,,ii  #aag? ,,congress  #b;d ,session   
,s4 #djfg  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,april #g1 #bjbb,mr4   
,book] 7= himself1 ,mr4 ,br[n1 & ,mr4   
,padilla7 introduc$ ! foll[+ bill2 :i* 0
 read twice & ref]r$ to ! ,committee on 
,f9ance  ,a ,,bill  ,to am5d title ,,xi 
( ! ,social ,security ,act to improve   
access to c>e = all ,m$ic>e & ,m$icaid  
b5efici>ies ?r\gh models te/$ "u ! ,c5t]
 = ,m$ic>e & ,m$icaid ,innovation1 & =  
o!r purposes4  #a4 ,%ort title ,?is ,act
 may be cit$ z ! ,john ,lewis ,equality 
9 ,m$ic>e & ,m$icaid ,treatm5t ,act (   
#bjbb4  #b4 ,improv+ access to c>e =    
,m$ic>e & ,m$icaid b5efici>ies ,section 
#aaae;,a ( ! ,social ,security ,act 7#db
 ,u4,s4,c4 #acae;a7 is am5d$-- 7#a7 9   
subsection 7a7-- 7,a7 9 p>agraph 7#a71  
by ins]t+ advance heal? equity & be=e   
improve ! coord9ation2 &  7,b7 9        
p>agraph 7#c7-- 7i7 by ins]t+ 7includ+ !
 ,(fice ( ,m9ority ,heal? ( ! ,c5t]s =  
,m$ic>e  ,m$icaid ,s]vices1 ! ,(fice (  
,rural ,heal? ,policy ( ! ,heal?        

,res\rces & ,s]vices ,adm9i/ration1 & ! 
,(fice on ,wom5's ,heal? ( ! ,dep>tm5t (
 ,heal? & ,human ,s]vices7 aft] relevant
 ,f$]al ag5cies2 &  7ii7 by /rik+ exp]ts
 ) exp]tise 9 m$ic9e & ins]t+ exp]ts )  
exp]tise 9 m$ic9e1 ! causes ( heal?     
disp>ities & ! social det]m9ants (      
heal?1 &2  7#b7 9 subsection 7b7-- 7,a7 
9 p>agraph 7#b7-- 7i7 9 subp>agraph     
7,a7-- 7,i7 by ins]t+ ! foll[+ aft] !   
fir/ s5t5ce3 ,prior to select+ a model  
"u ?is p>agraph1 ! ,secret>y %all       
consult ) ! ,(fice ( ,m9ority ,heal? ( !
 ,c5t]s = ,m$ic>e  ,m$icaid ,s]vices1 ! 
,(fice ( ,rural ,heal? ,policy ( !      
,heal? ,res\rces & ,s]vices             
,adm9i/ration1 & ! ,(fice on ,wom5's    
,heal? ( ! ,dep>tm5t ( ,heal? & ,human  
,s]vices to ensure t models "u          
consid]ation address heal? disp>ities & 
social det]m9ants ( heal? z appropriate 
= populations to be c>$ = "u ! model42  
7,,ii7 by ins]t+ &1 = models = :i* te/+ 
beg9s on or aft] ,janu>y #a1 #bjbc1     
address heal? equity z well z improv+   

access to c>e receiv$ by individuals    
receiv+ b5efits "u su* title aft]       
applicable title2 &  7,,iii7 by add+ at 
! end ! foll[+3 ,! models select$ "u ?is
 subp>agraph %all include ! social      
det]m9ants ( heal? paym5t model describ$
 9 subsection 7h71 ! te/+ ( :i* %all    
beg9 n lat] ?an ,decemb] #ca1 #bjbc42 & 
7ii7 9 subp>agraph 7,c71 by add+ at !   
end ! foll[+ new clauses3  7ix7 ,:e!r ! 
model w affect access to c>e f provid]s 
& suppli]s c>+ = high risk pati5ts or   
op]at+ 9 und]s]v$ areas4  7x7 ,:e!r !   
model has ! pot5tial to r$uce heal?     
disp>ities1 includ+ m9ority & rural     
heal? disp>ities4  2  7,b7 9 p>agraph   
7#c77;,b7-- 7i7 9 clause 7i71 by ins]t+ 
or heal? equity aft] quality ( c>e2     
7ii7 9 clause 7ii71 by ins]t+ or        
increas+ heal? inequities aft] quality (
 c>e2 &  7iii7 9 clause 7iii71 by ins]t+
 or heal? equity aft] quality ( c>e2 &  
7,c7 9 p>agraph 7#d77;,a7-- 7i7 9 clause
 7i71 by /rik+ 2 & & ins]t+ a semicolon2
  7ii7 9 clause 7ii71 by /rik+ ! p]iod &

 ins]t+ 2 &2 &  7iii7 by add+ at ! end !
 foll[+ new clause3  7iii7 = models =   
:i* te/+ beg9s on or aft] ,janu>y #a1   
#bjbc1 ! ext5t to :i* ! model improves  
heal? equity4  2  7#c7 9 subsection     
7c7-- 7,a7 9 p>agraph 7#a7-- 7i7 9      
subp>agraph 7,a71 by ins]t+ or1 beg9n+  
on or aft] ,janu>y #a1 #bjbc1 increas+  
heal? inequities be=e ! semicolon2 &    
7ii7 9 subp>agraph 7,b71 by ins]t+ or1  
beg9n+ on or aft] ,janu>y #a1 #bjbc1    
heal? equity aft] pati5t c>e2 &  7,b7 9 
p>agraph 7#c71 by ins]t+ or increase    
heal? disp>ities exp]i5c$ by            
b5efici>ies1 includ+ l[-income1 m9ority1
 or rural b5efici>ies1 or t su*         
expansion w\ld improve heal? equity be=e
 ! p]iod2  7#d7 9 subsection 7g71 by    
add+ at ! end ! foll[+3 ,= reports      
submitt$ aft] ! date ( enactm5t ( !     
,john ,lewis ,equality 9 ,m$ic>e &      
,m$icaid ,treatm5t ,act ( #bjbb1 ea* su*
 report %all include in=mation on !     
foll[+3 7#a7 ,! int]v5tions t address   
social det]m9ants ( heal?1 heal?        

disp>ities1 or heal? equity 9 paym5t    
models select$ by ! ,,cmi = te/+ "u ?is 
section4  7#b7 ,e/imat$ ,f$]al sav+s    
a*iev$ ?r\gh r$uc+ disp>ities1 includ+  
rural & m9ority heal? disp>ities1       
improv+ heal? equity1 or address+ social
 det]m9ants ( heal?4  7#c7 ,!           
effectiv5ess ( int]v5tions 9 mitigat+   
negative heal? outcomes & high] co/s    
associat$ ) social det]m9ants ( heal? )9
 models select$ by ! ,c5t] = ,m$ic>e &  
,m$icaid ,innovation = te/+4  7#d7 ,o!r 
areas det]m9$ appropriate by !          
,secret>y4  2 &  7#e7 by add+ at ! end !
 foll[+ new subsection3  7h7 ,social    
det]m9ants ( heal? paym5t model  7#a7 ,9
 g5]al ,! social det]m9ants ( heal?     
paym5t model describ$ 9 ?is subsection  
is a paym5t model t te/s ea* ( ! paym5t 
& s]vice deliv]y innovations describ$ 9 
p>agraph 7#b7 9 a region det]m9$        
appropriate by ! ,secret>y4  7#b7       
,paym5t & s]vice deliv]y innovations    
describ$ ,= purposes ( p>agraph 7#a71 ! 
paym5t & s]vice deliv]y innovations     

describ$ 9 ?is clause are ! foll[+3 7,a7
 ,paym5t & s]vice deliv]y innovations = 
behavioral heal? s]vices1 focus+ on     
ga!r+ actionable data to address ! high]
 co/s associat$ ) b5efici>ies ) diagnos$
 behavioral conditions4  7,b7 ,paym5t & 
s]vice deliv]y innovations t>get+       
conditions or comorbidities (           
individuals entitl$ or enroll$ "u !     
,m$ic>e program "u title ,,xviii &      
enroll$ "u a ,/ate plan "u ! ,m$icaid   
program "u title ,,xix to increase      
capacity 9 und]s]v$ areas4  7,c7 ,paym5t
 & s]vice deliv]y innovations t>get+    
conditions or comorbidities ( applicable
 individuals to increase capacity 9     
und]s]v$ areas4  7,d7 ,paym5t & s]vice  
deliv]y innovations t>get$ on ,m$icaid  
eligible pregnant & po/p>tum wom51 up to
 "o ye> aft] deliv]y4  4