,,ii #aahth ,,congress #ast ,session ,s4 #bhdj ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,september #ai1 #bjbc,mr4 ,sanders 7for himself and ,mr4 ,marshall7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to improve access to and the quality of primary health care1 expand the health workforce1 and for other purposes4 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,bipartisan ,primary ,care and ,health ,workforce ,act4 7b7 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4,,title ,i--,extension for community health centers1 the ,national ,health ,service ,corps1 and teaching health centers that operate ,,gme programs ,sec4 #aja4 ,programs of payments to teaching health centers that operate graduate medical education programs4,sec4 #ajb4 ,community health centers4,sec4 #ajc4 ,national ,health ,service ,corps4,sec4 #ajd4 ,,gao report4,sec4 #aje4 ,,oig report4,sec4 #ajf4 ,application of provisions4,,title ,,ii--,supporting the health care workforce,sec4 #bja4 ,rural residency planning and development program4,sec4 #bjb4 ,primary care training and enhancement program4,sec4 #bjc4 ,telehealth technology-enabled learning program4,sec4 #bjd4 ,expanding the number of primary care doctors4,sec4 #bje4 ,nurse education1 practice1 quality1 and retention grants4,sec4 #bjf4 ,nurse faculty loan program4,sec4 #bjg4 ,nurse faculty demonstration program4,sec4 #bjh4 ,nurse corps scholarship and loan repayment program4,sec4 #bji4 ,grants for primary care nurse residency training programs4,sec4 #baj4 ,state oral health workforce improvement grant program4,sec4 #baa4 ,oral health training programs4,sec4 #bab4 ,allied health professionals4,sec4 #bac4 ,budgetary treatment4,,title ,,iii--,reducing health care costs for patients,sec4 #cja4 ,banning anticompetitive terms in facility and insurance contracts that limit access to higher quality1 lower cost care4,sec4 #cjb4 ,honest billing requirements applicable to providers4,sec4 #cjc4 ,banning facility fees for certain services4,sec4 #cjd4 ,prevention and ,public ,health ,fund4 ,i ,extension for community health centers1 the ,national ,health ,service ,corps1 and teaching health centers that operate ,,gme programs #aja4 ,programs of payments to teaching health centers that operate graduate medical education programs 7a7 ,funding ,section #cdj;,h7g77#a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bef;h7g77#a77 is amended-- 7#a7 by striking such sums as may be necessary1 not to exceed2 7#b7 by striking #bjag1 and and inserting #bjag12 and 7#c7 by inserting and #cjj1jjj1jjj for each of fiscal years #bjbd through #bjbh1 after #bjbc14 7b7 ,per resident amount ,section #cdj;,h7a77#b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bef;h7a77#b77 is amended by adding at the end the following3 ,beginning in fiscal year #bjbd1 in accordance with paragraph 7#a71 but notwithstanding the capped amount referenced in subsections 7b77#b7 and 7d77#b71 the qualified teaching health center per resident amount for a fiscal year shall be not less than such amount for the previous fiscal year44 7c7 ,amount of payments ,section #cdj;,h of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bef;h7 is amended-- 7#a7 in subsection 7b77#b7-- 7,a7 in subparagraph 7,a71 by striking amount of funds appropriated under subsection 7g7 for such payments for that fiscal year and inserting total amount of funds available under subsection 7g7 and any amounts recouped under subsection 7f72 and 7,b7 in subparagraph 7,b71 by striking appropriated in a fiscal year under subsection 7g7 and inserting available under subsection 7g7 and any amounts recouped under subsection 7f72 and 7#b7 in subsection 7d77#b77;,b71 by striking amount appropriated for such expenses as determined in subsection 7g7 and inserting total amount of funds available under subsection 7g7 and any amounts recouped under subsection 7f74 7d7 ,priority payments ,section #cdj;,h7a77#c7 of ,public ,health ,service ,act 7#db ,u4,s4,c4 #bef;h7a77#c77 is amended-- 7#a7 in subparagraph 7,a71 by striking 2 or and inserting a semicolon2 7#b7 in subparagraph 7,b71 by striking the period and inserting 2 or2 and 7#c7 by adding at the end the following3 7,c7 are located in a ,state that does not already have a qualified teaching health center receiving funding under this section4 4 7e7 ,reporting requirements ,section #cdj;,h7h77#a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bef;h7h77#a77 is amended-- 7#a7 by redesignating subparagraph 7,h7 as subparagraph 7,i72 and 7#b7 by inserting after subparagraph 7,g7 the following3 7,h7 ,of the number of residents described in paragraph 7#d7 who completed their residency training1 the number practicing primary care 7meaning any of the areas of practice listed in the definition of a primary care residency program in section #gdi;,a7 #e years following completion of such training4 4 7f7 ,guidance ,the ,secretary shall update guidance and relevant information regarding ,states described in subparagraph 7,c7 of section #cdj;,h7a77#c7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bef;h7a77#c771 as amended by subsection 7d71 and make available model templates to assist health centers in such ,states to establish a teaching health center4 #ajb4 ,community health centers 7a7 ,community health center fund ,section #ajejc of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #bed;b-#b7 is amended-- 7#a7 in subsection 7b77#a77;,f7-- 7,a7 by striking #bjah and and inserting #bjah12 and 7,b7 by inserting before the semicolon the following3 1 and #e1hjj1jjj1jjj for each of fiscal years #bjbd through #bjbf2 and 7#b7 by adding at the end the following3 7f7 ,priority use of funds ,for fiscal years #bjbd through #bjbf1 with respect to #a1hjj1jjj1jjj of the amount appropriated under subsection 7b77#a77;,f71 the ,secretary shall prioritize awards to entities for purposes of-- 7#a7 increasing the number of low-income patients not enrolled in a group health plan or group or individual health insurance coverage who are served by health centers1 including through ,health ,center ,program ,new ,access ,points described in section #ccj7;e77#f7 of the ,public ,health ,service ,act1 including school-based service sites2 7#b7 increasing the required primary health services described in paragraph 7#a77;,a77i7 of section #ccj7;b7 of the ,public ,health ,service ,act and additional health services 7as defined in paragraph 7#b7 of such section7 offered by health centers2 and 7#c7 increasing patient case management1 enabling services1 and education services1 as described in clauses 7iii7 through 7v7 of section #ccj7;b77#a77;,a7 of the ,public ,health ,service ,act4 4 7b7 ,authorization of appropriations ,section #ccj7r77#a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b7r77#a77 is amended-- 7#a7 in subparagraph 7,g71 by striking fiscal year #bjaf1 and each subsequent fiscal year and inserting each of fiscal years #bjaf through #bjbc2 and 7#b7 by adding at the end the following3 7,h7 ,for each of fiscal years #bjbd through #bjbf1 #b1bjj1jjj1jjj4 7,i7 ,for fiscal year #bjbg1 and each subsequent fiscal year1 the amount appropriated for the preceding fiscal year adjusted by the product of-- 7i7 one plus the average percentage increase in costs incurred per patient served2 and 7ii7 one plus the average percentage increase in the total number of patients served4 4 7c7 ,allocation of funds ,section #ajejc of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #bed;b-#b71 as amended by subsection 7a71 is further amended by adding at the end the following3 7g7 ,allocation of funds ,for each of fiscal years #bjbd through #bjbf1 of the amounts appropriated under subsection 7b77#a77;,f7 for a fiscal year1 the ,secretary shall use-- 7#a7 at least #bde1jjj1jjj for awards to support health centers in each ,state that are receiving awards under section #ccj of the ,public ,health ,service ,act in extending operating hours1 in an amount determined pursuant to a formula and eligibility criteria developed by the ,secretary1 for the purposes of increasing access to services2 7#b7 at least #ee1jjj1jjj for awards under this section for health centers to expand school-based services and establish new school-based service sites2 and 7#c7 such sums as may be necessary for purposes of increasing the amount awarded pursuant to grants or cooperative agreements under section #ccj of the ,public ,health ,service ,act so that each recipient of such an award receives-- 7,a7 for fiscal year #bjbd1 at least #ae percent more than such recipient received for fiscal year #bjbc2 and 7,b7 for each of fiscal years #bjbe and #bjbf1 the amount received in the previous year adjusted by-- 7i7 the percent increase in the medical component of the consumer price index for the most recent #ab-month period for which applicable data is available2 plus 7ii7 one percent4 4 7d7 ,capital funding ,section #ajejc7;c7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #bed;b-#b7;c77 is amended-- 7#a7 in the subsection heading1 by inserting 1 ,capital funding after ,construction2 7#b7 by striking ,there is and inserting the following3 7#a7 ,construction ,there is 2 and 7#c7 by adding at the end the following3 7#b7 ,capital funding ,for the alteration1 renovation1 construction1 equipment1 and other capital costs of health centers that receive funding under section #ccj of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b71 in addition to amounts otherwise made available for such purpose1 there is appropriated to the ,secretary of ,health and ,human ,services1 out of amounts in the ,treasury not otherwise appropriated1 #c1jjj1jjj1jjj for fiscal year #bjbd1 to remain available until ,september #cj1 #bjbf4 ,in awarding amounts appropriated under this paragraph1 the ,secretary shall prioritize awards related to increasing access to dental and behavioral health services4 4 7e7 ,strategic plan ,to improve health outcomes through nutrition 7#a7 ,in general ,not later than one year after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services1 in consultation with the ,secretary of ,agriculture1 shall submit to the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate and the ,committee on ,energy and ,commerce of the ,house of ,representatives a #e-year strategic plan to improve health outcomes through nutrition for low-income or uninsured patient populations with severe1 complex chronic conditions and one or more diet-related conditions4 7#b7 ,report ,in carrying out paragraph 7#a71 the ,secretary of ,health and ,human ,services shall-- 7,a7 conduct an evaluation of previous and current federally-funded efforts of the ,department of ,health and ,human ,services to improve patient outcomes through nutrition interventions1 such as medically tailored meals and nutrition counseling2 and 7,b7 include in the strategic report recommendations for-- 7i7 reducing the financial impact of obesity and preventable chronic conditions resulting from obesity2 7ii7 empowering federally-funded community health centers1 rural health clinics1 and other relevant federally-funded facilities to provide produce prescriptions1 medically tailored groceries1 and medically tailored meals2 7iii7 promoting long-term adoption of improved nutrition habits1 including through increased culinary education and consumer nutrition aligned with the most recent ,dietary ,guidelines for ,americans published under section #cja of the ,national ,nutrition ,monitoring and ,related ,research ,act of #aiij 7#g ,u4,s4,c4 #ecda7 and incorporating behavioral modeling or other novel methods across ,federal programs2 7iv7 developing performance and quality metrics related to the delivery of produce prescriptions1 medically tailored groceries1 and medically tailored meals across relevant ,federal payers to aid in reimbursement strategies2 7v7 developing payment models for novel obesity care therapies for the treatment of diabetes that include behavioral and nutritional and dietary services and education2 7vi7 improving coordination of care and integrating nutrition services and resources within federally-funded community health centers1 rural health clinics1 and other federally-funded primary care facilities2 7vii7 bolstering partnerships with ,state and local governments and nongovernmental organizations2 and 7viii7 addressing geographic disparities in access to nutrition services and resources4 7f7 ,required primary health services 7#a7 ,in general ,section #ccj of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b7 is amended-- 7,a7 in subsection 7b77#a77;,a7-- 7i7 in clause 7i7-- 7,i7 in subclause 7,,iv71 by striking 2 and and inserting a semicolon2 7,,ii7 in subclause 7,v71 by adding and after the semicolon2 and 7,,iii7 by adding at the end the following3 7,,vi7 appropriate nutritional and dietary services2 2 7ii7 in clause 7ii71 by inserting and nutrition services after mental health services2 and 7iii7 in clause 7iii71 by inserting nutritional1 after educational12 and 7,b7 in subsection 7d77#a77;,a71 by inserting or one or more diet-related conditions before the semicolon4 7#b7 ,implementation of new required primary health service ,paragraph 7#d7 of section #ccj7;e7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b7e77 is amended to read as follows3 7#d7 ,limitation ,not more than #b grants may be made under paragraph 7#a77;,b7 for the same entity1 except that such limitation shall not apply for the period of #b years beginning on the date of enactment of the ,bipartisan ,primary ,care and ,health ,workforce ,act1 in any case where the only basis upon which paragraph 7#a77;,b7 applies to a health center is that the health center is not in noncompliance with the requirements under subsection 7b77#a77;,a77i77,,vi7 to provide appropriate nutritional and dietary services4 4 7g7 ,increase the use of provider tools ,to improve health outcomes ,not later than one year after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services1 in consultation with the ,secretary of ,agriculture1 shall submit to ,congress a report that includes-- 7#a7 recommendations for ,states to support the coordination of federally-funded nutrition programs and services provided by health care professionals in community health centers2 and 7#b7 data on the number of individuals enrolled in federally-subsidized health insurance coverage who are also enrolled in or eligible for federally-subsidized nutrition and food programs4 #ajc4 ,national ,health ,service ,corps ,section #ajejc7;b77#b7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #bed;b-#b7;b77#b77 is amended-- 7#a7 in subparagraph 7,g71 by striking 2 and and inserting a semicolon2 7#b7 in subparagraph 7,h71 by striking the period and inserting 2 and2 and 7#c7 by adding at the end the following3 7,i7 #iej1jjj1jjj for each of fiscal years #bjbd through #bjbf4 4 #ajd4 ,,gao report 7a7 ,in general ,not later than one year after the date of enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall submit to the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate and the ,committee on ,energy and ,commerce of the ,house of ,representatives a report assessing the effectiveness of the ,national ,health ,service ,corps 7referred to in this section as the ,,nhsc7 at attracting health care professionals to health professional shortage areas designated under section #ccb of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;e7 7referred to in this section as ,h,p,s,as71 such as by-- 7#a7 assessing the metrics used by the ,health ,resources and ,services ,administration in evaluating the program2 7#b7 comparing the retention rates of ,,nhsc participants in the ,h,p,s,as where they completed their period of obligated service to the retention rate of non-,,nhsc participants in the corresponding ,h,p,s,as2 7#c7 comparing the retention rates of ,,nhsc participants in the ,h,p,s,as where they completed their period of obligated service to the retention rates of ,,nhsc participants in ,h,p,s,as other than those where they completed their period of obligated service2 7#d7 identifying factors that influence a ,,nhsc participant's decision to practice in a ,,hpsa other than the ,,hpsa where they completed their period of obligated service2 7#e7 identifying factors other than participation in the ,national ,health ,service ,corps ,scholarship and ,loan ,repayment ,programs that attract health care professionals to a ,,hpsa2 7#f7 assessing the impact the ,,nhsc has on wages for health care professionals in a ,,hpsa2 and 7#g7 comparing the distribution of ,,nhsc participants across ,h,p,s,as1 including a comparison of rural versus non-rural ,h,p,s,as4 7b7 ,definition ,in this section1 the term ,,nhsc participant means a ,national ,health ,service ,corps member participating in the ,national ,health ,service ,corps ,scholarship or ,loan ,repayment ,program under subpart ,,iii of part ,d of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bedl et seq474 #aje4 ,,oig report ,not later than #b years after the date of enactment of this ,act1 the ,inspector ,general of the ,department of ,health and ,human ,services shall submit to ,congress a report on integrity efforts of the ,health ,resources and ,services ,administration with respect to programs carried out by the ,health ,resources and ,services ,administration4 ,such report shall include an assessment of-- 7#a7 the ways in which the ,administrator of the ,health ,resources and ,services ,administration 7referred to in this section as the ,administrator7 determines reasonable efforts are continuously made to establish and maintain collaborative relationships with health care providers2 7#b7 the ways in which the ,administrator ensures quality and continuity of care for underserved areas2 and 7#c7 the extent to which the ,administrator validates the financial responsibility of and use of grant funding by community health centers4 #ajf4 ,application of provisions 7a7 ,in general ,amounts appropriated pursuant to the amendments made by this title shall be subject to the requirements contained in ,public ,law #aag-cbh for funds for programs authorized under sections #ccj through #cdj of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b through #bef74 7b7 ,conforming amendment ,paragraph 7#d7 of section #cjad7;h7 of title #ah1 ,united ,states ,code1 and section #cja7;d7 of division ,,bb of the ,consolidated ,appropriations ,act1 #bjba4 and inserting section #cja7;d7 of division ,,bb of the ,consolidated ,appropriations ,act1 #bjba1 and section #ajf7;a7 of the ,bipartisan ,primary ,care and ,health ,workforce ,act4 ,,ii ,supporting the health care workforce #bja4 ,rural residency planning and development program ,title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bda et seq47 is amended by inserting after section #ccj;,a-#b the following3 #ccj;,a-#c4 ,rural residency planning and development program and rural residency planning and development technical assistance program 7a7 ,definition of rural residency program ,in this section1 the term rural residency program means a physician residency program1 including a rural track program1 accredited by the ,accreditation ,council for ,graduate ,medical ,education 7or a similar body7 that-- 7#a7 trains residents in rural areas 7as defined by the ,secretary7 for more than #ej percent of the total time of their residency2 and 7#b7 primarily focuses on producing physicians who will practice in rural areas1 as defined by the ,secretary4 7b7 ,rural residency planning and development program 7#a7 ,definition of eligible entity ,in this subsection1 the term eligible entity-- 7,a7 means-- 7i7 a domestic public or private nonprofit or for-profit entity2 7ii7 an ,indian ,tribe1 ,tribal health program1 ,tribal organization1 or ,urban ,indian organization 7as such terms are defined in section #d of the ,indian ,health ,care ,improvement ,act72 or 7iii7 a ,native ,hawaiian ,health organization as defined in section #ab of the ,native ,hawaiian ,health ,care ,improvement2 and 7,b7 may include faith-based or community-based organizations1 rural hospitals1 rural community-based ambulatory patient care centers 7including rural health clinics71 health centers operated by a ,native ,hawaiian ,health organization 7defined as described in subparagraph 7,a77iii771 an ,indian ,tribe1 a ,tribal health program1 a ,tribal organization1 or an ,urban ,indian organization 7defined as described in subparagraph 7,a77ii771 graduate medical education consortiums 7including institutions of higher education1 such as schools of allopathic medicine1 schools of osteopathic medicine1 or historically ,black colleges or universities 7as defined by the term part ,b institution in section #cbb of the ,higher ,education ,act of #aife or described in section #cbf7;e77#a7 of the ,higher ,education ,act of #aife7 or other minority-serving institutions 7as described in section #cga7;a7 of the ,higher ,education ,act of #aife71 or other organizations as determined appropriate by the ,secretary4 7#b7 ,grants 7,a7 ,in general ,the ,secretary may award grants to eligible entities to create new rural residency programs 7including adding new rural training sites to existing rural track programs74 7,b7 ,funding ,grants awarded under this subsection may be fully funded at the time of the award4 7,c7 ,term ,the term of a grant under this subsection shall be #d years and may be extended at the discretion of the ,secretary4 7#c7 ,applications 7,a7 ,in general ,to be eligible to receive a grant under this subsection1 an eligible entity shall prepare and submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require1 including a description of the pathway of the rural residency program as described in subparagraph 7,b74 7,b7 ,pathway ,a pathway of a rural residency program supported under this subsection shall be for-- 7i7 general primary care and high-need specialty care1 including family medicine1 internal medicine1 preventive medicine1 psychiatry1 or general surgery2 7ii7 maternal health and obstetrics1 which may be obstetrics and gynecology or family medicine with enhanced obstetrical training2 or 7iii7 any other pathway as determined appropriate by the ,secretary4 7c7 ,rural residency planning and development technical assistance 7#a7 ,definition of eligible entity ,in this subsection1 the term eligible entity means-- 7,a7 a domestic public or private nonprofit or for-profit entity2 or 7,b7 an ,indian ,tribe or ,tribal organization 7as such terms are defined in section #d of the ,indian ,health ,care ,improvement ,act74 7#b7 ,grants 7,a7 ,in general ,the ,secretary may award grants to eligible entities to provide technical assistance to awardees of and potential applicants of the program described in subsection 7b74 7,b7 ,funding ,grants awarded under this subsection may be fully funded at the time of the award4 7,c7 ,term ,the term of a grant under this subsection shall be #d years and may be extended at the discretion of the ,secretary4 7#c7 ,applications ,to be eligible to receive a grant under this subsection1 an eligible entity shall prepare and submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7d7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #ac1jjj1jjj for fiscal year #bjbd1 #ac1ejj1jj for fiscal year #bjbe1 and #ad1jjj1jjj for fiscal year #bjbf1 to remain available until expended4 4 #bjb4 ,primary care training and enhancement program ,section #gdg7;c77#a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bick7c77#a77 is amended-- 7#a7 by striking #dh1ibd1jjj for each of fiscal years #bjba through #bjbe and inserting #di1bej1jjj for fiscal year #bjbd1 #di1ejj1jjj for fiscal year #bjbe1 and #ej1jjj1jjj for fiscal year #bjbf2 and 7#b7 by striking subsection 7b77#a77;,b7 and inserting subsections 7b77#a77;,b7 and 7c74 #bjc4 ,telehealth technology-enabled learning program ,section #ccj,n7k7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;c-#bj7k77 is amended by striking #bjbf and inserting #bjbe1 and #aa1jjj1jjj for each of fiscal years #bjbf through #bjbh1 to remain available until expended4 #bjd4 ,expanding the number of primary care doctors ,section #gdg of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bick71 as amended by section #bjb1 is further amended-- 7#a7 by redesignating subsection 7c7 as subsection 7d72 and 7#b7 by inserting after subsection 7b7 the following3 7c7 ,expanding the number of primary care doctors 7#a7 ,in general ,the ,secretary shall award grants to eligible medical schools described in paragraph 7#b7 for the purpose of graduating more physicians who will practice a primary care discipline4 ,funds awarded under this subsection may be used for costs associated with faculty1 construction and capital improvements1 clinical support1 research support1 student supports1 and any other costs1 as determined by the ,secretary4 7#b7 ,eligibility ,to be eligible to receive a grant under this subsection1 a medical school shall-- 7,a7 be a nonprofit school of medicine or osteopathic medicine that is accredited by a nationally recognized accrediting agency or association2 and 7,b7 demonstrate in the grant application of the medical school-- 7i7 that not less than #cc percent of graduates from the medical school enter primary care and are1 as of the date of the application1 practicing primary care1 as calculated by dividing-- 7,i7 the number of physicians who graduated during such time period as is specified by the ,secretary who are practicing primary care2 by 7,,ii7 the total number of physicians who graduated during such time period2 and 7ii7 a plan to expand the number of graduates of the medical school who are practicing primary care2 and 7iii7 a commitment to use grant funds to supplement1 not supplant1 such school's investment in primary care medical education4 7#c7 ,expanding the number of minority primary care doctors ,of the amounts appropriated under paragraph 7#f77;,c71 the ,secretary shall awards not less than #bj percent to eligible medical schools described in paragraph 7#b7 that are historically ,black colleges and universities 7as defined by the term part ,b institution in section #cbb of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajfa7 or described in section #cbf7;e77#a7 of such ,act 7#bj ,u4,s4,c4 #ajfc;b7e77#a777 or other minority-serving institutions 7as described in section #cga7;a7 of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajfgq7a7774 7#d7 ,grant amounts2 geographic distribution 7,a7 ,grant amounts ,the ,secretary shall determine the amount of each grant awarded under this subsection1 which shall be based on the scope of the plan submitted by the medical school under paragraph 7#b77;,b77ii71 and other appropriate factors4 7,b7 ,geographic distribution ,in awarding grants under this subsection1 the ,secretary shall ensure1 to the greatest extent practicable1 that such grants are equitably distributed among the geographic regions of the ,united ,states4 7#e7 ,primary care ,in this subsection1 the term primary care means health care services related to family medicine1 internal medicine1 pediatrics1 obstetrics1 gynecology1 geriatrics1 or psychiatry4 7#f7 ,account to ,address the ,primary ,care ,physician ,shortage 7,a7 ,establishment of account ,there is established in the ,treasury an account1 to be known as the ,account to ,address the ,primary ,care ,physician ,shortage 7referred to in this subsection as the ,account71 for purposes of carrying out this subsection4 7,b7 ,transfer of direct spending 7i7 ,in general ,the ,secretary of the ,treasury shall transfer1 from the general fund of the ,treasury1 to the ,account #cjj1jjj1jjj for fiscal year #bjbd4 7ii7 ,amounts deposited ,any amounts transferred under clause 7i7 shall remain unavailable in the ,account until such amounts are appropriated pursuant to subparagraph 7,c74 7,c7 ,appropriations 7i7 ,authorization of appropriations ,for the period of fiscal years #bjbd through #bjbf1 there is authorized to be appropriated from the ,account to the ,secretary1 for the purpose of carrying out the activities under this subsection1 an amount not to exceed the total amount transferred to the ,account under subparagraph 7,b77i74 7ii7 ,offsetting future appropriations ,for fiscal years #bjbd through #bjbf1 for any discretionary appropriation under the heading ,account to ,address the ,primary ,care ,physician ,shortage provided to the ,secretary pursuant to the authorization of appropriations under clause 7i7 for the purpose of carrying out this subsection1 the total amount of such appropriations for the applicable fiscal year 7not to exceed the total amount remaining in the ,account7 shall be subtracted from the estimate of discretionary budget authority and the resulting outlays for any estimate under the ,congressional ,budget and ,impoundment ,control ,act of #aigd or the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe1 and the amount transferred to the ,account shall be reduced by the same amount4 7#g7 ,annual reports ,not later than ,october #a of fiscal years #bjbe through #bjbg1 the ,secretary shall submit to the ,committee on ,health1 ,education1 ,labor1 and ,pensions and the ,committee on ,appropriations of the ,senate and the ,committee on ,energy and ,commerce and the ,committee on ,appropriations of the ,house of ,representatives1 a report including a description of any use of funds provided pursuant to the authorization of appropriations under paragraph 7#f77;,c74 7#h7 ,limitations ,notwithstanding any transfer authority authorized by this subsection or any appropriations ,act1 any funds made available pursuant to the authorization of appropriations under paragraph 7#f77;,c7 may not be used for any purpose other than the program established under paragraph 7#a74 7#i7 ,sunset ,amounts remaining unappropriated in the ,account under this subsection shall be transferred back to the general fund of the ,treasury on ,october #a1 #bjbf4 4 #bje4 ,nurse education1 practice1 quality1 and retention grants 7a7 ,reauthorization ,section #hca of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bifp7 is amended by adding at the end the following3 7g7 ,authorization of appropriations ,to carry out this section 7other than subsection 7e771 in addition to amounts made available under section #hga7;a71 there are authorized to be appropriated #ei1dac1jjj for each of fiscal years #bjbd through #bjbf1 to remain available until expended4 4 7b7 ,expanding associate degree nursing programs ,section #hca of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bifp71 as amended by subsection 7a71 is further amended-- 7#a7 by redesignating subsections 7e7 through 7g7 as subsections 7f7 through 7h71 respectively2 and 7#b7 by inserting after subsection 7d7 the following3 7e7 ,supplemental appropriations expanding associate degree nursing programs 7#a7 ,authorization ,the ,secretary shall award grants to institutions of higher education 7as defined in section #aja of the ,higher ,education ,act of #aife7 offering an accredited registered nursing program at the associate degree level for the purpose of expanding the number of students enrolled in each such program4 7#b7 ,use of funds ,a recipient of a grant under this subsection shall use the grant funds to expand the number of students enrolled in the recipient's accredited registered nursing program1 which may include increasing nurse faculty and nurse faculty salaries1 expanding the number of qualified preceptors at clinical rotations sites1 providing direct support for students1 supporting partnerships with health facilities for clinical training1 purchasing and training faculty to use distance learning technologies and simulation equipment1 alteration1 renovation1 construction1 equipment1 and other capital improvement costs1 and other projects determined appropriate by the ,secretary4 7#c7 ,determination of number of students and application ,each institution of higher education that offers a program described in paragraph 7#a7 that desires to receive a grant under this subsection shall-- 7,a7 provide documentation from the last #d academic years1 or number of academic years the program has been accredited if less than #d1 demonstrating the average percentage of individuals who graduated from the nursing degree program with an associate degree within #aej percent of the expected completion time designated for the program2 and 7,b7 submit an application to the ,secretary at such time1 in such manner1 and accompanied by such information as the ,secretary may require1 including the average percent of individuals determined under subparagraph 7,a74 7#d7 ,definition ,for purposes of this subsection1 the term health facility means an ,indian health service center1 a ,native ,hawaiian health center1 a ,federally qualified health center1 a rural health clinic1 a nursing home1 a home health agency1 a hospice program1 a public health clinic1 a ,state or local department of public health1 a skilled nursing facility1 or an ambulatory surgical center4 7#e7 ,account to ,address the ,nursing ,workforce ,shortage 7,a7 ,establishment of account ,there is established in the ,treasury an account1 to be known as the ,account to ,address the ,nursing ,workforce ,shortage 7referred to in this subsection as the ,account71 for purposes of carrying out this subsection1 in addition to amounts otherwise made available1 including under section #hga7;a74 7,b7 ,transfer of direct spending 7i7 ,in general ,the ,secretary of the ,treasury shall transfer1 from the general fund of the ,treasury1 to the ,account #bdj1jjj1jjj for each of fiscal years #bjbd through #bjbh4 7ii7 ,amounts deposited ,any amounts transferred under clause 7i7 shall remain unavailable in the ,account until such amounts are appropriated pursuant to subparagraph 7,c74 7,c7 ,appropriations 7i7 ,authorization of appropriations ,for each of fiscal years #bjbd through #bjbh1 there is authorized to be appropriated from the ,account to the ,secretary1 for the purpose of carrying out the activities under this subsection1 in addition to amounts otherwise made available for such purpose1 an amount not to exceed the total amount transferred to the ,account under subparagraph 7,b77i74 7ii7 ,offsetting future appropriations ,for any of fiscal years #bjbd through #bjbh1 for any discretionary appropriation under the heading ,account to ,address the ,nursing ,workforce ,shortage provided to the ,secretary pursuant to the authorization of appropriations under clause 7i7 for an additional amount for carrying out this subsection1 the total amount of such appropriations for the applicable fiscal year 7not to exceed the total amount remaining in the ,account7 shall be subtracted from the estimate of discretionary budget authority and the resulting outlays for any estimate under the ,congressional ,budget and ,impoundment ,control ,act of #aigd or the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe1 and the amount transferred to the ,account shall be reduced by the same amount4 7#f7 ,annual reports ,not later than ,october #a of fiscal years #bjbe through #bjbi1 the ,secretary shall submit to the ,committee on ,health1 ,education1 ,labor1 and ,pensions and the ,committee on ,appropriations of the ,senate and the ,committee on ,energy and ,commerce and the ,committee on ,appropriations of the ,house of ,representatives1 a report including a description of any use of funds provided pursuant to the authorization of appropriations under paragraph 7#e77;,c74 7#g7 ,limitations ,notwithstanding any transfer authority authorized by this subsection or any appropriations ,act1 any funds made available pursuant to the authorization of appropriations under paragraph 7#e77;,c7 may not be used for any purpose other than the program established under paragraph 7#a74 7#h7 ,sunset ,amounts remaining unappropriated in the ,account under this subsection shall be transferred back to the general fund of the ,treasury on ,october #a1 #bjbh4 4 #bjf4 ,nurse faculty loan program ,section #hdf;,a of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bign-#a71 as amended by section #bjg1 is amended by inserting after subsection 7b7 the following3 7c7 ,funding 7#a7 ,authorization of appropriations 7,a7 ,in general ,to carry out this section 7other than subsection 7d771 in addition to amounts otherwise made available1 including under section #hga7;b7 and paragraph 7#b71 there are authorized to be appropriated #bh1ejj1jjj for each of fiscal years #bjbd through #bjbf1 to remain available until expended4 7#b7 ,account to ,address the ,nurse ,faculty ,workforce ,shortage 7,a7 ,establishment of account ,there is established in the ,treasury an account1 to be known as the ,account to ,address the ,nurse ,faculty ,shortage 7referred to in this paragraph as the ,account71 for purposes of carrying out this section 7other than subsection 7d77 in addition to amounts otherwise made available1 including under section #hga7;b7 and paragraph 7#a74 7,b7 ,transfer of direct spending 7i7 ,in general ,the ,secretary of the ,treasury shall transfer1 from the general fund of the ,treasury1 to the ,account #eg1jjj1jjj for each of fiscal years #bjbd through #bjbf4 7ii7 ,amounts deposited ,any amounts transferred under clause 7i7 shall remain unavailable in the ,account until such amounts are appropriated pursuant to subparagraph 7,c74 7,c7 ,appropriations 7i7 ,authorization of appropriations ,for each of fiscal years #bjbd through #bjbf1 there is authorized to be appropriated from the ,account to the ,secretary1 for the purpose of carrying out the activities under this section1 in addition to amounts otherwise made available for such purpose1 an amount not to exceed the total amount transferred to the ,account under subparagraph 7,b77i74 7ii7 ,offsetting future appropriations ,for any of fiscal years #bjbd through #bjbf1 for any discretionary appropriation under the heading ,account to ,address the ,nurse ,faculty ,shortage provided to the ,secretary pursuant to the authorization of appropriations under clause 7i7 for an additional amount for carrying out this section1 the total amount of such appropriations for the applicable fiscal year 7not to exceed the total amount remaining in the ,account7 shall be subtracted from the estimate of discretionary budget authority and the resulting outlays for any estimate under the ,congressional ,budget and ,impoundment ,control ,act of #aigd or the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe1 and the amount transferred to the ,account shall be reduced by the same amount4 7,d7 ,annual reports ,not later than ,october #a of fiscal years #bjbe through #bjbg1 the ,secretary shall submit to the ,committee on ,health1 ,education1 ,labor1 and ,pensions and the ,committee on ,appropriations of the ,senate and the ,committee on ,energy and ,commerce and the ,committee on ,appropriations of the ,house of ,representatives1 a report including a description of any use of funds provided pursuant to the authorization of appropriations under subparagraph 7,c74 7,e7 ,limitations ,notwithstanding any transfer authority authorized by this paragraph or any appropriations ,act1 any funds made available pursuant to the authorization of appropriations under subparagraph 7,c7 may not be used for any purpose other than the program under this section4 7,f7 ,sunset ,amounts remaining unappropriated in the ,account under this paragraph shall be transferred back to the general fund of the ,treasury on ,october #a1 #bjbf4 4 #bjg4 ,nurse faculty demonstration program ,section #hdf;,a of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bign-#a7 is amended-- 7#a7 by amending subsection 7a7 to read as follows3 7a7 ,in general ,to increase the number of qualified nursing faculty1 the ,secretary may-- 7#a7 enter into an agreement with any accredited school of nursing for the establishment and operation of a student loan fund in accordance with subsection 7b72 and 7#b7 award nurse faculty grants in accordance with subsection 7d74 2 7#b7 in subsection 7b7-- 7,a7 by redesignating subparagraphs 7,a7 through 7,d7 of paragraph 7#b7 as clauses 7i7 through 7iv71 respectively1 and adjusting the margins accordingly2 7,b7 by redesignating paragraphs 7#a7 through 7#e7 as subparagraphs 7,a7 through 7,e71 respectively1 and adjusting the margins accordingly2 7,c7 in subparagraph 7,c71 as so redesignated1 by striking subsection 7c7 and inserting paragraph 7#b72 and 7,d7 by striking 7b7 ,agreements--,each agreement entered into under subsection 7a7 shall-- and inserting the following3 7b7 ,school of nursing student loan fund 7#a7 ,in general ,each agreement entered into under subsection 7a77#a7 shall-- 2 7#c7 in subsection 7c7-- 7,a7 by striking subsection 7a7 each place it appears and inserting subsection 7a77#a72 7,b7 in paragraph 7#c71 by redesignating subparagraphs 7,a7 and 7,b7 as clauses 7i7 and 7ii71 respectively1 and adjusting the margins accordingly2 7,c7 in paragraph 7#f71 by redesignating subparagraphs 7,a7 and 7,b7 as clauses 7i7 and 7ii71 respectively1 and adjusting the margins accordingly2 7,d7 by redesignating paragraphs 7#a7 through 7#f7 as subparagraphs 7,a7 through 7,f71 respectively1 and adjusting the margins accordingly2 and 7,e7 in subparagraph 7,f77ii71 as so redesignated1 by striking subsection 7e7 and inserting paragraph 7#d72 7#d7 in subsection 7e71 by striking subsection 7c77#f77;,b7 and inserting paragraph 7#b77;,f77ii72 7#e7 by redesignating subsections 7c7 through 7e7 7before application of the amendment made by section #bjf7 as paragraphs 7#b7 through 7#d71 respectively1 and adjusting the margins accordingly2 and 7#f7 by adding after subsection 7c71 as added by section #bjf1 the following3 7d7 ,nurse faculty demonstration program 7#a7 ,in general ,the ,secretary shall establish and carry out a demonstration program described in subsection 7a77#b7 under which eligible schools of nursing receive a grant for purposes of supplementing the salaries of eligible nursing faculty members to enhance recruitment and retention of nursing faculty members4 7#b7 ,eligible entities ,to be eligible to receive a grant under this subsection1 an entity shall-- 7,a7 be an accredited school of nursing2 and 7,b7 submit an application to the ,secretary1 at such time1 in such manner1 and containing such information as the ,secretary may require1 including-- 7i7 7,i7 to the extent such information is available to the school of nursing1 the salary history of nursing faculty at such school who previously were nurses in clinical practice1 for the most recent #c-year period ending on the date of application1 adjusted for inflation as appropriate and broken down by credentials1 experience1 and levels of education of such nurses2 or 7,,ii7 if the information described in subclause 7,i7 is not available1 information on the average local salary of nurses in clinical practice1 adjusted for inflation as appropriate and broken down by credentials1 experience1 and levels of education of the individual nurses1 in accordance with such requirements as the ,secretary may specify2 7ii7 an attestation of the average nursing faculty salary at the school of nursing during the most recent #c-year period prior to the date of application1 adjusted for inflation1 as appropriate1 broken down by credentials1 experience1 and levels of education of such faculty members2 7iii7 the number of nursing faculty member vacancies at the entity at the time of application1 and the entity's projection of such vacancies over the ensuing #e-year period2 and 7iv7 a description of the entity's plans to identify funding sources to sustainably continue1 after the #b-year grant period1 the salary available to the eligible nursing faculty member pursuant to the program under this subsection during such grant program and to retain eligible nursing faculty members after the end of the grant period4 7#c7 ,awards ,a grant awarded under this subsection1 with respect to supporting eligible nursing faculty members1 shall-- 7,a7 be awarded to the school of nursing to supplement the salaries of eligible faculty members at the school of nursing1 annually1 for up to a #b-year period1 in an amount equal to1 for each eligible nursing faculty member at the eligible entity during the grant period1 the difference between-- 7i7 the average salary of nurses in clinical practice submitted under subclause 7,i7 or 7,,ii7 of paragraph 7#b77;,b77i72 and 7ii7 the greater of-- 7,i7 the salary for the eligible nursing faculty member at the school of nursing2 or 7,,ii7 the average nursing faculty salary submitted under paragraph 7#b77;,b77ii7 for faculty members with the same or similar credentials and level of education2 7,b7 notwithstanding section #hjc7;a71 be used in its entirety to supplement the eligible faculty member's salary2 and 7,c7 be conditioned upon the school of nursing maintaining1 for each year in which the award is made as described in subparagraph 7,a71 a salary for such faculty member at a level that is not less than the greater of the amount under subclause 7,i7 or 7,,ii7 of subparagraph 7,a77ii74 7#d7 ,priority ,in awarding grants under this subsection1 the ,secretary shall ensure the equitable geographic distribution of awards1 and shall give priority to applications from schools of nursing that demonstrate-- 7,a7 the greatest need for such grant1 which may be based upon the financial circumstances of the school of nursing1 eligible nurse faculty members1 the planned number of students to be trained or admitted off a wait list2 7,b7 training or partnerships to serve vulnerable patient populations1 such as through the location or activity of a school in a health professional shortage area 7as defined in section #ccb72 7,c7 recruitment and retention of faculty from underrepresented populations2 or 7,d7 other particular need for such grant1 including public institutions of higher education that offer #d-year degrees but at which the predominant degree awarded is an associate degree4 7#e7 ,rule of construction ,nothing in this subsection precludes a school of nursing or an eligible nursing faculty member receiving an award under this section from obtaining or receiving any other form of ,federal support or funding4 7#f7 ,report ,not later than #c years after the date of enactment of the ,bipartisan ,primary ,care and ,health ,workforce ,act1 the ,secretary shall submit to the ,committee on ,finance and the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate and the ,committee on ,ways and ,means and the ,committee on ,energy and ,commerce of the ,house of ,representatives1 a report that evaluates the program established under this subsection1 including-- 7,a7 the impact of such program on recruitment and retention rates of nursing faculty1 as available1 and specifically for each faculty member participating in the program2 and 7,b7 recommendations and considerations for ,congress on continuing the program under this subsection4 7#g7 ,definitions ,in this subsection3 7,a7 ,eligible nursing faculty member ,the term eligible nursing faculty member means a nursing faculty member who-- 7i7 was hired by a school of nursing within the #b-year period preceding the submission of an application under paragraph 7#b71 or a prospective nursing faculty member2 7ii7 is currently employed at the school of nursing and who demonstrates the need for such support2 7iii7 previously worked as a nurse in clinical practice or as a nurse faculty member at another school of nursing2 or 7iv7 may work on a part-time basis as a nursing faculty member1 for whom such award amounts described in paragraph 7#c7 shall be prorated relative to the amount of time participating in part-time teaching4 7,b7 ,inflation ,the term inflation means the ,consumer ,price ,index for all urban consumers 7all items2 ,u4,s4 city average74 7#h7 ,authorization of appropriations ,to carry out this subsection1 in addition to amounts otherwise available1 including under section #hga7;b71 there is authorized to be appropriated #ae1jjj1jjj for each of fiscal years #bjbd and #bjbe4 4 #bjh4 ,nurse corps scholarship and loan repayment program ,section #hdf of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bign7 is amended by adding at the end the following3 7j7 ,authorization of appropriations ,to carry out this section1 in addition to amounts otherwise made available1 including under section #hga7;b71 there are authorized to be appropriated #ic1fjj1jjj for fiscal year #bjbd1 #id1fjj1jjj for fiscal year #bjbe1 and #ie1fjj1jjj for fiscal year #bjbf1 to remain available until expended4 4 #bji4 ,grants for primary care nurse residency training programs ,section #ecaf of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #bif;j-#a7 is amended-- 7#a7 in the section heading1 by striking ,demonstration2 7#b7 in subsection 7a71 by striking demonstration2 7#c7 in subsection 7d7-- 7,a7 in paragraph 7#a77;,b71 by striking and at the end2 7,b7 by redesignating paragraph 7#b7 as paragraph 7#c72 and 7,c7 by inserting after paragraph 7#a7 the following3 7#b7 7,a7 in the case of an entity that does not have an established residency program for nurse practitioners at the time of the application1 demonstrate plans to establish a new residency program for nurse practitioners2 or 7,b7 in the case of an entity that has an established residency program for nurse practitioners at the time of the application1 demonstrate plans to use the grant under this section to offer not fewer than #d additional residency positions for new nurse practitioners to participate in such program2 and 2 and 7#d7 in subsection 7i71 by striking such sums as may be necessary for each of fiscal years #bjaa through #bjad and inserting #cj1jjj1jjj for each of fiscal years #bjbd through #bjbf4 #baj4 ,state oral health workforce improvement grant program ,subsection 7f7 of section #cdj;,g of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bef;g7 is amended by striking #ac1ijc1jjj for each of fiscal years #bjai through #bjbc and inserting #ae1bjj1jjj for fiscal year #bjbd1 #ae1ejj1jjj for fiscal year #bjbe1 and #ae1hjj1jjj for fiscal year #bjbf1 to remain available until expended4 #baa4 ,oral health training programs ,subsection 7f7 of section #gdh of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bick-#b7 is amended to read as follows3 7f7 ,authorization of appropriations 7#a7 ,in general ,to carry out this section1 there is authorized to be appropriated #bh1ejj1jjj for fiscal year #bjbf1 to remain available until expended4 7#b7 ,geographic distribution ,in awarding grants under this section1 the ,secretary shall ensure1 to the greatest extent practicable1 that such grants are equitably distributed among the geographical regions of the ,united ,states4 4 #bab4 ,allied health professionals 7a7 ,supporting dual or concurrent enrollment in the allied health projects program ,section #gee7;b77#a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bid;e7b77#a77 is amended-- 7#a7 in subparagraph 7,b71 by striking to individuals who have baccalaureate degrees in health-related sciences2 7#b7 in the flush text at the end of subparagraph 7,i71 by striking 2 and and inserting a semicolon2 7#c7 in subparagraph 7,j71 by striking the period and inserting 2 and2 and 7#d7 by adding at the end the following3 7,k7 those that establish or support a dual or concurrent enrollment program 7as defined in section #haja of the ,elementary and ,secondary ,education ,act of #aife7 if the dual or concurrent enrollment program-- 7i7 provides outreach on allied health careers requiring an industry-recognized credential1 a certificate1 or an associate degree1 to all high schools served by the local educational agency that is a partner in the partnership offering the dual or concurrent enrollment program2 7ii7 provides information to high school students about the training requirements and expected salary of allied health professions2 and 7iii7 provides academic and financial aid counseling to students who participate in the dual or concurrent enrollment program4 4 7b7 ,supporting dual or concurrent enrollment in the health careers opportunity program ,section #gci7;a77#b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bic;c7a77#b77 is amended-- 7#a7 in subparagraph 7,h71 by striking and after the semicolon2 7#b7 in subparagraph 7,i71 by striking the period at the end and inserting 2 and2 and 7#c7 by adding at the end the following3 7,j7 providing academic and financial aid counseling to support participation in a dual or concurrent enrollment program 7as defined in section #haja of the ,elementary and ,secondary ,education ,act of #aife7 that leads to an industry-recognized credential1 a certificate1 or an associate degree in the health professions or academic credits that can be transferred1 as indicated through an articulation agreement between #b or more community colleges or universities1 to obtain an industry-recognized credential1 a certificate1 or a degree in the health professions4 4 7c7 ,health care workforce innovation program ,section #gee7;b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bid;e7b77 is amended by adding at the end the following3 7#e7 7,a7 ,supporting and developing new innovative1 community-driven approaches for the education and training of allied health professionals1 including those described in subparagraph 7,f77i71 with an emphasis on expanding the supply of such professionals located in1 and meeting the needs of1 underserved communities and rural areas4 ,grants under this paragraph shall be awarded through a new program 7referred to as the ,health ,care ,workforce ,innovation ,program or in this paragraph as the ,program74 7,b7 ,to be eligible to receive a grant under the ,program an entity shall-- 7i7 be a ,federally qualified health center 7as defined in section #aije7l77#b77;,b7 of the ,social ,security ,act71 a ,state-level association or other consortium that represents and is comprised of ,federally qualified health centers1 or a certified rural health clinic that meets the requirements of section #ccd2 and 7ii7 submit to the ,secretary an application that1 at a minimum1 contains-- 7,i7 a description of how all trainees will be trained in accredited training programs either directly or through partnerships with public or nonprofit private entities2 7,,ii7 a description of the community-driven health care workforce innovation model to be carried out under the grant1 including the specific professions to be funded2 7,,iii7 the geographic service area that will be served1 including quantitative data1 if available1 showing that such particular area faces a shortage of health professionals and lacks access to health care2 7,,iv7 a description of the benefits provided to each health care professional trained under the proposed model during the education and training phase2 7,v7 a description of the experience that the applicant has in the recruitment1 retention1 and promotion of the well-being of workers and volunteers2 7,,vi7 a description of how the funding awarded under the ,program will supplement rather than supplant existing funding2 7,,vii7 a description of the scalability and replicability of the community-driven approach to be funded under the ,program2 7,,viii7 a description of the infrastructure1 outreach and communication plan and other program support costs required to operationalize the proposed model2 and 7,,ix7 any other information1 as the ,secretary determines appropriate4 7,c7 7i7 ,an entity shall use amounts received under a grant awarded under the ,program to carry out the innovative1 community-driven model described in the application under subparagraph 7,b74 ,such amounts may be used for launching new or expanding existing innovative health care professional partnerships1 including the following specific uses3 7,i7 ,establishing or expanding a partnership between an eligible entity and #a or more high schools1 accredited public or nonprofit private vocational-technical schools1 accredited public or nonprofit private #b-year colleges1 area health education centers1 and entities with clinical settings for the provision of education and training opportunities not available at the grantee's facilities4 7,,ii7 ,providing education and training programs to improve allied health professionals' readiness in settings that serve underserved communities and rural areas2 encouraging students from underserved and disadvantaged backgrounds and former patients to consider careers in health care1 and better reflecting and meeting community needs2 providing education and training programs for individuals to work in patient-centered1 team-based1 community-driven health care models that include integration with other clinical practitioners and training in cultural and linguistic competence2 providing pre-apprenticeship and apprenticeship programs for health care technical1 support1 and entry-level occupations1 particularly for those enrolled in dual or concurrent enrollment programs2 building a preceptorship training-to-practice model for medical1 behavioral health1 oral health1 and public health disciplines in an integrated1 community-driven setting2 providing and expanding internships1 career ladders1 and development opportunities for health care professionals1 including new and existing staff2 or investing in training equipment1 supplies1 and limited renovations or retrofitting of training space needed for grantees to carry out their particular model4 7ii7 ,amounts received under a grant awarded under the ,program shall not be used to support construction costs or to supplant funding from existing programs that support the applicant's health workforce4 7iii7 ,models funded under the ,program shall be for a duration of at least #c years4 7,d7 ,in awarding grants under the ,program1 the ,secretary may give priority to applicants that will use grant funds to support workforce innovation models that increase the number of individuals from underserved and disadvantaged backgrounds working in such health care professions1 improve access to health care 7including medical1 behavioral health and oral health7 in underserved communities1 or demonstrate that the model can be replicated in other underserved communities in a cost-efficient and effective manner to achieve the purposes of the ,program4 7,e7 ,an entity that receives a grant under the ,program shall provide periodic reports to the ,secretary detailing the findings and outcomes of the innovative1 community-driven model carried out under the grant4 ,such reports shall contain information in a manner and at such times as determined appropriate by the ,secretary4 7,f7 ,in this paragraph3 7i7 ,the term allied health care professional includes individuals who provide clinical support services1 including medical assistants1 dental assistants1 dental hygienists1 pharmacy technicians1 physical therapists and health care interpreters2 individuals providing non-clinical support1 such as billing and coding professionals and health information technology professionals2 dieticians2 medical technologists2 emergency medical technicians2 community health workers2 public health personnel2 and peer support workers4 7ii7 ,the term rural area has the meaning given such term by the ,administrator of the ,health ,resources and ,services ,administration4 7iii7 ,the term underserved communities means areas1 population groups1 and facilities designated as health professional shortage areas under section #ccb1 medically underserved areas as defined under section #ccj;,i7a771 or medically underserved populations as defined under section #ccj7;b77#c74 7,g7 7i7 ,there are authorized to be appropriated #ajj1jjj1jjj for each of fiscal years #bjbd through #bjbf1 to carry out this section1 to remain available until expended4 7ii7 ,a grant provided under the ,program shall not exceed #b1ejj1jjj for a grant period4 4 #bac4 ,budgetary treatment 7a7 ,statutory paygo scorecards ,the budgetary effects of section #cjb 7including the amendments made by such section71 up to #a1fga1jjj1jjj1 shall not be entered on either ,,paygo scorecard maintained pursuant to section #d7;d7 of the ,statutory ,pay ,as-,you-,go ,act of #bjaj 7#b ,u4,s4,c4 #icc7;d774 7b7 ,senate paygo scorecards ,the budgetary effects of section #cjb 7including the amendments made by such section71 up to #a1fga1jjj1jjj1 shall not be entered on any ,,paygo scorecard maintained for purposes of section #dajf of ,h4 ,con4 ,res4 #ga 7#aaeth ,congress74 7c7 ,reservation of savings ,none of the funds in the ,account to ,address the ,primary ,care ,physician ,shortage 7established under section #gdg7;c77#f7 of the ,public ,health ,service ,act1 as amended by section #bjd71 the ,account to ,address the ,nursing ,workforce ,shortage 7established under section #hca7;e77#e7 of the ,public ,health ,service ,act1 as amended by section #bje71 or the ,account to ,address the ,nurse ,faculty ,shortage 7established under section #hdf;,a7c77#b7 of the ,public ,health ,service ,act1 as amended by section #bjf7 shall be made available except to the extent provided in advance in appropriations ,acts1 and legislation or an ,act that rescinds or reduces amounts in such accounts shall not be estimated as a reduction in direct spending under the ,congressional ,budget and ,impoundment ,control ,act of #aigd or the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe4 ,,iii ,reducing health care costs for patients #cja4 ,banning anticompetitive terms in facility and insurance contracts that limit access to higher quality1 lower cost care 7a7 ,in general 7#a7 ,public ,health ,service ,act ,section #bgii;,a-#i of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#aai7 is amended-- 7,a7 by adding at the end the following3 7b7 ,protecting ,health ,plans ,network ,design ,flexibility 7#a7 ,in general ,a group health plan or a health insurance issuer offering group or individual health insurance coverage shall not enter into an agreement with a provider1 network or association of providers1 or other service provider offering access to a network of service providers if such agreement1 directly or indirectly-- 7,a7 restricts the group health plan or health insurance issuer from-- 7i7 directing or steering enrollees to other health care providers2 or 7ii7 offering incentives to encourage enrollees to utilize specific health care providers2 7,b7 requires the group health plan or health insurance issuer to enter into any additional contract with an affiliate of the provider as a condition of entering into a contract with such provider2 7,c7 requires the group health plan or health insurance issuer to agree to payment rates or other terms for any affiliate not party to the contract of the provider involved2 or 7,d7 restricts other group health plans or health insurance issuers not party to the contract from paying a lower rate for items or services than the contracting plan or issuer pays for such items or services4 7#b7 ,additional requirement for self-insured plans ,a self-insured group health plan shall not enter into an agreement with a provider1 network or association of providers1 third-party administrator1 or other service provider offering access to a network of providers if such agreement directly or indirectly requires the group health plan to certify1 attest1 or otherwise confirm in writing that the group health plan is bound by restrictive contracting terms between the service provider and a third-party administrator that the group health plan is not party to1 without a disclosure that such terms exist4 7#c7 ,exception for plans and issuers ,paragraph 7#a77;,a7 shall not apply to a group health plan or health insurance issuer offering group or individual health insurance coverage with respect to-- 7,a7 a health maintenance organization 7as defined in section #bgia7;b77#c771 if such health maintenance organization operates primarily through exclusive contracts with multi-specialty physician groups1 nor to any arrangement between such a health maintenance organization and its affiliates2 or 7,b7 a value-based network arrangement1 such as an exclusive provider network1 accountable care organization1 center of excellence1 a provider sponsored health insurance issuer that operates primarily through aligned multi-specialty physician group practices or integrated health systems1 or such other similar network arrangements as determined by the ,secretary through rulemaking4 7#d7 ,attestation ,a group health plan or health insurance issuer offering group or individual health insurance coverage shall annually submit to1 as applicable1 the applicable authority described in section #bgbc or the ,secretary of ,labor or the ,secretary of the ,treasury1 an attestation that such plan or issuer is in compliance with the requirements of this subsection4 7#e7 ,rule of construction ,nothing in this subsection shall be construed to limit network design or cost or quality initiatives by a group health plan or health insurance issuer1 including accountable care organizations1 exclusive provider organizations1 networks that tier providers by cost or quality or steer enrollees to centers of excellence1 or other pay-for-performance programs4 7#f7 ,compliance with respect to antitrust laws ,compliance with this subsection does not constitute compliance with the antitrust laws1 as defined in subsection 7a7 of the first section of the ,clayton ,act 7#ae ,u4,s4,c4 #ab7;a774 7#g7 ,grandfathering ,an applicable ,state authority may make a determination that the prohibitions under paragraph 7#a7 7with respect to conditions that would direct or steer to1 or offer incentives to encourage enrollees to use1 other health care providers7 will not apply in the ,state with respect to any specified agreement that is executed before the date of enactment of the ,bipartisan ,primary ,care and ,health ,workforce ,act1 for a maximum length of nonapplicability of up to #aj years from the date of execution of the contract if the applicable ,state authority determines that the contract is unlikely to significantly lessen competition4 ,with respect to a specified agreement for which an applicable ,state authority has made a determination under the preceding sentence an applicable ,state authority may determine whether renewal of the contract1 within the applicable #aj-year period1 is allowed4 2 and 7,b7 by redesignating paragraph 7#e7 of subsection 7a7 as subsection 7c71 adjusting the margin of such subsection accordingly1 and transferring such subsection 7c7 to appear after subsection 7b71 as added by subparagraph 7,a74 7#b7 ,employee ,retirement ,income ,security ,act of #aigd ,section #gbd of the ,employee ,retirement ,income ,security ,act of #aigd 7#bi ,u4,s4,c4 #aahem7 is amended-- 7,a7 by adding at the end the following3 7b7 ,protecting ,health ,plans ,network ,design ,flexibility 7#a7 ,in general ,a group health plan or a health insurance issuer offering group health insurance coverage shall not enter into an agreement with a provider1 network or association of providers1 or other service provider offering access to a network of service providers if such agreement1 directly or indirectly-- 7,a7 restricts the group health plan or health insurance issuer from-- 7i7 directing or steering enrollees to other health care providers2 or 7ii7 offering incentives to encourage enrollees to utilize specific health care providers2 7,b7 requires the group health plan or health insurance issuer to enter into any additional contract with an affiliate of the provider as a condition of entering into a contract with such provider2 7,c7 requires the group health plan or health insurance issuer to agree to payment rates or other terms for any affiliate not party to the contract of the provider involved2 or 7,d7 restricts other group health plans or health insurance issuers not party to the contract from paying a lower rate for items or services than the contracting plan or issuer pays for such items or services4 7#b7 ,additional requirement for self-insured plans ,a self-insured group health plan shall not enter into an agreement with a provider1 network or association of providers1 third-party administrator1 or other service provider offering access to a network of providers if such agreement directly or indirectly requires the group health plan to certify1 attest1 or otherwise confirm in writing that the group health plan is bound by restrictive contracting terms between the service provider and a third-party administrator that the group health plan is not party to1 without a disclosure that such terms exist4 7#c7 ,exception for plans and issuers ,paragraph 7#a77;,a7 shall not apply to a group health plan or health insurance issuer offering group health insurance coverage with respect to-- 7,a7 a health maintenance organization 7as defined in section #gcc7;b77#c771 if such health maintenance organization operates primarily through exclusive contracts with multi-specialty physician groups1 nor to any arrangement between such a health maintenance organization and its affiliates2 or 7,b7 a value-based network arrangement1 such as an exclusive provider network1 accountable care organization1 center of excellence1 a provider sponsored health insurance issuer that operates primarily through aligned multi-specialty physician group practices or integrated health systems1 or such other similar network arrangements as determined by the ,secretary through rulemaking4 7#d7 ,attestation ,a group health plan or health insurance issuer offering group health insurance coverage shall annually submit to1 as applicable1 the applicable authority described in section #bgbc of the ,public ,health ,service ,act or the ,secretary of ,labor or the ,secretary of the ,treasury1 an attestation that such plan or issuer is in compliance with the requirements of this subsection4 7#e7 ,rule of construction ,nothing in this subsection shall be construed to limit network design or cost or quality initiatives by a group health plan or health insurance issuer1 including accountable care organizations1 exclusive provider organizations1 networks that tier providers by cost or quality or steer enrollees to centers of excellence1 or other pay-for-performance programs4 7#f7 ,compliance with respect to antitrust laws ,compliance with this subsection does not constitute compliance with the antitrust laws1 as defined in subsection 7a7 of the first section of the ,clayton ,act 7#ae ,u4,s4,c4 #ab7;a774 7#g7 ,grandfathering ,an applicable ,state authority may make a determination that the prohibitions under paragraph 7#a7 7with respect to conditions that would direct or steer to1 or offer incentives to encourage enrollees to use1 other health care providers7 will not apply in the ,state with respect to any specified agreement that is executed before the date of enactment of the ,bipartisan ,primary ,care and ,health ,workforce ,act1 for a maximum length of nonapplicability of up to #aj years from the date of execution of the contract if the applicable ,state authority determines that the contract is unlikely to significantly lessen competition4 ,with respect to a specified agreement for which an applicable ,state authority has made a determination under the preceding sentence an applicable ,state authority may determine whether renewal of the contract1 within the applicable #aj-year period1 is allowed4 2 and 7,b7 by redesignating paragraph 7#d7 of subsection 7a7 as subsection 7c71 adjusting the margin of such subsection accordingly1 and transferring such subsection 7c7 to appear after subsection 7b71 as added by subparagraph 7,a74 7#c7 ,internal ,revenue ,code of #aihf ,section #ihbd of the ,internal ,revenue ,code of #aihf is amended-- 7,a7 by adding at the end the following3 7b7 ,protecting ,health ,plans ,network ,design ,flexibility 7#a7 ,in general ,a group health plan shall not enter into an agreement with a provider1 network or association of providers1 or other service provider offering access to a network of service providers if such agreement1 directly or indirectly-- 7,a7 restricts the group health plan from-- 7i7 directing or steering enrollees to other health care providers2 or 7ii7 offering incentives to encourage enrollees to utilize specific health care providers2 7,b7 requires the group health plan to enter into any additional contract with an affiliate of the provider as a condition of entering into a contract with such provider2 7,c7 requires the group health plan to agree to payment rates or other terms for any affiliate not party to the contract of the provider involved2 or 7,d7 restricts other group health plans not party to the contract from paying a lower rate for items or services than the contracting plan pays for such items or services4 7#b7 ,additional requirement for self-insured plans ,a self-insured group health plan shall not enter into an agreement with a provider1 network or association of providers1 third-party administrator1 or other service provider offering access to a network of providers if such agreement directly or indirectly requires the group health plan to certify1 attest1 or otherwise confirm in writing that the group health plan is bound by restrictive contracting terms between the service provider and a third-party administrator that the group health plan is not party to1 without a disclosure that such terms exist4 7#c7 ,exception for certain plans ,paragraph 7#a77;,a7 shall not apply to a group health plan with respect to-- 7,a7 a health maintenance organization 7as defined in section #ihcb7;b77#c771 if such health maintenance organization operates primarily through exclusive contracts with multi-specialty physician groups1 nor to any arrangement between such a health maintenance organization and its affiliates2 or 7,b7 a value-based network arrangement1 such as an exclusive provider network1 accountable care organization1 center of excellence1 a provider sponsored health insurance issuer that operates primarily through aligned multi-specialty physician group practices or integrated health systems1 or such other similar network arrangements as determined by the ,secretary through rulemaking4 7#d7 ,attestation ,a group health plan shall annually submit to1 as applicable1 the applicable authority described in section #bgbc of the ,public ,health ,service ,act or the ,secretary of ,labor or the ,secretary of the ,treasury1 an attestation that such plan is in compliance with the requirements of this subsection4 7#e7 ,rule of construction ,nothing in this subsection shall be construed to limit network design or cost or quality initiatives by a group health plan1 including accountable care organizations1 exclusive provider organizations1 networks that tier providers by cost or quality or steer enrollees to centers of excellence1 or other pay-for-performance programs4 7#f7 ,compliance with respect to antitrust laws ,compliance with this subsection does not constitute compliance with the antitrust laws1 as defined in subsection 7a7 of the first section of the ,clayton ,act 7#ae ,u4,s4,c4 #ab7;a774 7#g7 ,grandfathering ,an applicable ,state authority may make a determination that the prohibitions under paragraph 7#a7 7with respect to conditions that would direct or steer to1 or offer incentives to encourage enrollees to use1 other health care providers7 will not apply in the ,state with respect to any specified agreement that is executed before the date of enactment of the ,bipartisan ,primary ,care and ,health ,workforce ,act1 for a maximum length of nonapplicability of up to #aj years from the date of execution of the contract if the applicable ,state authority determines that the contract is unlikely to significantly lessen competition4 ,with respect to a specified agreement for which an applicable ,state authority has made a determination under the preceding sentence an applicable ,state authority may determine whether renewal of the contract1 within the applicable #aj-year period1 is allowed4 2 and 7,b7 by redesignating paragraph 7#d7 of subsection 7a7 as subsection 7c71 adjusting the margin of such subsection accordingly1 and transferring such subsection 7c7 to appear after subsection 7b71 as added by subparagraph 7,a74 7b7 ,regulations ,not later than #a year after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services1 the ,secretary of ,labor1 and the ,secretary of the ,treasury1 jointly1 shall promulgate regulations to carry out section #bgii;,a-#i7;b7 of the ,public ,health ,service ,act1 section #gbd7;b7 of the ,employee ,retirement ,income ,security ,act of #aigd1 and section #ihbd7;b7 of the ,internal ,revenue ,code of #aihf1 as added by subsection 7a74 7c7 ,effective date ,subsection 7b7 of section #bgii;,a-#i of the ,public ,health ,service ,act1 subsection 7b7 of section #gbd of the ,employee ,retirement ,income ,security ,act of #aigd1 and subsection 7b7 of section #ihbd of the ,internal ,revenue ,code of #aihf 7as added by paragraphs 7#a71 7#b71 and 7#c71 respectively1 of subsection 7a77 shall apply with respect to any contract entered into on or after the date that is #ah months after the date of enactment of this ,act4 ,with respect to an applicable contract that is in effect on the date of enactment of this ,act1 such subsection 7b7 shall apply on the earlier of the date of renewal of such contract or #c years after such date of enactment4 #cjb4 ,honest billing requirements applicable to providers 7a7 ,group health plan and health insurance issuer requirements 7#a7 ,public ,health ,service ,act ,part ,d of title ,,xxvii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#aaa et seq47 is amended by adding at the end the following3 #bgii;,a-#aa4 ,honest billing requirements applicable to plans and issuers ,a group health plan or health insurance issuer offering group or individual health insurance coverage may not pay a claim for items and services furnished on or after ,january #a1 #bjbf1 to an individual at an off-campus outpatient department of a provider 7as defined in section #bgii;,b-#aj7;b777 submitted by a health care provider or facility unless such claim submitted by such provider or facility includes a separate unique health identifier for the department where items and services were furnished1 in accordance with section #bgii;,b-#aj4 4 7#b7 ,employee ,retirement ,income ,security ,act of #aigd 7,a7 ,in general ,subpart ,b of part #g of subtitle ,b of title ,i of the ,employee ,retirement ,income ,security ,act of #aigd 7#bi ,u4,s4,c4 #aahe et seq47 is amended by adding at the end the following3 #gbf4 ,honest billing requirements applicable to plans and issuers ,a group health plan or health insurance issuer offering group health insurance coverage may not pay a claim for items and services furnished on or after ,january #a1 #bjbf1 to an individual at an off-campus outpatient department of a provider 7as defined in section #bgii;,b-#aj7;b77 of the ,public ,health ,service ,act7 submitted by a health care provider or facility unless such claim submitted by such provider or facility includes a separate unique health identifier for the department where items and services were furnished1 in accordance with section #bgii;,b-#aj of such ,act4 4 7,b7 ,clerical amendment ,the table of contents in section #a of the ,employee ,retirement ,income ,security ,act of #aigd 7#bi ,u4,s4,c4 #ajja et seq47 is amended by inserting after the item relating to section #gbe the following new item3 ,sec4 #gbf4 ,honest billing requirements applicable to plans and issuers4 4 7#c7 ,internal ,revenue ,code of #aihf 7,a7 ,in general ,subchapter ,b of chapter #ajj of the ,internal ,revenue ,code of #aihf is amended by adding at the end the following3 #ihbf4 ,honest billing requirements applicable to plans ,a group health plan may not pay a claim for items and services furnished on or after ,january #a1 #bjbf1 to an individual at an off-campus outpatient department of a provider 7as defined in section #bgii;,b-#aj7;b77 of the ,public ,health ,service ,act7 submitted by a health care provider or facility unless such claim submitted by such provider or facility includes a separate unique health identifier for the department where items and services were furnished1 in accordance with section #bgii;,b-#aj of such ,act4 4 7,b7 ,clerical amendment ,the table of sections for subchapter ,b of chapter #ajj of the ,internal ,revenue ,code of #aihf is amended by adding at the end the following new item3 ,sec4 #ihbf4 ,honest billing requirements applicable to plans4 4 7b7 ,requiring a separate identification number and an attestation for each off-,campus outpatient department of a provider 7#a7 ,in general ,part ,e of title ,,xxvii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#aca et seq47 is amended by adding at the end the following3 #bgii;,b-#aj4 ,honest billing requirements applicable to providers 7a7 ,requirements relating to unique health identifiers ,for items and services furnished1 on or after ,january #a1 #bjbf1 at an off-campus outpatient department of a provider to a participant1 beneficiary1 or enrollee with benefits under a group health plan or group or individual health insurance coverage offered by a health insurance issuer1 a health care provider or facility may not submit a claim to the group health plan or health insurance issuer1 bill the participant1 beneficiary1 or enrollee1 or hold liable the participant1 beneficiary1 or enrollee1 unless-- 7#a7 such provider or facility obtains a separate unique health identifier established for such department pursuant to section #aagc7;b7 of the ,social ,security ,act2 and 7#b7 such items and services are billed using the separate unique health identifier established for such department pursuant to paragraph 7#a74 7b7 ,off-,campus outpatient department of a provider ,the term off-campus outpatient department of a provider means a department of a provider 7as defined in section #dac4fe7;a77#b7 of title #db of the ,code of ,federal ,regulations1 as in effect on the date of the enactment of the ,bipartisan ,primary ,care and ,health ,workforce ,act7 that is not located-- 7#a7 on the campus 7as defined in such section #dac4fe7;a77#b77 of such provider2 or 7#b7 within the distance 7described in such definition of campus7 from a remote location of a hospital 7as defined in such section #dac4fe7;a77#b774 7c7 ,process for reporting suspected violations ,the ,secretary shall establish a process under which a suspected violation of this section may be reported to such ,secretary4 7d7 ,penalties ,the ,secretary may assess a civil monetary penalty against a hospital for a violation under this section in an amount-- 7#a7 in the case of a hospital with not more than #cj beds 7as determined under section #ahj4ij7;c77#b77;ii77,d7 of title #de1 ,code of ,federal ,regulations1 as in effect on the date of the enactment of the ,bipartisan ,primary ,care and ,health ,workforce ,act 7or any successor regulations771 not to exceed #cjj per day that the violation is ongoing1 as determined by the ,secretary2 and 7#b7 in the case of a hospital with more than #cj beds 7as so determined71 not to exceed #e1ejj per day that the violation is ongoing1 as determined by the ,secretary4 4 7#b7 ,conforming amendment ,section #bgii;,b-#d7;a77#a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#acd7;a77#a77 is amended by inserting 7other than section #bgii;,b-#aj7 after this part4 #cjc4 ,banning facility fees for certain services ,part ,e of title ,,xxvii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#aca et seq471 as amended by section #cjb7;b71 is further amended by adding at the end the following3 #bgii;,b-#aa4 ,banning facility fees for certain services 7a7 ,in general ,with respect to applicable items and services furnished to an individual on or after ,january #a1 #bjbf1 a health care provider or facility may not charge a facility fee 7regardless of how the fee is labeled7 to a group health plan1 a health insurance issuer offering group or individual health insurance coverage1 a participant1 beneficiary1 or enrollee in such a plan or coverage1 or an individual patient who is not covered by a group health plan1 health insurance coverage1 or a ,federal health care program 7as defined in section #aabh7;f7 of the ,social ,security ,act74 7b7 ,applicable items and services ,in this section1 the term applicable items and services means-- 7#a7 evaluation and management services described in section #ahcc7;cc77#a77;,b77i7 of the ,social ,security ,act2 7#b7 outpatient behavioral health services 7not including partial hospitalizations1 intensive outpatient program services1 and other services not typically provided in an office setting 7as the ,secretary may determine772 and 7#c7 any items and services 7including the items and services described in paragraphs 7#a7 and 7#b77 furnished via telehealth4 4 #cjd4 ,prevention and ,public ,health ,fund ,section #djjb7;b7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #cjju-#aa7;b77 is amended by striking paragraphs 7#h7 through 7#aj7 and inserting the following3 7#h7 for each of fiscal years #bjbf and #bjbg1 #a1dbe1jjj1jjj2 7#i7 for each of fiscal years #bjbh and #bjbi1 #a1die1jjj1jjj2 7#aj7 for fiscal year #bjcj1 #a1fhj1jjj1jjj2 and 7#aa7 for fiscal year #bjca and each fiscal year thereafter1 #b1jjj1jjj1jjj4 4