I 

117TH CONGRESS 

1ST SESSION H. R. 1349 

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

of certain accelerated and advance payments to grants under parts A 

and B of the Medicare program. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 25, 2021 

Ms. KAPTUR (for herself, Mr. GIBBS, Mr. FITZPATRICK, Mr. BERGMAN, Mrs. 

BEATTY, Mr. GONZALEZ of Ohio, Mr. VAN DREW, Mr. KATKO, Mr. 

MORELLE, Mrs. HAYES, Mr. STIVERS, Mr. ALLRED, and Mr. RYAN) 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 the conversion of certain accelerated and advance 

payments to grants under parts A and B of the Medicare 

program. 

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 COVID-19 Hospital 

5 and Health Provider Loan Conversion Act of 2021’’. 


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1 SEC. 2. PROVIDING FOR THE CONVERSION OF CERTAIN AC2 CELERATED AND ADVANCE PAYMENTS TO 

3 GRANTS UNDER PARTS A AND B OF THE 

4 MEDICARE PROGRAM. 

5 (a) CONVERSION OF PAYMENTS.— 

6 (1) PART A.—Section 1815(f) of the Social Se7 curity Act (42 U.S.C. 1395g(f)) is amended— 

8 (A) in paragraph (2), by adding at the end 

9 the following new subparagraph: 

10 ‘‘(D) In the case of an accelerated payment 

11 made to a hospital under such program on or after 

12 the date of the enactment of the CARES Act and 

13 so made during the emergency period described in 

14 section 1135(g)(1)(B), the Secretary shall waive the 

15 requirement that such payment be repaid (or re16 couped) if the hospital meets the requirements de17 scribed in paragraph (5), except that such waiver 

18 shall not apply with respect to any amounts from 

19 such payment that were not used for health care re20 lated expenses or lost revenues that are attributable 

21 to coronavirus as of December 31, 2021, based on 

22 the attestation of the hospital. The hospital shall 

23 repay any such amounts to the Secretary not later 

24 than July 1, 2023. The interest rate for any such 

25 amount not so repaid as of such date shall be 2 per26 cent if the hospital demonstrates hardship.’’; 


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1 (B) in paragraph (3), by inserting ‘‘and 

2 paragraph (2)(D)’’ after ‘‘paragraph (2)(C)’’; 

3 and 

4 (C) by adding at the end the following new 

5 paragraph: 

6 ‘‘(5) For purposes of paragraph (2)(D), the require7 ments described in this paragraph are the following: 

8 ‘‘(A) The hospital did not use any portion of a 

9 payment described in such paragraph for compensa10 tion or benefits, including salary, bonuses, awards of 

11 stock, or other financial benefits, for an officer or 

12 employee described in section 4004(a)(2) of the 

13 CARES Act (Public Law 116–136). 

14 ‘‘(B) The hospital used at least 60 percent of 

15 such payment for employee compensation (other 

16 than an officer or employee described in subpara17 graph (A)) during the period beginning on January 

18 1, 2020, and ending on December 31, 2021. 

19 ‘‘(C) The hospital did not balance bill or sur20 prise bill any COVID–19 patient.’’. 

21 (2) PART B.— 

22 (A) IN GENERAL.—In carrying out the 

23 program described in section 421.214 of title 

24 42, Code of Federal Regulations (or a successor 

25 regulation), in the case of a payment made 


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1 under such program to an entity on or after the 

2 date of the enactment of the CARES Act (Pub3 lic Law 116–136) and so made during the 

4 emergency period described in section 

5 1135(g)(1)(B) of the Social Security Act (42 

6 U.S.C. 1320b–5(g)(1)(B)), the Secretary of 

7 Health and Human Services shall waive the re8 quirement that such payment be repaid (or re9 couped) if the entity meets the requirements de10 scribed in subparagraph (B), except that such 

11 waiver shall not apply with respect to any 

12 amounts from such payment that were not used 

13 for health care related expenses or lost revenues 

14 that are attributable to coronavirus as of De15 cember 31, 2021, based on the attestation of 

16 the entity. The entity shall repay any such 

17 amounts to the Secretary not later than July 1, 

18 2023. The interest rate for any such amount 

19 not so repaid as of such date shall be 2 percent 

20 if the entity demonstrates hardship. 

21 (B) REQUIREMENTS.—For purposes of 

22 subparagraph (A), the requirements described 

23 in this subparagraph are the following: 

24 (i) The entity did not use any portion 

25 of a payment described in such subparaVerDate Sep 11 2014 19:41 Apr 08, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1349.IH H1349

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1 graph for compensation or benefits, includ2 ing salary, bonuses, awards of stock, or 

3 other financial benefits, for an officer or 

4 employee described in section 4004(a)(2) 

5 of the CARES Act (Public Law 116–136). 

6 (ii) The entity used at least 60 per7 cent of such payment for employee com8 pensation (other than an officer or em9 ployee described in clause (i)) during the 

10 period beginning on January 1, 2020, and 

11 ending on June 30, 2021. 

12 (iii) The entity did not balance bill or 

13 surprise bill any COVID–19 patient. 

14 (b) ENSURING THE SOLVENCY OF MEDICARE TRUST

15 FUNDS.— 

16 (1) FEDERAL HOSPITAL INSURANCE TRUST

17 FUND.—Section 1817 of the Social Security Act (42 

18 U.S.C. 1395i) is amended by adding at the end the 

19 following new subsection: 

20 ‘‘(l) ACCELERATED PAYMENT PROGRAM TRANS21 FERS.— 

22 ‘‘(1) IN GENERAL.—There shall be transferred 

23 from the General Fund of the Treasury to the Trust 

24 Fund, periodically (as determined by the Managing 

25 Trustee), amounts such that the aggregate amount 


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1 so transferred under this paragraph equals the total 

2 amount of specified payments (as defined in para3 graph (2)) made under this part. 

4 ‘‘(2) SPECIFIED PAYMENT.—In this subsection, 

5 the term ‘specified payment’ means a payment that 

6 is made— 

7 ‘‘(A) under section 1815(e)(3); and 

8 ‘‘(B) during the emergency period de9 scribed in section 1135(g)(1)(B).’’. 

10 (2) FEDERAL SUPPLEMENTARY MEDICAL IN11 SURANCE TRUST FUND.—Section 1844(f) of the So12 cial Security Act (42 U.S.C. 1395w(f)) is amend13 ed— 

14 (A) by striking ‘‘(1) There shall be trans15 ferred’’ and inserting ‘‘There shall be trans16 ferred’’; 

17 (B) by striking ‘‘during the period begin18 ning on the first day of the emergency period 

19 described in section 1135(g)(1)(B) and ending 

20 on the date of the enactment of this para21 graph’’ and inserting ‘‘during the emergency 

22 period described in section 1135(g)(1)(B)’’; and 

23 (C) by striking paragraph (2). 

24 (c) INSURER REQUIREMENTS.—Subpart II of part A 

25 of title XXVII of the Public Health Service Act (42 U.S.C. 


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1 300gg–11 et seq.) is amended by adding at the end the 

2 following new section: 

3 ‘‘SEC. 2730. COVERAGE AND PAYMENT REQUIREMENTS FOR 

4 ITEMS AND SERVICES FURNISHED TO COVID– 

5 19 PATIENTS OUT-OF-NETWORK. 

6 ‘‘In the case of an item or service furnished by a 

7 health care provider to a COVID–19 patient who is an 

8 enrollee in a group health plan or group or individual 

9 health insurance coverage offered by a health insurance 

10 issuer, if such provider does not have in effect a contrac11 tual relationship for furnishing such item or service under 

12 such plan or coverage, the plan or issuer (as applicable)— 

13 ‘‘(1) shall pay to such provider the amount 

14 which would have been payable to such provider had 

15 such provider had in effect such a relationship for 

16 furnishing such item or service; and 

17 ‘‘(2) shall ensure that any applicable cost-shar18 ing requirement is the same requirement that would 

19 have applied had such item or service been furnished 

20 by a provider that had in effect such a relation21 ship.’’. 

22 (d) PUBLICATION.—The Secretary of Health and 

23 Human Services shall publish on a public website the fol24 lowing: 


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1 (1) A specification of each hospital to which a 

2 waiver described in section 1815(f)(2)(D) of the So3 cial Security Act (42 U.S.C. 1395g(f)(2)(D)) applies 

4 and each entity to which a waiver described in sub5 section (a)(2)(A) applies. 

6 (2) The amount to which such waivers apply 

7 with respect to each such hospital and entity. 

Æ 


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