[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 934 Introduced in Senate (IS)]

<DOC>






117th CONGRESS
  1st Session
                                 S. 934

To amend title XVIII of the Social Security Act to improve rural health 
                            clinic payments.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 23, 2021

 Mr. Warner (for himself and Mr. Blunt) introduced the following bill; 
     which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
To amend title XVIII of the Social Security Act to improve rural health 
                            clinic payments.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Strengthening Rural Health Clinics 
Act of 2021''.

SEC. 2. RURAL HEALTH CLINIC PAYMENTS.

    (a) In General.--Section 1833(f)(3) of the Social Security Act (42 
U.S.C. 1395l(f)(3)) is amended--
            (1) in subparagraph (A)--
                    (A) in the matter preceding clause (i), by 
                inserting ``(or, in the case of a rural health clinic 
                described in subparagraph (B)(ii)(III), in the first 
                year in which the rural health clinic furnishes such 
                services)'' after ``March 31'';
                    (B) 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, in the 
                                        case of a rural health clinic 
                                        described in subparagraph 
                                        (B)(ii)(III), the per visit 
                                        payment amount applicable to 
                                        such rural health clinic for 
                                        rural health clinic services 
                                        furnished in the first year in 
                                        which such rural health clinic 
                                        furnishes such services); or
                                            ``(bb) the limit described 
                                        in paragraph (2)(A) (or, in the 
                                        case of a rural health clinic 
                                        described in subparagraph 
                                        (B)(ii)(III), the limit 
                                        established under paragraph (2) 
                                        for such first year);''; and
                    (C) in clause (ii)(I), by striking ``under clause 
                (i)(I)'' and inserting ``under subclause (I) or (II) of 
                clause (i), as applicable,'';
            (2) in subparagraph (B)--
                    (A) in the matter preceding clause (i), by striking 
                ``2019, was'' and inserting ``2020'';
                    (B) in clause (i)--
                            (i) by inserting ``was'' after ``(i)''; and
                            (ii) by inserting the following before the 
                        semicolon: ``, or, in the case of a rural 
                        health clinic described in clause (ii)(III), 
                        had an agreement described in such clause with 
                        such a hospital'';
                    (C) by striking clause (ii) and inserting the 
                following:
                            ``(ii)(I) was enrolled under section 
                        1866(j) (including temporary enrollment during 
                        the emergency period described in section 
                        1135(g)(1)(B) for such period);
                            ``(II) 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; or
                            ``(III) as determined by the Secretary, had 
                        a binding written agreement with an outside 
                        unrelated party for the construction, purchase, 
                        lease, or other establishment of such a rural 
                        health clinic as of that date.''; and
            (3) by adding at the end the following new subparagraph:
    ``(C)(i) In determining whether a provider-based rural health 
clinic had an agreement described in subparagraph (B)(ii)(III) as of 
December 31, 2020, the Secretary may consider appropriate evidence 
relating to the agreement submitted by the provider.
    ``(ii) Not later than 60 days after the date of the enactment of 
this subparagraph, the Secretary shall obtain an attestation (pursuant 
to section 413.65(b)(3) of title 42, Code of Federal Regulations, or 
any successor regulation) that such provider-based rural health clinic 
meets, or will meet, the requirements of a provider-based rural health 
clinic specified in section 413.65 of title 42, Code of Federal 
Regulations, or any successor regulation.
    ``(iii) The Secretary may audit, as appropriate, the compliance 
with subparagraph (B)(ii)(III) with respect to each provider-based 
rural health clinic to which such subparagraph applies. If the 
Secretary finds as a result of an audit under this clause that the 
applicable requirements were not met with respect to such provider-
based rural health clinic, the provider-based rural health clinic shall 
no longer be considered to be described in such subparagraph for 
purposes of this paragraph.''.
    (b) Effective Date.--The amendments made by this section shall take 
effect as if included in the enactment of the Consolidated 
Appropriations Act, 2021 (Public Law 116-260).
                                 <all>