I 

116TH CONGRESS 

2D SESSION H. R. 8826 

To amend the IMPACT Act of 2014 to reset data collection and the development of a payment system technical prototype for post-acute care providers under the Medicare program to take into account the effects 

of COVID–19. 

IN THE HOUSE OF REPRESENTATIVES 

NOVEMBER 30, 2020 

Ms. SEWELL of Alabama (for herself, Mr. PASCRELL, and Mr. SUOZZI) introduced the following bill; which was referred to the Committee on Ways 

and Means, and in addition to the Committee on Energy and Commerce, 

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 the IMPACT Act of 2014 to reset data collection 

and the development of a payment system technical prototype for post-acute care providers under the Medicare 

program to take into account the effects of COVID– 

19. 

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 Resetting the Impact 

5 Act (TRIA) of 2020’’. 


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1 SEC. 2. RESETTING DATA COLLECTION AND THE DEVELOP2 MENT OF A PAYMENT SYSTEM TECHNICAL 

3 PROTOTYPE FOR POST-ACUTE CARE PRO4 VIDERS UNDER THE MEDICARE PROGRAM TO 

5 TAKE INTO ACCOUNT THE EFFECTS OF 

6 COVID–19. 

7 (a) IN GENERAL.—Section 2(b)(2) of the IMPACT 

8 Act of 2014 (Public Law 113–185) is amended— 

9 (1) in subparagraph (A)— 

10 (A) in the matter preceding clause (i), by 

11 striking ‘‘Not later than’’ and all that follows 

12 through ‘‘subsection (a),’’ and inserting ‘‘Not 

13 earlier than the date that is 2 years after the 

14 later of January 1, 2021, and the date by which 

15 the Secretary of Health and Human Services 

16 has collected at least 12 specified calendar 

17 quarters (as defined in subparagraph (C)) of 

18 standardized patient assessment data under 

19 subsection (b) of section 1899B of the Social 

20 Security Act, of data on quality measures under 

21 subsection (c) of such section, and of resource 

22 use and claims data under subsection (d) of 

23 such section from each of the PAC payment 

24 systems (as defined in subsection (a)(2)(D) of 

25 such section),’’; 

26 (B) in clause (i)— 


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1 (i) in subclause (III), by striking 

2 ‘‘and’’ at the end; 

3 (ii) in subclause (IV), by striking the 

4 period at the end and inserting a semi5 colon; and 

6 (iii) by adding at the end the fol7 lowing new subclauses: 

8 ‘‘(V) ensure that payments under 

9 the system would be sufficient to sup10 port the resources needed to provide 

11 quality patient care, including with re12 spect to items and services needed by 

13 the highest-acuity patients, including 

14 those with or recovering from medi15 cally-complex occurrences of COVID– 

16 19 and those with major or extreme 

17 severity of illness (as defined by the 

18 All Patients Refined Diagnosis Re19 lated Groups (APR–DRG) patient 

20 classification system), to ensure that 

21 such individuals retain access to care 

22 in relevant PAC provider settings; 

23 ‘‘(VI) take into account, to the 

24 greatest extent possible, the most re25 cently available PAC provider data deVerDate Sep 11 2014 00:33 Dec 04, 2020 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H8826.IH H8826

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1 scribed in any of subsections (b) 

2 through (d) of section 1899B of such 

3 Act; and 

4 ‘‘(VII) taking into account the 

5 impact assessment described in clause 

6 (vi), ensure that payment and access 

7 to care under the system would be 

8 adequate for each PAC provider set9 ting during a pandemic of similar 

10 scope and impact as that of COVID– 

11 19.’’; 

12 (C) in clause (iv), by striking ‘‘and’’ at the 

13 end; 

14 (D) in clause (v) by striking the period at 

15 the end and inserting ‘‘; and’’; and 

16 (E) by adding at the end the following new 

17 clause: 

18 ‘‘(vi) an impact assessment that— 

19 ‘‘(I) evaluates the capabilities 

20 and limitations of each PAC provider 

21 setting with respect to quality of care, 

22 patient safety, and containment of in23 fectious disease during the emergency 

24 period described in section 


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1 1135(g)(1)(B) of the Social Security 

2 Act; 

3 ‘‘(II) reviews and compares the 

4 relative capabilities of each PAC pro5 vider setting in meeting the clinical 

6 needs of individuals with COVID–19 

7 and the needs of referring acute-care 

8 hospitals, including a specific assess9 ment of such capabilities with respect 

10 to individuals with high-acuity 

11 COVID–19 cases, including such indi12 viduals requiring ventilator services 

13 and such individuals with major and 

14 extreme levels of severity of illness (as 

15 defined under the APR–DRGs patient 

16 classification system) and individuals 

17 requiring intensive medical rehabilita18 tion, therapy, and rehabilitation nurs19 ing care; 

20 ‘‘(III) evaluates the relative abili21 ties of each PAC provider setting to 

22 prevent, mitigate, and contain the 

23 intra-facility and community spread of 

24 COVID–19; 


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1 ‘‘(IV) specifies the types of ad2 justments in clinical capacity, infec3 tion control protocols, isolation space, 

4 physical plant, personnel, access to 

5 personal protective equipment, and 

6 other changes by each PAC provider 

7 setting needed to safely mitigate the 

8 spread of future pandemics that are 

9 similar in scope and impact to that of 

10 COVID–19; and 

11 ‘‘(V) is made publicly available at 

12 least 6 months before the date on 

13 which the report under this subpara14 graph is submitted to Congress.’’; and 

15 (2) by adding at the end the following new sub16 paragraph: 

17 ‘‘(C) SPECIFIED CALENDAR QUARTER DE18 FINED.—For purposes of subparagraph (A), the 

19 term ‘specified calendar quarter’ means a cal20 endar quarter— 

21 ‘‘(i) beginning after the prospective 

22 payment system for home health agencies 

23 under section 1895 of the Social Security 

24 Act has incorporated the Patient-Driven 


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1 Groupings Model (as described at 83 Fed. 

2 Reg. 56446 et seq.); 

3 ‘‘(ii) beginning after the prospective 

4 payment system for skilled nursing facili5 ties under section 1888(e) of such Act has 

6 incorporated the Patient-Driven Payment 

7 Model (as described in 83 Fed. Reg. 39162 

8 et seq.); and 

9 ‘‘(iii) no portion of which occurs dur10 ing a nationwide public health emergency 

11 declared by the Secretary pursuant to sec12 tion 319 of the Public Health Service Act 

13 with respect to which any waiver has been 

14 effectuated by the Secretary pursuant to 

15 section 1135 of the Social Security Act.’’. 

16 (b) EFFECTIVE DATE.—The amendments made by 

17 subsection (a) shall take effect as if included in the enact18 ment of the IMPACT Act of 2014 (Public Law 113–185). 

Æ 


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