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Code · BILL · 116th Congress · H.R. 6800 (Engrossed in House) — Making emergency supplemental appropriations for the fiscal year ending September 30, 2020, and for other purposes. · Sec. 30203

Sec. 30203. Medicare hospital inpatient prospective payment system outlier payments for COVID–19 patients during certain emergency period

311 words·~1 min read·/bill/116/hr/6800/eh/section-30203

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Section 1886(d)(5)(A) of the Social Security Act ( 42 U.S.C. 1395ww(d)(5)(A) ) is amended— in clause (ii), by striking For cases and inserting Subject to clause (vii), for cases ; in clause (iii), by striking The amount and inserting Subject to clause (vii), the amount ; in clause (iv), by striking The total amount and inserting Subject to clause (vii), the total amount ; and by adding at the end the following new clause: For discharges that have a primary or secondary diagnosis of COVID–19 and that occur during the period beginning on the date of the enactment of this clause and ending on the sooner of January 31, 2021, or the last day of the emergency period described in section 1135(g)(1)(B), the amount of any additional payment under clause
(ii)for a subsection
(d)hospital for such a discharge shall be determined as if— clause
(ii)was amended by striking plus a fixed dollar amount determined by the Secretary ; the reference in clause
(iii)to approximate the marginal cost of care beyond the cutoff point applicable under clause
(i)or
(ii)were a reference to approximate the marginal cost of care beyond the cutoff point applicable under clause (i), or, in the case of an additional payment requested under clause (ii), be equal to 100 percent of the amount by which the costs of the discharge for which such additional payment is so requested exceed the applicable DRG prospective payment rate ; and clause
(iv)does not apply. . Section 1886(d)(3)(B) of the Social Security Act ( 42 U.S.C. 1395ww(d)(3)(B) ) is amended by inserting before the period the following: , other than additional payments described in clause
(vii)of such paragraph . Notwithstanding any other provision of law, the Secretary of Health and Human Services may implement the amendments made by this section by program instruction or otherwise.
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Sec. 30203
Medicare hospital inpatient prospective payment system outlier payments for COVID–19 patients during certain emergency period
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