[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 3559 Introduced in Senate (IS)]
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116th CONGRESS
2d Session
S. 3559
To provide emergency financial assistance to rural health care
facilities and providers impacted by the COVID-19 emergency.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
March 21, 2020
Mr. Bennet (for himself, Mr. Barrasso, Ms. Smith, Mr. Gardner, Mr.
Jones, and Mrs. Hyde-Smith) introduced the following bill; which was
read twice and referred to the Committee on Finance
_______________________________________________________________________
A BILL
To provide emergency financial assistance to rural health care
facilities and providers impacted by the COVID-19 emergency.
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 ``Immediate Relief for Rural
Facilities and Providers Act of 2020''.
SEC. 2. RURAL HEALTH CARE FACILITY GRANTS.
(a) Purpose.--It is the purpose of this section to provide funding
to stabilize rural hospitals and provide immediate financial relief to
prepare and respond to the COVID-19 emergency.
(b) Grants.--The Secretary, acting through the Administrator of the
Centers for Medicare & Medicaid Services, shall establish an emergency
operating grant program and shall award an emergency operating grant to
an eligible Medicare participating health care facility.
(c) Allotments and Payments.--
(1) Allotments.--The Secretary shall, from amounts
appropriated under subsection (i), allot to each facility
eligible for a grant under this section the sum of--
(A) an amount equal to the number of patient days
(including acute, swing-bed, and observation days) from
January 1, 2019, to April 1, 2019, with respect to the
facility, multiplied by $1,000; and
(B) an amount equal to the total amount of
reimbursements from all payer sources to the facility
from January 1, 2019, to April 1, 2019.
(2) Payments.--The Secretary shall make payments under
grants awarded to eligible facilities under this section in the
amount of the allotments described in paragraph (1).
(3) Time of grant.--A one time payment shall be made under
a grant awarded under this section not later than 14 days after
the date of enactment of this Act.
(d) Eligible Facilities.--
(1) In general.--To be eligible to receive a grant under
subsection (b), a Medicare participating health care facility
shall submit to the Secretary an application described in
paragraph (2).
(2) Application.--An application under this paragraph shall
be submitted to the Secretary not later that 180 days after the
date of enactment of this Act and shall contain such
information that the Secretary may require, including--
(A) a certification that--
(i) the facility will suffer financial
losses as a result of the COVID-19 emergency;
and
(ii) in the absence of an emergency grant
under this section, the facility would be
forced to either reduce staffing or operations;
(B) an assurance that the amount requested under
the grant exceeds 130 percent of the amount of revenue
collected by the facility during the same period of the
year preceding the year for which the request under
this section is made;
(C) the amount of spending incurred by the facility
as a result of the COVID-19 emergency;
(D) a description on how the facility will use
grant funds; and
(E) an assurance that the facility followed the
Secretary's recommendations related to the COVID-19
emergency.
(e) Reconciliation.--
(1) In general.--Not later than 2 years after the date on
which the COVID-19 emergency ends (as determined by the
Secretary), the Secretary shall promulgate regulations under
which a facility that receives an emergency grant under this
section shall reconcile the amount of the emergency grant
with--
(A) the entire amount of the grant allotted to the
facility in the case of a facility that was determined
not to be eligible under subsection (d);
(B) any reimbursements received by the facility
from third parties for services provided during such
emergency; and
(C) any portion of the grant funds that exceeds 130
percent of the amount of revenue collected by the
facility during the same 90-day period of the year
preceding the year for which the grant is being made as
determined through such reconciliation to have been
recovered by the facility through third-party payors,
in addition to any additional spending incurred by the
facility as a result of the COVID-19 emergency, with
the Federal Government.
(2) Recoupment.--The regulations under this subsection
shall include procedures through which the Federal Government
may recoup any portion of grant funds described in paragraph
(1).
(f) Limitations on Use of Funds.--
(1) Construction of facilities.--
(A) Limitations.--Grants awarded under this section
shall not be used by the facility for the purchase or
improvement of land, or the purchase, construction, or
permanent improvement of any building.
(B) Waiver.--The Secretary may wave the limitation
contained in subparagraph (A) upon a facility request
for such a waiver, if the Secretary finds that the
request describes circumstances that justify the
purchase of land or the constrictive of facilities (or
the making of permanent improvements) related to the
COVID-19 emergency.
(2) Political activities.--Grants awarded under this
section shall not be used in a manner involving the use of
grant funds, provisions of services, or the employment or
assignment of personnel, in a manner supporting or resulting in
the identification of such programs with any partisan or
nonpartisan political activity or any political activity
associated with a candidate, or contending faction or group, in
an election for public or party office.
(g) Legal Action.--A facility that receives an emergency grant
under this section shall be prohibited from commencing any legal action
against a patients to recover any costs associated with care provided
to the patient during the COVID-19 emergency.
(h) Definitions.--In this section:
(1) COVID-19 emergency.--The term ``COVID-19 emergency''
means 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).
(2) Medicare participating health care facility.--The terms
``Medicare participating health care facility'' and
``facility'' mean--
(A) an entity designated as--
(i) a Critical Access Hospital under
section 485 of subpart F of title 42, Code of
Federal Regulations; or
(ii) a subsection (d) hospital (as defined
in paragraph (1)(B) of section 1886(d)(1)(B) of
the Social Security Act (42 U.S.C.
1395ww(d)(1)(B))) that is located in a rural
area (as defined in paragraph (2)(D) of such
section); and
(B) a provider of services enrolled in the Medicare
program under section 1866(j) of the Social Security
Act (42 U.S.C. 1395cc(j)).
(3) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(i) Authorization of Appropriations.--There is authorized to be
appropriated such sums as may be necessary to carry out this section.
SEC. 3. REIMBURSEMENT ADJUSTMENT FOR SWING BED PROGRAM.
(a) Purpose.--It is the purpose of this section to improve the
health care system to prepare and respond to the COVID-19 emergency (as
defined in section 2).
(b) Adjustment.--The Secretary of Health and Human Services, acting
through the Administrator of the Centers for Medicare & Medicaid
Services, shall increase reimbursements for rural hospitals under the
swing bed program for the duration of the COVID-19 emergency.
(c) Amount.--The amount of an increase under subsection (b) shall
equal 20 percent of the amount of the swing bed reimbursement that a
rural hospital involved would otherwise receive under the swing bed
program.
(d) Termination.--This section shall not apply beginning on the
date that is 30 days after the date on which the COVID-19 emergency
ends (as determined by the Secretary).
SEC. 4. EMERGENCY GRANTS FOR PHYSICIANS' AND HEALTH CARE PROVIDERS'
PRACTICES.
(a) Purpose.--It is the purpose of this section to provide funding
to provide immediate relief and stabilization for physicians' and
health care providers' practices through emergency grants to prepare
and respond to the COVID-19 emergency.
(b) Amendment.--Title III of the Public Health Service Act is
amended by inserting after section 330A-1 (42 U.S.C. 254c-1a) the
following:
``SEC. 330A-2. EMERGENCY GRANTS FOR PHYSICIANS' AND HEALTH CARE
PROVIDERS' PRACTICES.
``(a) In General.--The Secretary shall establish a program to
support physicians' and health care providers' practices by awarding
emergency grants to eligible health care practices and ambulatory
surgery centers.
``(b) Allotments and Payments.--
``(1) Allotments.--The Secretary shall, from amounts
appropriated under subsection (e), allot to each eligible
health care practice or ambulatory surgery center an amount
equal to the actual payroll for the eligible health care
practice or ambulatory surgery center during the period
beginning January 1, 2019, and ending April 1, 2019.
``(2) Payments.--The Secretary shall make payments under
grants awarded under this section to each eligible health care
practice or ambulatory surgery center in the amount of the
allotment described in paragraph (1) with respect to each such
practice or center.
``(3) Time of grant.--Not later than 14 days after the date
of enactment of this section, the Secretary shall make a one-
time payment under a grant under this section to each eligible
health care practice or ambulatory surgery center.
``(c) Utilization of Payments.--Payments made under subsection (b)
shall be utilized, with respect to the grantee involved, to
compensate--
``(1) all hourly staff up to $25 per hour and salaried
staff up to $75,000 in full; and
``(2) all hourly staff above $25 per hour and salaried
staff above $75,000 at a rate of $25 per hour or $75,000 in
annual salary.
``(d) Definitions.--In this section:
``(1) Ambulatory surgery center.--The term `ambulatory
surgery center' has the meaning given such term in section
1833(i) of the Social Security Act.
``(2) Eligible health care practice.--The term `eligible
health care practice' means a corporation, limited liability
company, or unincorporated personal entity that provides health
care services of a physician or a health care provider as
licensed under State law.
``(3) Health care provider.--The term `health care
provider' means an individual providing health care services
under State law as determined by the Secretary.
``(4) Physician.--The term `physician' means an individual
that meets the definition under section 1861(r) of the Social
Security Act.
``(e) Authorization of Appropriations.--There is authorized to be
appropriated such sums as may be necessary to carry out this
section.''.
SEC. 5. EMERGENCY LOW-INTEREST LOANS FOR PHYSICIANS' AND HEALTH CARE
PROVIDERS' PRACTICES.
The Small Business Act is amended by inserting after section 32 (15
U.S.C. 657b) the following:
``SEC. 33. 2020 EMERGENCY LOW-INTEREST LOANS FOR PHYSICIANS' AND HEALTH
CARE PROVIDERS' PRACTICES.
``(a) Purpose.--It is the purpose of this section to provide low-
interest loans for physicians' and health care providers' practices or
ambulatory surgery centers, which as a result of the COVID-19
emergency, have suffered a significant financial impact.
``(b) Low-Interest Loans.--The Administrator shall provide any
eligible health care practice or ambulatory surgery center, which as a
result of the COVID-19 emergency, has suffered a significant financial
impact, a loan in such amount as may be necessary to enable such
enterprise to maintain or resume operations in order to assist in
maintaining and restoring the economic viability of the practice or
center. Loans authorized by this section shall be made without regard
to limitations on the size of loans which may otherwise be imposed by
any other provision of law or regulations promulgated pursuant thereto.
``(c) Interest.--Any loan made under this section shall be subject
to not to exceed .25 percent interest, and the President, if determined
necessary, may defer payments of principal for a period not to exceed 3
years after the date of such loan.
``(d) Deferred Interest Accrual.--Interest on a loan under this
section shall not begin to accrue until the date that is 24 months
after the date on which the COVID-19 emergency officially ends (as
determined by the Administrator).
``(e) Other Federal Assistance.--Loans made under this section
shall be in addition to any other Federal emergency assistance
available, except that such other assistance may be adjusted or
modified to the extent determined appropriate by the Administrator.
``(f) Definitions.--In this section:
``(1) Ambulatory surgery center.--The term `ambulatory
surgery center' has the meaning given such term in section
1833(i) of the Social Security Act.
``(2) Eligible health care practice.--The term `eligible
health care practice' means a corporation, limited liability
company, or unincorporated personal entity that provides health
care services of a physician or a health care provider as
licensed under State law.
``(3) Health care provider.--The term `health care
provider' means an individual providing health care services
under State law as determined by the Administrator.
``(4) Physician.--The term `physician' means an individual
that meets the definition under section 1861(r) of the Social
Security Act.
``(g) Sunset.--Low-interest loans under this section to eligible
health care practices and ambulatory surgery centers shall only be made
during the duration of the COVID-19 emergency.
``(h) Authorization of Appropriations.--There is authorized to be
appropriated such sums as may be necessary to carry out this
section.''.
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