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I
116TH CONGRESS
2D SESSION
H. R. 6263
To amend title XVIII of the Social Security Act to waive cost sharing
under the Medicare program for certain visits relating to testing for
COVID–19.
IN THE HOUSE OF REPRESENTATIVES
MARCH 12, 2020
Mr. SARBANES (for himself, Mr. DANNY K. DAVIS of Illinois, and Mr. COURT-
NEY) introduced the following bill; which was referred to the Committee
on Energy and Commerce, and in addition to the Committee on Ways
and Means, for a period to be subsequently determined by the Speaker,
in each case for consideration of such provisions as fall within the juris-
diction of the committee concerned
A BILL
To amend title XVIII of the Social Security Act to waive
cost sharing under the Medicare program for certain
visits relating to testing for COVID–19.
Be it enacted by the Senate and House of Representa-
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tives of the United States of America in Congress assembled,
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SECTION 1. WAIVING COST SHARING UNDER THE MEDI-
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CARE PROGRAM FOR CERTAIN VISITS RELAT-
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ING TO TESTING FOR COVID–19.
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(a) IN GENERAL.—Section 1833 of the Social Secu-
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rity Act (42 U.S.C. 1395l) is amended—
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(1) in subsection (a)(1)—
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(A) by striking ‘‘and’’ before ‘‘(CC)’’; and
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(B) by inserting before the period at the
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end the following: ‘‘, and (DD) with respect to
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a specified COVID–19 testing-related service
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described in paragraph (1) of subsection (cc)
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for which payment may be made under a speci-
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fied outpatient payment provision described in
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paragraph (2) of such subsection, the amounts
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paid shall be 100 percent of the payment
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amount otherwise recognized under such respec-
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tive specified outpatient payment provision for
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such service,’’;
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(2) in subsection (b), in the first sentence—
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(A) by striking ‘‘and’’ before ‘‘(10)’’; and
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(B) by inserting before the period at the
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end the following: ‘‘, and (11) such deductible
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shall not apply with respect to any specified
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COVID–19 testing-related service described in
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paragraph (1) of subsection (cc) for which pay-
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ment may be made under a specified outpatient
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payment provision described in paragraph (2)
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of such subsection’’; and
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(3) by adding at the end the following new sub-
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section:
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‘‘(cc) SPECIFIED
COVID–19 TESTING-RELATED
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SERVICES.—For purposes of subsection (a)(1)(DD):
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‘‘(1) DESCRIPTION.—
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‘‘(A) IN GENERAL.—A specified COVID–
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19 testing-related service described in this para-
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graph is a medical visit that—
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‘‘(i) is in any of the categories of
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HCPCS evaluation and management serv-
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ice codes described in subparagraph (B);
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‘‘(ii) is furnished during any portion
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of the emergency period defined in section
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1135(g)(1)(B) beginning on or after the
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date of the date of the enactment of this
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subsection; and
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‘‘(iii) results in an order for or admin-
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istration of an in vitro diagnostic product
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(as defined in section 809.3(a) of title 21,
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Code of Federal Regulations) administered
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during any portion of such emergency pe-
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riod beginning on or after the date of the
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enactment of this subsection for the detec-
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tion of SARS–CoV–2 or the diagnosis of
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the virus that causes COVID–19 that is
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approved, cleared, or authorized under sec-
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tion 510(k), 513, 515, or 564 of the Fed-
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eral Food, Drug, and Cosmetic Act.
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‘‘(B) CATEGORIES OF HCPCS CODES.—For
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purposes of subparagraph (A), the categories of
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HCPCS evaluation and management services
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codes are the following:
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‘‘(i) Office and other outpatient serv-
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ices.
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‘‘(ii) Hospital observation services.
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‘‘(iii) Emergency department services.
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‘‘(iv) Skilled nursing facility services.
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‘‘(v) Domiciliary, rest home, or custo-
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dial care services.
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‘‘(vi) Home services.
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‘‘(2) SPECIFIED OUTPATIENT PAYMENT PROVI-
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SION.—A specified outpatient payment provision de-
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scribed in this paragraph is any of the following:
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‘‘(A) The hospital outpatient prospective
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payment system under subsection (t).
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‘‘(B) The physician fee schedule under sec-
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tion 1848.
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‘‘(C) The prospective payment system de-
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veloped under section 1834(o).
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‘‘(D) Section 1834(g), with respect to an
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outpatient critical access hospital service.
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‘‘(E) The payment basis determined in
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regulations pursuant to section 1833(a)(3) for
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rural health clinic services.’’.
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(b) CLAIMS MODIFIER.—The Secretary of Health
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and Human Services shall provide for an appropriate
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modifier (or other identifier) to include on claims to iden-
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tify, for purposes of subparagraph (DD) of section
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1833(a)(1), as added by subsection (a), specified COVID–
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19 testing-related services described in paragraph (1) of
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section 1833(cc) of the Social Security Act, as added by
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subsection (a), for which payment may be made under a
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specified outpatient payment provision described in para-
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graph (2) of such subsection.
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(c) IMPLEMENTATION.—Notwithstanding any other
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provision of law, the Secretary of Health and Human
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Services may implement the provisions of, including
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amendments made by, this section through program in-
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struction or otherwise.
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Æ
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