H. R. 133—1766 
would not be permitted under section 423.505(m) of 
title 42, Code of Federal Regulations, or any successor 
regulation, if released by the Centers for Medicare 
& Medicaid Services. 
‘‘(B) CLARIFICATION.—The restrictions on disclosures 
described in subparagraph (A) shall also apply to disclo-
sures to individual Commissioners of the Medicare Pay-
ment Advisory Commission or of the Medicaid and CHIP 
Payment and Access Commission.’’. 
(b) ACCESS TO CERTAIN REBATE AND PAYMENT DATA UNDER 
MEDICARE AND MEDICAID.—Section 1927(b)(3)(D) of the Social Secu-
rity Act (42 U.S.C. 1396r–8(b)(3)(D)) is amended— 
(1) in the matter before clause (i), by striking ‘‘subsection 
(a)(6)(A)(ii)’’ and inserting ‘‘subsection (a)(6)(A)’’; 
(2) in clause (v), by striking ‘‘and’’ at the end; 
(3) in clause (vi), by striking the period at the end and 
inserting ‘‘, and’’; 
(4) by inserting after clause (vi) the following new clause: 
‘‘(vii) to permit the Executive Director of the Medi-
care Payment Advisory Commission and the Executive 
Director of the Medicaid and CHIP Payment and 
Access Commission to review the information pro-
vided.’’; 
(5) in the matter at the end, by striking ‘‘1860D–4(c)(2)(E)’’ 
and inserting ‘‘1860D–4(c)(2)(G)’’; and 
(6) by adding at the end the following new sentences: 
‘‘Any information disclosed to the Executive Director of the 
Medicare Payment Advisory Commission or the Executive 
Director of the Medicaid and CHIP Payment and Access 
Commission pursuant to this subparagraph shall not be dis-
closed by either such Executive Director in a form which dis-
closes the identity of a specific manufacturer or wholesaler 
or prices charged for drugs by such manufacturer or wholesaler. 
Such information also shall not be disclosed by either such 
Executive Director to individual Commissioners of the Medicare 
Payment Advisory Commission or of the Medicaid and CHIP 
Payment and Access Commission in a form which discloses 
the identity of a specific manufacturer or wholesaler or prices 
charged for drugs by such manufacturer or wholesaler.’’. 
SEC. 113. MORATORIUM ON PAYMENT UNDER THE MEDICARE PHYSI-
CIAN FEE SCHEDULE OF THE ADD ON CODE FOR INHER-
ENTLY 
COMPLEX 
EVALUATION 
AND 
MANAGEMENT 
VISITS. 
(a) IN GENERAL.—The Secretary of Health and Human Services 
may not, prior to January 1, 2024, make payment under the fee 
schedule under section 1848 of the Social Security Act (42 U.S.C. 
1395w–4) for services described by Healthcare Common Procedure 
Coding System (HCPCS) code G2211 (or any successor or substan-
tially similar code), as described in section II.F. of the final rule 
filed by the Secretary with the Office of the Federal Register for 
public inspection on December 2, 2020, and entitled ‘‘Medicare 
Program; CY 2021 Payment Policies under the Physician Fee 
Schedule and Other Changes to Part B Payment Policies; Medicare 
Shared Savings Program Requirements; Medicaid Promoting Inter-
operability Program Requirements for Eligible Professionals;
H. R. 133—1767 
Quality Payment Program; Coverage of Opioid Use Disorder Serv-
ices Furnished by Opioid Treatment Programs; Medicare Enroll-
ment of Opioid Treatment Programs; Electronic Prescribing for 
Controlled Substances for a Covered Part D Drug; Payment for 
Office/Outpatient Evaluation and Management Services; Hospital 
IQR Program; Establish New Code Categories; Medicare Diabetes 
Prevention Program (MDPP) Expanded Model Emergency Policy; 
Coding and Payment for Virtual Check-in Services Interim Final 
Rule Policy; Coding and Payment for Personal Protective Equipment 
(PPE) Interim Final Rule Policy; Regulatory Revisions in Response 
to the Public Health Emergency (PHE) for COVID-19; and Finaliza-
tion of Certain Provisions from the March 31st , May 8th and 
September 2nd Interim Final Rules in Response to the PHE for 
COVID-19’’. 
(b) IMPLEMENTATION.—Notwithstanding any other provision of 
law, the Secretary may implement this section by interim final 
rule, program instruction, or otherwise. 
SEC. 114. TEMPORARY FREEZE OF APM PAYMENT INCENTIVE THRESH-
OLDS. 
(a) IN GENERAL.—Section 1833(z)(2) of the Social Security Act 
(42 U.S.C. 1395l(z)(2)) is amended— 
(1) in subparagraph (B)— 
(A) in the heading, by striking ‘‘AND 2022’’ and inserting 
‘‘THROUGH 2024’’; and 
(B) in the matter preceding clause (i), by striking ‘‘2021 
and 2022’’ and inserting ‘‘each of 2021 through 2024’’; 
(2) in subparagraph (C)— 
(A) in the heading, by striking ‘‘2023’’ and inserting 
‘‘2025’’; and 
(B) in the matter preceding clause (i), by striking 
‘‘2023’’ and inserting ‘‘2025’’; and 
(3) in subparagraph (D), by adding at the end the following: 
‘‘With respect to 2023 and 2024, the Secretary shall use the 
same percentage criteria for counts of patients that are used 
in 2022.’’. 
(b) PARTIAL QUALIFYING APM PARTICIPANT MODIFICATIONS.— 
Section 1848(q)(1)(C)(iii) of the Social Security Act (42 U.S.C. 
1395w–4(q)(1)(C)(iii)) is amended— 
(1) in subclause (II), in the matter preceding item (aa), 
by striking ‘‘2021 and 2022’’ and inserting ‘‘each of 2021 through 
2024’’; and 
(2) in subclause (III), in the matter preceding item (aa), 
by striking ‘‘2023’’ and inserting ‘‘2025’’. 
(c) EFFECTIVE DATE.—The amendments made by this section 
shall take effect on the date of the enactment of this Act. 
SEC. 115. PERMITTING OCCUPATIONAL THERAPISTS TO CONDUCT THE 
INITIAL ASSESSMENT VISIT AND COMPLETE THE COM-
PREHENSIVE ASSESSMENT WITH RESPECT TO CERTAIN 
REHABILITATION SERVICES FOR HOME HEALTH AGEN-
CIES UNDER THE MEDICARE PROGRAM. 
Not later than January 1, 2022, the Secretary of Health and 
Human Services shall revise subsections (a)(2) and (b)(3) of section 
484.55 of title 42, Code of Federal Regulations, or a successor 
regulation, to permit an occupational therapist to conduct the initial 
assessment visit and to complete the comprehensive assessment 
(as such terms are described in such subsections, respectively)
H. R. 133—1768 
for home health services for an individual under title XVIII of 
the Social Security Act (42 U.S.C. 1395 et seq.) if the home health 
plan of care for such individual— 
(1) does not initially include skilled nursing care; 
(2) includes occupational therapy; and 
(3) includes physical therapy or speech language pathology. 
SEC. 116. CENTERS FOR MEDICARE & MEDICAID SERVICES PROVIDER 
OUTREACH AND REPORTING ON COGNITIVE ASSESS-
MENT AND CARE PLAN SERVICES. 
(a) OUTREACH.—The Secretary of Health and Human Services 
(in this section referred to as the ‘‘Secretary’’) shall conduct outreach 
to physicians and appropriate non-physician practitioners partici-
pating under the Medicare program under title XVIII of the Social 
Security Act (42 U.S.C. 1395 et seq.) with respect to Medicare 
payment for cognitive assessment and care plan services furnished 
to individuals with cognitive impairment such as Alzheimer’s dis-
ease and related dementias, identified as of January 1, 2018, by 
HCPCS code 99483, or any successor to such code (in this section 
referred to as ‘‘cognitive assessment and care plan services’’). Such 
outreach shall include a comprehensive, one-time education initia-
tive to inform such physicians and practitioners of the addition 
of such services as a covered benefit under the Medicare program, 
including the requirements for eligibility for such services. 
(b) REPORTS.— 
(1) HHS REPORT ON PROVIDER OUTREACH.—Not later than 
one year after the date of enactment of this Act, the Secretary 
of Health and Human Services shall submit to the Committee 
on Ways and Means and the Committee on Energy and Com-
merce of the House of Representatives and the Committee 
on Finance of the Senate a report on the outreach conducted 
under subsection (a). Such report shall include a description 
of the methods used for such outreach. 
(2) GAO REPORT ON UTILIZATION RATES.—Not later than 
3 years after such date of enactment, the Comptroller General 
of the United States shall submit to the Committee on Ways 
and Means and the Committee on Energy and Commerce of 
the House of Representatives and the Committee on Finance 
of the Senate a report on the number of Medicare beneficiaries 
who were furnished cognitive assessment and care plan services 
for which payment was made under title XVIII of the Social 
Security Act (42 U.S.C. 1395 et seq.). Such report shall include 
information on barriers Medicare beneficiaries face to access 
such services, and recommendations for such legislative and 
administrative action as the Comptroller General deems appro-
priate. 
SEC. 117. CONTINUED COVERAGE OF CERTAIN TEMPORARY TRANSI-
TIONAL HOME INFUSION THERAPY SERVICES. 
(a) IN GENERAL.—Section 1861(iii)(3)(C) of the Social Security 
Act (42 U.S.C. 1395x(iii)(3)(C)) is amended by inserting after clause 
(ii) the following flush sentence: 
‘‘Clause (ii) shall not apply to a self-administered drug or 
biological on a self-administered drug exclusion list if such 
drug or biological was included as a transitional home infusion 
drug under subparagraph (A)(iii) of section 1834(u)(7) and was 
identified by a HCPCS code described in subparagraph (C)(ii) 
of such section.’’.
H. R. 133—1769 
(b) EFFECTIVE DATE.—The amendment made by subsection (a) 
shall apply to items and services furnished on or after January 
1, 2021. 
(c) IMPLEMENTATION.—Notwithstanding any other provision of 
law, the Secretary of Health and Human Services may implement 
the amendment made by subsection (a) by interim final rule, pro-
gram instruction, or otherwise. 
SEC. 118. TRANSITIONAL COVERAGE AND RETROACTIVE MEDICARE 
PART D COVERAGE FOR CERTAIN LOW-INCOME BENE-
FICIARIES. 
Section 1860D–14 of the Social Security Act (42 U.S.C. 1395w– 
114) is amended— 
(1) by redesignating subsection (e) as subsection (f); and 
(2) by adding after subsection (d) the following new sub-
section: 
‘‘(e) LIMITED INCOME NEWLY ELIGIBLE TRANSITION PROGRAM.— 
‘‘(1) IN
GENERAL.—Beginning not later than January 1, 
2024, the Secretary shall carry out a program to provide transi-
tional coverage for covered part D drugs for LI NET eligible 
individuals in accordance with this subsection. 
‘‘(2) LI NET ELIGIBLE INDIVIDUAL DEFINED.—For purposes 
of this subsection, the term ‘LI NET eligible individual’ means 
a part D eligible individual who— 
‘‘(A) meets the requirements of clauses (ii) and (iii) 
of subsection (a)(3)(A); and 
‘‘(B) has not yet enrolled in a prescription drug plan 
or an MA–PD plan, or, who has so enrolled, but with 
respect to whom coverage under such plan has not yet 
taken effect. 
‘‘(3) TRANSITIONAL COVERAGE.—For purposes of this sub-
section, the term ‘transitional coverage’ means with respect 
to an LI NET eligible individual— 
‘‘(A) immediate access to covered part D drugs at the 
point of sale during the period that begins on the first 
day of the month such individual is determined to meet 
the requirements of clauses (ii) and (iii) of subsection 
(a)(3)(A) and ends on the date that coverage under a 
prescription drug plan or MA–PD plan takes effect with 
respect to such individual; and 
‘‘(B) in the case of an LI NET eligible individual who 
is a full-benefit dual eligible individual (as defined in sec-
tion 1935(c)(6)) or a recipient of supplemental security 
income benefits under title XVI, retroactive coverage (in 
the form of reimbursement of the amounts that would 
have been paid under this part had such individual been 
enrolled in a prescription drug plan or MA–PD plan) of 
covered part D drugs purchased by such individual during 
the period that begins on the date that is the later of— 
‘‘(i) the date that such individual was first eligible 
for a low-income subsidy under this part; or 
‘‘(ii) the date that is 36 months prior to the date 
such individual enrolls in a prescription drug plan 
or MA–PD plan, 
and ends on the date that coverage under such plan takes 
effect. 
‘‘(4) PROGRAM ADMINISTRATION.—