[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1868 Engrossed Amendment Senate (EAS)]

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                  In the Senate of the United States,

                                                        March 25, 2021.
    Resolved, That the bill from the House of Representatives (H.R. 
1868) entitled ``An Act to prevent across-the-board direct spending 
cuts, and for other purposes.'', do pass with the following

                               AMENDMENT:

             Strike all after the enacting clause and insert the 
      following:

SECTION 1. EXTENSION OF TEMPORARY SUSPENSION OF MEDICARE SEQUESTRATION.

    (a) Extension.--
            (1) In general.--Section 3709(a) of division A of the CARES 
        Act (2 U.S.C. 901a note) is amended by striking ``March 31, 
        2021'' and inserting ``December 31, 2021''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall take effect as if enacted as part of the CARES Act 
        (Public Law 116-136).
    (b) Offset.--Section 251A(6)(C) of the Balanced Budget and 
Emergency Deficit Control Act of 1985 (2 U.S.C. 901a(6)(C)) is 
amended--
            (1) in clause (i)--
                    (A) by striking ``first 6 months'' and inserting 
                ``first 5 \1/2\ months'';
                    (B) by striking ``4.0 percent'' and inserting ``2.0 
                percent''; and
                    (C) by striking ``and'' at the end;
            (2) in clause (ii)--
                    (A) by striking ``second 6 months'' and inserting 
                ``6-month period beginning on the day after the last 
                day of the period described in clause (i)''; and
                    (B) by striking ``0.0 percent.'' and inserting 
                ``4.0 percent; and''; and
            (3) by adding at the end the following:
                    ``(iii) with respect to the remaining \1/2\ month 
                in which such order is so effective for such fiscal 
                year, the payment reduction shall be 0.0 percent.''.

SEC. 2. TECHNICAL CORRECTIONS.

    (a) Rural Health Clinic Payments.--
            (1) In general.--Section 1833(f)(3) of the Social Security 
        Act (42 U.S.C. 1395l(f)(3)) is amended--
                    (A) in subparagraph (A)--
                            (i) in clause (i), by striking subclauses 
                        (I) and (II) and inserting the following:
                            ``(I) with respect to a rural health clinic 
                        that had a per visit payment amount established 
                        for services furnished in 2020--
                                    ``(aa) 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
                                    ``(bb) the limit described in 
                                paragraph (2)(A); and
                            ``(II) with respect to a rural health 
                        clinic that did not have a per visit payment 
                        amount established for services furnished in 
                        2020--
                                    ``(aa) the per visit payment amount 
                                applicable to such rural health clinic 
                                for rural health clinic services 
                                furnished in 2021; or
                                    ``(bb) the limit described in 
                                paragraph (2)(A); and''; and
                            (ii) in clause (ii)(I), by striking ``under 
                        clause (i)(I)'' and inserting ``under subclause 
                        (I) or (II) of clause (i), as applicable,''; 
                        and
                    (B) by striking subparagraph (B) and inserting the 
                following:
    ``(B) A rural health clinic described in this subparagraph is a 
rural health clinic that--
            ``(i) as of December 31, 2020, was in a hospital with less 
        than 50 beds and after such date such hospital continues to 
        have less than 50 beds (not taking into account any increase in 
        the number of beds pursuant to a waiver under subsection 
        (b)(1)(A) of section 1135 during the emergency period described 
        in subsection (g)(1)(B) of such section); and
            ``(ii)(I) as of December 31, 2020, was enrolled under 
        section 1866(j) (including temporary enrollment during such 
        emergency period for such emergency period); or
            ``(II) submitted an application for enrollment under 
        section 1866(j) (or a request for such a temporary enrollment 
        for such emergency period) that was received not later than 
        December 31, 2020.''.
            (2) Effective date.--The amendments made by this subsection 
        shall take effect as if included in the enactment of the 
        Consolidated Appropriations Act, 2021 (Public Law 116-260).
    (b) Additional Amount for Certain Hospitals With High 
Disproportionate Share.--Effective as if included in the enactment of 
section 203(a) of title II of division CC of Public Law 116-260, 
subsection (g) of section 1923 of the Social Security Act (42 U.S.C. 
1396r-4), as amended by such section, is amended by adding at the end 
the following:
            ``(3) Continued application of grandfathered transition 
        rule.--Notwithstanding paragraph (2) of this subsection (as in 
        effect on October 1, 2021), paragraph (2) of this subsection 
        (as in effect on September 30, 2021, and as applied under 
        section 4721(e) of the Balanced Budget Act of 1997, and amended 
        by section 607 of the Medicare, Medicaid, and SCHIP Balanced 
        Budget Refinement Act of 1999 (Public Law 106-113)) shall apply 
        in determining whether a payment adjustment for a hospital in a 
        State referenced in section 4721(e) of the Balanced Budget Act 
        of 1997 during a State fiscal year shall be considered 
        consistent with subsection (c).''.

            Attest:

                                                             Secretary.
117th CONGRESS

  1st Session

                               H.R. 1868

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                               AMENDMENT