Title: The Resetting the Impact Act (TRIA) of 2020
Policy area: Health

Summary:
The Resetting the Impact Act (TRIA) of 2020
This bill requires certain data collection and recommendations relating to a Medicare post-acute care prospective payment system to incorporate the effects of COVID-19 (i.e., coronavirus disease 2019) on providers and patients.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8826 Introduced in House (IH)]

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116th CONGRESS
  2d Session
                                H. R. 8826

   To amend the IMPACT Act of 2014 to reset data collection and the 
development of a payment system technical prototype for post-acute care 
 providers 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) 
 introduced 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 prototype 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 Representatives 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''.

SEC. 2. RESETTING DATA COLLECTION AND THE DEVELOPMENT OF A PAYMENT 
              SYSTEM TECHNICAL PROTOTYPE FOR POST-ACUTE CARE PROVIDERS 
              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)--
                            (i) in subclause (III), by striking ``and'' 
                        at the end;
                            (ii) in subclause (IV), by striking the 
                        period at the end and inserting a semicolon; 
                        and
                            (iii) by adding at the end the following 
                        new subclauses:
                                    ``(V) ensure that payments under 
                                the system would be sufficient to 
                                support the resources needed to provide 
                                quality patient care, including with 
                                respect to items and services needed by 
                                the highest-acuity patients, including 
                                those with or recovering from 
                                medically-complex occurrences of COVID-
                                19 and those with major or extreme 
                                severity of illness (as defined by the 
                                All Patients Refined Diagnosis Related 
                                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 
                                recently available PAC provider data 
                                described 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 setting 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 infectious disease during the 
                                emergency period described in section 
                                1135(g)(1)(B) of the Social Security 
                                Act;
                                    ``(II) reviews and compares the 
                                relative capabilities of each PAC 
                                provider setting in meeting the 
                                clinical needs of individuals with 
                                COVID-19 and the needs of referring 
                                acute-care hospitals, including a 
                                specific assessment of such 
                                capabilities with respect to 
                                individuals with high-acuity COVID-19 
                                cases, including such individuals 
                                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 
                                rehabilitation, therapy, and 
                                rehabilitation nursing care;
                                    ``(III) evaluates the relative 
                                abilities of each PAC provider setting 
                                to prevent, mitigate, and contain the 
                                intra-facility and community spread of 
                                COVID-19;
                                    ``(IV) specifies the types of 
                                adjustments in clinical capacity, 
                                infection 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 subparagraph is 
                                submitted to Congress.''; and
            (2) by adding at the end the following new subparagraph:
                    ``(C) Specified calendar quarter defined.--For 
                purposes of subparagraph (A), the term `specified 
                calendar quarter' means a calendar 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 Groupings Model 
                        (as described at 83 Fed. Reg. 56446 et seq.);
                            ``(ii) beginning after the prospective 
                        payment system for skilled nursing facilities 
                        under section 1888(e) of such Act has 
                        incorporated the Patient-Driven Payment Model 
                        (as described in 83 Fed. Reg. 39162 et seq.); 
                        and
                            ``(iii) no portion of which occurs during a 
                        nationwide public health emergency declared by 
                        the Secretary pursuant to section 319 of the 
                        Public Health Service Act with respect to which 
                        any waiver has been effectuated by the 
                        Secretary pursuant to section 1135 of the 
                        Social Security Act.''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
take effect as if included in the enactment of the IMPACT Act of 2014 
(Public Law 113-185).
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