,,ib ,union ,calendar ,no4 #daa #aafth ,,congress #b;d ,session ,h4 ,r4 #cice ,report ,no4 #aaf-eaa ,,in ,,the ,,house ,,of ,,representatives ,july #bd1 #bjai,mr4 ,carter of ,georgia 7for himself1 ,mr4 ,crdenas1 ,mr4 ,graves of ,georgia1 and ,mr4 ,bishop of ,georgia7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,september #ag1 #bjbj;,additional sponsors3 ,mr4 ,luetkemeyer1 ,ms4 ,kuster of ,new ,hampshire1 ,mr4 ,rush1 ,mr4 ,neguse1 ,mrs4 ,rodgers of ,washington1 ,mr4 ,kilmer1 ,mr4 ,griffith1 and ,mr4 ,soto ,september #ag1 #bjbj,reported with an amendment2 committed to the ,committee of the ,whole ,house on the ,state of the ,union and ordered to be printed,strike out all after the enacting clause and insert the part printed in italic,for text of introduced bill1 see copy of bill as introduced on ,july #bd1 #bjai ,a ,,bill ,to amend title ,,xix of the ,social ,security ,act to provide for the continuing requirement of ,medicaid coverage of nonemergency transportation to medically necessary services4 #a4 ,short title ,this ,act may be cited as the ,protecting ,patients ,transportation to ,care ,act4 #b4 ,medicaid coverage of certain medical transportation 7a7 ,continuing requirement of medicaid coverage of necessary transportation 7#a7 ,requirement ,section #aijb7;a77#d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#d77 is amended-- 7,a7 by striking and including provision for utilization and inserting including provision for utilization2 and 7,b7 by inserting after supervision of administration of the plan the following3 1 and1 subject to section #aijc7;i71 including a specification that the single ,state agency described in paragraph 7#e7 will ensure necessary transportation for beneficiaries under the ,state plan to and from providers and a description of the methods that such agency will use to ensure such transportation4 7#b7 ,application with respect to benchmark benefit packages and benchmark equivalent coverage ,section #aicg7;a77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifu-#g7;a77#a77 is amended-- 7,a7 in subparagraph 7,a71 by striking subsection 7,e7 and inserting subparagraphs 7,e7 and 7,f72 and 7,b7 by adding at the end the following new subparagraph3 7,f7 ,necessary transportation ,notwithstanding the preceding provisions of this paragraph1 a ,state may not provide medical assistance through the enrollment of an individual with benchmark coverage or benchmark equivalent coverage described in subparagraph 7,a77i7 unless1 subject to section #aijc7;i77#i7 and in accordance with section #aijb7;a77#d71 the benchmark benefit package or benchmark equivalent coverage 7or the ,state7-- 7i7 ensures necessary transportation for individuals enrolled under such package or coverage to and from providers2 and 7ii7 provides a description of the methods that will be used to ensure such transportation4 4 7#c7 ,limitation on federal financial participation ,section #aijc7;i7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7i77 is amended by inserting after paragraph 7#h7 the following new paragraph3 7#i7 with respect to any amount expended for non-emergency transportation authorized under section #aijb7;a77#d71 unless the ,state plan provides for the methods and procedures required under section #aijb7;a77#cj77;,a72 or 4 7#d7 ,effective date ,the amendments made by this subsection shall take effect on the date of the enactment of this ,act and shall apply to transportation furnished on or after such date4 7b7 ,medicaid program integrity measures related to coverage of nonemergency medical transportation 7#a7 ,gao study ,not later than two years after the date of the enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall conduct a study1 and submit to ,congress1 a report on coverage under the ,medicaid program under title ,,xix of the ,social ,security ,act of nonemergency transportation to medically necessary services4 ,such study shall take into account the #bjji report of the ,office of the ,inspector ,general of the ,department of ,health and ,human ,services1 titled ,fraud and ,abuse ,safeguards for ,medicaid ,nonemergency ,medical ,transportation 7,,oei-#jf-jg-jjcbjj74 ,such report shall include the following3 7,a7 ,an examination of the #ej ,states and the ,district of ,columbia to identify safeguards to prevent and detect fraud and abuse with respect to coverage under the ,medicaid program of nonemergency transportation to medically necessary services4 7,b7 ,an examination of transportation brokers to identify the range of safeguards against such fraud and abuse to prevent improper payments for such transportation4 7,c7 ,identification of the numbers1 types1 and outcomes of instances of fraud and abuse1 with respect to coverage under the ,medicaid program of such transportation1 that ,state ,medicaid ,fraud ,control ,units have investigated in recent years4 7,d7 ,identification of commonalities or trends in program integrity1 with respect to such coverage1 to inform risk management strategies of ,states and the ,centers for ,medicare ,medicaid ,services4 7#b7 ,stakeholder working group 7,a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,health and ,human ,services1 through the ,centers for ,medicare ,medicaid ,services1 shall convene a series of meetings to obtain input from appropriate stakeholders to facilitate discussion and shared learning about the leading practices for improving ,medicaid program integrity1 with respect to coverage of nonemergency transportation to medically necessary services4 7,b7 ,topics ,the meetings convened under subparagraph 7,a7 shall-- 7i7 focus on ongoing challenges to ,medicaid program integrity as well as leading practices to address such challenges2 and 7ii7 address specific challenges raised by stakeholders involved in coverage under the ,medicaid program of nonemergency transportation to medically necessary services1 including unique considerations for specific groups of ,medicaid beneficiaries meriting particular attention1 such as ,american ,indians and tribal land issues or accommodations for individuals with disabilities4 7,c7 ,stakeholders ,stakeholders described in subparagraph 7,a7 shall include individuals from ,state ,medicaid programs1 brokers for nonemergency transportation to medically necessary services that meet the criteria described in section #aijb7;a77#gj77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#gj77;,b771 providers 7including transportation network companies71 ,medicaid patient advocates1 and such other individuals specified by the ,secretary4 7#c7 ,guidance review ,not later than #ah months after the date of the enactment of this ,act1 the ,secretary of ,health and ,human ,services1 through the ,centers for ,medicare ,medicaid ,services1 shall assess guidance issued to ,states by the ,centers for ,medicare ,medicaid ,services relating to ,federal requirements for nonemergency transportation to medically necessary services under the ,medicaid program under title ,,xix of the ,social ,security ,act and update such guidance as necessary to ensure ,states have appropriate and current guidance in designing and administering coverage under the ,medicaid program of nonemergency transportation to medically necessary services4 7#d7 ,nemt transportation provider and driver requirements 7,a7 ,state plan requirement ,section #aijb7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77 is amended-- 7i7 by striking and at the end of paragraph 7#he72 7ii7 by striking the period at the end of paragraph 7#hf7 and inserting 2 and2 and 7iii7 by inserting after paragraph 7#hf7 the following new paragraph3 7#hg7 provide for a mechanism1 which may include attestation1 that ensures that1 with respect to any provider 7including a transportation network company7 or individual driver of nonemergency transportation to medically necessary services receiving payments under such plan 7but excluding any public transit authority71 at a minimum-- 7,a7 each such provider and individual driver is not excluded from participation in any ,federal health care program 7as defined in section #aabh;,b7f77 and is not listed on the exclusion list of the ,inspector ,general of the ,department of ,health and ,human ,services2 7,b7 each such individual driver has a valid driver's license2 7,c7 each such provider has in place a process to address any violation of a ,state drug law2 and 7,d7 each such provider has in place a process to disclose to the ,state ,medicaid program the driving history1 including any traffic violations1 of each such individual driver employed by such provider1 including any traffic violations4 4 7,b7 ,effective date 7i7 ,in general ,except as provided in clause 7ii71 the amendments made by subparagraph 7,a7 shall take effect on the date of the enactment of this ,act and shall apply to services furnished on or after the date that is one year after the date of the enactment of this ,act4 7ii7 ,exception if state legislation required ,in the case of a ,state plan for medical assistance under title ,,xix of the ,social ,security ,act which the ,secretary of ,health and ,human ,services determines requires ,state legislation 7other than legislation appropriating funds7 in order for the plan to meet the additional requirement imposed by the amendments made by subparagraph 7,a71 the ,state plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet this 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 ,act4 ,for purposes of the previous sentence1 in the case of a ,state that has a #b-year legislative session1 each year of such session shall be deemed to be a separate regular session of the ,state legislature4 7#e7 ,analysis of t-msis data ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,health and ,human ,services1 through the ,centers for ,medicare ,medicaid ,services1 shall analyze1 and submit to ,congress a report on1 the nation-wide data set under the ,transformed ,medicaid ,statistical ,information ,system to identify recommendations relating to coverage under the ,medicaid program under title ,,xix of the ,social ,security ,act of nonemergency transportation to medically necessary services4 ,september #ag1 #bjbj,reported with an amendment2 committed to the ,committee of the ,whole ,house on the ,state of the ,union and ordered to be printed