EASE Act

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 1248 Introduced in Senate (IS)]

<DOC>

119th CONGRESS
  1st Session
                                S. 1248

To amend title XI of the Social Security Act to require the Center for
 Medicare and Medicaid Innovation to test a model to improve access to
      specialty health services for certain Medicare and Medicaid
                             beneficiaries.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                             April 2, 2025

 Mr. Mullin (for himself, Mr. Padilla, and Mr. Tillis) introduced the
 following bill; which was read twice and referred to the Committee on
                                Finance

_______________________________________________________________________

                                 A BILL

To amend title XI of the Social Security Act to require the Center for
 Medicare and Medicaid Innovation to test a model to improve access to
      specialty health services for certain Medicare and Medicaid
                             beneficiaries.

    Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Ensuring Access to Specialty Care
Everywhere Act'' or the ``EASE Act''.

SEC. 2. REQUIRING THE CENTER FOR MEDICARE AND MEDICAID INNOVATION TO
              TEST A MODEL TO IMPROVE ACCESS TO SPECIALTY HEALTH
              SERVICES FOR CERTAIN MEDICARE AND MEDICAID BENEFICIARIES.

    (a) In General.--Section 1115A of the Social Security Act (42
U.S.C. 1315a) is amended--
            (1) in subsection (b)(2)--
                    (A) in subparagraph (A), in the third sentence, by
                inserting ``, and shall include the model described in
                subparagraph (B)(xxviii)'' before the period at the
                end; and
                    (B) in subparagraph (B), by adding at the end the
                following new clause:
                            ``(xxviii) The Specialty Health Care
                        Services Access Model described in subsection
                        (h).''; and
            (2) by adding at the end the following new subsection:
    ``(h) Specialty Health Care Services Access Model.--
            ``(1) In general.--For purposes of subsection
        (b)(2)(B)(xxviii), the Specialty Health Care Services Access
        Model described in this subsection is a model under which the
        Secretary enters into an agreement with one or more provider
        networks selected in accordance with paragraph (2) for purposes
        of furnishing specialty health care services (as specified by
        the Secretary) to eligible individuals through the use of
        digital modalities (such as telehealth and other remote
        technologies) in coordination with such individuals' primary
        care providers.
            ``(2) Selection of provider networks.--The Secretary shall
        select one or more networks of providers for purposes of
        furnishing services under the model described in paragraph (1).
        Any such network so selected shall--
                    ``(A) be comprised of at least 50 Federally
                qualified health centers, rural health clinics,
                critical access hospitals, or rural emergency
                hospitals, at least half of which are located in rural
                areas (as defined by the Administrator of the Health
                Resources and Services Administration);
                    ``(B) be a nonprofit entity under section 501(c)(3)
                of the Internal Revenue Code of 1986;
                    ``(C) have an established record of supporting the
                delivery of health care in rural and underserved
                communities in multiple regions throughout the country;
                and
                    ``(D) have the ability to collect, exchange, and
                evaluate data for purposes of the model described in
                paragraph (1).
            ``(3) Eligible individual defined.--For purposes of this
        subsection, the term `eligible individual' means an
        individual--
                    ``(A) who--
                            ``(i) is entitled to benefits under part A
                        of title XVIII or enrolled under part B of such
                        title; or
                            ``(ii) is enrolled under the Medicaid
                        program under title XIX or the Children's
                        Health Insurance Program under title XXI and
                        meets all components for eligibility for
                        medical assistance, child health assistance, or
                        pregnancy-related assistance (as applicable),
                        including those described in sections
                        1902(a)(46)(B) and 1137(d); and
                    ``(B) who is located in a rural or underserved area
                (as specified by the Secretary).''.
    (b) Limitation.--Any amounts appropriated or allocated to carry out
the amendments made by this section shall be subject to the
requirements contained in Public Law 117-328 for funds for programs
authorized under sections 330 through 340 of the Public Health Service
Act (42 U.S.C. 254b through 256).
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