II 117th CONGRESS 2d Session S. 3611 IN THE SENATE OF THE UNITED STATES February 9, 2022 Mrs. Shaheen (for herself and Ms. Collins ) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To provide for improvements in the reimbursement of eligible health care providers through the Provider Relief Fund, and for other purposes.

1. Short title This Act may be cited as the Provider Relief Fund Improvement Act . 2. COVID–19 provider relief fund improvements (a) Extension of deadline for eligible health care providers To use certain funds received from the COVID–19 provider relief fund (1) Payment received periods 1 and 2 Effective June 29, 2021, the deadline by which an eligible health care provider is required to use reimbursements from the Provider Relief Fund received by such eligible health care provider during a covered payment received period is extended until the end of the COVID–19 emergency period. (2) Adjustment of reporting time period The Secretary shall make appropriate adjustments to the reporting time period (as specified in the Provider Relief Fund guidance) that corresponds to a covered payment received period to reflect the extension of the applicable deadline under paragraph (1). (3) Modification of deadline for period 3 The deadline by which an eligible health care provider is required to use reimbursements from the Provider Relief Fund received by such eligible health care provider during the Payment Received Period referred to in the Provider Relief Fund Guidance as the Period 3 specified in table 1 of such guidance (beginning on January 1, 2021, and ending on June 30, 2021) shall be the later of— (A) the end of the COVID–19 emergency period; or (B) June 30, 2022. (b) Requirement To distribute remaining COVID–19 provider relief funds by March 31, 2022 (1) Requirement for distributions (A) In general Not later than March 31, 2022, the Secretary shall distribute to eligible health care providers for health care related expenses or lost revenues that are attributable to coronavirus, any remaining funds appropriated to the Provider Relief Fund as of the date of the enactment of this section for reimbursements. (B) Deadline to use funds The deadline by which an eligible health care provider is required to use reimbursements received pursuant to subparagraph (A) is June 30, 2023. (2) Accounting for health care related expenses or lost revenues in the second, third, and fourth quarters of 2021 Notwithstanding any other provision of law, distributions made under paragraph (1) to eligible health care providers shall account for financial losses and changes in operating expenses occurring in the second, third, or fourth quarter of calendar year 2021, that are attributable to coronavirus. (3) Allocation of payments returned due to previous deadlines (A) In general The Secretary shall establish a process for eligible health care providers to apply to receive funds from the Secretary in amounts up to the amount each such provider returned to the Provider Relief Fund due to previous reporting and use of funds deadlines. (B) Clarifications Funding under this paragraph shall be— (i) available with respect to amounts returned by eligible health care providers between June 30, 2021, and December 30, 2021; and (ii) in addition to amounts made available to such providers under paragraph (1). (c) Clarification of use of funds for workplace safety and security (1) In general Funds appropriated to the Provider Relief Fund for eligible health care providers and funds appropriated under section 1150C of the Social Security Act ( 42 U.S.C. 1320b–26 ) for eligible health care providers (as defined in subsection (e)(1) of such section) before, on, or after the date of the enactment of this section may be used to reimburse an eligible health care provider for expenses incurred by the eligible health care provider for measures taken to establish or improve the security of the workplace of such eligible health care provider and improve the safety of personnel of such eligible health care provider present at such workplace. (2) Additional clarification of permissible expenses Expenses for workplace security and safety of personnel of an eligible health care provider described in paragraph (1) shall include the following: (A) Mitigation of risk of violence at the workplace of such eligible health care provider, including the employment of additional security personnel, conduct of risk assessment activities, implementation of response plans, implementation of small-scale changes to physical plant (such as the addition of more secure locks, the use of key card access, altering ingress and egress points, and the installation of additional security cameras), and staff education and training. (B) Measures to prevent violence at the workplace and against personnel of such eligible health care provider, including education and training of personnel on de-escalation protocols and installation of panic buttons and other similar, required equipment. (C) Trauma support for personnel with respect to violence in the workplace, such as counseling and other supports in the event of significant workplace safety episodes, which may include events that do not result in violence but may have significant impacts on personnel and the operations of the eligible health care provider (commonly referred to as near-misses). (d) Definitions In this section: (1) Coronavirus The term coronavirus means severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) or another coronavirus with pandemic potential. (2) Covered payment received period The term covered payment received period means, with respect to Payment Received Periods referred to in the Provider Relief Fund Guidance— (A) the Period 1 specified in table 1 of such guidance (beginning on April 10, 2020, and ending on June 30, 2020); and (B) the Period 2 specified in such table (beginning on July 1, 2020, and ending on December 31, 2020). (3) COVID–19 emergency period The term COVID–19 emergency period means the emergency period described in section 1135(g)(1)(B) of the Social Security Act ( 42 U.S.C. 1320b–5(g)(1)(B) ). (4) Eligible health care provider The term eligible health care provider has the meaning given such term in the third proviso of the third paragraph under the heading Department of Health and Human Services—Office of the Secretary—Public Health and Social Services Emergency Fund in division B of the CARES Act ( Public Law 116–136 ). (5) Provider relief fund The term Provider Relief Fund means the funding appropriated to prevent, prepare for, and respond to coronavirus, domestically or internationally, 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 for which appropriations are made under— (A) the third paragraph under the heading Department of Health and Human Services—Office of the Secretary—Public Health and Social Services Emergency Fund in division B of the CARES Act ( Public Law 116–136 ); (B) the first paragraph under the heading Department of Health and Human Services—Office of the Secretary—Public Health and Social Services Emergency Fund in division B of the Paycheck Protection Program and Health Care Enhancement Act ( Public Law 116–139 ); and (C) the third paragraph under the heading Department of Health and Human Services—Office of the Secretary—Public Health and Social Services Emergency Fund of the Coronavirus Response and Relief Supplemental Appropriations Act, 2021 (division M of the Consolidated Appropriations Act, 2021 ( Public Law 116–260 )). (6) Provider relief fund guidance The term Provider Relief Fund Guidance refers to the guidance entitled Provider Relief Fund General and Targeted Distribution Post-Payment Notice of Reporting Requirements issued by the Secretary of Health and Human Services on June 11, 2021. (7) Secretary The term Secretary means the Secretary of Health and Human Services, acting through the Administrator of the Health Resources and Services Administration.