,,ii #aafth ,,congress #b;d ,session ,s4 #ceei ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,march #ba1 #bjbj,mr4 ,bennet 7for himself1 ,mr4 ,barrasso1 ,ms4 ,smith1 ,mr4 ,gardner1 ,mr4 ,jones1 and ,mrs4 ,hyde-,smith7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to provide emergency financial assistance to rural health care facilities and providers impacted by the ,,covid-#ai emergency4 #a4 ,short title ,this ,act may be cited as the ,immediate ,relief for ,rural ,facilities and ,providers ,act of #bjbj4 #b4 ,rural health care facility grants 7a7 ,purpose ,it is the purpose of this section to provide funding to stabilize rural hospitals and provide immediate financial relief to prepare and respond to the ,,covid-#ai emergency4 7b7 ,grants ,the ,secretary1 acting through the ,administrator of the ,centers for ,medicare ,medicaid ,services1 shall establish an emergency operating grant program and shall award an emergency operating grant to an eligible ,medicare participating health care facility4 7c7 ,allotments and payments 7#a7 ,allotments ,the ,secretary shall1 from amounts appropriated under subsection 7i71 allot to each facility eligible for a grant under this section the sum of-- 7,a7 an amount equal to the number of patient days 7including acute1 swing-bed1 and observation days7 from ,january #a1 #bjai1 to ,april #a1 #bjai1 with respect to the facility1 multiplied by #a1jjj2 and 7,b7 an amount equal to the total amount of reimbursements from all payer sources to the facility from ,january #a1 #bjai1 to ,april #a1 #bjai4 7#b7 ,payments ,the ,secretary shall make payments under grants awarded to eligible facilities under this section in the amount of the allotments described in paragraph 7#a74 7#c7 ,time of grant ,a one time payment shall be made under a grant awarded under this section not later than #ad days after the date of enactment of this ,act4 7d7 ,eligible facilities 7#a7 ,in general ,to be eligible to receive a grant under subsection 7b71 a ,medicare participating health care facility shall submit to the ,secretary an application described in paragraph 7#b74 7#b7 ,application ,an application under this paragraph shall be submitted to the ,secretary not later that #ahj days after the date of enactment of this ,act and shall contain such information that the ,secretary may require1 including-- 7,a7 a certification that-- 7i7 the facility will suffer financial losses as a result of the ,,covid-#ai emergency2 and 7ii7 in the absence of an emergency grant under this section1 the facility would be forced to either reduce staffing or operations2 7,b7 an assurance that the amount requested under the grant exceeds #acj percent of the amount of revenue collected by the facility during the same period of the year preceding the year for which the request under this section is made2 7,c7 the amount of spending incurred by the facility as a result of the ,,covid-#ai emergency2 7,d7 a description on how the facility will use grant funds2 and 7,e7 an assurance that the facility followed the ,secretary's recommendations related to the ,,covid-#ai emergency4 7e7 ,reconciliation 7#a7 ,in general ,not later than #b years after the date on which the ,,covid-#ai emergency ends 7as determined by the ,secretary71 the ,secretary shall promulgate regulations under which a facility that receives an emergency grant under this section shall reconcile the amount of the emergency grant with-- 7,a7 the entire amount of the grant allotted to the facility in the case of a facility that was determined not to be eligible under subsection 7d72 7,b7 any reimbursements received by the facility from third parties for services provided during such emergency2 and 7,c7 any portion of the grant funds that exceeds #acj percent of the amount of revenue collected by the facility during the same #ij-;day period of the year preceding the year for which the grant is being made as determined through such reconciliation to have been recovered by the facility through third-party payors1 in addition to any additional spending incurred by the facility as a result of the ,,covid-#ai emergency1 with the ,federal ,government4 7#b7 ,recoupment ,the regulations under this subsection shall include procedures through which the ,federal ,government may recoup any portion of grant funds described in paragraph 7#a74 7f7 ,limitations on use of funds 7#a7 ,construction of facilities 7,a7 ,limitations ,grants awarded under this section shall not be used by the facility for the purchase or improvement of land1 or the purchase1 construction1 or permanent improvement of any building4 7,b7 ,waiver ,the ,secretary may wave the limitation contained in subparagraph 7,a7 upon a facility request for such a waiver1 if the ,secretary finds that the request describes circumstances that justify the purchase of land or the constrictive of facilities 7or the making of permanent improvements7 related to the ,,covid-#ai emergency4 7#b7 ,political activities ,grants awarded under this section shall not be used in a manner involving the use of grant funds1 provisions of services1 or the employment or assignment of personnel1 in a manner supporting or resulting in the identification of such programs with any partisan or nonpartisan political activity or any political activity associated with a candidate1 or contending faction or group1 in an election for public or party office4 7g7 ,legal action ,a facility that receives an emergency grant under this section shall be prohibited from commencing any legal action against a patients to recover any costs associated with care provided to the patient during the ,,covid-#ai emergency4 7h7 ,definitions ,in this section3 7#a7 ,,covid-#ai emergency ,the term ,,covid-#ai emergency means the national emergency declared by the ,president under the ,national ,emergencies ,act 7#ej ,u4,s4,c4 #afja et seq47 with respect to the ,coronavirus ,disease #bjai 7,,covid-#ai74 7#b7 ,medicare participating health care facility ,the terms ,medicare participating health care facility and facility mean-- 7,a7 an entity designated as-- 7i7 a ,critical ,access ,hospital under section #dhe of subpart ,f of title #db1 ,code of ,federal ,regulations2 or 7ii7 a subsection 7d7 hospital 7as defined in paragraph 7#a77;,b7 of section #ahhf7;d77#a77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acieww7d77#a77;,b777 that is located in a rural area 7as defined in paragraph 7#b77;,d7 of such section72 and 7,b7 a provider of services enrolled in the ,medicare program under section #ahff7;j7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;cc7j774 7#c7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7i7 ,authorization of appropriations ,there is authorized to be appropriated such sums as may be necessary to carry out this section4 #c4 ,reimbursement adjustment for swing bed program 7a7 ,purpose ,it is the purpose of this section to improve the health care system to prepare and respond to the ,,covid-#ai emergency 7as defined in section #b74 7b7 ,adjustment ,the ,secretary of ,health and ,human ,services1 acting through the ,administrator of the ,centers for ,medicare ,medicaid ,services1 shall increase reimbursements for rural hospitals under the swing bed program for the duration of the ,,covid-#ai emergency4 7c7 ,amount ,the amount of an increase under subsection 7b7 shall equal #bj percent of the amount of the swing bed reimbursement that a rural hospital involved would otherwise receive under the swing bed program4 7d7 ,termination ,this section shall not apply beginning on the date that is #cj days after the date on which the ,,covid-#ai emergency ends 7as determined by the ,secretary74 #d4 ,emergency grants for physicians' and health care providers' practices 7a7 ,purpose ,it is the purpose of this section to provide funding to provide immediate relief and stabilization for physicians' and health care providers' practices through emergency grants to prepare and respond to the ,,covid-#ai emergency4 7b7 ,amendment ,title ,,iii of the ,public ,health ,service ,act is amended by inserting after section #ccj;,a-#a 7#db ,u4,s4,c4 #bed;c-#a;a7 the following3 #ccj;,a-#b4 ,emergency grants for physicians' and health care providers' practices 7a7 ,in general ,the ,secretary shall establish a program to support physicians' and health care providers' practices by awarding emergency grants to eligible health care practices and ambulatory surgery centers4 7b7 ,allotments and payments 7#a7 ,allotments ,the ,secretary shall1 from amounts appropriated under subsection 7e71 allot to each eligible health care practice or ambulatory surgery center an amount equal to the actual payroll for the eligible health care practice or ambulatory surgery center during the period beginning ,january #a1 #bjai1 and ending ,april #a1 #bjai4 7#b7 ,payments ,the ,secretary shall make payments under grants awarded under this section to each eligible health care practice or ambulatory surgery center in the amount of the allotment described in paragraph 7#a7 with respect to each such practice or center4 7#c7 ,time of grant ,not later than #ad days after the date of enactment of this section1 the ,secretary shall make a one-time payment under a grant under this section to each eligible health care practice or ambulatory surgery center4 7c7 ,utilization of payments ,payments made under subsection 7b7 shall be utilized1 with respect to the grantee involved1 to compensate-- 7#a7 all hourly staff up to #be per hour and salaried staff up to #ge1jjj in full2 and 7#b7 all hourly staff above #be per hour and salaried staff above #ge1jjj at a rate of #be per hour or #ge1jjj in annual salary4 7d7 ,definitions ,in this section3 7#a7 ,ambulatory surgery center ,the term ambulatory surgery center has the meaning given such term in section #ahcc7;i7 of the ,social ,security ,act4 7#b7 ,eligible health care practice ,the term eligible health care practice means a corporation1 limited liability company1 or unincorporated personal entity that provides health care services of a physician or a health care provider as licensed under ,state law4 7#c7 ,health care provider ,the term health care provider means an individual providing health care services under ,state law as determined by the ,secretary4 7#d7 ,physician ,the term physician means an individual that meets the definition under section #ahfa7r7 of the ,social ,security ,act4 7e7 ,authorization of appropriations ,there is authorized to be appropriated such sums as may be necessary to carry out this section4 4 #e4 ,emergency low-interest loans for physicians' and health care providers' practices ,the ,small ,business ,act is amended by inserting after section #cb 7#ae ,u4,s4,c4 #feg;b7 the following3 #cc4 #bjbj emergency low-interest loans for physicians' and health care providers' practices 7a7 ,purpose ,it is the purpose of this section to provide low-interest loans for physicians' and health care providers' practices or ambulatory surgery centers1 which as a result of the ,,covid-#ai emergency1 have suffered a significant financial impact4 7b7 ,low-,interest loans ,the ,administrator shall provide any eligible health care practice or ambulatory surgery center1 which as a result of the ,,covid-#ai emergency1 has suffered a significant financial impact1 a loan in such amount as may be necessary to enable such enterprise to maintain or resume operations in order to assist in maintaining and restoring the economic viability of the practice or center4 ,loans authorized by this section shall be made without regard to limitations on the size of loans which may otherwise be imposed by any other provision of law or regulations promulgated pursuant thereto4 7c7 ,interest ,any loan made under this section shall be subject to not to exceed 4#be percent interest1 and the ,president1 if determined necessary1 may defer payments of principal for a period not to exceed #c years after the date of such loan4 7d7 ,deferred interest accrual ,interest on a loan under this section shall not begin to accrue until the date that is #bd months after the date on which the ,,covid-#ai emergency officially ends 7as determined by the ,administrator74 7e7 ,other ,federal assistance ,loans made under this section shall be in addition to any other ,federal emergency assistance available1 except that such other assistance may be adjusted or modified to the extent determined appropriate by the ,administrator4 7f7 ,definitions ,in this section3 7#a7 ,ambulatory surgery center ,the term ambulatory surgery center has the meaning given such term in section #ahcc7;i7 of the ,social ,security ,act4 7#b7 ,eligible health care practice ,the term eligible health care practice means a corporation1 limited liability company1 or unincorporated personal entity that provides health care services of a physician or a health care provider as licensed under ,state law4 7#c7 ,health care provider ,the term health care provider means an individual providing health care services under ,state law as determined by the ,administrator4 7#d7 ,physician ,the term physician means an individual that meets the definition under section #ahfa7r7 of the ,social ,security ,act4 7g7 ,sunset ,low-interest loans under this section to eligible health care practices and ambulatory surgery centers shall only be made during the duration of the ,,covid-#ai emergency4 7h7 ,authorization of appropriations ,there is authorized to be appropriated such sums as may be necessary to carry out this section4 4