,i #aafth ,,congress #ast ,session ,h4 ,r4 #edch ,,in ,,the ,,house ,,of ,,representatives ,december #af1 #bjai ,mr4 ,cox of ,california 7for himself1 ,mr4 ,harder of ,california1 ,mr4 ,costa1 ,mr4 ,gallego1 ,mr4 ,o',halleran1 ,mrs4 ,kirkpatrick1 ,mr4 ,panetta1 and ,mr4 ,grijalva7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committee on ,ways and ,means1 for a period to be subsequently determined by the ,speaker1 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 ,services1 acting through the ,director of the ,centers for ,disease ,control and ,prevention1 to award grants to develop programs to increase health care providers' awareness of ,valley fever1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,end ,valley ,fever ,now ,act4 #b4 ,grants to develop programs to increase health care providers' awareness of ,valley fever ,part ,p of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;g et seq47 is amended by adding at the end the following3 #cii,v-#g4 ,grants to develop programs to increase health care providers' awareness of ,valley fever 7a7 ,in general ,the ,secretary1 acting through the ,administrator of the ,health ,resources and ,services ,administration and in consultation with the ,director of the ,centers for ,disease ,control and ,prevention1 shall make awards of grants or cooperative agreements to eligible entities to establish and carry out programs-- 7#a7 to increase health care providers' awareness of ,valley fever2 and 7#b7 to educate and train health care providers on the diagnosis and treatment of ,valley fever4 7b7 ,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 7which may include activities that do not rely on the use of broadband services7 to enhance education through distance learning1 continuing educational activities1 collaborative conferences1 and electronic and telelearning activities4 7c7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section #a1jjj1jjj for the period of fiscal years #bjba through #bjbc1 to remain available until expended4 7d7 ,condition ,a recipient of a grant under this section shall1 as a condition on receipt of the grant1 agree to develop curricula for the purposes specified in subsection 7a7 in coordination with local providers at hospitals and clinics4 7e7 ,definitions ,in this section3 7#a7 ,the term eligible entity means-- 7,a7 a ,state department of health 7or similar ,state authority72 7,b7 an institution of higher education 7as defined in section #aja of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajja771 including a medical school or continuing medical education program at such institution2 7,c7 an entity operating a graduate medical residency training program under section #cdj;,e or under section #cdj;,h2 or 7,d7 a teaching hospital 7as defined in section #dae4aeb of title #db1 ,code of ,federal ,regulations7 that has physicians and other medical providers with specialized knowledge in diagnosing and treating ,valley fever4 7#b7 ,the term ,valley fever means the condition caused by ,coccidioidomycosis4 4 #c4 ,study comparing different case definitions used to identify valley fever 7a7 ,in general ,the ,secretary of ,health and ,human ,services1 acting through the ,director of the ,centers for ,disease ,control and ,prevention shall conduct a study comparing different case definitions used to identify valley fever4 ,such study shall include the efficacy of the methods being used to establish such case definitions and the cost effectiveness of such methods1 including using the case definition for valley fever established by the ,council of ,state and ,territorial ,epidemiologist4 7b7 ,valley fever defined ,in this ,act1 the term ,valley fever has the meaning given the term in section #cii,v-#g of the ,public ,health ,service ,act4 #d4 ,allowing ,states to provide coverage under the ,medicaid program for items and services furnished in connection with qualifying ,valley fever clinical trials 7a7 ,in general ,section #aije7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a77 is amended-- 7#a7 in paragraph 7#bi71 by striking and at the end2 7#b7 by redesignating paragraph 7#cj7 as paragraph 7#ca72 and 7#c7 by inserting after paragraph 7#bi7 the following new paragraph3 7#cj7 items and services furnished in connection with participation in a qualifying ,valley fever clinical trial 7as defined in section #bgji;,a7b77#d7 of the ,public ,health ,service ,act71 including travel and incidental expenses1 regardless of whether such items and services are furnished by a participating provider under the ,medicaid program 7other than a provider excluded from participation in such program under section #aabh7 or whether such items and services are furnished in another ,state2 and 4 7b7 ,reduction in ,,fmap for ,states that do not provide coverage ,section #aije of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7 is amended-- 7#a7 in subsection 7b71 by striking and 7ff7 and inserting 7ff71 and 7gg72 and 7#b7 by adding at the end the following new subsection3 7gg7 ,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 #a1 #bjba1 the ,federal medical assistance percentage otherwise determined under subsection 7b7 for a ,state that does not provide coverage for items and services described in subsection 7a77#cj7 that are furnished during such quarter shall be reduced by #e percentage points4 4 7c7 ,ensuring access for ,medicaid expansion population ,section #aicg7;b77#e7 of such ,act is amended by inserting before the period at the end the following3 1 and beginning ,january #a1 #bjba1 coverage of items and services described in section #aije7;a77#cj74 7d7 ,prohibition on imposition of costsharing requirements ,title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 is amended-- 7#a7 in section #aiaf7;a77#b7-- 7,a7 in subparagraph 7,d71 by striking or at the end2 7,b7 in subparagraph 7,e71 by striking 2 and at the end and inserting 1 or2 and 7,c7 by adding at the end the following new subparagraph3 7,f7 items and services described in section #aije7;a77#cj72 and 2 and 7#b7 in section #aiaf;,a7b77#c77;,b71 by adding at the end the following new clause3 7xi7 ,items and services described in section #aije7;a77#cj74 4 7e7 ,continuous coverage for individuals who lose ,medicaid eligibility based on income ,section #aijb7;e7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7e77 is amended by adding at the end the following new paragraph3 7#af7 ,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 7or a waiver of such plan7 based on the application of modified adjusted gross income under paragraph 7#ad77;,a71 who while so eligible is furnished items and services described in section #aije7;a77#cj7 in connection with participation in a qualifying ,valley fever clinical trial 7as defined in section #bgji;,a7b77#d7 of the ,public ,health ,service ,act71 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 member1 such individual shall be deemed to continue to be an individual eligible for such medical assistance1 without regard to such change in income1 only with respect to such items and services through the end of the month in which such qualifying ,valley fever clinical trial ends4 4 7f7 ,effective date 7#a7 ,in general ,the amendments made by this section shall apply with respect to items and services furnished1 and eligibility determinations made1 on or after ,january #a1 #bjba4 7#b7 ,exception for ,state legislation ,in the case of a ,state plan under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 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 section1 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 ,act4 ,for purposes of the previous sentence1 in the case of a ,state that has a #b-year legislative session1 each year of the session shall be considered to be a separate regular session of the ,state legislature4 #e4 ,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 7a7 ,in general ,subpart ,i of part ,a of title ,,xxvii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg et seq47 is amended-- 7#a7 by redesignating the second section #bgji as section #bgaj2 and 7#b7 by inserting after the first section #bgji the following new section3 #bgji;,a4 ,coverage for individuals participating in qualifying ,valley fever clinical trials 7a7 ,in general ,notwithstanding section #bgji1 a group health plan or health insurance issuer offering group or individual health insurance coverage shall1 with respect to an enrollee of such plan or coverage1 respectively1 provide coverage for any item or service furnished to such enrollee in connection with such enrollee's participation in a qualifying ,valley fever clinical trial1 including travel and incidental expenses-- 7#a7 without regard to whether such item or service is furnished by a participating provider or participating facility with respect to such item or service2 and 7#b7 in a manner so that1 if such item or service is furnished to such enrollee by a nonparticipating provider or nonparticipating facility1 the cost-sharing requirement 7expressed as a copayment amount or coinsurance rate7 is not greater than the requirement that would apply if such item or service were furnished by a participating provider or participating facility4 7b7 ,definitions ,in this section3 7#a7 ,nonparticipating facility2 participating facility 7,a7 ,nonparticipating facility ,the term nonparticipating facility means1 with respect to an item or service and a group health plan or group or individual health insurance coverage1 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 coverage4 7,b7 ,participating facility ,the term participating facility means1 with respect to an item or service and a group health plan or group or individual health insurance coverage1 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 coverage4 7#b7 ,nonparticipating provider2 participating provider 7,a7 ,nonparticipating provider ,the term nonparticipating provider means1 with respect to an item or service and a group health plan or group or individual health insurance coverage1 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 coverage4 7,b7 ,participating provider ,the term participating provider means1 with respect to an item or service and a group health plan or group or individual health insurance coverage1 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 coverage4 7#c7 ,qualifying ,valley fever clinical trial 7,a7 ,in general ,the term qualifying ,valley fever clinical trial means a phase ,i1 phase ,,ii1 phase ,,iii1 or phase ,,iv clinical trial that is conducted in relation to the prevention1 detection1 or treatment of ,valley fever 7as defined in section #cii,v-#g7 and is described in any of the following clauses3 7i7 ,the study or investigation is approved or funded 7which may include funding through in-kind contributions7 by one or more of the following3 7,i7 ,the ,national ,institutes of ,health4 7,,ii7 ,the ,centers for ,disease ,control and ,prevention4 7,,iii7 ,the ,agency for ,healthcare ,research and ,quality4 7,,iv7 ,the ,centers for ,medicare ,medicaid ,services4 7,v7 ,a cooperative group or center of any of the entities described in subclauses 7,i7 through 7,,iv7 or the ,department of ,defense or the ,department of ,veterans ,affairs4 7,,vi7 ,a qualified non-governmental research entity identified in the guidelines issued by the ,national ,institutes of ,health for center support grants4 7,,vii7 ,any of the following if the conditions described in subparagraph 7,b7 are met3 7aa7 ,the ,department of ,veterans ,affairs4 7bb7 ,the ,department of ,defense4 7cc7 ,the ,department of ,energy4 7ii7 ,the clinical trial is conducted under an investigational new drug application reviewed by the ,food and ,drug ,administration4 7iii7 ,the clinical trial is a drug trial that is exempt from having such an investigational new drug application4 7,b7 ,conditions ,for purposes of subparagraph 7,a77i77,,vii71 the conditions described in this subparagraph1 with respect to a clinical trial approved or funded by an entity described in such subparagraph 7,a77i77,,vii71 are that the clinical trial has been reviewed and approved through a system of peer review that the ,secretary determines-- 7i7 to be comparable to the system of peer review of studies and investigations used by the ,national ,institutes of ,health2 and 7ii7 assures unbiased review of the highest scientific standards by qualified individuals with no interest in the outcome of the review4 4 7b7 ,effective date ,the amendments made by this section shall apply with respect to plan years beginning on or after ,january #a1 #bjba4 #f4 ,medicare coverage of items and services furnished in connection with qualifying ,valley fever clinical trials 7a7 ,coverage ,section #ahfa7s77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7s77#b77 is amended-- 7#a7 in subparagraph 7,,gg71 by striking and at the end2 7#b7 in subparagraph 7,,hh71 by striking the period at the end and inserting 2 and2 and 7#c7 by adding at the end the following new subparagraph3 7,,ii7 items and services furnished in connection with participation in a qualifying ,valley fever clinical trial 7as defined in section #bgji;,a7b77#d7 of the ,public ,health ,service ,act71 including travel and incidental expenses2 4 7b7 ,payment ,section #ahcc7;a77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciel7a77#a77 is amended-- 7#a7 by striking and 7,,cc7 and inserting 7,,cc72 and 7#b7 by inserting before the semicolon at the end the following3 1 and 7,,dd7 with respect to items and services described in section #ahfa7s77#b77;,,ii71 the amount paid shall be #ajj percent of the lesser of the actual charge for the services or the amount determined under the payment basis determined under section #ahdh4