Title: Relief for Rural Providers During Emergencies Act
Policy area: Health

Summary:
Relief for Rural Providers During Emergencies Act
This bill waives several requirements and establishes certain minimum funding for rural health care providers during the public health emergency relating to COVID-19 (i.e., coronavirus disease 2019).
Among other things, the bill maintains a provider's eligibility to participate in the 340B drug pricing program (i.e., a program that allows providers to receive covered outpatient drugs at reduced prices from manufacturers) for the duration of the public health emergency if the provider was already participating before the emergency began. The bill also requires the Centers for Medicare & Medicaid Services to temporarily waive specified requirements for Medicare and Medicaid providers and services, including certain criteria for critical access hospital certification and coverage of post-hospital care in skilled nursing facilities.
Additionally, the bill retroactively requires that at least 20% of appropriations to the Public Health and Social Services Emergency Fund under the Coronavirus Aid, Relief, and Economic Security (CARES) Act relating to COVID-19 provider assistance be distributed to rural health care providers.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 3631 Introduced in Senate (IS)]

<DOC>






116th CONGRESS
  2d Session
                                S. 3631

  To provide relief for rural providers during the national emergency 
        with respect to the Coronavirus Disease 2019 (COVID-19).


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 6, 2020

   Mr. Sasse introduced the following bill; which was read twice and 
                  referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
  To provide relief for rural providers during the national emergency 
        with respect to the Coronavirus Disease 2019 (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 ``Relief for Rural Providers During 
Emergencies Act''.

SEC. 2. PAUSING ELIGIBILITY DETERMINATIONS UNDER THE 340B DRUG PRICING 
              PROGRAM.

    (a) In General.--The Secretary of Health and Human Services shall, 
for any cost reporting period ending in 2020 or 2021, for any other 
cost reporting period in which the COVID-19 public health emergency is 
in effect during all or part of such period, and for any extended 
period under subsection (b)--
            (1) pause the process of making any determination as to 
        whether an entity, that was a covered entity for the most 
        recent cost reporting period prior to the first date on which 
        the COVID-19 public health emergency went into effect, 
        continues to be such a covered entity; and
            (2) deem any entity, that was a covered entity for the most 
        recent cost reporting period prior to the first date on which 
        the COVID-19 public health emergency went into effect, as 
        continuing to meet all requirements for being such a covered 
        entity.
    (b) Extension.--The Secretary shall extend the application of 
paragraphs (1) and (2) of subsection (a) to any cost reporting period 
that is not described in such subsection if necessary to ensure that no 
entity loses eligibility status as a covered entity for any reason 
related to the COVID-19 public health emergency.
    (c) Definitions.--In this section:
            (1) Covered entity.--The term ``covered entity'' has the 
        meaning given such term in section 340B(a)(4) of the Public 
        Health Service Act (42 U.S.C. 256b(a)(4)).
            (2) COVID-19 public health emergency.--The term ``COVID-19 
        public health emergency'' means the public health emergency 
        declared by the Secretary of Health and Human Services under 
        section 319 of the Public Health Service Act (42 U.S.C. 247d) 
        on January 31, 2020, with respect to COVID-19.

SEC. 3. WAIVER OF CERTAIN REQUIREMENTS DURING NATIONAL EMERGENCY.

    Notwithstanding any other provision of law, during any portion of 
the national emergency declared by the President under the National 
Emergencies Act (50 U.S.C. 1601 et seq.) with respect to the 
Coronavirus Disease 2019 (COVID-19) beginning on or after the date of 
the enactment of this Act and ending on the earlier of the date on 
which such emergency declaration terminates or the date that is 180 
days after such date of enactment, the Secretary shall--
            (1) waive any prior authorization requirements otherwise 
        applicable under titles XVIII and XIX of the Social Security 
        Act (42 U.S.C. 1395 et seq., 1396 et seq.) with respect to 
        treatment and testing for COVID-19;
            (2) with respect to inpatient hospital services (as defined 
        in section 1861(b) of such Act (42 U.S.C. 1395x(b))--
                    (A) waive any requirements otherwise applicable 
                under title XVIII that would otherwise prevent the 
                Secretary from providing reimbursement for inpatient 
                hospital services that are furnished off-site at an 
                unlicensed facility; and
                    (B) provide reimbursement for such services 
                furnished at such facility at an amount equal to the 
                payment amount determined under the hospital inpatient 
                prospective payment system under section 1886(d) of 
                such Act (42 U.S.C. 1395ww(d)) if the facility were a 
                subsection (d) hospital (as defined in paragraph (1)(B) 
                of such section); and
            (3) waive the provisions of section 1867(d) of the Social 
        Security Act (42 U.S.C. 1395dd(d)), relating to enforcement of 
        requirements with respect to examination and treatment for 
        emergency medical conditions and women in labor, for transfers 
        or redirections of patients away from hospital emergency 
        departments.

SEC. 4. RELIEF FOR CRITICAL ACCESS HOSPITALS.

    Notwithstanding any other provision of law, during the 60-day 
period beginning on the date of the enactment of this Act, the 
Secretary shall waive the following provisions of title XVIII of the 
Social Security Act:
            (1) With respect to certification of critical access 
        hospitals (as defined in section 1861(mm)(1)) of such Act (42 
        U.S.C. 1395x(mm)(1)), the limitation on the number of acute 
        care inpatient beds otherwise applicable under section 
        1820(c)(2)(B)(iii) of such Act (42 U.S.C. 1395i-
        4(c)(2)(B)(iii)).
            (2) With respect to inpatient critical access hospital 
        services (as defined in section 1861(mm)(2)) of such Act (42 
        U.S.C. 1395x(mm)(2)), the physician certification requirement 
        under section 1814(a)(8) of such Act (42 U.S.C. 1395f(a)(8)).

SEC. 5. RELIEF FOR SKILLED NURSING FACILITIES.

    (a) Temporary Waiver of 3-Day Hospitalization Requirement for 
Coverage of Post-Hospital Extended Care Services.--Notwithstanding any 
other provision of law, with respect to post-hospital extended care 
services (as defined in section 1861(i)) of the Social Security Act (42 
U.S.C. 1395x(i)) furnished during any portion of the national emergency 
declared by the President under the National Emergencies Act (50 U.S.C. 
1601 et seq.) with respect to the Coronavirus Disease 2019 (COVID-19) 
beginning on or after the date of the enactment of this Act and ending 
on the earlier of the date on which such emergency declaration 
terminates or the date that is 180 days after such date of enactment, 
the Secretary shall waive the 3-day hospitalization requirement for 
coverage of such services under such section 1861(i).
    (b) Medicare Skilled Nursing Facility Prospective Payment System 
Adjustment for Covid-19 Residents During National Emergency.--
            (1) In general.--Section 1888(e) of the Social Security Act 
        (42 U.S.C. 1395yy(e)) is amended--
                    (A) in paragraph (1), by striking ``and (12)'' and 
                inserting ``(12), and (13)''; and
                    (B) by inserting after paragraph (12) the following 
                new paragraph:
            ``(13) Adjustment for residents with covid-19.--During any 
        portion of the national emergency declared by the President 
        under the National Emergencies Act (50 U.S.C. 1601 et seq.) 
        with respect to the Coronavirus Disease 2019 (COVID-19) 
        beginning on or after the date of the enactment of this 
        paragraph and ending on the earlier of the date on which such 
        emergency declaration terminates or the date that is 180 days 
        after such date of enactment, in the case of a resident who has 
        a principal or secondary diagnosis of COVID-19, the per diem 
        amount of payment otherwise applicable shall be increased by 15 
        percent to reflect increased costs associated with such 
        residents.''.
            (2) Implementation.--Notwithstanding any other provision of 
        law, the Secretary may implement the amendments made by this 
        subsection by program instruction or otherwise.

SEC. 6. ENSURING RURAL PROVIDERS ARE INCLUDED IN CARES.

    (a) In General.--The third paragraph in the matter under the 
heading ``public health and social services emergency fund (including 
transfer of funds)'' under the heading Office Of The Secretary under 
the heading ``DEPARTMENT OF HEALTH AND HUMAN SERVICES'' of division B 
of the CARES Act (Public Law 116-136) is amended--
            (1) in the third proviso, by inserting ``, and includes 
        skilled nursing facilities, nursing facilities, assisted living 
        residences, and other types of facilities that provide housing 
        and care for seniors'' after ``as the Secretary may specify''; 
        and
            (2) by inserting after the second proviso the following: 
        ``Provided further, That the Secretary shall use at least 20 
        percent of the funds appropriated under this paragraph in this 
        Act to make payments under this paragraph to eligible health 
        care providers located in rural areas, as defined by the 
        Secretary:''.
    (b) Effective Date.--The amendments made by this section shall take 
effect as if included in the enactment of the CARES Act (Public Law 
116-136).
                                 <all>