ARC Act

I 117TH CONGRESS 1ST SESSION H. R. 3069 To provide relief for small rural hospitals from inaccurate instructions provided by certain medicare administrative contractors. IN THE HOUSE OF REPRESENTATIVES MAY 7, 2021 Ms. TENNEY (for herself, Mr. REED, Ms. STEFANIK, Mr. DELGADO, and Mr. KATKO) introduced the following bill; which was referred to the Com- mittee on Ways and Means A BILL To provide relief for small rural hospitals from inaccurate instructions provided by certain medicare administrative contractors. 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 ‘‘Access for Rural Com- 4 munities Act’’ or the ‘‘ARC Act’’. 5 VerDate Sep 11 2014 03:11 Jun 10, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H3069.IH H3069 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 3069 IH SEC. 2. RELIEF FOR SMALL RURAL HOSPITALS FROM INAC- 1 CURATE INSTRUCTIONS PROVIDED BY CER- 2 TAIN MEDICARE ADMINISTRATIVE CONTRAC- 3 TORS. 4 (a) APPLICATION OF REVISED VOLUME DECREASE 5 ADJUSTMENT METHODOLOGY.—Subject to subsection (b), 6 in the case of a sole community hospital or a medicare- 7 dependent, small rural hospital with respect to which a 8 medicare administrative contractor determined a volume 9 decrease adjustment applies for any specified cost report- 10 ing period, at the election of the hospital, the Secretary 11 of Health and Human Services shall recalculate the 12 amount of the volume decrease adjustment determined by 13 the medicare administrative contractor for such hospital 14 and specified cost reporting period using the revised vol- 15 ume decrease adjustment payment methodology for any 16 specified cost reporting period requested by the hospital 17 in its election. 18 (b) LIMITATION.— 19 (1) IN GENERAL.—Subsection (a) shall not 20 apply in the case of a sole community hospital or a 21 medicare-dependent, small rural hospital for which 22 the medicare administrative contractor determina- 23 tion of the volume decrease adjustment with respect 24 to a specified cost reporting period of the hospital is 25 administratively final before the date that is three 26 VerDate Sep 11 2014 03:11 Jun 10, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3069.IH H3069 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 3069 IH years before the date of the enactment of this sec- 1 tion. 2 (2) ADMINISTRATIVE FINALITY.—For purposes 3 of paragraph (1), the date on which the medicare 4 administrative contractor determination with respect 5 to a volume decrease adjustment for a specified cost 6 reporting period is administratively final is the latest 7 of the following: 8 (A) The date of the contractor determina- 9 tion (as defined in section 405.1801 of title 42, 10 Code of Federal Regulations). 11 (B) The date of the final outcome of any 12 reopening of the medicare administrative con- 13 tractor determination under section 405.1885 14 of title 42, Code of Federal Regulations. 15 (C) The date of the final outcome of the 16 final appeal filed by such hospital with respect 17 to such volume decrease adjustment for such 18 specified cost reporting period. 19 (c) DEFINITIONS.—In this section: 20 (1) MEDICARE ADMINISTRATIVE CON- 21 TRACTOR.—The term ‘‘medicare administrative con- 22 tractor’’ means the entity that has entered into a 23 contract with the Secretary of Health and Human 24 Services under section 1874A of the Social Security 25 VerDate Sep 11 2014 03:11 Jun 10, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3069.IH H3069 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 3069 IH Act (42 U.S.C. 1395kk–1) to service A/B Medicare 1 Administrative Contractor Jurisdiction K of the 2 Centers for Medicare & Medicaid Services as of July 3 1, 2016. 4 (2) MEDICARE-DEPENDENT, SMALL RURAL 5 HOSPITAL.—The term ‘‘medicare-dependent, small 6 rural hospital’’ has the meaning given such term 7 under section 1886(d)(5)(G)(iv) of the Social Secu- 8 rity Act (42 U.S.C. 1395ww(d)(5)(G)(iv)). 9 (3) REVISED VOLUME DECREASE ADJUSTMENT 10 PAYMENT METHODOLOGY.—The term ‘‘revised vol- 11 ume decrease adjustment payment methodology’’ 12 means the methodology to calculate the volume de- 13 crease adjustment that is described in the second 14 sentence of section 412.92(e)(3) of title 42, Code of 15 Federal Regulations (relating to the methodology to 16 calculate the volume decrease adjustment for sole 17 community hospitals (and, pursuant to section 18 412.108(d)(3) of such title 42, for medicare-depend- 19 ent, small rural hospitals) that is effective for cost 20 reporting periods beginning on or after October 1, 21 2017). 22 (4) SOLE COMMUNITY HOSPITAL.—The term 23 ‘‘sole community hospital’’ has the meaning given 24 such term under section 1886(d)(5)(D)(iii) of the 25 VerDate Sep 11 2014 03:11 Jun 10, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H3069.IH H3069 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 3069 IH Social Security Act (42 U.S.C. 1 1395ww(d)(5)(D)(iii)). 2 (5) SPECIFIED COST REPORTING PERIOD.—The 3 term ‘‘specified cost reporting period’’ means a cost 4 reporting period of a sole community hospital or a 5 medicare-dependent, small rural hospital, as the case 6 may be, that begins during a fiscal year before fiscal 7 year 2018. 8 (6) VOLUME DECREASE ADJUSTMENT.—The 9 term ‘‘volume decrease adjustment’’ means the ad- 10 justment required with respect to a sole community 11 hospital or a medicare-dependent, small rural hos- 12 pital, as the case may be, under subparagraph 13 (D)(ii) or subparagraph (G)(iii), respectively, of sec- 14 tion 1886(d)(5) of the Social Security Act (42 15 U.S.C. 1395ww(d)(5)). 16 Æ VerDate Sep 11 2014 03:11 Jun 10, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\H3069.IH H3069 kjohnson on DSK79L0C42PROD with BILLS