[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1868 Enrolled Bill (ENR)]

        H.R.1868

                    One Hundred Seventeenth Congress

                                 of the

                        United States of America


                          AT THE FIRST SESSION

           Begun and held at the City of Washington on Sunday,
          the third day of January, two thousand and twenty-one


                                 An Act


 
    To prevent across-the-board direct spending cuts, and for other 
                                purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,
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).''.

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.