I 
117TH CONGRESS 
1ST SESSION H. R. 2080 
To amend title XVIII of the Social Security Act to provide for temporary 
coverage of certain transportation services for certain individuals under 
the Medicare program, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 19, 2021 
Mr. BISHOP of Georgia (for himself, Mr. CARTER of Georgia, Mr. CA´RDENAS, 
Mr. GRIFFITH, Mr. GRIJALVA, Ms. PRESSLEY, Mr. COHEN, Mr. LEVIN 
of California, Mr. CARBAJAL, and Ms. SEWELL) introduced the following 
bill; which was referred to the Committee on Energy and Commerce, and 
in addition to the Committee on Ways and Means, for a period to be sub-
sequently determined by the Speaker, in each case for consideration of 
such provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to provide 
for temporary coverage of certain transportation services 
for certain individuals under the Medicare program, and 
for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Senior Access to Vac-
cines Ensured Act of 2021’’ or the ‘‘SAVE Act of 2021’’. 
VerDate Sep 11 2014 
00:14 May 22, 2021
Jkt 019200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H2080.IH
H2080
pbinns on DSKJLVW7X2PROD with BILLS
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) The Kaiser Family Foundation reported 
that only about 12 percent of Medicare beneficiaries 
are full Medicare-Medicaid dual eligibles and, thus, 
have Medicaid coverage for nonemergency medical 
transportation (NEMT) to access COVID–19 vac-
cination appointments and other health care ap-
pointments. According to the Commonwealth Fund, 
although 45 percent of Medicare beneficiaries have 
incomes lower than 200 percent of the federal pov-
erty level (FPL), which can limit their transpor-
tation options, Medicare does not currently cover 
NEMT. 
(2) Medicare beneficiaries over the age of 65, 
according to the Centers for Disease Control, are 24 
times more likely to die from COVID–19 than an 
adult aged 25–54. 
(3) A managed NEMT benefit that offers 
scheduling and other assistance would improve bene-
ficiaries’ access to the COVID–19 vaccine. It also 
would reduce Medicare expenditures by covering 
more cost-effective alternatives and avoiding the 
high cost of in-patient COVID–19 treatment. 
VerDate Sep 11 2014 
00:14 May 22, 2021
Jkt 019200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H2080.IH
H2080
pbinns on DSKJLVW7X2PROD with BILLS
SEC. 3. COVERAGE OF MANAGED, NONEMERGENT TRANS-
PORTATION SERVICES FOR CERTAIN INDI-
VIDUALS. 
Title XVIII of the Social Security Act (42 U.S.C. 
1395 et seq.) is amended by adding at the end the fol-
lowing new section: 
‘‘SEC. 1899C. MANAGED, NONEMERGENT TRANSPORTATION 
SERVICES BENEFIT PROGRAM. 
‘‘(a) ESTABLISHMENT.—The Secretary shall estab-
lish a program to be known as the ‘Managed, Nonemer-
gent Transportation Services Benefit Program’ for pur-
poses of furnishing qualifying individuals not more than 
2 round-trip managed, nonemergent transportation serv-
ices (as defined in subsection (c)) to COVID–19 vaccina-
tion sites (including community pharmacies) beginning 
April 1, 2021, and ending on the last day of the emergency 
period described in section 1135(g)(1)(B). 
‘‘(b) CONTRACT WITH QUALIFIED TRANSPORTATION 
MANAGER.— 
‘‘(1) IN GENERAL.—For each medicare admin-
istrative contractor jurisdiction for a year (beginning 
with 2021), the Secretary shall enter into a contract 
with one qualified transportation manager for pur-
poses of arranging for the provision of managed, 
nonemergent transportation services to qualifying in-
dividuals in such region. Such contract shall provide 
VerDate Sep 11 2014 
00:14 May 22, 2021
Jkt 019200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H2080.IH
H2080
pbinns on DSKJLVW7X2PROD with BILLS
that payment be made by the Secretary for such 
service on the basis of prepaid capitation payments 
(taking into account the charge described in para-
graph (2)(E)). 
‘‘(2) SELECTION.—Not later than 30 days after 
the date of the enactment of this section, notwith-
standing any other provision of law, the Secretary 
shall award contracts described in paragraph (1) 
through a competitive bidding process under which 
the Secretary evaluates applicant entities based on 
experience, past performance, references, available 
resources, and cost for purposes of selecting quali-
fied transportation managers, with preference given 
to applicants with prior satisfactory performance as 
a transportation broker under a program described 
in section 1902(a)(70). Not later than 15 days after 
such date of enactment, the Secretary shall publish 
guidance for prospective qualified transportation 
managers. Such guidance shall include information 
on how such manager may enter into a contract de-
scribed in this subsection and a description of terms 
and conditions applicable to such managers with 
such contracts. Such a manager shall meet the fol-
lowing requirements: 
VerDate Sep 11 2014 
00:14 May 22, 2021
Jkt 019200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H2080.IH
H2080
pbinns on DSKJLVW7X2PROD with BILLS
‘‘(A) The manager establishes procedures 
meeting criteria established by the Secretary for 
addressing beneficiary complaints and ensuring 
network transportation providers are licensed 
by the State for purposes of operating vehicles 
and are competent and courteous. 
‘‘(B) The manager is subject to regular 
audit and oversight by the State in which such 
manager operates in order to ensure the quality 
and timeliness of transportation services man-
aged and the adequacy of qualifying individuals’ 
access to medical care and services. 
‘‘(C) The manager complies with all re-
quirements specified in the contract described 
in paragraph (1). Such requirements shall in-
clude requirements related to— 
‘‘(i) reviews and evaluations to ensure 
the quality, appropriateness, and timeliness 
of such services arranged by such man-
ager; 
‘‘(ii) prohibitions on referrals and con-
flict of interest as the Secretary shall es-
tablish (based on the prohibitions on physi-
cian referrals under section 1877 and such 
other prohibitions and requirements as the 
VerDate Sep 11 2014 
00:14 May 22, 2021
Jkt 019200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H2080.IH
H2080
pbinns on DSKJLVW7X2PROD with BILLS
Secretary determines to be appropriate); 
and 
‘‘(iii) the development and implemen-
tation of a corrective action plan to ad-
dress any contract deficiencies. 
‘‘(D) The manager establishes procedures 
for determining an individual’s eligibility for 
managed, nonemergent transportation services 
under the program established under subsection 
(a) using criteria established by the Secretary 
under subsection (c)(3) and for scheduling and 
organizing the furnishing of such services. 
‘‘(c) DEFINITION.—For purposes of this section: 
‘‘(1) MANAGED, 
NONEMERGENT
TRANSPOR-
TATION SERVICES.—The term ‘managed, nonemer-
gent transportation services’ means the transpor-
tation of an individual by car, taxi, bus, or other 
similar means (as specified by the Secretary) to a 
provider or supplier of services where such individual 
is to be furnished items or services payable under 
this title. 
‘‘(2) QUALIFIED TRANSPORTATION MANAGER.— 
The term ‘qualified transportation manager’ means 
an entity that arranges, under contract with the 
VerDate Sep 11 2014 
00:14 May 22, 2021
Jkt 019200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H2080.IH
H2080
pbinns on DSKJLVW7X2PROD with BILLS
Secretary, for the provision of managed, nonemer-
gent transportation services to qualifying individuals. 
‘‘(3) 
QUALIFYING
INDIVIDUAL.—The 
term 
‘qualifying individual’ means an individual entitled 
to benefits under part A who is not enrolled under 
a Medicare Advantage plan under part C and who 
is not a full-benefit dual eligible individual (as de-
fined in paragraph (4)) who has no readily-available 
means of transportation (as determined by the Sec-
retary). In determining whether an individual has no 
readily-available means of transportation for pur-
poses of the previous sentence, the Secretary shall 
establish criteria similar to those used by States in 
making such determinations under a non-emergency 
medical transportation program under a State plan 
under title XIX (or a waiver of such plan), such as 
evaluating whether such individual— 
‘‘(A) has a driver’s license; 
‘‘(B) has a working vehicle available to 
such individual at such individual’s residence; 
‘‘(C) is incapable of driving due to a med-
ical condition; and 
‘‘(D) has inadequate financial resources to 
pay for transportation. 
VerDate Sep 11 2014 
00:14 May 22, 2021
Jkt 019200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H2080.IH
H2080
pbinns on DSKJLVW7X2PROD with BILLS
‘‘(4) FULL-BENEFIT
DUAL
ELIGIBLE
INDI-
VIDUAL.— 
‘‘(A) IN GENERAL.—The term ‘full-benefit 
dual eligible individual’ means for a State for a 
month an individual who— 
‘‘(i) is entitled to benefits under part 
A or enrolled under part B; and 
‘‘(ii) is determined eligible by the 
State for medical assistance for full bene-
fits under title XIX for such month under 
section 1902(a)(10)(A) or 1902(a)(10)(C), 
by reason of section 1902(f), or under any 
other category of eligibility for medical as-
sistance for full benefits under such title, 
as determined by the Secretary. 
‘‘(B) TREATMENT OF MEDICALLY NEEDY 
AND OTHER INDIVIDUALS REQUIRED TO SPEND 
DOWN.—In applying paragraph (1) in the case 
of an individual determined to be eligible by the 
State for medical assistance under section 
1902(a)(10)(C) or by reason of section 1902(f), 
the individual shall be treated as meeting the 
requirement of paragraph (1)(B) for any month 
if such medical assistance is provided for in any 
part of the month. 
VerDate Sep 11 2014 
00:14 May 22, 2021
Jkt 019200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H2080.IH
H2080
pbinns on DSKJLVW7X2PROD with BILLS
‘‘(d) FUNDING.—The Secretary shall provide for the 
transfer, from the Federal Supplementary Medical Insur-
ance Trust Fund under section 1841 to the Centers for 
Medicare & Medicaid Services Program Management Ac-
count, of such sums as may be necessary for purposes of 
carrying out this section. 
‘‘(e) CLARIFICATION.—The provisions of section 
1862(a) shall not apply to payments made under a con-
tract described in subsection (b)(1).’’. 
Æ 
VerDate Sep 11 2014 
00:14 May 22, 2021
Jkt 019200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6301
E:\BILLS\H2080.IH
H2080
pbinns on DSKJLVW7X2PROD with BILLS