H.R. 10331: Patient Navigation Assistance Act

This bill would require Medicaid to cover patient navigator services for people who are eligible for Medicaid. In practical terms, it would let states pay approved organizations for staff who help patients figure out and use health care and related support services.

What patient navigator services are

The bill defines a patient navigator as someone employed by a health care or community-based organization who gives individualized help, education, and resources to support informed decisions and timely access to care. The navigator would need to meet education, licensure, certification, or training requirements. Depending on the person’s role, this could include a nursing degree, a social work degree, a health-related degree, professional licensure, or completion of navigation training.

Patient navigator services would include:

• Referrals and related help connecting a person to needed services;
• Assistance linking someone to medical, social, logistical, financial, or other programs;
• Other services already listed in the Public Health Service Act’s patient navigation provisions;
• Any additional services the Secretary of Health and Human Services chooses to specify.

How Medicaid would change

The bill adds patient navigator services to the list of Medicaid services that states must cover. It also treats these services as Medicaid medical assistance for purposes of federal matching funds, meaning the federal government could help pay states for this benefit.

When it would take effect

The changes would generally apply to patient navigator services provided after the first day of the first calendar year beginning after the bill becomes law. If a state needs to change its own laws before it can comply, the bill gives that state additional time before it is considered out of compliance.

Relevant Companies

None found