Protect Seniors and Cut Waste Act

I 117TH CONGRESS 1ST SESSION H. R. 1999 To delay and offset the sequester under the Statutory Pay-As-You-Go Act of 2010 as a result of the enactment of the American Rescue Plan Act of 2021, and for other purposes. IN THE HOUSE OF REPRESENTATIVES MARCH 18, 2021 Mr. SMITH of Missouri (for himself, Mr. BRADY, Mr. BURGESS, Mr. COMER, Mr. HARRIS, Mr. WENSTRUP, and Mrs. RODGERS of Washington) intro- duced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committees on Energy and Commerce, Oversight and Reform, the Budget, and Education and Labor, for a pe- riod to be subsequently determined by the Speaker, in each case for con- sideration of such provisions as fall within the jurisdiction of the com- mittee concerned A BILL To delay and offset the sequester under the Statutory Pay- As-You-Go Act of 2010 as a result of the enactment of the American Rescue Plan Act of 2021, and for other purposes. 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 ‘‘Protect Seniors and 4 Cut Waste Act’’. 5 VerDate Sep 11 2014 01:55 May 13, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H1999.IH H1999 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 1999 IH SEC. 2. PAYGO ACT SEQUESTER. 1 The budgetary effects of the American Rescue Plan 2 Act of 2021 shall not be counted for purposes of deter- 3 mining whether a sequester occurs under the report issued 4 after Congress adjourns to end the 1st session of the 5 117th Congress and during January 2022 under section 6 5 of the Statutory Pay-As-You-Go Act of 2010. 7 SEC. 3. SUPPLEMENTAL APPROPRIATIONS FOR THE PUB- 8 LIC HEALTH AND SOCIAL SERVICES EMER- 9 GENCY FUND. 10 (a) SUPPLEMENTAL APPROPRIATION.—There is ap- 11 propriated, out of any amounts in the Treasury not other- 12 wise appropriated, for an additional amount for ‘‘Public 13 Health and Social Services Emergency Fund’ ’’, 14 $12,300,000,000, to remain available until expended, to 15 prevent, prepare for, and respond to coronavirus, domesti- 16 cally or internationally, which shall be for necessary ex- 17 penses to reimburse, through grants or other mechanisms, 18 eligible health care providers for health care related ex- 19 penses or lost revenues that are attributable to 20 coronavirus. 21 (b) CONDITIONS.—The following conditions shall 22 apply with respect to funds appropriated by subsection 23 (a): 24 (1) Such funds may not be used to reimburse 25 expenses or losses that have been reimbursed from 26 VerDate Sep 11 2014 01:55 May 13, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H1999.IH H1999 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 1999 IH other sources or that other sources are obligated to 1 reimburse. 2 (2) Recipients of payments under this section 3 shall submit reports and maintain documentation as 4 the Secretary of Health and Human Services deter- 5 mines are needed to ensure compliance with condi- 6 tions that are imposed by this subsection for such 7 payments, and such reports and documentation shall 8 be in such form, with such content, and in such time 9 as the Secretary may prescribe for such purpose. 10 (3) The term ‘‘eligible health care providers’’ 11 means public entities, Medicare or Medicaid enrolled 12 suppliers and providers, and such for-profit entities 13 and not-for-profit entities not otherwise described in 14 this paragraph as the Secretary may specify, within 15 the United States (including territories), that pro- 16 vide diagnoses, testing, or care for individuals with 17 possible or actual cases of COVID–19. 18 (4) The Secretary shall, on a rolling basis, re- 19 view applications and make payments under this sec- 20 tion. 21 (5) Funds appropriated under this section shall 22 be available for building or construction of tem- 23 porary structures, leasing of properties, medical sup- 24 plies and equipment including personal protective 25 VerDate Sep 11 2014 01:55 May 13, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H1999.IH H1999 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 1999 IH equipment and testing supplies, increased workforce 1 and trainings, emergency operation centers, retro- 2 fitting facilities, and surge capacity. 3 (6) In this section, the term ‘‘payment’’ means 4 a pre-payment, prospective payment, or retrospective 5 payment, as determined appropriate by the Sec- 6 retary. 7 (7) Payments under this section shall be made 8 in consideration of the most efficient payment sys- 9 tems practicable to provide emergency payment. 10 (8) To be eligible for a payment under this sec- 11 tion, an eligible health care provider shall submit to 12 the Secretary an application that includes a state- 13 ment justifying the need of the provider for the pay- 14 ment and the eligible health care provider shall have 15 a valid tax identification number. 16 (9) For any reimbursement by the Secretary 17 from the Provider Relief Fund to an eligible health 18 care provider that is a subsidiary of a parent organi- 19 zation, the parent organization may, allocate 20 (through transfers or otherwise) all or any portion 21 of such reimbursement among the subsidiary eligible 22 health care providers of the parent organization, in- 23 cluding reimbursements referred to by the Secretary 24 as ‘‘Targeted Distribution’’ payments, among sub- 25 VerDate Sep 11 2014 01:55 May 13, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1999.IH H1999 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 1999 IH sidiary eligible health care providers of the parent 1 organization, except that responsibility for reporting 2 the reallocated reimbursement shall remain with the 3 original recipient of such reimbursement. 4 (10) For any reimbursement from the Provider 5 Relief Fund to an eligible health care provider for 6 health care related expenses or lost revenues that 7 are attributable to coronavirus (including reimburse- 8 ments made before the date of the enactment of this 9 Act), such provider may calculate such lost revenues 10 using the Frequently Asked Questions guidance re- 11 leased by the Department of Health and Human 12 Services in June 2020, including the difference be- 13 tween such provider’s budgeted and actual revenue 14 budget if such budget had been established and ap- 15 proved prior to March 27, 2020. 16 (11) Of the amount made available in the third 17 paragraph under the heading ‘‘Department of 18 Health and Human Services—Office of the Sec- 19 retary—Public Health and Social Services Emer- 20 gency Fund’’ in Public Law 116–136, not less than 21 85 percent of the unobligated balances available as 22 of the date of enactment of this Act and of any 23 funds recovered from health care providers after the 24 date of enactment of this Act shall be for any suc- 25 VerDate Sep 11 2014 01:55 May 13, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1999.IH H1999 kjohnson on DSK79L0C42PROD with BILLS 6 •HR 1999 IH cessor to the Phase 3 General Distribution allocation 1 to make payments to eligible health care providers 2 based on applications that consider financial losses 3 and changes in operating expenses occurring in fis- 4 cal year 2021 that are attributable to coronavirus. 5 (12) Not later than 3 years after final pay- 6 ments are made under this section, the Office of In- 7 spector General of the Department of Health and 8 Human Services shall transmit a final report on 9 audit findings with respect to this program to the 10 Committees on Appropriations of the House of Rep- 11 resentatives and the Senate. 12 (13) Nothing in this section limits the authority 13 of the Inspector General or the Comptroller General 14 to conduct audits of interim payments at an earlier 15 date. 16 (14) Not later than 60 days after the date of 17 enactment of this Act, the Secretary of Health and 18 Human Services shall provide a report to the Com- 19 mittees on Appropriations of the House of Rep- 20 resentatives and the Senate on the obligation of 21 funds, including obligations to such eligible health 22 care providers, summarized by State of the payment 23 receipt. Such report shall be updated and submitted 24 VerDate Sep 11 2014 01:55 May 13, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H1999.IH H1999 kjohnson on DSK79L0C42PROD with BILLS 7 •HR 1999 IH to such Committees every 60 days until funds are 1 expended. 2 (c) EMERGENCY DESIGNATIONS.— 3 (1) Amounts repurposed in subsection (b) that 4 were previously designated by the Congress as an 5 emergency requirement pursuant to the Balanced 6 Budget and Emergency Deficit Control Act of 1985 7 are designated by the Congress as an emergency re- 8 quirement pursuant to section 251(b)(2)(A)(i) of the 9 Balanced Budget and Emergency Deficit Control 10 Act of 1985. 11 (2) The amount appropriated by subsection (a) 12 is designated by the Congress as being for an emer- 13 gency requirement pursuant to section 14 251(b)(2)(A)(i) of the Balanced Budget and Emer- 15 gency Deficit Control Act of 1985. 16 (3) Each amount designated in this Act by the 17 Congress as an emergency requirement pursuant to 18 section 251(b)(2)(A)(i) of the Balanced Budget and 19 Emergency Deficit Control Act of 1985 shall be 20 available only if the President subsequently so des- 21 ignates all such amounts and transmits such des- 22 ignations to the Congress. 23 (d) APPLICATION OF PROVISIONS.—Amounts appro- 24 priated pursuant to this section and pursuant to title II 25 VerDate Sep 11 2014 01:55 May 13, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H1999.IH H1999 kjohnson on DSK79L0C42PROD with BILLS 8 •HR 1999 IH of Public Law 117–2 shall be subject to the requirements 1 contained in Public Law 116–260 for funds for programs 2 authorized under sections 330 through 340 of the Public 3 Health Service Act. 4 SEC. 4. CORONAVIRUS STATE FISCAL RECOVERY FUND AD- 5 JUSTMENT. 6 (a) IN GENERAL.—Section 602 of the Social Security 7 Act is amended— 8 (1) in subsection (a)(1), by striking 9 ‘‘$219,800,000,000’’ and inserting 10 ‘‘$79,800,000,000’’; and 11 (2) in subsection (b)(3), by striking 12 ‘‘$195,300,000,000’’ and inserting 13 ‘‘$55,300,000,000’’. 14 (b) EFFECTIVE DATE.—The amendments made by 15 subsection (a) shall take effect as if included in the enact- 16 ment of the American Rescue Plan Act of 2021. 17 SEC. 5. TECHNICAL CORRECTIONS. 18 (a) RURAL HEALTH CLINIC PAYMENTS.— 19 (1) IN GENERAL.—Section 1833(f)(3) of the 20 Social Security Act (42 U.S.C. 1395l(f)(3)) is 21 amended— 22 (A) in subparagraph (A)— 23 (i) in clause (i), by striking subclauses 24 (I) and (II) and inserting the following: 25 VerDate Sep 11 2014 01:55 May 13, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H1999.IH H1999 kjohnson on DSK79L0C42PROD with BILLS 9 •HR 1999 IH ‘‘(I) with respect to a rural health 1 clinic that had a per visit payment amount 2 established for services furnished in 3 2020— 4 ‘‘(aa) the per visit payment 5 amount applicable to such rural 6 health clinic for rural health clinic 7 services furnished in 2020, increased 8 by the percentage increase in the MEI 9 applicable to primary care services 10 furnished as of the first day of 2021; 11 or 12 ‘‘(bb) the limit described in para- 13 graph (2)(A); and 14 ‘‘(II) with respect to a rural health 15 clinic that did not have a per visit payment 16 amount established for services furnished 17 in 2020— 18 ‘‘(aa) the per visit payment 19 amount applicable to such rural 20 health clinic for rural health clinic 21 services furnished in 2021; or 22 ‘‘(bb) the limit described in para- 23 graph (2)(A); and’’; and 24 VerDate Sep 11 2014 01:55 May 13, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H1999.IH H1999 kjohnson on DSK79L0C42PROD with BILLS 10 •HR 1999 IH (ii) in clause (ii)(I), by striking 1 ‘‘under clause (i)(I)’’ and inserting ‘‘under 2 subclause (I) or (II) of clause (i), as appli- 3 cable,’’; and 4 (B) in subparagraph (B)— 5 (i) in the matter preceding clause (i), 6 by striking ‘‘2019, was’’ and inserting 7 ‘‘2020’’; 8 (ii) in clause (i), by inserting ‘‘was’’ 9 after ‘‘(i)’’; and 10 (iii) by striking clause (ii) and insert- 11 ing the following: 12 ‘‘(ii)(I) was enrolled under section 1866(j) 13 (including temporary enrollment during the 14 emergency period described in section 15 1135(g)(1)(B) for such period); or 16 ‘‘(II) submitted an application for enroll- 17 ment under section 1866(j) (or requested such 18 a temporary enrollment for such period) that 19 was received not later than December 31, 20 2020.’’. 21 (2) EFFECTIVE DATE.—The amendments made 22 by this subsection shall take effect as if included in 23 the enactment of the Consolidated Appropriations 24 Act, 2021 (Public Law 116–260). 25 VerDate Sep 11 2014 01:55 May 13, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H1999.IH H1999 kjohnson on DSK79L0C42PROD with BILLS 11 •HR 1999 IH (b) ADDITIONAL AMOUNT FOR CERTAIN HOSPITALS 1 WITH HIGH DISPROPORATIONATE SHARE.—Effective as 2 if included in the enactment of section 203(a) of title II 3 of division CC of Public Law 116–260, subsection (g) of 4 section 1923 of the Social Security Act (42 U.S.C. 1396r– 5 4) amended by such section 203(a) is amended by adding 6 at the end the following new paragraph: 7 ‘‘(3) ADDITIONAL AMOUNT FOR CERTAIN HOS- 8 PITALS WITH HIGH DISPROPORATIONATE SHARE.— 9 ‘‘(A) IN GENERAL.—In the case of a hos- 10 pital with high disproportionate share (as de- 11 fined in subparagraph (B)) located in a State 12 referenced in subsection (e) of section 4721 of 13 the Balanced Budget Act of 1997, a payment 14 adjustment during a State fiscal year shall be 15 considered consistent with subsection (c) if the 16 payment adjustment does not exceed 175 per- 17 cent of the costs of furnishing hospital services 18 during the year, but only if the Governor of the 19 State certifies to the satisfaction of the Sec- 20 retary that the hospital’s applicable minimum 21 amount is used for health services during the 22 year. In determining the amount that is used 23 for such services during a year, there shall be 24 excluded any amounts received under the Public 25 VerDate Sep 11 2014 01:55 May 13, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H1999.IH H1999 kjohnson on DSK79L0C42PROD with BILLS 12 •HR 1999 IH Health Service Act, title V, title XVIII, or from 1 third party payors (not including the State plan 2 under this title) that are used for providing 3 such services during the year. 4 ‘‘(B) HOSPITAL WITH HIGH 5 DISPROPORATIONATE SHARE DEFINED.—In 6 subparagraph (A), a hosp [Text truncated for display. Full text available on Congress.gov.]