Title: ARC Act
Policy area: Health

Summary:
Access for Rural Communities Act or the ARC Act
This bill allows sole community hospitals and Medicare-dependent small rural hospitals to have the Centers for Medicare & Medicaid Services (CMS) recalculate certain payment adjustments that were initially determined by Medicare administrative contractors. Specifically, if a hospital received a volume decrease adjustment from an administrative contractor prior to FY2018, the hospital may elect to have the CMS recalculate the adjustment using methodology that took effect in FY2018, as specified. The bill's provisions do not apply to final determinations made by administrative contractors more than three years before the date of enactment of this bill.

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3069 Introduced in House (IH)]

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117th CONGRESS
  1st Session
                                H. R. 3069

      To provide relief for small rural hospitals from inaccurate 
 instructions provided by certain medicare administrative contractors.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 7, 2021

 Ms. Tenney (for herself, Mr. Reed, Ms. Stefanik, Mr. Delgado, and Mr. 
    Katko) introduced the following bill; which was referred to the 
                      Committee on Ways and Means

_______________________________________________________________________

                                 A BILL


 
      To provide relief for small rural hospitals from inaccurate 
 instructions provided by certain medicare administrative contractors.

    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 ``Access for Rural Communities Act'' 
or the ``ARC Act''.

SEC. 2. RELIEF FOR SMALL RURAL HOSPITALS FROM INACCURATE INSTRUCTIONS 
              PROVIDED BY CERTAIN MEDICARE ADMINISTRATIVE CONTRACTORS.

    (a) Application of Revised Volume Decrease Adjustment 
Methodology.--Subject to subsection (b), in the case of a sole 
community hospital or a medicare-dependent, small rural hospital with 
respect to which a medicare administrative contractor determined a 
volume decrease adjustment applies for any specified cost reporting 
period, at the election of the hospital, the Secretary of Health and 
Human Services shall recalculate the amount of the volume decrease 
adjustment determined by the medicare administrative contractor for 
such hospital and specified cost reporting period using the revised 
volume decrease adjustment payment methodology for any specified cost 
reporting period requested by the hospital in its election.
    (b) Limitation.--
            (1) In general.--Subsection (a) shall not apply in the case 
        of a sole community hospital or a medicare-dependent, small 
        rural hospital for which the medicare administrative contractor 
        determination of the volume decrease adjustment with respect to 
        a specified cost reporting period of the hospital is 
        administratively final before the date that is three years 
        before the date of the enactment of this section.
            (2) Administrative finality.--For purposes of paragraph 
        (1), the date on which the medicare administrative contractor 
        determination with respect to a volume decrease adjustment for 
        a specified cost reporting period is administratively final is 
        the latest of the following:
                    (A) The date of the contractor determination (as 
                defined in section 405.1801 of title 42, Code of 
                Federal Regulations).
                    (B) The date of the final outcome of any reopening 
                of the medicare administrative contractor determination 
                under section 405.1885 of title 42, Code of Federal 
                Regulations.
                    (C) The date of the final outcome of the final 
                appeal filed by such hospital with respect to such 
                volume decrease adjustment for such specified cost 
                reporting period.
    (c) Definitions.--In this section:
            (1) Medicare administrative contractor.--The term 
        ``medicare administrative contractor'' means the entity that 
        has entered into a contract with the Secretary of Health and 
        Human Services under section 1874A of the Social Security Act 
        (42 U.S.C. 1395kk-1) to service A/B Medicare Administrative 
        Contractor Jurisdiction K of the Centers for Medicare & 
        Medicaid Services as of July 1, 2016.
            (2) Medicare-dependent, small rural hospital.--The term 
        ``medicare-dependent, small rural hospital'' has the meaning 
        given such term under section 1886(d)(5)(G)(iv) of the Social 
        Security Act (42 U.S.C. 1395ww(d)(5)(G)(iv)).
            (3) Revised volume decrease adjustment payment 
        methodology.--The term ``revised volume decrease adjustment 
        payment methodology'' means the methodology to calculate the 
        volume decrease adjustment that is described in the second 
        sentence of section 412.92(e)(3) of title 42, Code of Federal 
        Regulations (relating to the methodology to calculate the 
        volume decrease adjustment for sole community hospitals (and, 
        pursuant to section 412.108(d)(3) of such title 42, for 
        medicare-dependent, small rural hospitals) that is effective 
        for cost reporting periods beginning on or after October 1, 
        2017).
            (4) Sole community hospital.--The term ``sole community 
        hospital'' has the meaning given such term under section 
        1886(d)(5)(D)(iii) of the Social Security Act (42 U.S.C. 
        1395ww(d)(5)(D)(iii)).
            (5) Specified cost reporting period.--The term ``specified 
        cost reporting period'' means a cost reporting period of a sole 
        community hospital or a medicare-dependent, small rural 
        hospital, as the case may be, that begins during a fiscal year 
        before fiscal year 2018.
            (6) Volume decrease adjustment.--The term ``volume decrease 
        adjustment'' means the adjustment required with respect to a 
        sole community hospital or a medicare-dependent, small rural 
        hospital, as the case may be, under subparagraph (D)(ii) or 
        subparagraph (G)(iii), respectively, of section 1886(d)(5) of 
        the Social Security Act (42 U.S.C. 1395ww(d)(5)).
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