Protecting Medicare and American Farmers from Sequester Cuts Act
Bill: S.610 | Sponsor: Sen. Kaine, Tim (D-VA)
Policy area: Health

Summary:
Protecting Medicare and American Farmers from Sequester Cuts Act
This bill makes several budgetary, technical, and procedural changes, particularly in relation to Medicare and increasing the debt limit.
Specifically, the bill continues to exempt Medicare from sequestration until March 31, 2022. (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 establishes expedited Senate procedures for considering legislation to increase the debt limit. The procedures limit debate, waive points of order, and prohibit amendments. The procedures may only be used once and expire after January 16, 2022.
Additionally, the bill (1) temporarily extends other provisions under Medicare, including a payment increase under the physician fee schedule; and (2) requires any debits recorded for FY2022 on the statutory pay-as-you-go (PAYGO) scorecards to be deducted from the scorecards for 2022 and added to the scorecards for 2023.

[117th Congress Public Law 71]
[From the U.S. Government Publishing Office]



[[Page 1505]]

    PROTECTING MEDICARE AND AMERICAN FARMERS FROM SEQUESTER CUTS ACT

[[Page 135 STAT. 1506]]

Public Law 117-71
117th Congress

                                 An Act


 
     To address behavioral health and well-being among health care 
           professionals. <<NOTE: Dec. 10, 2021 -  [S. 610]>> 

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled, <<NOTE: Protecting 
Medicare and American Farmers from Sequester Cuts Act.>> 
SECTION 1. <<NOTE: 2 USC 900 note.>>  SHORT TITLE.

    This Act may be cited as the ``Protecting Medicare and American 
Farmers from Sequester Cuts Act''.
SEC. 2. ADJUSTMENTS TO MEDICARE SEQUESTRATION REDUCTIONS.

    (a) Extension of Temporary Suspension Through March 2022.--
            (1) In general.--Section 3709(a) of division A of the CARES 
        Act (2 U.S.C. 901a note) is amended--
                    (A) in the subsection header by inserting ``and 
                Adjustment'' after ``Suspension''; and
                    (B) by striking ``December 31, 2021'' and inserting 
                ``March 31, 2022''.
            (2) <<NOTE: 2 USC 901a note.>>  Effective date.--The 
        amendments made by paragraph (1) shall take effect as if enacted 
        as part of the CARES Act (Public Law 116-136).

    (b) Adjustments to Medicare Program Sequestration Reduction With 
Respect to Fiscal Years 2022 and 2030.--Section 251A(6) of the Balanced 
Budget and Emergency Deficit Control Act of 1985 (2 U.S.C. 901a(6)) is 
amended--
            (1) by redesignating subparagraph (C) as subparagraph (E); 
        and
            (2) by inserting after subparagraph (B) the following new 
        subparagraphs:
                    ``(C) <<NOTE: Applicability.>>  Notwithstanding the 
                2 percent limit specified in subparagraph (A) for 
                payments for the Medicare programs specified in section 
                256(d), the sequestration order of the President under 
                such subparagraph for fiscal year 2022 shall be applied 
                to such payments so that with respect to the period 
                beginning on April 1, 2022, and ending on June 30, 2022, 
                the payment reduction shall be 1.0 percent.
                    ``(D) <<NOTE: Applicability.>>  Notwithstanding the 
                2 percent limit specified in subparagraph (A) for 
                payments for the Medicare programs specified in section 
                256(d), the sequestration order of the President under 
                such subparagraph for fiscal year 2030 shall be applied 
                to such payments so that--
                          ``(i) with respect to the first 6 months in 
                      which such order is effective for such fiscal 
                      year, the payment reduction shall be 2.25 percent; 
                      and

[[Page 135 STAT. 1507]]

                          ``(ii) with respect to the second 6 months in 
                      which such order is so effective for such fiscal 
                      year, the payment reduction shall be 3 percent.''.
SEC. 3. EXTENSION OF SUPPORT FOR PHYSICIANS AND OTHER 
                    PROFESSIONALS IN ADJUSTING TO MEDICARE PAYMENT 
                    CHANGES.

    (a) In General.--Section 1848 of the Social Security Act (42 U.S.C. 
1395w-4) is amended--
            (1) in subsection (c)(2)(B)(iv)(V), by striking ``2021'' and 
        inserting ``2021 or 2022''; and
            (2) in subsection (t)--
                    (A) in the subsection header, by striking ``2021'' 
                and inserting ``2021 and 2022'';
                    (B) in paragraph (1)--
                          (i) by striking ``during 2021'' and inserting 
                      ``during 2021 and 2022''; and
                          (ii) by striking ``for such services furnished 
                      on or after January 1, 2021, and before January 1, 
                      2022, by 3.75 percent.'' and inserting ``for--
                    ``(A) such services furnished on or after January 1, 
                2021, and before January 1, 2022, by 3.75 percent; and
                    ``(B) such services furnished on or after January 1, 
                2022, and before January 1, 2023, by 3.0 percent.''; and
                    (C) in paragraph (2)(C)--
                          (i) in the subparagraph header, by striking 
                      ``2021'' and inserting ``2021 and 2022'';
                          (ii) by inserting ``for services furnished in 
                      2021 or 2022'' after ``under this subsection''; 
                      and
                          (iii) by inserting ``or 2022, respectively'' 
                      before the period at the end.

    (b) Report.--Section 101(c) of division N of the Consolidated 
Appropriations Act, 2021 (Public Law 116-260) <<NOTE: 134 Stat. 1950.>>  
is amended--
            (1) in the first sentence--
                    (A) by striking ``April 1, 2022'' and inserting 
                ``each of April 1, 2022, and April 1, 2023''; and
                    (B) by striking ``, as added by subsection (a)'' and 
                inserting ``furnished during 2021 or 2022, 
                respectively''; and
            (2) in the second sentence--
                    (A) by striking ``Such report'' and inserting ``Each 
                such report''; and
                    (B) by inserting ``with respect to 2021 or 2022, as 
                applicable'' after ``under such section''.
SEC. 4. PRESERVING PATIENT ACCESS TO CRITICAL CLINICAL LAB 
                    SERVICES.

    (a) Revised Phase-in of Reductions From Private Payor Rate 
Implementation.--Section 1834A(b)(3) of the Social Security Act (42 
U.S.C. 1395m-1(b)(3)) is amended--
            (1) in subparagraph (A), by striking ``through 2024'' and 
        inserting ``through 2025''; and
            (2) in subparagraph (B)--
                    (A) in clause (ii), by striking ``for 2021'' and 
                inserting ``for each of 2021 and 2022''; and
                    (B) in clause (iii), by striking ``2022 through 
                2024'' and inserting ``2023 through 2025''.

[[Page 135 STAT. 1508]]

    (b) Revised Reporting Period for Reporting of Private Sector Payment 
Rates for Establishment of Medicare Payment Rates.--Section 
1834A(a)(1)(B) of the Social Security Act (42 U.S.C. 1395m-1(a)(1)(B)) 
is amended--
            (1) in clause (i), by striking ``December 31, 2021'' and 
        inserting ``December 31, 2022''; and
            (2) in clause (ii)--
                    (A) by striking ``January 1, 2022'' and inserting 
                ``January 1, 2023''; and
                    (B) by striking ``March 31, 2022'' and inserting 
                ``March 31, 2023''.
SEC. 5. DELAY TO THE IMPLEMENTATION OF THE RADIATION ONCOLOGY 
                    MODEL UNDER THE MEDICARE PROGRAM.

    Section 133 of Division CC of the Consolidated Appropriations Act, 
2021 (Public Law 116-260) <<NOTE: 134 Stat. 2976.>>  is amended by 
striking ``January 1, 2022'' and inserting ``January 1, 2023''.
SEC. 6. MEDICARE IMPROVEMENT FUND.

    Section 1898(b)(1) of the Social Security Act (42 U.S.C. 
1395iii(b)(1)) is amended by striking ``fiscal year 2021'' and all that 
follows through the period at the end and inserting ``fiscal year 2021, 
$101,000,000.''.
SEC. 7. <<NOTE: Determination. Time periods.>>  PAYGO ANNUAL 
                    REPORT.

    For the purposes of the annual report issued pursuant to section 5 
of the Statutory Pay-As-You-Go Act of 2010 (2 U.S.C. 934) after 
adjournment of the first session of the 117th Congress, and for 
determining whether a sequestration order is necessary under such 
section, the debit for the budget year on the 5-year scorecard, if any, 
and the 10-year scorecard, if any, shall be deducted from such scorecard 
in 2022 and added to such scorecard in 2023.
SEC. 8. EXPEDITED PROCEDURES FOR CONSIDERING AN INCREASE IN THE 
                    DEBT LIMIT.

    (a) Definition.--In this section, the term ``joint resolution'' 
means a joint resolution--
            (1) <<NOTE: Time period.>>  that is introduced by the 
        Majority Leader of the Senate, or a designee, during the period 
        beginning on the date of enactment of this Act and ending on 
        December 31, 2021;
            (2) which does not have a preamble;
            (3) the title of which is as follows: ``Joint resolution 
        relating to increasing the debt limit.''; and
            (4) the matter after the resolving clause of which is as 
        follows: ``That the limitation under section 3101(b) of title 
        31, United States Code, as most recently increased by Public Law 
        117-50 (31 U.S.C. 3101 note), is increased by $_________.'', the 
        blank space being appropriately filled in with the dollar amount 
        of the increase.

    (b) Expedited Consideration in Senate.--
            (1) Placement on calendar.--Upon introduction in the Senate, 
        the joint resolution shall be placed immediately on the 
        calendar.
            (2) Proceeding to consideration.--
                    (A) <<NOTE: Deadline.>>  In general.--
                Notwithstanding rule XXII of the Standing Rules of the 
                Senate, it is in order, not later than January 15, 2022 
                (even though a previous motion

[[Page 135 STAT. 1509]]

                to the same effect has been disagreed to) to move to 
                proceed to the consideration of the joint resolution.
                    (B) Procedure.--For a motion to proceed to the 
                consideration of the joint resolution--
                          (i) all points of order against the motion are 
                      waived;
                          (ii) the motion is not debatable;
                          (iii) the motion is not subject to a motion to 
                      postpone;
                          (iv) a motion to reconsider the vote by which 
                      the motion is agreed to or disagreed to shall not 
                      be in order; and
                          (v) if the motion is agreed to, the joint 
                      resolution shall remain the unfinished business 
                      until disposed of.
            (3) Floor consideration.--
                    (A) In general.--If the Senate proceeds to 
                consideration of the joint resolution--
                          (i) all points of order against the joint 
                      resolution (and against consideration of the joint 
                      resolution) are waived;
                          (ii) <<NOTE: Time period.>>  debate on the 
                      joint resolution, and all debatable motions and 
                      appeals in connection therewith, shall be limited 
                      to not more than 10 hours, which shall be divided 
                      equally between the Chairman and Ranking Member of 
                      the Committee on Finance;
                          (iii) an amendment to the joint resolution is 
                      not in order;
                          (iv) a motion to postpone or a motion to 
                      commit the joint resolution is not in order; and
                          (v) a motion to proceed to the consideration 
                      of other business is not in order.
                    (B) Vote on passage.--The vote on passage shall 
                occur immediately following the conclusion of the debate 
                on the joint resolution and a single quorum call if 
                requested in accordance with the rules of the Senate.
                    (C) Rulings of the chair on procedure.--Appeals from 
                the decisions of the Chair relating to the application 
                of this paragraph or the rules of the Senate, as the 
                case may be, to the procedure relating to the joint 
                resolution shall be decided without debate.
                    (D) Single measure authorized.--It shall not be in 
                order to consider more than 1 joint resolution under the 
                procedures under this paragraph.
                    (E) Sunset.--It shall not be in order to consider a 
                joint resolution under the procedures under this 
                paragraph after January 16, 2022.
            (4) Rules of the senate.--This subsection is enacted by 
        Congress--
                    (A) as an exercise of the rulemaking power of the 
                Senate, and as such is deemed a part of the rules of the 
                Senate, but applicable only with respect to the 
                procedure to be followed in the Senate in the case of a 
                joint resolution, and supersede other rules only to the 
                extent that they are inconsistent with such rules; and
                    (B) with full recognition of the constitutional 
                right of the Senate to change the rules (so far as 
                relating to

[[Page 135 STAT. 1510]]

                the procedure of the Senate) at any time, in the same 
                manner, and to the same extent as in the case of any 
                other rule of the Senate.

    Approved December 10, 2021.

LEGISLATIVE HISTORY--S. 610:
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CONGRESSIONAL RECORD, Vol. 167 (2021):
            Aug. 5, considered and passed Senate.
            Dec. 7, considered and passed House, amended. Senate 
                considered concurring in House amendment.
            Dec. 9, Senate concurred in House amendment.

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