The Resetting the Impact Act (TRIA) of 2020

I 116TH CONGRESS 2D SESSION H. R. 8826 To amend the IMPACT Act of 2014 to reset data collection and the develop- ment of a payment system technical prototype for post-acute care pro- viders under the Medicare program to take into account the effects of COVID–19. IN THE HOUSE OF REPRESENTATIVES NOVEMBER 30, 2020 Ms. SEWELL of Alabama (for herself, Mr. PASCRELL, and Mr. SUOZZI) intro- duced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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 the IMPACT Act of 2014 to reset data collection and the development of a payment system technical pro- totype for post-acute care providers under the Medicare program to take into account the effects of 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 Resetting the Impact 4 Act (TRIA) of 2020’’. 5 VerDate Sep 11 2014 00:33 Dec 04, 2020 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H8826.IH H8826 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 8826 IH SEC. 2. RESETTING DATA COLLECTION AND THE DEVELOP- 1 MENT OF A PAYMENT SYSTEM TECHNICAL 2 PROTOTYPE FOR POST-ACUTE CARE PRO- 3 VIDERS UNDER THE MEDICARE PROGRAM TO 4 TAKE INTO ACCOUNT THE EFFECTS OF 5 COVID–19. 6 (a) IN GENERAL.—Section 2(b)(2) of the IMPACT 7 Act of 2014 (Public Law 113–185) is amended— 8 (1) in subparagraph (A)— 9 (A) in the matter preceding clause (i), by 10 striking ‘‘Not later than’’ and all that follows 11 through ‘‘subsection (a),’’ and inserting ‘‘Not 12 earlier than the date that is 2 years after the 13 later of January 1, 2021, and the date by which 14 the Secretary of Health and Human Services 15 has collected at least 12 specified calendar 16 quarters (as defined in subparagraph (C)) of 17 standardized patient assessment data under 18 subsection (b) of section 1899B of the Social 19 Security Act, of data on quality measures under 20 subsection (c) of such section, and of resource 21 use and claims data under subsection (d) of 22 such section from each of the PAC payment 23 systems (as defined in subsection (a)(2)(D) of 24 such section),’’; 25 (B) in clause (i)— 26 VerDate Sep 11 2014 00:33 Dec 04, 2020 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H8826.IH H8826 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 8826 IH (i) in subclause (III), by striking 1 ‘‘and’’ at the end; 2 (ii) in subclause (IV), by striking the 3 period at the end and inserting a semi- 4 colon; and 5 (iii) by adding at the end the fol- 6 lowing new subclauses: 7 ‘‘(V) ensure that payments under 8 the system would be sufficient to sup- 9 port the resources needed to provide 10 quality patient care, including with re- 11 spect to items and services needed by 12 the highest-acuity patients, including 13 those with or recovering from medi- 14 cally-complex occurrences of COVID– 15 19 and those with major or extreme 16 severity of illness (as defined by the 17 All Patients Refined Diagnosis Re- 18 lated Groups (APR–DRG) patient 19 classification system), to ensure that 20 such individuals retain access to care 21 in relevant PAC provider settings; 22 ‘‘(VI) take into account, to the 23 greatest extent possible, the most re- 24 cently available PAC provider data de- 25 VerDate Sep 11 2014 00:33 Dec 04, 2020 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H8826.IH H8826 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 8826 IH scribed in any of subsections (b) 1 through (d) of section 1899B of such 2 Act; and 3 ‘‘(VII) taking into account the 4 impact assessment described in clause 5 (vi), ensure that payment and access 6 to care under the system would be 7 adequate for each PAC provider set- 8 ting during a pandemic of similar 9 scope and impact as that of COVID– 10 19.’’; 11 (C) in clause (iv), by striking ‘‘and’’ at the 12 end; 13 (D) in clause (v) by striking the period at 14 the end and inserting ‘‘; and’’; and 15 (E) by adding at the end the following new 16 clause: 17 ‘‘(vi) an impact assessment that— 18 ‘‘(I) evaluates the capabilities 19 and limitations of each PAC provider 20 setting with respect to quality of care, 21 patient safety, and containment of in- 22 fectious disease during the emergency 23 period described in section 24 VerDate Sep 11 2014 00:33 Dec 04, 2020 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H8826.IH H8826 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 8826 IH 1135(g)(1)(B) of the Social Security 1 Act; 2 ‘‘(II) reviews and compares the 3 relative capabilities of each PAC pro- 4 vider setting in meeting the clinical 5 needs of individuals with COVID–19 6 and the needs of referring acute-care 7 hospitals, including a specific assess- 8 ment of such capabilities with respect 9 to individuals with high-acuity 10 COVID–19 cases, including such indi- 11 viduals requiring ventilator services 12 and such individuals with major and 13 extreme levels of severity of illness (as 14 defined under the APR–DRGs patient 15 classification system) and individuals 16 requiring intensive medical rehabilita- 17 tion, therapy, and rehabilitation nurs- 18 ing care; 19 ‘‘(III) evaluates the relative abili- 20 ties of each PAC provider setting to 21 prevent, mitigate, and contain the 22 intra-facility and community spread of 23 COVID–19; 24 VerDate Sep 11 2014 00:33 Dec 04, 2020 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H8826.IH H8826 kjohnson on DSK79L0C42PROD with BILLS 6 •HR 8826 IH ‘‘(IV) specifies the types of ad- 1 justments in clinical capacity, infec- 2 tion control protocols, isolation space, 3 physical plant, personnel, access to 4 personal protective equipment, and 5 other changes by each PAC provider 6 setting needed to safely mitigate the 7 spread of future pandemics that are 8 similar in scope and impact to that of 9 COVID–19; and 10 ‘‘(V) is made publicly available at 11 least 6 months before the date on 12 which the report under this subpara- 13 graph is submitted to Congress.’’; and 14 (2) by adding at the end the following new sub- 15 paragraph: 16 ‘‘(C) SPECIFIED CALENDAR QUARTER DE- 17 FINED.—For purposes of subparagraph (A), the 18 term ‘specified calendar quarter’ means a cal- 19 endar quarter— 20 ‘‘(i) beginning after the prospective 21 payment system for home health agencies 22 under section 1895 of the Social Security 23 Act has incorporated the Patient-Driven 24 VerDate Sep 11 2014 00:33 Dec 04, 2020 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H8826.IH H8826 kjohnson on DSK79L0C42PROD with BILLS 7 •HR 8826 IH Groupings Model (as described at 83 Fed. 1 Reg. 56446 et seq.); 2 ‘‘(ii) beginning after the prospective 3 payment system for skilled nursing facili- 4 ties under section 1888(e) of such Act has 5 incorporated the Patient-Driven Payment 6 Model (as described in 83 Fed. Reg. 39162 7 et seq.); and 8 ‘‘(iii) no portion of which occurs dur- 9 ing a nationwide public health emergency 10 declared by the Secretary pursuant to sec- 11 tion 319 of the Public Health Service Act 12 with respect to which any waiver has been 13 effectuated by the Secretary pursuant to 14 section 1135 of the Social Security Act.’’. 15 (b) EFFECTIVE DATE.—The amendments made by 16 subsection (a) shall take effect as if included in the enact- 17 ment of the IMPACT Act of 2014 (Public Law 113–185). 18 Æ VerDate Sep 11 2014 00:33 Dec 04, 2020 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6301 E:\BILLS\H8826.IH H8826 kjohnson on DSK79L0C42PROD with BILLS