Health Equity and Accountability Act of 2026

[Congressional Bills 119th Congress] [From the U.S. Government Publishing Office] [H.R. 9877 Introduced in House (IH)]

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119th CONGRESS 2d Session H. R. 9877

To improve the health of minority individuals, and for other purposes.

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IN THE HOUSE OF REPRESENTATIVES

July 22, 2026

Mr. Ruiz (for himself, Ms. Kelly of Illinois, Ms. Meng, Ms. Norton, Ms. Bonamici, Ms. Chu, Ms. Wilson of Florida, Ms. Velazquez, Mrs. Ramirez, Mr. Hernandez, Mr. Garcia of Illinois, Mr. Lieu, Mr. Frost, Mr. Jackson of Illinois, Ms. Salinas, Ms. Pressley, Mr. Espaillat, Ms. Mejia, Mr. Menefee, Mr. Thanedar, Ms. Moore of Wisconsin, Mr. Carter of Louisiana, Mrs. Grijalva, Ms. Tokuda, Ms. Randall, Mr. Aguilar, and Mrs. Hayes) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Agriculture, Oversight and Government Reform, Education and Workforce, the Judiciary, the Budget, Veterans' Affairs, Natural Resources, Armed Services, Homeland Security, Financial Services, Transportation and Infrastructure, and Foreign Affairs, 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 improve the health of minority individuals, and for other purposes.

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 ``Health Equity and Accountability Act of 2026''.

SEC. 2. TABLE OF CONTENTS.

The table of contents for this Act is as follows:

Sec. 1. Short title. Sec. 2. Table of contents. TITLE I--DATA COLLECTION AND REPORTING

Sec. 1001. Strengthening data collection, improving data analysis, and expanding data reporting. Sec. 1002. Elimination of prerequisite of direct appropriations for data collection and analysis. Sec. 1003. Collection of data for the Medicare program. Sec. 1004. Revision of HIPAA claims standards. Sec. 1005. National Center for Health Statistics. Sec. 1006. Disparities data collected by the Federal Government. Sec. 1007. Data collection and analysis grants to minority-serving institutions. Sec. 1008. Safety and effectiveness of drugs with respect to racial and ethnic background. Sec. 1009. Improving health data regarding Native Hawaiians and Pacific Islanders. Sec. 1010. Data collection regarding pandemic preparedness, testing, infections, and deaths. Sec. 1011. Commission on Ensuring Data for Health Equity. Sec. 1012. Task Force on Preventing Bias in AI and Algorithms. Sec. 1013. Report on health of Middle Eastern and North African populations. Sec. 1014. Inclusion of Puerto Rico in National Survey on Drug Use and Health. TITLE II--CULTURALLY AND LINGUISTICALLY APPROPRIATE HEALTH AND HEALTH CARE

Sec. 2001. Definitions. Sec. 2002. Improving access to services for individuals with limited english proficiency. Sec. 2003. Ensuring standards for culturally and linguistically appropriate services in health care. Sec. 2004. Culturally and linguistically appropriate health care in the public health service act. Sec. 2005. Pilot program for improvement and development of state medical interpreting services. Sec. 2006. Training tomorrow's doctors for culturally and linguistically appropriate care: graduate medical education. Sec. 2007. Federal reimbursement for culturally and linguistically appropriate services under the Medicare, Medicaid, and State Children's Health Insurance programs. Sec. 2008. Increasing understanding of and improving health literacy. Sec. 2009. Requirements for health programs or activities receiving Federal funds. Sec. 2010. Report on Federal efforts to provide culturally and linguistically appropriate health care services. Sec. 2011. English instruction for individuals with limited english proficiency. Sec. 2012. Implementation. Sec. 2013. Language access services. Sec. 2014. Medically underserved populations. Sec. 2015. Improving access to Federal services by individuals with limited English proficiency. Sec. 2016. Stop Mental Health Stigma Act. TITLE III--HEALTH WORKFORCE DIVERSITY

Subtitle A--Diversifying the Health Care Workplace

Sec. 3001. Amendment to the Public Health Service Act. Sec. 3002. Hispanic-serving institutions, historically Black colleges and universities, historically Black professional or graduate institutions, Asian American and Native American Pacific Islander-serving institutions, Tribal Colleges, regional community-based organizations, and national minority medical associations. Sec. 3003. Loan repayment program of Centers for Disease Control and Prevention. Sec. 3004. Cooperative agreements for online degree programs at schools of public health and schools of allied health. Sec. 3005. National Health Care Workforce Commission. Sec. 3006. Scholarship and fellowship programs. Sec. 3007. McNair Postbaccalaureate Achievement Program. Sec. 3008. Rules for determination of full-time equivalent residents for cost-reporting periods. Sec. 3009. Developing and implementing strategies for local health equity. Sec. 3010. Health Professions Workforce Fund. Sec. 3011. Future advancement of academic nursing. Sec. 3012. Sense of Congress relating to graduate medical education. Sec. 3013. Career support for skilled, internationally educated health professionals. Sec. 3014. Study and report on strategies for increasing diversity. Sec. 3015. Conrad State 30 program; physician retention. Sec. 3016. Grants for schools of medicine and schools of osteopathic medicine in underserved areas. Subtitle B--Substance Use Disorder Treatment and Behavioral and Mental Health Workforce

Sec. 3021. Short title. Sec. 3022. Substance Use Disorder Treatment and Behavioral and Mental Health Workforce Scholarship Program. Subtitle C--ACCESS in Mental Health Act

Sec. 3031. Short title. Sec. 3032. Purpose. Sec. 3033. Grants to support graduate programs in mental and behavioral health professions at historically Black colleges and universities, tribal colleges and universities, and other minority- serving institutions. Subtitle D--Developing the Community Health Workforce Act

Sec. 3041. Improving recruitment and retention of Federal qualified health center staff. Sec. 3042. Community Health Center Workforce Pipeline Program. Sec. 3043. Expanding hospital and FQHC partnerships for graduate medical education. Sec. 3044. Expanding FQHC services. TITLE IV--IMPROVING HEALTH CARE ACCESS AND QUALITY

Sec. 4000. Definition. Subtitle A--Reducing Barriers to Accessing Care

Sec. 4001. The Protecting Sensitive Locations Act. Sec. 4002. Repeal of requirement for documentation evidencing citizenship or nationality under the Medicaid program. Sec. 4003. Removing barriers to health care and nutrition assistance for children, pregnant persons, and lawfully present individuals. Sec. 4004. Improve affordability and reduce premium costs of health insurance for consumers. Sec. 4005. Removing citizenship and immigration barriers to access to affordable health care under the ACA. Sec. 4006. HEAL for Immigrant Families Act. Sec. 4007. Study on the uninsured. Sec. 4008. Medicaid fallback coverage program for low-income adults in non-expansion States. Sec. 4009. Increase and extension of temporary enhanced FMAP for States which begin to expend amounts for certain mandatory individuals. Subtitle B--Improvement of Coverage

Sec. 4101. Medicaid in the territories. Sec. 4102. Extension of the Supplemental Security Income Program to Puerto Rico, the United States Virgin Islands, Guam, and American Samoa. Sec. 4103. Extension of Medicare secondary payer. Sec. 4104. Indian defined in title I of the Patient Protection and Affordable Care Act. Sec. 4105. Removing Medicare barrier to health care. Sec. 4106. Lowering Medicare premiums and prescription drug costs. Sec. 4107. Reducing cost-sharing, aligning income and resource eligibility tests, simplifying enrollment, and other program improvements for low- income beneficiaries. Sec. 4108. 100 percent FMAP for medical assistance provided by urban Indian organizations. Sec. 4109. 100 percent FMAP for medical assistance provided to a Native Hawaiian through a Federally qualified health center or a Native Hawaiian health care system under the Medicaid program. Sec. 4110. Repeal of requirement for estate recovery under the Medicaid program. Sec. 4111. Allow for suspension of Medicare benefits and premium liability for individuals who are incarcerated and provide a special enrollment period around the date of release. Sec. 4112. Federal employee health benefits plans. Sec. 4113. Continuation of Medicaid income eligibility standard for pregnant individuals and infants. Subtitle C--Expansion of Access

PART 1--General Provisions

Sec. 4201. Amendment to the Public Health Service Act. Sec. 4202. Border health grants. Sec. 4203. Critical access hospital improvements. Sec. 4204. Medicare remote monitoring pilot projects. Sec. 4205. Community health center collaborative access expansion. Sec. 4206. Facilitating the provision of telehealth services across State lines. Sec. 4207. Scoring of preventive health savings. Sec. 4208. Sense of Congress on maintenance of effort provisions regarding children's health. Sec. 4209. Protection of the HHS Offices of Minority Health. Sec. 4210. Office of Minority Health in Veterans Health Administration of Department of Veterans Affairs. Sec. 4211. Study of DSH payments to ensure hospital access for low- income patients. Sec. 4212. Reauthorization of programs under the Native Hawaiian Health Care Improvement Act. PART 2--Rural

Sec. 4221. Establishment of Rural Community Hospital (RCH) Program. Sec. 4222. Rural Health Quality Advisory Commission and demonstration projects. Sec. 4223. Rural health care services. PART 3--Indian Communities

Sec. 4231. Assistant Secretary of the Indian Health Service. Sec. 4232. Extension of full Federal medical assistance percentage to Indian health care providers. Sec. 4233. Conferring with urban Indian organizations. PART 4--Providers

Sec. 4241. Availability of non-English language speaking providers. Sec. 4242. Access to essential community providers. Sec. 4243. Provider network adequacy in communities of color. PART 5--Dental

Sec. 4251. Improving access to dental care. Sec. 4252. Oral health literacy and awareness campaign. Sec. 4253. Ensuring Kids Have Access to Medically Necessary Dental Care Act. Subtitle D--Advancing Health Equity Through Payment and Delivery Reform

Sec. 4301. Centers for Medicare & Medicaid Services reporting and value-based programs. Sec. 4302. Development and testing of disparity reducing delivery and payment models. Sec. 4303. Diversity in Centers for Medicare and Medicaid consultation. Sec. 4304. Supporting safety net and community-based providers to compete in value-based payment systems. Sec. 4305. Improving access to care for Medicare and Medicaid beneficiaries. Subtitle E--Health Empowerment Zones

Sec. 4401. Designation of health empowerment zones. Sec. 4402. Assistance to those seeking designation. Sec. 4403. Benefits of designation. Sec. 4404. Definition of Secretary. Sec. 4405. Authorization of appropriations. Subtitle F--Equitable Health Care for All

Sec. 4501. Data collection and reporting. Sec. 4502. Requiring equitable health care in the hospital value-based purchasing program. Sec. 4503. Provision of inequitable health care as a basis for permissive exclusion from Medicare and State health care programs. Sec. 4504. Office for Civil Rights and Health Equity of the Department of Health and Human Services. Sec. 4505. Prohibiting discrimination in health care. Sec. 4506. Federal Health Equity Commission. Sec. 4507. Grants for hospitals to promote equitable health care and outcomes. Subtitle G--Investing in Equity

Sec. 4601. Definitions. Sec. 4602. Strategy to incentivize health equity. Sec. 4603. Pay for Equity Advisory Council. Subtitle H--Miscellaneous

Sec. 4701. Coverage for acupuncturist services under the Medicare program. Sec. 4702. Repeal of denial of benefits. Sec. 4703. Addressing disparities in Medicare Advantage benchmark levels based on penetration. Sec. 4704. Women Expansion of Learning and Labor Safety (WELLS) Act. Sec. 4705. Access to Birth Control Act. Sec. 4706. Enabling State Medicaid programs to provide care through health homes to individuals with sickle cell disease. Sec. 4707. Grant program for community schools and health equity. Subtitle I--Territories Health Equity

PART 1--Medicare

subpart a--part a

Sec. 4801. Calculation of medicare DSH payments for IPPS hospitals in Puerto Rico. Sec. 4802. Rebasing target amount for hospitals in territories. Sec. 4803. Medicare DSH target adjustment for hospitals in territories. subpart b--part b

Sec. 4811. Eliminating late enrollment penalties under Part B of the Medicare program for certain individuals residing in Puerto Rico. subpart c--medicare advantage (part c)

Sec. 4821. Adjustment in benchmark for low-base payment counties in Puerto Rico. subpart d--part d

Sec. 4831. Automatic eligibility of certain low-income territorial residents for premium and cost-sharing subsidies under the Medicare program; sunset of enhanced allotment program. PART 2--Miscellaneous

Sec. 4841. Medicaid and CHIP territory transparency and information. Sec. 4842. Report on exclusion of territories from exchanges. Sec. 4843. Access to coverage for individuals in certain areas without any available exchange plans. Sec. 4844. Prohibition on disclosing Medicaid data. TITLE V--IMPROVING HEALTH OUTCOMES FOR WOMEN, GENDER-DIVERSE PEOPLE, CHILDREN, AND FAMILIES

Subtitle A--Underserved Communities

Sec. 5001. Grants to promote health for underserved communities. Subtitle B--Pregnancy Screening

Sec. 5101. Pregnancy intention screening initiative demonstration program. Sec. 5102. Birth defects prevention, risk reduction, and awareness. Subtitle C--Pregnancy-Related Care

Sec. 5201. Community access, resources, and empowerment for moms. Sec. 5202. MOMMIES. Sec. 5203. Social determinants for moms. Sec. 5204. Kira Johnson Act. Sec. 5205. Perinatal workforce. Sec. 5206. Data to Save Moms Act. Sec. 5207. Moms matter. Sec. 5208. Justice for Incarcerated Moms. Sec. 5209. Tech to save moms. Sec. 5210. IMPACT To Save Moms Act. Sec. 5211. Protecting moms and babies against climate change. Sec. 5212. Protect moms from domestic violence. Sec. 5213. Midwives schools and programs expansion. Sec. 5214. Gestational diabetes. Sec. 5215. Consumer education campaign. Sec. 5216. Bibliographic database of systematic reviews for care of childbearing individuals and newborns. Sec. 5217. Development of interprofessional maternity care educational models and tools. Sec. 5218. Dissemination of the quality family planning guidelines. Subtitle D--Federal Agency Coordination on Maternal Health

Sec. 5301. Interagency Coordinating Committee on the Promotion of Optimal Maternity Outcomes. Sec. 5302. Expansion of CDC Prevention Research Centers Program to include Centers on Optimal Maternity Outcomes. Sec. 5303. Expanding models to be tested by Center for Medicare and Medicaid Innovation to explicitly include maternity care and children's health models. Sec. 5304. Interagency update to the quality family planning guidelines. Subtitle E--Reproductive and Sexual Health

Sec. 5401. Sense of Congress on urgent issues concerning barriers to abortion access and vital solutions. Sec. 5402. Emergency contraception education and information programs. Sec. 5403. Duties of pharmacies to ensure provision of FDA-approved contraception. Sec. 5404. Real Education and Access for Healthy Youth Act. Sec. 5405. Compassionate assistance for rape emergencies. Sec. 5406. Menstrual Equity for All Act. Sec. 5407. Additional focus area for the Office on Women's Health. Sec. 5408. Including services furnished by certain students, interns, and residents supervised by certified nurse midwives or certified midwives within inpatient hospital services under Medicare. Sec. 5409. Grants to professional organizations and minority-serving institutions to increase diversity in maternal, reproductive, and sexual health professionals. Subtitle F--Children's Health

Sec. 5501. CARING for Kids Act. Sec. 5502. End Diaper Need Act. Sec. 5503. Decreasing the risk factors for sudden unexpected infant death and sudden unexplained death in childhood. Subtitle G--Elder Care

Sec. 5601. Expenses for household and elder care services necessary for gainful employment. Subtitle H--Miscellaneous Provisions

Sec. 5701. Clarification supporting permissible use of funds for stillbirth prevention activities. TITLE VI--MENTAL HEALTH AND SUBSTANCE USE DISORDERS

Sec. 6001. Sense of Congress. Subtitle A--Access to Care and Funding Streams

Sec. 6101. Coverage of substance use disorder counselor services and peer support specialist services under part B of the Medicare program. Sec. 6102. Reauthorization of Minority Fellowship Program. Sec. 6103. Additional funds for National Institutes of Health. Sec. 6104. Additional funds for National Institute on Minority Health and Health Disparities. Sec. 6105. Grants for increasing racial and ethnic minority access to high-quality trauma support services and mental health care. Subtitle B--Interprofessional Care

Sec. 6201. Health professions competencies to address racial and ethnic mental health inequities. Sec. 6202. Interprofessional health care teams for behavioral health care. Sec. 6203. Integrated Health Care Demonstration Program. Subtitle C--Workforce Development

Sec. 6301. Building an effective workforce in mental health. Sec. 6302. Demonstration program to increase language access at eligible health centers. Sec. 6303. Health professions competencies to address racial and ethnic minority mental health disparities. Subtitle D--Children's Mental Health

Sec. 6401. Grant programs to support pediatric behavioral health care. Sec. 6402. Increasing Federal investment in pediatric behavioral health services. Sec. 6403. Mental health in schools. Sec. 6404. Additional support for youth and young adult mental health service provision. Sec. 6405. Early intervention and prevention programs for transition- age youth. Sec. 6406. Strategies to increase access to telehealth under Medicaid and the Children's Health Insurance Program. Sec. 6407. Youth and young adult mental health promotion, prevention, intervention, and treatment. Subtitle E--Community-Based Care

Sec. 6501. Asian American, African American, Native Hawaiian, Pacific Islander, Indigenous, Middle Eastern and North African, and Hispanic and Latino behavioral health outreach and education strategy. Subtitle F--Reports

Sec. 6601. Addressing racial and ethnic minority mental health disparities research gaps. Sec. 6602. Research on adverse health effects associated with interactions with law enforcement. Sec. 6603. GeoAccess study. Sec. 6604. Co-occurring conditions. Sec. 6605. Study and report on the AANHPI youth mental health crisis. Sec. 6606. Study and report on strategies on the AANHPI behavioral health workforce shortage. Subtitle G--Miscellaneous Provisions

Sec. 6701. Strengthening mental health supports for BIPOC communities. Sec. 6702. STRONG support for children. Sec. 6703. Improving access to mental health. Sec. 6704. Program to establish public-private contributions to increase the available workforce of school- based mental health service providers. Sec. 6705. School social workers improving student success. Sec. 6706. Opioid grants to support caregivers, kinship care families, and kinship caregivers. Sec. 6707. Substance Use and Mental Health Services Administration and subagencies. Sec. 6708. Mental Health for Latinos Act. Sec. 6709. Supporting farmworkers' mental health. Sec. 6710. Clarifying coverage of occupational therapy under Medicare. Sec. 6711. Training community mental wellness workers. TITLE VII--ADDRESSING HIGH-IMPACT MINORITY DISEASES

Subtitle A--Cancer

Sec. 7001. Lung cancer mortality reduction. Sec. 7002. Expansion of prostate cancer research, outreach, screening, testing, access, and treatment effectiveness. Sec. 7003. Prostate research, imaging, and men's education. Sec. 7004. Prostate cancer detection research and education. Sec. 7005. National prostate cancer council. Sec. 7006. Improved medicaid coverage for certain breast and cervical cancer patients in the territories. Sec. 7007. Cancer prevention and treatment demonstration for ethnic and racial minorities. Sec. 7008. Reducing cancer disparities within the Medicare program. Subtitle B--Viral Hepatitis and Liver Cancer Control and Prevention

Sec. 7101. Biennial assessment of HHS hepatitis B and hepatitis C prevention, education, research, and medical management plan. Sec. 7102. Liver cancer and disease prevention, awareness, and patient tracking grants. Subtitle C--Acquired Bone Marrow Failure Diseases

Sec. 7201. Acquired bone marrow failure diseases. Subtitle D--Cardiovascular Disease, Chronic Disease, Obesity, and Other Disease Issues

Sec. 7301. Guidelines for disease screening for minority patients. Sec. 7302. CDC wisewoman screening program. Sec. 7303. Report on cardiovascular care for women and minorities. Sec. 7304. GAO report on structural and systemic factors that perpetuate cardiovascular disparities. Sec. 7305. Coverage of comprehensive tobacco cessation services in Medicaid, CHIP, and private health insurance. Sec. 7306. Clinical research funding for oral health. Sec. 7307. Guide on evidence-based strategies for public health department obesity prevention programs. Sec. 7308. Stephanie Tubbs Jones Uterine Fibroid Research and Education Act. Subtitle E--HIV/AIDS

Sec. 7401. Statement of policy. Sec. 7402. Additional funding for AIDS drug assistance program treatments. Sec. 7403. Enhancing the national HIV surveillance system. Sec. 7404. Evidence-based strategies for improving linkage to, and retention in, appropriate care. Sec. 7405. Improving entry into, and retention in, care and antiretroviral adherence for persons with HIV. Sec. 7406. Services to reduce HIV/AIDS in racial and ethnic minority communities. Sec. 7407. Minority AIDS initiative. Sec. 7408. Health care professionals treating individuals with HIV. Sec. 7409. HIV/AIDS provider loan repayment program. Sec. 7410. Dental education loan repayment program. Sec. 7411. Reducing new HIV infections among injecting drug users. Sec. 7412. Report on impact of HIV/AIDS in vulnerable populations. Sec. 7413. National HIV/AIDS observance days. Sec. 7414. Review of all Federal and State laws, policies, and regulations regarding the criminal prosecution of individuals for HIV-related offenses. Sec. 7415. Expanding support for condoms in prisons. Sec. 7416. Automatic reinstatement or enrollment in Medicaid for people who test positive for HIV before reentering communities. Sec. 7417. Stop HIV in prison. Sec. 7418. Transfer of funds for implementation of ending the HIV epidemic: A Plan for America. Sec. 7419. PrEP access and coverage. Subtitle F--Diabetes

Sec. 7501. Research, treatment, and education. Sec. 7502. Research, education, and other activities. Sec. 7503. Programs to educate health providers on the causes and effects of diabetes in minority populations. Sec. 7504. Research, education, and other activities regarding diabetes in American Indian populations. Sec. 7505. Updated report on health disparities. Subtitle G--Lung Disease

Sec. 7601. Asthma-related activities of the Centers for Disease Control and Prevention. Sec. 7602. Influenza and pneumonia vaccination campaign. Sec. 7603. Chronic obstructive pulmonary disease. Subtitle H--Tuberculosis

Sec. 7701. United States Government assistance to combat tuberculosis. Subtitle I--Osteoarthritis and Musculoskeletal Diseases

Sec. 7801. Osteoarthritis and other musculoskeletal health-related activities of the Centers for Disease Control and Prevention. Sec. 7802. Grants for comprehensive osteoarthritis and musculoskeletal disease health education within health professions schools. Subtitle J--Sleep and Circadian Rhythm Disorders

Sec. 7901. Sleep and circadian rhythm disorders research activities of the national institutes of health. Sec. 7902. Sleep and circadian rhythm health disparities-related activities of the Centers for Disease Control and Prevention. Sec. 7903. Grants for comprehensive sleep and circadian health education within health professions schools. Sec. 7904. Report on impact of sleep and circadian health disorders in vulnerable and racial/ethnic populations. Subtitle K--Kidney Disease Research, Surveillance, Prevention, and Treatment

Sec. 7901A. Kidney disease research in minority populations. Sec. 7901A-1. Kidney disease action plan. Sec. 7901A-2. Providing for staff-assisted home dialysis for certain hemodialysis and peritoneal dialysis patients. Sec. 7901A-3. Increasing kidney transplants in minority populations. Sec. 7901A-4. Environmental and occupational health programs. Sec. 7901A-5. Understanding the treatment patterns associated with providing care and treatment of kidney failure in minority populations. Sec. 7901A-6. Encouraging kidney care workforce in underserved areas. Sec. 7901A-7. The Jack Reynolds Memorial Medigap Expansion Act; Medigap coverage for beneficiaries with end-stage renal disease. Subtitle L--Diversity in Clinical Trials

Sec. 7901B. FDA review of clinical trial best practices. Sec. 7901B-1. Diversifying Investigations Via Equitable Research Studies for Everyone Trials Act. Sec. 7901B-2. Clinical trial diversity. Sec. 7901B-3. Patient experience data. Subtitle M--Additional Provisions Addressing High-Impact Minority Diseases

Sec. 7901C. Medicare coverage of multi-cancer early detection screening tests. Sec. 7901C-1. Amputation Reduction and Compassion Act. Sec. 7901C-2. Eliminating the coinsurance requirement for certain colorectal cancer screening tests furnished under the Medicare program. Sec. 7901C-3. Expanding the availability of medical nutrition therapy services under the Medicare program. Sec. 7901C-4. Encouraging the development and use of disarm antimicrobial drugs. Sec. 7901C-5. Treat and Reduce Obesity Act. Sec. 7901C-6. Incentives, improvements, and outreach to increase diversity in Alzheimer's disease research. Sec. 7901C-7. Stomach Cancer Prevention and Early Detection Act. Subtitle N--Health Equity and Rare Disease Act

Sec. 7901D. Short title. Sec. 7901D-1. NIH expansion, intensification, and coordination of research on rare diseases health equity. Sec. 7901D-2. Collaborative comprehensive plan to address rare diseases and conditions in minority populations. Sec. 7901D-3. Grants to collect and analyze data on rare diseases and conditions in minority populations. Sec. 7901D-4. Physician training programs with respect to rare diseases. Sec. 7901D-5. Increasing minority representation in research on rare diseases and conditions. Sec. 7901D-6. Report to Congress on Federal efforts on rare diseases and conditions in minority populations. Sec. 7901D-7. Research and awareness campaigns with respect to rare diseases and conditions in minority populations. Sec. 7901D-8. FDA survey and report on clinical trial diversity. Sec. 7901D-9. Tribal epidemiology center grant program. Sec. 7901D-10. Medicare review and report. Subtitle O--Asuncion Valdivia Heat Illness, Injury, and Fatality Prevention

Sec. 7901E. Employer duties. Sec. 7901E-1. Worker heat protection standards. Sec. 7901E-2. Implementation and enforcement. Sec. 7901E-3. General provisions. Sec. 7901E-4. Agenda for further review and action. Sec. 7901E-5. Definitions. Subtitle P--New Era of Preventing End-Stage Kidney Disease

Sec. 7901F. Centers of excellence on rare kidney disease research in the National Institute of Diabetes and Digestive and Kidney Diseases. Sec. 7901F-1. Understanding and slowing the progression of rare kidney disease through early intervention, testing, and treatment. Sec. 7901F-2. Provider education. Sec. 7901F-3. Delaying kidney disease impact. TITLE VIII--HEALTH INFORMATION TECHNOLOGY

Sec. 8001. Definitions. Subtitle A--Reducing Health Disparities Through Health IT

Sec. 8101. HRSA assistance to health centers for promotion of Health IT. Sec. 8102. Assessment of impact of Health IT on racial and ethnic minority communities; outreach and adoption of Health IT in such communities. Sec. 8103. Nondiscrimination and health equity in health information technology. Sec. 8104. Language access in health information technology. Subtitle B--Modifications To Achieve Parity in Existing Programs

Sec. 8201. Extending funding to strengthen the Health IT infrastructure in racial and ethnic minority communities. Sec. 8202. Extending competitive grants for the development of loan programs to facilitate adoption of certified EHR technology by providers serving racial and ethnic minority groups. Sec. 8203. Authorization of appropriations. Subtitle C--Additional Research and Studies

Sec. 8301. Data collection and assessments conducted in coordination with minority-serving institutions. Sec. 8302. Study of health information technology in medically underserved communities. Sec. 8303. Assessment of use and misuse of de-identified health data. Subtitle D--Closing Gaps in Funding To Adopt Certified EHRs

Sec. 8401. Extending Medicaid EHR incentive payments to rehabilitation facilities, long-term care facilities, and home health agencies. Sec. 8402. Extending physician assistant eligibility for Medicaid electronic health record incentive payments. Subtitle E--Expanding Access to Telehealth Services

Sec. 8501. Removing geographic requirements for telehealth services. Sec. 8502. Expanding originating sites. TITLE IX--ACCOUNTABILITY AND EVALUATION

Sec. 9001. Prohibition on discrimination in Federal assisted health care services and research on the basis of sex (including sexual orientation, gender identity, and pregnancy, including termination of pregnancy), race, color, national origin, marital status, familial status, or disability status. Sec. 9002. Treatment of Medicare payments under title VI of the Civil Rights Act of 1964. Sec. 9003. Accountability and transparency within the Department of Health and Human Services. Sec. 9004. United States Commission on Civil Rights. Sec. 9005. Sense of Congress concerning full funding of activities to eliminate racial and ethnic health disparities. Sec. 9006. GAO and NIH reports. Sec. 9007. Investigative and enforcement actions. Sec. 9008. Federal Health Equity Commission. TITLE X--ADDRESSING SOCIAL DETERMINANTS AND IMPROVING ENVIRONMENTAL JUSTICE

Subtitle A--In General

Sec. 10001. Definitions. Sec. 10002. Health impact assessments. Sec. 10003. Grant program to conduct environmental health improvement activities and to improve social determinants of health. Sec. 10004. Additional research on the relationship between the built environment and the health of community residents. Sec. 10005. Environment and public health restoration. Sec. 10006. GAO report on health effects of Deepwater Horizon oil rig explosion in the Gulf Coast. Sec. 10007. Establish an interagency council and grant programs on social determinants of health. Sec. 10008. Correcting Hurtful and Alienating Names in Government Expression (CHANGE). Sec. 10009. Andrew Kearse Accountability for Denial of Medical Care. Sec. 10010. Investing in community healing. Sec. 10011. Environmental justice mapping and data collection. Sec. 10012. Antiracism in public health. Sec. 10013. LGBTQ essential data. Sec. 10014. Social determinants accelerator. Sec. 10015. Improving social determinants of health. Sec. 10016. Notification regarding SNAP for students receiving Federal work-study assistance. Subtitle B--Gun Violence

Sec. 10101. Reaffirming research authority of the Centers for Disease Control and Prevention. Sec. 10102. National Violent Death Reporting System. Sec. 10103. Report on effects of gun violence on public health. Sec. 10104. Report on effects of gun violence on mental health in minority communities. Subtitle C--Nutrition for Women, Children, Families

Chapter 1--Senior Hunger Prevention

Sec. 10201. Short title. Sec. 10202. Improving SNAP efficacy. Sec. 10203. Streamlining nutrition access for older adults and adults with disabilities. Sec. 10204. Enrollment and outreach pilot program for older adults, kinship families, and adults with disabilities. Sec. 10205. Food delivery under supplemental nutrition assistance program. Sec. 10206. Commodity supplemental food program. Sec. 10207. Seniors farmers' market nutrition program. Sec. 10208. Infrastructure funding for farmers' markets; local procurement pilot program. Chapter 2--Closing the Meal Gap

Sec. 10211. Elimination of time limit. Sec. 10212. Inclusion of Puerto Rico in supplemental nutritional assistance program. Subtitle D--Universal School Meals

Sec. 10301. Short title. Sec. 10302. Effective date. Chapter 1--School Breakfast Program

Sec. 10311. Free school breakfast program. Chapter 2--School Lunch Program

Sec. 10321. Apportionment to States. Sec. 10322. Nutritional and other program requirements. Sec. 10323. Special assistance program. Sec. 10324. Price for paid lunch. Sec. 10325. Summer food service program for children. Sec. 10326. Summer electronic benefit transfer for children program. Sec. 10327. Child and adult care food program. Sec. 10328. Meals and supplements for children in afterschool care. Sec. 10329. Pilot projects. Sec. 10330. Fresh fruit and vegetable program. Sec. 10331. Training, technical assistance, and Food Service Management Institute. Sec. 10332. Reimbursement of school meal delinquent debt program. Sec. 10333. Conforming amendments. Chapter 3--Elementary and Secondary Education Data

Sec. 10341. Measure of poverty. Chapter 4--Amendments to Other Programs and Laws

Sec. 10351. Supplemental nutrition assistance program. Sec. 10352. Higher Education Act of 1965. Sec. 10353. Elementary and Secondary Education Act of 1965. Sec. 10354. America COMPETES Act. Sec. 10355. Workforce Innovation and Opportunity Act. Sec. 10356. National Science Foundation Authorization Act of 2002. Sec. 10357. Child care and development block grant. Sec. 10358. Children's Health Act of 2000. Sec. 10359. Juvenile justice and delinquency prevention. TITLE XI--PROTECTIONS TO COMBAT REGULATORY HARM TO HEALTH EQUITY

Sec. 11001. Repeal of Executive orders. Sec. 11002. Statutory restoration and reestablishment of Federal offices and programs. Sec. 11003. Reinstatement of Federal data collection standards. Sec. 11004. Reinstatement of anti-discrimination requirements for Federal contractors. Sec. 11005. Reaffirmation and codification of disparate impact liability. Sec. 11006. Limitations on future Executive action. Sec. 11007. Severability. Sec. 11008. Authorization of appropriations.

TITLE I--DATA COLLECTION AND REPORTING

SEC. 1001. STRENGTHENING DATA COLLECTION, IMPROVING DATA ANALYSIS, AND EXPANDING DATA REPORTING.

(a) Amendments to the Public Health Service Act.-- (1) Purposes.--The purposes of the amendments made by this subsection are to-- (A) promote culturally and linguistically appropriate data collection, analysis, and reporting by race, ethnicity, sex, primary language, sexual orientation, disability status, gender identity, age, and socioeconomic status in federally supported health programs; and (B) ensure that data with respect to race and ethnicity is collected in accordance with the Revisions to OMB's Statistical Policy Directive No. 15: Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity (89 Fed. Reg. 22182; March 29, 2024). (2) AHRQ general authorities.--Section 902(a) of the Public Health Service Act (42 U.S.C. 299a(a)) is amended-- (A) in paragraph (8), by striking ``and'' at the end; (B) in paragraph (9), by striking the period at the end and inserting ``; and''; and (C) by adding at the end the following: ``(10) cultural and linguistic competence of health care services and of data collection activities described under section 3101.''. (3) Definition of racial and ethnic minority group.-- (A) In general.--Section 1707(g)(1) of the Public Health Service Act (42 U.S.C. 300u-6(g)(1)) is amended to read as follows: ``(1)(A) The term `racial and ethnic minority group' means a group of individuals who are any of the following: ``(i) American Indian or Alaska Native. ``(ii) Asian. ``(iii) Black or African American, including individuals of African ancestry. ``(iv) Hispanic or Latino. ``(v) Middle Eastern or North African. ``(vi) Native Hawaiian or Pacific Islander. ``(B) The terms listed in clauses (i) through (vi) of subparagraph (A) shall have the meanings given such terms for purposes of the Revisions to OMB's Statistical Policy Directive No. 15: Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity (89 Fed. Reg. 22182; March 29, 2024).''. (B) References.--Except as otherwise specified, any reference to the term ``racial and ethnic minority group'' in any Federal regulation, guidance, order, or document for establishment or implementation of any federally conducted or supported health care or public health program, activity, or survey shall be treated as having the definition given to such term in section 1707(g) of the Public Health Service Act (42 U.S.C. 300u-6(g)). (C) Similar terminology.--Not later than 2 years after the date of enactment of this Act, the Secretary of Health and Human Services shall-- (i) identify all regulations, guidance, orders, and documents of the Department of Health and Human Services for establishment or implementation of a health care or public health program, activity, or survey that use, without a definition, terminology that is similar to the term ``racial and ethnic minority group''; and (ii) take such actions as may be necessary to clarify whether the definition of the term ``racial and ethnic minority group'' in section 1707(g)(1) of the Public Health Service Act (42 U.S.C. 300u-6(g)(1)), as amended by subparagraph (A), applies to such terminology. (4) Office of minority health duties.--Section 1707(b)(6) of the Public Health Service Act (42 U.S.C. 300u-6(b)(6)) is amended by inserting ``, and subgroups of racial and ethnic minority groups, and collects and reports such data consistent with the Revisions to OMB's Statistical Policy Directive No. 15: Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity (89 Fed. Reg. 22182; March 29, 2024) and the standards developed under section 3101(a)(2)(B)'' after ``the health status of each minority group''. (5) Office of the national coordinator for health information technology.--Section 3001 of the Public Health Service Act (42 U.S.C. 300jj-11) is amended-- (A) in subsection (b)-- (i) in paragraph (10), by striking ``and'' at the end; (ii) in paragraph (11), by striking the period at the end and inserting ``; and''; and (iii) by adding at the end the following: ``(12) ensures the interoperability of health information systems among federally conducted or supported health care or public health programs, State health agencies, and social service agencies.''; and (B) by amending clause (vii) in subsection (c)(3)(A) to read as follows: ``(vii) Strategies to enhance the use of health information technology in improving the quality of health care; reducing medical errors; reducing health disparities and ensuring the provision of equitable health services; improving public health; increasing prevention and coordination with community resources; ensuring interoperability among federally conducted or supported health care or public health programs, State health agencies, and social service agencies; and improving the continuity of care among health care settings.''. (6) Data collection, analysis, and quality.--Section 3101(a) of the Public Health Service Act (42 U.S.C. 300kk(a)) is amended-- (A) in paragraphs (1)(A), (1)(C), (2)(B) and (2)(E), by striking ``and disability status'' and inserting ``sexual orientation, gender identity, age, disability status, and socioeconomic status''; (B) in paragraph (1)-- (i) in subparagraph (C), by striking ``; and'' and inserting a semicolon; and (ii) by striking subparagraph (D) and inserting the following: ``(D) data for additional population groups if such groups can be aggregated into the data collection standards described under paragraph (2); and ``(E) data that is disaggregated by population groups, except in cases in which such disaggregation is statistically unreliable and the head of the program, activity, or survey documents such unreliability;''; (C) in paragraph (2)-- (i) by amending subparagraph (A) to read as follows: ``(A) with respect to data on race and ethnicity, use the standards provided in the Revisions to OMB's Statistical Policy Directive No. 15: Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity (89 Fed. Reg. 22182; March 29, 2024);''; (ii) in subparagraph (B), as amended by subparagraph (A), by adding before the semicolon ``that are equivalent, as practicable, to the standards described in subparagraph (A)''; and (iii) in subparagraph (C)-- (I) in clause (i), by striking ``and'' at the end; (II) in clause (ii), striking ``is a minor or legally incapacitated'' and inserting ``is a minor, requires assistance with communication in speech or writing, or is legally incapacitated''; and (III) by adding at the end the following: ``(iii) collects data in a manner that is culturally and linguistically appropriate and does not include questions unrelated to, or that could potentially deter, care, such as questions related to immigration status; and ``(iv) prohibits assignment of an individual to a population group by a provider or institution;''; (D) in paragraph (3), by amending subparagraph (B) to read as follows: ``(B) develop interoperability and security systems for data management among federally conducted or supported health care or public health programs, State health agencies, and social service agencies.''; and (E) by adding at the end the following: ``(4) Responses.--In collecting data under this subsection, the Secretary shall-- ``(A) allow respondents to select multiple race or ethnicities and provide detailed write-in responses, consistent with the Revisions to OMB's Statistical Policy Directive No. 15: Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity (89 Fed. Reg. 22182; March 29, 2024); and ``(B) ensure that any responses selecting multiple race or ethnicities, and write-in responses described in subparagraph (A), are retained by the Secretary and coded for analysis.''. (b) Corollary Provisions.-- (1) Recommendations by the data council.--The Data Council of the Department of Health and Human Services, in consultation with the Director of the National Center for Health Statistics, the Deputy Assistant Secretary for Minority Health, the Deputy Assistant Secretary for Women's Health, the Administrator of the Centers for Medicare & Medicaid Services, the National Coordinator for Health Information Technology, and other appropriate public and private entities and officials, shall make recommendations to the Secretary of Health and Human Services concerning how to-- (A) implement the amendments made by this section, while minimizing the cost and administrative burdens of data collection and reporting on all parties, including patients and providers, without reducing data granularity or deviating from the standards provided in the Revisions to OMB's Statistical Policy Directive No. 15: Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity (89 Fed. Reg. 22182; March 29, 2024); (B) require Federal agencies administering programs, activities, or surveys described in section 3101(a) of the Public Health Service Act (42 U.S.C. 300kk(a)) to monitor and report rates of missing or incomplete data required under such section and improve the completeness of such data; (C) expand awareness among Federal agencies, States, territories, Indian Tribes, counties, municipalities, health providers, health plans, and the general public that data collection, analysis, and reporting by race, ethnicity, sex, primary language, sexual orientation, gender identity, age, socioeconomic status, and disability status is legal and necessary to ensure equity and nondiscrimination in the quality of health care services; (D) ensure that future patient record systems-- (i) follow Federal standards promulgated under the HITECH Act (42 U.S.C. 201 note) for the collection and meaningful use of electronic health data on race, ethnicity, sex, primary language, sexual orientation, gender identity, age, socioeconomic status, and disability status; and (ii) are consistent with the United States Core Data for Interoperability data classes and use of structured, coded data elements and standardized value sets for race, ethnicity, sex, primary language, sexual orientation, gender identity, age, socioeconomic status, and disability status that support interoperability; (E) improve health and health care data collection and analysis for more population groups if such groups can be aggregated into minimum race and ethnicity categories, including exploring the feasibility of enhancing collection efforts in States, counties, and municipalities for racial and ethnic groups that comprise a significant proportion of the population of the State, county, or municipality; (F) subject to all applicable privacy and confidentiality requirements, including HIPAA privacy and security law as defined in section 3009(a) of the Public Health Service Act (42 U.S.C. 300jj-19(a)), provide researchers with greater access to racial, ethnic, primary language, sex, sexual orientation, gender identity, age, socioeconomic status, and disability status data, including de-identified, disaggregated datasets for research and public reporting, including for analysis of intersectional disparities across demographics; (G) ensure the cultural and linguistic competence of entities that receive Federal support to collect and report data pursuant to the amendments made by subsection (a); and (H) safeguard and prevent the misuse of data collected under section 3101 of the Public Health Service Act (42 U.S.C. 300kk), as amended by subsection (a)(6), without limiting the lawful collection, reporting, and use of disaggregated demographic data. (2) Rules of construction.--Nothing in this section shall be construed to-- (A) permit the use of information collected under this section or any provision amended by this section in a manner that would adversely affect any individual providing any such information, including adverse effects to the relatives of the individual and to the community or communities of the individual; or (B) diminish any requirements on health care providers to collect data, including such requirements in effect on or after the date of enactment of this Act. (3) Technical assistance for the analysis of health disparity data.--The Secretary of Health and Human Services, acting through the Director of the Agency for Healthcare Research and Quality, and in coordination with the Assistant Secretary for Planning and Evaluation, the Administrator of the Centers for Medicare & Medicaid Services, the Director of the National Center for Health Statistics, the Director of the National Institutes of Health, and the National Coordinator for Health Information Technology, shall provide technical assistance to agencies of the Department of Health and Human Services in meeting Federal standards for health disparity data collection and for analysis of racial, ethnic, nationality, sex, gender, sexual orientation, gender identity, geographical, age, primary language, disability status, socioeconomic, and other disparities in health and health care in programs conducted or supported by such agencies by-- (A) identifying appropriate quality assurance mechanisms to monitor for health disparities; (B) specifying the clinical, diagnostic, or therapeutic measures which should be monitored; (C) developing new quality measures relating to racial and ethnic disparities and their overlap with other disparity factors in health and health care; (D) identifying the level at which data analysis should be conducted; (E) sharing data with external organizations for research and quality improvement purposes; and (F) identifying and addressing issues relating to the interoperability of Federal- and State-level health information systems which undermine the ability of health-related programs collecting data under this section to achieve the purposes described in subsection (a)(1). (4) Authorization of appropriations.--To carry out this subsection, subsection (a), and the amendments made by subsection (a), there are authorized to be appropriated such sums as may be necessary for each of fiscal years 2027 through 2031. (c) Additional Amendments to the Public Health Service Act.--Title XXXIV of the Public Health Service Act, as added by titles II and III of this Act, is further amended by inserting after subtitle B the following:

``Subtitle C--Strengthening Data Collection, Improving Data Analysis, and Expanding Data Reporting

``SEC. 3431. ESTABLISHING GRANTS FOR DATA COLLECTION IMPROVEMENT ACTIVITIES.

``(a) In General.--The Secretary, acting through the Director of the Agency for Healthcare Research and Quality and in consultation with the Deputy Assistant Secretary for Minority Health, the Director of the National Institutes of Health, the Assistant Secretary for Planning and Evaluation, the National Coordinator for Health Information Technology, and the Director of the National Center for Health Statistics, shall establish a technical assistance program under which the Secretary provides grants to eligible entities to assist such entities in complying with section 3101. ``(b) Types of Assistance.--A grant provided under this section may be used to-- ``(1) enhance or upgrade computer technology that will facilitate collection, analysis, and reporting of racial, ethnic, primary language, sexual orientation, sex, gender identity, age, socioeconomic status, and disability status data; ``(2) improve methods for health data collection and analysis, including additional population groups if such groups can be aggregated into the race and ethnicity categories outlined by standards developed under section 3101; ``(3) develop mechanisms for submitting collected data subject to any applicable privacy and confidentiality regulations; ``(4) develop educational programs to inform health plans, health providers, health-related agencies, and the general public that data collection and reporting by race, ethnicity, primary language, sexual orientation, sex, gender identity, age, disability status, and socioeconomic status are legal and essential for eliminating health and health care disparities; and ``(5) develop educational programs to train health providers, health care organizations, health plans, health- related agencies, and frontline health care workers on how to collect and report disaggregated data in a culturally and linguistically appropriate manner, including the privacy and confidentiality interests of individuals from whom the data is collected. ``(c) Eligible Entity.--To be eligible for grants under this section, an entity shall-- ``(1) be a State, territory, Indian Tribe, municipality, county, health provider, health care organization, or health plan making a demonstrated effort to bring data collections into compliance with section 3101; ``(2) be in compliance with the standards provided in the Revisions to OMB's Statistical Policy Directive No. 15: Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity (89 Fed. Reg. 22182; March 29, 2024); and ``(3) agree to require training for personnel implementing the requirements of section 3101 on culturally appropriate, standardized data collection. ``(d) Authorization of Appropriations.--There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2027 through 2031.

``SEC. 3432. OVERSAMPLING OF UNDERREPRESENTED GROUPS IN FEDERAL HEALTH SURVEYS.

``(a) National Requirement.-- ``(1) In general.--The Secretary, acting through the Director of the National Center for Health Statistics, and other officials within the Department of Health and Human Services as the Secretary determines appropriate, shall develop and implement a sustainable national requirement applicable to all Federal health surveys and program data collections for the oversampling of underrepresented populations within the categories of race, ethnicity, sex, primary language, sexual orientation, disability status, gender identity, age, and socioeconomic status as determined appropriate by the Secretary. Such national requirement shall include-- ``(A) minimum sample thresholds for the oversampling of underrepresented populations; and ``(B) a requirement for oversampling of Middle Easterners and North Africans, Asian Americans, American Indians, Alaska Natives, Native Hawaiians, and Pacific Islanders. ``(2) Consultation.--In developing and implementing a national requirement, as described in paragraph (1), not later than 180 days after the date of the enactment of this section, the Secretary shall-- ``(A) consult with representatives of community groups, nonprofit organizations, nongovernmental organizations, and government agencies working with underrepresented populations; ``(B) solicit the participation of representatives from other Federal departments and agencies, including subagencies of the Department of Health and Human Services; and ``(C) consult on, and use as models, the 2014 National Health Interview Survey oversample of Native Hawaiian and Pacific Islander populations, the 2016 Behavioral Risk Factor Survey of Health Risk Behaviors Among Arab Adults Within the State of Michigan, and the 2017 Behavioral Risk Factor Surveillance System oversample of American Indian and Alaska Native communities. ``(b) Progress Report.--Not later than 2 years after the date of enactment of this section, the Secretary shall submit to the Congress a progress report, which shall include the national requirement under subsection (a)(1). ``(c) Authorization of Appropriations.--To carry out this section, there are authorized to be appropriated such sums as may be necessary for each of fiscal years 2027 through 2031.''. (d) Report to Congress.--Not later than 2 years after the date of enactment of this Act, the Secretary of Health and Human Services shall submit a report to Congress on the implementation of this section, including the amendments made by this section.

SEC. 1002. ELIMINATION OF PREREQUISITE OF DIRECT APPROPRIATIONS FOR DATA COLLECTION AND ANALYSIS.

Section 3101 of the Public Health Service Act (42 U.S.C. 300kk), as amended by section 1001(a), is further amended-- (1) by striking subsection (h); and (2) by redesignating subsection (i) as subsection (h).

SEC. 1003. COLLECTION OF DATA FOR THE MEDICARE PROGRAM.

Part A of title XI of the Social Security Act (42 U.S.C. 1301 et seq.) is amended by adding at the end the following:

``SEC. 1150D. COLLECTION OF DATA FOR THE MEDICARE PROGRAM.

``(a) Requirement.-- ``(1) In general.--The Commissioner of Social Security (in this section referred to as the `Commissioner'), in consultation with the Administrator of the Centers for Medicare & Medicaid Services (in this section referred to as the `Administrator'), shall collect data on the race, ethnicity, sex, primary language, sexual orientation, gender identity, socioeconomic status, age, and disability status of all applicants for social security benefits under title II or Medicare benefits under title XVIII. ``(2) Data collection standards.-- ``(A) In general.--In collecting data under paragraph (1), the Commissioner shall at least use the standards for data collection developed under section 3101 of the Public Health Service Act (42 U.S.C. 300kk) or the standards developed by the Office of Management and Budget, as the baseline standard, consistent with the Office of Management and Budget Statistical Policy Directive No. 15: Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, or any successor Office of Management and Budget directive. ``(B) No standards available.--In the event there are no standards for the demographic groups listed under paragraph (1), the Commissioner shall consult with stakeholder groups representing the various identities as well as with the Office of Minority Health within the Centers for Medicare & Medicaid Services to develop appropriate standards. ``(3) Data for additional population groups.--Where practicable, the data collected by the Commissioner under paragraph (1) shall include data for additional population groups if such groups can be aggregated into the race and ethnicity categories outlined by the data collection standards described in paragraph (2)(A). ``(4) Collection of data for minors and legally incapacitated individuals.--With respect to the collection of the data described in paragraph (1) of applicants who are under 18 years of age or otherwise legally incapacitated, the Commissioner shall require that-- ``(A) such data be collected from the parent or legal guardian of such an applicant; and ``(B) the primary language of the parent or legal guardian of such an applicant or recipient be used in collecting the data. ``(5) Quality of data.--The Commissioner shall periodically review the quality and completeness of the data collected under paragraph (1) and make adjustments as necessary to improve both. ``(6) Transmission of data.--Upon enrollment for Medicare benefits under title XVIII, the Commissioner shall transmit the demographic data of an individual as collected under paragraph (1) to the Centers for Medicare & Medicaid Services. ``(7) Analysis and reporting of data.--With respect to the data transmitted under paragraph (6), the Administrator, in consultation with the Commissioner, shall-- ``(A) require that such data be uniformly analyzed and that such analysis be reported at least annually to Congress; ``(B) incorporate such data in other analysis and reporting on health disparities and the provision of inequitable health care services by a health care provider, as appropriate; ``(C) make such data available to researchers, under the protections outlined in paragraph (8); ``(D) provide opportunities to individuals enrolled for Medicare benefits under title XVIII to submit updated data; ``(E) ensure that the provision of assistance or benefits to an applicant, or their relatives, is not denied or otherwise adversely affected because of the failure of the applicant to provide any of the data collected under paragraph (1); and ``(F) ensure that the provision of assistance or benefit to an applicant or their relatives is not denied or otherwise adversely affected because of the content of the data provided by the applicant, except where it is required by law. ``(8) Protection of data.--The Commissioner shall ensure (through the promulgation of regulations or otherwise) that all data collected pursuant to paragraph (1) is protected-- ``(A) under the same privacy protections as the Secretary applies to health data under the regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 (relating to the privacy of individually identifiable health information and other protections); and ``(B) from all inappropriate internal use by any entity that collects, stores, or receives the data

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