In the House of Representatives, U. S., 

December 7, 2021. 

Resolved, That the bill from the Senate (S. 610) entitled 

‘‘An Act to address behavioral health and well-being among 

health care professionals.’’, do pass with the following 

AMENDMENT: 

Strike out all after the enacting clause and insert: 

1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Protecting Medicare and 

3 American Farmers from Sequester Cuts Act’’. 

4 SEC. 2. ADJUSTMENTS TO MEDICARE SEQUESTRATION RE5 DUCTIONS. 

6 (a) EXTENSION OF TEMPORARY SUSPENSION

7 THROUGH MARCH 2022.— 

8 (1) IN GENERAL.—Section 3709(a) of division A 

9 of the CARES Act (2 U.S.C. 901a note) is amended— 

10 (A) in the subsection header by inserting 

11 ‘‘AND ADJUSTMENT’’ after ‘‘SUSPENSION’’; and 

12 (B) by striking ‘‘December 31, 2021’’ and 

13 inserting ‘‘March 31, 2022’’. 

14 (2) EFFECTIVE DATE.—The amendments made 

15 by paragraph (1) shall take effect as if enacted as 

16 part of the CARES Act (Public Law 116–136). 
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1 (b) ADJUSTMENTS TO MEDICARE PROGRAM SEQUES2 TRATION REDUCTION WITH RESPECT TO FISCAL YEARS

3 2022 AND 2030.—Section 251A(6) of the Balanced Budget 

4 and Emergency Deficit Control Act of 1985 (2 U.S.C. 

5 901a(6)) is amended— 

6 (1) by redesignating subparagraph (C) as sub7 paragraph (E); and 

8 (2) by inserting after subparagraph (B) the fol9 lowing new subparagraphs: 

10 ‘‘(C) Notwithstanding the 2 percent limit 

11 specified in subparagraph (A) for payments for 

12 the Medicare programs specified in section 

13 256(d), the sequestration order of the President 

14 under such subparagraph for fiscal year 2022 

15 shall be applied to such payments so that with 

16 respect to the period beginning on April 1, 2022, 

17 and ending on June 30, 2022, the payment re18 duction shall be 1.0 percent. 

19 ‘‘(D) Notwithstanding the 2 percent limit 

20 specified in subparagraph (A) for payments for 

21 the Medicare programs specified in section 

22 256(d), the sequestration order of the President 

23 under such subparagraph for fiscal year 2030 

24 shall be applied to such payments so that— 
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1 ‘‘(i) with respect to the first 6 months 

2 in which such order is effective for such fis3 cal year, the payment reduction shall be 

4 2.25 percent; and 

5 ‘‘(ii) with respect to the second 6 

6 months in which such order is so effective 

7 for such fiscal year, the payment reduction 

8 shall be 3 percent.’’. 

9 SEC. 3. EXTENSION OF SUPPORT FOR PHYSICIANS AND 

10 OTHER PROFESSIONALS IN ADJUSTING TO 

11 MEDICARE PAYMENT CHANGES. 

12 (a) IN GENERAL.—Section 1848 of the Social Security 

13 Act (42 U.S.C. 1395w–4) is amended— 

14 (1) in subsection (c)(2)(B)(iv)(V), by striking 

15 ‘‘2021’’ and inserting ‘‘2021 or 2022’’; and 

16 (2) in subsection (t)— 

17 (A) in the subsection header, by striking 

18 ‘‘2021’’ and inserting ‘‘2021 AND 2022’’; 

19 (B) in paragraph (1)— 

20 (i) by striking ‘‘during 2021’’ and in21 serting ‘‘during 2021 and 2022’’; and 

22 (ii) by striking ‘‘for such services fur23 nished on or after January 1, 2021, and be24 fore January 1, 2022, by 3.75 percent.’’ and 

25 inserting ‘‘for— 
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1 ‘‘(A) such services furnished on or after 

2 January 1, 2021, and before January 1, 2022, 

3 by 3.75 percent; and 

4 ‘‘(B) such services furnished on or after 

5 January 1, 2022, and before January 1, 2023, 

6 by 3.0 percent.’’; and 

7 (C) in paragraph (2)(C)— 

8 (i) in the subparagraph header, by 

9 striking ‘‘2021’’ and inserting ‘‘2021 AND

10 2022’’; 

11 (ii) by inserting ‘‘for services furnished 

12 in 2021 or 2022’’ after ‘‘under this sub13 section’’; and 

14 (iii) by inserting ‘‘or 2022, respec15 tively’’ before the period at the end. 

16 (b) REPORT.—Section 101(c) of division N of the Con17 solidated Appropriations Act, 2021 (Public Law 116–260) 

18 is amended— 

19 (1) in the first sentence— 

20 (A) by striking ‘‘April 1, 2022’’ and insert21 ing ‘‘each of April 1, 2022, and April 1, 2023’’; 

22 and 

23 (B) by striking ‘‘, as added by subsection 

24 (a)’’ and inserting ‘‘furnished during 2021 or 

25 2022, respectively’’; and 
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1 (2) in the second sentence— 

2 (A) by striking ‘‘Such report’’ and inserting 

3 ‘‘Each such report’’; and 

4 (B) by inserting ‘‘with respect to 2021 or 

5 2022, as applicable’’ after ‘‘under such section’’. 

6 SEC. 4. PRESERVING PATIENT ACCESS TO CRITICAL CLIN7 ICAL LAB SERVICES. 

8 (a) REVISED PHASE-IN OF REDUCTIONS FROM PRI9 VATE PAYOR RATE IMPLEMENTATION.—Section 

10 1834A(b)(3) of the Social Security Act (42 U.S.C. 1395m– 

11 1(b)(3)) is amended— 

12 (1) in subparagraph (A), by striking ‘‘through 

13 2024’’ and inserting ‘‘through 2025’’; and 

14 (2) in subparagraph (B)— 

15 (A) in clause (ii), by striking ‘‘for 2021’’ 

16 and inserting ‘‘for each of 2021 and 2022’’; and 

17 (B) in clause (iii), by striking ‘‘2022 

18 through 2024’’ and inserting ‘‘2023 through 

19 2025’’. 

20 (b) REVISED REPORTING PERIOD FOR REPORTING OF

21 PRIVATE SECTOR PAYMENT RATES FOR ESTABLISHMENT

22 OF MEDICARE PAYMENT RATES.—Section 1834A(a)(1)(B) 

23 of the Social Security Act (42 U.S.C. 1395m–1(a)(1)(B)) 

24 is amended— 
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1 (1) in clause (i), by striking ‘‘December 31, 

2 2021’’ and inserting ‘‘December 31, 2022’’; and 

3 (2) in clause (ii)— 

4 (A) by striking ‘‘January 1, 2022’’ and in5 serting ‘‘January 1, 2023’’; and 

6 (B) by striking ‘‘March 31, 2022’’ and in7 serting ‘‘March 31, 2023’’. 

8 SEC. 5. DELAY TO THE IMPLEMENTATION OF THE RADI9 ATION ONCOLOGY MODEL UNDER THE MEDI10 CARE PROGRAM. 

11 Section 133 of Division CC of the Consolidated Appro12 priations Act, 2021 (Public Law 116–260) is amended by 

13 striking ‘‘January 1, 2022’’ and inserting ‘‘January 1, 

14 2023’’. 

15 SEC. 6. MEDICARE IMPROVEMENT FUND. 

16 Section 1898(b)(1) of the Social Security Act (42 

17 U.S.C. 1395iii(b)(1)) is amended by striking ‘‘fiscal year 

18 2021’’ and all that follows through the period at the end 

19 and inserting ‘‘fiscal year 2021, $101,000,000.’’. 

20 SEC. 7. PAYGO ANNUAL REPORT. 

21 For the purposes of the annual report issued pursuant 

22 to section 5 of the Statutory Pay-As-You-Go Act of 2010 

23 (2 U.S.C. 934) after adjournment of the first session of the 

24 117th Congress, and for determining whether a sequestra25 tion order is necessary under such section, the debit for the 
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1 budget year on the 5-year scorecard, if any, and the 10- 

2 year scorecard, if any, shall be deducted from such scorecard 

3 in 2022 and added to such scorecard in 2023. 

4 SEC. 8. EXPEDITED PROCEDURES FOR CONSIDERING AN IN5 CREASE IN THE DEBT LIMIT. 

6 (a) DEFINITION.—In this section, the term ‘‘joint reso7 lution’’ means a joint resolution— 

8 (1) that is introduced by the Majority Leader of 

9 the Senate, or a designee, during the period beginning 

10 on the date of enactment of this Act and ending on 

11 December 31, 2021; 

12 (2) which does not have a preamble; 

13 (3) the title of which is as follows: ‘‘Joint resolu14 tion relating to increasing the debt limit.’’; and 

15 (4) the matter after the resolving clause of which 

16 is as follows: ‘‘That the limitation under section 

17 3101(b) of title 31, United States Code, as most re18 cently increased by Public Law 117–50 (31 U.S.C. 

19 3101 note), is increased by $lllllllll.’’, 

20 the blank space being appropriately filled in with the 

21 dollar amount of the increase. 

22 (b) EXPEDITED CONSIDERATION IN SENATE.— 

23 (1) PLACEMENT ON CALENDAR.—Upon introduc24 tion in the Senate, the joint resolution shall be placed 

25 immediately on the calendar. 
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1 (2) PROCEEDING TO CONSIDERATION.— 

2 (A) IN GENERAL.—Notwithstanding rule 

3 XXII of the Standing Rules of the Senate, it is 

4 in order, not later than January 15, 2022 (even 

5 though a previous motion to the same effect has 

6 been disagreed to) to move to proceed to the con7 sideration of the joint resolution. 

8 (B) PROCEDURE.—For a motion to proceed 

9 to the consideration of the joint resolution— 

10 (i) all points of order against the mo11 tion are waived; 

12 (ii) the motion is not debatable; 

13 (iii) the motion is not subject to a mo14 tion to postpone; 

15 (iv) a motion to reconsider the vote by 

16 which the motion is agreed to or disagreed 

17 to shall not be in order; and 

18 (v) if the motion is agreed to, the joint 

19 resolution shall remain the unfinished busi20 ness until disposed of. 

21 (3) FLOOR CONSIDERATION.— 

22 (A) IN GENERAL.—If the Senate proceeds to 

23 consideration of the joint resolution— 
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1 (i) all points of order against the joint 

2 resolution (and against consideration of the 

3 joint resolution) are waived; 

4 (ii) debate on the joint resolution, and 

5 all debatable motions and appeals in con6 nection therewith, shall be limited to not 

7 more than 10 hours, which shall be divided 

8 equally between the Chairman and Ranking 

9 Member of the Committee on Finance; 

10 (iii) an amendment to the joint resolu11 tion is not in order; 

12 (iv) a motion to postpone or a motion 

13 to commit the joint resolution is not in 

14 order; and 

15 (v) a motion to proceed to the consider16 ation of other business is not in order. 

17 (B) VOTE ON PASSAGE.—The vote on pas18 sage shall occur immediately following the con19 clusion of the debate on the joint resolution and 

20 a single quorum call if requested in accordance 

21 with the rules of the Senate. 

22 (C) RULINGS OF THE CHAIR ON PROCE23 DURE.—Appeals from the decisions of the Chair 

24 relating to the application of this paragraph or 

25 the rules of the Senate, as the case may be, to the 
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1 procedure relating to the joint resolution shall be 

2 decided without debate. 

3 (D) SINGLE MEASURE AUTHORIZED.—It 

4 shall not be in order to consider more than 1 

5 joint resolution under the procedures under this 

6 paragraph. 

7 (E) SUNSET.—It shall not be in order to 

8 consider a joint resolution under the procedures 

9 under this paragraph after January 16, 2022. 

10 (4) RULES OF THE SENATE.—This subsection is 

11 enacted by Congress— 

12 (A) as an exercise of the rulemaking power 

13 of the Senate, and as such is deemed a part of 

14 the rules of the Senate, but applicable only with 

15 respect to the procedure to be followed in the 

16 Senate in the case of a joint resolution, and su17 persede other rules only to the extent that they 

18 are inconsistent with such rules; and 

19 (B) with full recognition of the constitu20 tional right of the Senate to change the rules (so 

21 far as relating to the procedure of the Senate) at 

22 any time, in the same manner, and to the same 
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1 extent as in the case of any other rule of the Sen2 ate. 

Attest: 

Clerk. 
117TH CONGRESS 

1ST SESSION S. 610 

AMENDMENT