COVID Health Care Provider Assurance Act of 2020

I 116TH CONGRESS 2D SESSION H. R. 8756 To amend title XVIII of the Social Security Act to ensure adequate payment for certain physicians’ services furnished under part B of the Medicare program during the COVID–19 public health emergency. IN THE HOUSE OF REPRESENTATIVES NOVEMBER 17, 2020 Mr. RIGGLEMAN introduced the following bill; which was referred to the Com- mittee 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 provisions as fall within the jurisdiction of the committee concerned A BILL To amend title XVIII of the Social Security Act to ensure adequate payment for certain physicians’ services fur- nished under part B of the Medicare program during the COVID–19 public health 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 ‘‘COVID Health Care 4 Provider Assurance Act of 2020’’. 5 VerDate Sep 11 2014 03:33 Nov 26, 2020 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H8756.IH H8756 pbinns on DSKJLVW7X2PROD with BILLS 2 •HR 8756 IH SEC. 2. ENSURING ADEQUATE PAYMENT FOR CERTAIN 1 PHYSICIANS’ SERVICES FURNISHED UNDER 2 PART B OF THE MEDICARE PROGRAM DUR- 3 ING THE COVID–19 PUBLIC HEALTH EMER- 4 GENCY. 5 (a) ADJUSTMENT OF RELATIVE VALUE UNITS FOR 6 CERTAIN SERVICES.— 7 (1) IN GENERAL.—Section 1848(c)(2) of the 8 Social Security Act (42 U.S.C. 1395w–4(c)(2)) is 9 amended by adding at the end the following sub- 10 paragraph: 11 ‘‘(P) ADJUSTMENT OF RELATIVE VALUE 12 UNITS FOR CERTAIN SERVICES FURNISHED 13 DURING THE COVID–19 PUBLIC HEALTH EMER- 14 GENCY.— 15 ‘‘(i) IN GENERAL.—In the case of a 16 qualifying service (as defined in clause (ii)) 17 furnished during the period beginning on 18 the date of the enactment of this subpara- 19 graph and ending on the last day of the 20 emergency period described in section 21 1135(g)(1)(B), the Secretary shall increase 22 the single combined relative value unit ap- 23 plicable to such service otherwise deter- 24 mined under this paragraph by 20 percent. 25 VerDate Sep 11 2014 03:33 Nov 26, 2020 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H8756.IH H8756 pbinns on DSKJLVW7X2PROD with BILLS 3 •HR 8756 IH ‘‘(ii) QUALIFYING SERVICE DE- 1 FINED.—For purposes of clause (i), the 2 term ‘qualifying service’ means critical care 3 services, ventilation management services, 4 emergency intubation services, services re- 5 lating to the placement of invasive moni- 6 toring lines and transesophageal echo- 7 cardiography, bronchoscopy services, chest 8 tube insertion services, and feeding tube 9 insertion services, as specified by the Sec- 10 retary.’’. 11 (2) NONAPPLICATION OF BUDGET NEU- 12 TRALITY.—Section 1848(c)(2)(B)(iv) of the Social 13 Security Act (42 U.S.C. 1395w–4(c)(2)(B)(iv)) is 14 amended— 15 (A) in subclause (III), by striking ‘‘and’’ at 16 the end; 17 (B) in subclause (IV), by striking the pe- 18 riod and inserting ‘‘; and’’; and 19 (C) by adding at the end the following new 20 subclause: 21 ‘‘(V) subparagraph (P) shall not 22 be taken into account in applying 23 clause (ii)(II).’’. 24 VerDate Sep 11 2014 03:33 Nov 26, 2020 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H8756.IH H8756 pbinns on DSKJLVW7X2PROD with BILLS 4 •HR 8756 IH (b) ADJUSTMENT OF THE SEPARATE CONVERSION 1 FACTOR FOR ANESTHESIA SERVICES.— 2 (1) IN GENERAL.—Section 1848(d)(1)(D) of 3 the Social Security Act (42 U.S.C. 1395w– 4 4(d)(1)(D)) is amended— 5 (A) by striking ‘‘The separate’’ and insert- 6 ing the following: 7 ‘‘(i) IN GENERAL.—Subject to clause 8 (ii), the separate’’; and 9 (B) by adding at the end the following new 10 clause: 11 ‘‘(ii) SPECIAL RULE DURING THE 12 COVID–19 PUBLIC HEALTH EMERGENCY.— 13 The separate conversion factor for anes- 14 thesia services furnished during the period 15 beginning on the date of the enactment of 16 this clause and ending on the last day of 17 the emergency period described in section 18 1135(g)(1)(B) shall be equal to such factor 19 otherwise applicable under clause (i), in- 20 creased by 20 percent.’’. 21 (2) NONAPPLICATION OF BUDGET NEU- 22 TRALITY.—Section 1848(c)(2)(B)(iv) of the Social 23 Security Act (42 U.S.C. 1395w–4(c)(2)(B)(iv)), as 24 amended by subsection (a)(2), is further amended— 25 VerDate Sep 11 2014 03:33 Nov 26, 2020 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H8756.IH H8756 pbinns on DSKJLVW7X2PROD with BILLS 5 •HR 8756 IH (A) in subclause (IV), by striking ‘‘and’’ at 1 the end; 2 (B) in subclause (V), by striking the period 3 and inserting ‘‘; and’’; and 4 (C) by adding at the end the following new 5 subclause: 6 ‘‘(VI) subsection (d)(1)(D)(ii) 7 shall not be taken into account in ap- 8 plying clause (ii)(II).’’. 9 (c) ENSURING PAYMENT FOR CERTAIN CRITICAL 10 CARE SERVICES.— 11 (1) COVERAGE.—Section 1861(s)(2) of the So- 12 cial Security Act (42 U.S.C. 1395x(s)(2)) is amend- 13 ed— 14 (A) in subparagraph (GG), by striking 15 ‘‘and’’ after the semicolon at the end; 16 (B) in subparagraph (HH), by striking the 17 period at the end and adding ‘‘; and’’; and 18 (C) by adding at the end the following new 19 subparagraph: 20 ‘‘(II) specified critical care services (as defined 21 in subsection (kkk)) furnished during the period be- 22 ginning on the date of the enactment of this sub- 23 paragraph and ending on the last day of the emer- 24 gency period described in section 1135(g)(1)(B) to 25 VerDate Sep 11 2014 03:33 Nov 26, 2020 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H8756.IH H8756 pbinns on DSKJLVW7X2PROD with BILLS 6 •HR 8756 IH an inpatient of a hospital or a critical access hos- 1 pital;’’. 2 (2) SPECIFIED CRITICAL CARE SERVICES DE- 3 FINED.—Section 1861 of the Social Security Act (42 4 U.S.C. 1395x) is amended by adding at the end the 5 following new subsection: 6 ‘‘(kkk) SPECIFIED CRITICAL CARE SERVICES.— 7 ‘‘(1) IN GENERAL.—The term ‘specified critical 8 care services’ means— 9 ‘‘(A) physicians’ services not separately 10 payable under part B as of the day before the 11 date of the enactment of this subsection which 12 the Secretary determines are necessary for the 13 treatment of individuals with COVID–19; and 14 ‘‘(B) physicians’ services furnished by a 15 physician or practitioner (as defined in section 16 1842(b)(18)(C)), in conjunction with a physi- 17 cian or practitioner that is otherwise billing for 18 such services under such part, to an individual 19 for the treatment of COVID–19 that the Sec- 20 retary determines need to be furnished by more 21 than 1 physician or practitioner. 22 ‘‘(2) LIMITATION ON MULTIPLE BILLINGS.— 23 The Secretary may establish such limits as the Sec- 24 retary determines appropriate with respect to the 25 VerDate Sep 11 2014 03:33 Nov 26, 2020 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H8756.IH H8756 pbinns on DSKJLVW7X2PROD with BILLS 7 •HR 8756 IH number of physicians and practitioners who may bill 1 for a service described in paragraph (1)(B).’’. 2 (3) PAYMENT; COST SHARING.— 3 (A) IN GENERAL.—Section 1833(a)(1) of 4 the Social Security Act (42 U.S.C. 1395l(a)(1)) 5 is amended— 6 (i) by striking ‘‘and’’ before ‘‘(DD)’’; 7 and 8 (ii) by inserting before the semicolon 9 at the end the following: ‘‘, and (EE) with 10 respect to specified critical care services 11 (as defined in section 1861(kkk)), the 12 amount paid shall be an amount equal to 13 100 percent of the lesser of the amount 14 charged for the services and the payment 15 amount for such services determined under 16 the payment basis under section 1848’’. 17 (B) NONAPPLICATION OF DEDUCTIBLE.— 18 Section 1833(b) of the Social Security Act (42 19 U.S.C. 1395l(b)) is amended— 20 (i) by striking ‘‘and (12)’’ and insert- 21 ing ‘‘(12)’’; and 22 (ii) by striking ‘‘1861(s)(10)(A).’’ and 23 inserting ‘‘1861(s)(10)(A), and (13) such 24 deductible shall not apply with respect to 25 VerDate Sep 11 2014 03:33 Nov 26, 2020 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H8756.IH H8756 pbinns on DSKJLVW7X2PROD with BILLS 8 •HR 8756 IH specified critical care services (as defined 1 in section 1861(kkk)).’’. 2 (C) INCLUSION AS PHYSICIANS’ SERV- 3 ICES.—Section 1848(j)(3) of the Social Security 4 Act (42 U.S.C. 1395w–4(j)(3)) is amended by 5 inserting ‘‘(2)(II),’’ before ‘‘(3)’’. 6 Æ VerDate Sep 11 2014 03:33 Nov 26, 2020 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6301 E:\BILLS\H8756.IH H8756 pbinns on DSKJLVW7X2PROD with BILLS