Holding Providers Harmless From Medicare Cuts During COVID–19 Act of 2020

I 116TH CONGRESS 2D SESSION H. R. 8702 To amend title XVIII of the Social Security Act to provide for an increase in payment under part B of the Medicare program for certain services in response to COVID–19. IN THE HOUSE OF REPRESENTATIVES OCTOBER 30, 2020 Mr. BERA (for himself, Mr. BUCSHON, Mr. BRENDAN F. BOYLE of Pennsyl- vania, Mr. HOLDING, Mr. RUIZ, Mr. DAVID P. ROE of Tennessee, Ms. FINKENAUER, and Mr. MARSHALL) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provi- sions as fall within the jurisdiction of the committee concerned A BILL To amend title XVIII of the Social Security Act to provide for an increase in payment under part B of the Medicare program for certain services in response to COVID– 19. 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 ‘‘Holding Providers 4 Harmless From Medicare Cuts During COVID–19 Act of 5 2020’’. 6 VerDate Sep 11 2014 18:16 Nov 18, 2020 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H8702.IH H8702 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 8702 IH SEC. 2. PROVIDING FOR AN INCREASE IN PAYMENT UNDER 1 PART B OF THE MEDICARE PROGRAM FOR 2 CERTAIN SERVICES TO HOLD PROVIDERS 3 HARMLESS WHILE RESPONDING TO COVID– 4 19. 5 (a) IN GENERAL.—Section 1833 of the Social Secu- 6 rity Act (42 U.S.C. 1395l) is amended by adding at the 7 end the following new subsection: 8 ‘‘(dd) COVID–19 RELIEF PAYMENTS FOR CERTAIN 9 SERVICES.— 10 ‘‘(1) IN GENERAL.—In the case of an eligible 11 service (as defined in paragraph (2)(A)) furnished 12 during a specified year (as defined in paragraph 13 (2)(C)) by a supplier for which payment is made 14 under (or based on) the fee schedule established 15 under section 1848, in addition to the amount of 16 payment that would otherwise be made for such 17 service under this part, there also shall be paid at 18 the time such payment under section 1848 is made 19 an amount equal to the specified hold harmless relief 20 payment (as defined in paragraph (2)(B)) for such 21 service. 22 ‘‘(2) DEFINITIONS.—In this subsection: 23 ‘‘(A) ELIGIBLE SERVICE.— 24 ‘‘(i) IN GENERAL.—The term ‘eligible 25 service’ means, with respect to a service 26 VerDate Sep 11 2014 18:16 Nov 18, 2020 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H8702.IH H8702 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 8702 IH furnished in a specified year by a supplier 1 for which payment is made under (or 2 based on) the fee schedule established 3 under section 1848, any service (other 4 than a service described in clause (ii)) for 5 which the payment amount determined 6 under (or based on) such fee schedule for 7 such year and supplier is less than such 8 payment amount that would have been de- 9 termined under (or based on) such fee 10 schedule for such service and supplier had 11 such service been furnished in 2020. 12 ‘‘(ii) EXCLUDED SERVICES.—For pur- 13 poses of clause (i), the services described in 14 this clause are any of the following: 15 ‘‘(I) Services identified by any of 16 HCPCS codes 99202 through 99205 17 or by HCPCS code 99211 (or any 18 successor codes), but only if such 19 service is billed in conjunction with 20 HCPCS code GPC1X (or a successor 21 code). 22 ‘‘(II) Services identified by any of 23 HCPCS codes 99212 through 99215 24 (or any successor codes). 25 VerDate Sep 11 2014 18:16 Nov 18, 2020 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H8702.IH H8702 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 8702 IH ‘‘(III) Services identified by 1 HCPCS code GPC1X (or any suc- 2 cessor code). 3 ‘‘(B) SPECIFIED HOLD HARMLESS RELIEF 4 PAYMENT.—The term ‘specified hold harmless 5 relief payment’ means, with respect to an eligi- 6 ble service furnished in a specified year by a 7 supplier, the difference between the payment 8 amount determined under (or based on) the fee 9 schedule established under section 1848 for 10 such year and supplier and such amount that 11 would have been determined under (or based 12 on) such schedule for such service and supplier 13 had such service been furnished in 2020. 14 ‘‘(C) SPECIFIED YEAR.—The term ‘speci- 15 fied year’ means 2021 and 2022. 16 ‘‘(3) COORDINATION.—The amount of the addi- 17 tional payment for a service under this subsection 18 and subsection (m) shall be determined without re- 19 gard to any additional payment for the service under 20 subsection (m) and this subsection, respectively. The 21 amount of the additional payment for a service 22 under this subsection and subsection (z) shall be de- 23 termined without regard to any additional payment 24 VerDate Sep 11 2014 18:16 Nov 18, 2020 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H8702.IH H8702 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 8702 IH for the service under subsection (z) and this sub- 1 section, respectively. 2 ‘‘(4) CLARIFICATION.—For purposes of this 3 subsection, a service for which payment is made 4 under (or based on) the fee schedule established 5 under section 1848 includes a service payable under 6 section 1834(k). 7 ‘‘(5) LIMITATION ON JUDICIAL REVIEW.—There 8 shall be no administrative or judicial review under 9 section 1869, 1878, or otherwise, respecting the 10 identification of eligible services under this sub- 11 section.’’. 12 (b) CONFORMING AMENDMENT.—Section 13 1834(g)(2)(B) of the Social Security Act (42 U.S.C. 14 1395m(g)(2)(B)) is amended by striking ‘‘(x) and (y)’’ 15 and inserting ‘‘(x), (y), and (dd)’’. 16 Æ VerDate Sep 11 2014 18:16 Nov 18, 2020 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\H8702.IH H8702 pamtmann on DSKBC07HB2PROD with BILLS