I 
116TH CONGRESS 
2D SESSION 
H. R. 8826 
To amend the IMPACT Act of 2014 to reset data collection and the develop-
ment of a payment system technical prototype for post-acute care pro-
viders under the Medicare program to take into account the effects 
of COVID–19. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 30, 2020 
Ms. SEWELL of Alabama (for herself, Mr. PASCRELL, and Mr. SUOZZI) intro-
duced the following bill; which was referred to the Committee on Ways 
and Means, and in addition to the Committee on Energy and Commerce, 
for a period to be subsequently determined by the Speaker, in each case 
for consideration of such provisions as fall within the jurisdiction of the 
committee concerned 
A BILL 
To amend the IMPACT Act of 2014 to reset data collection 
and the development of a payment system technical pro-
totype for post-acute care providers under the Medicare 
program to take into account the effects of COVID– 
19. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as ‘‘The Resetting the Impact 
Act (TRIA) of 2020’’. 
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SEC. 2. RESETTING DATA COLLECTION AND THE DEVELOP-
MENT OF A PAYMENT SYSTEM TECHNICAL 
PROTOTYPE FOR POST-ACUTE CARE PRO-
VIDERS UNDER THE MEDICARE PROGRAM TO 
TAKE 
INTO 
ACCOUNT 
THE 
EFFECTS 
OF 
COVID–19. 
(a) IN GENERAL.—Section 2(b)(2) of the IMPACT 
Act of 2014 (Public Law 113–185) is amended— 
(1) in subparagraph (A)— 
(A) in the matter preceding clause (i), by 
striking ‘‘Not later than’’ and all that follows 
through ‘‘subsection (a),’’ and inserting ‘‘Not 
earlier than the date that is 2 years after the 
later of January 1, 2021, and the date by which 
the Secretary of Health and Human Services 
has collected at least 12 specified calendar 
quarters (as defined in subparagraph (C)) of 
standardized patient assessment data under 
subsection (b) of section 1899B of the Social 
Security Act, of data on quality measures under 
subsection (c) of such section, and of resource 
use and claims data under subsection (d) of 
such section from each of the PAC payment 
systems (as defined in subsection (a)(2)(D) of 
such section),’’; 
(B) in clause (i)— 
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(i) in subclause (III), by striking 
‘‘and’’ at the end; 
(ii) in subclause (IV), by striking the 
period at the end and inserting a semi-
colon; and 
(iii) by adding at the end the fol-
lowing new subclauses: 
‘‘(V) ensure that payments under 
the system would be sufficient to sup-
port the resources needed to provide 
quality patient care, including with re-
spect to items and services needed by 
the highest-acuity patients, including 
those with or recovering from medi-
cally-complex occurrences of COVID– 
19 and those with major or extreme 
severity of illness (as defined by the 
All Patients Refined Diagnosis Re-
lated Groups (APR–DRG) patient 
classification system), to ensure that 
such individuals retain access to care 
in relevant PAC provider settings; 
‘‘(VI) take into account, to the 
greatest extent possible, the most re-
cently available PAC provider data de-
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scribed in any of subsections (b) 
through (d) of section 1899B of such 
Act; and 
‘‘(VII) taking into account the 
impact assessment described in clause 
(vi), ensure that payment and access 
to care under the system would be 
adequate for each PAC provider set-
ting during a pandemic of similar 
scope and impact as that of COVID– 
19.’’; 
(C) in clause (iv), by striking ‘‘and’’ at the 
end; 
(D) in clause (v) by striking the period at 
the end and inserting ‘‘; and’’; and 
(E) by adding at the end the following new 
clause: 
‘‘(vi) an impact assessment that— 
‘‘(I) evaluates the capabilities 
and limitations of each PAC provider 
setting with respect to quality of care, 
patient safety, and containment of in-
fectious disease during the emergency 
period 
described 
in 
section 
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1135(g)(1)(B) of the Social Security 
Act; 
‘‘(II) reviews and compares the 
relative capabilities of each PAC pro-
vider setting in meeting the clinical 
needs of individuals with COVID–19 
and the needs of referring acute-care 
hospitals, including a specific assess-
ment of such capabilities with respect 
to 
individuals 
with 
high-acuity 
COVID–19 cases, including such indi-
viduals requiring ventilator services 
and such individuals with major and 
extreme levels of severity of illness (as 
defined under the APR–DRGs patient 
classification system) and individuals 
requiring intensive medical rehabilita-
tion, therapy, and rehabilitation nurs-
ing care; 
‘‘(III) evaluates the relative abili-
ties of each PAC provider setting to 
prevent, mitigate, and contain the 
intra-facility and community spread of 
COVID–19; 
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‘‘(IV) specifies the types of ad-
justments in clinical capacity, infec-
tion control protocols, isolation space, 
physical plant, personnel, access to 
personal protective equipment, and 
other changes by each PAC provider 
setting needed to safely mitigate the 
spread of future pandemics that are 
similar in scope and impact to that of 
COVID–19; and 
‘‘(V) is made publicly available at 
least 6 months before the date on 
which the report under this subpara-
graph is submitted to Congress.’’; and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(C) SPECIFIED CALENDAR QUARTER DE-
FINED.—For purposes of subparagraph (A), the 
term ‘specified calendar quarter’ means a cal-
endar quarter— 
‘‘(i) beginning after the prospective 
payment system for home health agencies 
under section 1895 of the Social Security 
Act has incorporated the Patient-Driven 
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