,i  #aae? ,,congress  #a/ ,session  ,h4 
,r4 #bggi  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,june #f1 #bjag,mr4   
,d5ham 7= himself & ,mr4 ,valadao7      
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce  ,a  
,,bill  ,to am5d title ,,xi ( ! ,social 
,security ,act to provide ?r\gh ! ,c5t] 
= ,m$ic>e & ,m$icaid ,innovation        
7,,cmmi7 = a ,m$icaid paym5t model      
demon/ration project on ,m$icaid        
reimbursem5t = physicians' s]vices 9    
c\nties ) a disproportionately high     
proportion ( ,m$icaid enrollees4  #a4   
,%ort title ,?is ,act may be cit$ z !   
,assess+ ,critical ,c>e ,ef=ts to       
,/r5g!n ,s]vices 7,,access7 ,act (      
#bjag4  #b4 ,,cmmi ,m$icaid paym5t model
 demon/ration project on ,m$icaid       
reimbursem5t = physicians' s]vices 9    
c\nties ) a disproportionately high     
proportion ( ,m$icaid enrollees ,section
 #aaae;,a7b7 ( ! ,social ,security ,act 
7#db ,u4,s4,c4 #acae;a7b77 is am5d$--   
7#a7 9 p>agraph 7#b77;,b71 by add+ at ! 

end ! foll[+ new clause3  7xxv7 ,focus+ 
on paym5t models "u title ,,xix =       
recruit+ & reta9+ physicians to s]ve    
l[-income applicable individuals resid+ 
9 disproportionate %>e c\nties 7z def9$ 
9 p>agraph 7#e77;,d774  2 &  7#b7 by    
add+ at ! end ! foll[+ new p>agraph3    
7#e7 ,m$icaid physicians' s]vice model =
 l[-income individuals 9                
disproportionate %>e c\nties  7,a7      
,selection ,beg9n+ n lat] ?an #f mon?s  
aft] ! date ( ! enactm5t ( ?is p>agraph1
 ! ,secret>y %all select = te/+ "o or m 
models describ$ 9 p>agraph              
7#b77;,b77xxv74  7,b7 ,design ,9        
select+1 & design+ ! te/+ =1 su* a model
 "u ?is subsection1 ,,cmi %all-- 7i7    
review ! mo/ successful models =        
recruit+ & reta9+ physicians to s]ve    
l[-income applicable individuals resid+ 
9 a disproportionate %>e c\nty 7z def9$ 
9 subp>agraph 7,d772 &  7ii7 incorporate
 lessons f successful /rategies t take  
into acc\nt h[ access to physicians'    
s]vices has improv$ = su* individuals4  

7,c7 ,evaluation ,9 evaluat+ ! p]=mance 
( su* a model "u p>agraph 7#d71 ,,cmi   
%all-- 7i7 evaluate ! applicability &   
expansion ( ! model to in=m national    
/rategies to be/ lev]age funds "u title 
,,xix to improve access to physicians'  
s]vices = l[-income applicable          
individuals resid+ 9 a disproportionate 
%>e c\nty2 &  7ii7 exam9e ! degree to   
:i* ,m$icaid paym5t /rategies 7su* z !  
use ( prim>y case managem5t1 m$ical     
homes1 & palliative c>e1 ! use ( paym5t 
rates = physicians' s]vices t are n less
 ?an ! ,m$ic>e paym5t rates t apply to  
su* c>e & s]vices "u "p ,b ( title      
,,xviii1 & all[+ ,f$]ally-qualifi$ heal?
 c5t]s to contract ) specialty          
physicians to be paid at                
,f$]ally-qualifi$ heal? c5t] paym5t     
rates = s]vices furni%$ 9 a physician's 
(fice71 includ+ su* /rategies z modifi$ 
?r\gh su* a model1 improve access1      
outcomes1 & pati5t satisfaction = su*   
individuals & r$uce em]g5cy dep>tm5t    
utilization by su* individuals4  7,d7   

,disproportionate %>e c\nty def9$ ,9 ?is
 p>agraph1 ! t]m disproportionate %>e   
c\nty means a c\nty 9 :i* at lea/ #ce   
p]c5t ( ! resid5ts ( ! c\nty are enroll$
 "u ! ,/ate plan "u title ,,xix 7or "u a
 waiv] ( su* plan74  4