RULES COMMITTEE PRINT 117–22

1 RULESCOMMITTEEPRINT117 22 TEXT OFHOUSEAMENDMENT TOS. 610 [Showing the text of the Protecting medicare and American Farmers from Sequester Cuts Act.] SECTION 1. SHORT TITLE. 1 This Act may be cited as the Protecting medicare 2and American Farmers from Sequester Cuts Act . 3 SEC. 2. ADJUSTMENTS TO medicare sequestration RE-4 DUCTIONS. 5(a) EXTENSIONOFTEMPORARYSUSPENSION 6 THROUGHMARCH2022. 7(1) IN GENERAL. Section 3709(a) of division 8A of the CARES Act (2 901a note) is 9amended 10(A) in the subsection header by inserting 11 ANDADJUSTMENT after SUSPENSION ; and 12(B) by striking December 31, 2021 and 13inserting March 31, 2022 . 14(2) EFFECTIVE DATE. The amendments made 15by paragraph (1) shall take effect as if enacted as 16part of the CARES Act (Public Law 116 136). 17(b) ADJUSTMENTS TOMEDICAREPROGRAMSEQUES-18 TRATIONREDUCTIONWITHRESPECT TOFISCALYEARS 192022 AND2030.

2 Section 251A(6) of the Balanced Budg-20 VerDate Nov 24 2008 11:58 Dec 07, 2021 Jkt 000000 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 C:\USERS\JRSHAPIRO\APPDATA\ROAMING\SOFTQ UAD\XMETAL\ \GEN\C\RCP_HASD ecember 7, 2021 (11:58 )G:\M\17\MISC\ :\VHLC\120721\ (827706|6)2 et and Emergency Deficit Control Act of 1985 (2 1901a(6)) is amended 2(1) by redesignating subparagraph (C) as sub-3paragraph (E); and 4(2) by inserting after subparagraph (B) the fol-5lowing new subparagraphs: 6 (C) Notwithstanding the 2 percent limit 7specified in subparagraph (A) for payments for 8the medicare programs specified in section 9256(d), the sequestration order of the President 10under such subparagraph for fiscal year 2022 11shall be applied to such payments so that with 12respect to the period beginning on April 1, 132022, and ending on June 30, 2022, the pay-14ment reduction shall be percent.

3 15 (D) Notwithstanding the 2 percent limit 16specified in subparagraph (A) for payments for 17the medicare programs specified in section 18256(d), the sequestration order of the President 19under such subparagraph for fiscal year 2030 20shall be applied to such payments so that 21 (i) with respect to the first 6 months 22in which such order is effective for such 23fiscal year, the payment reduction shall be percent; and 25 VerDate Nov 24 2008 11:58 Dec 07, 2021 Jkt 000000 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 C:\USERS\JRSHAPIRO\APPDATA\ROAMING\SOFTQ UAD\XMETAL\ \GEN\C\RCP_HASD ecember 7, 2021 (11:58 )G:\M\17\MISC\ :\VHLC\120721\ (827706|6)3 (ii) with respect to the second 6 1months in which such order is so effective 2for such fiscal year, the payment reduction 3shall be 3 percent.

4 4 SEC. 3. EXTENSION OF SUPPORT FOR PHYSICIANS AND 5 OTHER PROFESSIONALS IN ADJUSTING TO 6 medicare PAYMENT CHANGES. 7(a) INGENERAL. Section 1848 of the Social Secu-8rity Act (42 1395w 4) is amended 9(1) in subsection (c)(2)(B)(iv)(V), by striking 10 2021 and inserting 2021 or 2022 ; and 11(2) in subsection (t) 12(A) in the subsection header, by striking 13 2021 and inserting 2021 AND2022 ; 14(B) in paragraph (1) 15(i) by striking during 2021 and in-16serting during 2021 and 2022 ; and 17(ii) by striking for such services fur-18nished on or after January 1, 2021, and 19before January 1, 2022, by percent. 20and inserting for 21 (A) such services furnished on or after 22 January 1, 2021, and before January 1, 2022, 23by percent; and 24 VerDate Nov 24 2008 11:58 Dec 07, 2021 Jkt 000000 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 C:\USERS\JRSHAPIRO\APPDATA\ROAMING\SOFTQ UAD\XMETAL\ \GEN\C\RCP_HASD ecember 7, 2021 (11:58 )G:\M\17\MISC\ :\VHLC\120721\ (827706|6)4 (B) such services furnished on or after 1 January 1, 2022, and before January 1, 2023, 2by percent.

5 ; and 3(C) in paragraph (2)(C) 4(i) in the subparagraph header, by 5striking 2021 and inserting 2021 AND 62022 ; 7(ii) by inserting for services fur-8nished in 2021 or 2022 after under this 9subsection ; and 10(iii) by inserting or 2022, respec-11tively before the period at the end. 12(b) REPORT. Section 101(c) of division N of the 13 Consolidated Appropriations Act, 2021 (Public Law 116 14260) is amended 15(1) in the first sentence 16(A) by striking April 1, 2022 and insert-17ing each of April 1, 2022, and April 1, 2023 ; 18and 19(B) by striking , as added by subsection 20(a) and inserting furnished during 2021 or 212022, respectively ; and 22(2) in the second sentence 23(A) by striking Such report and insert-24ing Each such report ; and 25 VerDate Nov 24 2008 11:58 Dec 07, 2021 Jkt 000000 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 C:\USERS\JRSHAPIRO\APPDATA\ROAMING\SOFTQ UAD\XMETAL\ \GEN\C\RCP_HASD ecember 7, 2021 (11:58 )G:\M\17\MISC\ :\VHLC\120721\ (827706|6)5 (B) by inserting with respect to 2021 or 12022, as applicable after under such sec-2tion.

6 3 SEC. 4. PRESERVING PATIENT ACCESS TO CRITICAL CLIN-4 ICAL LAB SERVICES. 5(a) REVISEDPHASE-IN OFREDUCTIONSFROMPRI-6 VATEPAYORRATEIMPLEMENTATION. Section 71834A(b)(3) of the Social Security Act (42 81395m 1(b)(3)) is amended 9(1) in subparagraph (A), by striking through 102024 and inserting through 2025 ; and 11(2) in subparagraph (B) 12(A) in clause (ii), by striking for 2021 13and inserting for each of 2021 and 2022 ; 14and 15(B) in clause (iii), by striking 2022 16through 2024 and inserting 2023 through 172025 . 18(b) REVISEDREPORTINGPERIOD FORREPORTING 19 OFPRIVATESECTORPAYMENTRATES FORESTABLISH-20 MENTOFMEDICAREPAYMENTRATES. Section 211834A(a)(1)(B) of the Social Security Act (42 221395m 1(a)(1)(B)) is amended 23(1) in clause (i), by striking December 31, 242021 and inserting December 31, 2022 ; and 25 VerDate Nov 24 2008 11:58 Dec 07, 2021 Jkt 000000 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 C:\USERS\JRSHAPIRO\APPDATA\ROAMING\SOFTQ UAD\XMETAL\ \GEN\C\RCP_HASD ecember 7, 2021 (11:58 )G:\M\17\MISC\ :\VHLC\120721\ (827706|6)6 (2) in clause (ii) 1(A) by striking January 1, 2022 and in-2serting January 1, 2023 ; and 3(B) by striking March 31, 2022 and in-4serting March 31, 2023.

7 5 SEC. 5. DELAY TO THE IMPLEMENTATION OF THE RADI-6 ATION ONCOLOGY MODEL UNDER THE MEDI-7 CARE PROGRAM. 8 Section 133 of Division CC of the Consolidated Ap-9propriations Act, 2021 (Public Law 116 260) is amended 10by striking January 1, 2022 and inserting January 1, 112023 . 12 SEC. 6. medicare IMPROVEMENT FUND. 13 Section 1898(b)(1) of the Social Security Act (42 1395iii(b)(1)) is amended by striking fiscal year 152021 and all that follows through the period at the end 16and inserting fiscal year 2021, $101,000,000.. 17 SEC. 7. PAYGO ANNUAL REPORT. 18 For the purposes of the annual report issued pursu-19ant to section 5 of the Statutory Pay-As-You-Go Act of 202010 (2 934) after adjournment of the first session 21of the 117th Congress, and for determining whether a se-22questration order is necessary under such section, the 23debit for the budget year on the 5-year scorecard, if any, 24and the 10-year scorecard, if any, shall be deducted from 25 VerDate Nov 24 2008 11:58 Dec 07, 2021 Jkt 000000 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 C:\USERS\JRSHAPIRO\APPDATA\ROAMING\SOFTQ UAD\XMETAL\ \GEN\C\RCP_HASD ecember 7, 2021 (11:58 )G:\M\17\MISC\ :\VHLC\120721\ (827706|6)7 such scorecard in 2022 and added to such scorecard in 12023.

8 2 SEC. 8. EXPEDITED PROCEDURES FOR CONSIDERING AN 3 INCREASE IN THE DEBT LIMIT. 4(a) DEFINITION. In this section, the term joint 5resolution means a joint resolution 6(1) that is introduced by the Majority Leader 7of the Senate, or a designee, during the period be-8ginning on the date of enactment of this Act and 9ending on December 31, 2021; 10(2) which does not have a preamble; 11(3) the title of which is as follows: Joint reso-12lution relating to increasing the debt limit. ; and 13(4) the matter after the resolving clause of 14which is as follows: That the limitation under sec-15tion 3101(b) of title 31, United States Code, as 16most recently increased by Public Law 117 50 (31 3101 note), is increased by 18$lllllllll. , the blank space being ap-19propriately filled in with the dollar amount of the in-20crease.

9 21(b) EXPEDITEDCONSIDERATION INSENATE. 22(1) PLACEMENT ON CALENDAR. Upon intro-23duction in the Senate, the joint resolution shall be 24placed immediately on the calendar. 25 VerDate Nov 24 2008 11:58 Dec 07, 2021 Jkt 000000 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 C:\USERS\JRSHAPIRO\APPDATA\ROAMING\SOFTQ UAD\XMETAL\ \GEN\C\RCP_HASD ecember 7, 2021 (11:58 )G:\M\17\MISC\ :\VHLC\120721\ (827706|6)8 (2) PROCEEDING TO CONSIDERATION. 1(A) IN GENERAL. Notwithstanding rule 2 XXII of the Standing RULES of the Senate, it is 3in order, not later than January 15, 2022 (even 4though a previous motion to the same effect has 5been disagreed to) to move to proceed to the 6consideration of the joint resolution. 7(B) PROCEDURE. For a motion to pro-8ceed to the consideration of the joint resolu-9tion 10(i) all points of order against the mo-11tion are waived; 12(ii) the motion is not debatable; 13(iii) the motion is not subject to a mo-14tion to postpone; 15(iv) a motion to reconsider the vote by 16which the motion is agreed to or disagreed 17to shall not be in order; and 18(v) if the motion is agreed to, the 19joint resolution shall remain the unfinished 20business until disposed of.

10 21(3) FLOOR CONSIDERATION. 22(A) IN GENERAL. If the Senate proceeds 23to consideration of the joint resolution 24 VerDate Nov 24 2008 11:58 Dec 07, 2021 Jkt 000000 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 C:\USERS\JRSHAPIRO\APPDATA\ROAMING\SOFTQ UAD\XMETAL\ \GEN\C\RCP_HASD ecember 7, 2021 (11:58 )G:\M\17\MISC\ :\VHLC\120721\ (827706|6)9 (i) all points of order against the joint 1resolution (and against consideration of 2the joint resolution) are waived; 3(ii) debate on the joint resolution, and 4all debatable motions and appeals in con-5nection therewith, shall be limited to not 6more than 10 hours, which shall be divided 7equally between the Chairman and Rank-8ing Member of the COMMITTEE on Finance; 9(iii) an amendment to the joint resolu-10tion is not in order; 11(iv) a motion to postpone or a motion 12to commit the joint resolution is not in 13order; and 14(v) a motion to proceed to the consid-15eration of other business is not in order.