I 

117TH CONGRESS 

1ST SESSION H. R. 2080 

To amend title XVIII of the Social Security Act to provide for temporary 

coverage of certain transportation services for certain individuals under 

the Medicare program, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 19, 2021 

Mr. BISHOP of Georgia (for himself, Mr. CARTER of Georgia, Mr. CA ́RDENAS, 

Mr. GRIFFITH, Mr. GRIJALVA, Ms. PRESSLEY, Mr. COHEN, Mr. LEVIN

of California, Mr. CARBAJAL, and Ms. SEWELL) 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 provide 

for temporary coverage of certain transportation services 

for certain individuals under the Medicare program, 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 ‘‘Senior Access to Vac5 cines Ensured Act of 2021’’ or the ‘‘SAVE Act of 2021’’. 


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1 SEC. 2. FINDINGS. 

2 Congress finds the following: 

3 (1) The Kaiser Family Foundation reported 

4 that only about 12 percent of Medicare beneficiaries 

5 are full Medicare-Medicaid dual eligibles and, thus, 

6 have Medicaid coverage for nonemergency medical 

7 transportation (NEMT) to access COVID–19 vac8 cination appointments and other health care ap9 pointments. According to the Commonwealth Fund, 

10 although 45 percent of Medicare beneficiaries have 

11 incomes lower than 200 percent of the federal pov12 erty level (FPL), which can limit their transpor13 tation options, Medicare does not currently cover 

14 NEMT. 

15 (2) Medicare beneficiaries over the age of 65, 

16 according to the Centers for Disease Control, are 24 

17 times more likely to die from COVID–19 than an 

18 adult aged 25–54. 

19 (3) A managed NEMT benefit that offers 

20 scheduling and other assistance would improve bene21 ficiaries’ access to the COVID–19 vaccine. It also 

22 would reduce Medicare expenditures by covering 

23 more cost-effective alternatives and avoiding the 

24 high cost of in-patient COVID–19 treatment. 


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1 SEC. 3. COVERAGE OF MANAGED, NONEMERGENT TRANS2 PORTATION SERVICES FOR CERTAIN INDI3 VIDUALS. 

4 Title XVIII of the Social Security Act (42 U.S.C. 

5 1395 et seq.) is amended by adding at the end the fol6 lowing new section: 

7 ‘‘SEC. 1899C. MANAGED, NONEMERGENT TRANSPORTATION 

8 SERVICES BENEFIT PROGRAM. 

9 ‘‘(a) ESTABLISHMENT.—The Secretary shall estab10 lish a program to be known as the ‘Managed, Nonemer11 gent Transportation Services Benefit Program’ for pur12 poses of furnishing qualifying individuals not more than 

13 2 round-trip managed, nonemergent transportation serv14 ices (as defined in subsection (c)) to COVID–19 vaccina15 tion sites (including community pharmacies) beginning 

16 April 1, 2021, and ending on the last day of the emergency 

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

18 ‘‘(b) CONTRACT WITH QUALIFIED TRANSPORTATION

19 MANAGER.— 

20 ‘‘(1) IN GENERAL.—For each medicare admin21 istrative contractor jurisdiction for a year (beginning 

22 with 2021), the Secretary shall enter into a contract 

23 with one qualified transportation manager for pur24 poses of arranging for the provision of managed, 

25 nonemergent transportation services to qualifying in26 dividuals in such region. Such contract shall provide 


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1 that payment be made by the Secretary for such 

2 service on the basis of prepaid capitation payments 

3 (taking into account the charge described in para4 graph (2)(E)). 

5 ‘‘(2) SELECTION.—Not later than 30 days after 

6 the date of the enactment of this section, notwith7 standing any other provision of law, the Secretary 

8 shall award contracts described in paragraph (1) 

9 through a competitive bidding process under which 

10 the Secretary evaluates applicant entities based on 

11 experience, past performance, references, available 

12 resources, and cost for purposes of selecting quali13 fied transportation managers, with preference given 

14 to applicants with prior satisfactory performance as 

15 a transportation broker under a program described 

16 in section 1902(a)(70). Not later than 15 days after 

17 such date of enactment, the Secretary shall publish 

18 guidance for prospective qualified transportation 

19 managers. Such guidance shall include information 

20 on how such manager may enter into a contract de21 scribed in this subsection and a description of terms 

22 and conditions applicable to such managers with 

23 such contracts. Such a manager shall meet the fol24 lowing requirements: 


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1 ‘‘(A) The manager establishes procedures 

2 meeting criteria established by the Secretary for 

3 addressing beneficiary complaints and ensuring 

4 network transportation providers are licensed 

5 by the State for purposes of operating vehicles 

6 and are competent and courteous. 

7 ‘‘(B) The manager is subject to regular 

8 audit and oversight by the State in which such 

9 manager operates in order to ensure the quality 

10 and timeliness of transportation services man11 aged and the adequacy of qualifying individuals’ 

12 access to medical care and services. 

13 ‘‘(C) The manager complies with all re14 quirements specified in the contract described 

15 in paragraph (1). Such requirements shall in16 clude requirements related to— 

17 ‘‘(i) reviews and evaluations to ensure 

18 the quality, appropriateness, and timeliness 

19 of such services arranged by such man20 ager; 

21 ‘‘(ii) prohibitions on referrals and con22 flict of interest as the Secretary shall es23 tablish (based on the prohibitions on physi24 cian referrals under section 1877 and such 

25 other prohibitions and requirements as the 


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1 Secretary determines to be appropriate); 

2 and 

3 ‘‘(iii) the development and implemen4 tation of a corrective action plan to ad5 dress any contract deficiencies. 

6 ‘‘(D) The manager establishes procedures 

7 for determining an individual’s eligibility for 

8 managed, nonemergent transportation services 

9 under the program established under subsection 

10 (a) using criteria established by the Secretary 

11 under subsection (c)(3) and for scheduling and 

12 organizing the furnishing of such services. 

13 ‘‘(c) DEFINITION.—For purposes of this section: 

14 ‘‘(1) MANAGED, NONEMERGENT TRANSPOR15 TATION SERVICES.—The term ‘managed, nonemer16 gent transportation services’ means the transpor17 tation of an individual by car, taxi, bus, or other 

18 similar means (as specified by the Secretary) to a 

19 provider or supplier of services where such individual 

20 is to be furnished items or services payable under 

21 this title. 

22 ‘‘(2) QUALIFIED TRANSPORTATION MANAGER.— 

23 The term ‘qualified transportation manager’ means 

24 an entity that arranges, under contract with the 


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1 Secretary, for the provision of managed, nonemer2 gent transportation services to qualifying individuals. 

3 ‘‘(3) QUALIFYING INDIVIDUAL.—The term 

4 ‘qualifying individual’ means an individual entitled 

5 to benefits under part A who is not enrolled under 

6 a Medicare Advantage plan under part C and who 

7 is not a full-benefit dual eligible individual (as de8 fined in paragraph (4)) who has no readily-available 

9 means of transportation (as determined by the Sec10 retary). In determining whether an individual has no 

11 readily-available means of transportation for pur12 poses of the previous sentence, the Secretary shall 

13 establish criteria similar to those used by States in 

14 making such determinations under a non-emergency 

15 medical transportation program under a State plan 

16 under title XIX (or a waiver of such plan), such as 

17 evaluating whether such individual— 

18 ‘‘(A) has a driver’s license; 

19 ‘‘(B) has a working vehicle available to 

20 such individual at such individual’s residence; 

21 ‘‘(C) is incapable of driving due to a med22 ical condition; and 

23 ‘‘(D) has inadequate financial resources to 

24 pay for transportation. 


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1 ‘‘(4) FULL-BENEFIT DUAL ELIGIBLE INDI2 VIDUAL.— 

3 ‘‘(A) IN GENERAL.—The term ‘full-benefit 

4 dual eligible individual’ means for a State for a 

5 month an individual who— 

6 ‘‘(i) is entitled to benefits under part 

7 A or enrolled under part B; and 

8 ‘‘(ii) is determined eligible by the 

9 State for medical assistance for full bene10 fits under title XIX for such month under 

11 section 1902(a)(10)(A) or 1902(a)(10)(C), 

12 by reason of section 1902(f), or under any 

13 other category of eligibility for medical as14 sistance for full benefits under such title, 

15 as determined by the Secretary. 

16 ‘‘(B) TREATMENT OF MEDICALLY NEEDY

17 AND OTHER INDIVIDUALS REQUIRED TO SPEND

18 DOWN.—In applying paragraph (1) in the case 

19 of an individual determined to be eligible by the 

20 State for medical assistance under section 

21 1902(a)(10)(C) or by reason of section 1902(f), 

22 the individual shall be treated as meeting the 

23 requirement of paragraph (1)(B) for any month 

24 if such medical assistance is provided for in any 

25 part of the month. 


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1 ‘‘(d) FUNDING.—The Secretary shall provide for the 

2 transfer, from the Federal Supplementary Medical Insur3 ance Trust Fund under section 1841 to the Centers for 

4 Medicare & Medicaid Services Program Management Ac5 count, of such sums as may be necessary for purposes of 

6 carrying out this section. 

7 ‘‘(e) CLARIFICATION.—The provisions of section 

8 1862(a) shall not apply to payments made under a con9 tract described in subsection (b)(1).’’. 

Æ 


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