,,ii  #aaf? ,,congress  #b;d ,session   
,s4 #cfca  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,may #f1 #bjbj,mr4     
,sasse introduc$ ! foll[+ bill2 :i* 0   
read twice & ref]r$ to ! ,committee on  
,f9ance  ,a ,,bill  ,to provide relief =
 rural provid]s dur+ ! national em]g5cy 
) respect to ! ,coronavirus ,disease    
#bjai 7,,covid-#ai74  #a4 ,%ort title   
,?is ,act may be cit$ z ! ,relief =     
,rural ,provid]s ,dur+ ,em]g5cies ,act4 
#b4 ,paus+ eligibility det]m9ations "u !
 #cdj;,b drug pric+ program  7a7 ,9     
g5]al ,! ,secret>y ( ,heal? & ,human    
,s]vices %all1 = any co/ report+ p]iod  
end+ 9 #bjbj or #bjba1 = any o!r co/    
report+ p]iod 9 :i* ! ,,covid-#ai public
 heal? em]g5cy is 9 effect dur+ all or  
"p ( su* p]iod1 & = any ext5d$ p]iod "u 
subsection 7b7-- 7#a7 pause ! process ( 
mak+ any det]m9ation z to :e!r an       
entity1 t 0 a cov]$ entity = ! mo/ rec5t
 co/ report+ p]iod prior to ! fir/ date 
on :i* ! ,,covid-#ai public heal?       
em]g5cy w5t into effect1 cont9ues to be 

su* a cov]$ entity2 &  7#b7 deem any    
entity1 t 0 a cov]$ entity = ! mo/ rec5t
 co/ report+ p]iod prior to ! fir/ date 
on :i* ! ,,covid-#ai public heal?       
em]g5cy w5t into effect1 z cont9u+ to   
meet all requirem5ts = be+ su* a cov]$  
entity4  7b7 ,ext5sion ,! ,secret>y %all
 ext5d ! application ( p>agraphs 7#a7 & 
7#b7 ( subsection 7a7 to any co/ report+
 p]iod t is n describ$ 9 su* subsection 
if necess>y to ensure t no entity loses 
eligibility /atus z a cov]$ entity = any
 reason relat$ to ! ,,covid-#ai public  
heal? em]g5cy4  7c7 ,def9itions ,9 ?is  
section3 7#a7 ,cov]$ entity ,! t]m cov]$
 entity has ! mean+ giv5 su* t]m 9      
section #cdj;,b7a77#d7 ( ! ,public      
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#bef;b7a77#d774  7#b7 ,,covid-#ai public
 heal? em]g5cy ,! t]m ,,covid-#ai public
 heal? em]g5cy means ! public heal?     
em]g5cy decl>$ by ! ,secret>y ( ,heal? &
 ,human ,s]vices "u section #cai ( !    
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bdg;d7 on ,janu>y #ca1 #bjbj1

 ) respect to ,,covid-#ai4  #c4 ,waiv] (
 c]ta9 requirem5ts dur+ national em]g5cy
 ,not)/&+ any o!r provision ( law1 dur+ 
any portion ( ! national em]g5cy decl>$ 
by ! ,presid5t "u ! ,national ,em]g5cies
 ,act 7#ej ,u4,s4,c4 #afja et seq47 )   
respect to ! ,coronavirus ,disease #bjai
 7,,covid-#ai7 beg9n+ on or aft] ! date 
( ! enactm5t ( ?is ,act & end+ on !     
e>li] ( ! date on :i* su* em]g5cy       
decl>ation t]m9ates or ! date t is #ahj 
days aft] su* date ( enactm5t1 !        
,secret>y %all-- 7#a7 waive any prior   
au?orization requirem5ts o!rwise        
applicable "u titles ,,xviii & ,,xix ( !
 ,social ,security ,act 7#db ,u4,s4,c4  
#acie et seq41 #acif et seq47 ) respect 
to treatm5t & te/+ = ,,covid-#ai2  7#b7 
) respect to inpati5t hospital s]vices  
7z def9$ 9 section #ahfa7;b7 ( su* ,act 
7#db ,u4,s4,c4 #aciex7b77-- 7,a7 waive  
any requirem5ts o!rwise applicable "u   
title ,,xviii t w\ld o!rwise prev5t !   
,secret>y f provid+ reimbursem5t =      
inpati5t hospital s]vices t are furni%$ 

(f-site at an unlic5s$ facility2 &  7,b7
 provide reimbursem5t = su* s]vices     
furni%$ at su* facility at an am\nt     
equal to ! paym5t am\nt det]m9$ "u !    
hospital inpati5t prospective paym5t    
sy/em "u section #ahhf7;d7 ( su* ,act   
7#db ,u4,s4,c4 #acieww7d77 if ! facility
 7 a subsection 7d7 hospital 7z def9$ 9 
p>agraph 7#a77;,b7 ( su* section72 &    
7#c7 waive ! provisions ( section       
#ahfg7;d7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #acie;dd7d771 relat+ to  
en=cem5t ( requirem5ts ) respect to     
exam9ation & treatm5t = em]g5cy m$ical  
conditions & wom5 9 labor1 = transf]s or
 r$irections ( pati5ts away f hospital  
em]g5cy dep>tm5ts4  #d4 ,relief =       
critical access hospitals ,not)/&+ any  
o!r provision ( law1 dur+ ! #fj-;day    
p]iod beg9n+ on ! date ( ! enactm5t (   
?is ,act1 ! ,secret>y %all waive !      
foll[+ provisions ( title ,,xviii ( !   
,social ,security ,act3 7#a7 ,) respect 
to c]tification ( critical access       
hospitals 7z def9$ 9 section            

#ahfa7mm77#a77 ( su* ,act 7#db ,u4,s4,c4
 #aciex7mm77#a771 ! limitation on !     
numb] ( acute c>e inpati5t b$s o!rwise  
applicable "u section                   
#ahbj7;c77#b77;,b77iii7 ( su* ,act 7#db 
,u4,s4,c4 #acie;i-#d7;c77#b77;,b77iii774
  7#b7 ,) respect to inpati5t critical  
access hospital s]vices 7z def9$ 9      
section #ahfa7mm77#b77 ( su* ,act 7#db  
,u4,s4,c4 #aciex7mm77#b771 ! physician  
c]tification requirem5t "u section      
#ahad7;a77#h7 ( su* ,act 7#db ,u4,s4,c4 
#acie;f7a77#h774  #e4 ,relief = skill$  
nurs+ facilities  7a7 ,tempor>y waiv] ( 
#c-;,day hospitalization requirem5t =   
cov]age ( po/-,hospital ext5d$ c>e      
s]vices ,not)/&+ any o!r provision (    
law1 ) respect to po/-hospital ext5d$   
c>e s]vices 7z def9$ 9 section          
#ahfa7;i77 ( ! ,social ,security ,act   
7#db ,u4,s4,c4 #aciex7i77 furni%$ dur+  
any portion ( ! national em]g5cy decl>$ 
by ! ,presid5t "u ! ,national ,em]g5cies
 ,act 7#ej ,u4,s4,c4 #afja et seq47 )   
respect to ! ,coronavirus ,disease #bjai

 7,,covid-#ai7 beg9n+ on or aft] ! date 
( ! enactm5t ( ?is ,act & end+ on !     
e>li] ( ! date on :i* su* em]g5cy       
decl>ation t]m9ates or ! date t is #ahj 
days aft] su* date ( enactm5t1 !        
,secret>y %all waive ! #c-;day          
hospitalization requirem5t = cov]age (  
su* s]vices "u su* section #ahfa7;i74   
7b7 ,m$ic>e skill$ nurs+ facility       
prospective paym5t sy/em adju/m5t =     
covid-#ai resid5ts dur+ national em]g5cy
  7#a7 ,9 g5]al ,section #ahhh7;e7 ( !  
,social ,security ,act 7#db ,u4,s4,c4   
#acieyy7e77 is am5d$-- 7,a7 9 p>agraph  
7#a71 by /rik+ & 7#ab7 & ins]t+ 7#ab71 &
 7#ac72 &  7,b7 by ins]t+ aft] p>agraph 
7#ab7 ! foll[+ new p>agraph3  7#ac7     
,adju/m5t = resid5ts ) covid-#ai ,dur+  
any portion ( ! national em]g5cy decl>$ 
by ! ,presid5t "u ! ,national ,em]g5cies
 ,act 7#ej ,u4,s4,c4 #afja et seq47 )   
respect to ! ,coronavirus ,disease #bjai
 7,,covid-#ai7 beg9n+ on or aft] ! date 
( ! enactm5t ( ?is p>agraph & end+ on ! 
e>li] ( ! date on :i* su* em]g5cy       

decl>ation t]m9ates or ! date t is #ahj 
days aft] su* date ( enactm5t1 9 ! case 
( a resid5t :o has a pr9cipal or        
second>y diagnosis ( ,,covid-#ai1 ! p]  
diem am\nt ( paym5t o!rwise applicable  
%all be increas$ by #ae p]c5t to reflect
 increas$ co/s associat$ ) su* resid5ts4
  4  7#b7 ,implem5tation ,not)/&+ any   
o!r provision ( law1 ! ,secret>y may    
implem5t ! am5dm5ts made by ?is         
subsection by program in/ruction or     
o!rwise4  #f4 ,ensur+ rural provid]s are
 includ$ 9 ,,c>es  7a7 ,9 g5]al ,! ?ird 
p>agraph 9 ! matt] "u ! head+ public    
heal? & social s]vices em]g5cy fund     
7includ+ transf] ( funds7 "u ! head+    
,(fice ,( ,! ,secret>y "u ! head+       
,,dep>tm5t ,,( ,,heal? ,,& ,,human      
,,s]vices ( division ,b ( ! ,,c>es ,act 
7,public ,law #aaf-acf7 is am5d$-- 7#a7 
9 ! ?ird proviso1 by ins]t+ 1 & includes
 skill$ nurs+ facilities1 nurs+         
facilities1 assi/$ liv+ resid5ces1 & o!r
 types ( facilities t provide h\s+ & c>e
 = s5iors aft] z ! ,secret>y may        

specify2 &  7#b7 by ins]t+ aft] ! second
 proviso ! foll[+3 ,provid$ fur!r1 ,t ! 
,secret>y %all use at lea/ #bj p]c5t ( !
 funds appropriat$ "u ?is p>agraph 9 ?is
 ,act to make paym5ts "u ?is p>agraph to
 eligible heal? c>e provid]s locat$ 9   
rural areas1 z def9$ by ! ,secret>y34   
7b7 ,effective date ,! am5dm5ts made by 
?is section %all take effect z if       
includ$ 9 ! enactm5t ( ! ,,c>es ,act    
7,public ,law #aaf-acf74