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<dc:title>116 S3344 IS: Protecting the American Taxpayer and Medicare Act</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2021-12-08</dc:date>
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<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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<distribution-code display="yes">II</distribution-code><congress>117th CONGRESS</congress><session>1st Session</session><legis-num>S. 3344</legis-num><current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber><action><action-date date="20211208">December 8, 2021</action-date><action-desc><sponsor name-id="S389">Mr. Kennedy</sponsor> (for himself, <cosponsor name-id="S293">Mr. Graham</cosponsor>, <cosponsor name-id="S407">Mr. Hagerty</cosponsor>, <cosponsor name-id="S374">Mr. Cotton</cosponsor>, <cosponsor name-id="S365">Mr. Scott of South Carolina</cosponsor>, <cosponsor name-id="S404">Mr. Scott of Florida</cosponsor>, <cosponsor name-id="S396">Mrs. Blackburn</cosponsor>, <cosponsor name-id="S399">Mr. Hawley</cosponsor>, <cosponsor name-id="S343">Mr. Boozman</cosponsor>, <cosponsor name-id="S344">Mr. Hoeven</cosponsor>, <cosponsor name-id="S411">Mr. Marshall</cosponsor>, and <cosponsor name-id="S350">Mr. Rubio</cosponsor>) introduced the following bill; which was read twice and referred to the <committee-name committee-id="SSFI00">Committee on Finance</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title>To protect the American Taxpayer and Medicare.</official-title></form><legis-body><section id="S1" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Protecting the American Taxpayer and Medicare Act</short-title></quote>.</text></section><section id="H3E26508B2F6340778ECE404E1207E767"><enum>2.</enum><header>Adjustments to Medicare sequestration reductions</header><subsection id="H1E95EB3DBA3E4B149CCD145657162A5C"><enum>(a)</enum><header>Extension of temporary suspension through March 2022</header><paragraph id="HE80436E96BF74D7397CBAF25494B53A5"><enum>(1)</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—</text><subparagraph id="HD9E4EE025AD04CF2BCAAE4675C877A45"><enum>(A)</enum><text>in the subsection header by inserting <quote><header-in-text level="subsection" style="OLC">and adjustment</header-in-text></quote> after <quote><header-in-text level="subsection" style="OLC">suspension</header-in-text></quote>; and</text></subparagraph><subparagraph id="H7CD5869E6F194C4BABAFE89BB44B128B"><enum>(B)</enum><text>by striking <quote>December 31, 2021</quote> and inserting <quote>March 31, 2022</quote>.</text></subparagraph></paragraph><paragraph id="H7E9453709DE04A7688D418F1A10FC1C6"><enum>(2)</enum><header>Effective date</header><text>The amendments made by paragraph (1) 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></paragraph></subsection><subsection id="H28CEE6CD4DD542C6A50F5C04741A888B"><enum>(b)</enum><header>Adjustments to Medicare program sequestration reduction with respect to fiscal years 2022 and 2030</header><text>Section 251A(6) of the Balanced Budget and Emergency Deficit Control Act of 1985 (<external-xref legal-doc="usc" parsable-cite="usc/2/901a">2 U.S.C. 901a(6)</external-xref>) is amended—</text><paragraph id="HC302FBD685B64693A90AC040C53DD91F"><enum>(1)</enum><text>by redesignating subparagraph (C) as subparagraph (E); and</text></paragraph><paragraph id="H7366592BD413442DA93C42DF7DB69ADD"><enum>(2)</enum><text>by inserting after subparagraph (B) the following new subparagraphs:</text><quoted-block style="OLC" id="H365784C548A643E3A9668C7B6EF021DA" display-inline="no-display-inline"><subparagraph id="H49EAE388004A4043992EEBCD70242271"><enum>(C)</enum><text display-inline="yes-display-inline">Notwithstanding the 2 percent limit specified in subparagraph (A) for payments for the Medicare programs specified in section 256(d), the sequestration order of the President under such subparagraph for fiscal year 2022 shall be applied to such payments so that with respect to the period beginning on April 1, 2022, and ending on June 30, 2022, the payment reduction shall be 1.0 percent.</text></subparagraph><subparagraph id="H2DF6D38152E84797B3BAB48A47BA35AB"><enum>(D)</enum><text display-inline="yes-display-inline">Notwithstanding the 2 percent limit specified in subparagraph (A) for payments for the Medicare programs specified in section 256(d), the sequestration order of the President under such subparagraph for fiscal year 2030 shall be applied to such payments so that—</text><clause id="H186F8BBB560F4EDABB0269BB32481766"><enum>(i)</enum><text>with respect to the first 6 months in which such order is effective for such fiscal year, the payment reduction shall be 2.25 percent; and</text></clause><clause id="H2955DD1F6EF644ACA6DA636626E22942"><enum>(ii)</enum><text>with respect to the second 6 months in which such order is so effective for such fiscal year, the payment reduction shall be 3 percent. </text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection></section><section id="HA581FBDD987E409288B7496961A42EB0"><enum>3.</enum><header>Extension of support for physicians and other professionals in adjusting to Medicare payment changes</header><subsection id="H83D1E27177764100B64ED5C1FB24AC13"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1848 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395w-4">42 U.S.C. 1395w–4</external-xref>) is amended—</text><paragraph id="H3CFFF58BC8084102B580D2A7DFC935C9" commented="no"><enum>(1)</enum><text>in subsection (c)(2)(B)(iv)(V), by striking <quote>2021</quote> and inserting <quote>2021 or 2022</quote>; and </text></paragraph><paragraph id="H97692D42E74949FD82205275C2FD0F10"><enum>(2)</enum><text>in subsection (t)—</text><subparagraph id="H905CC55486A9428F81274F055D309254"><enum>(A)</enum><text display-inline="yes-display-inline">in the subsection header, by striking <quote><header-in-text level="subsection" style="OLC">2021</header-in-text></quote> and inserting <quote><header-in-text level="subsection" style="OLC">2021 and 2022</header-in-text></quote>;</text></subparagraph><subparagraph id="H05EAA498180348AFA713091AF809D202"><enum>(B)</enum><text>in paragraph (1)—</text><clause id="H29D28B610A0449F1954A3A3193915C86"><enum>(i)</enum><text>by striking <quote>during 2021</quote> and inserting <quote>during 2021 and 2022</quote>; and</text></clause><clause id="HA157770DB5134E8E96E8A20266787140"><enum>(ii)</enum><text>by striking <quote>for such services furnished on or after January 1, 2021, and before January 1, 2022, by 3.75 percent.</quote> and inserting </text><quoted-block style="OLC" id="HB572343176D34958948F0FF0A3105A82" display-inline="yes-display-inline"><text>for—</text><subparagraph id="H46B05964DD784C2CADF6671AFA5789F8"><enum>(A)</enum><text display-inline="yes-display-inline">such services furnished on or after January 1, 2021, and before January 1, 2022, by 3.75 percent; and</text></subparagraph><subparagraph id="HBEC676BFB45A4A3CB2AD70E0B67CA219"><enum>(B)</enum><text display-inline="yes-display-inline">such services furnished on or after January 1, 2022, and before January 1, 2023, by 3.0 percent.</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block></clause></subparagraph><subparagraph id="HFB242293382C416EA80466420C235784"><enum>(C)</enum><text>in paragraph (2)(C)—</text><clause id="H7F78314C0FCE4DA985107C533A150EE4"><enum>(i)</enum><text>in the subparagraph header, by striking <quote><header-in-text level="subparagraph" style="OLC">2021</header-in-text></quote> and inserting <quote><header-in-text level="subparagraph" style="OLC">2021 and 2022</header-in-text></quote>;</text></clause><clause id="HE4B395D89583430B9A272949C07FB829"><enum>(ii)</enum><text>by inserting <quote>for services furnished in 2021 or 2022</quote> after <quote>under this subsection</quote>; and</text></clause><clause id="H3EE696EE0CAB432CBBAE5F1A7EBB42EE"><enum>(iii)</enum><text>by inserting <quote>or 2022, respectively</quote> before the period at the end.</text></clause></subparagraph></paragraph></subsection><subsection id="HC9B0B3180BBA43CBB64BDCF5BBDBC558" commented="no"><enum>(b)</enum><header>Report</header><text>Section 101(c) of division N of the Consolidated Appropriations Act, 2021 (<external-xref legal-doc="public-law" parsable-cite="pl/116/260">Public Law 116–260</external-xref>) is amended—</text><paragraph id="HC91C01B7D6F142B0887D0C4E4251B800" commented="no"><enum>(1)</enum><text>in the first sentence—</text><subparagraph id="H32086E25ABA84F5EA0039A6A02DBC16B"><enum>(A)</enum><text>by striking <quote>April 1, 2022</quote> and inserting <quote>each of April 1, 2022, and April 1, 2023</quote>; and</text></subparagraph><subparagraph id="H905FC7BEB84542659424BDD9542E8720" commented="no"><enum>(B)</enum><text>by striking <quote>, as added by subsection (a)</quote> and inserting <quote>furnished during 2021 or 2022, respectively</quote>; and</text></subparagraph></paragraph><paragraph id="H5A69D4D064514DB59CA727DCB17A2946"><enum>(2)</enum><text>in the second sentence—</text><subparagraph id="H7182C4974598410E9C743809AB6CDE4B"><enum>(A)</enum><text>by striking <quote>Such report</quote> and inserting <quote>Each such report</quote>; and</text></subparagraph><subparagraph id="H9EB6B7BD47A243CF91511500F1E8093C"><enum>(B)</enum><text>by inserting <quote>with respect to 2021 or 2022, as applicable</quote> after <quote>under such section</quote>. </text></subparagraph></paragraph></subsection></section><section id="HB681C4C7B4004EFB833A68E8C881E5B8"><enum>4.</enum><header>Preserving patient access to critical clinical lab services</header><subsection id="H50023EA2AE7A4B40983E9B80D240242C"><enum>(a)</enum><header>Revised phase-In of reductions from private payor rate implementation</header><text display-inline="yes-display-inline">Section 1834A(b)(3) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395m-1">42 U.S.C. 1395m–1(b)(3)</external-xref>) is amended—</text><paragraph id="H70E0E1C043614C3C9F91397CB7AE4DD3"><enum>(1)</enum><text>in subparagraph (A), by striking <quote>through 2024</quote> and inserting <quote>through 2025</quote>; and</text></paragraph><paragraph id="HA39914A2E4E84CB092D51C400918249E"><enum>(2)</enum><text>in subparagraph (B)—</text><subparagraph id="H1011018A913A475A963D9533193F013E"><enum>(A)</enum><text>in clause (ii), by striking <quote>for 2021</quote> and inserting <quote>for each of 2021 and 2022</quote>; and</text></subparagraph><subparagraph id="H971B50F79FFE4735B62B5065F3ACDE65"><enum>(B)</enum><text>in clause (iii), by striking <quote>2022 through 2024</quote> and inserting <quote>2023 through 2025</quote>.</text></subparagraph></paragraph></subsection><subsection id="H95B4BC4DBEE249829951F70DA7E30774"><enum>(b)</enum><header>Revised Reporting Period for Reporting of Private Sector Payment Rates for Establishment of Medicare Payment Rates</header><text display-inline="yes-display-inline">Section 1834A(a)(1)(B) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395m-1">42 U.S.C. 1395m–1(a)(1)(B)</external-xref>) is amended—</text><paragraph id="H804511F6502A4CAC9DC5237EC24C7163"><enum>(1)</enum><text display-inline="yes-display-inline">in clause (i), by striking <quote>December 31, 2021</quote> and inserting <quote>December 31, 2022</quote>; and</text></paragraph><paragraph id="H148250B35C974336A85688878302280E"><enum>(2)</enum><text>in clause (ii)—</text><subparagraph id="H2911D245EA1A4DFC96522E9B0D837606"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>January 1, 2022</quote> and inserting <quote>January 1, 2023</quote>; and</text></subparagraph><subparagraph id="H2DC49A87AF5441BE99F786D62C911D70"><enum>(B)</enum><text>by striking <quote>March 31, 2022</quote> and inserting <quote>March 31, 2023</quote>. </text></subparagraph></paragraph></subsection></section><section id="H1B99733EE8464A87B297EF54A43C5EE6" section-type="subsequent-section"><enum>5.</enum><header>Delay to the implementation of the radiation oncology model under the Medicare program</header><text display-inline="no-display-inline">Section 133 of Division CC of the Consolidated Appropriations Act, 2021 (<external-xref legal-doc="public-law" parsable-cite="pl/116/260">Public Law 116–260</external-xref>) is amended by striking <quote>January 1, 2022</quote> and inserting <quote>January 1, 2023</quote>.</text></section><section id="HF8EB8CB4961F4C9D8D2C445D3D46EFB5"><enum>6.</enum><header>Medicare Improvement Fund</header><text display-inline="no-display-inline">Section 1898(b)(1) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395iii">42 U.S.C. 1395iii(b)(1)</external-xref>) is amended by striking <quote>fiscal year 2021</quote> and all that follows through the period at the end and inserting <quote>fiscal year 2021, $101,000,000.</quote>. </text></section><section commented="no" id="H7C6D16731AF44AFEA08335EB41680D81" section-type="subsequent-section"><enum>7.</enum><header>PAYGO annual report</header><text display-inline="no-display-inline">For the purposes of the annual report issued pursuant to section 5 of the Statutory Pay-As-You-Go Act of 2010 (<external-xref legal-doc="usc" parsable-cite="usc/2/934">2 U.S.C. 934</external-xref>) after adjournment of the first session of the 117th Congress, and for determining whether a sequestration order is necessary under such section, the debit for the budget year on the 5-year scorecard, if any, and the 10-year scorecard, if any, shall be deducted from such scorecard in 2022 and added to such scorecard in 2023. </text></section></legis-body></bill> 

