Medicare Accelerated and Advance Payments Improvement Act

II 116TH CONGRESS 2D SESSION S. 3750 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 SENATE OF THE UNITED STATES MAY 14, 2020 Mrs. SHAHEEN (for herself, Mr. BENNET, Ms. SMITH, Ms. CORTEZ MASTO, Ms. HASSAN, Mr. JONES, Mr. REED, Mr. BLUMENTHAL, Mr. HEINRICH, Mr. MANCHIN, Mr. DURBIN, Ms. KLOBUCHAR, Ms. WARREN, Ms. ROSEN, and Mr. MARKEY) 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 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’’. 5 VerDate Sep 11 2014 16:01 Jun 03, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S3750.IS S3750 pamtmann on DSKBC07HB2PROD with BILLS 2 •S 3750 IS 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 16:01 Jun 03, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3750.IS S3750 pamtmann on DSKBC07HB2PROD with BILLS 3 •S 3750 IS 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 16:01 Jun 03, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3750.IS S3750 pamtmann on DSKBC07HB2PROD with BILLS 4 •S 3750 IS (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 such program, in the case of a payment made 12 under such program on or after the date of the 13 enactment of the CARES Act (Public Law 14 116–136) and so made during the emergency 15 period described in section 1135(g)(1)(B) of the 16 Social Security Act (42 U.S.C. 1320b– 17 5(g)(1)(B)), the Secretary of Health and 18 Human Services— 19 (i) shall treat such payment as if such 20 payment were made from the General 21 Fund of the Treasury; 22 (ii) upon request of the entity receiv- 23 ing such payment, shall— 24 VerDate Sep 11 2014 16:01 Jun 03, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S3750.IS S3750 pamtmann on DSKBC07HB2PROD with BILLS 5 •S 3750 IS (I) provide 1 year before claims 1 are offset to recoup the payment; 2 (II) provide that any such offset 3 of a claim to recoup such payment 4 shall not exceed 25 percent of the 5 amount of such claim; and 6 (III) allow not less than 2 years 7 from the date of the first advance 8 payment before requiring that the 9 outstanding balance be paid in full; 10 and 11 (iii) may waive the requirement that 12 such payment be repaid (or recouped) if, 13 not earlier than 2 years from the date of 14 the first advance payment, the entity sub- 15 mits to the Secretary a request for such 16 waiver containing such information that 17 demonstrates that— 18 (I) requiring repayment of such 19 payment (or recouping such payment) 20 would constitute an extreme hardship 21 for the entity; 22 (II) the entity made efforts to 23 maintain a comparable number of em- 24 ployees at a comparable level of pay 25 VerDate Sep 11 2014 16:01 Jun 03, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S3750.IS S3750 pamtmann on DSKBC07HB2PROD with BILLS 6 •S 3750 IS during the such emergency period 1 compared to the number of, and level 2 of pay for, such employees as of the 3 day before the beginning of such pe- 4 riod; and 5 (III) the entity did not increase 6 executive compensation or undertake 7 any stock buyback, if applicable, dur- 8 ing such emergency period. 9 (b) INTEREST RATES.— 10 (1) PART A.—Section 1815(d) of the Social Se- 11 curity Act (42 U.S.C. 1395g(d)) is amended by in- 12 serting before the period at the end the following: 13 ‘‘(or, in the case of such a determination made with 14 respect to a payment made on or after the date of 15 the enactment of the CARES Act and during the 16 emergency period described in section 1135(g)(1)(B) 17 under the program under subsection (e)(3), at a rate 18 of 1 percent)’’. 19 (2) PART B.—Section 1833(j) of the Social Se- 20 curity Act (42 U.S.C. 1395l(j)) is amended by in- 21 serting before the period at the end the following: 22 ‘‘(or, in the case of such a determination made with 23 respect to a payment made on or after the date of 24 the enactment of the CARES Act and during the 25 VerDate Sep 11 2014 16:01 Jun 03, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S3750.IS S3750 pamtmann on DSKBC07HB2PROD with BILLS 7 •S 3750 IS emergency period described in section 1135(g)(1)(B) 1 under the program described in section 421.214 of 2 title 42, Code of Federal Regulations (or a successor 3 regulation), at a rate of 1 percent)’’. 4 (c) REPORT.— 5 (1) REPORTS DURING COVID–19 EMERGENCY.— 6 Not later than 2 weeks after the date of the enact- 7 ment of this section, and every 2 weeks thereafter 8 during the emergency period described in section 9 1135(g)(1)(B) of the Social Security Act (42 U.S.C. 10 1320b–5(g)(1)(B)), the Secretary of Health and 11 Human Services shall submit to the Committee on 12 Ways and Means and the Committee on Energy and 13 Commerce of the House of Representatives, and the 14 Committee on Finance of the Senate, a report that 15 includes the following: 16 (A) The total amount of payments made 17 under section 1815(e)(3) of the Social Security 18 Act (42 U.S.C. 1395g(e)(3)) and under the pro- 19 gram described in section 421.214 of title 42, 20 Code of Federal Regulations (or a successor 21 regulation) during the 2-week period preceding 22 the date of the submission of such report. 23 (B) The number of entities receiving such 24 payments during such period. 25 VerDate Sep 11 2014 16:01 Jun 03, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S3750.IS S3750 pamtmann on DSKBC07HB2PROD with BILLS 8 •S 3750 IS (C) A specification of each such entity. 1 (2) REPORTS AFTER COVID–19 EMERGENCY.— 2 (A) IN GENERAL.—Not later than 6 3 months after the termination of the emergency 4 period described in paragraph (1), and every 6 5 months thereafter until all specified payments 6 (as defined in subparagraph (B)) have been re- 7 couped or repaid, the Secretary of Health and 8 Human Services shall submit to the Committee 9 on Ways and Means and the Committee on En- 10 ergy and Commerce of the House of Represent- 11 atives, and the Committee on Finance of the 12 Senate, a report that includes the following: 13 (i) The total amount of all specified 14 payments that have been recouped or re- 15 paid. 16 (ii) The total amount of all specified 17 payments that have been recouped or re- 18 paid. 19 (iii) The amount of interest that has 20 accrued with respect to all specified pay- 21 ments. 22 (B) SPECIFIED PAYMENTS.—For purposes 23 of subparagraph (A), the term ‘‘specified pay- 24 ments’’ means all payments made under section 25 VerDate Sep 11 2014 16:01 Jun 03, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S3750.IS S3750 pamtmann on DSKBC07HB2PROD with BILLS 9 •S 3750 IS 1815(e)(3) of the Social Security Act (42 1 U.S.C. 1395g(e)(3)) or under the program de- 2 scribed in section 421.214 of title 42, Code of 3 Federal Regulations (or a successor regulation) 4 made on or after the date of the enactment of 5 the CARES Act (Public Law 116–136) during 6 the emergency period described in such sub- 7 paragraph. 8 Æ VerDate Sep 11 2014 16:01 Jun 03, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6301 E:\BILLS\S3750.IS S3750 pamtmann on DSKBC07HB2PROD with BILLS