II 

117TH CONGRESS 

1ST SESSION S. 918 

To offer financial support to health care providers, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 23, 2021 

Mr. BARRASSO (for himself and Mr. COTTON) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To offer financial support to health care providers, 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 ‘‘Protecting Seniors Ac5 cess to Health Care Act’’. 

6 SEC. 2. PROVIDER RELIEF FUND. 

7 (a) SUPPLEMENTAL APPROPRIATION.—There is ap8 propriated, out of any amounts in the Treasury not other9 wise appropriated, for an additional amount for ‘‘Public 

10 Health and Social Services Emergency Fund’’, 

11 $12,300,000,000, to remain available until expended, to 


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1 prevent, prepare for, and respond to coronavirus, domesti2 cally or internationally, which shall be for necessary ex3 penses to reimburse, through grants or other mechanisms, 

4 eligible health care providers for health care related ex5 penses or lost revenues that are attributable to 

6 coronavirus. 

7 (b) CONDITIONS.—The following conditions shall 

8 apply with respect to funds appropriated by subsection 

9 (a): 

10 (1) Such funds may not be used to reimburse 

11 expenses or losses that have been reimbursed from 

12 other sources or that other sources are obligated to 

13 reimburse. 

14 (2) Recipients of payments under this section 

15 shall submit reports and maintain documentation as 

16 the Secretary of Health and Human Services (re17 ferred to in this section as the ‘‘Secretary’’) deter18 mines are needed to ensure compliance with condi19 tions that are imposed by this subsection for such 

20 payments, and such reports and documentation shall 

21 be in such form, with such content, and in such time 

22 as the Secretary may prescribe for such purpose. 

23 (3) The Secretary shall, on a rolling basis, re24 view applications and make payments under this sec25 tion. 


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1 (4) Funds appropriated under this section shall 

2 be available for building or construction of tem3 porary structures, leasing of properties, medical sup4 plies and equipment including personal protective 

5 equipment and testing supplies, increased workforce 

6 and trainings, emergency operation centers, retro7 fitting facilities, and surge capacity. 

8 (5) Payments under this section shall be made 

9 in consideration of the most efficient payment sys10 tems practicable to provide emergency payment. 

11 (6) To be eligible for a payment under this sec12 tion, an eligible health care provider shall submit to 

13 the Secretary an application that includes a state14 ment justifying the need of the provider for the pay15 ment and the eligible health care provider shall have 

16 a valid tax identification number. 

17 (7) For any reimbursement by the Secretary 

18 from the Provider Relief Fund to an eligible health 

19 care provider that is a subsidiary of a parent organi20 zation, the parent organization may, allocate 

21 (through transfers or otherwise) all or any portion 

22 of such reimbursement among the subsidiary eligible 

23 health care providers of the parent organization, in24 cluding reimbursements referred to by the Secretary 

25 as ‘‘Targeted Distribution’’ payments, among subVerDate Sep 11 2014 01:06 Apr 13, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S918.IS S918

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1 sidiary eligible health care providers of the parent 

2 organization, except that responsibility for reporting 

3 the reallocated reimbursement shall remain with the 

4 original recipient of such reimbursement. 

5 (8) For any reimbursement from the Provider 

6 Relief Fund to an eligible health care provider for 

7 health care related expenses or lost revenues that 

8 are attributable to coronavirus (including reimburse9 ments made before the date of the enactment of this 

10 Act), such provider may calculate such lost revenues 

11 using the Frequently Asked Questions guidance re12 leased by the Department of Health and Human 

13 Services in June 2020, including the difference be14 tween such provider’s budgeted and actual revenue 

15 budget if such budget had been established and ap16 proved prior to March 27, 2020. 

17 (9) Not later than 3 years after final payments 

18 are made under this section, the Office of Inspector 

19 General of the Department of Health and Human 

20 Services shall transmit a final report on audit find21 ings with respect to this program to the Committee 

22 on Appropriations of the Senate and the Committee 

23 on Appropriations of the House of Representatives. 

24 (10) Nothing in this section limits the authority 

25 of the Inspector General or the Comptroller General 


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1 of the United States to conduct audits of interim 

2 payments at an earlier date. 

3 (11) Not later than 60 days after the date of 

4 enactment of this Act, the Secretary shall provide a 

5 report to the Committee on Appropriations of the 

6 Senate and the Committee on Appropriations of the 

7 House of Representatives on the obligation of funds, 

8 including obligations to such eligible health care pro9 viders, summarized by State of the payment receipt. 

10 Such report shall be updated and submitted to such 

11 Committees every 60 days until funds are expended. 

12 (c) APPLICATION OF REQUIREMENTS, RULES, AND

13 PROCEDURES.—The Secretary shall apply any require14 ments, rules, or procedures as the Secretary determines 

15 appropriate for the efficient execution of this section. 

16 (d) APPLICATION OF PROVISIONS.—Amounts appro17 priated pursuant to this section and pursuant to title II 

18 of Public Law 117–2 shall be subject to the requirements 

19 contained in Public Law 116–260 for funds for programs 

20 authorized under sections 330 through 340 of the Public 

21 Health Service Act (42 U.S.C. 254b through 256). 

22 (e) DEFINITIONS.—For purposes of this section: 

23 (1) The term ‘‘eligible health care providers’’ 

24 means public entities, Medicare or Medicaid enrolled 

25 suppliers and providers, and such for-profit entities 


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1 and not-for-profit entities not otherwise described in 

2 this paragraph as the Secretary may specify, within 

3 the United States (including territories), that pro4 vide diagnoses, testing, or care for individuals with 

5 possible or actual cases of COVID–19. 

6 (2) The term ‘‘payment’’ means a pre-payment, 

7 prospective payment, or retrospective payment, as 

8 the Secretary determines appropriate. 

9 SEC. 3. RURAL HEALTH CLINIC PAYMENTS. 

10 (a) IN GENERAL.—Section 1833(f)(3) of the Social 

11 Security Act (42 U.S.C. 1395l(f)(3)) is amended— 

12 (1) in subparagraph (A)— 

13 (A) in clause (i), by striking subclauses (I) 

14 and (II) and inserting the following: 

15 ‘‘(I) with respect to a rural 

16 health clinic that had a per visit pay17 ment amount established for services 

18 furnished in 2020— 

19 ‘‘(aa) the per visit payment 

20 amount applicable to such rural 

21 health clinic for rural health clin22 ic services furnished in 2020, in23 creased by the percentage in24 crease in the MEI applicable to 


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1 primary care services furnished 

2 as of the first day of 2021; or 

3 ‘‘(bb) the limit described in 

4 paragraph (2)(A); and 

5 ‘‘(II) with respect to a rural 

6 health clinic that did not have a per 

7 visit payment amount established for 

8 services furnished in 2020— 

9 ‘‘(aa) the per visit payment 

10 amount applicable to such rural 

11 health clinic for rural health clin12 ic services furnished in 2021; or 

13 ‘‘(bb) the limit described in 

14 paragraph (2)(A); and’’; and 

15 (B) in clause (ii)(I), by striking ‘‘under 

16 clause (i)(I)’’ and inserting ‘‘under subclause 

17 (I) or (II) of clause (i), as applicable,’’; and 

18 (2) by striking subparagraph (B) and inserting 

19 the following: 

20 ‘‘(B) A rural health clinic described in this subpara21 graph is a rural health clinic that— 

22 ‘‘(i) as of December 31, 2020, is in a hospital 

23 with less than 50 beds and after such date such hos24 pital continues to have less than 50 beds (not taking 

25 into account any increase in the number of beds purVerDate Sep 11 2014 01:06 Apr 13, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S918.IS S918

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1 suant to a waiver under subsection (b)(1)(A) of sec2 tion 1135 during the emergency period described in 

3 subsection (g)(1)(B) of such section); and 

4 ‘‘(ii)(I) as of December 31, 2020, was enrolled 

5 under section 1866(j) (including temporary enroll6 ment during such emergency period for such emer7 gency period); or 

8 ‘‘(II) submitted an application to enroll under 

9 section 1866(j) (or a request for such a temporary 

10 enrollment for such emergency period) that was re11 ceived not later than December 31, 2020.’’. 

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

13 this section shall take effect as if included in the enact14 ment of the Consolidated Appropriations Act, 2021 (Pub15 lic Law 116–260). 

16 SEC. 4. RESCISSION OF APPROPRIATIONS FOR THE 

17 CORONAVIRUS STATE FISCAL RECOVERY 

18 FUND. 

19 (a) RESCISSION.—Of the unobligated balances of 

20 amounts appropriated under section 602(a)(1) of the So21 cial Security Act (as added by section 9901 of the Amer22 ican Rescue Plan Act of 2021 (Public Law 117–2)) on 

23 the date of enactment of this Act, $12,300,000,000 is re24 scinded. 


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1 (b) CONFORMING AMENDMENTS.—Section 602 of the 

2 Social Security Act (as added by section 9901 of the 

3 American Rescue Plan Act of 2021 (Public Law 117–2)) 

4 is amended— 

5 (1) in subsection (a)(1), by striking 

6 ‘‘$219,800,000,000’’ and inserting 

7 ‘‘$207,500,000,000’’; and 

8 (2) in subsection (b)(3)(A), by striking 

9 ‘‘$195,300,000,000’’ and inserting 

10 ‘‘$183,000,000,000’’. 

11 SEC. 5. INDIVIDUALS NOT LAWFULLY PRESENT IN UNITED 

12 STATES PRECLUDED FROM 2021 RECOVERY 

13 REBATES. 

14 (a) IN GENERAL.—Section 6428B(c) of the Internal 

15 Revenue Code of 1986, as added by the American Rescue 

16 Plan Act of 2021, is amended by striking ‘‘and’’ at the 

17 end of paragraph (2), by redesignating paragraph (3) as 

18 paragraph (4), and by inserting after paragraph (2) the 

19 following new paragraph: 

20 ‘‘(3) any individual who was not lawfully 

21 present in the United States as of the date of the 

22 enactment of the American Rescue Plan Act of 

23 2021, and’’. 

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

25 this section shall take effect as if included in the enactVerDate Sep 11 2014 01:06 Apr 13, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S918.IS S918

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1 ment of section 9601 of the American Rescue Plan Act 

2 of 2021. 

3 SEC. 6. INCARCERATED INDIVIDUALS PRECLUDED FROM 

4 2021 RECOVERY REBATES. 

5 (a) IN GENERAL.—Section 6428B(c) of the Internal 

6 Revenue Code of 1986, as added by the American Rescue 

7 Plan Act of 2021 and amended by the preceding provi8 sions of this Act, is amended by striking ‘‘and’’ at the 

9 end of paragraph (3), by redesignating paragraph (4) as 

10 paragraph (5), and by inserting after paragraph (3) the 

11 following new paragraph: 

12 ‘‘(4) any individual who was incarcerated on the 

13 date of the enactment of the American Rescue Plan 

14 Act of 2021, and’’. 

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

16 this section shall take effect as if included in the enact17 ment of section 9601 of the American Rescue Plan Act 

18 of 2021. 

19 SEC. 7. INDIVIDUALS NOT LAWFULLY PRESENT IN UNITED 

20 STATES PRECLUDED FROM RECEIVING 

21 COBRA CONTINUATION COVERAGE. 

22 (a) IN GENERAL.—Section 9501(a)(3) of the Amer23 ican Rescue Plan Act of 2021 (Public Law 117–2) is 

24 amended— 


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1 (1) in subparagraph (A), by striking at the end 

2 ‘‘and’’; 

3 (2) in subparagraph (B), by striking the period 

4 at the end and inserting ‘‘; and’’; and 

5 (3) by adding at the end the following new sub6 paragraph: 

7 ‘‘(C) is lawfully present in the United 

8 States as of the date of the enactment of this 

9 Act.’’. 

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

11 subsection (a) shall take effect as if included in the enact12 ment of section 9501 of the American Rescue Plan Act 

13 of 2021. 

Æ 


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