The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021

I 117TH CONGRESS 1ST SESSION H. R. 1349 To amend title XVIII of the Social Security Act to provide for the conversion of certain accelerated and advance payments to grants under parts A and B of the Medicare program. IN THE HOUSE OF REPRESENTATIVES FEBRUARY 25, 2021 Ms. KAPTUR (for herself, Mr. GIBBS, Mr. FITZPATRICK, Mr. BERGMAN, Mrs. BEATTY, Mr. GONZALEZ of Ohio, Mr. VAN DREW, Mr. KATKO, Mr. MORELLE, Mrs. HAYES, Mr. STIVERS, Mr. ALLRED, and Mr. RYAN) in- troduced the following bill; which was referred to the Committee on En- ergy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdic- tion of the committee concerned A BILL To amend title XVIII of the Social Security Act to provide for the conversion of certain accelerated and advance payments to grants under parts A and B of the Medicare program. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as ‘‘The COVID-19 Hospital 4 and Health Provider Loan Conversion Act of 2021’’. 5 VerDate Sep 11 2014 19:41 Apr 08, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H1349.IH H1349 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 1349 IH SEC. 2. PROVIDING FOR THE CONVERSION OF CERTAIN AC- 1 CELERATED AND ADVANCE PAYMENTS TO 2 GRANTS UNDER PARTS A AND B OF THE 3 MEDICARE PROGRAM. 4 (a) CONVERSION OF PAYMENTS.— 5 (1) PART A.—Section 1815(f) of the Social Se- 6 curity Act (42 U.S.C. 1395g(f)) is amended— 7 (A) in paragraph (2), by adding at the end 8 the following new subparagraph: 9 ‘‘(D) In the case of an accelerated payment 10 made to a hospital under such program on or after 11 the date of the enactment of the CARES Act and 12 so made during the emergency period described in 13 section 1135(g)(1)(B), the Secretary shall waive the 14 requirement that such payment be repaid (or re- 15 couped) if the hospital meets the requirements de- 16 scribed in paragraph (5), except that such waiver 17 shall not apply with respect to any amounts from 18 such payment that were not used for health care re- 19 lated expenses or lost revenues that are attributable 20 to coronavirus as of December 31, 2021, based on 21 the attestation of the hospital. The hospital shall 22 repay any such amounts to the Secretary not later 23 than July 1, 2023. The interest rate for any such 24 amount not so repaid as of such date shall be 2 per- 25 cent if the hospital demonstrates hardship.’’; 26 VerDate Sep 11 2014 19:41 Apr 08, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H1349.IH H1349 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 1349 IH (B) in paragraph (3), by inserting ‘‘and 1 paragraph (2)(D)’’ after ‘‘paragraph (2)(C)’’; 2 and 3 (C) by adding at the end the following new 4 paragraph: 5 ‘‘(5) For purposes of paragraph (2)(D), the require- 6 ments described in this paragraph are the following: 7 ‘‘(A) The hospital did not use any portion of a 8 payment described in such paragraph for compensa- 9 tion or benefits, including salary, bonuses, awards of 10 stock, or other financial benefits, for an officer or 11 employee described in section 4004(a)(2) of the 12 CARES Act (Public Law 116–136). 13 ‘‘(B) The hospital used at least 60 percent of 14 such payment for employee compensation (other 15 than an officer or employee described in subpara- 16 graph (A)) during the period beginning on January 17 1, 2020, and ending on December 31, 2021. 18 ‘‘(C) The hospital did not balance bill or sur- 19 prise bill any COVID–19 patient.’’. 20 (2) PART B.— 21 (A) IN GENERAL.—In carrying out the 22 program described in section 421.214 of title 23 42, Code of Federal Regulations (or a successor 24 regulation), in the case of a payment made 25 VerDate Sep 11 2014 19:41 Apr 08, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H1349.IH H1349 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 1349 IH under such program to an entity on or after the 1 date of the enactment of the CARES Act (Pub- 2 lic Law 116–136) and so made during the 3 emergency period described in section 4 1135(g)(1)(B) of the Social Security Act (42 5 U.S.C. 1320b–5(g)(1)(B)), the Secretary of 6 Health and Human Services shall waive the re- 7 quirement that such payment be repaid (or re- 8 couped) if the entity meets the requirements de- 9 scribed in subparagraph (B), except that such 10 waiver shall not apply with respect to any 11 amounts from such payment that were not used 12 for health care related expenses or lost revenues 13 that are attributable to coronavirus as of De- 14 cember 31, 2021, based on the attestation of 15 the entity. The entity shall repay any such 16 amounts to the Secretary not later than July 1, 17 2023. The interest rate for any such amount 18 not so repaid as of such date shall be 2 percent 19 if the entity demonstrates hardship. 20 (B) REQUIREMENTS.—For purposes of 21 subparagraph (A), the requirements described 22 in this subparagraph are the following: 23 (i) The entity did not use any portion 24 of a payment described in such subpara- 25 VerDate Sep 11 2014 19:41 Apr 08, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1349.IH H1349 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 1349 IH graph for compensation or benefits, includ- 1 ing salary, bonuses, awards of stock, or 2 other financial benefits, for an officer or 3 employee described in section 4004(a)(2) 4 of the CARES Act (Public Law 116–136). 5 (ii) The entity used at least 60 per- 6 cent of such payment for employee com- 7 pensation (other than an officer or em- 8 ployee described in clause (i)) during the 9 period beginning on January 1, 2020, and 10 ending on June 30, 2021. 11 (iii) The entity did not balance bill or 12 surprise bill any COVID–19 patient. 13 (b) ENSURING THE SOLVENCY OF MEDICARE TRUST 14 FUNDS.— 15 (1) FEDERAL HOSPITAL INSURANCE TRUST 16 FUND.—Section 1817 of the Social Security Act (42 17 U.S.C. 1395i) is amended by adding at the end the 18 following new subsection: 19 ‘‘(l) ACCELERATED PAYMENT PROGRAM TRANS- 20 FERS.— 21 ‘‘(1) IN GENERAL.—There shall be transferred 22 from the General Fund of the Treasury to the Trust 23 Fund, periodically (as determined by the Managing 24 Trustee), amounts such that the aggregate amount 25 VerDate Sep 11 2014 19:41 Apr 08, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1349.IH H1349 pamtmann on DSKBC07HB2PROD with BILLS 6 •HR 1349 IH so transferred under this paragraph equals the total 1 amount of specified payments (as defined in para- 2 graph (2)) made under this part. 3 ‘‘(2) SPECIFIED PAYMENT.—In this subsection, 4 the term ‘specified payment’ means a payment that 5 is made— 6 ‘‘(A) under section 1815(e)(3); and 7 ‘‘(B) during the emergency period de- 8 scribed in section 1135(g)(1)(B).’’. 9 (2) FEDERAL SUPPLEMENTARY MEDICAL IN- 10 SURANCE TRUST FUND.—Section 1844(f) of the So- 11 cial Security Act (42 U.S.C. 1395w(f)) is amend- 12 ed— 13 (A) by striking ‘‘(1) There shall be trans- 14 ferred’’ and inserting ‘‘There shall be trans- 15 ferred’’; 16 (B) by striking ‘‘during the period begin- 17 ning on the first day of the emergency period 18 described in section 1135(g)(1)(B) and ending 19 on the date of the enactment of this para- 20 graph’’ and inserting ‘‘during the emergency 21 period described in section 1135(g)(1)(B)’’; and 22 (C) by striking paragraph (2). 23 (c) INSURER REQUIREMENTS.—Subpart II of part A 24 of title XXVII of the Public Health Service Act (42 U.S.C. 25 VerDate Sep 11 2014 19:41 Apr 08, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H1349.IH H1349 pamtmann on DSKBC07HB2PROD with BILLS 7 •HR 1349 IH 300gg–11 et seq.) is amended by adding at the end the 1 following new section: 2 ‘‘SEC. 2730. COVERAGE AND PAYMENT REQUIREMENTS FOR 3 ITEMS AND SERVICES FURNISHED TO COVID– 4 19 PATIENTS OUT-OF-NETWORK. 5 ‘‘In the case of an item or service furnished by a 6 health care provider to a COVID–19 patient who is an 7 enrollee in a group health plan or group or individual 8 health insurance coverage offered by a health insurance 9 issuer, if such provider does not have in effect a contrac- 10 tual relationship for furnishing such item or service under 11 such plan or coverage, the plan or issuer (as applicable)— 12 ‘‘(1) shall pay to such provider the amount 13 which would have been payable to such provider had 14 such provider had in effect such a relationship for 15 furnishing such item or service; and 16 ‘‘(2) shall ensure that any applicable cost-shar- 17 ing requirement is the same requirement that would 18 have applied had such item or service been furnished 19 by a provider that had in effect such a relation- 20 ship.’’. 21 (d) PUBLICATION.—The Secretary of Health and 22 Human Services shall publish on a public website the fol- 23 lowing: 24 VerDate Sep 11 2014 19:41 Apr 08, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H1349.IH H1349 pamtmann on DSKBC07HB2PROD with BILLS 8 •HR 1349 IH (1) A specification of each hospital to which a 1 waiver described in section 1815(f)(2)(D) of the So- 2 cial Security Act (42 U.S.C. 1395g(f)(2)(D)) applies 3 and each entity to which a waiver described in sub- 4 section (a)(2)(A) applies. 5 (2) The amount to which such waivers apply 6 with respect to each such hospital and entity. 7 Æ VerDate Sep 11 2014 19:41 Apr 08, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6301 E:\BILLS\H1349.IH H1349 pamtmann on DSKBC07HB2PROD with BILLS