Title: To prevent across-the-board direct spending cuts, and for other purposes.
Policy area: Health

Summary:
This bill makes several budgetary and technical changes to provisions under Medicare, Medicaid, and the American Rescue Plan Act of 2021, which provided additional relief to address the ongoing impact of COVID-19 (i.e., coronavirus disease 2019).
The bill exempts the budgetary effects of the American Rescue Plan Act of 2021 and this bill from the Statutory Pay-As-You-Go Act of 2010 (PAYGO), and exempts this bill from the Senate PAYGO rule. The bill also 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

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1868 Introduced in House (IH)]

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117th CONGRESS
  1st Session
                                H. R. 1868

    To prevent across-the-board direct spending cuts, and for other 
                               purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 12, 2021

Mr. Yarmuth (for himself, Mr. Neal, Mr. Pallone, and Mr. David Scott of 
   Georgia) introduced the following bill; which was referred to the 
 Committee on the Budget, and in addition to the Committees on Energy 
   and Commerce, and Ways and Means, 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 prevent across-the-board direct spending cuts, 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. PREVENTING PAYGO SEQUESTRATION.

    (a) Statutory PAYGO Scorecards.--The budgetary effects of this Act 
and the American Rescue Plan Act of 2021 (Public Law 117-2) shall not 
be counted on either PAYGO scorecard maintained pursuant to section 
4(d) of the Statutory Pay-As-You-Go Act of 2010 (2 U.S.C. 933(d)).
    (b) Senate PAYGO Scorecards.--The budgetary effects of this Act 
shall not be counted on any PAYGO scorecard maintained for purposes of 
section 4106 of H. Con. Res. 71 (115th Congress).

SEC. 2. EXTENSION OF TEMPORARY SUSPENSION OF MEDICARE SEQUESTRATION.

    (a) 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''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
take effect as if enacted as part of the CARES Act (Public Law 116-
136).

SEC. 3. TECHNICAL CORRECTIONS.

    (a) Disregard of Certain Additional Compensation for Purposes of 
Medicaid and Chip.--Section 2104(h) of the CARES Act (15 U.S.C. 
9023(h)) is amended by striking ``Federal pandemic unemployment 
compensation'' and inserting ``Federal Pandemic Unemployment 
Compensation or Mixed Earner Unemployment Compensation''.
    (b) 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).
    (c) Eligibility for Reemployment Services.--Section 306(a) of the 
Social Security Act (42 U.S.C. 506(a)) is amended--
            (1) by striking ``individuals referred to reemployment 
        services as described in section 303(j)'' and inserting 
        ``claimants for unemployment compensation, including claimants 
        referred to reemployment services as described in section 
        303(j),''; and
            (2) by striking ``such individuals'' and inserting ``such 
        claimants''.
    (d) 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.''.
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