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<dublinCore>
<dc:title>117 HR 1868 EH: To prevent across-the-board direct spending cuts, and for other purposes.</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date></dc:date>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<form>
<distribution-code display="no">I</distribution-code> 
<congress>117th CONGRESS</congress> <session>1st Session</session> 
<legis-num>H. R. 1868</legis-num> 
<current-chamber display="no">IN THE HOUSE OF REPRESENTATIVES</current-chamber> 
<legis-type>AN ACT</legis-type> 
<official-title display="yes">To prevent across-the-board direct spending cuts, and for other purposes.</official-title> 
</form> 
<legis-body id="H2B6A11B0B98349FAB29BD2C5BBD3B998" style="OLC"> 
<section id="H2B0155984881421B9B5CED3864A8E993" section-type="section-one"><enum>1.</enum><header>Preventing PAYGO sequestration</header> 
<subsection id="H6E3CA4B361814135B7BB2EEE472D6184"><enum>(a)</enum><header>Statutory PAYGO scorecards</header><text display-inline="yes-display-inline">The budgetary effects of this Act and the American Rescue Plan Act of 2021 (<external-xref legal-doc="public-law" parsable-cite="pl/117/2">Public Law 117–2</external-xref>) shall not be counted on either PAYGO scorecard maintained pursuant to section 4(d) of the Statutory Pay-As-You-Go Act of 2010 (<external-xref legal-doc="usc" parsable-cite="usc/2/933">2 U.S.C. 933(d)</external-xref>).</text></subsection> <subsection id="HC403D98E2DF4418F9DF159906DB60571"><enum>(b)</enum><header>Senate PAYGO scorecards</header><text display-inline="yes-display-inline">The budgetary effects of this Act shall not be counted on any PAYGO scorecard maintained for purposes of section 4106 of H. Con. Res. 71 (115th Congress). </text></subsection> </section> 
<section id="H0C6FED91A610460FAFEF543A249FB2F2"><enum>2.</enum><header>Extension of temporary suspension of medicare sequestration</header> 
<subsection id="H77350C9DB126498EA1F1436278288BF7"><enum>(a)</enum><header>In general</header><text>Section 3709(a) of division A of the CARES Act (<external-xref legal-doc="usc" parsable-cite="usc/2/901a">2 U.S.C. 901a</external-xref> note) is amended by striking <quote>March 31, 2021</quote> and inserting <quote>December 31, 2021</quote>.</text></subsection> <subsection id="HE3282C951672435FA0820F1C1FAA56BE"><enum>(b)</enum><header>Effective date</header><text>The amendment made by subsection (a) shall take effect as if enacted as part of the CARES Act (<external-xref legal-doc="public-law" parsable-cite="pl/116/136">Public Law 116–136</external-xref>).</text></subsection></section> 
<section id="HBE5CBF597A2744008BFF5122089AA47F"><enum>3.</enum><header>Technical corrections</header> 
<subsection id="H2A82DBAE2498409C8DE20AFDE296F346"><enum>(a)</enum><header>Disregard of certain additional compensation for purposes of medicaid and chip</header><text>Section 2104(h) of the CARES Act (<external-xref legal-doc="usc" parsable-cite="usc/15/9023">15 U.S.C. 9023(h)</external-xref>) is amended by striking <quote>Federal pandemic unemployment compensation</quote> and inserting <quote>Federal Pandemic Unemployment Compensation or Mixed Earner Unemployment Compensation</quote>.</text></subsection> <subsection id="HABC8CB562CB943B68A9C7FB08DD8B988"><enum>(b)</enum><header>Rural health clinic payments</header> <paragraph id="H7D948D39D1A74684958733B22CE0DF54"><enum>(1)</enum><header>In general</header><text>Section 1833(f)(3) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(f)(3)</external-xref>) is amended—</text> 
<subparagraph id="HE9CA940DD7E845FD9D5E097C89ED50B7"><enum>(A)</enum><text>in subparagraph (A)—</text> <clause id="HBFECBDA3AECB4138AFEE2BBF12E61E51"><enum>(i)</enum><text>in clause (i), by striking subclauses (I) and (II) and inserting the following:</text> 
<quoted-block id="H65855790D75B43C8AE9A48F694E52D36" style="OLC"> 
<subclause id="H42F105CC7A4F488D9CB377B39185E1AC" indent="up1"><enum>(I)</enum><text>with respect to a rural health clinic that had a per visit payment amount established for services furnished in 2020—</text> <item id="HC13854B7172A42748CD4E33E816354AC"><enum>(aa)</enum><text>the per visit payment amount applicable to such rural health clinic for rural health clinic services furnished in 2020, increased by the percentage increase in the MEI applicable to primary care services furnished as of the first day of 2021; or</text></item> 
<item id="H93205566D65E4E38922C0BED0C03CA7D"><enum>(bb)</enum><text>the limit described in paragraph (2)(A); and</text></item></subclause> <subclause id="H3E6A03E3329C47B48C3E3E1FDAE64949" indent="up1"><enum>(II)</enum><text>with respect to a rural health clinic that did not have a per visit payment amount established for services furnished in 2020—</text> 
<item id="H29AEF62D4C56420DA6C29B4C5705F82C"><enum>(aa)</enum><text>the per visit payment amount applicable to such rural health clinic for rural health clinic services furnished in 2021; or</text></item> <item id="H60C7DFA831344D41BC0345567A331CE4"><enum>(bb)</enum><text>the limit described in paragraph (2)(A); and</text></item></subclause><after-quoted-block>; and</after-quoted-block></quoted-block></clause> 
<clause id="H3759AE01DB2147F0AD71AC77E2A7DAB3"><enum>(ii)</enum><text>in clause (ii)(I), by striking <quote>under clause (i)(I)</quote> and inserting <quote>under subclause (I) or (II) of clause (i), as applicable,</quote>; and</text></clause></subparagraph> <subparagraph id="H6DFB33E70B074F49AEFD0FA55CB90BA6"><enum>(B)</enum><text>in subparagraph (B)—</text> 
<clause id="H3FC5DEAD4B064661B27829C338221320"><enum>(i)</enum><text>in the matter preceding clause (i), by striking <quote>2019, was</quote> and inserting <quote>2020</quote>;</text></clause> <clause id="H9833E97197D9421AAD8ED589D15C4DD2"><enum>(ii)</enum><text>in clause (i), by inserting <quote>was</quote> after <quote>(i)</quote>; and</text></clause> 
<clause id="HA00236F3234841B9AB26540C2741F99F"><enum>(iii)</enum><text>by striking clause (ii) and inserting the following:</text> <quoted-block id="HA5490838282E4118BA2B3C87DFC0C336" style="OLC"> <clause id="H1FEFF46C6E2E4A5FA8A894003AEEFEAA" indent="up1"><enum>(ii)</enum> <subclause id="HB5EA7F912661446CA475A43F2B21354E" display-inline="yes-display-inline"><enum>(I)</enum><text>was enrolled under section 1866(j) (including temporary enrollment during the emergency period described in section 1135(g)(1)(B) for such period); or</text></subclause> 
<subclause id="H39D9722C6DA44A3CB4B802F4C739CE70" indent="up1"><enum>(II)</enum><text>submitted an application for enrollment under section 1866(j) (or requested such a temporary enrollment for such period) that was received not later than December 31, 2020.</text></subclause></clause><after-quoted-block>.</after-quoted-block></quoted-block></clause></subparagraph></paragraph> <paragraph id="HA25390023E2E4E8390EEEAEEE8621CA2"><enum>(2)</enum><header>Effective date</header><text>The amendments made by this subsection shall take effect as if included in the enactment of the Consolidated Appropriations Act, 2021 (<external-xref legal-doc="public-law" parsable-cite="pl/116/260">Public Law 116–260</external-xref>).</text></paragraph></subsection> 
<subsection id="H94C21770A855459484C6D6859195C4B8"><enum>(c)</enum><header>Eligibility for reemployment services</header><text>Section 306(a) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/506">42 U.S.C. 506(a)</external-xref>) is amended—</text> <paragraph id="H31C3E3AF4F3849BA95F0DF37341F86FF"><enum>(1)</enum><text>by striking <quote>individuals referred to reemployment services as described in section 303(j)</quote> and inserting <quote>claimants for unemployment compensation, including claimants referred to reemployment services as described in section 303(j),</quote>; and</text></paragraph> 
<paragraph id="HC0C2D1B217E44C05A25738BF1F7FF0EA"><enum>(2)</enum><text>by striking <quote>such individuals</quote> and inserting <quote>such claimants</quote>.</text></paragraph></subsection> <subsection id="HCB84F221108C4786BE98F816DA950986"><enum>(d)</enum><header>Additional amount for certain hospitals with high disproporationate share</header><text>Effective as if included in the enactment of section 203(a) of title II of division CC of <external-xref legal-doc="public-law" parsable-cite="pl/116/260">Public Law 116–260</external-xref>, subsection (g) of section 1923 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396r-4">42 U.S.C. 1396r–4</external-xref>) amended by such section 203(a) is amended by adding at the end the following new paragraph:</text> 
<quoted-block id="H24630C0637204651A6134FAA667A0253" style="OLC"> 
<paragraph id="HC6FF5DF6F8F5482F9D16455F58996361"><enum>(3)</enum><header>Additional amount for certain hospitals with high disproporationate share</header><text display-inline="yes-display-inline"></text> <subparagraph id="H1A20EEBD231B4973ABD6ED9B545DE6AF"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">In the case of a hospital with high disproportionate share (as defined in subparagraph (B)) located in a State referenced in subsection (e) of section 4721 of the Balanced Budget Act of 1997, a payment adjustment during a State fiscal year shall be considered consistent with subsection (c) if the payment adjustment does not exceed 175 percent of the costs of furnishing hospital services during the year, but only if the Governor of the State certifies to the satisfaction of the Secretary that the hospital’s applicable minimum amount is used for health services during the year. In determining the amount that is used for such services during a year, there shall be excluded any amounts received under the Public Health Service Act, title V, title XVIII, or from third party payors (not including the State plan under this title) that are used for providing such services during the year.</text></subparagraph> 
<subparagraph id="H9008BACBF33D4D37AA3D51191C0B3F9E"><enum>(B)</enum><header>Hospital with high disproporationate share defined</header><text>In subparagraph (A), a hospital is a <quote>hospital with high disproportionate share</quote> if—</text> <clause id="H1665D85042C34B28868728267D185581"><enum>(i)</enum><text>the hospital is owned or operated by the State (or by an instrumentality or a unit of government within the State); and</text></clause> 
<clause id="H4833517338C24DFFA12758916E265D4D"><enum>(ii)</enum><text>the hospital—</text> <subclause id="HA1893E9E15EE4E2A90A4BFEA4ABC6904"><enum>(I)</enum><text>meets the requirement described in subparagraphs (A) or (B) of subsection (b)(1); or</text></subclause> 
<subclause id="H071C2975140C4AFABB05BDBFBF5D7AF6"><enum>(II)</enum><text>has the largest number of inpatient days attributable to individuals entitled to benefits under the State plan of any hospital in such State for the previous fiscal year.</text></subclause></clause></subparagraph> <subparagraph id="HE16D990BF7E94683B98C2E392E771CCD"><enum>(C)</enum><header>Applicable minimum amount defined</header><text>In subparagraph (A), the <quote>applicable minimum amount</quote> for a hospital for a fiscal year is equal to the difference between the amount of the hospital’s payment adjustment for the fiscal year and the costs to the hospital of furnishing hospital services described in paragraph (1)(A) during the fiscal year.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section> 
</legis-body> <attestation><attestation-group><attestation-date date="20210318" chamber="House">Passed the House of Representatives March 19, 2021.</attestation-date><attestor display="no">Cheryl L. Johnson,</attestor><role>Clerk.</role></attestation-group></attestation> 
<endorsement display="yes"></endorsement> 
</bill> 


