on receipt of the grant, agree to develop curricula for
the purposes specified in subsection (a) in coordination with local
providers at hospitals and clinics.
``(e) Definitions.--In this section:
``(1) The term `eligible entity' means--
``(A) a State department of health (or similar
State authority);
``(B) an institution of higher education (as
defined in section 101 of the Higher Education Act of
1965 (20 U.S.C. 1001)), including a medical school or
continuing medical education program at such
institution;
``(C) an entity operating a graduate medical
residency training program under section 340E or under
section 340H; or
``(D) a teaching hospital (as defined in section
415.152 of title 42, Code of Federal Regulations) that
has physicians and other medical providers with
specialized knowledge in diagnosing and treating Valley
fever.
``(2) The term `Valley fever' means the condition caused by
Coccidioidomycosis.''.
SEC. 3. STUDY COMPARING DIFFERENT CASE DEFINITIONS USED TO IDENTIFY
VALLEY FEVER.
(a) In General.--The Secretary of Health and Human Services, acting
through the Director of the Centers for Disease Control and Prevention
shall conduct a study comparing different case definitions used to
identify valley fever. Such study shall include the efficacy of the
methods being used to establish such case definitions and the cost
effectiveness of such methods, including using the case definition for
valley fever established by the Council of State and Territorial
Epidemiologist.
(b) Valley Fever Defined.--In this Act, the term ``Valley fever''
has the meaning given the term in section 399V-7 of the Public Health
Service Act.
SEC. 4. ALLOWING STATES TO PROVIDE COVERAGE UNDER THE MEDICAID PROGRAM
FOR ITEMS AND SERVICES FURNISHED IN CONNECTION WITH
QUALIFYING VALLEY FEVER CLINICAL TRIALS.
(a) In General.--Section 1905(a) of the Social Security Act (42
U.S.C. 1396d(a)) is amended--
(1) in paragraph (29), by striking ``and'' at the end;
(2) by redesignating paragraph (30) as paragraph (31); and
(3) by inserting after paragraph (29) the following new
paragraph:
``(30) items and services furnished in connection with
participation in a qualifying Valley fever clinical trial (as
defined in section 2709A(b)(4) of the Public Health Service
Act), including travel and incidental expenses, regardless of
whether such items and services are furnished by a
participating provider under the Medicaid program (other than a
provider excluded from participation in such program under
section 1128) or whether such items and services are furnished
in another State; and''.
(b) Reduction in FMAP for States That Do Not Provide Coverage.--
Section 1905 of the Social Security Act (42 U.S.C. 1396d) is amended--
(1) in subsection (b), by striking ``and (ff)'' and
inserting ``(ff), and (gg)''; and
(2) by adding at the end the following new subsection:
``(gg) Reduction in FMAP for States That Do Not Provide Coverage
for Certain Items and Services.--With respect to a calendar quarter
beginning on or after January 1, 2021, the Federal medical assistance
percentage otherwise determined under subsection (b) for a State that
does not provide coverage for items and services described in
subsection (a)(30) that are furnished during such quarter shall be
reduced by 5 percentage points.''.
(c) Ensuring Access for Medicaid Expansion Population.--Section
1937(b)(5) of such Act is amended by inserting before the period at the
end the following: ``, and beginning January 1, 2021, coverage of items
and services described in section 1905(a)(30)''.
(d) Prohibition on Imposition of Costsharing Requirements.--Title
XIX of the Social Security Act (42 U.S.C. 1396 et seq.) is amended--
(1) in section 1916(a)(2)--
(A) in subparagraph (D), by striking ``or'' at the
end;
(B) in subparagraph (E), by striking ``; and'' at
the end and inserting ``, or''; and
(C) by adding at the end the following new
subparagraph:
``(F) items and services described in section
1905(a)(30); and''; and
(2) in section 1916A(b)(3)(B), by adding at the end the
following new clause:
``(xi) Items and services described in
section 1905(a)(30).''.
(e) Continuous Coverage for Individuals Who Lose Medicaid
Eligibility Based on Income.--Section 1902(e) of the Social Security
Act (42 U.S.C. 1396a(e)) is amended by adding at the end the following
new paragraph:
``(16) Continuous coverage for items and services furnished
in connection with qualifying valley fever clinical trials.--In
the case of an individual who is eligible for medical
assistance under the State plan (or a waiver of such plan)
based on the application of modified adjusted gross income
under paragraph (14)(A), who while so eligible is furnished
items and services described in section 1905(a)(30) in
connection with participation in a qualifying Valley fever
clinical trial (as defined in section 2709A(b)(4) of the Public
Health Service Act), and who while so furnished such items and
services loses eligibility for such medical assistance due to a
change in income of the family of which such individual is a
member, such individual shall be deemed to continue to be an
individual eligible for such medical assistance, without regard
to such change in income, only with respect to such items and
services through the end of the month in which such qualifying
Valley fever clinical trial ends.''.
(f) Effective Date.--
(1) In general.--The amendments made by this section shall
apply with respect to items and services furnished, and
eligibility determinations made, on or after January 1, 2021.
(2) 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.) that the Secretary of Health and Human
Services determines requires State legislation in order for the
respective plan to meet any requirement 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 the enactment
of this Act. 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.
SEC. 5. REQUIREMENT FOR GROUP HEALTH PLANS AND HEALTH INSURANCE ISSUERS
TO PROVIDE COVERAGE FOR ITEMS AND SERVICES FURNISHED IN
CONNECTION WITH QUALIFYING VALLEY FEVER CLINICAL TRIALS.
(a) In General.--Subpart I of part A of title XXVII of the Public
Health Service Act (42 U.S.C. 300gg et seq.) is amended--
(1) by redesignating the second section 2709 as section
2710; and
(2) by inserting after the first section 2709 the following
new section:
``SEC. 2709A. COVERAGE FOR INDIVIDUALS PARTICIPATING IN QUALIFYING
VALLEY FEVER CLINICAL TRIALS.
``(a) In General.--Notwithstanding section 2709, a group health
plan or health insurance issuer offering group or individual health
insurance coverage shall, with respect to an enrollee of such plan or
coverage, respectively, provide coverage for any item or service
furnished to such enrollee in connection with such enrollee's
participation in a qualifying Valley fever clinical trial, including
travel and incidental expenses--
``(1) without regard to whether such item or service is
furnished by a participating provider or participating facility
with respect to such item or service; and
``(2) in a manner so that, if such item or service is
furnished to such enrollee by a nonparticipating provider or
nonparticipating facility, the cost-sharing requirement
(expressed as a copayment amount or coinsurance rate) is not
greater than the requirement that would apply if such item or
service were furnished by a participating provider or
participating facility.
``(b) Definitions.--In this section:
``(1) Nonparticipating facility; participating facility.--
``(A) Nonparticipating facility.--The term
`nonparticipating facility' means, with respect to an
item or service and a group health plan or group or
individual health insurance coverage, a health care
facility that does not have a contractual relationship
with the sponsor of such plan or issuer of such
coverage for furnishing such item or service under the
plan or coverage.
``(B) Participating facility.--The term
`participating facility' means, with respect to an item
or service and a group health plan or group or
individual health insurance coverage, a health care
facility that has a contractual relationship with the
sponsor of such plan or issuer of such coverage for
furnishing such item or service under the plan or
coverage.
``(2) Nonparticipating provider; participating provider.--
``(A) Nonparticipating provider.--The term
`nonparticipating provider' means, with respect to an
item or service and a group health plan or group or
individual health insurance coverage, a physician or
other health care provider who is acting within the
scope of practice of that provider's license or
certification under applicable State law and who does
not have a contractual relationship with the sponsor of
such plan or issuer of such coverage for furnishing
such item or service under the plan or coverage.
``(B) Participating provider.--The term
`participating provider' means, with respect to an item
or service and a group health plan or group or
individual health insurance coverage, a physician or
other health care provider who is acting within the
scope of practice of that provider's license or
certification under applicable State law and who has a
contractual relationship with the sponsor of such plan
or issuer of such coverage for furnishing such item or
service under the plan or coverage.
``(3) Qualifying valley fever clinical trial.--
``(A) In general.--The term `qualifying Valley
fever clinical trial' means a phase I, phase II, phase
III, or phase IV clinical trial that is conducted in
relation to the prevention, detection, or treatment of
Valley fever (as defined in section 399V-7) and is
described in any of the following clauses:
``(i) The study or investigation is
approved or funded (which may include funding
through in-kind contributions) by one or more
of the following:
``(I) The National Institutes of
Health.
``(II) The Centers for Disease
Control and Prevention.
``(III) The Agency for Healthcare
Research and Quality.
``(IV) The Centers for Medicare &
Medicaid Services.
``(V) A cooperative group or center
of any of the entities described in
subclauses (I) through (IV) or the
Department of Defense or the Department
of Veterans Affairs.
``(VI) A qualified non-governmental
research entity identified in the
guidelines issued by the National
Institutes of Health for center support
grants.
``(VII) Any of the following if the
conditions described in subparagraph
(B) are met:
``(aa) The Department of
Veterans Affairs.
``(bb) The Department of
Defense.
``(cc) The Department of
Energy.
``(ii) The clinical trial is conducted
under an investigational new drug application
reviewed by the Food and Drug Administration.
``(iii) The clinical trial is a drug trial
that is exempt from having such an
investigational new drug application.
``(B) Conditions.--For purposes of subparagraph
(A)(i)(VII), the conditions described in this
subparagraph, with respect to a clinical trial approved
or funded by an entity described in such subparagraph
(A)(i)(VII), are that the clinical trial has been
reviewed and approved through a system of peer review
that the Secretary determines--
``(i) to be comparable to the system of
peer review of studies and investigations used
by the National Institutes of Health; and
``(ii) assures unbiased review of the
highest scientific standards by qualified
individuals with no interest in the outcome of
the review.''.
(b) Effective Date.--The amendments made by this section shall
apply with respect to plan years beginning on or after January 1, 2021.
SEC. 6. MEDICARE COVERAGE OF ITEMS AND SERVICES FURNISHED IN CONNECTION
WITH QUALIFYING VALLEY FEVER CLINICAL TRIALS.
(a) Coverage.--Section 1861(s)(2) of the Social Security Act (42
U.S.C. 1395x(s)(2)) is amended--
(1) in subparagraph (GG), by striking ``and'' at the end;
(2) in subparagraph (HH), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following new subparagraph:
``(II) items and services furnished in connection with
participation in a qualifying Valley fever clinical trial (as
defined in section 2709A(b)(4) of the Public Health Service
Act), including travel and incidental expenses;''.
(b) Payment.--Section 1833(a)(1) of the Social Security Act (42
U.S.C. 1395l(a)(1)) is amended--
(1) by striking ``and (CC)'' and inserting ``(CC)''; and
(2) by inserting before the semicolon at the end the
following: ``, and (DD) with respect to items and services
described in section 1861(s)(2)(II), the amount paid shall be
100 percent of the lesser of the actual charge for the services
or the amount determined under the payment basis determined
under section 1848''.
<all>
Introduced in House
Introduced in House
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.
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.
Referred to the Subcommittee on Health.
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