I 

117TH CONGRESS 

1ST SESSION H. R. 1838 

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

clinic payments, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 11, 2021 

Mr. LUETKEMEYER (for himself, Mr. SESSIONS, Mr. JACKSON, Mr. 

ARRINGTON, Mr. GUEST, and Mr. LONG) introduced the following bill; 

which was referred to the Committee on Energy and Commerce, and in 

addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such 

provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To amend title XVIII of the Social Security Act to improve 

rural health clinic payments, and for other purposes. 

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 ‘‘Affordable Access to 

5 Rural Health Care Act’’. 

6 SEC. 2. IMPROVING RURAL HEALTH CLINIC PAYMENTS. 

7 (a) IN GENERAL.—Section 1833(f) of the Social Se8 curity Act (42 U.S.C. 1395l(f)) is amended— 


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1 (1) by adding at the end the following new 

2 paragraphs: 

3 ‘‘(4) EXCEPTION.—In establishing limits under 

4 subsection (a) on payment for rural health clinic 

5 services provided by rural health clinics which sub6 mits to the Secretary a certification that the hospital 

7 has a binding written agreement with an outside un8 related party for the construction or purchase of 

9 such rural health clinic before March 30, 2021, the 

10 Secretary shall— 

11 ‘‘(A) during the first year during which 

12 such rural health clinic furnishes such services, 

13 make payments to such rural health clinic with14 out the application of such limits; and 

15 ‘‘(B) during any subsequent year, make 

16 payments in accordance with this subsection. 

17 ‘‘(5) AUDIT.—Not later than 60 days after the 

18 date of the enactment of this paragraph, the Sec19 retary shall audit the compliance with requirements 

20 of paragraph (4) with respect to each rural health 

21 clinic to which such paragraph applies. If the Sec22 retary finds as a result of an audit under this clause 

23 that the applicable requirements were not met with 

24 respect to such rural health clinic, the rural health 


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1 clinic shall receive payments under this subsection 

2 notwithstanding such paragraph.’’. 

3 (b) UTILIZATION OF MEDICARE ENROLLMENT AP4 PLICATION FORM.—The Secretary of Health and Human 

5 Services shall utilize Form CMS 855A (or any successor 

6 Medicare Enrollment Application form) to review the eligi7 bility of rural health clinics (as defined in section 

8 1861(aa)(2) of the Social Security Act (42 U.S.C. 

9 1395x(aa)(2))) to receive payments pursuant to the mid10 build exception described in section 1833(f)(4) of such Act 

11 (42 U.S.C. 1935l(f)(4)). 

12 (c) REPORT.—Not later than 120 days after the date 

13 of the enactment of this Act, the Secretary of Health and 

14 Human Services shall submit to Congress a report on the 

15 findings of the audit described in paragraph (5) of section 

16 1833(f) of the Social Security Act (42 U.S.C. 1935l(f)). 

Æ 


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