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Code · BILL · 118th Congress · S. 5218 (Introduced in Senate) — To amend titles XI and XVIII of the Social Security Act to strengthen, increase oversight of, and compliance with, se... · Sec. 202

Sec. 202. Medicare accelerated and advance payments in response to cybersecurity incidents

760 words·~3 min read·/bill/118/s/5218/is/section-202

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Section 1815(e)(3) of the Social Security Act ( 42 U.S.C. 1395g(e)(3) ) is amended to read as follows: Subject to subsection (f), in the case of an eligible provider of services (as defined in subparagraph (B)) that has an agreement in effect under section 1866 and that has significant cash flow problems resulting from operations of its medicare administrative contractor under section 1874A or from unusual circumstances of such provider’s operation, including significant disruption to Medicare claims processing due to a cybersecurity incident (as defined in subparagraph (C)), the Secretary may make available appropriate accelerated payments subject to appropriate safeguards against fraud, waste, and abuse determined by the Secretary.
In this paragraph, the term eligible providers of services means— a subsection
(d)hospital or a subsection
(d)Puerto Rico hospital (as defined for purposes of section 1886); a hospital described in any of clauses
(i)through
(vi)of section 1886(d)(1)(B); a critical access hospital (as defined in section 1861(mm)(1)); a rural emergency hospital (as defined in section 1861(kkk)(2)); a skilled nursing facility (as defined in section 1819(a)); a home health agency (as defined in section 1861(o)); a hospice program (as defined in section 1861(dd)(2)); a comprehensive outpatient rehabilitation facility (as defined in section 1861(cc)(2)); a rural health clinic (as defined in section 1861(aa)(2)); a Federally qualified health center (as defined in section 1861(aa)(4)); an opioid treatment program (as defined in section 1861(jjj)(2)); and a community mental health center (as defined in section 1861(ff)(3)(B)). In this paragraph, the term cybersecurity incident has the meaning given the term incident in section 2200 of the Homeland Security Act of 2002. Notwithstanding any other provision of law, the Secretary may implement the provisions of this paragraph by program instruction or otherwise. . Section 1835 of the Social Security Act ( 42 U.S.C. 1395n ) is amended by adding at the end the following new subsection: Upon the request of a supplier (as defined in section 1861(d)) that is participating in the Medicare program under this title, that is furnishing items or services under this part, and that has significant cash flow problems resulting from operations of its medicare administrative contractor under section 1874A or from unusual circumstances of such supplier’s operation, including significant disruption to Medicare claims processing due to a cybersecurity incident (as defined in paragraph (2)), the Secretary may make available appropriate advance payments subject to appropriate safeguards against fraud, waste, and abuse determined by the Secretary. In this paragraph, the term cybersecurity incident has the meaning given the term incident in section 2200 of the Homeland Security Act of 2002. Notwithstanding any other provision of law, the Secretary may implement the provisions of this subsection by program instruction or otherwise. . Section 1817 of the Social Security Act ( 42 U.S.C. 1395i ) is amended by adding at the end the following new subsection: Beginning on the date of enactment of this subsection, there shall be transferred from the General Fund of the Treasury to the Trust Fund an amount, as estimated by the Chief Actuary of the Centers for Medicare & Medicaid Services, equal to the amount of accelerated payments made for items and services under this part. There shall be transferred from the Trust Fund to the General Fund of the Treasury amounts equivalent to the sum of— the amounts by which claims have offset (in whole or in part) the amount of such payments described in paragraph (1); and the amount of such payments that have been repaid (in whole or in part). Amounts described in paragraphs
(1)and
(2)shall be transferred from time to time as determined appropriate by the Secretary. . Section 1844 of the Social Security Act ( 42 U.S.C. 1395w ) is amended by adding at the end the following new subsection: Beginning on the date of enactment of this subsection, there shall be transferred from the General Fund of the Treasury to the Trust Fund an amount, as estimated by the Chief Actuary of the Centers for Medicare & Medicaid Services, equal to amounts paid in advance for items and services under this part. There shall be transferred from the Trust Fund to the General Fund of the Treasury amounts equivalent to the sum of— the amounts by which claims have offset (in whole or in part) the amount of such payments described in paragraph (1); and the amount of such payments that have been repaid (in whole or in part). Amounts described in paragraphs
(1)and
(2)shall be transferred from time to time as determined appropriate by the Secretary. .
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