Medicare Crisis Program Act of 2020

I 116TH CONGRESS 2D SESSION H. R. 6674 To ensure access to affordable, comprehensive health insurance benefits for certain uninsured individuals during the COVID–19 emergency, and to ensure adequate coverage of treatments for COVID–19 under the Medi- care and Medicaid programs and under group health plans and group or individual health insurance coverage, and for other purposes. IN THE HOUSE OF REPRESENTATIVES MAY 1, 2020 Ms. JAYAPAL (for herself, Mr. KENNEDY, Mr. BLUMENAUER, Ms. CLARKE of New York, Mr. COHEN, Mrs. DINGELL, Mr. MICHAEL F. DOYLE of Pennsylvania, Mr. ESPAILLAT, Mr. HASTINGS, Mrs. HAYES, Ms. JACK- SON LEE, Mr. KHANNA, Ms. LEE of California, Mr. LOWENTHAL, Mr. MCGOVERN, Ms. MENG, Mrs. NAPOLITANO, Mr. NEGUSE, Ms. NORTON, Ms. OCASIO-CORTEZ, Ms. OMAR, Ms. PINGREE, Ms. PRESSLEY, Mr. RASKIN, Ms. SCHAKOWSKY, Mr. SOTO, Mr. TAKANO, Ms. TLAIB, Mr. VARGAS, Mr. WELCH, Ms. GABBARD, Mr. ENGEL, and Ms. VELA´ZQUEZ) introduced the following bill; which was referred to the Committee on En- ergy and Commerce, and in addition to the Committees on Ways and Means, Education and Labor, and Armed Services, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee con- cerned A BILL To ensure access to affordable, comprehensive health insur- ance benefits for certain uninsured individuals during the COVID–19 emergency, and to ensure adequate cov- erage of treatments for COVID–19 under the Medicare and Medicaid programs and under group health plans VerDate Sep 11 2014 21:30 May 08, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6652 E:\BILLS\H6674.IH H6674 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 6674 IH and group or individual health insurance coverage, 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 ‘‘Medicare Crisis Pro- 4 gram Act of 2020’’. 5 TITLE I—MEDICARE 6 SEC. 101. COVID–19 MEDICARE ENROLLMENT OPTION. 7 (a) IN GENERAL.—Title XVIII of the Social Security 8 Act (42 U.S.C. 1395c et seq.) is amended by adding at 9 the end the following new section: 10 ‘‘COVID–19 MEDICARE ENROLLMENT OPTION 11 ‘‘SEC. 1899C. (a) OPTION.— 12 ‘‘(1) ELIGIBILITY.—Every individual who meets 13 the requirements described in paragraph (2) shall be 14 eligible to enroll under this section. 15 ‘‘(2) REQUIREMENTS.—For purposes of para- 16 graph (1), the requirements described in this para- 17 graph are the following: 18 ‘‘(A) The individual— 19 ‘‘(i) experienced a loss of, or reduction 20 in, employment during the specified period 21 (as defined in subsection (h)) and was ap- 22 proved for unemployment benefits relating 23 VerDate Sep 11 2014 21:30 May 08, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H6674.IH H6674 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 6674 IH to such loss or reduction in the State in 1 which such individual resides; or 2 ‘‘(ii) is the spouse, child, or other de- 3 pendent of an individual described in 4 clause (i). 5 ‘‘(B) The individual is not— 6 ‘‘(i) otherwise entitled to benefits 7 under part A or eligible to enroll under 8 part A or part B; 9 ‘‘(ii) enrolled under a Federal health 10 care program (as defined in section 11 1128B(f)) or the program established 12 under chapter 89 of title 5, United States 13 Code; 14 ‘‘(iii) enrolled under an eligible em- 15 ployer-sponsored plan (as defined in sec- 16 tion 5000A(f)(2) of the Internal Revenue 17 Code of 1986), but only if such plan— 18 ‘‘(I) includes the essential health 19 benefits package (as defined in section 20 1302(a) of the Patient Protection and 21 Affordable Care Act); and 22 ‘‘(II) the employee’s required 23 contribution (within the meaning of 24 section 5000A(e)(1)(B) of such Code, 25 VerDate Sep 11 2014 21:30 May 08, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H6674.IH H6674 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 6674 IH except that such contribution shall be 1 determined with respect to self-only or 2 family coverage, as applicable to the 3 employee) with respect to the plan 4 does not exceed the percentage speci- 5 fied in section 36B(c)(2)(C)(i)(II) of 6 such Code for the applicable year; or 7 ‘‘(iv) enrolled under a qualified health 8 plan (as defined in section 1301(a) of such 9 Act). 10 ‘‘(3) BENEFITS.—An individual enrolled under 11 this section is entitled to the same benefits under 12 this title as an individual who is entitled to benefits 13 under part A and enrolled under part B and, at the 14 option of the individual, eligible for prescription drug 15 benefits under part D. 16 ‘‘(b) ENROLLMENT AND COVERAGE PERIODS.—The 17 Secretary shall establish enrollment and coverage periods 18 for individuals who enroll under this section. A coverage 19 period with respect to an individual enrolled under this 20 section shall be retroactive to the date on which the indi- 21 vidual experienced the loss or reduction described in sub- 22 section (a)(2)(A)(i). 23 ‘‘(c) ENROLLMENT PREMIUM.— 24 VerDate Sep 11 2014 21:30 May 08, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H6674.IH H6674 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 6674 IH ‘‘(1) AMOUNT OF MONTHLY PREMIUMS.—There 1 shall be no monthly premium for an individual en- 2 rolled under this section except as provided in para- 3 graph (2). 4 ‘‘(2) PREMIUM FOR OPTIONAL PART D BENE- 5 FITS.—In the case an individual enrolled under this 6 section elects to receive coverage under a prescrip- 7 tion drug plan under part D, there shall be a month- 8 ly premium with respect to such individual in an 9 amount determined appropriate by the Secretary. 10 ‘‘(d) PAYMENT OF PREMIUMS.— 11 ‘‘(1) PAYMENT.—Premiums for enrollment 12 under this section shall be paid to the Secretary at 13 such times, and in such manner, as the Secretary 14 determines appropriate. 15 ‘‘(2) DEPOSIT.—Amounts collected by the Sec- 16 retary under this section shall be deposited in the 17 Medicare COVID–19 Trust Fund established under 18 subsection (e). 19 ‘‘(e) MEDICARE COVID–19 TRUST FUND.— 20 ‘‘(1) IN GENERAL.—There is hereby created on 21 the books of the Treasury of the United States a 22 trust fund to be known as the ‘Medicare COVID–19 23 Trust Fund’ (in this subsection referred to as the 24 ‘Trust Fund’). The Trust Fund shall consist of such 25 VerDate Sep 11 2014 21:30 May 08, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H6674.IH H6674 pamtmann on DSKBC07HB2PROD with BILLS 6 •HR 6674 IH gifts and bequests as may be made and such 1 amounts as may be deposited in, or appropriated to, 2 such fund as provided in this title. 3 ‘‘(2) PREMIUMS.—Premiums collected under 4 subsection (d) shall be transferred to the Trust 5 Fund. 6 ‘‘(3) INCORPORATION OF PROVISIONS.—Sub- 7 sections (b) through (i) of section 1841 shall apply 8 with respect to the Trust Fund and this title in the 9 same manner as they apply with respect to the Fed- 10 eral Supplementary Medical Insurance Trust Fund 11 and part B, respectively, except that in applying 12 such section 1841, any reference in such section to 13 ‘this part’ shall be construed to be a reference to 14 this section and any reference in section 1841(h) to 15 section 1840(d) and in section 1841(i) to sections 16 1840(b)(1) and 1842(g) are deemed to be references 17 to comparable authority exercised under this section. 18 ‘‘(f) TERMINATION OF COVERAGE.—Coverage of an 19 individual enrolled under this section shall terminate on 20 the earliest of the following: 21 ‘‘(1) The date on which the individual becomes 22 entitled to benefits under part A or eligible to enroll 23 under such part A or part B (as determined without 24 regard to this section). 25 VerDate Sep 11 2014 21:30 May 08, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H6674.IH H6674 pamtmann on DSKBC07HB2PROD with BILLS 7 •HR 6674 IH ‘‘(2) The date on which the individual becomes 1 enrolled in coverage described in any of clauses (ii) 2 through (iv) of subsection (a)(2)(B) (as determined 3 without regard to this section). 4 ‘‘(3) The end of the specified period (as defined 5 in subsection (h)) with respect to such individual. 6 ‘‘(g) ENROLLMENT INFORMATION.— 7 ‘‘(1) GUIDANCE.—The Secretary of Labor shall 8 publish guidance for States with respect to informa- 9 tion to be included by States on unemployment por- 10 tals for purposes of facilitating enrollment of individ- 11 uals under this section. 12 ‘‘(2) PROVISION OF INFORMATION TO CMS.—In 13 the case of a claim for unemployment benefits sub- 14 mitted to a State that indicates that the individual 15 may be eligible for enrollment under this section, the 16 State shall provide such information regarding such 17 individual as the Secretary may specify to the Sec- 18 retary. 19 ‘‘(3) ONLINE ENROLLMENT.—The Secretary 20 shall create an online application form to facilitate 21 enrollment under this section. 22 ‘‘(h) SPECIFIED PERIOD.— 23 ‘‘(1) IN GENERAL.—In this section, the term 24 ‘specific period’ means, with respect to an individual 25 VerDate Sep 11 2014 21:30 May 08, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H6674.IH H6674 pamtmann on DSKBC07HB2PROD with BILLS 8 •HR 6674 IH residing in a State, the date beginning on the first 1 day of the emergency period (as described in section 2 1135(g)(1)(B)) and ending on the date that is 3 3 months after the first day occurring on or after the 4 date of the enactment of this section that the aver- 5 age unemployment rate for the 12-month period 6 ending on such first day— 7 ‘‘(A) in such State is not more than 2 per- 8 centage points higher that the average unem- 9 ployment rate in such State during the period 10 consisting of October 1 through December 31 11 of 2019; and 12 ‘‘(B) in the United States is not more than 13 2 percentage points higher than the average un- 14 employment rate in the United States during 15 the period consisting of October 1 through De- 16 cember 31 of 2019. 17 ‘‘(2) NOTICE.—In the case of an individual en- 18 rolled under this section, if the specified period with 19 respect to such individual ends while such individual 20 is so enrolled, the Secretary shall provide notice to 21 such individual of the end of such period and an ex- 22 planation that coverage under this section shall ter- 23 minate with respect to such individual not later than 24 VerDate Sep 11 2014 21:30 May 08, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H6674.IH H6674 pamtmann on DSKBC07HB2PROD with BILLS 9 •HR 6674 IH the date that is 3 months after the end of such pe- 1 riod. 2 ‘‘(i) FUNDING.—There is appropriated, out of any 3 monies in the Treasury not otherwise obligated, to the 4 Trust Fund described in subsection (e) such sums as may 5 be necessary to carry out this section (including for the 6 payment of part A and part B benefits for individuals en- 7 rolled under this section).’’. 8 (b) MEDIGAP.—Section 1882 of the Social Security 9 Act is amended by adding at the end the following new 10 subsection: 11 ‘‘(aa) DEVELOPMENT OF NEW STANDARDS FOR CER- 12 TAIN MEDICARE SUPPLEMENTAL POLICIES RELATING TO 13 COVID–19 ENROLLMENT OPTION.—The Secretary shall 14 request the National Association of Insurance Commis- 15 sioners to review and revise the standards for benefit pack- 16 ages described in subsection (p)(1), to otherwise update 17 standards to include requirements for each medicare sup- 18 plemental policy that offers such a policy in a State, with 19 respect to each year, to accept every individual in the 20 State who is enrolled pursuant to section 1899C and who 21 applies for such coverage for such year if the individual 22 applies for enrollment in such policy during the 30-day 23 period following the date of enrollment pursuant to section 24 1899C and to accept every such individual during a period 25 VerDate Sep 11 2014 21:30 May 08, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H6674.IH H6674 pamtmann on DSKBC07HB2PROD with BILLS 10 •HR 6674 IH of transition from enrollment pursuant to such section to 1 enrollment under this title pursuant to eligibility other 2 than under such section. Such revisions shall be made con- 3 sistent with the rules applicable under subsection 4 (p)(1)(E) with the reference to the ‘1991 NAIC Model 5 Regulation’ deemed a reference to the NAIC Model Regu- 6 lation as published in the Federal Register on December 7 4, 1998, and as subsequently updated by the National As- 8 sociation of Insurance Commissioners to reflect previous 9 changes in law and the reference to ‘date of enactment 10 of this subsection’ deemed a reference to the date of enact- 11 ment of this subsection (aa).’’. 12 SEC. 102. HOLDING MEDICARE BENEFICIARIES HARMLESS 13 FOR SPECIFIED COVID–19 TREATMENT SERV- 14 ICES FURNISHED UNDER PART A OR PART B 15 OF THE MEDICARE PROGRAM. 16 (a) IN GENERAL.—Notwithstanding any other provi- 17 sion of law, in the case of a specified COVID–19 treat- 18 ment service (as defined in subsection (b)) furnished to 19 an individual entitled to benefits under part A or enrolled 20 under part B of title XVIII of the Social Security Act (42 21 U.S.C. 1395 et seq.) or enrolled under section 1899C of 22 the Social Security Act for which payment is made under 23 such part A or such part B, the Secretary of Health and 24 VerDate Sep 11 2014 21:30 May 08, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H6674.IH H6674 pamtmann on DSKBC07HB2PROD with BILLS 11 •HR 6674 IH Human Services (in this section referred to as the ‘‘Sec- 1 retary’’) shall provide that— 2 (1) any cost sharing required (including any de- 3 ductible, copayment, or coinsurance) applicable to 4 such individual under such part A or such part B 5 with respect to such item or service is paid by the 6 Secretary; 7 (2) the provider of services or supplier (as de- 8 fined in section 1861 of the Social Security Act (42 9 U.S.C. 1395x)) does not hold such individual liable 10 for such requirement; and 11 (3) no prior authorization or other utilization 12 management requirement is applied with respect to 13 such service. 14 (b) DEFINITION OF SPECIFIED COVID–19 TREAT- 15 MENT SERVICES.—For purposes of this section, the term 16 ‘‘specified COVID–19 treatment service’’ means any item 17 or service— 18 (1) relating to the treatment or diagnosis of 19 COVID–19; 20 (2) furnished to an individual in an emergency 21 department where such individual presents with 22 COVID–19 symptoms; or 23 (3) in the case of an individual furnished a test 24 for COVID–19 or diagnosed with COVID–19, fur- 25 VerDate Sep 11 2014 21:30 May 08, 2020 J [Text truncated for display. 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