H.R. 1868, An Act to prevent across-the-board direct spending cuts — In the Senate (March 25, 2021)

Summary

In the Senate on March 25, 2021, a resolution provided that the House bill H.R. 1868, an act to prevent across-the-board direct spending cuts, do pass with an amendment that strikes all after the enacting clause. Section 1 extends the temporary suspension of Medicare sequestration by amending section 3709(a) of division A of the CARES Act to strike March 31, 2021, effective as if enacted as part of the CARES Act. It also amends the offset in the Balanced Budget and Emergency Deficit Control Act of 1985. Section 2 contains technical corrections, including rural health clinic payments.

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     In the Senate of the United States,
                                            March 25, 2021.
     Resolved, That the bill from the House of Representa-
tives (H.R. 1868) entitled ‘‘An Act to prevent across-the-
board direct spending cuts, and for other purposes.’’, do pass
with the following

                  AMENDMENT:
          Strike all after the enacting clause and insert the
     following:
 1   SECTION 1. EXTENSION OF TEMPORARY SUSPENSION OF

 2               MEDICARE SEQUESTRATION.

 3       (a) EXTENSION.—
 4            (1) IN GENERAL.—Section 3709(a) of division A
 5       of the CARES Act (2 U.S.C. 901a note) is amended
 6       by striking ‘‘March 31, 2021’’ and inserting ‘‘Decem-
 7       ber 31, 2021’’.
 8            (2) EFFECTIVE DATE.—The amendment made by
 9       paragraph (1) shall take effect as if enacted as part
10       of the CARES Act (Public Law 116–136).
                                   2
 1       (b) OFFSET.—Section 251A(6)(C) of the Balanced
 2 Budget and Emergency Deficit Control Act of 1985 (2
 3 U.S.C. 901a(6)(C)) is amended—
 4             (1) in clause (i)—
 5                    (A) by striking ‘‘first 6 months’’ and insert-
 6             ing ‘‘first 5 1⁄2 months’’;
 7                    (B) by striking ‘‘4.0 percent’’ and inserting
 8             ‘‘2.0 percent’’; and
 9                    (C) by striking ‘‘and’’ at the end;
10             (2) in clause (ii)—
11                    (A) by striking ‘‘second 6 months’’ and in-
12             serting ‘‘6-month period beginning on the day
13             after the last day of the period described in
14             clause (i)’’; and
15                    (B) by striking ‘‘0.0 percent.’’ and inserting
16             ‘‘4.0 percent; and’’; and
17             (3) by adding at the end the following:
18                    ‘‘(iii) with respect to the remaining       ⁄
                                                                 12


19             month in which such order is so effective for such
20             fiscal year, the payment reduction shall be 0.0
21             percent.’’.
22   SEC. 2. TECHNICAL CORRECTIONS.

23       (a) RURAL HEALTH CLINIC PAYMENTS.—




      † HR 1868 EAS
                                 3
 1            (1) IN GENERAL.—Section 1833(f)(3) of the So-
 2      cial Security Act (42 U.S.C. 1395l(f)(3)) is amend-
 3      ed—
 4                   (A) in subparagraph (A)—
 5                        (i) in clause (i), by striking subclauses
 6                   (I) and (II) and inserting the following:
 7                        ‘‘(I) with respect to a rural health clin-
 8                   ic that had a per visit payment amount es-
 9                   tablished for services furnished in 2020—
10                             ‘‘(aa)   the   per   visit   payment
11                        amount applicable to such rural health
12                        clinic for rural health clinic services
13                        furnished in 2020, increased by the
14                        percentage increase in the MEI appli-
15                        cable to primary care services fur-
16                        nished as of the first day of 2021; or
17                             ‘‘(bb) the limit described in para-
18                        graph (2)(A); and
19                        ‘‘(II) with respect to a rural health
20                   clinic that did not have a per visit payment
21                   amount established for services furnished in
22                   2020—
23                             ‘‘(aa)   the   per   visit   payment
24                        amount applicable to such rural health




     † HR 1868 EAS
                                      4
 1                         clinic for rural health clinic services
 2                         furnished in 2021; or
 3                              ‘‘(bb) the limit described in para-
 4                         graph (2)(A); and’’; and
 5                         (ii) in clause (ii)(I), by striking
 6                    ‘‘under clause (i)(I)’’ and inserting ‘‘under
 7                    subclause (I) or (II) of clause (i), as appli-
 8                    cable,’’; and
 9                    (B) by striking subparagraph (B) and in-
10             serting the following:
11       ‘‘(B) A rural health clinic described in this subpara-
12 graph is a rural health clinic that—
13             ‘‘(i) as of December 31, 2020, was in a hospital
14       with less than 50 beds and after such date such hos-
15       pital continues to have less than 50 beds (not taking
16       into account any increase in the number of beds pur-
17       suant to a waiver under subsection (b)(1)(A) of sec-
18       tion 1135 during the emergency period described in
19       subsection (g)(1)(B) of such section); and
20             ‘‘(ii)(I) as of December 31, 2020, was enrolled
21       under section 1866(j) (including temporary enroll-
22       ment during such emergency period for such emer-
23       gency period); or
24             ‘‘(II) submitted an application for enrollment
25       under section 1866(j) (or a request for such a tem-


      † HR 1868 EAS
                               5
 1       porary enrollment for such emergency period) that
 2       was received not later than December 31, 2020.’’.
 3             (2) EFFECTIVE DATE.—The amendments made
 4       by this subsection shall take effect as if included in
 5       the enactment of the Consolidated Appropriations Act,
 6       2021 (Public Law 116–260).
 7       (b) ADDITIONAL AMOUNT FOR CERTAIN HOSPITALS
 8 WITH HIGH DISPROPORTIONATE SHARE.—Effective as if
 9 included in the enactment of section 203(a) of title II of
10 division CC of Public Law 116–260, subsection (g) of sec-
11 tion 1923 of the Social Security Act (42 U.S.C. 1396r–4),
12 as amended by such section, is amended by adding at the
13 end the following:
14             ‘‘(3)   CONTINUED     APPLICATION   OF   GRAND-

15       FATHERED       TRANSITION     RULE.—Notwithstanding

16       paragraph (2) of this subsection (as in effect on Octo-
17       ber 1, 2021), paragraph (2) of this subsection (as in
18       effect on September 30, 2021, and as applied under
19       section 4721(e) of the Balanced Budget Act of 1997,
20       and amended by section 607 of the Medicare, Med-
21       icaid, and SCHIP Balanced Budget Refinement Act
22       of 1999 (Public Law 106–113)) shall apply in deter-
23       mining whether a payment adjustment for a hospital
24       in a State referenced in section 4721(e) of the Bal-




      † HR 1868 EAS
                              6
1      anced Budget Act of 1997 during a State fiscal year
2      shall be considered consistent with subsection (c).’’.

       Attest:




                                                   Secretary.




    † HR 1868 EAS
117TH CONGRESS
   1ST SESSION   H.R. 1868
        AMENDMENT


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