H. R. 1868, One Hundred Seventeenth Congress of the United States of America

Summary

H.R. 1868 is an Act of the One Hundred Seventeenth Congress, First Session, to prevent across-the-board direct spending cuts, and for other purposes. Section 1, Extension of Temporary Suspension of Medicare Sequestration, amends section 3709(a) of division A of the CARES Act by striking ‘‘March 31, 2021’’ and inserting ‘‘December 31, 2021’’, effective as if enacted as part of the CARES Act. It also amends the offset in section 251A(6)(C) of the Balanced Budget and Emergency Deficit Control Act of 1985. Section 2, Technical Corrections, includes provisions on per visit payment amounts for rural health clinics.

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H. R. 1868



               One Hundred Seventeenth Congress
                           of the
                   United States of America
                                 AT T H E F I R S T S E S S I O N

                      Begun and held at the City of Washington on Sunday,
                     the third day of January, two thousand and twenty-one




                                               An Act
                  To prevent across-the-board direct spending cuts, 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. EXTENSION OF TEMPORARY SUSPENSION OF MEDICARE
                          SEQUESTRATION.
                (a) EXTENSION.—
                     (1) IN GENERAL.—Section 3709(a) of division A of the
                CARES Act (2 U.S.C. 901a note) is amended by striking ‘‘March
                31, 2021’’ and inserting ‘‘December 31, 2021’’.
                     (2) EFFECTIVE DATE.—The amendment made by paragraph
                (1) shall take effect as if enacted as part of the CARES Act
                (Public Law 116–136).
                (b) OFFSET.—Section 251A(6)(C) of the Balanced Budget and
             Emergency Deficit Control Act of 1985 (2 U.S.C. 901a(6)(C)) is
             amended—
                     (1) in clause (i)—
                           (A) by striking ‘‘first 6 months’’ and inserting ‘‘first
                     5 1⁄2 months’’;
                           (B) by striking ‘‘4.0 percent’’ and inserting ‘‘2.0 per-
                     cent’’; and
                           (C) by striking ‘‘and’’ at the end;
                     (2) in clause (ii)—
                           (A) by striking ‘‘second 6 months’’ and inserting ‘‘6-
                     month period beginning on the day after the last day
                     of the period described in clause (i)’’; and
                           (B) by striking ‘‘0.0 percent.’’ and inserting ‘‘4.0 percent;
                     and’’; and
                     (3) by adding at the end the following:
                           ‘‘(iii) with respect to the remaining 1⁄2 month in which
                     such order is so effective for such fiscal year, the payment
                     reduction shall be 0.0 percent.’’.
             SEC. 2. TECHNICAL CORRECTIONS.
                 (a) RURAL HEALTH CLINIC PAYMENTS.—
                      (1) IN GENERAL.—Section 1833(f)(3) of the Social Security
                 Act (42 U.S.C. 1395l(f)(3)) is amended—
                           (A) in subparagraph (A)—
                                (i) in clause (i), by striking subclauses (I) and
                           (II) and inserting the following:
                                ‘‘(I) with respect to a rural health clinic that had
                           a per visit payment amount established for services
                           furnished in 2020—
                                H. R. 1868—2

                            ‘‘(aa) the per visit payment amount applicable
                      to such rural health clinic for rural health clinic
                      services furnished in 2020, increased by the
                      percentage increase in the MEI applicable to pri-
                      mary care services furnished as of the first day
                      of 2021; or
                            ‘‘(bb) the limit described in paragraph (2)(A);
                      and
                      ‘‘(II) with respect to a rural health clinic that did
                not have a per visit payment amount established for
                services furnished in 2020—
                            ‘‘(aa) the per visit payment amount applicable
                      to such rural health clinic for rural health clinic
                      services furnished in 2021; or
                            ‘‘(bb) the limit described in paragraph (2)(A);
                      and’’; and
                      (ii) in clause (ii)(I), by striking ‘‘under clause (i)(I)’’
                and inserting ‘‘under subclause (I) or (II) of clause
                (i), as applicable,’’; and
                (B) by striking subparagraph (B) and inserting the
         following:
    ‘‘(B) A rural health clinic described in this subparagraph is
a rural health clinic that—
         ‘‘(i) as of December 31, 2020, was in a hospital with less
    than 50 beds and after such date such hospital continues to
    have less than 50 beds (not taking into account any increase
    in the number of beds pursuant to a waiver under subsection
    (b)(1)(A) of section 1135 during the emergency period described
    in subsection (g)(1)(B) of such section); and
         ‘‘(ii)(I) as of December 31, 2020, was enrolled under section
    1866(j) (including temporary enrollment during such emergency
    period for such emergency period); or
         ‘‘(II) submitted an application for enrollment under section
    1866(j) (or a request for such a temporary enrollment for such
    emergency period) that was received not later than December
    31, 2020.’’.
         (2) EFFECTIVE DATE.—The amendments made by this sub-
    section shall take effect as if included in the enactment of
    the Consolidated Appropriations Act, 2021 (Public Law 116–
    260).
    (b) ADDITIONAL AMOUNT FOR CERTAIN HOSPITALS WITH HIGH
DISPROPORTIONATE SHARE.—Effective as if included in the enact-
ment of section 203(a) of title II of division CC of Public Law
116–260, subsection (g) of section 1923 of the Social Security Act
(42 U.S.C. 1396r–4), as amended by such section, is amended by
adding at the end the following:
         ‘‘(3) CONTINUED APPLICATION OF GRANDFATHERED TRANSI-
    TION RULE.—Notwithstanding paragraph (2) of this subsection
    (as in effect on October 1, 2021), paragraph (2) of this subsection
    (as in effect on September 30, 2021, and as applied under
    section 4721(e) of the Balanced Budget Act of 1997, and
    amended by section 607 of the Medicare, Medicaid, and SCHIP
    Balanced Budget Refinement Act of 1999 (Public Law 106–
    113)) shall apply in determining whether a payment adjustment
    for a hospital in a State referenced in section 4721(e) of the
                      H. R. 1868—3

Balanced Budget Act of 1997 during a State fiscal year shall
be considered consistent with subsection (c).’’.




                    Speaker of the House of Representatives.




                 Vice President of the United States and
                                      President of the Senate.


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