258 
the end of the COVID–19 public health emer-
gency period. 
(B) USE OF FUNDS.—A State to which a 
grant is made under this section shall only use 
grant funds in accordance with subsection (d). 
(C) MAINTENANCE OF STATE EFFORT.— 
Federal funds paid to a State pursuant to this 
section must be used to supplement, but not 
supplant, the level of State funds expended for 
home and community-based services for eligible 
individuals programs in effect for such individ-
uals at the time the grant is awarded under 
this section. 
(4) MONTHLY GRANT PAYMENT AMOUNTS.— 
(A) IN GENERAL.—Subject to paragraph 
(5), the Secretary shall pay to each State that 
is awarded a grant under this section, for each 
month during the State’s grant period (as de-
fined in subparagraph (C)), an amount equal to 
15 percent of the amount determined for the 
State under subparagraph (B). 
(B) AVERAGE MONTHLY HCBS EXPENDI-
TURES.—The amount determined for a State 
under this subparagraph is the amount equal 
to— 
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(i) the sum of— 
(I) the average annual amount of 
State expenditures under title XIX of 
the Social Security Act (42 U.S.C. 
1396 et seq.) that are attributable to 
providing medical assistance for home 
and community-based services for the 
3 most recent fiscal years for which 
data is available; and 
(II) the average annual amount, 
if any, received by the State pursuant 
to an MFP demonstration project 
conducted under section 6071 of the 
Deficit Reduction Act of 2005 (42 
U.S.C. 1396a note) for the 3 most re-
cent fiscal years for which data is 
available; divided by 
(ii) 12. 
(C) GRANT
PERIOD
DEFINED.—In this 
paragraph, the term ‘‘grant period’’ means, 
with respect to a State, the period of months— 
(i) beginning with the month in which 
the Secretary approves the State’s applica-
tion for a grant under this section; and 
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(ii) ending with the 12th month that 
begins after the end of the COVID–19 
public health emergency period. 
(5) GRANTS TO INDIAN TRIBES.— 
(A) IN GENERAL.—During the COVID–19 
public health emergency period, the Secretary 
may award grants to an Indian tribe in the 
same manner, and subject to the same require-
ments, as apply to a State, except as otherwise 
provided in this paragraph. 
(B) APPLICATION.—Any Indian tribe seek-
ing a grant under this section shall submit to 
the Secretary an application that includes (in 
addition to any other information the Secretary 
shall require) an identification of the population 
and service area or areas to be served by the 
activities and programs that will be funded by 
the grant. 
(C) 
MONTHLY
GRANT
PAYMENT 
AMOUNTS.— 
(i) IN GENERAL.—The Secretary shall 
pay to each Indian tribe that is awarded a 
grant under this section, for each month 
during the tribe’s grant period (as defined 
in clause (iii)), an amount equal to 15 per-
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cent of the amount determined for the 
tribe under clause (ii). 
(ii) TRIBAL
SHARE
OF
MONTHLY 
HCBS EXPENDITURES.—The amount deter-
mined for an Indian tribe under this clause 
is equal to the— 
(I) the total of the average an-
nual amount of State expenditures 
made by a State or States under title 
XIX of the Social Security Act (42 
U.S.C. 1396 et seq.) that are attrib-
utable to providing medical assistance 
for home and community-based serv-
ices to eligible individuals who reside 
in the service area or areas identified 
by the tribe pursuant to subparagraph 
(B) for the 3 most recent fiscal years 
for which data is available; divided by 
(II) 12. 
(iii) 
GRANT
PERIOD.—The 
term 
‘‘grant period’’ has the same meaning with 
respect to an Indian tribe as the term has 
with respect to a State under paragraph 
(4)(C). 
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262 
(D) 
REDUCTION
OF
STATE
GRANT 
AMOUNTS.—If any State in which lies a service 
area or areas identified by an Indian tribe in a 
successful grant application pursuant to sub-
paragraph (B) is also awarded a grant under 
this section, the Secretary shall reduce the 
amount payable to such State each month 
under paragraph (4) by the portion of the 
amount payable to the Indian tribe under this 
paragraph that is attributable to expenditures 
by the State. 
(d) PERMISSIBLE USES OF FUNDS.— 
(1) IN GENERAL.—A State to which a grant is 
made under this section may use grant funds— 
(A) to work with community partners such 
as Area Agencies on Aging, Independent Living 
Centers, non-profit home and community based 
service providers, and other entities providing 
home and community-based services; 
(B) during the COVID–19 public health 
emergency period, for the purposes described in 
paragraph (2); and 
(C) after the end of such period, for the 
purposes described in paragraph (3). 
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(2) PERMISSIBLE
USES
DURING
THE
EMER-
GENCY
PERIOD.—The purposes described in this 
paragraph for which a State may use grant funds 
awarded under this section are the following: 
(A) To increase rates for home health and 
direct service worker agencies to provide home 
and community-based services under the State 
Medicaid program, provided that any agency or 
individual that receives payment under such an 
increased rate increases the compensation it 
pays its home health or direct service workers. 
(B) To provide paid sick leave, paid family 
leave, and paid medical leave for home health 
workers and direct service workers. 
(C) To provide hazard pay, overtime pay, 
and shift differential pay for home health work-
ers and direct service workers. 
(D) To provide home and community- 
based services to eligible individuals who are on 
waiting lists for programs approved under sec-
tions 1115 or 1915 of the Social Security Act 
(42 U.S.C. 1315, 1396n). 
(E) To purchase emergency supplies and 
equipment necessary to enhance access to serv-
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services and have chosen to temporarily move to 
a more restrictive setting. 
(L) To prepare information and public 
health and educational materials in accessible 
formats about prevention, treatment, recovery 
and other aspects of COVID–19 for eligible in-
dividuals, their families, and the general com-
munity served by home health and direct service 
agencies, including formats accessible to people 
with low literacy or intellectual disabilities. 
(M) To pay for American sign language in-
terpreters to assist in providing home and com-
munity-based services to eligible individuals and 
to inform the general public about COVID–19. 
(N) To allow for day service providers to 
shift to providing home-based services. 
(O) To pay for COVID–19 testing in home 
settings. 
(P) To pay for other expenses deemed ap-
propriate by the Secretary and which meet the 
criteria of the home and community-based set-
tings rule. 
(3) PERMISSIBLE
USES
AFTER
THE
EMER-
GENCY
PERIOD.—The purpose described in this 
paragraph for which a State may use grant funds 
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awarded under this section is to assist eligible indi-
viduals who had to relocate to a nursing facility or 
institutional setting from their homes during the 
COVID–19 public health emergency period in— 
(A) moving back to their homes (including 
by paying for moving costs); 
(B) resuming home and community-based 
services; 
(C) receiving mental health services and 
necessary rehabilitative service to regain skills 
lost while relocated during the public health 
emergency period; and 
(D) continuing home and community-based 
services for eligible individuals who were served 
from a waiting list for such services during the 
public health emergency period. 
(e) REPORTING REQUIREMENTS.— 
(1) STATE
REPORTING
REQUIREMENTS.—Not 
later than 18 months after the end of the COVID– 
19 public health emergency period, any State that 
received a grant under this section shall submit a re-
port to the Secretary that contains the following in-
formation: 
(A) Activities and programs that were 
funded using grant amounts. 
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(B) The number of eligible individuals who 
were served by such activities and programs. 
(C) The number of eligible individuals who 
were able to resume home and community- 
based services as a result of such activities and 
programs. 
(2) HHS REPORT.—Not later than 18 months 
after the end of the COVID–19 public health emer-
gency period, the Secretary shall issue a public sum-
mary of the grants awarded under this section. 
(f) APPROPRIATION.— 
(1) IN GENERAL.—Subject to paragraph (2), 
there are appropriated for fiscal year 2020 from any 
funds in the Treasury not otherwise appropriated 
such sums as are necessary to carry out this section, 
to remain available until expended. 
(2) 
AVAILABILITY
OF
APPROPRIATIONS.— 
Amounts made available under paragraph (1) shall 
not be available for the awarding of grants to States 
that do not submit an application for such a grant 
before the date described in subsection (c)(3)(A). 
(3) UNUSED GRANT FUNDS.—A State that re-
ceives a grant under this section shall return to the 
Secretary any portion of such grant that is unused 
as of the date that is 1 year after the last day of 
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the COVID–19 public health emergency period, and 
such returned portion shall revert to the Treasury. 
(g) PROVIDING
HOME
AND
COMMUNITY-BASED 
SERVICES IN ACUTE CARE HOSPITALS.—Section 1902(h) 
of the Social Security Act (42 U.S.C. 1396a(h)) is amend-
ed— 
(1) by inserting ‘‘(1)’’ after ‘‘(h)’’; 
(2) by inserting ‘‘, home and community-based 
services provided under subsection (c), (d), or (i) of 
section 1915 or under a waiver under section 1115, 
self-directed personal assistance services provided 
pursuant to a written plan of care under section 
1915(j), and home and community-based attendant 
services and supports under section 1915(k)’’ before 
the period; and 
(3) by adding at the end the following: 
‘‘(2) Nothing in this title, title XVIII, or title XI shall 
be construed as prohibiting receipt of any care or services 
specified in paragraph (1) in an acute care hospital that 
are— 
‘‘(A) identified in an individual’s person-cen-
tered plan of services and supports (or comparable 
plan of care); 
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‘‘(B) provided to meet needs of the individual 
that are not met through the provision of hospital 
services; 
‘‘(C) not a substitute for services that the hos-
pital is obligated to provide through its conditions of 
participation or under Federal or State law; and 
‘‘(D) designed to ensure smooth transitions be-
tween acute care settings and home and community- 
based settings, and to preserve the individual’s func-
tions.’’. 
SEC. 70104. DELAY IN REDUCTION OF FMAP FOR MEDICAID 
PERSONAL 
CARE 
SERVICES 
FURNISHED 
WITHOUT 
AN 
ELECTRONIC 
VISIT 
VERIFICATION SYSTEM. 
Section 1903(l) of the Social Security Act (42 U.S.C. 
1396b(l)) is amended— 
(1) in paragraph (1)— 
(A) by striking ‘‘January 1, 2020’’ and in-
serting ‘‘the date that is 6 months after the end 
of the emergency period described in section 
1135(g)(1)(B)’’; and 
(B) in subparagraph (A), by inserting ‘‘(if 
applicable)’’ after ‘‘percentage points’’ each 
place it appears; and 
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270 
(2) in paragraph (4)(A)(i), by inserting before 
the semicolon the following: ‘‘(if applicable) or for 
calendar quarters occurring during the period begin-
ning on the date that is 6 months after the end of 
the 
emergency 
period 
described 
in 
section 
1135(g)(1)(B) and ending on the date that is 1 year 
after the end of such period’’. 
SEC. 70105. COVERAGE AT NO COST SHARING OF COVID–19 
VACCINE AND TREATMENT. 
(a) MEDICAID.— 
(1) IN GENERAL.—Section 1905(a)(4) of the 
Social Security Act (42 U.S.C. 1396d(a)(4)) is 
amended— 
(A) by striking ‘‘and (D)’’ and inserting 
‘‘(D)’’; and 
(B) by striking the semicolon at the end 
and inserting ‘‘; (E) a COVID–19 vaccine li-
censed under section 351 of the Public Health 
Service Act and the administration of such vac-
cine; and (F) items and services furnished for 
the treatment of COVID–19 or a condition that 
may complicate the treatment of COVID–19;’’. 
(2) PROHIBITION OF COST SHARING.— 
(A) IN GENERAL.—Subsections (a)(2) and 
(b)(2) of section 1916 of the Social Security 
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271 
Act (42 U.S.C. 1396o), as amended by section 
6004(a)(2)(A) 
of 
the 
Families 
First 
Coronavirus Response Act, are each amended— 
(i) in subparagraph (F), by striking 
‘‘or’’ at the end; 
(ii) in subparagraph (G), by striking 
‘‘; and’’ and inserting ‘‘, or’’; and 
(iii) by adding at the end the fol-
lowing subparagraphs: 
‘‘(H) a COVID–19 vaccine licensed under 
section 351 of the Public Health Service Act 
and the administration of such vaccine, or 
‘‘(I) any item or service furnished for the 
treatment of COVID–19 or a condition that 
may complicate the treatment of COVID–19; 
and’’. 
(B) APPLICATION TO ALTERNATIVE COST 
SHARING.—Section 1916A(b)(3)(B) of the So-
cial 
Security 
Act 
(42 
U.S.C. 
1396o– 
1(b)(3)(B)), 
as 
amended 
by 
section 
6004(a)(2)(B) 
of 
the 
Families 
First 
Coronavirus Response Act, is amended— 
(i) in clause (xi), by striking ‘‘any 
visit’’ and inserting ‘‘any service’’; and 
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(ii) by adding at the end the following 
clauses: 
‘‘(xii) A COVID–19 vaccine licensed 
under section 351 of the Public Health 
Service Act and the administration of such 
vaccine. 
‘‘(xiii) An item or service furnished 
for the treatment of COVID–19 or a con-
dition that may complicate the treatment 
of COVID–19.’’. 
(C) 
CLARIFICATION.—The 
amendments 
made this subsection shall apply with respect to 
a State plan of a territory in the same manner 
as a State plan of one of the 50 States. 
(b) STATE PEDIATRIC VACCINE DISTRIBUTION PRO-
GRAM.—Section 1928 of the Social Security Act (42 
U.S.C. 1396s) is amended— 
(1) in subsection (a)(1)— 
(A) in subparagraph (A), by striking ‘‘; 
and’’ and inserting a semicolon; 
(B) in subparagraph (B), by striking the 
period and inserting ‘‘; and’’; and 
(C) by adding at the end the following sub-
paragraph: 
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‘‘(C) each vaccine-eligible child (as defined 
in subsection (b)) is entitled to receive a 
COVID–19 vaccine from a program-registered 
provider (as defined in subsection (h)(8)) with-
out charge for— 
‘‘(i) the cost of such vaccine; or 
‘‘(ii) the administration of such vac-
cine.’’; 
(2) in subsection (c)(2)— 
(A) in subparagraph (C)(ii), by inserting ‘‘, 
but may not impose a fee for the administration 
of a COVID–19 vaccine’’ before the period; and 
(B) by adding at the end the following sub-
paragraph: 
‘‘(D) The provider will provide and admin-
ister an approved COVID–19 vaccine to a vac-
cine-eligible child in accordance with the same 
requirements as apply under the preceding sub-
paragraphs to the provision and administration 
of a qualified pediatric vaccine to such a 
child.’’; and 
(3) in subsection (d)(1), in the first sentence, 
by inserting ‘‘, including with respect to a COVID– 
19 vaccine licensed under section 351 of the Public 
Health Service Act’’ before the period. 
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274 
(c) CHIP.— 
(1) IN GENERAL.—Section 2103(c) of the So-
cial Security Act (42 U.S.C. 1397cc(c)), as amended 
by section 6004(b)(1) of the Families First 
Coronavirus Response Act, is amended by adding at 
the end the following paragraph: 
‘‘(11) COVERAGE OF COVID–19 VACCINES AND 
TREATMENT.—The child health assistance provided 
to a targeted low-income child shall include coverage 
of— 
‘‘(A) any COVID–19 vaccine licensed 
under section 351 of the Public Health Service 
Act and the administration of such vaccine; and 
‘‘(B) any item or service furnished for the 
treatment of COVID–19 or a condition that 
may complicate the treatment of COVID–19.’’. 
(2) PROHIBITION OF COST SHARING.—Section 
2103(e)(2) of the Social Security Act (42 U.S.C. 
1397cc(e)(2)), as amended by section 6004(b)(3) of 
the Families First Coronavirus Response Act, is 
amended— 
(A) in the paragraph header, by inserting 
‘‘A COVID–19 VACCINE, COVID–19 TREATMENT,’’ 
before ‘‘OR PREGNANCY-RELATED ASSISTANCE’’; 
and 
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275 
(B) by striking ‘‘visits described in section 
1916(a)(2)(G), or’’ and inserting ‘‘services de-
scribed in section 1916(a)(2)(G), vaccines de-
scribed in section 1916(a)(2)(H), items or serv-
ices described in section 1916(a)(2)(I), or’’. 
(d) CONFORMING AMENDMENTS.—Section 1937 of 
the Social Security Act (42 U.S.C. 1396u–7) is amend-
ed— 
(1) in subsection (a)(1)(B), by inserting ‘‘, 
under 
subclause 
(XXIII) 
of 
section 
1902(a)(10)(A)(ii),’’ 
after 
‘‘section 
1902(a)(10)(A)(i)’’; and 
(2) in subsection (b)(5), by adding before the 
period the following: ‘‘, and, effective on the date of 
the enactment of the Take Responsibility for Work-
ers and Families Act, must comply with subpara-
graphs (F) through (I) of subsections (a)(2) and 
(b)(2) of sections 1916 and 1916A’’. 
(e) EFFECTIVE DATE.—The amendments made by 
this section shall take effect on the date of enactment of 
this Act and shall apply with respect to a COVID–19 vac-
cine beginning on the date that such vaccine is licensed 
under section 351 of the Public Health Service Act (42 
U.S.C. 262). 
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SEC. 70106. OPTIONAL COVERAGE AT NO COST SHARING OF 
COVID–19 TREATMENT AND VACCINES UNDER 
MEDICAID FOR UNINSURED INDIVIDUALS. 
(a) IN GENERAL.—Section 1902(a)(10) of the Social 
Security Act (42 U.S.C. 1396a(a)(10) is amended, in the 
matter following subparagraph (G), by striking ‘‘and any 
visit described in section 1916(a)(2)(G)’’ and inserting the 
following: ‘‘, any COVID–19 vaccine that is administered 
during any such portion (and the administration of such 
vaccine), any item or service that is furnished during any 
such portion for the treatment of COVID–19 or a condi-
tion that may complicate the treatment of COVID–19, 
and any services described in section 1916(a)(2)(G)’’. 
(b) DEFINITION OF UNINSURED INDIVIDUAL.—Sub-
section (ss) of section 1902 of the Social Security Act (42 
U.S.C. 1396a), as added by section 6004(a)(3)(C) of the 
Families First Coronavirus Response Act, is amended to 
read as follows: 
‘‘(ss) UNINSURED INDIVIDUAL DEFINED.—For pur-
poses of this section, the term ‘uninsured individual’ 
means, notwithstanding any other provision of this title, 
any individual who is not covered by minimum essential 
coverage (as defined in section 5000A(f)(1) of the Internal 
Revenue Code of 1986).’’. 
(c) CLARIFICATION REGARDING EMERGENCY SERV-
ICES FOR CERTAIN INDIVIDUALS.—Section 1903(v)(2) of 
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the Social Security Act (42 U.S.C. 1396b(v)(2)) is amend-
ed by adding at the end the following flush sentence: 
‘‘For purposes of subparagraph (A), care and serv-
ices described in such subparagraph include any in 
vitro 
diagnostic 
product 
described 
in 
section 
1905(a)(3)(B) that is administered during any por-
tion of the emergency period described in such sec-
tion beginning on or after the date of the enactment 
of this sentence (and the administration of such 
product), any COVID–19 vaccine that is adminis-
tered during any such portion (and the administra-
tion of such vaccine), any item or service that is fur-
nished during any such portion for the treatment of 
COVID–19 or a condition that may complicate the 
treatment of COVID–19, and any services described 
in section 1916(a)(2)(G).’’. 
(d) INCLUSION
OF COVID–19 CONCERN
AS
AN 
EMERGENCY CONDITION.—Section 1903(v)(3) of the So-
cial Security Act (42 U.S.C. 1396b(v)(3)) is amended by 
adding at the end the following flush sentence: 
‘‘Such term includes any indication that an alien de-
scribed in paragraph (1) may have contracted 
COVID–19.’’. 
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SEC. 70107. TEMPORARY INCREASE IN MEDICAID FEDERAL 
FINANCIAL 
PARTICIPATION 
FOR 
TELE-
HEALTH SERVICES. 
(a) IN GENERAL.—Subject to subsection (b), for each 
calendar quarter occurring during the period beginning on 
the first day 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)) and ending on the last day of the cal-
endar quarter in which the last day of such emergency 
period occurs, in the case of a State that has expenditures 
for telehealth services furnished during such quarter for 
which payment may be made to the State under section 
1903(a) of the Social Security Act (42 U.S.C. 1396b(a)), 
the percentage of Federal financial participation otherwise 
required to be paid to such State under such section for 
such amounts expended shall be increased by one percent-
age point. 
(b) REQUIREMENTS.—A State described in sub-
section (a) may not receive the percentage increase in Fed-
eral financial participation described in such subsection 
with respect to a calendar quarter unless the State pro-
vides for telehealth services under the State plan approved 
under such title XIX (or a waiver of such plan) during 
such quarter in the same manner and to the same extent 
that telehealth services are covered under section 1834(m) 
of the Social Security Act (42 U.S.C. 1395m(m)), includ-
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279 
ing pursuant to any waiver under section 1135 of such 
Act (42 U.S.C. 1320b–5). Nothing in the preceding sen-
tence shall be construed as requiring a State to pay for 
telehealth services furnished to an individual eligible under 
the State plan (or waiver) at a rate that would exceed the 
payment amount that otherwise would be made under the 
State plan (or waiver) for such services. 
SEC. 70108. EXTENSION OF FULL FEDERAL MEDICAL AS-
SISTANCE PERCENTAGE TO INDIAN HEALTH 
CARE PROVIDERS. 
Section 1905 of the Social Security Act (42 U.S.C. 
1396d) is amended— 
(1) in subsection (a)(9), by inserting ‘‘and in-
cluding such services furnished in any location by or 
through an Indian health care provider (as defined 
in section 1932(h)(4)(A))’’ before the semicolon; and 
(2) in subsection (b)— 
(A) by inserting ‘‘(whether or not such 
services are provided within such a facility)’’ 
following ‘‘received through an Indian Health 
Service facility,’’; and 
(B) by striking ‘‘Indian Health Care Im-
provement Act)’’ and inserting ‘‘Indian Health 
Care Improvement Act), or through an Urban 
Indian organization (as defined in section 4 of 
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280 
the Indian Health Care Improvement Act) pur-
suant to a grant or contract with the Indian 
Health Service under title V of the Indian 
Health Care Improvement Act’’. 
SEC. 70109. MEDICAID COVERAGE FOR CITIZENS OF FREE-
LY ASSOCIATED STATES. 
(a) IN GENERAL.—Section 402(b)(2) of the Personal 
Responsibility and Work Opportunity Reconciliation Act 
of 1996 (8 U.S.C. 1612(b)(2)) is amended by adding at 
the end the following new subparagraph: 
‘‘(G) MEDICAID EXCEPTION FOR CITIZENS 
OF FREELY ASSOCIATED STATES.—With respect 
to eligibility for benefits for the designated Fed-
eral program defined in paragraph (3)(C) (re-
lating to the Medicaid program), section 401(a) 
and paragraph (1) shall not apply to any indi-
vidual who lawfully resides in 1 of the 50 States 
or the District of Columbia in accordance with 
the Compacts of Free Association between the 
Government of the United States and the Gov-
ernments of the Federated States of Micro-
nesia, the Republic of the Marshall Islands, and 
the Republic of Palau and shall not apply, at 
the option of the Governor of Puerto Rico, the 
Virgin Islands, Guam, the Northern Mariana 
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Islands, or American Samoa as communicated 
to the Secretary of Health and Human Services 
in writing, to any individual who lawfully re-
sides in the respective territory in accordance 
with such Compacts.’’. 
(b) EXCEPTION TO 5–YEAR LIMITED ELIGIBILITY.— 
Section 403(d) of such Act (8 U.S.C. 1613(d)) is amend-
ed— 
(1) in paragraph (1), by striking ‘‘or’’ at the 
end; 
(2) in paragraph (2), by striking the period at 
the end and inserting ‘‘; or’’; and 
(3) by adding at the end the following new 
paragraph: 
‘‘(3) 
an 
individual 
described 
in 
section 
402(b)(2)(G), but only with respect to the des-
ignated 
Federal 
program 
defined 
in 
section 
402(b)(3)(C).’’. 
(c) DEFINITION
OF QUALIFIED ALIEN.—Section 
431(b) of such Act (8 U.S.C. 1641(b)) is amended— 
(1) in paragraph (6), by striking ‘‘; or’’ at the 
end and inserting a comma; 
(2) in paragraph (7), by striking the period at 
the end and inserting ‘‘, or’’; and 
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(3) by adding at the end the following new 
paragraph: 
‘‘(8) an individual who lawfully resides in the 
United States in accordance with a Compact of Free 
Association referred to in section 402(b)(2)(G), but 
only with respect to the designated Federal program 
defined in section 402(b)(3)(C) (relating to the Med-
icaid program).’’. 
(d) CONFORMING AMENDMENTS.—Section 1108 of 
the Social Security Act (42 U.S.C. 1308), as amended by 
section 101(b), is further amended— 
(1) in subsection (f), in the matter preceding 
paragraph (1), by striking ‘‘subsections (g) and (h) 
and section 1935(e)(1)(B)’’ and inserting ‘‘sub-
sections (g), (h), and (i) and section 1935(e)(1)(B)’’; 
and 
(2) by adding at the end the following: 
‘‘(i) EXCLUSION OF MEDICAL ASSISTANCE EXPENDI-
TURES FOR CITIZENS OF FREELY ASSOCIATED STATES.— 
Expenditures for medical assistance provided to an indi-
vidual described in section 431(b)(8) of the Personal Re-
sponsibility and Work Opportunity Reconciliation Act of 
1996 (8 U.S.C. 1641(b)(8)) shall not be taken into ac-
count for purposes of applying payment limits under sub-
sections (f) and (g).’’. 
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(e) EFFECTIVE DATE.—The amendments made by 
this section shall apply to benefits for items and services 
furnished on or after the date of the enactment of this 
Act. 
SEC. 70110. INCREASED FMAP FOR MEDICAL ASSISTANCE 
TO NEWLY ELIGIBLE INDIVIDUALS. 
(a) IN GENERAL.—Section 1905(y)(1) of the Social 
Security Act (42 U.S.C. 1396d(y)(1)) is amended— 
(1) in subparagraph (A), by striking ‘‘2014, 
2015, and 2016’’ and inserting ‘‘each of the first 3 
consecutive 12-month periods in which the State 
provides medical assistance to newly eligible individ-
uals’’; 
(2) in subparagraph (B), by striking ‘‘2017’’ 
and inserting ‘‘the fourth consecutive 12-month pe-
riod in which the State provides medical assistance 
to newly eligible individuals’’; 
(3) in subparagraph (C), by striking ‘‘2018’’ 
and inserting ‘‘the fifth consecutive 12-month period 
in which the State provides medical assistance to 
newly eligible individuals’’; 
(4) in subparagraph (D), by striking ‘‘2019’’ 
and inserting ‘‘the sixth consecutive 12-month period 
in which the State provides medical assistance to 
newly eligible individuals’’; and 
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(5) in subparagraph (E), by striking ‘‘2020 and 
each year thereafter’’ and inserting ‘‘the seventh 
consecutive 12-month period in which the State pro-
vides medical assistance to newly eligible individuals 
and each such period thereafter’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall take effect as if included in the enact-
ment of the Patient Protection and Affordable Care Act. 
SEC. 70111. RENEWAL OF APPLICATION OF MEDICARE PAY-
MENT RATE FLOOR TO PRIMARY CARE SERV-
ICES FURNISHED UNDER MEDICAID AND IN-
CLUSION OF ADDITIONAL PROVIDERS. 
(a) RENEWAL
OF PAYMENT FLOOR; ADDITIONAL 
PROVIDERS.— 
(1) IN GENERAL.—Section 1902(a)(13) of the 
Social Security Act (42 U.S.C. 1396a(a)(13)) is 
amended by striking subparagraph (C) and inserting 
the following: 
‘‘(C) payment for primary care services (as 
defined in subsection (jj)) at a rate that is not 
less than 100 percent of the payment rate that 
applies to such services and physician under 
part B of title XVIII (or, if greater, the pay-
ment rate that would be applicable under such 
part if the conversion factor under section 
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1848(d) for the year involved were the conver-
sion factor under such section for 2009), and 
that is not less than the rate that would other-
wise apply to such services under this title if 
the rate were determined without regard to this 
subparagraph, and that are— 
‘‘(i) furnished in 2013 and 2014, by a 
physician with a primary specialty designa-
tion of family medicine, general internal 
medicine, or pediatric medicine; or 
‘‘(ii) furnished during the period be-
ginning on the first day of the first month 
beginning after the date of the enactment 
of the Take Responsibility for Workers and 
Families Act and ending on the last day of 
the calendar quarter during which the last 
day of the emergency period described in 
section 1135(g)(1)(B) occurs— 
‘‘(I) by a physician with a pri-
mary specialty designation of family 
medicine, general internal medicine, 
pediatric medicine, or obstetrics and 
gynecology, but only if the physician 
self-attests that the physician is 
board-certified in family medicine, 
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general internal medicine, pediatric 
medicine, or obstetrics and gyne-
cology, respectively; 
‘‘(II) by a physician with a pri-
mary specialty designation of a family 
medicine subspecialty, an internal 
medicine subspecialty, a pediatric sub-
specialty, or a subspecialty of obstet-
rics and gynecology, without regard to 
the board that offers the designation 
for such a subspecialty, but only if the 
physician self-attests that the physi-
cian is board-certified in such a sub-
specialty; 
‘‘(III) by an advanced practice 
clinician, as defined by the Secretary, 
that works under the supervision of— 
‘‘(aa) a physician described 
in subclause (I) or (II); or 
‘‘(bb) a nurse practitioner or 
a physician assistant (as such 
terms are defined in section 
1861(aa)(5)(A)) who is working 
in accordance with State law, or 
a certified nurse-midwife (as de-
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midwife 
described 
in 
subclause 
(III)(bb), in accordance with proce-
dures that ensure that the portion of 
the payment for such services that the 
nurse practitioner, physician assist-
ant, or certified nurse-midwife is paid 
is not less than the amount that the 
nurse practitioner, physician assist-
ant, or certified nurse-midwife would 
be paid if the services were provided 
under part B of title XVIII;’’. 
(2) 
CONFORMING
AMENDMENTS.—Section 
1905(dd) of the Social Security Act (42 U.S.C. 
1396d(dd)) is amended— 
(A) by striking ‘‘Notwithstanding’’ and in-
serting the following: 
‘‘(1) IN GENERAL.—Notwithstanding’’; 
(B) by inserting ‘‘or furnished during the 
additional period specified in paragraph (2),’’ 
after ‘‘2015,’’; and 
(C) by adding at the end the following: 
‘‘(2) ADDITIONAL
PERIOD.—For purposes of 
paragraph (1), the additional period specified in this 
paragraph is the period with respect to which section 
1902(a)(13)(C)(ii) applies.’’. 
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(b) IMPROVED TARGETING OF PRIMARY CARE.—Sec-
tion 1902(jj) of the Social Security Act (42 U.S.C. 
1396a(jj)) is amended— 
(1) by redesignating paragraphs (1) and (2) as 
subparagraphs (A) and (B), respectively, and mov-
ing the margin of each such subparagraph, as so re-
designated, 2 ems to the right; 
(2) by striking ‘‘For purposes of’’ and inserting 
the following: 
‘‘(1) IN GENERAL.—For purposes of’’; and 
(3) by adding at the end the following: 
‘‘(2) EXCLUSIONS.—Such term does not include 
any services described in subparagraph (A) or (B) of 
paragraph (1) if such services are provided in an 
emergency department of a hospital during the pe-
riod described in subsection (a)(13)(C)(ii).’’. 
(c) ENSURING PAYMENT BY MANAGED CARE ENTI-
TIES.— 
(1) IN
GENERAL.—Section 1903(m)(2)(A) of 
the Social Security Act (42 U.S.C. 1396b(m)(2)(A)) 
is amended— 
(A) in clause (xii), by striking ‘‘and’’ after 
the semicolon; 
(B) in clause (xiii)— 
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(i) by moving the margin of such 
clause 2 ems to the left; and 
(ii) by striking the period at the end 
and inserting ‘‘; and’’; and 
(C) by inserting after clause (xiii) the fol-
lowing: 
‘‘(xiv) such contract provides that (I) payments 
to health care providers specified in section 
1902(a)(13)(C) for furnishing primary care services 
defined in section 1902(jj) during a year or period 
specified in section 1902(a)(13)(C) are at least equal 
to the amounts set forth and required by the Sec-
retary by regulation, (II) the entity shall, upon re-
quest, provide documentation to the State that is 
sufficient to enable the State and the Secretary to 
ensure compliance with subclause (I), and (III) the 
Secretary shall approve payments described in sub-
clause (I) that are furnished through an agreed- 
upon capitation, partial capitation, or other value- 
based payment arrangement if the agreed-upon capi-
tation, partial capitation, or other value-based pay-
ment arrangement is based on a reasonable method-
ology and the entity provides documentation to the 
State that is sufficient to enable the State and the 
Secretary to ensure compliance with subclause (I).’’. 
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(2) 
CONFORMING
AMENDMENT.—Section 
1932(f) of the Social Security Act (42 U.S.C. 
1396u–2(f)) is amended by inserting ‘‘and clause 
(xiv) of section 1903(m)(2)(A)’’ before the period. 
(3) EFFECTIVE DATE.—The amendments made 
by this subsection shall apply with respect to con-
tracts entered into on or after the date of the enact-
ment of this Act. 
SEC. 70112. TEMPORARY INCREASE IN MEDICAID DSH AL-
LOTMENTS. 
(a) IN GENERAL.—Section 1923(f)(3) of the Social 
Security Act (42 U.S.C. 1396r–4(f)(3)) is amended— 
(1) in subparagraph (A), by striking ‘‘and sub-
paragraph (E)’’ and inserting ‘‘and subparagraphs 
(E) and (F)’’; and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(F) TEMPORARY
INCREASE
IN
ALLOT-
MENTS
DURING
CERTAIN
PUBLIC
HEALTH 
EMERGENCY.—The DSH allotment for any 
State is— 
‘‘(i) for fiscal year 2020, equal to 
102.5 percent of the DSH allotment that 
would be determined under this paragraph 
for the State for fiscal year 2020 without 
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application of this subparagraph, notwith-
standing subparagraphs (B) and (C); and 
‘‘(ii) for a subsequent fiscal year (if 
any) during which the emergency period 
defined in paragraph (1)(B) of section 
1135(g) of the Social Security Act is in ef-
fect, equal to 102.5 percent of the DSH al-
lotment determined under this subpara-
graph for the State for the previous fiscal 
year. 
For each fiscal year after fiscal year 2020 dur-
ing which the emergency period described in 
clause (ii) is not in effect, the DSH allotment 
for a State for such fiscal year is equal to the 
DSH allotment that would have been deter-
mined under this paragraph for such fiscal year 
if this subparagraph had not been enacted.’’. 
(b) SENSE OF CONGRESS.—It is the sense of Con-
gress that a State should prioritize making payments 
under the State plan of the State under title XIX of the 
Social Security Act (42 U.S.C. 1396 et seq.) (or a waiver 
of such plan) to disproportionate share hospitals that have 
a higher share of COVID–19 patients relative to other 
such hospitals in the State. 
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293 
SEC. 70113. TEMPORARY ALLOWANCE FOR MEDICAL AS-
SISTANCE UNDER MEDICAID FOR INMATES 
DURING 
30-DAY 
PERIOD 
PRECEDING 
RE-
LEASE. 
The subdivision (A) following paragraph (30) of sec-
tion 1905(a) of the Social Security Act (42 U.S.C. 
1396d(a)) is amended by inserting ‘‘and except during the 
30-day period preceding the date of release of such indi-
vidual from such public institution, but only if such 30- 
day period occurs during the emergency period described 
in section 1135(g)(1)(B)’’ after ‘‘medical institution’’. 
SEC. 70114. EXTENSION OF EXISTING SECTION 1115 DEM-
ONSTRATION PROJECTS. 
(a) APPLICABILITY.—This section shall apply with 
respect to demonstration projects operated by States pur-
suant to section 1115(a) of the Social Security Act (42 
U.S.C. 1315(a)) to promote the objectives of title XIX or 
XXI of the Social Security Act with a project term set 
to end on or before December 31, 2020. 
(b) APPROVAL OF EXTENSION.—Upon request by a 
State, the Secretary of Health and Human Services shall 
approve an extension of the waiver and expenditure au-
thorities for a demonstration project described in sub-
section (a) for a period up to and including December 31, 
2021, to ensure continuity of programs and funding dur-
ing 
the 
emergency 
period 
described 
in 
section 
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294 
1135(g)(1)(B) of the Social Security Act (42 U.S.C. 42 
U.S.C. 1320b–5(g)(1)(B)). 
(c) EXTENSION TERMS AND CONDITIONS.—(1) The 
approval pursuant to this section shall extend the terms 
and conditions that applied to the demonstration project 
to the extension period. Financial terms and conditions 
shall continue at levels equivalent to the prior demonstra-
tion or program year. All demonstration program compo-
nents shall be extended to operate through ffthe end of 
the extension term. In its request for an extension, the 
state shall identify operational and programmatic changes 
necessary to continue and stabilize programs into the ex-
tension period and shall work with the Secretary of Health 
and Human Services to implement such changes. 
(2) Notwithstanding the foregoing, the State 
may request, and the Secretary of Health and 
Human Services may approve, modifications to a 
demonstration project’s terms and conditions to ad-
dress the impact of the federally designated public 
health emergency with respect to COVID–19. Such 
modifications may, at the option of the State, be-
come effective retroactive to the start of the calendar 
quarter in which the first day of the emergency pe-
riod described in paragraph (1)(B) of section 
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1135(g) of the Social Security Act 42 U.S.C. 42 
U.S.C. 1320b–5(g)) occurs. 
(d) BUDGET NEUTRALITY.—Budget neutrality for 
extensions under this section shall be deemed to have been 
met at the conclusion of the extension period, and States 
receiving extensions under this section shall not be re-
quired to submit a budget neutrality analysis for the ex-
tension period. 
(e) EXPEDITED APPLICATION PROCESS.—The Fed-
eral and State public notice and comment procedures or 
other time constraints otherwise applicable to demonstra-
tion project amendments shall be waived to expedite a 
State’s extension request pursuant to this section. The 
Secretary of Health and Human Services shall approve the 
extension application within 45 days of a State’s submis-
sion of its request, or such other timeframe as is mutually 
agreed to with the State. 
(f) CONTINUATION
OF SECRETARIAL AUTHORITY 
UNDER DECLARED EMERGENCY.—This section does not 
restrict the Secretary of Health and Human Services from 
exercising existing flexibilities through demonstration 
projects operated pursuant to section 1115 of the Social 
Security Act (42 U.S.C. 1315) in conjunction with the 
COVID–19 public health emergency. 
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(g) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall authorize the Secretary of Health and Human 
Service to approve or extend a waiver that fails to meet 
the requirements of section 1115 of the Social Security 
Act (42 U.S.C. 1315). 
SEC. 70115. MODIFICATION OF REDUCTIONS IN MEDICAID 
DSH ALLOTMENTS. 
Section 1923(f)(7)(A) of the Social Security Act (42 
U.S.C. 1396r–4(f)(7)(A)) is amended— 
(1) in clause (i), in the matter preceding sub-
clause (I), by striking ‘‘For the period beginning 
May 23, 2020, and ending September 30, 2020, and 
for each of fiscal years 2021 through 2025’’ and in-
serting ‘‘For the period beginning December 1, 
2020, and ending September 30, 2021, and for each 
of fiscal years 2022 through 2025’’; and 
(2) in clause (ii)— 
(A) in subclause (I), by striking ‘‘for the 
period beginning May 23, 2020, and ending 
September 30, 2020’’ and inserting ‘‘for the pe-
riod beginning December 1, 2020, and ending 
September 30, 2021’’; and 
(B) in subclause (II), by striking ‘‘for each 
of fiscal years 2021 through 2025’’ and insert-
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297 
ing ‘‘for each of fiscal years 2022 through 
2025’’. 
SEC. 70116. EXTENSION OF MONEY FOLLOWS THE PERSON 
REBALANCING DEMONSTRATION. 
(a) IN GENERAL.—Section 6071(h)(1) of the Deficit 
Reduction Act of 2005 (42 U.S.C. 1396a note) is amend-
ed— 
(1) in subparagraph (F), by striking ‘‘and’’ at 
the end; and 
(2) by striking subparagraph (G) and inserting 
the following: 
‘‘(G) $450,000,000 for fiscal year 2020; 
and 
‘‘(H) $75,206,000 for the period beginning 
on October 1, 2020, and ending on November 
30, 2020.’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall take effect as if included in the enact-
ment of the Further Consolidated Appropriations Act, 
2020 (Public Law 116–94). 
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298 
SEC. 70117. EXTENSION OF PROTECTION FOR MEDICAID 
RECIPIENTS OF HOME AND COMMUNITY- 
BASED SERVICES AGAINST SPOUSAL IMPOV-
ERISHMENT. 
(a) IN GENERAL.—Section 2404 of Public Law 111– 
148 (42 U.S.C. 1396r–5 note) is amended by striking 
‘‘May 22, 2020’’ and inserting ‘‘November 30, 2020’’. 
(b) RULE OF CONSTRUCTION.—Nothing in section 
2404 of Public Law 111–148 (42 U.S.C. 1396r–5 note) 
or section 1902(a)(17) or 1924 of the Social Security Act 
(42 U.S.C. 1396a(a)(17), 1396r–5) shall be construed as 
prohibiting a State from applying an income or resource 
disregard under a methodology authorized under section 
1902(r)(2) of such Act (42 U.S.C. 1396a(r)(2))— 
(1) to the income or resources of an individual 
described in section 1902(a)(10)(A)(ii)(VI) of such 
Act (42 U.S.C. 1396a(a)(10)(A)(ii)(VI)) (including 
a disregard of the income or resources of such indi-
vidual’s spouse); or 
(2) on the basis of an individual’s need for 
home and community-based services authorized 
under subsection (c), (d), (i), or (k) of section 1915 
of such Act (42 U.S.C. 1396n) or under section 
1115 of such Act (42 U.S.C. 1315). 
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299 
SEC. 70118. EXTENSION OF THE COMMUNITY MENTAL 
HEALTH SERVICES DEMONSTRATION PRO-
GRAM. 
Section 223(d)(3) of the Protecting Access to Medi-
care Act of 2014 (42 U.S.C. 1396a note) is amended by 
striking ‘‘May 22, 2020’’ and inserting ‘‘November 30, 
2020’’. 
TITLE II—MEDICARE 
SEC. 70201. COVERAGE OF THE COVID-19 VACCINE UNDER 
THE MEDICARE PROGRAM WITHOUT ANY 
COST-SHARING. 
(a) MEDICAL AND OTHER HEALTH SERVICES.—Sec-
tion 1861(s)(10)(A) of the Social Security Act (42 U.S.C. 
1395x(s)(10)(A)) is amended by inserting ‘‘, and COVID- 
19 vaccine and its administration’’ after ‘‘influenza vac-
cine and its administration’’. 
(b) PART B DEDUCTIBLE.—Section 1833(b) of the 
Social Security Act (42 U.S.C. 1395l(b)) is amended, in 
the first sentence— 
(1) by striking ‘‘and’’ before ‘‘(11)’’; and (B) by 
inserting before the period at the end the following: 
‘‘, and (11) 
(2) by inserting before the period at the end the 
following: ‘‘, and (12) such deductible shall not 
apply with respect a COVID-19 vaccine and its ad-
ministration described in section 1861(s)(10)(A)’’. 
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(c) WAIVING COST-SHARING UNDER MEDICARE AD-
VANTAGE.—Section 1852(a)(1)(B) of the Social Security 
Act (42 U.S.C. 1395w–22(a)(1)(B)) is amended— 
(1) in clause (iv)— 
(A) by redesignating subclause (VI) as 
subclause (VII); and 
(B) by inserting after subclause (V) the 
following new subclause: 
‘‘(VI) COVID-19 vaccines and 
the administration of such vaccines, 
as 
described 
in 
section 
1861(s)(10)(A).’’; and 
(2) in clause (v), by striking ‘‘subclauses (IV) 
and (V)’’ and inserting ‘‘subclauses (IV), (V), and 
(VI)’’. 
(d) IMPLEMENTATION.—Notwithstanding any other 
provision of law, the Secretary of Health and Human 
Services may implement the amendments made by sub-
section (c) by program instruction or otherwise. 
(e) PAYMENT FOR ADMINISTRATION OF COVID-19 
VACCINE.—The payment amount under part B of title 
XVIII of the Social Security Act for the administration 
of a COVID-19 vaccine pursuant to the amendment made 
by subsection (a) shall be the same as the payment 
amount under such part for the administration of an influ-
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enza vaccine, pneumococcal vaccine, and a hepatitis B vac-
cine. 
(f) AUTHORITY
FOR ROSTER BILLING.—Notwith-
standing any other provision of law, the Secretary of 
Health and Human Services may, by program instruction 
or otherwise, include a COVID-19 vaccine as a vaccine 
with respect to which the Secretary permits roster billing 
for purposes of payment under part B of title XVIII of 
the Social Security Act. 
(g) EFFECTIVE DATE.—The amendments made by 
this section shall take effect on the date of enactment of 
this Act and shall apply with respect to a COVID-19 vac-
cine beginning on the date that such vaccine is licensed 
under section 351 of the Public Health Service Act (42 
U.S.C. 262). 
SEC. 70202. HOLDING MEDICARE BENEFICIARIES HARM-
LESS FOR SPECIFIED COVID-19 TREATMENT 
SERVICES FURNISHED UNDER PART A OR 
PART B OF THE MEDICARE PROGRAM. 
(a) IN GENERAL.—Notwithstanding any other provi-
sion of law, in the case of a specified COVID-19 treatment 
service (as defined in subsection (b)) furnished to an indi-
vidual entitled to benefits under part A or enrolled under 
part B of title XVIII of the Social Security Act (42 U.S.C. 
1395 et seq.) for which payment is made under such part 
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302 
A or such part B, the Secretary of Health and Human 
Services (in this section referred to as the ‘‘Secretary’’) 
shall provide that— 
(1) any cost-sharing required (including any de-
ductible, copayment, or coinsurance) applicable to 
such individual under such part A or such part B 
with respect to such item or service is paid by the 
Secretary; and 
(2) the provider of services or supplier (as de-
fined in section 1861 of the Social Security Act (42 
U.S.C. 1395x)) does not hold such individual liable 
for such requirement. 
(b) DEFINITION OF SPECIFIED COVID-19 TREAT-
MENT SERVICES.—For purposes of this section, the term 
‘‘specified COVID-19 treatment service’’ means any item 
or service furnished to an individual for which payment 
may be made under part A or part B of title XVIII of 
the Social Security Act (42 U.S.C. 1395 et seq.) if such 
item or service is included in a claim with an ICD-10- 
CM code relating to COVID-19 (as described in the docu-
ment entitled ‘‘ICD-10-CM Official Coding Guidelines - 
Supplement Coding encounters related to COVID-19 
Coronavirus Outbreak’’ published on February 20, 2020, 
or as otherwise specified by the Secretary). 
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(c) RECOVERY OF COST-SHARING AMOUNTS PAID BY 
THE SECRETARY IN THE CASE OF SUPPLEMENTAL IN-
SURANCE COVERAGE.— 
(1) IN GENERAL.—In the case of any amount 
paid by the Secretary pursuant to subsection (a)(1) 
that the Secretary determines would otherwise have 
been paid by a group health plan or health insurance 
issuer (as such terms are defined in section 2791 of 
the Public Health Service Act (42 U.S.C. 300gg– 
91)), a private entity offering a medicare supple-
mental policy under section 1882 of the Social Secu-
rity Act (42 U.S.C. 1395ss), any other health plan 
offering supplemental coverage, a State plan under 
title XIX of the Social Security Act, or the Secretary 
of Defense under the TRICARE program, such 
plan, issuer, private entity, other health plan, State 
plan, or Secretary of Defense, as applicable, shall 
pay to the Secretary, not later than 1 year after 
such plan, issuer, private entity, other health plan, 
State plan, or Secretary of Defense receives a notice 
under paragraph (3), such amount in accordance 
with this subsection. 
(2) REQUIRED INFORMATION.—Not later than 
9 months after the date of the enactment of this 
Act, each group health plan, health insurance issuer, 
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304 
private entity, other health plan, State plan, and 
Secretary of Defense described in paragraph (1) 
shall submit to the Secretary such information as 
the Secretary determines necessary for purposes of 
carrying out this subsection. Such information so 
submitted shall be updated by such plan, issuer, pri-
vate entity, other health plan, State plan, or Sec-
retary of Defense, as applicable, at such time and in 
such manner as specified by the Secretary. 
(3) REVIEW OF CLAIMS AND NOTIFICATION.— 
The Secretary shall establish a process under which 
claims for items and services for which the Secretary 
has paid an amount pursuant to subsection (a)(1) 
are reviewed for purposes of identifying if such 
amount would otherwise have been paid by a plan, 
issuer, private entity, other health plan, State plan, 
or Secretary of Defense described in paragraph (1). 
In the case such a claim is so identified, the Sec-
retary shall determine the amount that would have 
been otherwise payable by such plan, issuer, private 
entity, other health plan, State plan, or Secretary of 
Defense and notify such plan, issuer, private entity, 
other health plan, State plan, or Secretary of De-
fense of such amount. 
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(4) ENFORCEMENT.—The Secretary may im-
pose a civil monetary penalty in an amount deter-
mined appropriate by the Secretary in the case of a 
plan, issuer, private entity, other health plan, or 
State plan that fails to comply with a provision of 
this section. The provisions of section 1128A of the 
Social Security Act shall apply to a civil monetary 
penalty imposed under the previous sentence in the 
same manner as such provisions apply to a penalty 
or proceeding under subsection (a) or (b) of such 
section. 
(d) FUNDING.—The Secretary shall provide for the 
transfer to the Centers for Medicare & Medicaid Program 
Management Account from the Federal Hospital Insur-
ance Trust Fund and the Federal Supplementary Trust 
Fund (in such portions as the Secretary determines appro-
priate) $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 
Department 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). 
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306 
(f) IMPLEMENTATION.—Notwithstanding any other 
provision of law, the Secretary may implement the provi-
sions of this section by program instruction or otherwise. 
SEC. 70203. MEDICARE SEQUESTER DELAY. 
During the period beginning on May 1, 2020, and 
ending on such date the emergency period described in 
section 1135(g)(1)(B) of the Social Security Act (42 
U.S.C. 1320b–5(g)(1)(B)) ends, the Medicare program 
under title XVIII of the Social Security Act (42 U.S.C. 
1395 et seq.) shall be exempt from reduction under any 
sequestration order issued pursuant to section 254 of the 
Balanced Budget and Emergency Deficit Control Act of 
1985 before, on, or after the date of enactment of this 
Act. 
SEC. 70204. ENHANCING MEDICARE TELEHEALTH SERV-
ICES FOR FEDERALLY QUALIFIED HEALTH 
CENTERS AND RURAL HEALTH CLINICS DUR-
ING THE EMERGENCY PERIOD. 
Section 1834(m) of the Social Security Act (42 
U.S.C. 1395m(m)) is amended— 
(1) in the first sentence of paragraph (1), by 
striking ‘‘The Secretary’’ and inserting ‘‘Subject to 
paragraph (8), the Secretary’’; 
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(2) in paragraph (2)(A), by striking ‘‘The Sec-
retary’’ and inserting ‘‘Subject to paragraph (8), the 
Secretary’’; 
(3) in paragraph (4)— 
(A) in subparagraph (A), by striking ‘‘The 
term’’ and inserting ‘‘Subject to paragraph 
(8),the term’’; and 
(B) in subparagraph (F)(i), by striking 
‘‘The term’’ and inserting ‘‘Subject to para-
graph (8), the term’’; and 
(4) by adding at the end the following new 
paragraph: 
‘‘(8) ENHANCING TELEHEALTH SERVICES FOR 
FEDERALLY
QUALIFIED
HEALTH
CENTERS
AND 
RURAL HEALTH CLINICS DURING THE EMERGENCY 
PERIOD.— 
‘‘(A) IN GENERAL.—During the emergency 
period described in section 1135(g)(1)(B)— 
‘‘(i) the Secretary shall pay for tele-
health services that are furnished via a 
telecommunications system by a Federally 
qualified health center or a rural health 
clinic to an eligible telehealth individual en-
rolled under this part notwithstanding that 
the Federally qualified health center or 
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rural clinic providing the telehealth service 
is not at the same location as the bene-
ficiary; 
‘‘(ii) the amount of payment to a Fed-
erally qualified health center or rural 
health clinic that serves as a distant site 
for such a telehealth service shall be deter-
mined under subparagraph (B); and 
‘‘(iii) for purposes of this subsection— 
‘‘(I) the term ‘distant site’ in-
cludes a Federally qualified health 
center or rural health clinic that fur-
nishes a telehealth service to an eligi-
ble telehealth individual; and 
‘‘(II) the term ‘telehealth serv-
ices’ includes a rural health clinic 
service or Federally qualified health 
center service that is furnished using 
telehealth to the extent that payment 
codes corresponding to services identi-
fied by the Secretary under clause (i) 
or (ii) of paragraph (4)(F) are listed 
on the corresponding claim for such 
rural health clinic service or Federally 
qualified health center service. 
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309 
‘‘(B) SPECIAL PAYMENT RULE.—The Sec-
retary shall develop and implement payment 
methods that apply under this subsection to a 
Federally qualified health center or rural health 
clinic that serves as a distant site that furnishes 
a telehealth service to an eligible telehealth indi-
vidual during such emergency period. Such pay-
ment methods shall be based on payment rates 
that are similar to the national average pay-
ment rates for comparable telehealth services 
under the physician fee schedule under section 
1848. Notwithstanding any other provision of 
law, the Secretary may implement such pay-
ment methods through program instruction or 
otherwise.’’. 
SEC. 70205. GUARANTEED ISSUE OF CERTAIN MEDIGAP 
POLICIES. 
(a) GUARANTEED ISSUE OF MEDIGAP POLICIES TO 
ALL MEDIGAP-ELIGIBLE MEDICARE BENEFICIARIES.— 
(1) IN GENERAL.—Section 1882(s) of the So-
cial Security Act (42 U.S.C. 1395ss(s)) is amend-
ed— 
(A) in paragraph (2)(A), by striking ‘‘65 
years of age or older and is enrolled for benefits 
under part B’’ and inserting ‘‘entitled to, or en-
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310 
rolled for, benefits under part A and enrolled 
for benefits under part B’’; 
(B) in paragraph (2)(D), by striking ‘‘who 
is 65 years of age or older as of the date of 
issuance and’’; 
(C) in paragraph (3)(B)(ii), by striking ‘‘is 
65 years of age or older and’’; and 
(D) in paragraph (3)(B)(vi), by striking 
‘‘at age 65’’. 
(2) ADDITIONAL
ENROLLMENT
PERIOD
FOR 
CERTAIN INDIVIDUALS.— 
(A) ONE-TIME ENROLLMENT PERIOD.— 
(i) IN
GENERAL.—In the case of a 
specified individual, the Secretary shall es-
tablish a one-time enrollment period de-
scribed in clause (iii) during which such an 
individual may enroll in any medicare sup-
plemental policy of the individual’s choos-
ing. 
(ii) 
APPLICATION.—The 
provisions 
of— 
(I) paragraph (2) of section 
1882(s) of the Social Security Act (42 
U.S.C. 1395ss(s)) shall apply with re-
spect to a specified individual who is 
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described in subclause (I) of subpara-
graph (B)(iii) as if references in such 
paragraph (2) to the 6 month period 
described in subparagraph (A) of such 
paragraph were references to the one- 
time enrollment period established 
under clause (i); and 
(II) paragraph (3) of such sec-
tion shall apply with respect to a spec-
ified individual who is described in 
subclause 
(II) 
of 
subparagraph 
(B)(iii) as if references in such para-
graph (3) to the period specified in 
subparagraph (E) of such paragraph 
were references to the one-time enroll-
ment period established under clause 
(i). 
(iii) PERIOD.—The enrollment period 
established under clause (i) shall be the 6- 
month period beginning on January 1, 
2024. 
(B) SPECIFIED
INDIVIDUAL.—For pur-
poses of this paragraph, the term ‘‘specified in-
dividual’’ means an individual who— 
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(i) is entitled to hospital insurance 
benefits under part A of title XVIII of the 
Social Security Act (42 U.S.C. 1395c et 
seq.) pursuant to section 226(b) or section 
226A of such Act (42 U.S.C. 426(b); 426– 
1); 
(ii) is enrolled for benefits under part 
B of such Act (42 U.S.C. 1395j et seq.); 
and 
(iii)(I) would not, but for the amend-
ments made by subparagraphs (A) and (B) 
of paragraph (1) and the provisions of this 
paragraph (if such provisions applied to 
such individual), be eligible for the guaran-
teed issue of a medicare supplemental pol-
icy under paragraph (2) of section 1882(s) 
of such Act (42 U.S.C. 1395ss(s)); or 
(II) would not, but for the amend-
ments made by subparagraphs (C) and (D) 
of paragraph (1) and the provisions of this 
paragraph (if such provisions applied to 
such individual), be eligible for the guaran-
teed issue of a medicare supplemental pol-
icy under paragraph (3) of such section. 
(C) OUTREACH PLAN.— 
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313 
(i) IN GENERAL.—The Secretary shall 
develop an outreach plan to notify specified 
individuals of the one-time enrollment pe-
riod established under subparagraph (A). 
(ii) 
CONSULTATION.—In 
imple-
menting the outreach plan developed under 
clause (i), the Secretary shall consult with 
consumer advocates, brokers, insurers, the 
National Association of Insurance Commis-
sioners, and State Health Insurance As-
sistance Programs. 
(3) EFFECTIVE DATE.—The amendments made 
by paragraph (1) shall apply to medicare supple-
mental policies effective on or after January 1, 
2024. 
(b) GUARANTEED ISSUE OF MEDIGAP POLICIES FOR 
MEDICARE ADVANTAGE ENROLLEES.— 
(1) IN
GENERAL.—Section 1882(s)(3) of the 
Social Security Act (42 U.S.C. 1395ss(s)(3)), as 
amended by subsection (a), is further amended— 
(A) in subparagraph (B), by adding at the 
end the following new clause: 
‘‘(vii) The individual— 
‘‘(I) was enrolled in a Medicare Advantage 
plan under part C for not less than 12 months; 
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314 
‘‘(II) subsequently disenrolled from such 
plan; 
‘‘(III) elects to receive benefits under this 
title through the original Medicare fee-for-serv-
ice program under parts A and B; and 
‘‘(IV) has not previously elected to receive 
benefits under this title through the original 
Medicare fee-for-service program pursuant to 
disenrollment from a Medicare Advantage plan 
under part C.’’; 
(B) by striking subparagraph (C)(iii) and 
inserting the following: 
‘‘(iii) Subject to subsection (v)(1), for purposes of an 
individual described in clause (vi) or (vii) of subparagraph 
(B), a medicare supplemental policy described in this sub-
paragraph shall include any medicare supplemental pol-
icy.’’; and 
(C) in subparagraph (E)— 
(i) in clause (iv), by striking ‘‘and’’ at 
the end; 
(ii) in clause (v), by striking the pe-
riod at the end and inserting ‘‘; and’’; and 
(iii) by adding at the end the fol-
lowing new clause— 
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315 
‘‘(vi) in the case of an individual described in 
subparagraph (B)(vii), the annual, coordinated elec-
tion period (as defined in section 1851(e)(3)(B)) or 
a continuous open enrollment period (as defined in 
section 1851(e)(2)) during which the individual 
disenrolls from a Medicare Advantage plan under 
part C.’’. 
(2) EFFECTIVE DATE.—The amendments made 
by paragraph (1) shall apply to medicare supple-
mental policies effective on or after January 1, 
2024. 
SEC. 70206. 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 
Security 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: 
‘‘(F) provide for reasonable access to the 
use of a telephone, including TTY and TDD 
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316 
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 in-
form each such resident (or a representative of 
such resident) of such access and any changes 
in policies or procedures 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 
emergency period defined in section 1135(g)(1)(B) 
of the Social Security Act (42 U.S.C. 1320b– 
5(g)(1)(B)). 
(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 ac-
cess rights described in section 1819(c)(3)(F) of the 
Social Security Act (42 U.S.C. 1395i–3(c)(3)(F)). 
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317 
SEC. 70207. 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 So-
cial Security Act (42 U.S.C. 1395ww(d)(5)(A)) is amend-
ed— 
(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 
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 de-
termined 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 ‘approxi-
mate the marginal cost of care beyond the cutoff 
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318 
point applicable under clause (i) or (ii)’ were a ref-
erence to ‘approximate the marginal cost of care be-
yond 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 ex-
ceed 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’’. 
(c) APPLICATION TO SITE NEUTRAL IPPS PAYMENT 
RATES.—Section 1886(m)(6)(B) of the Social Security 
Act (42 U.S.C. 1395ww(m)(6)(B)) is amended— 
(1) in clause (i)— 
(A) in the matter preceding subclause (I), 
by striking ‘‘In this paragraph’’ and inserting 
‘‘Subject to clause (ii), in this paragraph’’; 
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(B) in subclause (I), by striking ‘‘clause 
(iii)’’ and inserting ‘‘clause (iv)’’; and 
(C) in subclause (II), by striking ‘‘clause 
(ii)’’ and inserting ‘‘clause (iii)’’; 
(2) in clause (ii), in the matter preceding sub-
clause (I), by striking ‘‘clause (iv)’’ and inserting 
‘‘clause (v)’’; 
(3) in clause (iii)(I), by striking ‘‘clause (ii)’’ 
and inserting ‘‘clause (iii)’’; 
(4) in clause (iv), by striking ‘‘clause (ii)(I)’’ 
and inserting ‘‘clause (iii)(I)’’; 
(5) by redesignating clauses (ii) through (iv) as 
clauses (iii) through (v), respectively; and 
(6) by inserting after clause (i) the following 
new clause: 
‘‘(ii) 
EXCEPTION.—Notwithstanding 
clause (i), the term ‘applicable site neutral 
payment rate’ means— 
‘‘(I) for discharges that have a 
primary or secondary diagnosis of 
COVID-19 and that occur during any 
portion of the emergency period de-
scribed in section 1135(g)(1)(B) oc-
curring during a cost reporting period 
described in clause (i)(I), the greater 
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of the blended payment rate specified 
in clause (iv) or the percent described 
in clause (iii)(II); and 
‘‘(II) for discharges that have a 
primary or secondary diagnosis of 
COVID-19 and that occur during any 
portion of the emergency period de-
scribed in section 1135(g)(1)(B) oc-
curring during a cost reporting period 
described in clause (i)(II), the percent 
described in clause (iii)(II).’’. 
(d) IMPLEMENTATION.—Notwithstanding any other 
provision of law, the Secretary of Health and Human 
Services may implement the amendments made by this 
section by program instruction or otherwise. 
SEC. 70208. COVERAGE OF TREATMENTS FOR COVID–19 AT 
NO COST SHARING UNDER THE MEDICARE 
ADVANTAGE PROGRAM. 
(a) IN GENERAL.—Section 1852(a)(1)(B) of the So-
cial 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 
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service (as defined in section 70202(b) of 
the Take Responsibility for Workers and 
Families Act) that is furnished 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 re-
spect to such service, impose— 
‘‘(I) any cost-sharing require-
ment (including a deductible, copay-
ment, 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) REIMBURSEMENT
OF MEDICARE ADVANTAGE 
PLANS FOR ELIMINATION OF COST SHARING.—Section 
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1853 of the Social Security Act (42 U.S.C. 1395w–23) 
is amended by adding at the end the following new sub-
section: 
‘‘(p) ADDITIONAL PAYMENT TO ACCOUNT FOR COST 
SHARING
ELIMINATION
FOR
COVID-19 TREATMENT 
SERVICES.— 
‘‘(1) IN GENERAL.—A Medicare Advantage plan 
shall notify the Secretary of the total dollar amount 
of cost sharing that, but for the application of sec-
tion 1852(a)(1)(B)(vii), would have been required 
under such plan for specified COVID-19 treatment 
services (as defined in section 70202(b) of the Take 
Responsibility for Workers and Families Act) fur-
nished during a plan year described in such section 
to individuals enrolled in the plan. The Secretary 
shall make periodic and timely payments in accord-
ance with this subsection to such plan that, in the 
aggregate, equal such total dollar amount. 
‘‘(2) TIMING OF PAYMENT.—Payments by the 
Secretary under this subsection shall be made begin-
ning March 1, 2021, for amounts described in such 
paragraph that would have been required under such 
plan for specified COVID-19 treatment services fur-
nished during plan year 2020. Payments by the Sec-
retary under this subsection for such amounts that 
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would have been so required under such plan for 
such services furnished during a plan year subse-
quent to plan year 2020 shall be made beginning 
March 1 of the plan year following such subsequent 
plan year. 
‘‘(3) NON-APPLICATION.—Section 1853(c)(7) 
shall not apply with respect to the application of this 
subsection. 
‘‘(4) APPROPRIATION.—There are transferred 
to the Centers for Medicare & Medicaid Program 
Management Fund, out of any monies in the Treas-
ury not otherwise obligated, such sums as may be 
necessary to the Secretary for purposes of making 
payments under this subsection.’’. 
(c) IMPLEMENTATION.—Notwithstanding any other 
provision of law, the Secretary of Health and Human 
Services may implement the amendments made by this 
section by program instruction or otherwise. 
SEC. 70209. ESTABLISHING A RISK CORRIDOR PROGRAM 
FOR MEDICARE ADVANTAGE PLANS DURING 
THE COVID-19 EMERGENCY. 
(a) IN GENERAL.—Section 1853 of the Social Secu-
rity Act (42 U.S.C. 1395w–23), as amended by section 
70208(b), is further amended by adding at the end the 
following new subsection: 
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‘‘(q) RISK
CORRIDOR
PROGRAM
DURING
THE 
COVID-19 EMERGENCY.— 
‘‘(1) IN GENERAL.—The Secretary shall estab-
lish and administer a program of risk corridors for 
each plan year, any portion of which occurs during 
the 
emergency 
period 
defined 
in 
section 
1135(g)(1)(B), under which the Secretary shall 
make payments to MA organizations offering a 
Medicare Advantage plan based on the ratio of the 
allowable costs of the plan to the aggregate pre-
miums of the plan. 
‘‘(2) PAYMENT METHODOLOGY.—The Secretary 
shall provide under the program established under 
paragraph (1) that if the allowable costs for a Medi-
care Advantage plan for any plan year are more 
than 105 percent of the target amount, the Sec-
retary shall pay to the plan an amount equal to 75 
percent of the allowable costs in excess of 105 per-
cent of the target amount. 
‘‘(3) TIMING.— 
‘‘(A) SUBMISSION
OF
INFORMATION
BY 
PLANS.—With respect to a plan year for which 
the program described in paragraph (1) is es-
tablished and administered, not later than July 
1 of the succeeding plan year each MA organi-
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zation offering a Medicare Advantage plan shall 
submit to the Secretary such information as the 
Secretary may require for purposes of carrying 
out such program. 
‘‘(B) PAYMENT.—The Secretary shall pay 
to an MA organization offering a Medicare Ad-
vantage plan eligible to receive a payment under 
the program with respect to a plan year the 
amount provided under paragraph (2) for such 
plan year not later than 60 days after such or-
ganization submits information with respect to 
such plan and plan year under subparagraph 
(A). 
‘‘(4) DEFINITIONS.— 
‘‘(A) ALLOWABLE COSTS.— 
‘‘(i) IN GENERAL.—The amount of al-
lowable costs of a MA organization offering 
a Medicare Advantage plan for a plan year 
is an amount equal to the total costs 
(other than administrative costs) of such 
plan in providing benefits covered by such 
plan, but only to the extent that such costs 
are incurred with respect to such benefits 
for items and services that are benefits 
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under the original medicare fee-for-service 
program option. 
‘‘(ii) REDUCTIONS.—Allowable costs 
for a Medicare Advantage plan for a plan 
year shall be reduced by any payment 
made under subsection (p) with respect to 
such plan and such plan year. 
‘‘(B) 
TARGET
AMOUNT.—The 
target 
amount described in this paragraph is, with re-
spect to a Medicare Advantage plan and a plan 
year, the total amount of payments paid to the 
MA organization for the plan for benefits under 
the original medicare fee-for-service program 
option for the plan year, taking into account 
amounts paid by the Secretary and enrollees, 
based upon the bid amount submitted under 
section 1854, reduced by the total amount of 
administrative expenses for the year assumed in 
such bid. 
‘‘(5) FUNDING.—There are appropriated to the 
Centers for Medicare & Medicaid Services Program 
Management Account, out of any monies in the 
Treasury not otherwise obligated, such sums as may 
be necessary for purposes of carrying out this sub-
section.’’. 
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327 
(b) IMPLEMENTATION.—Notwithstanding any other 
provision of law, the Secretary of Health and Human 
Service may implement the amendments made by this sec-
tion by program instruction or otherwise. 
SEC. 70210. REQUIRING COVERAGE UNDER MEDICARE 
PDPS AND MA–PD PLANS, WITHOUT THE IM-
POSITION OF COST SHARING OR UTILIZA-
TION 
MANAGEMENT 
REQUIREMENTS, 
OF 
DRUGS INTENDED TO TREAT COVID-19 DUR-
ING CERTAIN EMERGENCIES. 
(a) COVERAGE REQUIREMENT.— 
(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 fol-
lowing new subparagraph: 
‘‘(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— 
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‘‘(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-
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 Janu-
ary 31, 2020, entitled ‘Determination that 
a Public Health Emergency Exists Nation-
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(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 cov-
erage 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 oc-
curs during 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 Nationwide 
as the Result of the 2019 Novel Coronavirus’ (in-
cluding 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 cov-
erage is in accordance with subsection (b)(8).’’. 
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(2) 
ELIMINATION
OF
COST-SHARING
FOR 
DRUGS INTENDED TO TREAT COVID-19 DISPENSED 
TO INDIVIDUALS WHO ARE SUBSIDY ELIGIBLE INDI-
VIDUALS.—Section 1860D–14(a) of the Social Secu-
rity 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 ‘‘Sub-
ject 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’’; 
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(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).’’. 
(c) IMPLEMENTATION.—Notwithstanding any other 
provision of law, the Secretary of Health and Human 
Services may implement the amendments made by this 
section by program instruction or otherwise. 
SEC. 70211. REQUIRING MEDICARE PDPS AND MA–PD 
PLANS TO ALLOW DURING THE COVID-19 
EMERGENCY PERIOD FOR FILLS AND RE-
FILLS OF COVERED PART D DRUGS FOR UP 
TO A 3-MONTH SUPPLY. 
(a) IN GENERAL.—Section 1860D–4(b) of the Social 
Security Act (42 U.S.C. 1395w–104(b)) is amended by 
adding at the end the following new paragraph: 
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‘‘(4) ENSURING ACCESS DURING COVID-19 PUB-
LIC HEALTH EMERGENCY PERIOD.— 
‘‘(A) IN GENERAL.—During the emergency 
period described in section 1135(g)(1)(B), sub-
ject to subparagraph (B), a prescription drug 
plan or MA–PD plan shall, notwithstanding any 
cost and utilization management, medication 
therapy management, or other such programs 
under this part, permit a part D eligible indi-
vidual enrolled in such plan to obtain in a sin-
gle fill or refill, at the option of such individual, 
the total day supply (not to exceed a 90-day 
supply) prescribed for such individual for a cov-
ered part D drug. 
‘‘(B) SAFETY
EDIT
EXCEPTION.—A pre-
scription drug plan or MA–PD plan may not 
permit a part D eligible individual to obtain a 
single fill or refill inconsistent with an applica-
ble safety edit.’’. 
(b) IMPLEMENTATION.—Notwithstanding any other 
provision of law, the Secretary of Health and Human 
Services may implement the amendment made by this sec-
tion by program instruction or otherwise. 
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334 
SEC. 70212. EXTENSION OF THE WORK GEOGRAPHIC INDEX 
FLOOR UNDER THE MEDICARE PROGRAM. 
Section 1848(e)(1)(E) of the Social Security Act (42 
U.S.C. 1395w–4(e)(1)(E)) is amended by striking ‘‘May 
23, 2020’’ and inserting ‘‘December 1, 2020’’. 
SEC. 70213. EXTENSION OF FUNDING FOR QUALITY MEAS-
URE ENDORSEMENT, INPUT, AND SELECTION. 
(a) IN GENERAL.—Section 1890(d)(2) of the Social 
Security Act (42 U.S.C. 1395aaa(d)(2)) is amended— 
(1) in the first sentence, by striking ‘‘and 
$4,830,000 for the period beginning on October 1, 
2019, and ending on May 22, 2020’’ and inserting 
‘‘$25,170,000 for fiscal year 2020, and $5,013,699 
for the period beginning on October 1, 2020, and 
ending on November 30, 2020’’; and 
(2) in the third sentence, by striking ‘‘for each 
of fiscal years 2018 and 2019 and for the period be-
ginning on October 1, 2019, and ending on May 22, 
2020’’ and inserting ‘‘for each of fiscal years 2018 
through 2020 and for the period beginning on Octo-
ber 1, 2020, and ending on November 30, 2020’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall take effect as if included in the enact-
ment of the Further Consolidated Appropriations Act, 
2020 (Public Law 116–94). 
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335 
SEC. 70214. EXTENSION OF FUNDING OUTREACH AND AS-
SISTANCE FOR LOW-INCOME PROGRAMS. 
(a) ADDITIONAL FUNDING FOR STATE HEALTH IN-
SURANCE PROGRAMS.—Subsection (a)(1)(B) of section 
119 of the Medicare Improvements for Patients and Pro-
viders Act of 2008 (42 U.S.C. 1395b–3 note) is amend-
ed— 
(1) in clause (xi), by striking ‘‘and’’ at the end; 
(2) in clause (xii), by striking the period at the 
end and inserting a semicolon; and 
(3) by inserting after clause (xii) the following 
new clauses: 
‘‘(xiii) for the period beginning on 
May 23, 2020, and ending on September 
30, 2020, of $5,383,562; and 
‘‘(xiv) for the period beginning on Oc-
tober 1, 2020, and ending on November 
30, 2020, of $2,506,849.’’. 
(b) ADDITIONAL FUNDING FOR AREA AGENCIES ON 
AGING.—Subsection (b)(1)(B) of such section 119, as so 
amended, is amended— 
(1) in clause (xi), by striking ‘‘and’’ at the end; 
(2) in clause (xii), by striking the period at the 
end and inserting a semicolon; and 
(3) by inserting after clause (xii) the following 
new clauses: 
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‘‘(xiii) for the period beginning on 
May 23, 2020, and ending on September 
30, 2020, of $5,383,562; and 
‘‘(xiv) for the period beginning on Oc-
tober 1, 2020, and ending on November 
30, 2020, of $2,506,849.’’. 
(c) ADDITIONAL FUNDING
FOR AGING
AND DIS-
ABILITY RESOURCE CENTERS.—Subsection (c)(1)(B) of 
such section 119, as so amended, is amended— 
(1) in clause (xi), by striking ‘‘and’’ at the end; 
(2) in clause (xii), by striking the period at the 
end and inserting a semicolon; and 
(3) by inserting after clause (xii) the following 
new clauses: 
‘‘(xiii) for the period beginning on 
May 23, 2020, and ending on September 
30, 2020, of $1,794,521; and 
‘‘(xiv) for the period beginning on Oc-
tober 1, 2020, and ending on November 
30, 2020, of $835,616.’’. 
(d) ADDITIONAL FUNDING
FOR CONTRACT WITH 
THE NATIONAL CENTER FOR BENEFITS AND OUTREACH 
ENROLLMENT.—Subsection (d)(2) of such section 119, as 
so amended, is amended— 
(1) in clause (xi), by striking ‘‘and’’ at the end; 
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‘‘(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 
paragraph: 
‘‘(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 Secu-
rity 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 individual 
who is otherwise eligible to enroll in a 
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339 
qualified health plan through the Ex-
change 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 plan shall begin, at the option of the 
individual, on April 1, 2020, or on the first 
day of the month following the day the in-
dividual selects a plan through such special 
enrollment period. 
‘‘(B) EXCEPTION.—The requirement of 
subparagraph (A) shall not apply to a State-op-
erated or State-established Exchange if such 
Exchange, prior to the date of the enactment of 
this paragraph, established or otherwise pro-
vided for a special enrollment period to address 
access to coverage under qualified health plans 
offered through such Exchange during the 
emergency 
period 
described 
in 
section 
1135(g)(1)(B) of the Social Security Act.’’. 
(b) FEDERAL EXCHANGE OUTREACH
AND EDU-
CATIONAL ACTIVITIES.—Section 1321(c) of the Patient 
Protection and Affordable Care Act (42 U.S.C. 18041(c)) 
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340 
is amended by adding at the end the following new para-
graph: 
‘‘(3) OUTREACH
AND
EDUCATIONAL
ACTIVI-
TIES.— 
‘‘(A) IN GENERAL.—In the case of an Ex-
change established or operated by the Secretary 
within a State pursuant to this subsection, the 
Secretary shall carry out outreach and edu-
cational activities for purposes of informing po-
tential enrollees in qualified health plans offered 
through the Exchange of the availability of cov-
erage under such plans and financial assistance 
for coverage under such plans. Such outreach 
and educational activities shall be provided in a 
manner that is culturally and linguistically ap-
propriate to the needs of the populations being 
served by the Exchange (including hard-to- 
reach populations, such as racial and sexual mi-
norities, limited English proficient populations, 
and young adults). 
‘‘(B) LIMITATION ON USE OF FUNDS.—No 
funds appropriated under this paragraph shall 
be used for expenditures for promoting non- 
ACA compliant health insurance coverage. 
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341 
‘‘(C) NON-ACA COMPLIANT
HEALTH
IN-
SURANCE
COVERAGE.—For purposes of sub-
paragraph (B): 
‘‘(i) The term ‘non-ACA compliant 
health insurance coverage’ means health 
insurance coverage, or a group health plan, 
that is not a qualified health plan. 
‘‘(ii) Such term includes the following: 
‘‘(I) An association health plan. 
‘‘(II) Short-term limited duration 
insurance. 
‘‘(D) FUNDING.—Out of any funds in the 
Treasury not otherwise appropriated, there are 
hereby appropriated $25,000,000 to carry out 
this paragraph. Funds appropriated under this 
subparagraph shall remain available until ex-
pended.’’. 
(c) 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. 70302. SHORT-TERM LIMITED DURATION INSURANCE 
RULE PROHIBITION. 
The Secretary of Health and Human Services, the 
Secretary of the Treasury, and the Secretary of Labor 
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342 
may not take any action to implement, enforce, or other-
wise give effect to the rule entitled ‘‘Short-Term, Limited 
Duration Insurance’’ (83 Fed. Reg. 38212 (August 3, 
2018)), and the Secretaries may not promulgate any sub-
stantially similar rule. 
SEC. 70303. RAPID COVERAGE OF PREVENTIVE SERVICES 
AND VACCINES FOR COVID-19. 
(a) IN GENERAL.—In the case of a qualifying 
COVID-19 preventive service, notwithstanding section 
2713(b) of the Public Health Service Act (42 U.S.C. 
300gg–13(b)) (including the regulations under section 
2590.715–2713 of title 29, Code of Federal Regulations, 
section 54.9815–2713 of title 26, Code of Federal Regula-
tions, and section 147.130 of title 45, Code of Federal 
Regulations), the Secretary of Health and Human Serv-
ices, Secretary of Labor, and Secretary of the Treasury 
shall apply to group health plans and health insurance 
issuers offering group or individual health insurance cov-
erage the requirement under section 2713(a) of the Public 
Health Service Act (42 U.S.C. 300gg–13(a)), with respect 
to such services, as if such section 2713(a)— 
(1) required the coverage of such service under 
such plans and such coverage be effective not later 
than the specified date (as defined in subsection 
(b)(2)) with respect to such service; and 
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343 
(2) applied to grandfathered health plans (as 
defined in section 1251(e) of the Patient Protection 
and Affordable Care Act (42 U.S.C. 18011(e))). 
(b) DEFINITIONS.—For purposes of this section: 
(1) QUALIFYING COVID-19 PREVENTIVE SERV-
ICE.—The term ‘‘qualifying COVID-19 preventive 
service’’ means an item, service, or immunization 
that is intended to prevent or mitigate COVID-19 
and that is— 
(A) an evidence-based item or service that 
has in effect a rating of ‘‘A’’ or ‘‘B’’ in the cur-
rent recommendations of the United States Pre-
ventive Services Task Force; or 
(B) an immunization that has in effect a 
recommendation from the Advisory Committee 
on Immunization Practices of the Centers for 
Disease Control and Prevention with respect to 
the individual involved. 
(2) SPECIFIED
DATE.—The term ‘‘specified 
date’’ means— 
(A) with respect to a qualifying COVID-19 
preventive 
service 
described 
in 
paragraph 
(1)(A), the date that is 15 business days after 
the date on which a rating, as described in such 
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344 
paragraph, is made with respect to such service; 
and 
(B) with respect to a qualifying COVID-19 
preventive 
service 
described 
in 
paragraph 
(1)(B), the date that is 15 business days after 
the date on which a recommendation, as de-
scribed in such paragraph, is made relating to 
the service. 
(3) ADDITIONAL
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 Service 
Act (42 U.S.C. 300gg–91), section 733 of the Em-
ployee Retirement Income Security Act (29 U.S.C. 
1191b), and section 9832 of the Internal Revenue 
Code of 1986, as applicable. 
(c) IMPLEMENTATION.—The Secretary of Health and 
Human Services, Secretary of Labor, and Secretary of the 
Treasury may implement the provisions of this section 
through program instruction, subregulatory guidance, or 
otherwise. 
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SEC. 70304. 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 
Affordable 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 
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- 
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346 
19 but is never diagnosed as such, if the following 
conditions 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 diag-
nosis 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 of the Treasury shall jointly issue 
guidance specifying applicable diagnoses and medi-
cally 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 indi-
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347 
vidual health insurance coverage offered by a health 
insurance issuer. 
(c) REIMBURSEMENT TO PLANS AND COVERAGE FOR 
WAIVING COST-SHARING.— 
(1) IN GENERAL.—A group health plan or a 
health insurance issuer offering group or individual 
health insurance coverage (including a grandfathered 
health plan (as defined in section 1251(e) of the Pa-
tient Protection and Affordable Care Act)) that does 
not impose cost sharing requirements as described in 
subsection (a) shall notify the Secretary of Health 
and Human Services, Secretary of Labor, and Sec-
retary of the Treasury (through a joint process es-
tablished jointly by the Secretaries) of the total dol-
lar amount of cost-sharing that, but for the applica-
tion of subsection (a), would have been required 
under such plans and coverage for items and serv-
ices related to COVID-19 furnished during the pe-
riod to which subsection (a) applies to enrollees, par-
ticipants, and beneficiaries in the plan or coverage to 
whom such subsection applies, but which was not 
imposed for such items and services so furnished 
pursuant to such subsection and the Secretary of 
Health and Human Services, in coordination with 
the Secretary of Labor and the Secretary of the 
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348 
Treasury, shall make payments in accordance with 
this subsection to the plan or issuer equal to such 
total dollar amount. 
(2) METHODOLOGY FOR PAYMENTS.—The Sec-
retary of Health and Human Service, in coordina-
tion with the Secretary of Labor and the Secretary 
of the Treasury shall establish a payment system for 
making payments under this subsection. Any such 
system shall make payment for the value of cost 
sharing not imposed by the plan or issuer involved. 
(3) TIMING
OF
PAYMENTS.—Payments made 
under paragraph (1) shall be made no later than 
May 1, 2021, for amounts of cost sharing waivers 
with respect to 2020. Payments under this sub-
section with respect to such waivers with respect to 
a year subsequent to 2020 that begins during the 
period to which subsection (a) applies shall be made 
no later than May of the year following such subse-
quent year. 
(4) APPROPRIATIONS.—There is authorized to 
be appropriated, and there is appropriated, out of 
any monies in the Treasury not otherwise appro-
priated, such funds as are necessary to carry out 
this subsection. 
(d) ENFORCEMENT.— 
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349 
(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 in-
surance 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 Se-
curity 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 
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 enforcement mechanism otherwise applicable 
pursuant to paragraph (1). 
(e) 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. 
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350 
(f) 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 
Service Act (42 U.S.C. 300gg–91), section 733 of the Em-
ployee Retirement Income Security Act of 1974 (29 
U.S.C. 1191b), and section 9832 of the Internal Revenue 
Code of 1986, as applicable. 
SEC. 70305. REQUIRING PRESCRIPTION DRUG REFILL NOTI-
FICATIONS 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 
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 connection with a group health plan, that provides bene-
fits for prescription drugs under such plan or such cov-
erage shall provide to each individual enrolled under such 
plan or such coverage who resides in an emergency area 
during an emergency period, not later than 5 business 
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351 
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 70305(d)(2) of the Take Responsi-
bility for Workers and Families Act, not later than 5 busi-
ness days after the date of the enactment of this section), 
a notification— 
‘‘(1) of whether such plan or coverage will 
waive, during such period with respect to such an in-
dividual, any time restrictions under such plan or 
coverage 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 or coverage; and 
‘‘(2) in the case that such plan or coverage will 
waive such restrictions during such period with re-
spect to such an individual, that contains informa-
tion on how such an individual may obtain such a 
refill. 
‘‘(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 
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352 
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 con-
tents of the Employee Retirement Income Security 
Act of 1974 is amended by inserting after the item 
relating to section 714 the following: 
‘‘Sec. 715. Additional market reforms. 
‘‘Sec. 716. Provision of prescription drug refill notifications during emer-
gencies.’’. 
(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 
insurance coverage, that provides benefits for prescription 
drugs under such plan or such coverage shall provide to 
each individual enrolled under such plan or such coverage 
who resides in an emergency area during an emergency 
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 
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353 
70305(d)(2) of the Take Responsibility for Workers and 
Families Act, not later than 5 business days after the date 
of the enactment of this section), a notification— 
‘‘(1) of whether such plan or coverage will 
waive, during such period with respect to such an in-
dividual, any time restrictions under such plan or 
coverage 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 or coverage; and 
‘‘(2) in the case that such plan or coverage will 
waive such restrictions during such period with re-
spect to such an individual, that contains informa-
tion on how such an individual may obtain such a 
refill. 
‘‘(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.’’. 
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354 
(c) IRC.— 
(1) IN
GENERAL.—Subchapter B of chapter 
100 of the Internal Revenue Code of 1986 is amend-
ed 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 pro-
vides benefits for prescription drugs under such plan shall 
provide to each individual enrolled under such plan who 
resides in an emergency area during an emergency period, 
not later than 5 business days after the date of the begin-
ning of such period with respect to such area (or, the case 
of the emergency period described in section 70305(d)(2) 
of the Take Responsibility for Workers and Families Act, 
not later than 5 business days after the date of the enact-
ment of this section), a notification— 
‘‘(1) of whether such plan will waive, during 
such period with respect to such an individual, any 
time restrictions under such plan on any authorized 
refills for such drugs to enable such refills in ad-
vance of when such refills would otherwise have been 
permitted under such plan; and 
‘‘(2) in the case that such plan will waive such 
restrictions during such period with respect to such 
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355 
an individual, that contains information on how such 
an individual may obtain such a refill. 
‘‘(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 Inter-
nal 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 
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356 
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’’. 
SEC. 70306. IMPROVEMENT OF CERTAIN NOTIFICATIONS 
PROVIDED 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 applica-
ble, and any such notification’’ and insert-
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357 
ing ‘‘of subsection (a), whichever is appli-
cable; 
‘‘(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 Pa-
tient Protection and Affordable Care Act through 
which such a qualified beneficiary may be eligible to 
enroll in a qualified health plan (as defined in sec-
tion 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 direc-
tory maintained 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 
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358 
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 
enrollment 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 
Protection and Affordable Care Act) and the re-
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359 
quirements 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 Rev-
enue 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 in-
serting 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 ac-
cordance with the notification requirements 
under subsection (b)’’; and 
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360 
(C) by striking ‘‘For purposes of para-
graph (4),’’ and all that follows through ‘‘such 
notification is made.’’ and inserting the fol-
lowing: 
‘‘(b) RULES RELATING TO NOTIFICATION OF QUALI-
FIED BENEFICIARIES
BY PLAN ADMINISTRATOR.—For 
purposes 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 cov-
ered 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 Pa-
tient Protection and Affordable Care Act through 
which such a qualified beneficiary may be eligible to 
enroll in a qualified health plan (as defined in sec-
tion 1301 of the Patient Protection and Affordable 
Care Act), including— 
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361 
‘‘(A) 
the 
publicly 
accessible 
Internet 
website address for such Exchange; 
‘‘(B) 
the 
publicly 
accessible 
Internet 
website address for the Find Local Help direc-
tory maintained 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 
enrollment 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 
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362 
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 
Protection and Affordable Care Act) and the re-
quirements 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 Rev-
enue 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 
Internal Revenue Code of 1986 is amended— 
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363 
(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 in-
serting the following: 
‘‘(A) IN GENERAL.—In accordance’’; 
(D) by inserting after ‘‘of such bene-
ficiary’s rights under this subsection’’ the fol-
lowing: ‘‘in accordance with the notification re-
quirements 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: 
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364 
‘‘(B) ALTERNATIVE
MEANS
OF
COMPLI-
ANCE WITH REQUIREMENT FOR NOTIFICATION 
OF MULTIEMPLOYER PLANS BY EMPLOYERS.— 
The requirements of subparagraph (A)(ii) shall 
be considered satisfied in the case of a multiem-
ployer plan in connection with a qualifying 
event described in paragraph (3)(B) if the plan 
provides that the determination of the occur-
rence of such qualifying event will be made by 
the plan administrator. 
‘‘(C) RULES RELATING TO NOTIFICATION 
OF QUALIFIED BENEFICIARIES BY PLAN ADMIN-
ISTRATOR.—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 
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365 
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 
respect to whom such notification is made, 
include information regarding any Ex-
change established under title I of the Pa-
tient 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— 
‘‘(I) the publicly accessible Inter-
net website address for such Ex-
change; 
‘‘(II) 
the 
publicly 
accessible 
Internet website address for the Find 
Local Help directory maintained by 
the 
Department 
of 
Health 
and 
Human Services on the healthcare.gov 
Internet website (or a successor 
website); 
‘‘(III) a clear explanation that— 
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366 
‘‘(aa) 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 individual 
elects to enroll in such continu-
ation coverage and subsequently 
elects to terminate such continu-
ation 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 enroll-
ment 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-
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367 
ing in such a qualified health 
plan; 
‘‘(IV) 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 es-
sential health benefits (as defined in 
section 1302(b) of the Patient Protec-
tion and Affordable 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. 
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368 
(d) MODEL NOTICES.—Not later than 14 days after 
the date of the enactment of this Act, the Secretary of 
the Labor, in consultation with the Secretary of the Treas-
ury 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 
general notice and the model COBRA continuation 
coverage election notice developed by the Secretary 
of Labor for purposes of facilitating compliance of 
group health plans with the notification require-
ments under section 606 of the Employee Retire-
ment Income Security Act of 1974 (29 U.S.C. 1166) 
to include the information 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 
coverage general notice and the model COBRA con-
tinuation coverage election notice as the ‘‘model 
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369 
COBRA continuation coverage and Affordable Care 
Act coverage general notice’’ and the ‘‘model 
COBRA continuation coverage and Affordable Care 
Act coverage election notice’’, respectively. 
SEC. 70307. PRESERVING HEALTH BENEFITS FOR WORK-
ERS. 
(a) PREMIUM ASSISTANCE FOR COBRA CONTINU-
ATION COVERAGE FOR INDIVIDUALS AND THEIR FAMI-
LIES.— 
(1) PROVISION OF PREMIUM ASSISTANCE.— 
(A) 
REDUCTION
OF
PREMIUMS
PAY-
ABLE.—In the case of any premium for a pe-
riod of coverage beginning on or after the date 
of the enactment of this Act for COBRA con-
tinuation coverage with respect to any assist-
ance eligible individual, such individual shall be 
treated for purposes of any COBRA continu-
ation provision as having paid the amount of 
such premium if such individual pays (or a per-
son other than such individual’s employer pays 
on behalf of such individual) 0 percent of the 
amount of such premium (as determined with-
out regard to this subsection). 
(B) PLAN ENROLLMENT OPTION.— 
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370 
(i) IN
GENERAL.—Notwithstanding 
the COBRA continuation provisions, an as-
sistance eligible individual may, not later 
than 90 days after the date of notice of the 
plan enrollment option described in this 
subparagraph, elect to enroll in coverage 
under a plan offered by the employer in-
volved, or the employee organization in-
volved (including, for this purpose, a joint 
board of trustees of a multiemployer trust 
affiliated with one or more multiemployer 
plans), that is different than coverage 
under the plan in which such individual 
was enrolled at the time the qualifying 
event occurred, and such coverage shall be 
treated as COBRA continuation coverage 
for purposes of the applicable COBRA con-
tinuation coverage provision. 
(ii) REQUIREMENTS.—An assistance 
eligible individual may elect to enroll in 
different coverage as described in clause (i) 
only if— 
(I) the employer involved has 
made a determination that such em-
ployer will permit assistance eligible 
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371 
individuals to enroll in different cov-
erage as provided for this subpara-
graph; 
(II) the premium for such dif-
ferent coverage does not exceed the 
premium for coverage in which the in-
dividual was enrolled at the time the 
qualifying event occurred; 
(III) the different coverage in 
which the individual elects to enroll is 
coverage that is also offered to the ac-
tive employees of the employer at the 
time at which such election is made; 
and 
(IV) the different coverage is 
not— 
(aa) coverage that provides 
only dental, vision, counseling, or 
referral services (or a combina-
tion of such services); 
(bb) a flexible spending ar-
rangement (as defined in section 
106(c)(2) of the Internal Rev-
enue Code of 1986); or 
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372 
(cc) coverage that provides 
coverage for services or treat-
ments furnished in an on-site 
medical facility maintained by 
the employer and that consists 
primarily of first-aid services, 
prevention and wellness care, or 
similar care (or a combination of 
such care). 
(C) PREMIUM REIMBURSEMENT.—For pro-
visions providing the payment of such premium, 
see section 6432 of the Internal Revenue Code 
of 1986, as added by paragraph (12). 
(2) LIMITATION OF PERIOD OF PREMIUM AS-
SISTANCE.— 
(A) ELIGIBILITY
FOR
ADDITIONAL
COV-
ERAGE.—Paragraph (1)(A) shall not apply with 
respect to any assistance eligible individual for 
months of coverage beginning on or after— 
(i) the earlier of the first date that 
such individual is eligible for coverage 
under any other group health plan (other 
than coverage consisting of only dental, vi-
sion, counseling, or referral services (or a 
combination thereof), coverage under a 
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373 
flexible spending arrangement (as defined 
in section 106(c)(2) of the Internal Rev-
enue Code of 1986), coverage of treatment 
that is furnished in an on-site medical fa-
cility maintained by the employer and that 
consists primarily of first-aid services, pre-
vention and wellness care, or similar care 
(or a combination thereof)), is eligible for 
benefits under title XVIII of the Social Se-
curity Act, or enrolls in a qualified health 
plan (as defined in section 1301(a) of the 
Patient Protection and Affordable Care 
Act (42 U.S.C. 18021(a)) offered through 
an Exchange established under title I of 
the Patient Protection and Affordable Care 
Act; and 
(ii) the earliest of— 
(I) the date which is 9 months 
after the first day of the first month 
that paragraph (1)(A) applies with re-
spect to such individual; 
(II) the date following the expira-
tion of the maximum period of con-
tinuation coverage required under the 
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374 
applicable COBRA continuation cov-
erage provision; or 
(III) the date following the expi-
ration of the period of continuation 
coverage allowed under paragraph 
(4)(B)(ii). 
(B) TIMING
OF
ELIGIBILITY
FOR
ADDI-
TIONAL COVERAGE.—For purposes of subpara-
graph (A)(i), an individual shall not be treated 
as eligible for coverage under a group health 
plan before the first date on which such indi-
vidual could be covered under such plan. 
(C) 
NOTIFICATION
REQUIREMENT.—An 
assistance eligible individual shall notify in writ-
ing the group health plan with respect to which 
paragraph (1)(A) applies if such paragraph 
ceases to apply by reason of subparagraph 
(A)(i). Such notice shall be provided to the 
group health plan in such time and manner as 
may be specified by the Secretary of Labor. 
(3) ASSISTANCE
ELIGIBLE
INDIVIDUAL.—For 
purposes of this section, the term ‘‘assistance eligible 
individual’’ means any qualified beneficiary if— 
(A) at any time during the emergency pe-
riod described in section 1135(g)(1)(B) of the 
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375 
Social 
Security 
Act 
(42 
U.S.C. 
1320b– 
5(g)(1)(B)) such qualified beneficiary is eligible 
for COBRA continuation coverage by reason of 
qualifying event specified in section 603(2) of 
the Employee Retirement Income Security Act 
of 1974, section 4980B(f)(3)(B) of the Internal 
Revenue Code of 1986, section 2203(2) of the 
Public Health Service Act, or section 8905a of 
title 5, United States Code; and 
(B) such qualified beneficiary elects such 
coverage. 
(4) EXTENSION OF ELECTION PERIOD AND EF-
FECT ON COVERAGE.— 
(A) IN GENERAL.—For purposes of apply-
ing section 605(a) of the Employee Retirement 
Income 
Security 
Act 
of 
1974, 
section 
4980B(f)(5)(A) of the Internal Revenue Code 
of 1986, section 2205(a) of the Public Health 
Service Act, and section 8905a(c)(2) of title 5, 
United States Code, in the case of— 
(i) an individual who does not have an 
election of COBRA continuation coverage 
in effect on the date of the enactment of 
this Act but who would be an assistance el-
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376 
igible individual if such election were so in 
effect; or 
(ii) an individual who elected COBRA 
continuation coverage on or after the first 
date of the emergency period described in 
section 1135(g)(1)(B) of the Social Secu-
rity Act (42 U.S.C. 1320b–5(g)(1)(B)) and 
disenrolled from such coverage before the 
date of the enactment of this Act; 
such individual may elect the COBRA continu-
ation coverage under the COBRA continuation 
coverage provisions containing such sections 
during the period beginning on the date of the 
enactment of this Act and ending 60 days after 
the date on which the notification required 
under paragraph (7)(C) is provided to such in-
dividual. 
(B) COMMENCEMENT
OF
COVERAGE; NO 
REACH-BACK.—Any COBRA continuation cov-
erage elected by a qualified beneficiary during 
an extended election period under subparagraph 
(A)— 
(i) shall commence with the first pe-
riod of coverage beginning on or after the 
date of the enactment of this Act; and 
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377 
(ii) shall not extend beyond the period 
of COBRA continuation coverage that 
would have been required under the appli-
cable COBRA continuation coverage provi-
sion if the coverage had been elected as re-
quired under such provision. 
(5) EXPEDITED REVIEW OF DENIALS OF PRE-
MIUM ASSISTANCE.—In any case in which an indi-
vidual requests treatment as an assistance eligible 
individual and is denied such treatment by the group 
health plan, the Secretary of Labor (or the Sec-
retary of Health and Human Services in connection 
with COBRA continuation coverage which is pro-
vided other than pursuant to part 6 of subtitle B of 
title I of the Employee Retirement Income Security 
Act of 1974), in consultation with the Secretary of 
the Treasury, shall provide for expedited review of 
such denial. An individual shall be entitled to such 
review upon application to such Secretary in such 
form and manner as shall be provided by such Sec-
retary. Such Secretary shall make a determination 
regarding such individual’s eligibility within 15 busi-
ness days after receipt of such individual’s applica-
tion for review under this paragraph. Either Sec-
retary’s determination upon review of the denial 
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378 
shall be de novo and shall be the final determination 
of such Secretary. A reviewing court shall grant def-
erence to such Secretary’s determination. The provi-
sions of this paragraph, paragraphs (1) through (4), 
and paragraph (7) shall be treated as provisions of 
title I of the Employee Retirement Income Security 
Act of 1974 for purposes of part 5 of subtitle B of 
such title. 
(6) DISREGARD OF SUBSIDIES FOR PURPOSES 
OF
FEDERAL
AND
STATE
PROGRAMS.—Notwith-
standing any other provision of law, any premium 
reduction with respect to an assistance eligible indi-
vidual under this subsection shall not be considered 
income or resources in determining eligibility for, or 
the amount of assistance or benefits provided under, 
any other public benefit provided under Federal law 
or the law of any State or political subdivision there-
of. 
(7) NOTICES TO INDIVIDUALS.— 
(A) GENERAL NOTICE.— 
(i) IN GENERAL.—In the case of no-
tices provided under section 606(a)(4) of 
the Employee Retirement Income Security 
Act of 1974 (29 U.S.C. 1166(4)), section 
4980B(f)(6)(D) of the Internal Revenue 
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379 
Code of 1986, section 2206(4) of the Pub-
lic Health Service Act (42 U.S.C. 300bb– 
6(4)), or section 8905a(f)(2)(A) of title 5, 
United States Code, with respect to indi-
viduals who, during the period described in 
paragraph (3)(A), become entitled to elect 
COBRA continuation coverage, the re-
quirements of such sections shall not be 
treated as met unless such notices include 
an additional notification to the recipient 
of— 
(I) the availability of premium 
reduction with respect to such cov-
erage under this subsection; and 
(II) the option to enroll in dif-
ferent coverage if the employer per-
mits assistance eligible individuals to 
elect enrollment in different coverage 
(as described in paragraph (1)(B)). 
(ii) ALTERNATIVE
NOTICE.—In the 
case of COBRA continuation coverage to 
which the notice provision under such sec-
tions does not apply, the Secretary of 
Labor, in consultation with the Secretary 
of the Treasury and the Secretary of 
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380 
Health and Human Services, shall, in con-
sultation with administrators of the group 
health plans (or other entities) that provide 
or administer the COBRA continuation 
coverage involved, provide rules requiring 
the provision of such notice. 
(iii) FORM.—The requirement of the 
additional notification under this subpara-
graph may be met by amendment of exist-
ing notice forms or by inclusion of a sepa-
rate document with the notice otherwise 
required. 
(B) SPECIFIC REQUIREMENTS.—Each ad-
ditional notification under subparagraph (A) 
shall include— 
(i) the forms necessary for estab-
lishing eligibility for premium reduction 
under this subsection; 
(ii) the name, address, and telephone 
number necessary to contact the plan ad-
ministrator and any other person main-
taining relevant information in connection 
with such premium reduction; 
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381 
(iii) a description of the extended elec-
tion period provided for in paragraph 
(4)(A); 
(iv) a description of the obligation of 
the qualified beneficiary under paragraph 
(2)(C) to notify the plan providing continu-
ation coverage of eligibility for subsequent 
coverage under another group health plan 
or eligibility for benefits under title XVIII 
of the Social Security Act and the penalty 
provided under section 6720C of the Inter-
nal Revenue Code of 1986 for failure to so 
notify the plan; 
(v) a description, displayed in a 
prominent manner, of the qualified bene-
ficiary’s right to a reduced premium and 
any conditions on entitlement to the re-
duced premium; 
(vi) a description of the option of the 
qualified beneficiary to enroll in different 
coverage if the employer permits such ben-
eficiary to elect to enroll in such different 
coverage under paragraph (1)(B); 
(vii) information regarding any Ex-
change established under title I of the Pa-
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382 
tient Protection and Affordable Care Act 
through which a qualified beneficiary may 
be eligible to enroll in a qualified health 
plan, including— 
(I) the publicly accessible inter-
net website address for such Ex-
change; 
(II) the publicly accessible inter-
net website address for the Find 
Local Help directory maintained by 
the 
Department 
of 
Health 
and 
Human Services on the healthcare.gov 
internet 
website 
(or 
a 
successor 
website); 
(III) a clear explanation that— 
(aa) an individual who is eli-
gible 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 individual 
elects to enroll in such continu-
ation coverage and subsequently 
elects to terminate such continu-
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383 
ation 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 enroll-
ment 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 as-
sistance with respect to enrolling 
in such a qualified health plan; 
(IV) 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 es-
sential health benefits (as defined in 
section 1302(b) of such Act (42 
U.S.C. 18022(b))) and the require-
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384 
ments applicable to such a qualified 
health plan under part A of title 
XXVII of the Public Health Service 
Act (42 U.S.C. 300gg et seq.); 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 of the Inter-
nal Revenue Code of 1986. 
(C) NOTICE
IN
CONNECTION
WITH
EX-
TENDED ELECTION PERIODS.—In the case of 
any assistance eligible individual (or any indi-
vidual described in paragraph (4)(A)) who be-
came entitled to elect COBRA continuation cov-
erage before the date of the enactment of this 
Act, the administrator of the group health plan 
(or other entity) involved shall provide (within 
60 days after the date of enactment of this Act) 
for the additional notification required to be 
provided under subparagraph (A) and failure to 
provide such notice shall be treated as a failure 
to meet the notice requirements under the ap-
plicable COBRA continuation provision. 
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385 
(D) MODEL NOTICES.—Not later than 30 
days after the date of enactment of this Act— 
(i) the Secretary of the Labor, in con-
sultation with the Secretary of the Treas-
ury and the Secretary of Health and 
Human Services, shall prescribe models for 
the additional notification required under 
this paragraph (other than the additional 
notification described in clause (ii)); and 
(ii) in the case of any additional noti-
fication provided pursuant to subpara-
graph (A) under section 8905a(f)(2)(A) of 
title 5, United States Code, the Office of 
Personnel Management shall prescribe a 
model for such additional notification. 
(8) REGULATIONS.—The Secretary of the 
Treasury may prescribe such regulations or other 
guidance as may be necessary or appropriate to 
carry out the provisions of this subsection, including 
the prevention of fraud and abuse under this sub-
section, except that the Secretary of Labor and the 
Secretary of Health and Human Services may pre-
scribe such regulations (including interim final regu-
lations) or other guidance as may be necessary or 
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386 
appropriate to carry out the provisions of para-
graphs (5), (7), and (9). 
(9) OUTREACH.—The Secretary of Labor, in 
consultation with the Secretary of the Treasury and 
the Secretary of Health and Human Services, shall 
provide outreach consisting of public education and 
enrollment assistance relating to premium reduction 
provided under this subsection. Such outreach shall 
target employers, group health plan administrators, 
public assistance programs, States, insurers, and 
other entities as determined appropriate by such 
Secretaries. Such outreach shall include an initial 
focus on those individuals electing continuation cov-
erage who are referred to in paragraph (7)(C). In-
formation on such premium reduction, including en-
rollment, shall also be made available on websites of 
the Departments of Labor, Treasury, and Health 
and Human Services. 
(10) DEFINITIONS.—For purposes of this sec-
tion: 
(A) ADMINISTRATOR.—The term ‘‘admin-
istrator’’ has the meaning given such term in 
section 3(16)(A) of the Employee Retirement 
Income Security Act of 1974. 
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387 
(B) COBRA CONTINUATION COVERAGE.— 
The term ‘‘COBRA continuation coverage’’ 
means continuation coverage provided pursuant 
to part 6 of subtitle B of title I of the Em-
ployee Retirement Income Security Act of 1974 
(other than under section 609), title XXII of 
the Public Health Service Act, section 4980B of 
the Internal Revenue Code of 1986 (other than 
subsection (f)(1) of such section insofar as it 
relates to pediatric vaccines), or section 8905a 
of title 5, United States Code, or under a State 
program that provides comparable continuation 
coverage. Such term does not include coverage 
under a health flexible spending arrangement 
under a cafeteria plan within the meaning of 
section 125 of the Internal Revenue Code of 
1986. 
(C) COBRA CONTINUATION PROVISION.— 
The term ‘‘COBRA continuation provision’’ 
means the provisions of law described in sub-
paragraph (B). 
(D) 
COVERED
EMPLOYEE.—The 
term 
‘‘covered employee’’ has the meaning given such 
term in section 607(2) of the Employee Retire-
ment Income Security Act of 1974. 
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388 
(E) QUALIFIED BENEFICIARY.—The term 
‘‘qualified beneficiary’’ has the meaning given 
such term in section 607(3) of the Employee 
Retirement Income Security Act of 1974. 
(F) GROUP
HEALTH
PLAN.—The term 
‘‘group health plan’’ has the meaning given 
such term in section 607(1) of the Employee 
Retirement Income Security Act of 1974. 
(G) STATE.—The term ‘‘State’’ includes 
the District of Columbia, the Commonwealth of 
Puerto Rico, the Virgin Islands, Guam, Amer-
ican Samoa, and the Commonwealth of the 
Northern Mariana Islands. 
(H) PERIOD
OF
COVERAGE.—Any ref-
erence in this subsection to a period of coverage 
shall be treated as a reference to a monthly or 
shorter period of coverage with respect to which 
premiums are charged with respect to such cov-
erage. 
(11) REPORTS.— 
(A) INTERIM REPORT.—The Secretary of 
the Treasury shall submit an interim report to 
the Committee on Education and Labor, the 
Committee on Ways and Means, and the Com-
mittee on Energy and Commerce of the House 
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389 
of Representatives and the Committee on 
Health, Education, Labor, and Pensions and 
the Committee on Finance of the Senate re-
garding the premium reduction provided under 
this subsection that includes— 
(i) the number of individuals provided 
such assistance as of the date of the re-
port; and 
(ii) the total amount of expenditures 
incurred (with administrative expenditures 
noted separately) in connection with such 
assistance as of the date of the report. 
(B) FINAL
REPORT.—As soon as prac-
ticable after the last period of COBRA continu-
ation coverage for which premium reduction is 
provided under this section, the Secretary of the 
Treasury shall submit a final report to each 
Committee referred to in subparagraph (A) that 
includes— 
(i) the number of individuals provided 
premium reduction under this section; 
(ii) 
the 
average 
dollar 
amount 
(monthly and annually) of premium reduc-
tions provided to such individuals; and 
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390 
(iii) the total amount of expenditures 
incurred (with administrative expenditures 
noted separately) in connection with pre-
mium reduction under this section. 
(12) COBRA PREMIUM ASSISTANCE.— 
(A) IN GENERAL.—Subchapter B of chap-
ter 65 of the Internal Revenue Code of 1986 is 
amended by adding at the end the following 
new section: 
‘‘SEC. 6432. COBRA PREMIUM ASSISTANCE. 
‘‘(a) IN GENERAL.—The person to whom premiums 
are payable under COBRA continuation coverage shall be 
reimbursed as provided in subsection (c) for the amount 
of premiums not paid by assistance eligible individuals by 
reason of section 70307 of the Take Responsibility for 
Workers and Families Act. 
‘‘(b) PERSON ENTITLED TO REIMBURSEMENT.—For 
purposes of subsection (a), except as otherwise provided 
by the Secretary, the person to whom premiums are pay-
able under COBRA continuation coverage shall be treated 
as being— 
‘‘(1) in the case of any group health plan which 
is a multiemployer plan (as defined in section 3(37) 
of the Employee Retirement Income Security Act of 
1974), the plan, 
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391 
‘‘(2) in the case of any group health plan not 
described in paragraph (1)— 
‘‘(A) which is subject to the COBRA con-
tinuation provisions contained in— 
‘‘(i) this title, 
‘‘(ii) the Employee Retirement Income 
Security Act of 1974, 
‘‘(iii) the Public Health Service Act, 
or 
‘‘(iv) title 5, United States Code, or 
‘‘(B) under which some or all of the cov-
erage is not provided by insurance, 
the employer maintaining the plan, and 
‘‘(3) in the case of any group health plan not 
described in paragraph (1) or (2), the insurer pro-
viding the coverage under the group health plan. 
‘‘(c) METHOD OF REIMBURSEMENT.—Except as oth-
erwise provided by the Secretary— 
‘‘(1) TREATMENT
AS
PAYMENT
OF
PAYROLL 
TAXES.—Each person entitled to reimbursement 
under subsection (a) (and filing a claim for such re-
imbursement at such time and in such manner as 
the Secretary may require) shall be treated for pur-
poses of this title and section 1324(b)(2) of title 31, 
United States Code, as having paid to the Secretary, 
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392 
on the date that the assistance eligible individual’s 
premium payment is received, payroll taxes in an 
amount equal to the portion of such reimbursement 
which relates to such premium. To the extent that 
the amount treated as paid under the preceding sen-
tence exceeds the amount of such person’s liability 
for such taxes, the Secretary shall credit or refund 
such excess in the same manner as if it were an 
overpayment of such taxes. 
‘‘(2) OVERSTATEMENTS.—Any overstatement of 
the reimbursement to which a person is entitled 
under this section (and any amount paid by the Sec-
retary as a result of such overstatement) shall be 
treated as an underpayment of payroll taxes by such 
person and may be assessed and collected by the 
Secretary in the same manner as payroll taxes. 
‘‘(3) REIMBURSEMENT
CONTINGENT
ON
PAY-
MENT OF REMAINING PREMIUM.—No reimbursement 
may be made under this section to a person with re-
spect to any assistance eligible individual until after 
the reduced premium required under section 70307 
of such Act with respect to such individual has been 
received. 
‘‘(d) DEFINITIONS.—For purposes of this section— 
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393 
‘‘(1) PAYROLL
TAXES.—The term ‘payroll 
taxes’ means— 
‘‘(A) amounts required to be deducted and 
withheld for the payroll period under section 
3402 (relating to wage withholding), 
‘‘(B) amounts required to be deducted for 
the payroll period under section 3102 (relating 
to FICA employee taxes), and 
‘‘(C) amounts of the taxes imposed for the 
payroll period under section 3111 (relating to 
FICA employer taxes). 
‘‘(2) PERSON.—The term ‘person’ includes any 
governmental entity. 
‘‘(e) REPORTING.—Each person entitled to reim-
bursement under subsection (a) for any period shall sub-
mit such reports (at such time and in such manner) as 
the Secretary may require, including— 
‘‘(1) an attestation of involuntary termination 
of employment for each covered employee on the 
basis of whose termination entitlement to reimburse-
ment is claimed under subsection (a), 
‘‘(2) a report of the amount of payroll taxes off-
set under subsection (a) for the reporting period and 
the estimated offsets of such taxes for the subse-
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394 
quent reporting period in connection with reimburse-
ments under subsection (a), and 
‘‘(3) a report containing the TINs of all covered 
employees, the amount of subsidy reimbursed with 
respect to each covered employee and qualified bene-
ficiaries, and a designation with respect to each cov-
ered employee as to whether the subsidy reimburse-
ment is for coverage of 1 individual or 2 or more in-
dividuals. 
‘‘(f) REGULATIONS.—The Secretary shall issue such 
regulations or other guidance as may be necessary or ap-
propriate to carry out this section, including— 
‘‘(1) the requirement to report information or 
the establishment of other methods for verifying the 
correct amounts of reimbursements under this sec-
tion, and 
‘‘(2) the application of this section to group 
health plans that are multiemployer plans (as de-
fined in section 3(37) of the Employee Retirement 
Income Security Act of 1974).’’. 
(B) SOCIAL SECURITY TRUST FUNDS HELD 
HARMLESS.—In determining any amount trans-
ferred or appropriated to any fund under the 
Social Security Act, section 6432 of the Inter-
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395 
nal Revenue Code of 1986 shall not be taken 
into account. 
(C) CLERICAL AMENDMENT.—The table of 
sections for subchapter B of chapter 65 of the 
Internal Revenue Code of 1986 is amended by 
adding at the end the following new item: 
‘‘Sec. 6432. COBRA premium assistance.’’. 
(D) EFFECTIVE DATE.—The amendments 
made by this paragraph shall apply to pre-
miums to which subsection (a)(1)(A) applies. 
(E) SPECIAL RULE.— 
(i) IN GENERAL.—In the case of an 
assistance eligible individual who pays, 
with respect to the first period of COBRA 
continuation coverage to which subsection 
(a)(1)(A) applies or the immediately subse-
quent period, the full premium amount for 
such coverage, the person to whom such 
payment is payable shall— 
(I) make a reimbursement pay-
ment to such individual for the 
amount of such premium paid in ex-
cess of the amount required to be paid 
under subsection (a)(1)(A); or 
(II) provide credit to the indi-
vidual for such amount in a manner 
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396 
that reduces one or more subsequent 
premium payments that the individual 
is required to pay under such sub-
section for the coverage involved. 
(ii) 
REIMBURSING
EMPLOYER.—A 
person to which clause (i) applies shall be 
reimbursed as provided for in section 6432 
of the Internal Revenue Code of 1986 for 
any payment made, or credit provided, to 
the employee under such clause. 
(iii) PAYMENT OF CREDITS.—Unless 
it is reasonable to believe that the credit 
for the excess payment in clause (i)(II) will 
be used by the assistance eligible individual 
within 180 days of the date on which the 
person receives from the individual the 
payment of the full premium amount, a 
person to which clause (i) applies shall 
make the payment required under such 
clause to the individual within 60 days of 
such payment of the full premium amount. 
If, as of any day within the 180-day pe-
riod, it is no longer reasonable to believe 
that the credit will be used during that pe-
riod, payment equal to the remainder of 
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397 
the credit outstanding shall be made to the 
individual within 60 days of such day. 
(13) PENALTY
FOR
FAILURE
TO
NOTIFY 
HEALTH PLAN OF CESSATION OF ELIGIBILITY FOR 
PREMIUM ASSISTANCE.— 
(A) IN GENERAL.—Part I of subchapter B 
of chapter 68 of the Internal Revenue Code of 
1986 is amended by adding at the end the fol-
lowing new section: 
‘‘SEC. 6720C. PENALTY FOR FAILURE TO NOTIFY HEALTH 
PLAN OF CESSATION OF ELIGIBILITY FOR 
COBRA PREMIUM ASSISTANCE. 
‘‘(a) IN GENERAL.—Any person required to notify a 
group health plan under section 70307 of the Take Re-
sponsibility for Workers and Families Act who fails to 
make such a notification at such time and in such manner 
as the Secretary of Labor may require shall pay a penalty 
of 110 percent of the premium reduction provided under 
such section after termination of eligibility under such 
subsection. 
‘‘(b) REASONABLE CAUSE EXCEPTION.—No penalty 
shall be imposed under subsection (a) with respect to any 
failure if it is shown that such failure is due to reasonable 
cause and not to willful neglect.’’. 
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398 
(B) CLERICAL AMENDMENT.—The table of 
sections of part I of subchapter B of chapter 68 
of such Code is amended by adding at the end 
the following new item: 
‘‘Sec. 6720C. Penalty for failure to notify health plan of cessation of eligibility 
for COBRA premium assistance.’’. 
(14) COORDINATION WITH HCTC.— 
(A) IN GENERAL.—Section 35(g)(9) of the 
Internal Revenue Code of 1986 is amended to 
read as follows: 
‘‘(9) COBRA PREMIUM
ASSISTANCE.—In the 
case of an assistance eligible individual who receives 
premium reduction for COBRA continuation cov-
erage under section 70307 of the Take Responsi-
bility for Workers and Families Act for any month 
during the taxable year, such individual shall not be 
treated as an eligible individual, a certified indi-
vidual, or a qualifying family member for purposes 
of this section or section 7527 with respect to such 
month.’’. 
(B) EFFECTIVE
DATE.—The amendment 
made by subparagraph (A) shall apply to tax-
able years ending after the date of the enact-
ment of this Act. 
(15) EXCLUSION OF COBRA PREMIUM ASSIST-
ANCE FROM GROSS INCOME.— 
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399 
(A) IN GENERAL.—Part III of subchapter 
B of chapter 1 of the Internal Revenue Code of 
1986 is amended by inserting after section 
139B the following new section: 
‘‘SEC. 139I. COBRA PREMIUM ASSISTANCE. 
‘‘In the case of an assistance eligible individual (as 
defined in section 70307 of the Take Responsibility for 
Workers and Families Act), gross income does not include 
any premium reduction provided under subsection (a) of 
such section.’’. 
(B) CLERICAL AMENDMENT.—The table of 
sections for part III of subchapter B of chapter 
1 of such Code is amended by inserting after 
the item relating to section 139B the following 
new item: 
‘‘Sec. 139I. COBRA premium assistance.’’. 
(C) EFFECTIVE DATE.—The amendments 
made by this paragraph shall apply to taxable 
years ending after the date of the enactment of 
this Act. 
(b) PRESERVING AFFORDABLE COVERAGE FOR FUR-
LOUGHED WORKERS.— 
(1) IN GENERAL.—The Secretary of Labor, in 
coordination with the Secretary of the Treasury, 
shall establish a process whereby the premium as-
sistance under subsection (a) shall be available to an 
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400 
individual who has been subject to a furlough at any 
time during the emergency period described in sec-
tion 1135(g)(1)(B) of the Social Security Act (42 
U.S.C. 1320b–5(g)(1)(B)). 
(2) FURLOUGH DEFINED.— 
(A) IN GENERAL.—In this subsection, the 
term ‘‘furlough’’ means a temporary cessation 
of work at the will of the employer during 
which an individual remains employed and cov-
ered under a group health plan. 
(B) GROUP HEALTH PLAN DEFINED.—In 
this paragraph, the term ‘‘group health plan’’ 
has the meaning given such term in section 
607(1) of the Employee Retirement Income Se-
curity Act of 1974. 
(3) TREATMENT WITH RESPECT TO INTERNAL 
REVENUE CODE OF 1986.—For purposes of sections 
6432, 6720C, 35(g)(9), and 139I of the Internal 
Revenue Code of 1986, any premium assistance pro-
vided pursuant to any process established under this 
subsection to individuals who have been subject to a 
furlough shall be treated in the same manner as pre-
mium assistance for COBRA continuation coverage. 
(c) ELIMINATION OF PREMIUM SUBSIDY FOR HIGH- 
INCOME INDIVIDUALS.— 
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401 
(1) RECAPTURE OF SUBSIDY FOR HIGH-INCOME 
INDIVIDUALS.—If— 
(A) premium assistance is provided under 
this section with respect to any COBRA con-
tinuation coverage which covers the taxpayer, 
the taxpayer’s spouse, or any dependent (within 
the meaning of section 152 of the Internal Rev-
enue Code of 1986, determined without regard 
to subsections (b)(1), (b)(2), and (d)(1)(B) 
thereof) of the taxpayer during any portion of 
the taxable year, and 
(B) the taxpayer’s modified adjusted gross 
income for such taxable year exceeds $125,000 
($250,000 in the case of a joint return), 
then the tax imposed by chapter 1 of such Code with 
respect to the taxpayer for such taxable year shall 
be increased by the amount of such assistance. 
(2) PHASE-IN OF RECAPTURE.— 
(A) IN GENERAL.—In the case of a tax-
payer whose modified adjusted gross income for 
the taxable year does not exceed $145,000 
($290,000 in the case of a joint return), the in-
crease in the tax imposed under paragraph (1) 
shall not exceed the phase-in percentage of such 
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402 
increase (determined without regard to this 
paragraph). 
(B) PHASE-IN
PERCENTAGE.—For pur-
poses of this subsection, the term ‘‘phase-in 
percentage’’ means the ratio (expressed as a 
percentage) obtained by dividing— 
(i) the excess of described in subpara-
graph (B) of paragraph (1), by 
(ii) $20,000 ($40,000 in the case of a 
joint return). 
(3) OPTION FOR HIGH-INCOME INDIVIDUALS TO 
WAIVE ASSISTANCE AND AVOID RECAPTURE.—Not-
withstanding subsection (a)(3), an individual shall 
not be treated as an assistance eligible individual for 
purposes of this section and section 6432 of the In-
ternal Revenue Code of 1986 if such individual— 
(A) makes a permanent election (at such 
time and in such form and manner as the Sec-
retary of the Treasury may prescribe) to waive 
the right to the premium assistance provided 
under this section, and 
(B) notifies the entity to whom premiums 
are reimbursed under section 6432(a) of such 
Code of such election. 
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403 
(4) MODIFIED ADJUSTED GROSS INCOME.—For 
purposes of this subsection, the term ‘‘modified 
gross income’’ means the adjusted gross income (as 
defined in section 62 of the Internal Revenue Code 
of 1986) of the taxpayer for the taxable year in-
creased by any amount excluded from gross income 
under section 911, 931, or 933 of such Code. 
(5) CREDITS
NOT
ALLOWED
AGAINST
TAX, 
ETC.—For purposes determining regular tax liability 
under section 26(b) of such Code, the increase in tax 
under this subsection shall not be treated as a tax 
imposed under chapter 1 of such Code. 
(6) REGULATIONS.—The Secretary of the 
Treasury shall issue such regulations or other guid-
ance as are necessary or appropriate to carry out 
this subsection, including requirements that the enti-
ty to whom premiums are reimbursed under section 
6432(a) of the Internal Revenue Code of 1986 re-
port to the Secretary, and to each assistance eligible 
individual, the amount of premium assistance pro-
vided under subsection (a) with respect to each such 
individual. 
(7) EFFECTIVE DATE.—The provisions of this 
subsection shall apply to taxable years ending after 
the date of the enactment of this Act. 
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404 
SEC. 70308. RISK CORRIDOR PROGRAM. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (in this section referred to as the ‘‘Sec-
retary’’) shall establish and administer a program of risk 
corridors for plan years 2020 and 2021 under which the 
Secretary shall make payments to health insurance issuers 
offering health insurance coverage in the individual or 
small group market based on the ratio of the allowable 
costs of the coverage to the aggregate premiums of the 
coverage. 
(b) PAYMENT METHODOLOGY.—The Secretary shall 
provide under the program established under subsection 
(a) that if the allowable costs for a health insurance issuer 
offering health insurance coverage in the individual or 
small group market for any plan year are more than 105 
percent of the target amount, the Secretary shall pay to 
the issuer an amount equal to 75 percent of the allowable 
costs in excess of 105 percent of the target amount. 
(c) INFORMATION COLLECTION.—The Secretary shall 
establish a process under which information is collected 
from health insurance issuers offering health insurance 
coverage in the individual or small group market for pur-
poses of carrying out this section. 
(d) DEFINITIONS.— 
(1) ALLOWABLE COSTS.— 
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405 
(A) IN GENERAL.—The amount of allow-
able costs of a health insurance issuer offering 
health insurance coverage in the individual or 
small group market for any year is an amount 
equal to the total costs (other than administra-
tive costs) of such issuer in providing benefits 
covered by such coverage. 
(B) 
CERTAIN
REDUCTIONS.—Allowable 
costs shall reduced by any— 
(i) risk adjustment payments received 
under section 1341 of the Patient Protec-
tion and Affordable Care Act (42 U.S.C. 
18061); 
(ii) reinsurance payments received 
pursuant to a waiver approved under sec-
tion 1332 of such Act (42 U.S.C. 18052); 
and 
(iii) payments received pursuant to 
section 70304. 
(2) ADDITIONAL TERMS.—For purposes of this 
section, the terms ‘‘health insurance issuer’’, ‘‘health 
insurance coverage’’, ‘‘individual market’’, and 
‘‘small group market’’ have the meanings given such 
terms in section 2791 of the Public Health Service 
Act (42 U.S.C. 300gg–91). 
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406 
(3) TARGET AMOUNT.—The target amount of 
health insurance coverage offered in the individual 
or small group market for any year is an amount 
equal to the total premiums (including any premium 
subsidies under any governmental program), reduced 
by the administrative costs of the coverage. 
(e) IMPLEMENTATION.—The Secretary of Health and 
Human Services may implement the provisions of this sec-
tion by subregulatory guidance, program instruction, or 
otherwise. 
(f) APPROPRIATION.—There are appropriated, out of 
any monies in the Treasury not otherwise obligated, such 
sums as may be necessary to carry out this section. 
SEC. 70309. COVERAGE OF IN VITRO DIAGNOSTIC PROD-
UCTS. 
(a) IN GENERAL.—Section 6001 of division F of the 
Families First Coronavirus Response Act (Public Law 
116–127) is amended— 
(1) by amending subsection (a)(1) to read as 
follows: 
‘‘(1) Qualified in vitro diagnostic products and 
the administration of such in vitro diagnostic prod-
ucts.’’; and 
(2) in subsection (d)— 
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407 
(A) by striking ‘‘TERMS.—The terms’’ and 
inserting the following: ‘‘TERMS.—In this sec-
tion: 
‘‘(1) 
HEALTH
INSURANCE
TERMS.—The 
terms’’; and 
(B) by adding at the end the following: 
‘‘(2) QUALIFIED IN VITRO DIAGNOSTIC PROD-
UCT.— 
‘‘(A) The term ‘qualified in vitro diagnostic 
product’ means an in vitro diagnostic product 
(as defined in section 809.3(a) of title 21, Code 
of Federal Regulations) for the detection of 
SARS–CoV–2 or the diagnosis of the virus that 
causes COVID–19 that is approved, cleared, or 
authorized under section 510(k), 513, 515, or 
564 of the Federal Food, Drug, and Cosmetic 
Act (21 U.S.C. 360(k), 360c, 360e, and 
360bbb–3). 
‘‘(B) Such term includes an in vitro diag-
nostic test that— 
‘‘(i) subject to subparagraph (C), is 
developed and used in a laboratory cer-
tified to perform high-complexity testing 
pursuant to section 353 of the Public 
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408 
Health Service Act (42 U.S.C. 263a) and 
with respect to which such laboratory— 
‘‘(I) validates prior to use for the 
detection of SARS–CoV–2 or the di-
agnosis of the virus that causes 
COVID–19, including by obtaining 
confirmation of validation using an 
assay authorized under section 564 of 
the Federal Food, Drug, and Cos-
metic Act (21 U.S.C. 360bbb–3); 
‘‘(II) notifies the Secretary of 
such use; and 
‘‘(III) includes a statement to-
gether with the results of the test that 
reads: ‘This test has not been FDA 
cleared or approved. This test has 
been authorized by FDA under an 
emergency use authorization for use 
by authorized laboratories. This test 
has been authorized only for the de-
tection of nucleic acid from SARS- 
CoV-2, not for any other viruses or 
pathogens’; 
‘‘(ii) is developed and used in a lab-
oratory certified to perform high-com-
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409 
plexity testing pursuant to section 353 of 
the Public Health Service Act (42 U.S.C. 
263a) and such laboratory— 
‘‘(I) is operating under an au-
thorization of the State (as defined in 
section 2 of the Public Health Service 
Act (42 U.S.C. 201)) in which such 
laboratory is located and such State 
has notified the Secretary of its inten-
tion to review tests intended to diag-
nose SARS–CoV–2 or diagnose the 
virus that causes COVID–19 to be 
used in such State; 
‘‘(II) has notified the Secretary 
of such use for such purpose in such 
State; and 
‘‘(III) includes a statement to-
gether with the results of the test that 
reads: ‘This test was developed for use 
as a part of a response to the public 
health emergency declared to address 
the outbreak of COVID–19. This test 
has not been reviewed by the Food 
and Drug Administration’; or 
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‘‘(iii) is developed by a commercial 
test manufacturer that, with respect to 
such test— 
‘‘(I) validates such test prior to 
use to detect SARS–CoV–2 or diag-
nose the virus that causes COVID–19, 
including by obtaining confirmation of 
validation using an assay authorized 
under section 564 of the Federal 
Food, Drug, and Cosmetic Act (21 
U.S.C. 360bbb–3); 
‘‘(II) notifies the Secretary of 
such use; and 
‘‘(III) includes a statement to-
gether with the results of the test that 
reads: ‘This test has not been FDA 
cleared or approved. This test has 
been authorized by FDA under an 
emergency use authorization for use 
by authorized laboratories. This test 
has been authorized only for the de-
tection of nucleic acid from SARS- 
CoV-2, not for any other viruses or 
pathogens’. 
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411 
‘‘(C) Such term shall not include a test de-
scribed in clause (i) or (iii) of subparagraph (B) 
if— 
‘‘(i) the emergency use authorization 
request submitted by a laboratory or man-
ufacturer described in such respective 
clause with respect to such test has been 
denied; or 
‘‘(ii) such laboratory or manufacturer 
does not submit such a request within 15 
business days of the notification under 
subclause (II) of such respective subpara-
graph.’’. 
(b) CONFORMING AMENDMENT.—Subparagraph (B) 
of section 1905(a)(3) of the Social Security Act (42 
U.S.C. 1396d(a)(3)), as added by section 6004(a)(1) of 
division F of the Families First Coronavirus Response 
Act) is amended to read as follows: 
‘‘(B) qualified in vitro diagnostic products 
(as defined in section 6001(d) of division F of 
the Families First Coronavirus Response Act) 
and the administration of such in vitro diag-
nostic products;’’. 
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412 
SEC. 70310. SENSE OF CONGRESS REGARDING SURPRISE 
MEDICAL BILLS. 
(a) FINDINGS.—Congress finds the following: 
(1) Surprise medical bills can be financially dev-
astating for consumers. 
(2) Surprise medical bills are often unavoidable 
and occur in situations where consumers have no 
ability to reasonably choose an in-network provider 
or insurance company networks are too narrow for 
consumers to be able to access seamless in-network 
care. 
(3) Consumers and their financial stability 
should not be caught in the middle between insur-
ance companies and health care providers. 
(4) It is imperative that Congress enacts a com-
prehensive, long-term solution to protect consumers 
and end surprise medical billing. 
(5) During the COVID-19 pandemic, con-
sumers across the country will increasingly require 
emergency or unanticipated health care services and 
at the same time may have limited access to in-net-
work providers due to the increased demand on the 
health care system and it is critical that they are not 
deterred from seeking care due to the threat of a 
surprise medical bill. 
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413 
(6) The virus is now spreading faster in the 
United States than anywhere else in the world and 
experts indicate that day by day, more hospital beds 
will be full, more resources will be depleted, and the 
virus will claim more lives. 
(b) SENSE OF CONGRESS.—It is the sense of the 
Congress that, during the COVID-19 pandemic— 
(1) heath care providers should refrain from 
balance billing consumers for out-of-network claims 
related to COVID-19 testing or treatment and insur-
ance companies should do their utmost to secure ac-
cess to in-network treatment for their plan partici-
pants, including providing adequate reimbursement 
rates for services; and 
(2) consumers’ cost-sharing should be limited to 
what they would have paid if the providers testing 
or treating them for COVID-19 were in-network for 
their insurance plan. 
TITLE IV—PROVISIONS RELAT-
ING TO OLDER AMERICANS 
ACT OF 1965 
SEC. 70401. COMBATING HUNGER FOR OLDER AMERICANS 
DURING CORONAVIRUS CRISIS. 
(a) HOME DELIVERED NUTRITION SERVICES CRI-
TERIA APPLICABLE UNDER THE OLDER AMERICANS ACT 
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414 
OF 1965 DURING FISCAL YEAR 2020 TO RESPOND TO 
THE COVID-19 PUBLIC HEALTH EMERGENCY.—For 
purposes of State agencies determining the delivery of nu-
trition services under subpart 2 of part C of title III of 
the Older Americans Act of 1965 (42 U.S.C. 3030f et 
seq.), during the portion of COVID-19 public health emer-
gency declared under section 319 of the Public Health 
Service Act (42 U.S.C. 247d) that occurs in the period 
beginning on the date of the enactment of this Act and 
ending on September 30, 2020, the State agencies shall 
include among individuals receiving delivery because they 
are homebound an individual age 60 and older, or an indi-
vidual with a disability (of any age), who is unable to ob-
tain nutrition because the individual is under a quar-
antine, practicing social distancing, or otherwise unable to 
leave home, due to the emergency. 
(b) CONGREGATE NUTRITION SERVICES CRITERIA 
APPLICABLE UNDER THE OLDER AMERICANS ACT OF 
1965 DURING FISCAL YEAR 2020 TO RESPOND TO THE 
COVID-19 PUBLIC HEALTH EMERGENCY.— If a State 
demonstrates, to the satisfaction of the Assistant Sec-
retary (as defined in section 102 of the Older Americans 
Act of 1965 (42 U.S.C.3002), that funds received by the 
State and attributable to funds appropriated under para-
graph (1) or (2) of section 303(b) of the Older Americans 
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415 
Act of 1965 (42 U.S.C. 3023(b)), including funds trans-
ferred under subparagraph (A) of paragraph (4) of such 
section without regard to the exception referring to sub-
paragraph (B) specified in such subparagraph (A), for fis-
cal year 2020 are insufficient to satisfy the need for serv-
ices under subpart I or subpart II of part C of title III 
of the Older Americans Act of 1965 (42 U.S.C. 3030d– 
2 et seq.) in fiscal year 2020 during the COVID-19 public 
health emergency declared under section 319 of the Public 
Health Service Act (42 U.S.C. 247d), the Assistant Sec-
retary shall allow State and area agencies on aging, with-
out prior approval, to transfer up to 100 percent of the 
funds so received between subpart 1 and subpart 2 of such 
part C for use the State or area agency on aging considers 
appropriate to meet the needs of the area served. 
(c) WAIVER.—To facilitate implementation of sub-
parts 1 and 2 of part C of title III of the Older Americans 
Act of 1965 (42 U.S.C. 3030e et seq.) during any portion 
of the COVID-19 public health emergency declared under 
section 319 of the Public Health Service Act (42 U.S.C. 
247d) that occurs in the period beginning on the date of 
the enactment of this Act and ending on September 30, 
2020, the Assistant Secretary for Aging may waive the 
requirements for emergency meals to comply with the re-
quirements of clauses (i) and (ii) of section 339(2)(A) of 
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416 
the Older Americans Act of 1965 (42 U.S.C. 3030g– 
21(2)(A)). 
SEC. 70402. ACCESS OF THE STATE LONG-TERM CARE OM-
BUDSMAN TO RESIDENTS OF LONG-TERM 
CARE FACILITIES DURING THE COVID-19 PUB-
LIC HEALTH EMERGENCY IN FISCAL YEAR 
2020. 
During any portion of the COVID-19 public health 
emergency declared under section 319 of the Public 
Health Service Act (42 U.S.C. 247d) that occurs in the 
period beginning on the date of the enactment of this Act 
and ending on September 30, 2020, the State Long-Term 
Care Ombudsman shall have continuing direct access (or 
other access through the use of technology to the greatest 
extent practicable) to residents of long-term care facilities 
to provide the services described in section 712(a)(3)(B) 
of the Older Americans Act of 1965 (42 U.S.C. 
3058h(a)(3)(B)). 
SEC. 70403. CONTINUITY OF SERVICE AND OPPORTUNITIES 
FOR PARTICIPANTS IN COMMUNITY SERVICE 
ACTIVITIES UNDER TITLE V OF THE OF THE 
OLDER AMERICANS ACT OF 1965. 
To ensure continuity of service and opportunities for 
participants in community service activities under title V 
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417 
of the of the Older Americans Act of 1965 (42 U.S.C. 
3056–3056p), the Secretary of Labor— 
(1)(A) may allow for individuals participating 
in such activities as of March 1, 2020, to extend 
their participation for a period that exceeds the pe-
riod described in section 518(a)(3)(B)(i) of such Act 
if the Secretary determines such extension is appro-
priate due to the effects of the COVID-19 public 
heath emergency declared under section 319 of the 
Public Health Service Act (42 U.S.C. 247d), and 
(B) may extend the average participation cap 
for eligible individuals applicable to grantees under 
section 502(b)(1)(C) of such Act to a cap the Sec-
retary determines is appropriate due to the effects of 
the COVID-19 public heath emergency declared 
under section 319 of the Public Health Service Act 
(42 U.S.C. 247d), and 
(2) may increase the amount available to pay 
the authorized administrative costs to an amount 
not to exceed 20 percent of the grant amount if the 
Secretary determines that such increase is necessary 
to adequately respond to the additional administra-
tive needs to respond to the COVID-19 public health 
emergency declared under section 319 of the Public 
Health Service Act (42 U.S.C. 247d). 
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418 
TITLE V—PUBLIC HEALTH 
POLICIES 
Subtitle A—Improving Public 
Health and Medical Response 
SEC. 70501. REIMBURSEMENT FOR ADDITIONAL HEALTH 
SERVICES RELATING TO CORONAVIRUS. 
Title V of division A of the Families First 
Coronavirus Response Act (Public Law 116–127) is 
amended under the heading ‘‘Department of Health and 
Human Services—Office of the Secretary—Public Health 
and Social Services Emergency Fund’’ is amended by in-
serting ‘‘, or treatment related to SARS–CoV–2 or 
COVID–19 for uninsured individuals’’ after ‘‘or visits de-
scribed in paragraph (2) of such section for uninsured in-
dividuals’’. 
SEC. 
70502. 
PUBLIC 
HEALTH 
DATA 
SYSTEM 
TRANS-
FORMATION. 
Subtitle C of title XXVIII of the Public Health Serv-
ice Act (42 U.S.C. 300hh–31 et seq.) is amended by add-
ing at the end the following: 
‘‘SEC. 
2822. 
PUBLIC 
HEALTH 
DATA 
SYSTEM 
TRANS-
FORMATION. 
‘‘(a) EXPANDING CDC AND PUBLIC HEALTH DE-
PARTMENT CAPABILITIES.— 
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‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention, shall— 
‘‘(A) conduct activities to expand, enhance, 
and improve applicable public health data sys-
tems used by the Centers for Disease Control 
and Prevention, related to the interoperability 
and improvement of such systems (including as 
it relates to preparedness for, prevention and 
detection of, and response to public health 
emergencies); and 
‘‘(B) award grants or cooperative agree-
ments to State, local, Tribal, or territorial pub-
lic health departments for the expansion and 
modernization of public health data systems, to 
assist public health departments in— 
‘‘(i) assessing current data infrastruc-
ture capabilities and gaps to improve and 
increase consistency in data collection, 
storage, analysis and, as appropriate, to 
improve dissemination of public health-re-
lated information; 
‘‘(ii) improving secure public health 
data collection, transmission, exchange, 
maintenance, and analysis; 
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‘‘(iii) improving the secure exchange 
of data between the Centers for Disease 
Control and Prevention, State, local, Trib-
al, and territorial public health depart-
ments, public health organizations, and 
health care providers, including by public 
health officials in multiple jurisdictions 
within such State, as appropriate, and by 
simplifying and supporting reporting by 
health care providers, as applicable, pursu-
ant to State law, including through the use 
of health information technology; 
‘‘(iv) enhancing the interoperability of 
public health data systems (including sys-
tems created or accessed by public health 
departments) with health information tech-
nology, including with health information 
technology 
certified 
under 
section 
3001(c)(5); 
‘‘(v) supporting and training data sys-
tems, data science, and informatics per-
sonnel; 
‘‘(vi) supporting earlier disease and 
health condition detection, such as through 
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421 
near real-time data monitoring, to support 
rapid public health responses; 
‘‘(vii) supporting activities within the 
applicable jurisdiction related to the expan-
sion and modernization of electronic case 
reporting; and 
‘‘(viii) developing and disseminating 
information related to the use and impor-
tance of public health data. 
‘‘(2) DATA STANDARDS.—In carrying out para-
graph (1), the Secretary, acting through the Direc-
tor of the Centers for Disease Control and Preven-
tion, shall, as appropriate and in consultation with 
the Office of the National Coordinator for Health 
Information Technology, designate data and tech-
nology standards (including standards for interoper-
ability) for public health data systems, with def-
erence given to standards published by consensus- 
based standards development organizations with 
public input and voluntary consensus-based stand-
ards bodies. 
‘‘(3) 
PUBLIC-PRIVATE
PARTNERSHIPS.—The 
Secretary may develop and utilize public-private 
partnerships for technical assistance, training, and 
related implementation support for State, local, 
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422 
Tribal, and territorial public health departments, 
and the Centers for Disease Control and Prevention, 
on the expansion and modernization of electronic 
case reporting and public health data systems, as 
applicable. 
‘‘(b) REQUIREMENTS.— 
‘‘(1) 
HEALTH
INFORMATION
TECHNOLOGY 
STANDARDS.—The Secretary may not award a grant 
or cooperative agreement under subsection (a)(1)(B) 
unless the applicant uses or agrees to use standards 
endorsed by the National Coordinator for Health In-
formation 
Technology 
pursuant 
to 
section 
3001(c)(1) or adopted by the Secretary under sec-
tion 3004. 
‘‘(2) WAIVER.—The Secretary may waive the 
requirement under paragraph (1) with respect to an 
applicant if the Secretary determines that the activi-
ties under subsection (a)(1)(B) cannot otherwise be 
carried out within the applicable jurisdiction. 
‘‘(3) APPLICATION.—A State, local, Tribal, or 
territorial health department applying for a grant or 
cooperative agreement under this section shall sub-
mit an application to the Secretary at such time and 
in such manner as the Secretary may require. Such 
application shall include information describing— 
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423 
‘‘(A) the activities that will be supported 
by the grant or cooperative agreement; and 
‘‘(B) how the modernization of the public 
health data systems involved will support or im-
pact the public health infrastructure of the 
health department, including a description of 
remaining gaps, if any, and the actions needed 
to address such gaps. 
‘‘(c) STRATEGY AND IMPLEMENTATION PLAN.—Not 
later than 180 days after the date of enactment of this 
section, the Secretary, acting through the Director of the 
Centers for Disease Control and Prevention, shall submit 
to the Committee on Health, Education, Labor, and Pen-
sions of the Senate and the Committee on Energy and 
Commerce of the House of Representatives a coordinated 
strategy and an accompanying implementation plan that 
identifies and demonstrates the measures the Secretary 
will utilize to— 
‘‘(1) update and improve applicable public 
health data systems used by the Centers for Disease 
Control and Prevention; and 
‘‘(2) carry out the activities described in this 
section to support the improvement of State, local, 
Tribal, and territorial public health data systems. 
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424 
‘‘(d) 
CONSULTATION.—The 
Secretary, 
acting 
through the Director of the Centers for Disease Control 
and Prevention, shall consult with State, local, Tribal, and 
territorial health departments, professional medical and 
public health associations, associations representing hos-
pitals or other health care entities, health information 
technology experts, and other appropriate public or private 
entities regarding the plan and grant program to mod-
ernize public health data systems pursuant to this section. 
Activities under this subsection may include the provision 
of technical assistance and training related to the ex-
change of information by such public health data systems 
used by relevant health care and public health entities at 
the local, State, Federal, Tribal, and territorial levels, and 
the development and utilization of public-private partner-
ships for implementation support applicable to this sec-
tion. 
‘‘(e) REPORT TO CONGRESS.—Not later than 1 year 
after the date of enactment of this section, the Secretary 
shall submit a report to the Committee on Health, Edu-
cation, Labor, and Pensions of the Senate and the Com-
mittee on Energy and Commerce of the House of Rep-
resentatives that includes— 
‘‘(1) a description of any barriers to— 
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425 
‘‘(A) public health authorities imple-
menting interoperable public health data sys-
tems and electronic case reporting; 
‘‘(B) the exchange of information pursuant 
to electronic case reporting; or 
‘‘(C) reporting by health care providers 
using such public health data systems, as ap-
propriate, and pursuant to State law; 
‘‘(2) an assessment of the potential public 
health impact of implementing electronic case re-
porting and interoperable public health data sys-
tems; and 
‘‘(3) a description of the activities carried out 
pursuant to this section. 
‘‘(f) ELECTRONIC CASE REPORTING.—In this sec-
tion, the term ‘electronic case reporting’ means the auto-
mated identification, generation, and bilateral exchange of 
reports of health events among electronic health record or 
health information technology systems and public health 
authorities. 
‘‘(g) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there are authorized to be appro-
priated $100,000,000 for each of fiscal years 2021 
through 2025.’’. 
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426 
SEC. 70503. REPORTING ON COVID-19 TESTING AND RE-
SULTS. 
State and local governments, laboratories, and health 
systems receiving funds or assistance pursuant to division 
A of the Families First Coronavirus Response Act (Public 
Law 116–127) or pursuant to division A of this Act shall 
ensure that— 
(1) the respective State Emergency Operations 
Center and State and local public health depart-
ments, receive regular and real-time reporting on 
data, in a timely manner, on testing and results, in-
cluding positive and negative laboratory results, as 
well as reporting on cases and severe outcomes re-
sulting from COVID-19, as determined by the Direc-
tor of the Centers for Disease Control and Preven-
tion; and 
(2) such data is transmitted in a regular and 
timely manner to the Centers for Disease Control 
and Prevention. 
SEC. 70504. CENTERS FOR DISEASE CONTROL AND PREVEN-
TION COVID-19 RESPONSE LINE. 
(a) IN GENERAL.—During the public health emer-
gency declared by the Secretary of Health and Human 
Services pursuant to section 319 of the Public Health 
Service Act (42 U.S.C. 247d) on January 31, 2020 with 
respect to COVID-19, the Secretary, acting through the 
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427 
Director of the Centers for Disease Control and Preven-
tion, shall maintain a toll-free telephone number to ad-
dress public health queries, including questions concerning 
COVID-19. 
(b) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there is authorized to be appropriated 
$10,000,000, to remain available until expended. 
SEC. 70505. AWARENESS CAMPAIGN. 
The Secretary of Health and Human Services, acting 
through the Director of the Centers for Disease Control 
and Prevention and in coordination with other offices and 
agencies, as appropriate, shall award competitive grants 
or contracts to one or more public or private entities to 
carry out a national campaign, based on available sci-
entific evidence, to increase awareness and knowledge of 
COVID-19, including countering stigma associated with 
COVID-19 and improving information on the availability 
of diagnostic testing and other related services at commu-
nity health centers. 
SEC. 70506. ADDITIONAL FUNDING FOR MEDICAL RESERVE 
CORPS. 
Section 2813 of the Public Health Service Act (42 
U.S.C. 300hh–15) is amended by striking ‘‘$11,200,000 
for each of fiscal years 2019 through 2023’’ and inserting 
VerDate Sep 11 2014 
05:03 Mar 24, 2020
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