Medicare Accelerated and Advance Payments Improvement Act of 2020

I 116TH CONGRESS 2D SESSION H. R. 6837 To amend title XVIII of the Social Security Act to modify the accelerated and advance payment programs under parts A and B of the Medicare program during the COVID-19 emergency. IN THE HOUSE OF REPRESENTATIVES MAY 12, 2020 Mr. SCHNEIDER (for himself, Mr. KIND, Ms. SEWELL of Alabama, and Mr. DANNY K. DAVIS of Illinois) introduced the following bill; which was re- ferred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently de- termined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To amend title XVIII of the Social Security Act to modify the accelerated and advance payment programs under parts A and B of the Medicare program during the COVID-19 emergency. 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 Accelerated 4 and Advance Payments Improvement Act of 2020’’. 5 VerDate Sep 11 2014 01:48 May 30, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H6837.IH H6837 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 6837 IH SEC. 2. MODIFYING THE ACCELERATED AND ADVANCE PAY- 1 MENT PROGRAMS UNDER PARTS A AND B OF 2 THE MEDICARE PROGRAM DURING THE 3 COVID-19 EMERGENCY. 4 (a) SPECIAL REPAYMENT RULES.— 5 (1) PART A.—Section 1815(f)(2)(C) of the So- 6 cial Security Act (42 U.S.C. 1395g(f)(2)(C)) is 7 amended to read as follows: 8 ‘‘(C) In the case of an accelerated payment 9 made under such program on or after the date of 10 the enactment of the CARES Act and so made dur- 11 ing the emergency period described in section 12 1135(g)(1)(B)— 13 ‘‘(i) such payment shall be treated as if 14 such payment were made from the General 15 Fund of the Treasury; 16 ‘‘(ii) upon request of the hospital, the Sec- 17 retary shall— 18 ‘‘(I) provide 1 year before claims are 19 offset to recoup such payment; 20 ‘‘(II) provide that any such offset of a 21 claim to recoup such payment shall not ex- 22 ceed 25 percent of the amount of such 23 claim; and 24 ‘‘(III) allow not less than 2 years 25 from the date of the first accelerated pay- 26 VerDate Sep 11 2014 01:48 May 30, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H6837.IH H6837 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 6837 IH ment before requiring that the outstanding 1 balance be paid in full; and 2 ‘‘(iii) the Secretary may waive the require- 3 ment that such payment be repaid (or re- 4 couped) if, not earlier than 2 years from the 5 date of the first accelerated payment, the hos- 6 pital submits to the Secretary a request for 7 such waiver containing such information that 8 demonstrates that— 9 ‘‘(I) requiring repayment of such pay- 10 ment (or recouping such payment) would 11 constitute an extreme hardship for the hos- 12 pital; 13 ‘‘(II) the hospital made efforts to 14 maintain a comparable number of employ- 15 ees at a comparable level of pay during the 16 such emergency period compared to the 17 number of, and level of pay for, such em- 18 ployees as of the day before the beginning 19 of such period; and 20 ‘‘(III) the hospital did not increase ex- 21 ecutive compensation or undertake any 22 stock buyback, if applicable, during such 23 emergency period.’’. 24 (2) PART B.— 25 VerDate Sep 11 2014 01:48 May 30, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H6837.IH H6837 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 6837 IH (A) CONTINUING CONDUCT OF ADVANCE 1 PAYMENT PROGRAM.—Notwithstanding any 2 other provision of law, the Secretary of Health 3 and Human Services shall carry out the pro- 4 gram described in section 421.214 of title 42, 5 Code of Federal Regulations (or a successor 6 regulation) for the duration of the emergency 7 period described in section 1135(g)(1)(B) of the 8 Social Security Act (42 U.S.C. 1320b– 9 5(g)(1)(B)). 10 (B) REPAYMENT RULES.—In carrying out 11 the program described in section 421.214 of 12 title 42, Code of Federal Regulations (or a suc- 13 cessor regulation), in the case of a payment 14 made under such program on or after the date 15 of the enactment of the CARES Act (Public 16 Law 116–136) and so made during the emer- 17 gency period described in section 1135(g)(1)(B) 18 of the Social Security Act (42 U.S.C. 1320b– 19 5(g)(1)(B)), the Secretary of Health and 20 Human Services— 21 (i) shall treat such payment as if such 22 payment were made from the General 23 Fund of the Treasury; and 24 VerDate Sep 11 2014 01:48 May 30, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H6837.IH H6837 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 6837 IH (ii) upon request of the entity receiv- 1 ing such payment, shall— 2 (I) provide 1 year before claims 3 are offset to recoup the payment; 4 (II) provide that any such offset 5 of a claim to recoup such payment 6 shall not exceed 25 percent of the 7 amount of such claim; and 8 (III) allow not less than 2 years 9 from the date of the first advance 10 payment before requiring that the 11 outstanding balance be paid in full; 12 and 13 (iii) may waive the requirement that 14 such payment be repaid (or recouped) if, 15 not earlier than 2 years from the date of 16 the first advance payment, the entity sub- 17 mits to the Secretary a request for such 18 waiver containing such information that 19 demonstrates that— 20 (I) requiring repayment of such 21 payment (or recouping such payment) 22 would constitute an extreme hardship 23 for the entity; 24 VerDate Sep 11 2014 01:48 May 30, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H6837.IH H6837 kjohnson on DSK79L0C42PROD with BILLS 6 •HR 6837 IH (II) the entity made efforts to 1 maintain a comparable number of em- 2 ployees at a comparable level of pay 3 during the such emergency period 4 compared to the number of, and level 5 of pay for, such employees as of the 6 day before the beginning of such pe- 7 riod; and 8 (III) the entity did not increase 9 executive compensation or undertake 10 any stock buyback, if applicable, dur- 11 ing such emergency period. 12 (b) INTEREST RATES.— 13 (1) PART A.—Section 1815(d) of the Social Se- 14 curity Act (42 U.S.C. 1395g(d)) is amended by in- 15 serting before the period at the end the following: 16 ‘‘(or, in the case of such a determination made with 17 respect to a payment made on or after the date of 18 the enactment of the CARES Act and during the 19 emergency period described in section 1135(g)(1)(B) 20 under the program under subsection (e)(3), at a rate 21 of 1 percent)’’. 22 (2) PART B.—Section 1833(j) of the Social Se- 23 curity Act (42 U.S.C. 1395l(j)) is amended by in- 24 serting before the period at the end the following: 25 VerDate Sep 11 2014 01:48 May 30, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H6837.IH H6837 kjohnson on DSK79L0C42PROD with BILLS 7 •HR 6837 IH ‘‘(or, in the case of such a determination made with 1 respect to a payment made on or after the date of 2 the enactment of the CARES Act and during the 3 emergency period described in section 1135(g)(1)(B) 4 under the program described in section 421.214 of 5 title 42, Code of Federal Regulations (or a successor 6 regulation), at a rate of 1 percent)’’. 7 (c) REPORT.— 8 (1) REPORTS DURING COVID-19 EMERGENCY.— 9 Not later than 2 weeks after the date of the enact- 10 ment of this section, and every 2 weeks thereafter 11 during the emergency period described in section 12 1135(g)(1)(B) of the Social Security Act (42 U.S.C. 13 1320b–5(g)(1)(B)), the Secretary of Health and 14 Human Services shall submit to the Committee on 15 Ways and Means and the Committee on Energy and 16 Commerce of the House of Representatives, and the 17 Committee on Finance of the Senate, a report that 18 includes the following: 19 (A) The total amount of payments made 20 under section 1815(e)(3) of the Social Security 21 Act (42 U.S.C. 1395g(e)(3)) and under the pro- 22 gram described in section 421.214 of title 42, 23 Code of Federal Regulations (or a successor 24 VerDate Sep 11 2014 01:48 May 30, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H6837.IH H6837 kjohnson on DSK79L0C42PROD with BILLS 8 •HR 6837 IH regulation) during the 2-week period preceding 1 the date of the submission of such report. 2 (B) The number of entities receiving such 3 payments during such period. 4 (C) A specification of each such entity. 5 (2) REPORTS AFTER COVID-19 EMERGENCY.— 6 (A) IN GENERAL.—Not later than 6 7 months after the termination of the emergency 8 period described in paragraph (1), and every 6 9 months thereafter until all specified payments 10 (as defined in subparagraph (B)) have been re- 11 couped or repaid, the Secretary of Health and 12 Human Services shall submit to the Committee 13 on Ways and Means and the Committee on En- 14 ergy and Commerce of the House of Represent- 15 atives, and the Committee on Finance of the 16 Senate, a report that includes the following: 17 (i) The total amount of all specified 18 payments that have been recouped or re- 19 paid. 20 (ii) The total amount of all specified 21 payments that have been recouped or re- 22 paid. 23 VerDate Sep 11 2014 01:48 May 30, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H6837.IH H6837 kjohnson on DSK79L0C42PROD with BILLS 9 •HR 6837 IH (iii) The amount of interest that has 1 accrued with respect to all specified pay- 2 ments. 3 (B) SPECIFIED PAYMENTS.—For purposes 4 of subparagraph (A), the term ‘‘specified pay- 5 ments’’ means all payments made under section 6 1815(e)(3) of the Social Security Act (42 7 U.S.C. 1395g(e)(3)) or under the program de- 8 scribed in section 421.214 of title 42, Code of 9 Federal Regulations (or a successor regulation) 10 made on or after the date of the enactment of 11 the CARES Act (Public Law 116–136) during 12 the emergency period described in such sub- 13 paragraph. 14 Æ VerDate Sep 11 2014 01:48 May 30, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6301 E:\BILLS\H6837.IH H6837 kjohnson on DSK79L0C42PROD with BILLS