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Version 00 · Introduced in House · Sep 10, 2026
Patient Navigation Assistance Act
This bill requires state Medicaid programs to cover patient navigator services for enrollees. Patient navigator services are services that help link an individual with medical, social, logistical, financial, or other programs or services to address the individual's needs.
People & committees
Rep. DeSaulnier, Mark [D-CA-10] · D–CA
Legislative record
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Referred to the House Committee on Energy and Commerce.
Introduced in House
Introduced in House
Primary sources
Text links open the official source. We also preserved the text version used in the PlainBill explanation below.
No related bills are listed in this snapshot. This does not establish whether the proposal has appeared in earlier Congresses.
Source last updated: Oct 8, 2026. Consult Congress.gov for the current record.
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PlainBill explanation
Based on the full Introduced in House · 2026-09-10 text. This explanation has not received human editorial review. This overview describes the proposal’s major provisions; it does not establish what its real-world effects would be.
The proposed Patient Navigation Assistance Act would require state Medicaid programs to reimburse qualifying organizations for patient navigator services provided to eligible people. Navigators help people understand care options and connect with medical care and other support. The bill would also include these services in the definition used for federal Medicaid matching payments, subject to provider requirements and implementation rules.
This Act may be cited as the Patient Navigation Assistance Act.
provide that the State shall reimburse an eligible entity (as defined in subsection (zz)(1)) for any patient navigator service (as defined in subsection (zz)(3)) that is provided— (A) to an individual who is eligible for medical assistance under the State plan; and (B) by a patient navigator (as defined in subsection (zz)(2)) through the eligible entity.
provides individualized education and resources to facilitate informed decision-making and timely access to quality health and psychosocial care
(b) Treatment as medical assistance for purposes of FMAP Section 1905(a) of the Social Security Act (42 U.S.C. 1396d(a)) is amended
States would have to reimburse an eligible organization for qualifying services delivered through that organization by a qualifying patient navigator to someone eligible under the state's Medicaid plan.
(91) provide that the State shall reimburse an eligible entity (as defined in subsection (zz)(1)) for any patient navigator service (as defined in subsection (zz)(3)) that is provided— (A) to an individual who is eligible for medical assistance under the State plan; and (B) by a patient navigator (as defined in subsection (zz)(2)) through the eligible entity.
Eligible organizations would have to meet an existing Public Health Service Act definition and comply with that law's applicable requirements concerning navigator duties, community knowledge, prohibitions, applications, and reports. The bill incorporates those requirements by reference.
The term eligible entity means an entity that— (A) is an eligible entity (as defined in subsection (l)(1) of section 340A of the Public Health Service Act); and (B) complies with the following requirements of such section (insofar as they apply to a grant recipient under such section): (i) Subsection (b) (relating to patient navigator duties and community knowledge). (ii) Subsection (c) (relating to prohibitions). (iii) Subsection (e) (relating to applications). (iv) Subsection (j)(3) (relating to reports).
A patient navigator would have to work for a health care or community organization and provide individualized education and resources to help people make informed decisions and obtain timely health care and support for psychological and social needs.
The term patient navigator means an individual who— (i) is employed by a health care or community-based organization and provides individualized education and resources to facilitate informed decision-making and timely access to quality health and psychosocial care
The navigator qualification language lists specified college degrees, applicable professional licensing and certification, competency-based navigation training, or a federally approved training program. Applicable professional requirements include state or jurisdiction limits on the services a licensed or certified person may perform.
(ii) has obtained and complies with education, licensure, or certification, including at least— (I) a bachelor’s degree in nursing from an accredited university, master’s degree in social work from an accredited university, or bachelor’s degree in a health-related field from an accredited university; (II) licensing and certification requirements for a registered nurse, social work, or clinical practitioner, as applicable, and scope of practice requirements, as defined by the State or jurisdiction in which the individual is licensed or certified; (III) completion of competency-based navigation training sessions or courses for clinical or non-clinical professionals, as applicable; or (IV) subject to subparagraph (B), completion of a training program approved by the Secretary for purposes of section 340A(l)(3) of the Public Health Service Act.
The federally approved training option would stop satisfying the navigator qualification requirement after the date three years following the date the new provisions begin applying to services under section 2(c). This expiration applies to that training option.
(B) Transitional limitation The training described in subclause (IV) of subparagraph (A)(ii) shall not satisfy the requirement of subparagraph (A)(ii) after the date that is 3 years after the date on which the provisions of this subsection apply to patient navigator services pursuant to section 2(c) of the Patient Navigator Assistance Act.
Covered navigator services would include referrals and related help connecting people to medical, social, logistical, financial, or other services addressing their identified needs. Coverage would also include services listed in an existing Public Health Service Act provision and other services specified by the Secretary of Health and Human Services.
The term patient navigator service means a service provided by a patient navigator to an individual, including— (A) referrals and related activities to help the individual obtain needed services, including activities that help link the individual with medical, social, logistical, financial, or other programs or services to address identified or specified needs of the individual; (B) services specified under paragraphs (1) through (6) of subsection (b) of section 340A of the Public Health Service Act; and (C) other services specified by the Secretary.
The bill would add qualifying navigator services to Medicaid's definition of medical assistance for federal matching payments—the federal government's share of qualifying state Medicaid spending. The added category would apply only to services meeting the new reimbursement requirements.
(b) Treatment as medical assistance for purposes of FMAP Section 1905(a) of the Social Security Act (42 U.S.C. 1396d(a)) is amended— (1) in paragraph (31), by striking and at the end; (2) by redesignating paragraph (32) as paragraph (33); and (3) by inserting after paragraph (31) the following new paragraph: (32) patient navigator services (as defined in section 1902(zz)(3)) that are provided in a manner that meets the requirements of section 1902(a)(91); and .
Generally, the amendments would apply to navigator services provided after the first day of the first calendar year beginning after enactment. The bill provides an exception for states needing legislation to comply.
(c) Effective date (1) In general Subject to paragraph (2), the amendments made by this section shall apply to patient navigator services provided after the first day of the first calendar year that begins after the date of enactment of this Act. (2) Exception for State legislation
If the Secretary determines that a state needs legislation to comply, its Medicaid plan would receive temporary protection from being found noncompliant solely for failing to meet a new requirement. That protection would last until the first day of the first calendar quarter after the close of the state's first regular legislative session beginning after enactment. Each year of a two-year session would count separately.
In the case of a State plan under title XIX of the Social Security Act, which the Secretary of Health and Human Services determines requires State legislation in order for the respective plan to meet any requirement imposed by amendments made by this Act, the respective plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such an additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session shall be considered to be a separate regular session of the State legislature.
The supplied actions snapshot, updated October 8, 2026, records introduction in the House and referral to the House Committee on Energy and Commerce on September 10, 2026.
Source snapshot updated 2026-10-08T19:24:40Z. 2026-09-10: Referred to the House Committee on Energy and Commerce. 2026-09-10: Introduced in House
A closer look
Reviewed version: Introduced in House · 2026-09-10. These findings describe provisions and who may benefit; they are not judgments of waste, corruption, or motive.
This review covers the supplied bill text. “None identified” does not rule out provisions in later versions or accompanying reports and disclosures.
Provisions outside the bill’s main subject, or policy changes attached to appropriations.
None identified in the reviewed text
No unrelated provision or policy rider was identified in the complete supplied introduced text. This conclusion does not establish absence in other versions or accompanying materials.
Spending directed to particular recipients or places outside ordinary competitive or formula-based allocation.
None identified in the reviewed text
No congressionally directed spending for particular recipients or places was identified in the complete supplied introduced text. This conclusion is limited to that version and does not determine formal earmark status in absent accompanying materials.
Narrow exceptions, exemptions, or preferential treatment that warrant a closer look.
None identified in the reviewed text
No materially narrow preferential benefit warranting a finding was identified in the complete supplied introduced text. Program coverage, provider qualifications, and implementation exceptions alone do not establish such a benefit. This conclusion is limited to that version.
Full text preserved for this analysis. Legislative record snapshot: Oct 8, 2026. How PlainBill uses AI