Strengthening Rural Health Clinics Act of 2021

II 117TH CONGRESS 1ST SESSION S. 934 To amend title XVIII of the Social Security Act to improve rural health clinic payments. IN THE SENATE OF THE UNITED STATES MARCH 23, 2021 Mr. WARNER (for himself and Mr. BLUNT) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XVIII of the Social Security Act to improve rural health clinic payments. 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 ‘‘Strengthening Rural 4 Health Clinics Act of 2021’’. 5 SEC. 2. RURAL HEALTH CLINIC PAYMENTS. 6 (a) IN GENERAL.—Section 1833(f)(3) of the Social 7 Security Act (42 U.S.C. 1395l(f)(3)) is amended— 8 (1) in subparagraph (A)— 9 VerDate Sep 11 2014 04:42 Apr 14, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S934.IS S934 pbinns on DSKJLVW7X2PROD with BILLS 2 •S 934 IS (A) in the matter preceding clause (i), by 1 inserting ‘‘(or, in the case of a rural health clin- 2 ic described in subparagraph (B)(ii)(III), in the 3 first year in which the rural health clinic fur- 4 nishes such services)’’ after ‘‘March 31’’; 5 (B) in clause (i), by striking subclauses (I) 6 and (II) and inserting the following: 7 ‘‘(I) with respect to a rural 8 health clinic that had a per visit pay- 9 ment amount established for services 10 furnished in 2020— 11 ‘‘(aa) the per visit payment 12 amount applicable to such rural 13 health clinic for rural health clin- 14 ic services furnished in 2020, in- 15 creased by the percentage in- 16 crease in the MEI applicable to 17 primary care services furnished 18 as of the first day of 2021; or 19 ‘‘(bb) the limit described in 20 paragraph (2)(A); and 21 ‘‘(II) with respect to a rural 22 health clinic that did not have a per 23 visit payment amount established for 24 services furnished in 2020— 25 VerDate Sep 11 2014 04:42 Apr 14, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S934.IS S934 pbinns on DSKJLVW7X2PROD with BILLS 3 •S 934 IS ‘‘(aa) the per visit payment 1 amount applicable to such rural 2 health clinic for rural health clin- 3 ic services furnished in 2021 (or, 4 in the case of a rural health clin- 5 ic described in subparagraph 6 (B)(ii)(III), the per visit payment 7 amount applicable to such rural 8 health clinic for rural health clin- 9 ic services furnished in the first 10 year in which such rural health 11 clinic furnishes such services); or 12 ‘‘(bb) the limit described in 13 paragraph (2)(A) (or, in the case 14 of a rural health clinic described 15 in subparagraph (B)(ii)(III), the 16 limit established under paragraph 17 (2) for such first year);’’; and 18 (C) in clause (ii)(I), by striking ‘‘under 19 clause (i)(I)’’ and inserting ‘‘under subclause 20 (I) or (II) of clause (i), as applicable,’’; 21 (2) in subparagraph (B)— 22 (A) in the matter preceding clause (i), by 23 striking ‘‘2019, was’’ and inserting ‘‘2020’’; 24 (B) in clause (i)— 25 VerDate Sep 11 2014 04:42 Apr 14, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S934.IS S934 pbinns on DSKJLVW7X2PROD with BILLS 4 •S 934 IS (i) by inserting ‘‘was’’ after ‘‘(i)’’; and 1 (ii) by inserting the following before 2 the semicolon: ‘‘, or, in the case of a rural 3 health clinic described in clause (ii)(III), 4 had an agreement described in such clause 5 with such a hospital’’; 6 (C) by striking clause (ii) and inserting the 7 following: 8 ‘‘(ii)(I) was enrolled under section 9 1866(j) (including temporary enrollment 10 during the emergency period described in 11 section 1135(g)(1)(B) for such period); 12 ‘‘(II) submitted an application for en- 13 rollment under section 1866(j) (or re- 14 quested such a temporary enrollment for 15 such period) that was received not later 16 than December 31, 2020; or 17 ‘‘(III) as determined by the Secretary, 18 had a binding written agreement with an 19 outside unrelated party for the construc- 20 tion, purchase, lease, or other establish- 21 ment of such a rural health clinic as of 22 that date.’’; and 23 (3) by adding at the end the following new sub- 24 paragraph: 25 VerDate Sep 11 2014 04:42 Apr 14, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S934.IS S934 pbinns on DSKJLVW7X2PROD with BILLS 5 •S 934 IS ‘‘(C)(i) In determining whether a provider-based 1 rural health clinic had an agreement described in subpara- 2 graph (B)(ii)(III) as of December 31, 2020, the Secretary 3 may consider appropriate evidence relating to the agree- 4 ment submitted by the provider. 5 ‘‘(ii) Not later than 60 days after the date of the en- 6 actment of this subparagraph, the Secretary shall obtain 7 an attestation (pursuant to section 413.65(b)(3) of title 8 42, Code of Federal Regulations, or any successor regula- 9 tion) that such provider-based rural health clinic meets, 10 or will meet, the requirements of a provider-based rural 11 health clinic specified in section 413.65 of title 42, Code 12 of Federal Regulations, or any successor regulation. 13 ‘‘(iii) The Secretary may audit, as appropriate, the 14 compliance with subparagraph (B)(ii)(III) with respect to 15 each provider-based rural health clinic to which such sub- 16 paragraph applies. If the Secretary finds as a result of 17 an audit under this clause that the applicable require- 18 ments were not met with respect to such provider-based 19 rural health clinic, the provider-based rural health clinic 20 shall no longer be considered to be described in such sub- 21 paragraph for purposes of this paragraph.’’. 22 (b) EFFECTIVE DATE.—The amendments made by 23 this section shall take effect as if included in the enact- 24 VerDate Sep 11 2014 04:42 Apr 14, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S934.IS S934 pbinns on DSKJLVW7X2PROD with BILLS 6 •S 934 IS ment of the Consolidated Appropriations Act, 2021 (Pub- 1 lic Law 116–260). 2 Æ VerDate Sep 11 2014 04:42 Apr 14, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6301 E:\BILLS\S934.IS S934 pbinns on DSKJLVW7X2PROD with BILLS