II 

116TH CONGRESS 

2D SESSION S. 3750 

To amend title XVIII of the Social Security Act to modify the accelerated 

and advance payment programs under parts A and B of the Medicare 

program during the COVID–19 emergency. 

IN THE SENATE OF THE UNITED STATES 

MAY 14, 2020 

Mrs. SHAHEEN (for herself, Mr. BENNET, Ms. SMITH, Ms. CORTEZ MASTO, 

Ms. HASSAN, Mr. JONES, Mr. REED, Mr. BLUMENTHAL, Mr. HEINRICH, 

Mr. MANCHIN, Mr. DURBIN, Ms. KLOBUCHAR, Ms. WARREN, Ms. 

ROSEN, and Mr. MARKEY) 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 modify 

the accelerated and advance payment programs under 

parts A and B of the Medicare program during the 

COVID–19 emergency. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Medicare Accelerated 

5 and Advance Payments Improvement Act’’. 


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1 SEC. 2. MODIFYING THE ACCELERATED AND ADVANCE PAY2 MENT PROGRAMS UNDER PARTS A AND B OF 

3 THE MEDICARE PROGRAM DURING THE 

4 COVID–19 EMERGENCY. 

5 (a) SPECIAL REPAYMENT RULES.— 

6 (1) PART A.—Section 1815(f)(2)(C) of the So7 cial Security Act (42 U.S.C. 1395g(f)(2)(C)) is 

8 amended to read as follows: 

9 ‘‘(C) In the case of an accelerated payment 

10 made under such program on or after the date of 

11 the enactment of the CARES Act and so made dur12 ing the emergency period described in section 

13 1135(g)(1)(B)— 

14 ‘‘(i) such payment shall be treated as if 

15 such payment were made from the General 

16 Fund of the Treasury; 

17 ‘‘(ii) upon request of the hospital, the Sec18 retary shall— 

19 ‘‘(I) provide 1 year before claims are 

20 offset to recoup such payment; 

21 ‘‘(II) provide that any such offset of a 

22 claim to recoup such payment shall not ex23 ceed 25 percent of the amount of such 

24 claim; and 

25 ‘‘(III) allow not less than 2 years 

26 from the date of the first accelerated payVerDate Sep 11 2014 16:01 Jun 03, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3750.IS S3750

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1 ment before requiring that the outstanding 

2 balance be paid in full; and 

3 ‘‘(iii) the Secretary may waive the require4 ment that such payment be repaid (or re5 couped) if, not earlier than 2 years from the 

6 date of the first accelerated payment, the hos7 pital submits to the Secretary a request for 

8 such waiver containing such information that 

9 demonstrates that— 

10 ‘‘(I) requiring repayment of such pay11 ment (or recouping such payment) would 

12 constitute an extreme hardship for the hos13 pital; 

14 ‘‘(II) the hospital made efforts to 

15 maintain a comparable number of employ16 ees at a comparable level of pay during the 

17 such emergency period compared to the 

18 number of, and level of pay for, such em19 ployees as of the day before the beginning 

20 of such period; and 

21 ‘‘(III) the hospital did not increase ex22 ecutive compensation or undertake any 

23 stock buyback, if applicable, during such 

24 emergency period.’’. 

25 (2) PART B.— 


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1 (A) CONTINUING CONDUCT OF ADVANCE

2 PAYMENT PROGRAM.—Notwithstanding any 

3 other provision of law, the Secretary of Health 

4 and Human Services shall carry out the pro5 gram described in section 421.214 of title 42, 

6 Code of Federal Regulations (or a successor 

7 regulation) for the duration of the emergency 

8 period described in section 1135(g)(1)(B) of the 

9 Social Security Act (42 U.S.C. 1320b– 

10 5(g)(1)(B)). 

11 (B) REPAYMENT RULES.—In carrying out 

12 such program, in the case of a payment made 

13 under such program on or after the date of the 

14 enactment of the CARES Act (Public Law 

15 116–136) and so made during the emergency 

16 period described in section 1135(g)(1)(B) of the 

17 Social Security Act (42 U.S.C. 1320b– 

18 5(g)(1)(B)), the Secretary of Health and 

19 Human Services— 

20 (i) shall treat such payment as if such 

21 payment were made from the General 

22 Fund of the Treasury; 

23 (ii) upon request of the entity receiv24 ing such payment, shall— 


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1 (I) provide 1 year before claims 

2 are offset to recoup the payment; 

3 (II) provide that any such offset 

4 of a claim to recoup such payment 

5 shall not exceed 25 percent of the 

6 amount of such claim; and 

7 (III) allow not less than 2 years 

8 from the date of the first advance 

9 payment before requiring that the 

10 outstanding balance be paid in full; 

11 and 

12 (iii) may waive the requirement that 

13 such payment be repaid (or recouped) if, 

14 not earlier than 2 years from the date of 

15 the first advance payment, the entity sub16 mits to the Secretary a request for such 

17 waiver containing such information that 

18 demonstrates that— 

19 (I) requiring repayment of such 

20 payment (or recouping such payment) 

21 would constitute an extreme hardship 

22 for the entity; 

23 (II) the entity made efforts to 

24 maintain a comparable number of em25 ployees at a comparable level of pay 


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1 during the such emergency period 

2 compared to the number of, and level 

3 of pay for, such employees as of the 

4 day before the beginning of such pe5 riod; and 

6 (III) the entity did not increase 

7 executive compensation or undertake 

8 any stock buyback, if applicable, dur9 ing such emergency period. 

10 (b) INTEREST RATES.— 

11 (1) PART A.—Section 1815(d) of the Social Se12 curity Act (42 U.S.C. 1395g(d)) is amended by in13 serting before the period at the end the following: 

14 ‘‘(or, in the case of such a determination made with 

15 respect to a payment made on or after the date of 

16 the enactment of the CARES Act and during the 

17 emergency period described in section 1135(g)(1)(B) 

18 under the program under subsection (e)(3), at a rate 

19 of 1 percent)’’. 

20 (2) PART B.—Section 1833(j) of the Social Se21 curity Act (42 U.S.C. 1395l(j)) is amended by in22 serting before the period at the end the following: 

23 ‘‘(or, in the case of such a determination made with 

24 respect to a payment made on or after the date of 

25 the enactment of the CARES Act and during the 


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1 emergency period described in section 1135(g)(1)(B) 

2 under the program described in section 421.214 of 

3 title 42, Code of Federal Regulations (or a successor 

4 regulation), at a rate of 1 percent)’’. 

5 (c) REPORT.— 

6 (1) REPORTS DURING COVID–19 EMERGENCY.— 

7 Not later than 2 weeks after the date of the enact8 ment of this section, and every 2 weeks thereafter 

9 during the emergency period described in section 

10 1135(g)(1)(B) of the Social Security Act (42 U.S.C. 

11 1320b–5(g)(1)(B)), the Secretary of Health and 

12 Human Services shall submit to the Committee on 

13 Ways and Means and the Committee on Energy and 

14 Commerce of the House of Representatives, and the 

15 Committee on Finance of the Senate, a report that 

16 includes the following: 

17 (A) The total amount of payments made 

18 under section 1815(e)(3) of the Social Security 

19 Act (42 U.S.C. 1395g(e)(3)) and under the pro20 gram described in section 421.214 of title 42, 

21 Code of Federal Regulations (or a successor 

22 regulation) during the 2-week period preceding 

23 the date of the submission of such report. 

24 (B) The number of entities receiving such 

25 payments during such period. 


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1 (C) A specification of each such entity. 

2 (2) REPORTS AFTER COVID–19 EMERGENCY.— 

3 (A) IN GENERAL.—Not later than 6 

4 months after the termination of the emergency 

5 period described in paragraph (1), and every 6 

6 months thereafter until all specified payments 

7 (as defined in subparagraph (B)) have been re8 couped or repaid, the Secretary of Health and 

9 Human Services shall submit to the Committee 

10 on Ways and Means and the Committee on En11 ergy and Commerce of the House of Represent12 atives, and the Committee on Finance of the 

13 Senate, a report that includes the following: 

14 (i) The total amount of all specified 

15 payments that have been recouped or re16 paid. 

17 (ii) The total amount of all specified 

18 payments that have been recouped or re19 paid. 

20 (iii) The amount of interest that has 

21 accrued with respect to all specified pay22 ments. 

23 (B) SPECIFIED PAYMENTS.—For purposes 

24 of subparagraph (A), the term ‘‘specified pay25 ments’’ means all payments made under section 


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1 1815(e)(3) of the Social Security Act (42 

2 U.S.C. 1395g(e)(3)) or under the program de3 scribed in section 421.214 of title 42, Code of 

4 Federal Regulations (or a successor regulation) 

5 made on or after the date of the enactment of 

6 the CARES Act (Public Law 116–136) during 

7 the emergency period described in such sub8 paragraph. 

Æ 


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