To prevent across-the-board direct spending cuts, and for other purposes.
Bill: H.R.1868 | Sponsor: Rep. Yarmuth, John A. (D-KY)
Policy area: Health

Summary:
This bill makes several budgetary and technical changes to provisions under Medicare and Medicaid.
The bill continues to exempt Medicare from sequestration until December 31, 2021. (Sequestration is a process of automatic, usually across-the-board spending reductions under which budgetary resources are permanently cancelled to enforce specific budget policy goals.)
The bill also specifically

[117th Congress Public Law 7]
[From the U.S. Government Publishing Office]



[[Page 135 STAT. 251]]

Public Law 117-7
117th Congress

                                 An Act


 
    To prevent across-the-board direct spending cuts, and for other 
            purposes. <<NOTE: Apr. 14, 2021 -  [H.R. 1868]>> 

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,
SECTION 1. EXTENSION OF TEMPORARY SUSPENSION OF MEDICARE 
                              SEQUESTRATION.

    (a) Extension.--
            (1) In general.--Section 3709(a) of division A of the CARES 
        Act (2 U.S.C. 901a note) is amended by striking ``March 31, 
        2021'' and inserting ``December 31, 2021''.
            (2) <<NOTE: 2 USC 901a note.>>  Effective date.--The 
        amendment made by paragraph (1) shall take effect as if enacted 
        as part of the CARES Act (Public Law 116-136).

    (b) Offset.--Section 251A(6)(C) of the Balanced Budget and Emergency 
Deficit Control Act of 1985 (2 U.S.C. 901a(6)(C)) is amended--
            (1) in clause (i)--
                    (A) by striking ``first 6 months'' and inserting 
                ``first 5 \1/2\ months'';
                    (B) by striking ``4.0 percent'' and inserting ``2.0 
                percent''; and
                    (C) by striking ``and'' at the end;
            (2) in clause (ii)--
                    (A) by striking ``second 6 months'' and inserting 
                ``6-month period beginning on the day after the last day 
                of the period described in clause (i)''; and
                    (B) by striking ``0.0 percent.'' and inserting ``4.0 
                percent; and''; and
            (3) by adding at the end the following:
                    ``(iii) with respect to the remaining \1/2\ month in 
                which such order is so effective for such fiscal year, 
                the payment reduction shall be 0.0 percent.''.
SEC. 2. TECHNICAL CORRECTIONS.

    (a) Rural Health Clinic Payments.--
            (1) In general.--Section 1833(f)(3) of the Social Security 
        Act (42 U.S.C. 1395l(f)(3)) is amended--
                    (A) in subparagraph (A)--
                          (i) in clause (i), by striking subclauses (I) 
                      and (II) and inserting the following:
                          ``(I) with respect to a rural health clinic 
                      that had a per visit payment amount established 
                      for services furnished in 2020--

[[Page 135 STAT. 252]]

                                    ``(aa) the per visit payment amount 
                                applicable to such rural health clinic 
                                for rural health clinic services 
                                furnished in 2020, increased by the 
                                percentage increase in the MEI 
                                applicable to primary care services 
                                furnished as of the first day of 2021; 
                                or
                                    ``(bb) the limit described in 
                                paragraph (2)(A); and
                          ``(II) with respect to a rural health clinic 
                      that did not have a per visit payment amount 
                      established for services furnished in 2020--
                                    ``(aa) the per visit payment amount 
                                applicable to such rural health clinic 
                                for rural health clinic services 
                                furnished in 2021; or
                                    ``(bb) the limit described in 
                                paragraph (2)(A); and''; and
                          (ii) in clause (ii)(I), by striking ``under 
                      clause (i)(I)'' and inserting ``under subclause 
                      (I) or (II) of clause (i), as applicable,''; and
                    (B) by striking subparagraph (B) and inserting the 
                following:

    ``(B) A rural health clinic described in this subparagraph is a 
rural health clinic that--
            ``(i) as of December 31, 2020, was in a hospital with less 
        than 50 beds and after such date such hospital continues to have 
        less than 50 beds (not taking into account any increase in the 
        number of beds pursuant to a waiver under subsection (b)(1)(A) 
        of section 1135 during the emergency period described in 
        subsection (g)(1)(B) of such section); and
            ``(ii)(I) as of December 31, 2020, was enrolled under 
        section 1866(j) (including temporary enrollment during such 
        emergency period for such emergency period); or
            ``(II) submitted an application for enrollment under section 
        1866(j) (or a request for such a temporary enrollment for such 
        emergency period) that was received not later than December 31, 
        2020.''.
            (2) <<NOTE: 42 USC 1395l note.>>  Effective date.--The 
        amendments made by this subsection shall take effect as if 
        included in the enactment of the Consolidated Appropriations 
        Act, 2021 (Public Law 116-260).

    (b) <<NOTE: 42 USC 1396r-4 note.>>  Additional Amount for Certain 
Hospitals With High Disproportionate Share.--Effective as if included in 
the enactment of section 203(a) of title II of division CC of Public Law 
116-260, subsection (g) of section 1923 of the Social Security Act (42 
U.S.C. 1396r-4), as amended by such section, is amended by adding at the 
end the following:
            ``(3) Continued application of grandfathered transition 
        rule.--Notwithstanding paragraph (2) of this subsection (as in 
        effect on October 1, 2021), paragraph (2) of this subsection (as 
        in effect on September 30, 2021, and as applied under section 
        4721(e) of the Balanced Budget Act of 1997, and amended by 
        section 607 of the Medicare, Medicaid, and SCHIP Balanced Budget 
        Refinement Act of 1999 (Public Law 106-113)) shall apply in 
        determining whether a payment adjustment for a hospital in a 
        State referenced in section 4721(e) of the

[[Page 135 STAT. 253]]

        Balanced Budget Act of 1997 during a State fiscal year shall be 
        considered consistent with subsection (c).''.

    Approved April 14, 2021.

LEGISLATIVE HISTORY--H.R. 1868:
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CONGRESSIONAL RECORD, Vol. 167 (2021):
            Mar. 19, considered and passed House.
            Mar. 25, considered and passed Senate, amended.
            Apr. 13, House concurred in Senate amendment.

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