Title: Protect Seniors and Cut Waste Act
Policy area: Health

Summary:
Protect Seniors and Cut Waste Act
This bill prohibits the budgetary effects of the American Rescue Plan Act of 2021 from being counted for the purposes of determining whether a specified sequester occurs under the Statutory Pay-As-You-Go Act of 2010.
(The American Rescue Plan Act of 2021 provided funding to address the impact of COVID-19. 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 modifies several other provisions related to COVID-19 spending. Among other modifications, the bill

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1999 Introduced in House (IH)]

<DOC>






117th CONGRESS
  1st Session
                                H. R. 1999

To delay and offset the sequester under the Statutory Pay-As-You-Go Act 
of 2010 as a result of the enactment of the American Rescue Plan Act of 
                     2021, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 18, 2021

Mr. Smith of Missouri (for himself, Mr. Brady, Mr. Burgess, Mr. Comer, 
 Mr. Harris, Mr. Wenstrup, and Mrs. Rodgers of Washington) introduced 
  the following bill; which was referred to the Committee on Ways and 
   Means, and in addition to the Committees on Energy and Commerce, 
Oversight and Reform, the Budget, and Education and Labor, 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 delay and offset the sequester under the Statutory Pay-As-You-Go Act 
of 2010 as a result of the enactment of the American Rescue Plan Act of 
                     2021, and for other purposes.

    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 ``Protect Seniors and Cut Waste Act''.

SEC. 2. PAYGO ACT SEQUESTER.

    The budgetary effects of the American Rescue Plan Act of 2021 shall 
not be counted for purposes of determining whether a sequester occurs 
under the report issued after Congress adjourns to end the 1st session 
of the 117th Congress and during January 2022 under section 5 of the 
Statutory Pay-As-You-Go Act of 2010.

SEC. 3. SUPPLEMENTAL APPROPRIATIONS FOR THE PUBLIC HEALTH AND SOCIAL 
              SERVICES EMERGENCY FUND.

    (a) Supplemental Appropriation.--There is appropriated, out of any 
amounts in the Treasury not otherwise appropriated, for an additional 
amount for ``Public Health and Social Services Emergency Fund''', 
$12,300,000,000, to remain available until expended, to prevent, 
prepare for, and respond to coronavirus, domestically or 
internationally, which shall be for necessary expenses to reimburse, 
through grants or other mechanisms, eligible health care providers for 
health care related expenses or lost revenues that are attributable to 
coronavirus.
    (b) Conditions.--The following conditions shall apply with respect 
to funds appropriated by subsection (a):
            (1) Such funds may not be used to reimburse expenses or 
        losses that have been reimbursed from other sources or that 
        other sources are obligated to reimburse.
            (2) Recipients of payments under this section shall submit 
        reports and maintain documentation as the Secretary of Health 
        and Human Services determines are needed to ensure compliance 
        with conditions that are imposed by this subsection for such 
        payments, and such reports and documentation shall be in such 
        form, with such content, and in such time as the Secretary may 
        prescribe for such purpose.
            (3) The term ``eligible health care providers'' means 
        public entities, Medicare or Medicaid enrolled suppliers and 
        providers, and such for-profit entities and not-for-profit 
        entities not otherwise described in this paragraph as the 
        Secretary may specify, within the United States (including 
        territories), that provide diagnoses, testing, or care for 
        individuals with possible or actual cases of COVID-19.
            (4) The Secretary shall, on a rolling basis, review 
        applications and make payments under this section.
            (5) Funds appropriated under this section shall be 
        available for building or construction of temporary structures, 
        leasing of properties, medical supplies and equipment including 
        personal protective equipment and testing supplies, increased 
        workforce and trainings, emergency operation centers, 
        retrofitting facilities, and surge capacity.
            (6) In this section, the term ``payment'' means a pre-
        payment, prospective payment, or retrospective payment, as 
        determined appropriate by the Secretary.
            (7) Payments under this section shall be made in 
        consideration of the most efficient payment systems practicable 
        to provide emergency payment.
            (8) To be eligible for a payment under this section, an 
        eligible health care provider shall submit to the Secretary an 
        application that includes a statement justifying the need of 
        the provider for the payment and the eligible health care 
        provider shall have a valid tax identification number.
            (9) For any reimbursement by the Secretary from the 
        Provider Relief Fund to an eligible health care provider that 
        is a subsidiary of a parent organization, the parent 
        organization may, allocate (through transfers or otherwise) all 
        or any portion of such reimbursement among the subsidiary 
        eligible health care providers of the parent organization, 
        including reimbursements referred to by the Secretary as 
        ``Targeted Distribution'' payments, among subsidiary eligible 
        health care providers of the parent organization, except that 
        responsibility for reporting the reallocated reimbursement 
        shall remain with the original recipient of such reimbursement.
            (10) For any reimbursement from the Provider Relief Fund to 
        an eligible health care provider for health care related 
        expenses or lost revenues that are attributable to coronavirus 
        (including reimbursements made before the date of the enactment 
        of this Act), such provider may calculate such lost revenues 
        using the Frequently Asked Questions guidance released by the 
        Department of Health and Human Services in June 2020, including 
        the difference between such provider's budgeted and actual 
        revenue budget if such budget had been established and approved 
        prior to March 27, 2020.
            (11) Of the amount made available in the third paragraph 
        under the heading ``Department of Health and Human Services--
        Office of the Secretary--Public Health and Social Services 
        Emergency Fund'' in Public Law 116-136, not less than 85 
        percent of the unobligated balances available as of the date of 
        enactment of this Act and of any funds recovered from health 
        care providers after the date of enactment of this Act shall be 
        for any successor to the Phase 3 General Distribution 
        allocation to make payments to eligible health care providers 
        based on applications that consider financial losses and 
        changes in operating expenses occurring in fiscal year 2021 
        that are attributable to coronavirus.
            (12) Not later than 3 years after final payments are made 
        under this section, the Office of Inspector General of the 
        Department of Health and Human Services shall transmit a final 
        report on audit findings with respect to this program to the 
        Committees on Appropriations of the House of Representatives 
        and the Senate.
            (13) Nothing in this section limits the authority of the 
        Inspector General or the Comptroller General to conduct audits 
        of interim payments at an earlier date.
            (14) Not later than 60 days after the date of enactment of 
        this Act, the Secretary of Health and Human Services shall 
        provide a report to the Committees on Appropriations of the 
        House of Representatives and the Senate on the obligation of 
        funds, including obligations to such eligible health care 
        providers, summarized by State of the payment receipt. Such 
        report shall be updated and submitted to such Committees every 
        60 days until funds are expended.
    (c) Emergency Designations.--
            (1) Amounts repurposed in subsection (b) that were 
        previously designated by the Congress as an emergency 
        requirement pursuant to the Balanced Budget and Emergency 
        Deficit Control Act of 1985 are designated by the Congress as 
        an emergency requirement pursuant to section 251(b)(2)(A)(i) of 
        the Balanced Budget and Emergency Deficit Control Act of 1985.
            (2) The amount appropriated by subsection (a) is designated 
        by the Congress as being for an emergency requirement pursuant 
        to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 
        Deficit Control Act of 1985.
            (3) Each amount designated in this Act by the Congress as 
        an emergency requirement pursuant to section 251(b)(2)(A)(i) of 
        the Balanced Budget and Emergency Deficit Control Act of 1985 
        shall be available only if the President subsequently so 
        designates all such amounts and transmits such designations to 
        the Congress.
    (d) Application of Provisions.--Amounts appropriated pursuant to 
this section and pursuant to title II of Public Law 117-2 shall be 
subject to the requirements contained in Public Law 116-260 for funds 
for programs authorized under sections 330 through 340 of the Public 
Health Service Act.

SEC. 4. CORONAVIRUS STATE FISCAL RECOVERY FUND ADJUSTMENT.

    (a) In General.--Section 602 of the Social Security Act is 
amended--
            (1) in subsection (a)(1), by striking ``$219,800,000,000'' 
        and inserting ``$79,800,000,000''; and
            (2) in subsection (b)(3), by striking ``$195,300,000,000'' 
        and inserting ``$55,300,000,000''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
take effect as if included in the enactment of the American Rescue Plan 
Act of 2021.

SEC. 5. 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--
                                    ``(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) in subparagraph (B)--
                            (i) in the matter preceding clause (i), by 
                        striking ``2019, was'' and inserting ``2020'';
                            (ii) in clause (i), by inserting ``was'' 
                        after ``(i)''; and
                            (iii) by striking clause (ii) and inserting 
                        the following:
                    ``(ii)(I) was enrolled under section 1866(j) 
                (including temporary enrollment during the emergency 
                period described in section 1135(g)(1)(B) for such 
                period); or
                    ``(II) submitted an application for enrollment 
                under section 1866(j) (or requested such a temporary 
                enrollment for such period) that was received not later 
                than December 31, 2020.''.
            (2) 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) Additional Amount for Certain Hospitals With High 
Disproporationate 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) amended by such section 203(a) is amended by adding at the end 
the following new paragraph:
            ``(3) Additional amount for certain hospitals with high 
        disproporationate share.--
                    ``(A) In general.--In the case of a hospital with 
                high disproportionate share (as defined in subparagraph 
                (B)) located in a State referenced in subsection (e) of 
                section 4721 of the Balanced Budget Act of 1997, a 
                payment adjustment during a State fiscal year shall be 
                considered consistent with subsection (c) if the 
                payment adjustment does not exceed 175 percent of the 
                costs of furnishing hospital services during the year, 
                but only if the Governor of the State certifies to the 
                satisfaction of the Secretary that the hospital's 
                applicable minimum amount is used for health services 
                during the year. In determining the amount that is used 
                for such services during a year, there shall be 
                excluded any amounts received under the Public Health 
                Service Act, title V, title XVIII, or from third party 
                payors (not including the State plan under this title) 
                that are used for providing such services during the 
                year.
                    ``(B) Hospital with high disproporationate share 
                defined.--In subparagraph (A), a hospital is a 
                `hospital with high disproportionate share' if--
                            ``(i) the hospital is owned or operated by 
                        the State (or by an instrumentality or a unit 
                        of government within the State); and
                            ``(ii) the hospital--
                                    ``(I) meets the requirement 
                                described in subparagraphs (A) or (B) 
                                of subsection (b)(1); or
                                    ``(II) has the largest number of 
                                inpatient days attributable to 
                                individuals entitled to benefits under 
                                the State plan of any hospital in such 
                                State for the previous fiscal year.
                    ``(C) Applicable minimum amount defined.--In 
                subparagraph (A), the `applicable minimum amount' for a 
                hospital for a fiscal year is equal to the difference 
                between the amount of the hospital's payment adjustment 
                for the fiscal year and the costs to the hospital of 
                furnishing hospital services described in paragraph 
                (1)(A) during the fiscal year.''.

SEC. 6. INDIVIDUALS NOT LAWFULLY PRESENT IN UNITED STATES PRECLUDED 
              FROM 2021 RECOVERY REBATES.

    (a) In General.--Section 6428B(c) of the Internal Revenue Code of 
1986, as added by the American Rescue Plan Act of 2021, is amended by 
striking ``and'' at the end of paragraph (2), by redesignating 
paragraph (3) as paragraph (4), and by inserting after paragraph (2) 
the following new paragraph:
            ``(3) any individual who was not lawfully present in the 
        United States as of the date of the enactment of the American 
        Rescue Plan Act of 2021, and''.
    (b) Effective Date.--The amendments made by this section shall take 
effect as if included in the enactment of section 9601 of the American 
Rescue Plan Act of 2021.

SEC. 7. INCARCERATED INDIVIDUALS PRECLUDED FROM 2021 RECOVERY REBATES.

    (a) In General.--Section 6428B(c) of the Internal Revenue Code of 
1986, as added by the American Rescue Plan Act of 2021 and amended by 
the preceding provisions of this Act, is amended by striking ``and'' at 
the end of paragraph (3), by redesignating paragraph (4) as paragraph 
(5), and by inserting after paragraph (3) the following new paragraph:
            ``(4) any individual who was incarcerated on the date of 
        the enactment of the American Rescue Plan Act of 2021, and''.
    (b) Effective Date.--The amendments made by this section shall take 
effect as if included in the enactment of section 9601 of the American 
Rescue Plan Act of 2021.

SEC. 8. REQUIRING A SOCIAL SECURITY NUMBER TO RECEIVE COBRA 
              CONTINUATION COVERAGE.

    (a) In General.--Section 9501(a)(3) of the American Rescue Plan Act 
of 2021 (Public Law 117-2) is amended--
            (1) in subparagraph (A), by striking at the end ``and'';
            (2) in subparagraph (B), by striking the period at the end 
        and inserting ``; and''; and
            (3) by adding at the end the following new subparagraph:
                    ``(C) has been issued a social security number (as 
                defined in section 24(h)(7) of the Internal Revenue 
                Code of 1986) by the Social Security Administration.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
take effect as if included in the enactment of section 9501 of the 
American Rescue Plan Act of 2021.

SEC. 9. RESCISSIONS OF AMERICAN RESCUE PLAN ACT OF 2021 FUNDS.

    Of the funds appropriated by the American Rescue Plan Act of 2021 
(Public Law 117-2), all unobligated funds available under the following 
provisions of such Act are hereby rescinded:
            (1) Section 2021 (relating to the National Endowment for 
        the Arts).
            (2) Section 2022 (relating to the National Endowment for 
        the Humanities).
            (3) Section 4001 (relating to the Emergency Federal 
        Employee Leave Fund).
                                 <all>