[Congressional Record Volume 167, Number 56 (Thursday, March 25, 2021)]
[Senate]
[Page S1839]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 1410. Mrs. SHAHEEN (for herself and Ms. Collins) proposed an 
amendment to the bill H.R. 1868, to prevent across-the-board direct 
spending cuts, and for other purposes; as follows:

        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).''.
                                 ______