,i  #aaf? ,,congress  #a/ ,session  ,h4 
,r4 #ecbf  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,decemb] #e1 #bjai,ms4
 ,sn*ez 7= h]self & ,ms4 ,s*ak[sky7     
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,ways & ,means1 & 9    
addition to ! ,committee on ,en]gy &    
,comm]ce1 = a p]iod to be subsequ5tly   
det]m9$ by ! ,speak]1 9 ea* case =      
consid]ation ( su* provisions z fall )9 
! jurisdiction ( ! committee conc]n$  ,a
 ,,bill  ,to am5d titles ,,xviii & ,,xix
 ( ! ,social ,security ,act to prohibit 
skill$ nurs+ facilities & nurs+         
facilities f us+ pre-dispute arbitration
 agreem5ts ) respect to resid5ts ( ^?   
facilities "u ! ,m$ic>e & ,m$icaid      
programs1 & = o!r purposes4  #a4 ,%ort  
title ,?is ,act may be cit$ z !         
,fairness 9 ,nurs+ ,home ,arbitration   
,act4  #b4 ,prohibit+ pre-dispute       
arbitration agreem5ts  7a7 ,m$ic>e      
,section #ahai7;c7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #acie;i-#c7;c77 is 
am5d$ by add+ at ! end ! foll[+ new     

p>agraph3  7#g7 ,prohibition on use (   
pre-dispute arbitration agreem5ts  7,a7 
,9 g5]al ,a skill$ nurs+ facility may n 
require1 solicit1 accept1 or move to    
en=ce a pre-dispute arbitration agreem5t
 f or on behalf ( any resid5t1 :e!r !   
agreem5t is made be=e1 dur+1 or aft] !  
resid5t's admission to ! facility4  7,b7
 ,application ,?is p>agraph %all apply  
to ! skill$ nurs+ facility & to any o!r 
bus9ess or p]son provid+ or responsible 
= provid+ skill$ nurs+ s]vices to !     
resid5t4  7,c7 ,no validity or en=cem5t 
,a pre-dispute arbitration agreem5t %all
 n be valid or specifically en=ceable   
aga9/ a resid5t or =m] resid5t ( a      
skill$ nurs+ facility1 )\t reg>d to :e!r
 ! agreem5t 0 made prior to or aft] !   
effective date ( ?is p>agraph4  7,d7    
,def9ition ( pre-dispute arbitration    
agreem5t ,9 ?is p>agraph1 ! t]m         
pre-dispute arbitration agreem5t means  
any agreem5t to arbitrate a dispute :5 !
 dispute has aris5 aft] su* agreem5t has
 be5 made4  7,e7 ,judicial review ,a    

det]m9ation z to :e!r & h[ ?is p>agraph 
applies to an arbitration agreem5t %all 
be det]m9$ "u ,f$]al law by a c\rt (    
compet5t jurisdiction1 r ?an an         
arbitrator1 )\t reg>d to :e!r ! p>ty    
oppos+ arbitration *all5ges su* agreem5t
 specifically or 9 conjunction ) any o!r
 t]m ( ! contract conta9+ su* agreem5t4 
4  7b7 ,m$icaid  7#a7 ,home &           
community-bas$ s]vices & home heal? c>e 
s]vices ,section #aiae ( ! ,social      
,security ,act 7#db ,u4,s4,c4 #acifn7 is
 am5d$ by add+ at ! end ! foll[+ new    
subsection3  7m7 ,prohibit+ pre-,dispute
 arbitration agreem5ts  7#a7 ,9 g5]al ,=
 home & community-bas$ s]vices or home  
heal? c>e s]vices provid$ "u a waiv] "u 
?is section1 section                    
#aijb7;a77#aj77;,d71 or any o!r         
provision au?oriz+ ! provision ( home & 
community-bas$ s]vices or home heal? c>e
 s]vices "u ?is title1 ! provid] ( su*  
s]vices 7& any employee1 ag5t1 relat$   
entity1 or affiliate ( su* provid]7 may 
n require1 solicit1 accept1 or move to  

en=ce a pre-dispute arbitration agreem5t
 f or on behalf ( any individual receiv+
 su* s]vices1 :e!r ! agreem5t is made   
be=e1 dur+1 or aft] ! fir/ date on :i*  
s]vices are receiv$4 ,a pre-dispute     
arbitration agreem5t betwe5 su* a       
provid] 7or entity or p]son7 & an       
individual receiv+ s]vices 7or :o =m]ly 
receiv$ s]vices7 %all n be valid or     
en=ceable1 )\t reg>d to :e!r su*        
agreem5t 0 made prior to ! effective    
date ( ?is subsection4  7#b7 ,def9ition 
( pre-dispute arbitration agreem5t ,!   
t]m pre-dispute arbitration agreem5t    
means any agreem5t to arbitrate a       
dispute :5 ! dispute has aris5 aft] su* 
agreem5t has be5 made4  7#c7 ,judicial  
review ,a det]m9ation z to :e!r & h[ ?is
 subsection applies to an arbitration   
agreem5t %all be det]m9$ "u ,f$]al law  
by a c\rt ( compet5t jurisdiction1 r ?an
 an arbitrator1 )\t reg>d to :e!r ! p>ty
 oppos+ arbitration *all5ges su*        
agreem5t specifically or 9 conjunction )
 any o!r t]m ( ! contract conta9+ su*   

agreem5t4  4  7#b7 ,nurs+ facilities    
,section #aiai7;c7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #acifr7c77 is am5d$
 by add+ at ! end ! foll[+ new p>agraph3
  7#i7 ,prohibition on use ( pre-dispute
 arbitration agreem5ts  7,a7 ,9 g5]al ,a
 nurs+ facility may n require1 solicit1 
accept1 or move to en=ce a pre-dispute  
arbitration agreem5t f or on behalf (   
any resid5t1 :e!r ! agreem5t is made    
be=e1 dur+1 or aft] ! resid5t's         
admission to ! facility4  7,b7          
,application ,?is p>agraph %all apply to
 ! nurs+ facility & to any o!r bus9ess  
or p]son provid+ or responsible =       
provid+ nurs+ s]vices to ! resid5t4     
7,c7 ,no validity or en=cem5t ,a        
pre-dispute arbitration agreem5t %all n 
be valid or specifically en=ceable aga9/
 a resid5t or =m] resid5t ( a nurs+     
facility1 )\t reg>d to :e!r ! agreem5t 0
 made prior to or aft] ! effective date 
( ?is p>agraph4  7,d7 ,def9ition (      
pre-dispute arbitration agreem5t ,9 ?is 
p>agraph1 ! t]m pre-dispute arbitration 

agreem5t means any agreem5t to arbitrate
 a dispute :5 ! dispute has aris5 aft]  
su* agreem5t has be5 made4  7,e7        
,judicial review ,a det]m9ation z to    
:e!r & h[ ?is p>agraph applies to an    
arbitration agreem5t %all be det]m9$ "u 
,f$]al law by a c\rt ( compet5t         
jurisdiction1 r ?an an arbitrator1 )\t  
reg>d to :e!r ! p>ty oppos+ arbitration 
*all5ges su* agreem5t specifically or 9 
conjunction ) any o!r t]m ( ! contract  
conta9+ su* agreem5t4  4  #c4 ,effective
 date2 application ( am5dm5ts ,?is ,act1
 & ! am5dm5ts made by ?is ,act1 %all    
take effect on ! date ( ! enactm5t ( ?is
 ,act4