Text of Amendments to S. 178, August 4, 2020 — Congressional Record, Senate
Summary
This is page S4765 of the Congressional Record, Senate, August 4, 2020, printing the text of amendments to S. 178 submitted by Mr. GRASSLEY and intended to be proposed to amendment SA 2499 by Mr. MCCONNELL. SA 2510 adds Title II, Supporting Patients, Providers, Older Americans in Responding to COVID-19. Section 201 would maintain the 2021 Medicare Part B premium and deductible at 2020 levels. Section 202 would improve the Medicare hospital accelerated and advance payments programs, striking 120 days for 270 days and 12 months for 18 months in the repayment periods, with up to 270 days before claims are offset. Another part of the text defines eligible families with children who are in need as a result of the COVID-19 public health emergency.
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“Text of Amendments to S. 178, August 4, 2020 — Congressional Record, Senate.”
Original at www.govinfo.gov. Archived at Pandemic Darlings, https://pandemicdarlings.com/source-documents/crec-crec-2020-08-04-crec-2020-08-04-pt1-pgs4765-2-9e62bfc614/
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August 4, 2020 CONGRESSIONAL RECORD — SENATE S4765
payments, vouchers, and other forms of ben- SA 2511. Mr. GRASSLEY submitted Fund an amount, as estimated by the Chief
efits designed to meet a family’s ongoing an amendment intended to be proposed Actuary of the Centers for Medicare & Med-
basic needs as defined by the Secretary. to amendment SA 2499 proposed by Mr. icaid Services, equal to amounts paid under
‘‘(B) ELIGIBLE FAMILIES.— the advance payment program under section
MCCONNELL to the bill S. 178, to con-
‘‘(i) IN GENERAL.—The term ‘eligible fam- 421.214 of title 42, Code of Federal Regula-
ily’ means a family (including a family of demn gross human rights violations of tions (or any successor regulation) during
one) that— ethnic Turkic Muslims in Xinjiang, and the period beginning on March 28, 2020, and
‘‘(I) has 1 or more children who have not calling for an end to arbitrary deten- ending on July 9, 2020.
attained 18 years of age; and tion, torture, and harassment of these ‘‘(2) There shall be transferred from the
‘‘(II) is in need as a result of the public communities inside and outside China; Trust Fund to the General Fund of the
health emergency with respect to the which was ordered to lie on the table; Treasury amounts equivalent to the sum of—
Coronavirus Disease 2019 (COVID-19) as de- as follows: ‘‘(A) the amounts by which claims have
termined by the State in accordance with offset (in whole or in part) the amount of
At the end, add the following:
clause (ii). such advance payments described in para-
TITLE II—SUPPORTING PATIENTS, PRO- graph (1); and
‘‘(ii) CRITERIA FOR NEED BASED ON COVID-19
VIDERS, OLDER AMERICANS, AND FOS- ‘‘(B) the amount of such advance payments
PUBLIC HEALTH EMERGENCY.—A State shall
TER YOUTH IN RESPONDING TO COVID– that has been repaid (in whole or in part),
define and publish on a publicly available
19 under the advance payment program under
website maintained by the State the criteria
for determining a family is in need as a re- Subtitle A—Promoting Access to Care and such section 421.214 (or any such successor
sult of the public health emergency with re- Services regulation).
spect to the Coronavirus Disease 2019 SEC. 201. MAINTAINING 2021 MEDICARE PART B ‘‘(3) Amounts described in paragraphs (1)
(COVID-19) and shall report such criteria to PREMIUM AND DEDUCTIBLE AT 2020 and (2) shall be transferred from time to
LEVELS CONSISTENT WITH ACTU- time as appropriate.’’.
the Secretary. The Secretary shall publish
ARIALLY FAIR RATES. (d) INDENTATION CORRECTION.—Section
all the State criteria reported under this
(a) 2021 PREMIUM AND DEDUCTIBLE AND RE- 1839(i)(3)(A)(ii) of the Social Security Act (42
clause on a publicly available website main-
PAYMENT THROUGH FUTURE PREMIUMS.—Sec- U.S.C. 1395r(i)(3)(A)(ii)) is amended by mov-
tained by the Secretary.
tion 1839(a) of the Social Security Act (42 ing the indentation of subclause (I) two ems
‘‘(C) NON-RECURRENT SHORT-TERM BENE-
U.S.C. 1395r(a)) is amended— to the right.
FITS.—The term ‘non-recurrent short-term
(1) in the second sentence of paragraph (1), SEC. 202. IMPROVEMENTS TO THE MEDICARE
benefits’ means benefits intended to address
by striking ‘‘(5) and (6)’’ and inserting ‘‘(5), HOSPITAL ACCELERATED AND AD-
a specific crisis or need as defined by the
(6), and (7)’’; VANCE PAYMENTS PROGRAMS DUR-
Secretary.
(2) in paragraph (6)(C)— ING THE COVID–19 PUBLIC HEALTH
‘‘(D) POVERTY LINE.—The term ‘poverty EMERGENCY.
(A) in clause (i), by striking ‘‘section
line’ means the income official poverty line, (a) PART A.—
1844(d)(1)’’ and inserting ‘‘subsections (d)(1)
as defined by the Office of Management and (1) REPAYMENT PERIODS.—Section
and (e)(1) of section 1844’’; and
Budget, and revised annually in accordance 1815(f)(2)(C) of the Social Security Act (42
(B) in clause (ii), by striking ‘‘paragraph
with section 673(2) of the Community Serv- U.S.C. 1395g(f)(2)(C)) is amended—
(5)’’ and inserting ‘‘paragraphs (5) and (7)’’;
ices Block Grant Act (42 U.S.C. 9902(2)). (A) in clause (i), by striking ‘‘120 days’’ and
and
‘‘(E) STATE.—The term ‘State’ has the inserting ‘‘270 days’’; and
(3) by adding at the end the following:
meaning given that term in section 419(5) ‘‘(7) In applying this part (including sub- (B) in clause (ii), by striking ‘‘12 months’’
and includes Indian tribes, as defined in sec- section (i) and section 1833(b)), the monthly and inserting ‘‘18 months’’.
tion 419(4). actuarial rate for enrollees age 65 and over (2) AUTHORITY FOR DISCRETION.—Section
‘‘(F) WORK SUPPORTS.—The term ‘work sup- for 2021 shall be the same as the monthly ac- 1815(f)(2)(A)(ii) of the Social Security Act (42
ports’ means benefits provided to help fami- tuarial rate for enrollees age 65 and over for U.S.C. 1395g(f)(2)(A)(ii)) is amended by insert-
lies obtain, retain, or advance in employ- 2020.’’. ing ‘‘(or, with respect to requests submitted
ment as defined by the Secretary.’’. (b) TRANSITIONAL GOVERNMENT CONTRIBU- to the Secretary on or after July 9, 2020,
(2) REPEAL.—Effective October 1, 2021, sub- TION.—Section 1844 of the Social Security may)’’after ‘‘shall.’’.
section (c) of section 403 of the Social Secu- Act (42 U.S.C. 1395w) is amended— (b) PART B.—In carrying out the advance
rity Act (42 U.S.C. 603) (as added by para- (1) in subsection (a), by adding at the end payments program described in section
graph (1)) is repealed. the following new sentence: ‘‘In applying 421.214 of title 42, Code of Federal Regula-
(b) DISREGARD FROM LIMITATION ON TOTAL paragraph (1), the amounts transferred under tions (or a successor regulation), the Sec-
PAYMENTS TO TERRITORIES.— subsection (e)(1) with respect to enrollees de- retary of Health and Human Services, in the
(1) IN GENERAL.—Section 1108(a)(2) of the scribed in subparagraphs (A) and (B) of such case of a payment made under such program
Social Security Act (42 U.S.C. 1308(a)(2)) is subsection shall be treated as premiums pay- during the emergency period described in
amended by inserting ‘‘403(c)(3),’’ after able and deposited in the Trust Fund under section 1135(g)(1)(B) of the Social Security
‘‘403(a)(5),’’. subparagraphs (A) and (B), respectively, of Act (42 U.S.C. 1320b–5(g)(1)(B)), upon request
(2) SUNSET.—Effective October 1, 2021, sec- paragraph (1).’’; and of the supplier receiving such payment,
tion 1108(a)(2) of the Social Security Act (42 (2) by adding at the end the following: shall—
U.S.C. 1308(a)(2)) is amended by striking ‘‘(e)(1) For 2021, there shall be transferred (1) provide up to 270 days before claims are
‘‘403(c)(3),’’ (as added by paragraph (1)). from the General Fund to the Trust Fund an offset to recoup the payment; and
amount, as estimated by the Chief Actuary (2) allow not less than 14 months from the
SA 2510. Mr. GRASSLEY submitted of the Centers for Medicare & Medicaid Serv- date of the first advance payment before re-
an amendment intended to be proposed ices, equal to the reduction in aggregate pre- quiring that the outstanding balance be paid
to amendment SA 2499 proposed by Mr. miums payable under this part for a month in full.
MCCONNELL to the bill S. 178, to con- in such year (excluding any changes in (c) EFFECTIVE DATE.—The amendments
amounts collected under section 1839(i)) that made by this section shall take effect as if
demn gross human rights violations of
are attributable to the application of section included in the enactment of the
ethnic Turkic Muslims in Xinjiang, and 1839(a)(7) with respect to—
calling for an end to arbitrary deten- Coronavirus Aid, Relief, and Economic Secu-
‘‘(A) enrollees age 65 and over; and
rity Act (Public Law 116–136).
tion, torture, and harassment of these ‘‘(B) enrollees under age 65.
(d) IMPLEMENTATION.—Notwithstanding
communities inside and outside China; Such amounts shall be transferred from time
to time as appropriate. any other provision of law, the Secretary of
which was ordered to lie on the table; ‘‘(2) Premium increases affected under sec- Health and Human Services may implement
as follows: tion 1839(a)(6) shall not be taken into ac- the provisions of, and the amendments made
At the end, add the following: count in applying subsection (a). by, this section by program instruction or
SEC. ll. SUPPLEMENTAL EMERGENCY UNEM- ‘‘(3) There shall be transferred from the otherwise.
PLOYMENT RELIEF FOR GOVERN- Trust Fund to the General Fund of the SEC. 203. AUTHORITY TO EXTEND MEDICARE
MENTAL ENTITIES AND NONPROFIT Treasury amounts equivalent to the addi- TELEHEALTH WAIVERS.
ORGANIZATIONS. tional premiums payable as a result of the (a) AUTHORITY.—Section 1834(m) of the So-
(a) IN GENERAL.—Section 903(i)(1)(B) of the application of section 1839(a)(6), excluding cial Security Act (42 U.S.C. 1395m(m)) is
Social Security Act (42 U.S.C. 1103(i)(1)(B)) is amended by adding at the end the following
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the aggregate payments attributable to the
amended by striking ‘‘one-half’’ and insert- application of section 1839(i)(3)(A)(ii)(II).’’. new paragraph:
ing ‘‘75 percent’’. (c) ADDITIONAL TRANSITIONAL GOVERNMENT ‘‘(9) AUTHORITY TO EXTEND TELEHEALTH
(b) EFFECTIVE DATE.—The amendment CONTRIBUTION.—Section 1844 of the Social Se- WAIVERS AND POLICIES.—
made by subsection (a) shall take effect as if curity Act (42 U.S.C. 1395w), as amended by ‘‘(A) AUTHORITY.—Notwithstanding the
included in the enactment of the Relief for subsection (b)(2), is amended by adding at preceding provisions of this subsection and
Workers Affected by Coronavirus Act (con- the end the following: section 1135, subject to subparagraph (B), if
tained in subtitle A of title II of division A ‘‘(f)(1) There shall be transferred from the the emergency period under section
of the CARES Act (Public Law 116–136)). General Fund of the Treasury to the Trust 1135(g)(1)(B) expires prior to December 31,
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S4766 CONGRESSIONAL RECORD — SENATE August 4, 2020
2021, the authority provided the Secretary (A) STUDY.—The Secretary shall conduct a the first day after the end of such emergency
under section 1135(b)(8) to waive or modify study on the impact of telehealth and other period’’ after ‘‘1135(g)(1)(B)’’;
requirements with respect to a telehealth virtual services furnished under the Medi- (ii) in clause (ii), by striking ‘‘and’’ at the
service, and modifications of policies with care program under title XVIII of the Social end;
respect to telehealth services made by in- Security Act (42 U.S.C. 1395 et seq.) during (iii) by redesignating clause (iii) as clause
terim final rule applicable to such period, the emergency period described in section (iv); and
shall be extended through December 31, 2021. 1135(g)(1)(B) of such Act (42 U.S.C. 1320b– (iv) by inserting after clause (ii) the fol-
‘‘(B) NO REQUIREMENT TO EXTEND.— Noth- 5(g)(1)(B)). In conducting such study, the lowing new clause:
ing in subparagraph (A) shall require the Secretary shall— ‘‘(iii) the geographic requirements de-
Secretary to extend any specific waiver or (i) assess the impact of such services on ac- scribed in paragraph (4)(C)(i) shall not apply
modification or modifications of policies cess to care, health outcomes, and spending with respect to such a telehealth service;
that the Secretary does not find appropriate by type of physician, practitioner, or other and’’;
for extension. entity, and by patient demographics and (C) in subparagraph (B)(i)—
‘‘(C) IMPLEMENTATION.—Notwithstanding other characteristics that include— (i) in the first sentence, by inserting ‘‘and
any provision of law, the provisions of this (I) age, gender, race, and type of eligibility the 5-year period beginning on the first day
paragraph may be implemented by interim for the Medicare program; after the end of such emergency period’’ be-
final rule, program instructions or other- (II) dual eligibility for both the Medicare fore the period; and
wise.’’. program and the Medicaid program under (ii) in the third sentence, by striking ‘‘pro-
(b) MEDPAC EVALUATION AND REPORT.— title XIX of such Act (42 U.S.C. 1396 et seq.); gram instruction or otherwise’’ and inserting
(1) STUDY.— (III) residing in an area of low-population ‘‘interim final rule, program instruction, or
(A) IN GENERAL.—The Medicare Payment density or a health professional shortage otherwise’’; and
Advisory Commission (in this subsection re- area (as defined in section 332(a)(1)(A) of the (D) by adding at the end the following new
ferred to as the ‘‘Commission’’) shall conduct Public Health Service Act (42 U.S.C. subparagraph:
an evaluation of— 254e(a)(1)(A))) ; ‘‘(C) REQUIREMENT DURING ADDITIONAL PE-
(i) the expansions of telehealth services (IV) diagnoses, such as a diagnosis of RIOD.—
under part B of title XVII of the Social Secu- COVID–19, a chronic condition, or a mental ‘‘(i) IN GENERAL.—During the 5-year period
rity Act related to the COVID-19 public health disorder or substance use disorder; beginning on the first day after the end of
health emergency described in section (V) telecommunication modality used, in- the emergency period described in section
1135(g)(1)(B) of such Act (42 U.S.C. 1320b– 1135(g)(1)(B), payment may only be made
cluding extent to which the services are fur-
5(g)(1)(B)); and
nished using audio-only technology; under this paragraph for a telehealth service
(ii) the appropriate treatment of such ex-
(VI) residing in a State other than the described in subparagraph (A)(i) that is fur-
pansions after the expiration of such public
State in which the furnishing physician, nished to an eligible telehealth individual if
health emergency.
practitioner, or other entity is located; and such service is furnished by a qualified pro-
(B) ANALYSIS.—The evaluation under sub-
(VII) other characteristics and information vider (as defined in clause (ii)).
paragraph (A) shall include an analysis of
determined appropriate by the Secretary; ‘‘(ii) DEFINITION OF QUALIFIED PROVIDER.—
each the following:
and For purposes of this subparagraph, the term
(i) Which, if any, of such expansions should
(ii) to the extent feasible, assess such im- ‘qualified provider’ means, with respect to a
be continued after the expiration of the such
pact based on— telehealth service described in subparagraph
public health emergency,
(ii) Whether any such continued expan- (I) the type of technology used to furnish (A)(i) that is furnished to an eligible tele-
sions should be limited to, or differentially the service; health individual, a Federally qualified
applied to, clinicians participating in certain (II) the extent to which patient privacy is health center or rural health clinic that fur-
value-based payment models. protected; nished to such individual, during the 3-year
(iii) How Medicare should pay for tele- (III) the extent to which documented or period ending on the date the telehealth
health services after the expiration of such suspected fraud or abuse occurred; and service was furnished, an item or service in
public health emergency, and the implica- (IV) patient satisfaction. person for which—
tions of payment approaches on aggregate (B) USE OF INFORMATION.—The Secretary ‘‘(I) payment was made under this title; or
Medicare program spending, may use reliable non-governmental sources ‘‘(II) such payment would have been made
(iv) Medicare program integrity and bene- of information in assessing the impact of if such individual were entitled to, or en-
ficiary safeguards that may be warranted characteristics described in subparagraph rolled for, benefits under this title at the
with the coverage of telehealth services. (A) under the study. time such item or service was furnished.’’.
(C) REPORT.— (b) EFFECTIVE DATE.—The amendments
(v) The implications of expanded Medicare
(i) INTERIM PROVISION OF INFORMATION.— made by this section (other than the amend-
coverage of telehealth services for bene-
The Secretary shall, as determined appro- ment made by subsection (a)(2)(D)) shall
ficiary access to care and the quality of care
priate, periodically during such emergency take effect as if included in the enactment of
provided via telehealth.
period, post on the internet website of the the Coronavirus Aid, Relief, and Economic
(vi) Other areas determined appropriate by
Centers for Medicare & Medicaid services Security Act (Public Law 116–136).
the Commission.
data on utilization of telehealth and other SEC. 205. TEMPORARY CARRYOVER FOR HEALTH
(2) REPORT.—Not later than June 15, 2021, AND DEPENDENT CARE FLEXIBLE
the Commission shall submit to Congress a virtual services under the Medicare program
SPENDING ARRANGEMENTS.
report containing the results of the evalua- and the impact of characteristics described
in subparagraph (A) on such utilization. (a) INCREASE IN CARRYOVER FOR HEALTH
tion conducted under paragraph (1), together FLEXIBLE SPENDING ARRANGEMENTS.—A plan
with recommendations for such legislation (ii) REPORT.—Not later than 15 months
after date of enactment of this Act, the Sec- or other arrangement that otherwise satis-
and administrative action as the Commis- fies all of the applicable requirements of sec-
sion determines appropriate. retary shall submit to Congress a report on
the study conducted under subparagraph (A), tions 106 and 125 of the Internal Revenue
(c) HHS PROVISION OF INFORMATION AND Code of 1986 (including any rules or regula-
STUDY AND REPORT.— together with recommendations for such leg-
tions thereunder) shall not fail to be treated
(1) PRE–COVID–19 PUBLIC HEALTH EMERGENCY islation and administrative action as the
as a cafeteria plan or health flexible spend-
TELEHEALTH AUTHORITY.—Not later than 3 Secretary determines appropriate.
ing arrangement merely because such plan
months after the date of enactment of this SEC. 204. EXTENDING MEDICARE TELEHEALTH or arrangement permits participants to
Act, the Secretary of Health and Human FLEXIBILITIES FOR FEDERALLY carry over an amount not in excess of $2,750
Services (in this subsection referred to as the QUALIFIED HEALTH CENTERS AND
RURAL HEALTH CLINICS.
of unused benefits or contributions remain-
‘‘Secretary’’) shall make available on the ing in a health flexible spending arrange-
internet website of the Centers for Medicare (a) IN GENERAL.—Section 1834(m) of the So- ment from the plan year ending in 2020 to
& Medicaid Services information describing cial Security Act (42 U.S.C. 1395m(m)) is the plan year ending in 2021.
the requirements applicable to telehealth amended— (b) CARRYOVER FOR DEPENDENT CARE
services and other virtual services under the (1) in paragraph (4)(C)— FLEXIBLE SPENDING ARRANGEMENTS.—A plan
original Medicare fee-for-service program (A) in clause (i), in the matter preceding or other arrangement that otherwise satis-
under parts A and B of title XVIII of the So- subclause (I), by striking ‘‘and (7)’’ and in- fies all applicable requirements of sections
cial Security Act (42 U.S.C. 1395 et seq.) and serting ‘‘(7), and (8)’’; and 106, 125, and 129 of the Internal Revenue Code
the Medicare Advantage program under part (B) in clause (ii)(X), by inserting ‘‘or para- of 1986 (including any rules or regulations
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C of such title prior to the waiver or modi- graph (8)(A)(i)’’ before the period; and thereunder) shall not fail to be treated as a
fication of such requirements during the (2) in paragraph (8)— cafeteria plan or dependent care flexible
emergency period described in section (A) in the paragraph heading by inserting spending arrangement merely because such
1135(g)(1)(B) of the Social Security Act (42 ‘‘AND FOR AN ADDITIONAL PERIOD AFTER’’ after plan or arrangement permits participants to
U.S.C. 1320b–5(g)(1)(B)), as established by ‘‘DURING ’’; carry over (under rules similar to the rules
statute, regulation, and sub-regulatory guid- (B) in subparagraph (A)— applicable to health flexible spending ar-
ance under such title. (i) in the matter preceding clause (i), by in- rangements) an amount, not in excess of the
(2) STUDY AND REPORT.— serting ‘‘and the 5-year period beginning on amount in effect under section 129(a)(2)(A) of
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August 4, 2020 CONGRESSIONAL RECORD — SENATE S4767
such Code, of unused benefits or contribu- ‘‘(v) TERMINATION.—This subparagraph fiscal year 2020 for making grants in accord-
tions remaining in a dependent care flexible shall not apply to any taxable year begin- ance with this section to the highest State
spending arrangement from the plan year ning after December 31, 2021.’’. courts described in section 438 of the Social
ending in 2020 to the plan year ending in 2021. (b) EFFECTIVE DATE.—The amendment Security Act (42 U.S.C. 629h). Grants made
(c) RETROACTIVE APPLICATION.—An em- made by this section shall apply to taxable under this section shall be considered to be
ployer shall be permitted to amend its cafe- years beginning after December 31, 2019. Court Improvement Program grants made
teria plan to effectuate the carry over al- SEC. 207. SUPPORT FOR OLDER FOSTER YOUTH. under such section 438, subject to the suc-
lowed under subsection (a) or (b), provided (a) FUNDING INCREASES.—The dollar ceeding provisions of this section.
that such amendment— amount specified in section 477(h)(1) of the (b) DISTRIBUTION OF FUNDS.—
(1) is adopted not later than the last day of Social Security Act (42 U.S.C. 677(h)(1)) for (1) IN GENERAL.—From the amount appro-
the plan year ending in 2020; and fiscal year 2020 is deemed to be $193,000,000. priated under subsection (a), the Secretary
(2) provides that the carry over allowed (b) PROGRAMMATIC FLEXIBILITY.—During shall—
under subsection (a) or (b) shall be in effect the COVID–19 public health emergency: (A) reserve up to $500,000 for Tribal court
as of the first day of the plan year ending in (1) SUSPENSION OF CERTAIN REQUIREMENTS improvement activities; and
2020. UNDER THE EDUCATION AND TRAINING VOUCHER (B) pay from the amount remaining after
(d) DEFINITIONS.—Any term used in this PROGRAM.—The Secretary may allow a State the application of subparagraph (A), a grant
section which is also used in section 106, 125, to waive the applicability of the requirement to each highest State court that is approved
or 129 of the Internal Revenue Code of 1986 or in section 477(i)(3) of the Social Security Act to receive a grant under section 438 of the
the rules or regulations thereunder shall (42 U.S.C. 677(i)(3)) that a youth must be en- Social Security Act for the purpose described
have the same meaning as when used in such rolled in a postsecondary education or train- in subsection (a)(3) of that section for fiscal
section or rules or regulations. ing program or making satisfactory progress year 2020 .
SEC. 206. ON-SITE EMPLOYEE CLINICS. toward completion of that program if a (2) AMOUNT.—The amount of the grant
(a) IN GENERAL.—Paragraph (1) of section youth is unable to meet these requirements awarded to a highest State court under this
223(c) of the Internal Revenue Code of 1986 is due to the public health emergency. section is equal to the sum of—
amended by adding at the end the following (2) AUTHORITY TO WAIVE LIMITATIONS ON (A) $85,000; and
new subparagraph: PERCENTAGE OF FUNDS USED FOR HOUSING AS- (B) the amount that bears the same ratio
‘‘(D) SPECIAL RULE FOR QUALIFIED ITEMS SISTANCE AND ELIGIBILITY FOR SUCH ASSIST- to the amount appropriated under subsection
AND SERVICES.— ANCE.—Notwithstanding subsections (b)(3)(B) (a) that remains after the application of
‘‘(i) IN GENERAL.—For purposes of subpara- and (b)(3)(C) of section 477 of the Social Se- paragraph (1)(A) and subparagraph (A) of this
graph (A)(ii), an individual shall not be curity Act (42 U.S.C. 677), a State may— paragraph, as the number of individuals in
treated as covered under a health plan de- (A) use more than 30 percent of the the State who have not attained 21 years of
scribed in subclauses (I) and (II) of such sub- amounts paid to the State from its allot- age bears to the total number of such indi-
paragraph merely because the individual is ment under subsection (c) of such section for viduals in all States (based on the most re-
eligible to receive, or receives, qualified a fiscal year for room or board payments; cent year for which data are available from
items and services— and the Bureau of the Census).
‘‘(I) at a healthcare facility located at a fa- (B) expend amounts paid to the State from (3) OTHER RULES.—
cility owned or leased by the employer of the its allotment under subsection (c) of such (A) IN GENERAL.—The grants awarded to
individual (or of the individual’s spouse), or section for a fiscal year for room or board for the highest State courts under this section
‘‘(II) at a healthcare facility operated pri- youth who have attained age 18, are no shall be in addition to any grants made to
marily for the benefit of employees of the longer in foster care or otherwise eligible for such courts under section 438 of such Act for
employer of the individual (or of the individ- services under such section, and experienced any fiscal year.
ual’s spouse). foster care at 14 years of age or older. (B) NO MATCHING REQUIREMENT.—The limi-
‘‘(ii) QUALIFIED ITEMS AND SERVICES DE- (c) SPECIAL RULES.— tation on the use of funds specified in section
FINED.—For purposes of this subparagraph, (1) NONAPPLICATION OF MATCHING FUNDS RE- 438(d) of such Act (42 U.S.C. 629h(d)) shall not
the term ‘qualified items and services’ QUIREMENT FOR INCREASED FUNDING.—With apply to the grants awarded under this sec-
means the following: respect to the amount allotted to a State tion.
‘‘(I) Physical examination. under section 477(c)(1) of the Social Security (C) NO ADDITIONAL APPLICATION.—The Sec-
‘‘(II) Immunizations, including injections Act (42 U.S.C. 677(c)(1)) for fiscal year 2020, retary shall award grants to the highest
of antigens provided by employees. the Secretary shall apply section State courts under this section without re-
‘‘(III) Drugs or biologicals other than a 474(a)(4)(A)(i) of such Act (42 U.S.C. quiring such courts to submit an additional
prescribed drug (as such term is defined in 674(a)(4)(A)(i)) to the additional amount of application.
section 213(d)(3)). such allotment resulting from the deemed (D) REPORTS.—The Secretary may estab-
‘‘(IV) Treatment for injuries occurring in increase in the dollar amount specified in lish reporting criteria specific to the grants
the course of employment. section 477(h)(1) of such Act (42 U.S.C. awarded under this section.
‘‘(V) Preventive care for chronic conditions 677(h)(1)) for fiscal year 2020 under subsection (E) REDISTRIBUTION OF FUNDS.—If a highest
(as defined in clause (iv)). (a) by substituting ‘‘100 percent’’ for ‘‘80 per- State court does not accept a grant awarded
‘‘(VI) Management of chronic conditions or cent’’. under this section, or does not agree to com-
diseases. (2) NO RESERVATION FOR EVALUATION, TECH- ply with any reporting requirements imposed
‘‘(VII) Drug testing. NICAL ASSISTANCE, PERFORMANCE MEASURE- under subparagraph (D) or the use of funds
‘‘(VIII) Hearing or vision screenings and re- MENT, AND DATA COLLECTION ACTIVITIES.—Sec- requirements specified in subsection (c), the
lated services. tion 477(g)(2) of such Act (42 U.S.C. 677(g)(2)) Secretary shall redistribute the grant funds
‘‘(IX) Testing, vaccines, or treatments for shall not apply to the portion of the deemed that would have been awarded to that court
the virus SARS–CoV–2 or coronavirus disease dollar amount for section 477(h)(1) of such among the other highest State courts that
2019 (COVID–19). Act (42 U.S.C. 677(h)(1)) for fiscal year 2020 are awarded grants under this section and
‘‘(iii) AGGREGATION.—For purposes of under subsection (a) that exceeds the dollar agree to comply with such reporting and use
clause (i), all persons treated as a single em- amount specified in that section for such fis- of funds requirements.
ployer under subsection (b), (c), (m), or (o) of cal year. (c) USE OF FUNDS.—A highest State court
section 414 shall be treated as a single em- (d) DEFINITIONS.—In this section: awarded a grant under this section shall use
ployer. (1) COVID–19 PUBLIC HEALTH EMERGENCY.— the grant funds to address needs stemming
‘‘(iv) PREVENTIVE CARE FOR CHRONIC CONDI- The term ‘‘COVID–19 public health emer- from the COVID–19 public health emergency,
TIONS.—For purposes of this subparagraph, gency’’ means the public health emergency which may include any of the following:
the term ‘preventive care for chronic condi- declared by the Secretary pursuant to sec- (1) Technology investments to facilitate
tions’ means any item or service specified in tion 319 of the Public Health Service Act on the transition to remote hearings for depend-
the Appendix of Internal Revenue Service January 31, 2020, entitled ‘‘Determination ency courts when necessary as a direct result
Notice 2019-45 which is prescribed to treat an that a Public Health Emergency Exists Na- of the COVID–19 public health emergency.
individual diagnosed with the associated tionwide as the Result of the 2019 Novel (2) Training for judges, attorneys, and
chronic condition specified in such Appendix Coronavirus’’ and includes any renewal of caseworkers on facilitating and partici-
for the purpose of preventing the exacer- such declaration pursuant to such section pating in remote technology hearings that
bation of such chronic condition or the de- 319. still comply with due process, meet Congres-
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velopment of a secondary condition, includ- (2) SECRETARY.—The term ‘‘Secretary’’ sionally mandated requirements, ensure
ing any amendment, addition, removal, or means the Secretary of Health and Human child safety and well-being, and help inform
other modification made by the Secretary Services. judicial decision-making.
(pursuant to the authority granted to the SEC. 208. COURT IMPROVEMENT PROGRAM. (3) Programs to help families address as-
Secretary under paragraph (2)(C)) to the (a) TEMPORARY FUNDING INCREASES.—Out pects of the case plan to avoid delays in legal
items or services specified in such Appendix of any money in the Treasury of the United proceedings that would occur as a direct re-
subsequent to the date of enactment of this States not otherwise appropriated, there are sult of the COVID–19 public health emer-
subparagraph. appropriated to the Secretary, $10,000,000 for gency.
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S4768 CONGRESSIONAL RECORD — SENATE August 4, 2020
(4) Other purposes to assist courts, court (A) the individual’s designation to serve on (3) COORDINATION WITH OTHER FEDERAL EN-
personnel, or related staff related to the 1 or more teams under an emergency procla- TITIES.—The Secretary shall seek input as
COVID–19 public health emergency. mation by the Secretary; appropriate on the training courses devel-
(d) DEFINITIONS.—In this section: (B) the mission of the team; oped under this subsection from the Elder
(1) COVID–19 PUBLIC HEALTH EMERGENCY.— (C) the authority of the individual to per- Justice Coordinating Council and the Direc-
The term ‘‘COVID–19 public health emer- form the team mission; tor of the Centers for Disease Control and
gency’’ means the public health emergency (D) the individual’s authority to access Prevention.
declared by the Secretary pursuant to sec- places, persons, and materials necessary for (4) INTERACTIVE WEBSITE.—The Secretary is
tion 319 of the Public Health Service Act on the team member’s performance of the authorized to create an interactive website
January 31, 2020, entitled ‘‘Determination team’s mission; to disseminate training materials and re-
that a Public Health Emergency Exists Na- (E) the requirement that team members lated information in the areas of infection
tionwide as the Result of the 2019 Novel maintain the confidentiality of patient in- control and prevention, for purposes of car-
Coronavirus’’ and includes any renewal of formation shared with such individuals by a rying out this subsection during the COVID–
such declaration pursuant to such section participating provider; and 19 public health emergency period.
319. (F) the required security background SEC. 214. PROMOTING TRANSPARENCY IN COVID–
(2) SECRETARY.—The term ‘‘Secretary’’ checks that the individual has passed. 19 REPORTING BY NURSING FACILI-
means the Secretary of Health and Human (3) SECRETARIAL OVERSIGHT.—The Sec- TIES.
Services. retary may, at any time, disband any strike Not later than 10 days after the date of en-
Subtitle B—Emergency Support and COVID– team and rescind the letter of authorization actment of this Act, and at least weekly
19 Protection for Nursing Homes for any team member. thereafter during the COVID-19 public health
SEC. 211. DEFINITIONS. (4) TEAM AND MEMBER AUTHORITY.—A team emergency period, the Secretary shall pro-
and team member may not use the letter of vide the Governor of each State with a list of
In this subtitle:
authorization described in paragraph (2) for all participating providers in the State with
(1) COVID–19.—The term ‘‘COVID–19’’
any purpose except in connection with the respect to which the reported cases of
means the 2019 Novel Coronavirus or 2019-
team’s mission of acting in good faith to pro- COVID–19 in visitors to, personnel of, and
nCoV.
mote resident and employee safety in par- residents of, such providers increased during
(2) COVID–19 PUBLIC HEALTH EMERGENCY PE-
ticipating providers in which COVID–19 is the previous week (or, in the case of the first
RIOD.—The term ‘‘COVID–19 public health
confirmed to be present. such list, during the 10-day period beginning
emergency period’’ means the period begin-
(5) ADMINISTRATION.—The Secretary, in on the date of enactment of this Act).
ning on the first day of the emergency period
defined in paragraph (1)(B) of section 1135(g) consultation with the Director of the Cen- SEC. 215. FUNDING.
of the Social Security Act (42 U.S.C. 1320b- ters for Disease Control and Prevention, may The Secretary may use amounts appro-
5(g)) and ending on the last day of the cal- establish protocols and procedures for re- priated for COVID–19 response and related
endar quarter in which the last day of such questing the assistance of a strike team es- activities pursuant to the CARES Act (Pub-
emergency period occurs. tablished under this section and any other lic Law 116–136) and subsequently enacted
(3) NURSING FACILITY.—The term ‘‘nursing procedures deemed necessary for the team’s legislation to carry out this subtitle.
facility’’ has the meaning given that term in operation.
section 1919(a) of the Social Security Act (42 (6) SUPPLEMENTATION OF OTHER RESPONSE SA 2512. Mr. MORAN (for himself and
U.S.C. 1396r(a)). EFFORTS.—Strike teams established by the Mr. BLUMENTHAL) proposed an amend-
(4) PARTICIPATING PROVIDER.—The term Secretary under this section shall supple- ment to the bill S. 2330, to amend the
‘‘participating provider’’ means a skilled ment and not supplant response efforts car- Ted Stevens Olympic and Amateur
nursing facility or a nursing facility that has ried out by a State strike team or a tech- Sports Act to provide for congressional
been assigned a national provider identifier nical assistance team established by the Sec-
retary during the COVID-19 public health
oversight of the board of directors of
number by the Secretary and has executed the United States Olympic and
an agreement to participate in the Medicare emergency period
SEC. 213. PROMOTING COVID–19 TESTING AND IN-
Paralympic Committee and to protect
program established under title XVIII of the
Social Security Act (42 U.S.C. 1395 et seq.) or FECTION CONTROL IN NURSING FA- amateur athletes from emotional,
the Medicaid program established under title CILITIES. physical, and sexual abuse, and for
XIX of such Act (42 U.S.C. 1396 et seq.). (a) NURSING HOME PROTECTIONS.—The Sec- other purposes; as follows:
(5) SECRETARY.—The term ‘‘Secretary’’ retary, in consultation with the Elder Jus- Strike all after the enacting clause and in-
means the Secretary of Health and Human tice Coordinating Council, is authorized dur- sert the following:
Services. ing the COVID–19 public health emergency SECTION 1. SHORT TITLE.
(6) SKILLED NURSING FACILITY.—The term period to enhance efforts by participating This Act may be cited as the ‘‘Empowering
‘‘skilled nursing facility’’ has the meaning providers to respond to COVID–19, including Olympic, Paralympic, and Amateur Athletes
given that term in section 1819(a) of the So- through— Act of 2020’’.
cial Security Act (42 U.S.C. 1395i–3(a)). (1) development of online training courses SEC. 2. FINDINGS.
(7) STATE.—Except as otherwise provided, for personnel of participating providers, sur-
Congress makes the following findings:
the term ‘‘State’’ has the meaning given vey agencies, the long-term care ombudsman
such term for purposes of title XIX of the So- of each State, and other individuals to facili-
SA 2513. Mr. CASSIDY (for himself,
cial Security Act (42 U.S.C. 1396 et seq.). tate the implementation of subsection (b);
(2) enhanced diagnostic testing of visitors Mr. DAINES, Mr. ROMNEY, and Mr.
SEC. 212.ESTABLISHING COVID–19 STRIKE
TEAMS FOR NURSING FACILITIES. to, personnel of, and residents of, partici- RUBIO) submitted an amendment in-
(a) IN GENERAL.—The Secretary is author- pating providers in which measures of tended to be proposed to amendment
ized to establish and support the operation of COVID–19 in the community support more SA 2499 proposed by Mr. MCCONNELL to
strike teams comprised of individuals with frequent testing for COVID–19; the bill S. 178, to condemn gross human
relevant skills, qualifications, and experi- (3) development of training materials for rights violations of ethnic Turkic Mus-
ence to respond to COVID–19-related crises in personnel of participating providers, the lims in Xinjiang, and calling for an end
participating providers during the COVID–19 long-term care ombudsman of each State,
to arbitrary detention, torture, and
public health emergency period, based on and other individuals to facilitate the imple-
mentation of subsection (c); and harassment of these communities in-
data reported by such providers to the Cen-
ters for Disease Control and Prevention. (4) providing support to participating pro- side and outside China; which was or-
(b) MISSION AND COMPOSITION OF STRIKE viders in areas deemed by the Secretary to dered to lie on the table; as follows:
TEAMS.— require additional assistance due to the pres- At the appropriate place, insert the fol-
(1) IN GENERAL.—Strike teams established ence COVID–19 infections. lowing:
by the Secretary may include assessment, (b) TRAINING ON BEST PRACTICES IN INFEC- SEC. lll. SUPPLEMENTARY 2020 RECOVERY RE-
testing, and clinical teams, and a mission for TION CONTROL AND PREVENTION.— BATES FOR INDIVIDUALS.
each such team may include performing (1) IN GENERAL.—The Secretary shall de- (a) IN GENERAL.—Subchapter B of chapter
medical examinations, conducting COVID–19 velop training courses on infection control 65 of subtitle F of the Internal Revenue Code
testing, and assisting participating providers and prevention, including cohorting, strate- of 1986 is amended by inserting after section
with the implementation of infection control gies and use of telehealth to mitigate the 6428 the following new section:
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practices (such as quarantine, isolation, or transmission of COVID–19 in participating ‘‘SEC. 6428A. SUPPLEMENTARY 2020 RECOVERY
disinfection procedures). providers during the COVID–19 public health REBATES FOR INDIVIDUALS.
(2) LETTER OF AUTHORIZATION.—Strike emergency period. ‘‘(a) IN GENERAL.—In addition to the credit
teams and members of such teams shall be (2) DEVELOPMENT.—To the extent prac- allowed under section 6428, in the case of an
subject to the Secretary’s oversight and di- ticable, the training programs developed by eligible individual, there shall be allowed as
rection and the Secretary may issue a letter the Secretary under this subsection shall use a credit against the tax imposed by subtitle
of authorization to team members describ- best practices in infection control and pre- A for the first taxable year beginning in 2020
ing— vention. an amount equal to the sum of—
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