End Valley Fever Now Act

I 116TH CONGRESS 1ST SESSION H. R. 5438 To direct the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, to award grants to develop programs to increase health care providers’ awareness of Valley fever, and for other purposes. IN THE HOUSE OF REPRESENTATIVES DECEMBER 16, 2019 Mr. COX of California (for himself, Mr. HARDER of California, Mr. COSTA, Mr. GALLEGO, Mr. O’HALLERAN, Mrs. KIRKPATRICK, Mr. PANETTA, and Mr. GRIJALVA) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To direct the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, to award grants to develop pro- grams to increase health care providers’ awareness of Valley fever, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘End Valley Fever Now 4 Act’’. 5 VerDate Sep 11 2014 01:44 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H5438.IH H5438 kjohnson on DSK79L0C42 with BILLS 2 •HR 5438 IH SEC. 2. GRANTS TO DEVELOP PROGRAMS TO INCREASE 1 HEALTH CARE PROVIDERS’ AWARENESS OF 2 VALLEY FEVER. 3 Part P of title III of the Public Health Service Act 4 (42 U.S.C. 280g et seq.) is amended by adding at the end 5 the following: 6 ‘‘SEC. 399V–7. GRANTS TO DEVELOP PROGRAMS TO IN- 7 CREASE HEALTH CARE PROVIDERS’ AWARE- 8 NESS OF VALLEY FEVER. 9 ‘‘(a) IN GENERAL.—The Secretary, acting through 10 the Administrator of the Health Resources and Services 11 Administration and in consultation with the Director of 12 the Centers for Disease Control and Prevention, shall 13 make awards of grants or cooperative agreements to eligi- 14 ble entities to establish and carry out programs— 15 ‘‘(1) to increase health care providers’ aware- 16 ness of Valley fever; and 17 ‘‘(2) to educate and train health care providers 18 on the diagnosis and treatment of Valley fever. 19 ‘‘(b) USE OF FUNDS.—An eligible entity selected to 20 receive a grant or contract under this section shall use 21 amounts awarded under such a grant or contract to pro- 22 vide innovative supportive activities (which may include 23 activities that do not rely on the use of broadband serv- 24 ices) to enhance education through distance learning, con- 25 VerDate Sep 11 2014 01:44 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H5438.IH H5438 kjohnson on DSK79L0C42 with BILLS 3 •HR 5438 IH tinuing educational activities, collaborative conferences, 1 and electronic and telelearning activities. 2 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 3 are authorized to be appropriated to carry out this section 4 $1,000,000 for the period of fiscal years 2021 through 5 2023, to remain available until expended. 6 ‘‘(d) CONDITION.—A recipient of a grant under this 7 section shall, as a condition on receipt of the grant, agree 8 to develop curricula for the purposes specified in sub- 9 section (a) in coordination with local providers at hospitals 10 and clinics. 11 ‘‘(e) DEFINITIONS.—In this section: 12 ‘‘(1) The term ‘eligible entity’ means— 13 ‘‘(A) a State department of health (or 14 similar State authority); 15 ‘‘(B) an institution of higher education (as 16 defined in section 101 of the Higher Education 17 Act of 1965 (20 U.S.C. 1001)), including a 18 medical school or continuing medical education 19 program at such institution; 20 ‘‘(C) an entity operating a graduate med- 21 ical residency training program under section 22 340E or under section 340H; or 23 ‘‘(D) a teaching hospital (as defined in sec- 24 tion 415.152 of title 42, Code of Federal Regu- 25 VerDate Sep 11 2014 01:44 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H5438.IH H5438 kjohnson on DSK79L0C42 with BILLS 4 •HR 5438 IH lations) that has physicians and other medical 1 providers with specialized knowledge in diag- 2 nosing and treating Valley fever. 3 ‘‘(2) The term ‘Valley fever’ means the condi- 4 tion caused by Coccidioidomycosis.’’. 5 SEC. 3. STUDY COMPARING DIFFERENT CASE DEFINITIONS 6 USED TO IDENTIFY VALLEY FEVER. 7 (a) IN GENERAL.—The Secretary of Health and 8 Human Services, acting through the Director of the Cen- 9 ters for Disease Control and Prevention shall conduct a 10 study comparing different case definitions used to identify 11 valley fever. Such study shall include the efficacy of the 12 methods being used to establish such case definitions and 13 the cost effectiveness of such methods, including using the 14 case definition for valley fever established by the Council 15 of State and Territorial Epidemiologist. 16 (b) VALLEY FEVER DEFINED.—In this Act, the term 17 ‘‘Valley fever’’ has the meaning given the term in section 18 399V–7 of the Public Health Service Act. 19 VerDate Sep 11 2014 01:44 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H5438.IH H5438 kjohnson on DSK79L0C42 with BILLS 5 •HR 5438 IH SEC. 4. ALLOWING STATES TO PROVIDE COVERAGE UNDER 1 THE MEDICAID PROGRAM FOR ITEMS AND 2 SERVICES FURNISHED IN CONNECTION WITH 3 QUALIFYING VALLEY FEVER CLINICAL 4 TRIALS. 5 (a) IN GENERAL.—Section 1905(a) of the Social Se- 6 curity Act (42 U.S.C. 1396d(a)) is amended— 7 (1) in paragraph (29), by striking ‘‘and’’ at the 8 end; 9 (2) by redesignating paragraph (30) as para- 10 graph (31); and 11 (3) by inserting after paragraph (29) the fol- 12 lowing new paragraph: 13 ‘‘(30) items and services furnished in connec- 14 tion with participation in a qualifying Valley fever 15 clinical trial (as defined in section 2709A(b)(4) of 16 the Public Health Service Act), including travel and 17 incidental expenses, regardless of whether such items 18 and services are furnished by a participating pro- 19 vider under the Medicaid program (other than a pro- 20 vider excluded from participation in such program 21 under section 1128) or whether such items and serv- 22 ices are furnished in another State; and’’. 23 (b) REDUCTION IN FMAP FOR STATES THAT DO 24 NOT PROVIDE COVERAGE.—Section 1905 of the Social 25 Security Act (42 U.S.C. 1396d) is amended— 26 VerDate Sep 11 2014 01:44 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H5438.IH H5438 kjohnson on DSK79L0C42 with BILLS 6 •HR 5438 IH (1) in subsection (b), by striking ‘‘and (ff)’’ and 1 inserting ‘‘(ff), and (gg)’’; and 2 (2) by adding at the end the following new sub- 3 section: 4 ‘‘(gg) REDUCTION IN FMAP FOR STATES THAT DO 5 NOT PROVIDE COVERAGE FOR CERTAIN ITEMS AND 6 SERVICES.—With respect to a calendar quarter beginning 7 on or after January 1, 2021, the Federal medical assist- 8 ance percentage otherwise determined under subsection 9 (b) for a State that does not provide coverage for items 10 and services described in subsection (a)(30) that are fur- 11 nished during such quarter shall be reduced by 5 percent- 12 age points.’’. 13 (c) ENSURING ACCESS FOR MEDICAID EXPANSION 14 POPULATION.—Section 1937(b)(5) of such Act is amend- 15 ed by inserting before the period at the end the following: 16 ‘‘, and beginning January 1, 2021, coverage of items and 17 services described in section 1905(a)(30)’’. 18 (d) PROHIBITION ON IMPOSITION OF COSTSHARING 19 REQUIREMENTS.—Title XIX of the Social Security Act 20 (42 U.S.C. 1396 et seq.) is amended— 21 (1) in section 1916(a)(2)— 22 (A) in subparagraph (D), by striking ‘‘or’’ 23 at the end; 24 VerDate Sep 11 2014 01:44 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H5438.IH H5438 kjohnson on DSK79L0C42 with BILLS 7 •HR 5438 IH (B) in subparagraph (E), by striking ‘‘; 1 and’’ at the end and inserting ‘‘, or’’; and 2 (C) by adding at the end the following new 3 subparagraph: 4 ‘‘(F) items and services described in sec- 5 tion 1905(a)(30); and’’; and 6 (2) in section 1916A(b)(3)(B), by adding at the 7 end the following new clause: 8 ‘‘(xi) Items and services described in 9 section 1905(a)(30).’’. 10 (e) CONTINUOUS COVERAGE FOR INDIVIDUALS WHO 11 LOSE MEDICAID ELIGIBILITY BASED ON INCOME.—Sec- 12 tion 1902(e) of the Social Security Act (42 U.S.C. 13 1396a(e)) is amended by adding at the end the following 14 new paragraph: 15 ‘‘(16) CONTINUOUS COVERAGE FOR ITEMS AND 16 SERVICES FURNISHED IN CONNECTION WITH QUALI- 17 FYING VALLEY FEVER CLINICAL TRIALS.—In the 18 case of an individual who is eligible for medical as- 19 sistance under the State plan (or a waiver of such 20 plan) based on the application of modified adjusted 21 gross income under paragraph (14)(A), who while so 22 eligible is furnished items and services described in 23 section 1905(a)(30) in connection with participation 24 in a qualifying Valley fever clinical trial (as defined 25 VerDate Sep 11 2014 01:44 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H5438.IH H5438 kjohnson on DSK79L0C42 with BILLS 8 •HR 5438 IH in section 2709A(b)(4) of the Public Health Service 1 Act), and who while so furnished such items and 2 services loses eligibility for such medical assistance 3 due to a change in income of the family of which 4 such individual is a member, such individual shall be 5 deemed to continue to be an individual eligible for 6 such medical assistance, without regard to such 7 change in income, only with respect to such items 8 and services through the end of the month in which 9 such qualifying Valley fever clinical trial ends.’’. 10 (f) EFFECTIVE DATE.— 11 (1) IN GENERAL.—The amendments made by 12 this section shall apply with respect to items and 13 services furnished, and eligibility determinations 14 made, on or after January 1, 2021. 15 (2) EXCEPTION FOR STATE LEGISLATION.—In 16 the case of a State plan under title XIX of the So- 17 cial Security Act (42 U.S.C. 1396 et seq.) that the 18 Secretary of Health and Human Services determines 19 requires State legislation in order for the respective 20 plan to meet any requirement imposed by amend- 21 ments made by this section, the respective plan shall 22 not be regarded as failing to comply with the re- 23 quirements of such title solely on the basis of its 24 failure to meet such an additional requirement be- 25 VerDate Sep 11 2014 01:44 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H5438.IH H5438 kjohnson on DSK79L0C42 with BILLS 9 •HR 5438 IH fore the first day of the first calendar quarter begin- 1 ning after the close of the first regular session of the 2 State legislature that begins after the date of the en- 3 actment of this Act. For purposes of the previous 4 sentence, in the case of a State that has a 2-year 5 legislative session, each year of the session shall be 6 considered to be a separate regular session of the 7 State legislature. 8 SEC. 5. REQUIREMENT FOR GROUP HEALTH PLANS AND 9 HEALTH INSURANCE ISSUERS TO PROVIDE 10 COVERAGE FOR ITEMS AND SERVICES FUR- 11 NISHED IN CONNECTION WITH QUALIFYING 12 VALLEY FEVER CLINICAL TRIALS. 13 (a) IN GENERAL.—Subpart I of part A of title 14 XXVII of the Public Health Service Act (42 U.S.C. 300gg 15 et seq.) is amended— 16 (1) by redesignating the second section 2709 as 17 section 2710; and 18 (2) by inserting after the first section 2709 the 19 following new section: 20 ‘‘SEC. 2709A. COVERAGE FOR INDIVIDUALS PARTICIPATING 21 IN QUALIFYING VALLEY FEVER CLINICAL 22 TRIALS. 23 ‘‘(a) IN GENERAL.—Notwithstanding section 2709, a 24 group health plan or health insurance issuer offering 25 VerDate Sep 11 2014 01:44 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H5438.IH H5438 kjohnson on DSK79L0C42 with BILLS 10 •HR 5438 IH group or individual health insurance coverage shall, with 1 respect to an enrollee of such plan or coverage, respec- 2 tively, provide coverage for any item or service furnished 3 to such enrollee in connection with such enrollee’s partici- 4 pation in a qualifying Valley fever clinical trial, including 5 travel and incidental expenses— 6 ‘‘(1) without regard to whether such item or 7 service is furnished by a participating provider or 8 participating facility with respect to such item or 9 service; and 10 ‘‘(2) in a manner so that, if such item or serv- 11 ice is furnished to such enrollee by a nonpartici- 12 pating provider or nonparticipating facility, the cost- 13 sharing requirement (expressed as a copayment 14 amount or coinsurance rate) is not greater than the 15 requirement that would apply if such item or service 16 were furnished by a participating provider or partici- 17 pating facility. 18 ‘‘(b) DEFINITIONS.—In this section: 19 ‘‘(1) NONPARTICIPATING FACILITY; PARTICI- 20 PATING FACILITY.— 21 ‘‘(A) NONPARTICIPATING FACILITY.—The 22 term ‘nonparticipating facility’ means, with re- 23 spect to an item or service and a group health 24 plan or group or individual health insurance 25 VerDate Sep 11 2014 01:44 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H5438.IH H5438 kjohnson on DSK79L0C42 with BILLS 11 •HR 5438 IH coverage, a health care facility that does not 1 have a contractual relationship with the sponsor 2 of such plan or issuer of such coverage for fur- 3 nishing such item or service under the plan or 4 coverage. 5 ‘‘(B) PARTICIPATING FACILITY.—The term 6 ‘participating facility’ means, with respect to an 7 item or service and a group health plan or 8 group or individual health insurance coverage, a 9 health care facility that has a contractual rela- 10 tionship with the sponsor of such plan or issuer 11 of such coverage for furnishing such item or 12 service under the plan or coverage. 13 ‘‘(2) NONPARTICIPATING PROVIDER; PARTICI- 14 PATING PROVIDER.— 15 ‘‘(A) NONPARTICIPATING PROVIDER.—The 16 term ‘nonparticipating provider’ means, with re- 17 spect to an item or service and a group health 18 plan or group or individual health insurance 19 coverage, a physician or other health care pro- 20 vider who is acting within the scope of practice 21 of that provider’s license or certification under 22 applicable State law and who does not have a 23 contractual relationship with the sponsor of 24 such plan or issuer of such coverage for fur- 25 VerDate Sep 11 2014 01:44 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H5438.IH H5438 kjohnson on DSK79L0C42 with BILLS 12 •HR 5438 IH nishing such item or service under the plan or 1 coverage. 2 ‘‘(B) PARTICIPATING PROVIDER.—The 3 term ‘participating provider’ means, with re- 4 spect to an item [Text truncated for display. 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