1071 
Trust Fund and the Federal Supplementary Trust Fund 
(in such portions as the Secretary determines appropriate) 
$100,000,000 for purposes of carrying out this section. 
(e) REPORT.—Not later than 3 years after the date of 
the enactment of this Act, the Inspector General of the De-
partment of Health and Human Services shall submit to 
Congress a report containing an analysis of amounts paid 
pursuant to subsection (a)(1) compared to amounts paid 
to the Secretary pursuant to subsection (c). 
(f) IMPLEMENTATION.—Notwithstanding any other 
provision of law, the Secretary may implement the provi-
sions of this section by program instruction or otherwise. 
SEC. 202. ENSURING COMMUNICATIONS ACCESSIBILITY 
FOR RESIDENTS OF SKILLED NURSING FA-
CILITIES DURING THE COVID–19 EMERGENCY 
PERIOD. 
(a) IN GENERAL.—Section 1819(c)(3) of the Social Se-
curity Act (42 U.S.C. 1395i–3(c)(3)) is amended— 
(1) in subparagraph (D), by striking ‘‘and’’ at 
the end; 
(2) in subparagraph (E), by striking the period 
and inserting ‘‘; and’’; and 
(3) by adding at the end the following new sub-
paragraph:
1072 
‘‘(F) provide for reasonable access to the use 
of a telephone, including TTY and TDD services 
(as defined for purposes of section 483.10 of title 
42, Code of Federal Regulations (or a successor 
regulation)), and the internet (to the extent 
available to the facility) and inform each such 
resident (or a representative of such resident) of 
such access and any changes in policies or proce-
dures of such facility relating to limitations on 
external visitors.’’. 
(b) COVID–19 PROVISIONS.— 
(1) GUIDANCE.—Not later than 15 days after the 
date of the enactment of this Act, the Secretary of 
Health and Human Service shall issue guidance on 
steps skilled nursing facilities may take to ensure 
residents have access to televisitation during the emer-
gency period defined in section 1135(g)(1)(B) of the 
Social Security Act (42 U.S.C. 1320b–5(g)(1)(B)). 
Such guidance shall include information on how such 
facilities will notify residents of such facilities, rep-
resentatives of such residents, and relatives of such 
residents of the rights of such residents to such tele-
visitation, and ensure timely and equitable access to 
such televisitation.
1073 
(2) REVIEW OF FACILITIES.—The Secretary of 
Health and Human Services shall take such steps as 
determined appropriate by the Secretary to ensure 
that residents of skilled nursing facilities and rel-
atives of such residents are made aware of the access 
rights described in section 1819(c)(3)(F) of the Social 
Security Act (42 U.S.C. 1395i–3(c)(3)(F)). 
SEC. 203. MEDICARE HOSPITAL INPATIENT PROSPECTIVE 
PAYMENT SYSTEM OUTLIER PAYMENTS FOR 
COVID–19 PATIENTS DURING CERTAIN EMER-
GENCY PERIOD. 
(a) IN GENERAL.—Section 1886(d)(5)(A) of the Social 
Security Act (42 U.S.C. 1395ww(d)(5)(A)) is amended— 
(1) in clause (ii), by striking ‘‘For cases’’ and 
inserting ‘‘Subject to clause (vii), for cases’’; 
(2) in clause (iii), by striking ‘‘The amount’’ 
and inserting ‘‘Subject to clause (vii), the amount’’; 
(3) in clause (iv), by striking ‘‘The total 
amount’’ and inserting ‘‘Subject to clause (vii), the 
total amount’’; and 
(4) by adding at the end the following new 
clause: 
‘‘(vii) For discharges that have a primary or sec-
ondary diagnosis of COVID–19 and that occur during the 
period beginning on the date of the enactment of this clause
1074 
and ending on the sooner of January 31, 2021, or the last 
day of the emergency period described in section 
1135(g)(1)(B), the amount of any additional payment 
under clause (ii) for a subsection (d) hospital for such a 
discharge shall be determined as if— 
‘‘(I) clause (ii) was amended by striking ‘plus a 
fixed dollar amount determined by the Secretary’; 
‘‘(II) the reference in clause (iii) to ‘approximate 
the marginal cost of care beyond the cutoff point ap-
plicable under clause (i) or (ii)’ were a reference to 
‘approximate the marginal cost of care beyond the 
cutoff point applicable under clause (i), or, in the 
case of an additional payment requested under clause 
(ii), be equal to 100 percent of the amount by which 
the costs of the discharge for which such additional 
payment is so requested exceed the applicable DRG 
prospective payment rate’; and 
‘‘(III) clause (iv) does not apply.’’. 
(b) EXCLUSION
FROM
REDUCTION
IN
AVERAGE 
STANDARDIZED AMOUNTS PAYABLE TO HOSPITALS LO-
CATED IN CERTAIN AREAS.—Section 1886(d)(3)(B) of the 
Social Security Act (42 U.S.C. 1395ww(d)(3)(B)) is 
amended by inserting before the period the following: ‘‘, 
other than additional payments described in clause (vii) of 
such paragraph’’.
1075 
(c) IMPLEMENTATION.—Notwithstanding any other 
provision of law, the Secretary of Health and Human Serv-
ices may implement the amendments made by this section 
by program instruction or otherwise. 
SEC. 204. COVERAGE OF TREATMENTS FOR COVID–19 AT NO 
COST SHARING UNDER THE MEDICARE AD-
VANTAGE PROGRAM. 
(a) IN GENERAL.—Section 1852(a)(1)(B) of the Social 
Security Act (42 U.S.C. 1395w–22(a)(1)(B)) is amended by 
adding at the end the following new clause: 
‘‘(vii) SPECIAL COVERAGE RULES FOR 
SPECIFIED
COVID–19
TREATMENT
SERV-
ICES.—Notwithstanding clause (i), in the 
case of a specified COVID–19 treatment 
service (as defined in section 201(b) of the 
Investing in America’s Health Care During 
the COVID–19 Pandemic Act) that is fur-
nished during a plan year occurring during 
any portion of the emergency period defined 
in section 1135(g)(1)(B) beginning on or 
after the date of the enactment of this 
clause, a Medicare Advantage plan may 
not, with respect to such service, impose—
1076 
‘‘(I) any cost-sharing requirement 
(including a deductible, copayment, or 
coinsurance requirement); and 
‘‘(II) in the case such service is a 
critical specified COVID–19 treatment 
service (including ventilator services 
and intensive care unit services), any 
prior authorization or other utilization 
management requirement. 
A Medicare Advantage plan may not take 
the application of this clause into account 
for purposes of a bid amount submitted by 
such plan under section 1854(a)(6).’’. 
(b) IMPLEMENTATION.—Notwithstanding any other 
provision of law, the Secretary of Health and Human Serv-
ices may implement the amendments made by this section 
by program instruction or otherwise. 
SEC. 205. REQUIRING COVERAGE UNDER MEDICARE PDPS 
AND MA–PD PLANS, WITHOUT THE IMPOSI-
TION OF COST SHARING OR UTILIZATION 
MANAGEMENT REQUIREMENTS, OF DRUGS IN-
TENDED TO TREAT COVID–19 DURING CER-
TAIN EMERGENCIES. 
(a) COVERAGE REQUIREMENT.—
1077 
(1) IN GENERAL.—Section 1860D–4(b)(3) of the 
Social Security Act (42 U.S.C. 1395w–104(b)(3)) is 
amended by adding at the end the following new sub-
paragraph: 
‘‘(I) REQUIRED INCLUSION OF DRUGS IN-
TENDED TO TREAT COVID–19.— 
‘‘(i) IN
GENERAL.—Notwithstanding 
any other provision of law, a PDP sponsor 
offering a prescription drug plan shall, with 
respect to a plan year, any portion of which 
occurs during the period described in clause 
(ii), be required to— 
‘‘(I) include in any formulary— 
‘‘(aa) all covered part D 
drugs with a medically accepted 
indication (as defined in section 
1860D–2(e)(4)) to treat COVID– 
19 that are marketed in the 
United States; and 
‘‘(bb) all drugs authorized 
under section 564 or 564A of the 
Federal Food, Drug, and Cosmetic 
Act to treat COVID–19; and 
‘‘(II) not impose any prior au-
thorization or other utilization man-
1078 
agement requirement with respect to 
such drugs described in item (aa) or 
(bb) of subclause (I) (other than such a 
requirement that limits the quantity of 
drugs due to safety). 
‘‘(ii) PERIOD
DESCRIBED.—For pur-
poses of clause (i), the period described in 
this clause is the period during which there 
exists the public health emergency declared 
by the Secretary pursuant to section 319 of 
the Public Health Service Act on January 
31, 2020, entitled ‘Determination that a 
Public Health Emergency Exists Nation-
wide as the Result of the 2019 Novel 
Coronavirus’ (including any renewal of 
such declaration pursuant to such sec-
tion).’’. 
(b) ELIMINATION OF COST SHARING.— 
(1) ELIMINATION OF COST-SHARING FOR DRUGS 
INTENDED TO TREAT COVID–19 UNDER STANDARD AND 
ALTERNATIVE PRESCRIPTION DRUG COVERAGE.—Sec-
tion 1860D–2 of the Social Security Act (42 U.S.C. 
1395w–102) is amended— 
(A) in subsection (b)—
1079 
(i) in paragraph (1)(A), by striking 
‘‘The coverage’’ and inserting ‘‘Subject to 
paragraph (8), the coverage’’; 
(ii) in paragraph (2)— 
(I) in subparagraph (A), by in-
serting after ‘‘Subject to subparagraphs 
(C) and (D)’’ the following: ‘‘and para-
graph (8)’’; 
(II) in subparagraph (C)(i), by 
striking ‘‘paragraph (4)’’ and inserting 
‘‘paragraphs (4) and (8)’’; and 
(III) in subparagraph (D)(i), by 
striking ‘‘paragraph (4)’’ and inserting 
‘‘paragraphs (4) and (8)’’; 
(iii) in paragraph (4)(A)(i), by strik-
ing ‘‘The coverage’’ and inserting ‘‘Subject 
to paragraph (8), the coverage’’; and 
(iv) by adding at the end the following 
new paragraph: 
‘‘(8) ELIMINATION OF COST-SHARING FOR DRUGS 
INTENDED TO TREAT COVID–19.—The coverage does 
not impose any deductible, copayment, coinsurance, 
or other cost-sharing requirement for drugs described 
in section 1860D–4(b)(3)(I)(i)(I) with respect to a 
plan year, any portion of which occurs during the pe-
1080 
riod during which there exists the public health emer-
gency declared by the Secretary pursuant to section 
319 of the Public Health Service Act on January 31, 
2020, entitled ‘Determination that a Public Health 
Emergency Exists Nationwide as the Result of the 
2019 Novel Coronavirus’ (including any renewal of 
such declaration pursuant to such section).’’; and 
(B) in subsection (c), by adding at the end 
the following new paragraph: 
‘‘(4) SAME ELIMINATION OF COST-SHARING FOR 
DRUGS INTENDED TO TREAT COVID–19.—The coverage 
is in accordance with subsection (b)(8).’’. 
(2) ELIMINATION OF COST-SHARING FOR DRUGS 
INTENDED TO TREAT COVID–19 DISPENSED TO INDI-
VIDUALS
WHO
ARE
SUBSIDY
ELIGIBLE
INDIVID-
UALS.—Section 1860D–14(a) of the Social Security 
Act (42 U.S.C. 1395w–114(a)) is amended— 
(A) in paragraph (1)— 
(i) in subparagraph (D)— 
(I) in clause (ii), by striking ‘‘In 
the case of’’ and inserting ‘‘Subject to 
subparagraph (F), in the case of’’; and 
(II) in clause (iii), by striking 
‘‘In the case of’’ and inserting ‘‘Subject
1081 
to subparagraph (F), in the case of’’; 
and 
(ii) by adding at the end the following 
new subparagraph: 
‘‘(F) ELIMINATION OF COST-SHARING FOR 
DRUGS
INTENDED
TO
TREAT
COVID–19.—Cov-
erage that is in accordance with section 1860D– 
2(b)(8).’’; and 
(B) in paragraph (2)— 
(i) in subparagraph (B), by striking 
‘‘A reduction’’ and inserting ‘‘Subject to 
subparagraph (F), a reduction’’; 
(ii) in subparagraph (D), by striking 
‘‘The substitution’’ and inserting ‘‘Subject 
to subparagraph (F), the substitution’’; 
(iii) in subparagraph (E), by inserting 
after ‘‘Subject to’’ the following: ‘‘subpara-
graph (F) and’’; and 
(iv) by adding at the end the following 
new subparagraph: 
‘‘(F) ELIMINATION OF COST-SHARING FOR 
DRUGS
INTENDED
TO
TREAT
COVID–19.—Cov-
erage that is in accordance with section 1860D– 
2(b)(8).’’.
1082 
(c) IMPLEMENTATION.—Notwithstanding any other 
provision of law, the Secretary of Health and Human Serv-
ices may implement the amendments made by this section 
by program instruction or otherwise. 
SEC. 206. MEDICARE SPECIAL ENROLLMENT PERIOD FOR 
INDIVIDUALS RESIDING IN COVID–19 EMER-
GENCY AREAS. 
(a) IN GENERAL.—Section 1837(i) of the Social Secu-
rity Act (42 U.S.C. 1395p(i)) is amended by adding at the 
end the following new paragraph: 
‘‘(5)(A) In the case of an individual who— 
‘‘(i) is eligible under section 1836 to enroll 
in the medical insurance program established by 
this part, 
‘‘(ii) did not enroll (or elected not to be 
deemed enrolled) under this section during an 
enrollment period, and 
‘‘(iii) during the emergency period (as de-
scribed in section 1135(g)(1)(B)), resided in an 
emergency area (as described in such section), 
there shall be a special enrollment period de-
scribed in subparagraph (B). 
‘‘(B) The special enrollment period referred 
to in subparagraph (A) is the period that begins 
not later than December 1, 2020, and ends on
1084 
pital Insurance Trust Fund (as described in section 1817 
of the Social Security Act (42 U.S.C. 1395i)) and the Fed-
eral Supplementary Medical Insurance Trust Fund (as de-
scribed in section 1841 of such Act (42 U.S.C. 1395t)), in 
such proportions as determined appropriate by the Sec-
retary, 
to 
the 
Social 
Security 
Administration, 
of 
$30,000,000, to remain available until expended, for pur-
poses of carrying out the amendments made by this section. 
(d) IMPLEMENTATION.—Notwithstanding any other 
provision of law, the Secretary of Health and Human Serv-
ices may implement the amendments made by this section 
by program instruction or otherwise. 
SEC. 207. COVID–19 SKILLED NURSING FACILITY PAYMENT 
INCENTIVE PROGRAM. 
(a) IN GENERAL.—Section 1819 of the Social Security 
Act (42 U.S.C. 1395i–3) is amended by adding at the end 
the following new subsection: 
‘‘(k) COVID–19 DESIGNATION PROGRAM.— 
‘‘(1) IN GENERAL.—Not later than 2 weeks after 
the date of the enactment of this subsection, the Sec-
retary shall establish a program under which a skilled 
nursing facility that makes an election described in 
paragraph (2)(A) and meets the requirements de-
scribed in paragraph (2)(B) is designated (or a por-
tion of such facility is so designated) as a COVID–
1085 
19 treatment center and receives incentive payments 
under section 1888(e)(13). 
‘‘(2) DESIGNATION.— 
‘‘(A) IN GENERAL.—A skilled nursing facil-
ity may elect to be designated (or to have a por-
tion of such facility designated) as a COVID–19 
treatment center under the program established 
under paragraph (1) if the facility submits to 
the Secretary, at a time and in a manner speci-
fied by the Secretary, an application for such 
designation that contains such information as 
required by the Secretary and demonstrates that 
such facility meets the requirements described in 
subparagraph (B). 
‘‘(B) REQUIREMENTS.—The requirements 
described in this subparagraph with respect to a 
skilled nursing facility are the following: 
‘‘(i) The facility has a star rating with 
respect to staffing of 4 or 5 on the Nursing 
Home Compare website (as described in 
subsection (i)) and has maintained such a 
rating on such website during the 2-year pe-
riod ending on the date of the submission of 
the application described in subparagraph 
(A).
1086 
‘‘(ii) The facility has a star rating of 
4 or 5 with respect to health inspections on 
such website and has maintained such a 
rating on such website during such period. 
‘‘(iii) During such period, the Sec-
retary or a State has not found a deficiency 
with such facility relating to infection con-
trol that the Secretary or State determined 
immediately jeopardized the health or safety 
of the residents of such facility (as described 
in paragraph (1) or (2)(A) of subsection 
(h), as applicable). 
‘‘(iv) The facility provides care at such 
facility (or, in the case of an election made 
with respect to a portion of such facility, to 
provide care in such portion of such facil-
ity) only to eligible individuals. 
‘‘(v) The facility arranges for and 
transfers all residents of such facility (or 
such portion of such facility, as applicable) 
who are not eligible individuals to other 
skilled nursing facilities (or other portions 
of such facility, as applicable).
1087 
‘‘(vi) The facility complies with the no-
tice requirement described in paragraph 
(4). 
‘‘(vii) The facility meets the reporting 
requirement described in paragraph (5). 
‘‘(viii) Any other requirement deter-
mined appropriate by the Secretary. 
‘‘(3) DURATION OF DESIGNATION.— 
‘‘(A) IN
GENERAL.—A designation of a 
skilled nursing facility (or portion of such facil-
ity) as a COVID–19 treatment center shall begin 
on a date specified by the Secretary and end 
upon the earliest of the following: 
‘‘(i) The revocation of such designation 
under subparagraph (B). 
‘‘(ii) The submission of a notification 
by such facility to the Secretary that such 
facility elects to terminate such designation. 
‘‘(iii) The termination of the program 
(as specified in paragraph (6)). 
‘‘(B) REVOCATION.—The Secretary may re-
voke the designation of a skilled nursing facility 
(or portion of such facility) as a COVID–19 
treatment center if the Secretary determines that
1088 
the facility is no longer in compliance with a re-
quirement described in paragraph (2)(B). 
‘‘(4) RESIDENT
NOTICE
REQUIREMENT.—For 
purposes of paragraph (2)(B)(vi), the notice require-
ment described in this paragraph is that, not later 
than 72 hours before the date specified by the Sec-
retary under paragraph (3)(A) with respect to the 
designation of a skilled nursing facility (or portion of 
such facility) as a COVID–19 treatment center, the 
facility provides a notification to each resident of 
such facility (and to appropriate representatives or 
family members of each such resident, as specified by 
the Secretary) that contains the following: 
‘‘(A) Notice of such designation. 
‘‘(B) In the case such resident is not an eli-
gible individual (and, in the case such designa-
tion is made only with respect to a portion of 
such facility, resides in such portion of such fa-
cility)— 
‘‘(i) a specification of when and where 
such resident will be transferred (or moved 
within such facility); 
‘‘(ii) an explanation that, in lieu of 
such transfer or move, such resident may 
arrange for transfer to such other setting
1089 
(including a home) selected by the resident; 
and 
‘‘(iii) if such resident so arranges to be 
transferred to a home, information on 
Internet resources for caregivers who elect to 
care for such resident at home. 
‘‘(C) Contact information for the State 
long-term care ombudsman (established under 
section 307(a)(12) of the Older Americans Act of 
1965) for the applicable State. 
‘‘(5) REPORTING REQUIREMENT.— 
‘‘(A) IN GENERAL.—For purposes of para-
graph (2)(B)(vii), the reporting requirement de-
scribed in this paragraph is, with respect to a 
skilled nursing facility, that the facility reports 
to the Secretary, weekly and in such manner 
specified by the Secretary, the following (but 
only to the extent the information described in 
clauses (i) through (vii) is not otherwise reported 
to the Secretary weekly): 
‘‘(i) The number of COVID–19 related 
deaths at such facility. 
‘‘(ii) The number of discharges from 
such facility.
1090 
‘‘(iii) The number of admissions to 
such facility. 
‘‘(iv) The number of beds occupied and 
the number of beds available at such facil-
ity. 
‘‘(v) The number of residents on a ven-
tilator at such facility. 
‘‘(vi) The number of clinical and non-
clinical staff providing direct patient care 
at such facility. 
‘‘(vii) Such other information deter-
mined appropriate by the Secretary. 
‘‘(B) NONAPPLICATION OF PAPERWORK RE-
DUCTION ACT.—Chapter 35 of title 44, United 
States Code (commonly known as the ‘Paperwork 
Reduction Act’), shall not apply to the collection 
of information under this paragraph. 
‘‘(6) DEFINITION.—For purposes of this sub-
section, the term ‘eligible individual’ means an indi-
vidual who, during the 30-day period ending on the 
first day on which such individual is a resident of a 
COVID–19 treatment center (on or after the date such 
center is so designated), was furnished a test for 
COVID–19 that came back positive.
1091 
‘‘(7) TERMINATION.—The program established 
under paragraph (1) shall terminate upon the termi-
nation of the emergency period described in section 
1135(g)(1)(B). 
‘‘(8) PROHIBITION ON ADMINISTRATIVE AND JU-
DICIAL REVIEW.—There shall be no administrative or 
judicial review under section 1869, 1878, or otherwise 
of a designation of a skilled nursing facility (or por-
tion of such facility) as a COVID–19 treatment cen-
ter, or revocation of such a designation, under this 
subsection.’’. 
(b) PAYMENT INCENTIVE.—Section 1888(e) of the So-
cial Security Act (42 U.S.C. 1395yy(e)) is amended— 
(1) in paragraph (1), in the matter preceding 
subparagraph (A), by striking ‘‘and (12)’’ and insert-
ing ‘‘(12), and (13)’’; and 
(2) by adding at the end the following new para-
graph: 
‘‘(13) ADJUSTMENT FOR COVID–19 TREATMENT 
CENTERS.—In the case of a resident of a skilled nurs-
ing facility that has been designated as a COVID–19 
treatment center under section 1819(k) (or in the case 
of a resident who resides in a portion of such facility 
that has been so designated), if such resident is an eli-
gible individual (as defined in paragraph (5) of such
1092 
section), the per diem amount of payment for such 
resident otherwise applicable shall be increased by 20 
percent to reflect increased costs associated with such 
residents.’’. 
SEC. 208. FUNDING FOR STATE STRIKE TEAMS FOR RESI-
DENT AND EMPLOYEE SAFETY IN SKILLED 
NURSING FACILITIES AND NURSING FACILI-
TIES. 
(a) IN GENERAL.—Of the amounts made available 
under subsection (c), the Secretary of Health and Human 
Services (referred to in this section as the ‘‘Secretary’’) shall 
allocate such amounts among the States, in a manner that 
takes into account the percentage of skilled nursing facilities 
and nursing facilities in each State that have residents or 
employees who have been diagnosed with COVID–19, for 
purposes of establishing and implementing strike teams in 
accordance with subsection (b). 
(b) USE OF FUNDS.—A State that receives funds under 
this section shall use such funds to establish and implement 
a strike team that will be deployed to a skilled nursing facil-
ity or nursing facility in the State with diagnosed or sus-
pected cases of COVID–19 among residents or staff for the 
purposes of assisting with clinical care, infection control, 
or staffing.
1093 
(c) AUTHORIZATION OF APPROPRIATIONS.—For pur-
poses of carrying out this section, there is authorized to be 
appropriated $500,000,000. 
(d) DEFINITIONS.—In this section: 
(1) NURSING FACILITY.—The term ‘‘nursing fa-
cility’’ has the meaning given such term in section 
1919(a) of the Social Security Act (42 U.S.C. 
1396r(a)). 
(2) SKILLED
NURSING
FACILITY.—The term 
‘‘skilled nursing facility’’ has the meaning given such 
term in section 1819(a) of the Social Security Act (42 
U.S.C. 1395i–3(a)). 
SEC. 209. PROVIDING FOR INFECTION CONTROL SUPPORT 
TO SKILLED NURSING FACILITIES THROUGH 
CONTRACTS WITH QUALITY IMPROVEMENT 
ORGANIZATIONS. 
(a) IN GENERAL.—Section 1862(g) of the Social Secu-
rity Act (42 U.S.C. 1395y(g)) is amended— 
(1) by striking ‘‘The Secretary’’ and inserting 
‘‘(1) The Secretary’’; and 
(2) by adding at the end the following new para-
graph: 
‘‘(2)(A) The Secretary shall ensure that at least 1 con-
tract with a quality improvement organization described in 
paragraph (1) entered into on or after the date of the enact-
1094 
ment of this paragraph and before the end of the emergency 
period described in section 1135(g)(1)(B) (or in effect as 
of such date) includes the requirement that such organiza-
tion provide to skilled nursing facilities with cases of 
COVID–19 (or facilities attempting to prevent outbreaks of 
COVID–19) infection control support described in subpara-
graph (B) during such period. 
‘‘(B) For purposes of subparagraph (A), the infection 
control support described in this subparagraph is, with re-
spect to skilled nursing facilities described in such subpara-
graph, the development and dissemination to such facilities 
of protocols relating to the prevention or mitigation of 
COVID–19 at such facilities and the provision of training 
materials to such facilities relating to such prevention or 
mitigation.’’. 
(b) FUNDING.—The Secretary of Health and Human 
Services shall provide for the transfer from the Federal Sup-
plementary Medical Insurance Trust Fund (as described in 
section 1841 of the Social Security Act (42 U.S.C. 1395t)) 
and the Federal Hospital Insurance Trust Fund (as de-
scribed in section 1817 of such Act (42 U.S.C. 1395i)), in 
such proportions as determined appropriate by the Sec-
retary, to the Centers for Medicare & Medicaid Services 
Program Management Account, of $210,000,000, to remain 
available until expended, for purposes of entering into con-
1095 
tracts with quality improvement organizations under part 
B of title XI of such Act (42 U.S.C. 1320c et seq.). Of the 
amount transferred pursuant to the previous sentence, not 
less that $110,000,000 shall be used for purposes of entering 
into such a contract that includes the requirement described 
in section 1862(g)(2)(A) of such Act (as added by subsection 
(a)). 
SEC. 210. REQUIRING LONG TERM CARE FACILITIES TO RE-
PORT CERTAIN INFORMATION RELATING TO 
COVID–19 CASES AND DEATHS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (in this section referred to as the ‘‘Sec-
retary’’) shall, as soon as practicable, require that the infor-
mation described in paragraph (1) of section 483.80(g) of 
title 42, Code of Federal Regulations, or a successor regula-
tion, be reported by a facility (as defined for purposes of 
such section). 
(b) DEMOGRAPHIC
INFORMATION.—The Secretary 
shall post the following information with respect to skilled 
nursing facilities (as defined in section 1819(a) of the So-
cial Security Act (42 U.S.C. 1395i–3(a))) and nursing fa-
cilities (as defined in section 1919(a) of such Act (42 U.S.C. 
1396r(a))) on the Nursing Home Compare website (as de-
scribed in section 1819(i) of the Social Security Act (42
1096 
U.S.C. 1395i–3(i))), or a successor website, aggregated by 
State: 
(1) The age, race/ethnicity, and preferred lan-
guage of the residents of such skilled nursing facilities 
and nursing facilities with suspected or confirmed 
COVID–19 infections, including residents previously 
treated for COVID–19. 
(2) The age, race/ethnicity, and preferred lan-
guage relating to total deaths and COVID–19 deaths 
among residents of such skilled nursing facilities and 
nursing facilities. 
(c) CONFIDENTIALITY.—Any information reported 
under this section that is made available to the public shall 
be made so available in a manner that protects the identity 
of residents of skilled nursing facilities and nursing facili-
ties. 
(d) IMPLEMENTATION.—The Secretary may implement 
the provisions of this section be program instruction or oth-
erwise. 
SEC. 211. FLOOR ON THE MEDICARE AREA WAGE INDEX FOR 
HOSPITALS IN ALL-URBAN STATES. 
(a) IN GENERAL.—Section 1886(d)(3)(E) of the Social 
Security Act (42 U.S.C. 1395ww(d)(3)(E)) is amended— 
(1) in clause (i), in the first sentence, by striking 
‘‘or (iii)’’ and inserting ‘‘, (iii), or (iv)’’; and
1097 
(2) by adding at the end the following new 
clause: 
‘‘(iv) FLOOR
ON
AREA
WAGE
INDEX 
FOR HOSPITALS IN ALL-URBAN STATES.— 
‘‘(I) IN GENERAL.—For discharges 
occurring on or after October 1, 2021, 
the area wage index applicable under 
this subparagraph to any hospital in 
an all-urban State (as defined in sub-
clause (IV)) may not be less than the 
minimum area wage index for the fis-
cal year for hospitals in that State, as 
established under subclause (II). 
‘‘(II) 
MINIMUM
AREA
WAGE 
INDEX.—For purposes of subclause (I), 
the Secretary shall establish a min-
imum area wage index for a fiscal 
year for hospitals in each all-urban 
State using the methodology described 
in section 412.64(h)(4) of title 42, Code 
of Federal Regulations, as in effect for 
fiscal year 2018. 
‘‘(III) WAIVING
BUDGET
NEU-
TRALITY.—Pursuant to the fifth sen-
tence of clause (i), this subsection shall
1098 
not be applied in a budget neutral 
manner. 
‘‘(IV) 
ALL-URBAN
STATE
DE-
FINED.—In this clause, the term ‘all- 
urban State’ means a State in which 
there are no rural areas (as defined in 
paragraph (2)(D)) or a State in which 
there are no hospitals classified as 
rural under this section.’’. 
(b) WAIVING BUDGET NEUTRALITY.— 
(1) TECHNICAL
AMENDATORY
CORRECTION.— 
Section 10324(a)(2) of Public Law 111–148 is 
amended by striking ‘‘third sentence’’ and inserting 
‘‘fifth sentence’’. 
(2) WAIVER.—Section 1886(d)(3)(E)(i) of the 
Social Security Act (42 U.S.C. 1395ww(d)(3)(E)(i)) 
is amended, in the fifth sentence— 
(A) by striking ‘‘and the amendments’’ and 
inserting ‘‘, the amendments’’; and 
(B) by inserting ‘‘, and the amendments 
made by section 211 of the Investing in Amer-
ica’s Health Care During the COVID–19 Pan-
demic Act’’ after ‘‘Care Act’’.
1099 
SEC. 212. RELIEF FOR SMALL RURAL HOSPITALS FROM IN-
ACCURATE 
INSTRUCTIONS 
PROVIDED 
BY 
CERTAIN MEDICARE ADMINISTRATIVE CON-
TRACTORS. 
Section 1886(d)(5) of the Social Security Act (42 
U.S.C. 1395ww(d)(5)) is amended by adding at the end the 
following new subparagraph: 
‘‘(N)(i) Subject to clause (ii), in the case of a sole com-
munity hospital or a medicare-dependent, small rural hos-
pital with respect to which a medicare administrative con-
tractor initially determined and paid a volume decrease ad-
justment under subparagraph (D)(ii) or (G)(iii) for a speci-
fied cost reporting period, at the election of the hospital, 
the Secretary of Health and Human Services shall replace 
the volume decrease adjustment subsequently determined for 
that specified cost reporting period by the medicare admin-
istrative contractor with the volume decrease adjustment 
initially determined and paid by the medicare administra-
tive contractor for that specified cost reporting period. 
‘‘(ii)(I) Clause (i) shall not apply in the case of a sole 
community hospital or a medicare-dependent, small rural 
hospital for which the medicare administrative contractor 
determination of the volume decrease adjustment with re-
spect to a specified cost reporting period of the hospital is 
administratively final before the date that is three years 
before the date of the enactment of this section.
1100 
‘‘(II) For purposes of subclause (I), the date on which 
the medicare administrative contractor determination with 
respect to a volume decrease adjustment for a specified cost 
reporting period is administratively final is the latest of 
the following: 
‘‘(aa) The date of the contractor determination 
(as defined in section 405.1801 of title 42, Code of 
Federal Regulations). 
‘‘(bb) The date of the final outcome of any re-
opening of the medicare administrative contractor de-
termination under section 405.1885 of title 42, Code 
of Federal Regulations. 
‘‘(cc) The date of the final outcome of the final 
appeal filed by such hospital with respect to such vol-
ume decrease adjustment for such specified cost re-
porting period. 
‘‘(iii) For purposes of this subparagraph, the term 
‘specified cost reporting period’ means a cost reporting pe-
riod of a sole community hospital or a medicare-dependent, 
small rural hospital, as the case may be, that begins during 
a fiscal year before fiscal year 2018.’’.
1101 
SEC. 213. DEEMING CERTAIN HOSPITALS TO BE LOCATED 
IN AN URBAN AREA FOR PURPOSES OF PAY-
MENT FOR INPATIENT HOSPITAL SERVICES 
UNDER THE MEDICARE PROGRAM. 
Section 1886(d)(10) of the Social Security Act (42 
U.S.C. 1395ww(d)(10)) is amended by adding at the end 
the following new subparagraph: 
‘‘(G)(i) For purposes of payment under this subsection 
for discharges occurring during the 3-year period beginning 
on October 1, 2020, each hospital located in Albany, Sara-
toga, Schenectady, Montgomery, or Rensselaer County of 
New York shall be deemed to be located in the urban area 
of Hartford-East Hartford-Middletown, Connecticut (CBSA 
25540), notwithstanding any other reclassification or redes-
ignation that otherwise would have applied for purposes of 
the wage index under this paragraph or subparagraphs (B) 
or (E) of paragraph (8). 
‘‘(ii) Any deemed location of a hospital pursuant to 
clause (i) shall be treated as a decision of the Medicare Geo-
graphic Classification Review Board for purposes of para-
graph (8)(D).’’. 
SEC. 214. EFFECTIVE DATE OF MEDICARE COVERAGE OF 
COVID–19 VACCINES WITHOUT ANY COST- 
SHARING. 
Effective as if included in the enactment of the CARES 
Act (Public Law 116–136; 42 U.S.C. 13951 note), section
1102 
3713(d) of such Act is amended by inserting before the pe-
riod at the end the following: ‘‘or authorized for emergency 
use under section 564 of the Federal Food, Drug, and Cos-
metic Act (21 U.S.C. 360bbb–3)’’. 
TITLE III—PRIVATE INSURANCE 
PROVISIONS 
SEC. 301. SPECIAL ENROLLMENT PERIOD THROUGH EX-
CHANGES. 
(a) SPECIAL ENROLLMENT PERIOD THROUGH EX-
CHANGES.—Section 1311(c) of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18031(c)) is amended— 
(1) in paragraph (6)— 
(A) in subparagraph (C), by striking at the 
end ‘‘and’’; 
(B) in subparagraph (D), by striking at the 
end the period and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(E) subject to subparagraph (B) of para-
graph (8), the special enrollment period de-
scribed in subparagraph (A) of such para-
graph.’’; and 
(2) by adding at the end the following new para-
graph:
1103 
‘‘(8) SPECIAL ENROLLMENT PERIOD FOR CER-
TAIN PUBLIC HEALTH EMERGENCY.— 
‘‘(A) IN
GENERAL.—The Secretary shall, 
subject to subparagraph (B), require an Ex-
change to provide— 
‘‘(i) for a special enrollment period 
during the emergency period described in 
section 1135(g)(1)(B) of the Social Security 
Act— 
‘‘(I) which shall begin on the date 
that is one week after the date of the 
enactment of this paragraph and 
which, in the case of an Exchange es-
tablished or operated by the Secretary 
within a State pursuant to section 
1321(c), shall be an 8-week period; and 
‘‘(II) during which any indi-
vidual who is otherwise eligible to en-
roll in a qualified health plan through 
the Exchange may enroll in such a 
qualified health plan; and 
‘‘(ii) that, in the case of an individual 
who enrolls in a qualified health plan 
through the Exchange during such enroll-
ment period, the coverage period under such
1104 
plan shall begin on the first day of the 
month following the day the individual se-
lects a plan through such special enrollment 
period. 
‘‘(B) EXCEPTION.—The requirement of sub-
paragraph (A) shall not apply to a State-oper-
ated or State-established Exchange if such Ex-
change, prior to the date of the enactment of this 
paragraph, established or otherwise provided for 
a special enrollment period to address access to 
coverage under qualified health plans offered 
through such Exchange during the emergency pe-
riod described in section 1135(g)(1)(B) of the So-
cial Security Act.’’. 
(b) IMPLEMENTATION.—The Secretary of Health and 
Human Services may implement the provisions of (includ-
ing amendments made by) this section through subregu-
latory guidance, program instruction, or otherwise. 
SEC. 302. EXPEDITED MEETING OF ACIP FOR COVID–19 VAC-
CINES. 
(a) IN GENERAL.—Notwithstanding section 3091 of 
the 21st Century Cures Act (21 U.S.C. 360bbb–4 note), the 
Advisory Committee on Immunization Practices shall meet 
and issue a recommendation with respect to a vaccine that 
is intended to prevent or treat COVID–19 not later than
1105 
15 business days after the date on which such vaccine is 
licensed under section 351 of the Public Health Service Act 
(42 U.S.C. 262). 
(b) DEFINITION.—In this section, the term ‘‘Advisory 
Committee on Immunization Practices’’ means the Advi-
sory Committee on Immunization Practices established by 
the Secretary of Health and Human Services pursuant to 
section 222 of the Public Health Service Act (42 U.S.C. 
217a), acting through the Director of the Centers for Disease 
Control and Prevention. 
SEC. 303. COVERAGE OF COVID–19 RELATED TREATMENT AT 
NO COST SHARING. 
(a) IN GENERAL.—A group health plan and a health 
insurance issuer offering group or individual health insur-
ance coverage (including a grandfathered health plan (as 
defined in section 1251(e) of the Patient Protection and Af-
fordable Care Act)) shall provide coverage, and shall not 
impose any cost sharing (including deductibles, copay-
ments, and coinsurance) requirements, for the following 
items and services furnished during any portion of the 
emergency period defined in paragraph (1)(B) of section 
1135(g) of the Social Security Act (42 U.S.C. 1320b–5(g)) 
beginning on or after the date of the enactment of this Act: 
(1) Medically necessary items and services (in-
cluding in-person or telehealth visits in which such
1106 
items and services are furnished) that are furnished 
to an individual who has been diagnosed with (or 
after provision of the items and services is diagnosed 
with) COVID–19 to treat or mitigate the effects of 
COVID–19. 
(2) Medically necessary items and services (in-
cluding in-person or telehealth visits in which such 
items and services are furnished) that are furnished 
to an individual who is presumed to have COVID–19 
but is never diagnosed as such, if the following condi-
tions are met: 
(A) Such items and services are furnished 
to the individual to treat or mitigate the effects 
of COVID–19 or to mitigate the impact of 
COVID–19 on society. 
(B) Health care providers have taken ap-
propriate steps under the circumstances to make 
a diagnosis, or confirm whether a diagnosis was 
made, with respect to such individual, for 
COVID–19, if possible. 
(b) ITEMS AND SERVICES RELATED TO COVID–19.— 
For purposes of this section— 
(1) not later than one week after the date of the 
enactment of this section, the Secretary of Health and 
Human Services, Secretary of Labor, and Secretary
1107 
of the Treasury shall jointly issue guidance specifying 
applicable diagnoses and medically necessary items 
and services related to COVID–19; and 
(2) such items and services shall include all 
items or services that are relevant to the treatment or 
mitigation of COVID–19, regardless of whether such 
items or services are ordinarily covered under the 
terms of a group health plan or group or individual 
health insurance coverage offered by a health insur-
ance issuer. 
(c) ENFORCEMENT.— 
(1) APPLICATION
WITH
RESPECT
TO
PHSA, 
ERISA, AND IRC.—The provisions of this section shall 
be applied by the Secretary of Health and Human 
Services, Secretary of Labor, and Secretary of the 
Treasury to group health plans and health insurance 
issuers offering group or individual health insurance 
coverage as if included in the provisions of part A of 
title XXVII of the Public Health Service Act, part 7 
of the Employee Retirement Income Security Act of 
1974, and subchapter B of chapter 100 of the Internal 
Revenue Code of 1986, as applicable. 
(2) PRIVATE RIGHT OF ACTION.—An individual 
with respect to whom an action is taken by a group 
health plan or health insurance issuer offering group
1108 
or individual health insurance coverage in violation 
of subsection (a) may commence a civil action against 
the plan or issuer for appropriate relief. The previous 
sentence shall not be construed as limiting any en-
forcement mechanism otherwise applicable pursuant 
to paragraph (1). 
(d) IMPLEMENTATION.—The Secretary of Health and 
Human Services, Secretary of Labor, and Secretary of the 
Treasury may implement the provisions of this section 
through sub-regulatory guidance, program instruction or 
otherwise. 
(e) TERMS.—The terms ‘‘group health plan’’; ‘‘health 
insurance issuer’’; ‘‘group health insurance coverage’’, and 
‘‘individual health insurance coverage’’ have the meanings 
given such terms in section 2791 of the Public Health Serv-
ice Act (42 U.S.C. 300gg–91), section 733 of the Employee 
Retirement Income Security Act of 1974 (29 U.S.C. 1191b), 
and section 9832 of the Internal Revenue Code of 1986, as 
applicable. 
SEC. 304. REQUIRING PRESCRIPTION DRUG REFILL NOTIFI-
CATIONS DURING EMERGENCIES. 
(a) ERISA.— 
(1) IN GENERAL.—Subpart B of part 7 of sub-
title B of title I of the Employee Retirement Income 
Security Act of 1974 (29 U.S.C. 1185 et seq.) is
1109 
amended by adding at the end the following new sec-
tion: 
‘‘SEC. 716. PROVISION OF PRESCRIPTION DRUG REFILL NO-
TIFICATIONS DURING EMERGENCIES. 
‘‘(a) IN GENERAL.—A group health plan, and a health 
insurance issuer offering health insurance coverage in con-
nection with a group health plan, that provides benefits for 
prescription drugs under such plan or such coverage shall 
provide to each participant or beneficiary under such plan 
or such coverage who resides in an emergency area during 
an emergency period— 
‘‘(1) not later than 5 business days after the date 
of the beginning of such period with respect to such 
area (or, the case of the emergency period described 
in section 304(d)(2) of the Investing in America’s 
Health Care During the COVID–19 Pandemic Act, 
not later than 5 business days after the date of the 
enactment of this section), a notification (written in 
a manner that is clear and understandable to the av-
erage participant or beneficiary)— 
‘‘(A) of whether such plan or coverage will 
waive, during such period with respect to such a 
participant or beneficiary, any time restrictions 
under such plan or coverage on any authorized 
refills for such drugs to enable such refills in ad-
1110 
vance of when such refills would otherwise have 
been permitted under such plan or coverage; and 
‘‘(B) in the case that such plan or coverage 
will waive such restrictions during such period 
with respect to such a participant or beneficiary, 
that contains information on how such a partici-
pant or beneficiary may obtain such a refill; and 
‘‘(2) in the case such plan or coverage elects to 
so waive such restrictions during such period with re-
spect to such a participant or beneficiary after the 
notification described in paragraph (1) has been pro-
vided with respect to such period, not later than 5 
business days after such election, a notification of 
such election that contains the information described 
in subparagraph (B) of such paragraph. 
‘‘(b) EMERGENCY AREA; EMERGENCY PERIOD.—For 
purposes of this section, an ‘emergency area’ is a geo-
graphical area in which, and an ‘emergency period’ is the 
period during which, there exists— 
‘‘(1) an emergency or disaster declared by the 
President pursuant to the National Emergencies Act 
or the Robert T. Stafford Disaster Relief and Emer-
gency Assistance Act; and
1111 
‘‘(2) a public health emergency declared by the 
Secretary pursuant to section 319 of the Public 
Health Service Act.’’. 
(2) CLERICAL AMENDMENT.—The table of con-
tents of the Employee Retirement Income Security 
Act of 1974 is amended by inserting after the item re-
lating to section 714 the following: 
‘‘Sec. 715. Additional market reforms. 
‘‘Sec. 716. Provision of prescription drug refill notifications during emergencies.’’. 
(b) PHSA.—Subpart II of part A of title XXVII of 
the Public Health Service Act (42 U.S.C. 300gg–11 et seq.) 
is amended by adding at the end the following new section: 
‘‘SEC. 2730. PROVISION OF PRESCRIPTION DRUG REFILL 
NOTIFICATIONS DURING EMERGENCIES. 
‘‘(a) IN GENERAL.—A group health plan, and a health 
insurance issuer offering group or individual health insur-
ance coverage, that provides benefits for prescription drugs 
under such plan or such coverage shall provide to each par-
ticipant, beneficiary, or enrollee enrolled under such plan 
or such coverage who resides in an emergency area during 
an emergency period— 
‘‘(1) not later than 5 business days after the date 
of the beginning of such period with respect to such 
area (or, the case of the emergency period described 
in section 304(d)(2) of the Investing in America’s 
Health Care During the COVID–19 Pandemic Act,
1112 
not later than 5 business days after the date of the 
enactment of this section), a notification (written in 
a manner that is clear and understandable to the av-
erage participant, beneficiary, or enrollee)— 
‘‘(A) of whether such plan or coverage will 
waive, during such period with respect to such a 
participant, beneficiary, or enrollee, any time re-
strictions under such plan or coverage on any 
authorized refills for such drugs to enable such 
refills in advance of when such refills would oth-
erwise have been permitted under such plan or 
coverage; and 
‘‘(B) in the case that such plan or coverage 
will waive such restrictions during such period 
with respect to such a participant, beneficiary, 
or enrollee, that contains information on how 
such a participant, beneficiary, or enrollee may 
obtain such a refill; and 
‘‘(2) in the case such plan or coverage elects to 
so waive such restrictions during such period with re-
spect to such a participant, beneficiary, or enrollee 
after the notification described in paragraph (1) has 
been provided with respect to such period, not later 
than 5 business days after such election, a notifica-
1113 
tion of such election that contains the information de-
scribed in subparagraph (B) of such paragraph. 
‘‘(b) EMERGENCY AREA; EMERGENCY PERIOD.—For 
purposes of this section, an ‘emergency area’ is a geo-
graphical area in which, and an ‘emergency period’ is the 
period during which, there exists— 
‘‘(1) an emergency or disaster declared by the 
President pursuant to the National Emergencies Act 
or the Robert T. Stafford Disaster Relief and Emer-
gency Assistance Act; and 
‘‘(2) a public health emergency declared by the 
Secretary pursuant to section 319.’’. 
(c) IRC.— 
(1) IN GENERAL.—Subchapter B of chapter 100 
of the Internal Revenue Code of 1986 is amended by 
adding at the end the following new section: 
‘‘SEC. 9816. PROVISION OF PRESCRIPTION DRUG REFILL 
NOTIFICATIONS DURING EMERGENCIES. 
‘‘(a) IN GENERAL.—A group health plan that provides 
benefits for prescription drugs under such plan shall pro-
vide to each participant or beneficiary enrolled under such 
plan who resides in an emergency area during an emer-
gency period, not later than 5 business days after the date 
of the beginning of such period with respect to such area 
(or, the case of the emergency period described in section
1114 
304(d)(2) of the Investing in America’s Health Care During 
the COVID–19 Pandemic Act, not later than 5 business 
days after the date of the enactment of this section)— 
‘‘(1) a notification (written in a manner that is 
clear and understandable to the average participant 
or beneficiary)— 
‘‘(A) of whether such plan will waive, dur-
ing such period with respect to such a partici-
pant or beneficiary, any time restrictions under 
such plan on any authorized refills for such 
drugs to enable such refills in advance of when 
such refills would otherwise have been permitted 
under such plan; and 
‘‘(B) in the case that such plan will waive 
such restrictions during such period with respect 
to such a participant or beneficiary, that con-
tains information on how such a participant or 
beneficiary may obtain such a refill; and 
‘‘(2) in the case such plan elects to so waive such 
restrictions during such period with respect to such a 
participant or beneficiary after the notification de-
scribed in paragraph (1) has been provided with re-
spect to such period, not later than 5 business days 
after such election, a notification of such election that
1115 
contains the information described in subparagraph 
(B) of such paragraph. 
‘‘(b) EMERGENCY AREA; EMERGENCY PERIOD.—For 
purposes of this section, an ‘emergency area’ is a geo-
graphical area in which, and an ‘emergency period’ is the 
period during which, there exists— 
‘‘(1) an emergency or disaster declared by the 
President pursuant to the National Emergencies Act 
or the Robert T. Stafford Disaster Relief and Emer-
gency Assistance Act; and 
‘‘(2) a public health emergency declared by the 
Secretary pursuant to section 319 of the Public 
Health Service Act.’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions for subchapter B of chapter 100 of the Internal 
Revenue Code of 1986 is amended by adding at the 
end the following new item: 
‘‘Sec. 9816. Provision of prescription drug refill notifications during emer-
gencies.’’. 
(d) EFFECTIVE DATE.—The amendments made by this 
section shall apply with respect to— 
(1) emergency periods beginning on or after the 
date of the enactment of this Act; and 
(2) the emergency period relating to the public 
health emergency declared by the Secretary of Health 
and Human Services pursuant to section 319 of the
1116 
Public Health Service Act on January 31, 2020, enti-
tled ‘‘Determination that a Public Health Emergency 
Exists Nationwide as the Result of the 2019 Novel 
Coronavirus’’. 
SEC. 305. IMPROVEMENT OF CERTAIN NOTIFICATIONS PRO-
VIDED TO QUALIFIED BENEFICIARIES BY 
GROUP HEALTH PLANS IN THE CASE OF 
QUALIFYING EVENTS. 
(a) EMPLOYEE RETIREMENT INCOME SECURITY ACT 
OF 1974.— 
(1) IN GENERAL.—Section 606 of the Employee 
Retirement Income Security Act of 1974 (29 U.S.C. 
1166) is amended— 
(A) in subsection (a)(4), in the matter fol-
lowing subparagraph (B), by striking ‘‘under 
this subsection’’ and inserting ‘‘under this part 
in accordance with the notification requirements 
under subsection (c)’’; and 
(B) in subsection (c)— 
(i) by striking ‘‘For purposes of sub-
section (a)(4), any notification’’ and insert-
ing ‘‘For purposes of subsection (a)(4)— 
‘‘(1) any notification’’; 
(ii) by striking ‘‘, whichever is appli-
cable, and any such notification’’ and in-
1117 
serting ‘‘of subsection (a), whichever is ap-
plicable; 
‘‘(2) any such notification’’; and 
(iii) by striking ‘‘such notification is 
made’’ and inserting ‘‘such notification is 
made; and 
‘‘(3) any such notification shall, with respect to 
each qualified beneficiary with respect to whom such 
notification is made, include information regarding 
any Exchange established under title I of the Patient 
Protection and Affordable Care Act through which 
such a qualified beneficiary may be eligible to enroll 
in a qualified health plan (as defined in section 1301 
of the Patient Protection and Affordable Care Act), 
including— 
‘‘(A) the publicly accessible Internet website 
address for such Exchange; 
‘‘(B) the publicly accessible Internet website 
address for the Find Local Help directory main-
tained by the Department of Health and Human 
Services on the healthcare.gov Internet website 
(or a successor website); 
‘‘(C) a clear explanation that— 
‘‘(i) an individual who is eligible for 
continuation coverage may also be eligible
1118 
to enroll, with financial assistance, in a 
qualified health plan offered through such 
Exchange, but, in the case that such indi-
vidual elects to enroll in such continuation 
coverage and subsequently elects to termi-
nate such continuation coverage before the 
period of such continuation coverage ex-
pires, such individual will not be eligible to 
enroll in a qualified health plan offered 
through such Exchange during a special en-
rollment period; and 
‘‘(ii) an individual who elects to enroll 
in continuation coverage will remain eligi-
ble to enroll in a qualified health plan of-
fered through such Exchange during an 
open enrollment period and may be eligible 
for financial assistance with respect to en-
rolling in such a qualified health plan; 
‘‘(D) information on consumer protections 
with respect to enrolling in a qualified health 
plan offered through such Exchange, including 
the requirement for such a qualified health plan 
to provide coverage for essential health benefits 
(as defined in section 1302(b) of the Patient Pro-
tection and Affordable Care Act) and the require-
1119 
ments applicable to such a qualified health plan 
under part A of title XXVII of the Public Health 
Service Act; and 
‘‘(E) information on the availability of fi-
nancial assistance with respect to enrolling in a 
qualified health plan, including the maximum 
income limit for eligibility for a premium tax 
credit under section 36B of the Internal Revenue 
Code of 1986.’’. 
(2) EFFECTIVE DATE.—The amendments made 
by paragraph (1) shall apply with respect to quali-
fying events occurring on or after the date that is 14 
days after the date of the enactment of this Act. 
(b) PUBLIC HEALTH SERVICE ACT.— 
(1) IN GENERAL.—Section 2206 of the Public 
Health Service Act (42 U.S.C. 300bb–6) is amend-
ed— 
(A) by striking ‘‘In accordance’’ and insert-
ing the following: 
‘‘(a) IN GENERAL.—In accordance’’; 
(B) by striking ‘‘of such beneficiary’s rights 
under this subsection’’ and inserting ‘‘of such 
beneficiary’s rights under this title in accordance 
with the notification requirements under sub-
section (b)’’; and
1120 
(C) by striking ‘‘For purposes of paragraph 
(4),’’ and all that follows through ‘‘such notifica-
tion is made.’’ and inserting the following: 
‘‘(b) RULES RELATING TO NOTIFICATION OF QUALI-
FIED BENEFICIARIES BY PLAN ADMINISTRATOR.—For pur-
poses of subsection (a)(4)— 
‘‘(1) any notification shall be made within 14 
days of the date on which the plan administrator is 
notified under paragraph (2) or (3) of subsection (a), 
whichever is applicable; 
‘‘(2) any such notification to an individual who 
is a qualified beneficiary as the spouse of the covered 
employee shall be treated as notification to all other 
qualified beneficiaries residing with such spouse at 
the time such notification is made; and 
‘‘(3) any such notification shall, with respect to 
each qualified beneficiary with respect to whom such 
notification is made, include information regarding 
any Exchange established under title I of the Patient 
Protection and Affordable Care Act through which 
such a qualified beneficiary may be eligible to enroll 
in a qualified health plan (as defined in section 1301 
of the Patient Protection and Affordable Care Act), 
including—
1121 
‘‘(A) the publicly accessible Internet website 
address for such Exchange; 
‘‘(B) the publicly accessible Internet website 
address for the Find Local Help directory main-
tained by the Department of Health and Human 
Services on the healthcare.gov Internet website 
(or a successor website); 
‘‘(C) a clear explanation that— 
‘‘(i) an individual who is eligible for 
continuation coverage may also be eligible 
to enroll, with financial assistance, in a 
qualified health plan offered through such 
Exchange, but, in the case that such indi-
vidual elects to enroll in such continuation 
coverage and subsequently elects to termi-
nate such continuation coverage before the 
period of such continuation coverage ex-
pires, such individual will not be eligible to 
enroll in a qualified health plan offered 
through such Exchange during a special en-
rollment period; and 
‘‘(ii) an individual who elects to enroll 
in continuation coverage will remain eligi-
ble to enroll in a qualified health plan of-
fered through such Exchange during an
1122 
open enrollment period and may be eligible 
for financial assistance with respect to en-
rolling in such a qualified health plan; 
‘‘(D) information on consumer protections 
with respect to enrolling in a qualified health 
plan offered through such Exchange, including 
the requirement for such a qualified health plan 
to provide coverage for essential health benefits 
(as defined in section 1302(b) of the Patient Pro-
tection and Affordable Care Act) and the require-
ments applicable to such a qualified health plan 
under part A of title XXVII; and 
‘‘(E) information on the availability of fi-
nancial assistance with respect to enrolling in a 
qualified health plan, including the maximum 
income limit for eligibility for a premium tax 
credit under section 36B of the Internal Revenue 
Code of 1986.’’. 
(2) EFFECTIVE DATE.—The amendments made 
by paragraph (1) shall apply with respect to quali-
fying events occurring on or after the date that is 14 
days after the date of the enactment of this Act. 
(c) INTERNAL REVENUE CODE OF 1986.— 
(1) IN GENERAL.—Section 4980B(f)(6) of the In-
ternal Revenue Code of 1986 is amended—
1123 
(A) in subparagraph (D)— 
(i) in clause (ii), by striking ‘‘under 
subparagraph (C)’’ and inserting ‘‘under 
clause (iii)’’; and 
(ii) by redesignating clauses (i) and 
(ii) as subclauses (I) and (II), respectively, 
and moving the margin of each such sub-
clause, as so redesignated, 2 ems to the 
right; 
(B) by redesignating subparagraphs (A) 
through (D) as clauses (i) through (iv), respec-
tively, and moving the margin of each such 
clause, as so redesignated, 2 ems to the right; 
(C) by striking ‘‘In accordance’’ and insert-
ing the following: 
‘‘(A) IN GENERAL.—In accordance’’; 
(D) by inserting after ‘‘of such beneficiary’s 
rights under this subsection’’ the following: ‘‘in 
accordance with the notification requirements 
under subparagraph (C)’’; and 
(E) by striking ‘‘The requirements of sub-
paragraph (B)’’ and all that follows through 
‘‘such notification is made.’’ and inserting the 
following:
1124 
‘‘(B) ALTERNATIVE MEANS OF COMPLIANCE 
WITH REQUIREMENT FOR NOTIFICATION OF MUL-
TIEMPLOYER
PLANS
BY
EMPLOYERS.—The re-
quirements of subparagraph (A)(ii) shall be con-
sidered satisfied in the case of a multiemployer 
plan in connection with a qualifying event de-
scribed in paragraph (3)(B) if the plan provides 
that the determination of the occurrence of such 
qualifying event will be made by the plan ad-
ministrator. 
‘‘(C) RULES RELATING TO NOTIFICATION OF 
QUALIFIED
BENEFICIARIES
BY
PLAN
ADMINIS-
TRATOR.—For 
purposes 
of 
subparagraph 
(A)(iv)— 
‘‘(i) any notification shall be made 
within 14 days (or, in the case of a group 
health plan which is a multiemployer plan, 
such longer period of time as may be pro-
vided in the terms of the plan) of the date 
on which the plan administrator is notified 
under clause (ii) or (iii) of subparagraph 
(A), whichever is applicable; 
‘‘(ii) any such notification to an indi-
vidual who is a qualified beneficiary as the 
spouse of the covered employee shall be
1125 
treated as notification to all other qualified 
beneficiaries residing with such spouse at 
the time such notification is made; and 
‘‘(iii) any such notification shall, with 
respect to each qualified beneficiary with re-
spect to whom such notification is made, in-
clude information regarding any Exchange 
established under title I of the Patient Pro-
tection and Affordable Care Act through 
which such a qualified beneficiary may be 
eligible to enroll in a qualified health plan 
(as defined in section 1301 of the Patient 
Protection and Affordable Care Act), includ-
ing— 
‘‘(I) the publicly accessible Inter-
net website address for such Exchange; 
‘‘(II) the publicly accessible Inter-
net website address for the Find Local 
Help directory maintained by the De-
partment of Health and Human Serv-
ices on the healthcare.gov Internet 
website (or a successor website); 
‘‘(III) a clear explanation that— 
‘‘(aa) an individual who is 
eligible for continuation coverage
1126 
may also be eligible to enroll, with 
financial assistance, in a quali-
fied health plan offered through 
such Exchange, but, in the case 
that such individual elects to en-
roll in such continuation coverage 
and subsequently elects to termi-
nate such continuation coverage 
before the period of such continu-
ation coverage expires, such indi-
vidual will not be eligible to enroll 
in a qualified health plan offered 
through such Exchange during a 
special enrollment period; and 
‘‘(bb) an individual who 
elects to enroll in continuation 
coverage will remain eligible to 
enroll in a qualified health plan 
offered through such Exchange 
during an open enrollment period 
and may be eligible for financial 
assistance with respect to enroll-
ing in such a qualified health 
plan;
1127 
‘‘(IV) information on consumer 
protections with respect to enrolling in 
a qualified health plan offered through 
such Exchange, including the require-
ment for such a qualified health plan 
to provide coverage for essential health 
benefits (as defined in section 1302(b) 
of the Patient Protection and Afford-
able Care Act) and the requirements 
applicable to such a qualified health 
plan under part A of title XXVII of the 
Public Health Service Act; and 
‘‘(V) information on the avail-
ability of financial assistance with re-
spect to enrolling in a qualified health 
plan, including the maximum income 
limit for eligibility for a premium tax 
credit under section 36B.’’. 
(2) EFFECTIVE DATE.—The amendments made 
by paragraph (1) shall apply with respect to quali-
fying events occurring on or after the date that is 14 
days after the date of the enactment of this Act. 
(d) MODEL NOTICES.—Not later than 14 days after 
the date of the enactment of this Act, the Secretary of the
1128 
Labor, in consultation with the Secretary of the Treasury 
and the Secretary of Health and Human Services, shall— 
(1) update the model Consolidated Omnibus 
Budget Reconciliation Act of 1985 (referred to in this 
subsection as ‘‘COBRA’’) continuation coverage gen-
eral notice and the model COBRA continuation cov-
erage election notice developed by the Secretary of 
Labor for purposes of facilitating compliance of group 
health plans with the notification requirements under 
section 606 of the Employee Retirement Income Secu-
rity Act of 1974 (29 U.S.C. 1166) to include the in-
formation described in paragraph (3) of subsection (c) 
of such section 606, as added by subsection (a)(1); 
(2) provide an opportunity for consumer testing 
of each such notice, as so updated, to ensure that each 
such notice is clear and understandable to the average 
participant or beneficiary of a group health plan; 
and 
(3) rename the model COBRA continuation cov-
erage general notice and the model COBRA continu-
ation coverage election notice as the ‘‘model COBRA 
continuation coverage and Affordable Care Act cov-
erage general notice’’ and the ‘‘model COBRA con-
tinuation coverage and Affordable Care Act coverage 
election notice’’, respectively.
1147 
rollment 
period 
described 
in 
section 
1311(c)(8)(A) of such Act; 
(B) for the premium tax credit under sec-
tion 36B of the Internal Revenue Code of 1986; 
and 
(C) for any increase to the premium tax 
credit an individual otherwise receives under sec-
tion 36B of the Internal Revenue Code of 1986 
by reason of subsection (g) of such section. 
(2) PUBLICATION
OF
INFORMATION .—Section 
1311(b) of the Patient Protection and Affordable Care 
Act (42 U.S.C. 18031(b)) by adding at the end the 
following new paragraph: 
‘‘(3) PUBLICATION OF INFORMATION RELATING 
TO A SPECIAL ENROLLMENT PERIOD AND CREDITS.— 
An Exchange shall, not later than 7 days after the 
date of the enactment of this paragraph, prominently 
post on the homepage of the Internet website for such 
Exchange information with respect to the special en-
rollment period described in subsection (c)(8)(A) and 
hyperlinks to information with respect to the eligi-
bility of individuals described in such subsection— 
‘‘(A) to enroll in a qualified health plan of-
fered through an Exchange during a special en-
rollment period described in such subsection;
1148 
‘‘(B) for the premium tax credit under sec-
tion 36B of the Internal Revenue Code of 1986; 
and 
‘‘(C) for any increase to the premium tax 
credit an individual otherwise receives under sec-
tion 36B of the Internal Revenue Code of 1986 
by reason of subsection (g) of such section.’’. 
SEC. 313. TEMPORARY MODIFICATION OF LIMITATIONS ON 
RECONCILIATION OF TAX CREDITS FOR COV-
ERAGE UNDER A QUALIFIED HEALTH PLAN 
WITH ADVANCE PAYMENTS OF SUCH CREDIT. 
(a) IN GENERAL.—Section 36B(f)(2)(B) of the Inter-
nal Revenue Code of 1986 is amended by adding at the end 
the following new clause: 
‘‘(iii) TEMPORARY
MODIFICATION
OF 
LIMITATION ON INCREASE.—In the case of 
any taxable year beginning in 2020 or 
2021, clause (i) shall be applied— 
‘‘(I) by substituting ‘600 percent’ 
for ‘400 percent’ the first place it ap-
pears therein, and 
‘‘(II) by substituting the following 
table for the table contained therein: 
‘‘If the household income (expressed as a percent of 
poverty line) is: 
The applicable dollar 
amount is: 
Less than 500% ..............................................................
$0 
At least 500% but less than 550% ...............................
$1,600