,i  #aaeth ,,congress  #ast ,session    
,h4 ,r4 #bggi  ,,in ,,the ,,house ,,of  
,,representatives  ,june #f1 #bjag,mr4  
,denham 7for himself and ,mr4 ,valadao7 
introduced the following bill2 which was
 referred to the ,committee on ,energy  
and ,commerce  ,a ,,bill  ,to amend     
title ,,xi of the ,social ,security ,act
 to provide through the ,center for     
,medicare and ,medicaid ,innovation     
7,,cmmi7 for a ,medicaid payment model  
demonstration project on ,medicaid      
reimbursement for physicians' services  
in counties with a disproportionately   
high proportion of ,medicaid enrollees4 
#a4 ,short title ,this ,act may be cited
 as the ,assessing ,critical ,care      
,efforts to ,strengthen ,services       
7,,access7 ,act of #bjag4  #b4 ,,cmmi   
,medicaid payment model demonstration   
project on ,medicaid reimbursement for  
physicians' services in counties with a 
disproportionately high proportion of   
,medicaid enrollees ,section #aaae;,a7b7
 of the ,social ,security ,act 7#db     

,u4,s4,c4 #acae;a7b77 is amended--  7#a7
 in paragraph 7#b77;,b71 by adding at   
the end the following new clause3  7xxv7
 ,focusing on payment models under title
 ,,xix for recruiting and retaining     
physicians to serve low-income          
applicable individuals residing in      
disproportionate share counties 7as     
defined in paragraph 7#e77;,d774  2 and 
7#b7 by adding at the end the following 
new paragraph3  7#e7 ,medicaid          
physicians' service model for low-income
 individuals in disproportionate share  
counties  7,a7 ,selection ,beginning not
 later than #f months after the date of 
the enactment of this paragraph1 the    
,secretary shall select for testing one 
or more models described in paragraph   
7#b77;,b77xxv74  7,b7 ,design ,in       
selecting1 and designing the testing    
for1 such a model under this subsection1
 ,,cmi shall-- 7i7 review the most      
successful models for recruiting and    
retaining physicians to serve low-income
 applicable individuals residing in a   

disproportionate share county 7as       
defined in subparagraph 7,d772 and  7ii7
 incorporate lessons from successful    
strategies that take into account how   
access to physicians' services has      
improved for such individuals4  7,c7    
,evaluation ,in evaluating the          
performance of such a model under       
paragraph 7#d71 ,,cmi shall-- 7i7       
evaluate the applicability and expansion
 of the model to inform national        
strategies to best leverage funds under 
title ,,xix to improve access to        
physicians' services for low-income     
applicable individuals residing in a    
disproportionate share county2 and  7ii7
 examine the degree to which ,medicaid  
payment strategies 7such as the use of  
primary case management1 medical homes1 
and palliative care1 the use of payment 
rates for physicians' services that are 
not less than the ,medicare payment     
rates that apply to such care and       
services under part ,b of title ,,xviii1
 and allowing ,federally-qualified      

health centers to contract with         
specialty physicians to be paid at      
,federally-qualified health center      
payment rates for services furnished in 
a physician's office71 including such   
strategies as modified through such a   
model1 improve access1 outcomes1 and    
patient satisfaction for such           
individuals and reduce emergency        
department utilization by such          
individuals4  7,d7 ,disproportionate    
share county defined ,in this paragraph1
 the term disproportionate share county 
means a county in which at least #ce    
percent of the residents of the county  
are enrolled under the ,state plan under
 title ,,xix 7or under a waiver of such 
plan74  4