II 

Calendar No. 31 

117TH CONGRESS 

1ST SESSION H. R. 1868 

IN THE SENATE OF THE UNITED STATES 

MARCH 22, 2021 

Received 

MARCH 24, 2021 

Read the first time 

MARCH 25, 2021 

Read the second time and placed on the calendar 

AN ACT 

To prevent across-the-board direct spending cuts, 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. PREVENTING PAYGO SEQUESTRATION. 

4 (a) STATUTORY PAYGO SCORECARDS.—The budg5 etary effects of this Act and the American Rescue Plan 

6 Act of 2021 (Public Law 117–2) shall not be counted on 

7 either PAYGO scorecard maintained pursuant to section 


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1 4(d) of the Statutory Pay-As-You-Go Act of 2010 (2 

2 U.S.C. 933(d)). 

3 (b) SENATE PAYGO SCORECARDS.—The budgetary 

4 effects of this Act shall not be counted on any PAYGO 

5 scorecard maintained for purposes of section 4106 of H. 

6 Con. Res. 71 (115th Congress). 

7 SEC. 2. EXTENSION OF TEMPORARY SUSPENSION OF MEDI8 CARE SEQUESTRATION. 

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

10 the CARES Act (2 U.S.C. 901a note) is amended by strik11 ing ‘‘March 31, 2021’’ and inserting ‘‘December 31, 

12 2021’’. 

13 (b) EFFECTIVE DATE.—The amendment made by 

14 subsection (a) shall take effect as if enacted as part of 

15 the CARES Act (Public Law 116–136). 

16 SEC. 3. TECHNICAL CORRECTIONS. 

17 (a) DISREGARD OF CERTAIN ADDITIONAL COM18 PENSATION FOR PURPOSES OF MEDICAID AND CHIP.— 

19 Section 2104(h) of the CARES Act (15 U.S.C. 9023(h)) 

20 is amended by striking ‘‘Federal pandemic unemployment 

21 compensation’’ and inserting ‘‘Federal Pandemic Unem22 ployment Compensation or Mixed Earner Unemployment 

23 Compensation’’. 

24 (b) RURAL HEALTH CLINIC PAYMENTS.— 


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1 (1) IN GENERAL.—Section 1833(f)(3) of the 

2 Social Security Act (42 U.S.C. 1395l(f)(3)) is 

3 amended— 

4 (A) in subparagraph (A)— 

5 (i) in clause (i), by striking subclauses 

6 (I) and (II) and inserting the following: 

7 ‘‘(I) with respect to a rural health 

8 clinic that had a per visit payment amount 

9 established for services furnished in 

10 2020— 

11 ‘‘(aa) the per visit payment 

12 amount applicable to such rural 

13 health clinic for rural health clinic 

14 services furnished in 2020, increased 

15 by the percentage increase in the MEI 

16 applicable to primary care services 

17 furnished as of the first day of 2021; 

18 or 

19 ‘‘(bb) the limit described in para20 graph (2)(A); and 

21 ‘‘(II) with respect to a rural health 

22 clinic that did not have a per visit payment 

23 amount established for services furnished 

24 in 2020— 


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1 ‘‘(aa) the per visit payment 

2 amount applicable to such rural 

3 health clinic for rural health clinic 

4 services furnished in 2021; or 

5 ‘‘(bb) the limit described in para6 graph (2)(A); and’’; and 

7 (ii) in clause (ii)(I), by striking 

8 ‘‘under clause (i)(I)’’ and inserting ‘‘under 

9 subclause (I) or (II) of clause (i), as appli10 cable,’’; and 

11 (B) in subparagraph (B)— 

12 (i) in the matter preceding clause (i), 

13 by striking ‘‘2019, was’’ and inserting 

14 ‘‘2020’’; 

15 (ii) in clause (i), by inserting ‘‘was’’ 

16 after ‘‘(i)’’; and 

17 (iii) by striking clause (ii) and insert18 ing the following: 

19 ‘‘(ii)(I) was enrolled under section 1866(j) 

20 (including temporary enrollment during the 

21 emergency period described in section 

22 1135(g)(1)(B) for such period); or 

23 ‘‘(II) submitted an application for enroll24 ment under section 1866(j) (or requested such 

25 a temporary enrollment for such period) that 


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1 was received not later than December 31, 

2 2020.’’. 

3 (2) EFFECTIVE DATE.—The amendments made 

4 by this subsection shall take effect as if included in 

5 the enactment of the Consolidated Appropriations 

6 Act, 2021 (Public Law 116–260). 

7 (c) ELIGIBILITY FOR REEMPLOYMENT SERVICES.— 

8 Section 306(a) of the Social Security Act (42 U.S.C. 

9 506(a)) is amended— 

10 (1) by striking ‘‘individuals referred to reem11 ployment services as described in section 303(j)’’ 

12 and inserting ‘‘claimants for unemployment com13 pensation, including claimants referred to reemploy14 ment services as described in section 303(j),’’; and 

15 (2) by striking ‘‘such individuals’’ and inserting 

16 ‘‘such claimants’’. 

17 (d) ADDITIONAL AMOUNT FOR CERTAIN HOSPITALS

18 WITH HIGH DISPROPORATIONATE SHARE.—Effective as 

19 if included in the enactment of section 203(a) of title II 

20 of division CC of Public Law 116–260, subsection (g) of 

21 section 1923 of the Social Security Act (42 U.S.C. 1396r– 

22 4) amended by such section 203(a) is amended by adding 

23 at the end the following new paragraph: 

24 ‘‘(3) ADDITIONAL AMOUNT FOR CERTAIN HOS25 PITALS WITH HIGH DISPROPORATIONATE SHARE.— 


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1 ‘‘(A) IN GENERAL.—In the case of a hos2 pital with high disproportionate share (as de3 fined in subparagraph (B)) located in a State 

4 referenced in subsection (e) of section 4721 of 

5 the Balanced Budget Act of 1997, a payment 

6 adjustment during a State fiscal year shall be 

7 considered consistent with subsection (c) if the 

8 payment adjustment does not exceed 175 per9 cent of the costs of furnishing hospital services 

10 during the year, but only if the Governor of the 

11 State certifies to the satisfaction of the Sec12 retary that the hospital’s applicable minimum 

13 amount is used for health services during the 

14 year. In determining the amount that is used 

15 for such services during a year, there shall be 

16 excluded any amounts received under the Public 

17 Health Service Act, title V, title XVIII, or from 

18 third party payors (not including the State plan 

19 under this title) that are used for providing 

20 such services during the year. 

21 ‘‘(B) HOSPITAL WITH HIGH

22 DISPROPORATIONATE SHARE DEFINED.—In 

23 subparagraph (A), a hospital is a ‘hospital with 

24 high disproportionate share’ if— 


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1 ‘‘(i) the hospital is owned or operated 

2 by the State (or by an instrumentality or 

3 a unit of government within the State); 

4 and 

5 ‘‘(ii) the hospital— 

6 ‘‘(I) meets the requirement de7 scribed in subparagraphs (A) or (B) 

8 of subsection (b)(1); or 

9 ‘‘(II) has the largest number of 

10 inpatient days attributable to individ11 uals entitled to benefits under the 

12 State plan of any hospital in such 

13 State for the previous fiscal year. 

14 ‘‘(C) APPLICABLE MINIMUM AMOUNT DE15 FINED.—In subparagraph (A), the ‘applicable 

16 minimum amount’ for a hospital for a fiscal 

17 year is equal to the difference between the 

18 amount of the hospital’s payment adjustment 

19 for the fiscal year and the costs to the hospital 

20 of furnishing hospital services described in 

21 paragraph (1)(A) during the fiscal year.’’. 

Passed the House of Representatives March 19, 

2021. 

Attest: CHERYL L. JOHNSON, 

Clerk. 


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Calendar No. 31 

117TH CONGRESS 

1ST SESSION H. R. 1868 

AN ACT 

To prevent across-the-board direct spending cuts, 

and for other purposes. 

MARCH 25, 2021 

Read the second time and placed on the calendar 


pamtmann on DSKBC07HB2PROD with BILLS