All Roll Calls
Yes: 922 • No: 431
117-hr-1868117th CongressWALLET
To prevent across-the-board direct spending cuts, and for other purposes.
Sponsored By: Representative Yarmuth, John A. [D-KY-3]
Became Law
Summary
Extends the suspension of Medicare sequestration through December 31, 2021. It changes how the sequester paybacks are recovered so initial cuts are smaller and a final half-month has no reduction.
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- Hospitals and other Medicare providers see a modified recovery schedule. The law makes the first 5.5 months tied to a 2.0 percent reduction, the next 6 months tied to a 4.0 percent reduction, and the remaining half-month tied to a 0.0 percent reduction, which smooths temporary payment disruptions through 2021.
- Rural Health Clinics and high-disproportionate-share hospitals get technical payment fixes. Per-visit payment updates for 2020 and 2021 are redefined based on whether a clinic had a 2020 rate and the primary care market update percentage on January 1, 2021. Eligibility for higher clinic payments is tied to hospitals with fewer than 50 beds as of December 31, 2020 and to enrollment under section 1866(j). The law also preserves a grandfathered transition rule for high-DSH hospital payment adjustments.
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Bill Overview
Analyzed Economic Effects
3 provisions identified: 1 benefits, 0 costs, 2 mixed.
Medicare payment cuts paused, then reshaped
The law extends the pause on Medicare sequestration through December 31, 2021. Medicare payments are not cut during this period. It also changes how sequester cuts are spread in a fiscal year: 2.0% for the first 5.5 months, 4.0% for the next 6 months, and 0.0% for the final half month. This timing shifts when providers see smaller or larger reductions.
Grandfathered Medicaid payment rules for hospitals
The law keeps earlier rules for checking Medicaid disproportionate‑share hospital (DSH) payment adjustments in certain States. It uses the rules that were in effect on September 30, 2021 for those hospitals. This protects how those payment checks are done under federal limits.
New pay and rules for rural clinics
Rural health clinics get updated 2021 per‑visit payments. If a clinic had a 2020 amount, its 2021 rate is that amount increased by the 2021 primary‑care MEI, up to the statutory cap. If not, its 2021 rate is the applicable 2021 amount, up to the cap. Higher payments apply only to clinics tied to hospitals with under 50 beds as of December 31, 2020, and that were enrolled or applied by that date. Temporary bed increases under emergency waivers do not count.
Sponsors & CoSponsors
Sponsor
Yarmuth, John A. [D-KY-3]
KY • D
Cosponsors
Rep. Neal, Richard E. [D-MA-1]
MA • D
Sponsored 3/12/2021
Rep. Pallone, Frank [D-NJ-6]
NJ • D
Sponsored 3/12/2021
Rep. Scott, David [D-GA-13]
GA • D
Sponsored 3/12/2021
Rep. Larson, John B. [D-CT-1]
CT • D
Sponsored 3/17/2021
Rep. Schakowsky, Janice D. [D-IL-9]
IL • D
Sponsored 3/17/2021
Rep. Panetta, Jimmy [D-CA-19]
CA • D
Sponsored 3/17/2021
Rep. Green, Al [D-TX-9]
TX • D
Sponsored 3/19/2021
Roll Call Votes
house vote • 4/13/2021
On Motion to Suspend the Rules and Concur in the Senate Amendment
Yes: 384 • No: 38
senate vote • 3/25/2021
On Passage of the Bill H.R. 1868
Yes: 90 • No: 2
house vote • 3/19/2021
On Passage
Yes: 246 • No: 175
house vote • 3/19/2021
On Motion to Recommit
Yes: 202 • No: 216