{"format":1,"id":"117-hr-1868","congress":117,"number":"H.R. 1868","kind":"bill","group":"bills","title":"To prevent across-the-board direct spending cuts, and for other purposes.","title_source":"Display Title","official_title":"To prevent across-the-board direct spending cuts, and for other purposes.","titles":[{"type":"Official Title as Introduced","title":"To prevent across-the-board direct spending cuts, and for other purposes."},{"type":"Display Title","title":"To prevent across-the-board direct spending cuts, and for other purposes."}],"outcome":"became_law","law_number":"Public Law 117-7","introduced":"2021-03-12","chambers":{"house":{"status":"roll_call","date":"2021-04-13","vote":{"id":"117-2021-h98","question":"On Motion to Suspend the Rules and Concur in the Senate Amendment","title":"To prevent across-the-board direct spending cuts, and for other purposes","result":"Passed","yea":384,"nay":38,"present":0,"not_voting":6,"source":"https://clerk.house.gov/evs/2021/roll098.xml"}},"senate":{"status":"roll_call","date":"2021-03-25","vote":{"id":"117-2021-s142","question":"On Passage of the Bill","title":"H.R. 1868, As Amended","result":"Bill Passed","yea":90,"nay":2,"present":0,"not_voting":8,"source":"https://www.senate.gov/legislative/LIS/roll_call_votes/vote1171/vote_117_1_00142.xml"}}},"president":{"status":"signed","date":"2021-04-14"},"vice_president_tie_breaker":null,"latest_action":{"text":"Became Public Law No: 117-7.","date":"2021-04-14"},"nominees":null,"amendments":[{"number":"S.Amdt. 1411","sponsor":"Sen. Scott, Rick [R-FL]","purpose":"To improve the bill.","result":"Amendment Rejected","date":"2021-03-25","yea":47,"nay":50,"present":0,"not_voting":3,"source":"https://www.senate.gov/legislative/LIS/roll_call_votes/vote1171/vote_117_1_00141.xml"}],"other_votes":[{"chamber":"house","date":"2021-03-19","question":"On Motion to Recommit","title":"To prevent across-the-board direct spending cuts, and for other purposes","result":"Failed","yea":202,"nay":216,"present":0,"not_voting":11,"kind":"procedural","source":"https://clerk.house.gov/evs/2021/roll095.xml"},{"chamber":"house","date":"2021-03-19","question":"On Passage","title":"To prevent across-the-board direct spending cuts, and for other purposes","result":"Passed","yea":246,"nay":175,"present":0,"not_voting":8,"kind":"final_candidate","source":"https://clerk.house.gov/evs/2021/roll096.xml"},{"chamber":"senate","date":"2021-03-25","question":"On the Amendment","title":"Scott (FL) Amdt. No. 1411","result":"Amendment Rejected","yea":47,"nay":50,"present":0,"not_voting":3,"kind":"amendment","source":"https://www.senate.gov/legislative/LIS/roll_call_votes/vote1171/vote_117_1_00141.xml"}],"crs_summary":{"date":"2021-04-14","stage":"Public Law","blocks":[{"k":"p","t":"This bill makes several budgetary and technical changes to provisions under Medicare and Medicaid."},{"k":"p","t":"The bill continues to exempt Medicare from sequestration until December 31, 2021. (Sequestration is a process of automatic, usually across-the-board spending reductions under which budgetary resources are permanently cancelled to enforce specific budget policy goals.)"},{"k":"p","t":"The bill also specifically"},{"k":"li","t":"applies certain modified payment limits to rural health clinics that temporarily enrolled in Medicare during the public health emergency relating to COVID-19 (i.e., coronavirus disease 2019) or that applied to enroll by December 31, 2020; and","d":1},{"k":"li","t":"preserves higher Medicaid disproportionate-share hospital payments for public hospitals in California under forthcoming payment methodology changes.","d":1}],"words":105},"summary":{"main_subject":{"text":"Extends the temporary suspension of Medicare sequestration through December 31, 2021, and makes technical changes to Medicare rural health clinic payment limits and Medicaid disproportionate share hospital payment rules.","cites":[{"label":"Sec. 1","href":"https://www.congress.gov/bill/117th-congress/house-bill/1868/text/enr#H978962FAFAE841CCB602ED466A9774A8:~:text=1.%20Extension%20of%20temporary%20suspension%20of%20medicare"},{"label":"Sec. 2","href":"https://www.congress.gov/bill/117th-congress/house-bill/1868/text/enr#H6481920A05F44F148769BF0BCEB20BC3:~:text=2.%20Technical%20corrections"}]},"core_areas":["Medicare sequestration suspension","Medicare rural health clinic payment limits","Medicaid disproportionate share hospital payments"],"what_it_does":[{"text":"Amends section 3709(a) of division A of the CARES Act to change the end date of the Medicare sequestration suspension from March 31, 2021 to December 31, 2021, effective as if enacted as part of the CARES Act.","cite":{"label":"Sec. 1","href":"https://www.congress.gov/bill/117th-congress/house-bill/1868/text/enr#H978962FAFAE841CCB602ED466A9774A8:~:text=1.%20Extension%20of%20temporary%20suspension%20of%20medicare"}},{"text":"Changes the payment reduction percentages in section 251A(6)(C) of the Balanced Budget and Emergency Deficit Control Act of 1985: 2.0 percent for the first 5 1/2 months, 4.0 percent for the following 6-month period, and 0.0 percent for the remaining 1/2 month.","cite":{"label":"Sec. 1","href":"https://www.congress.gov/bill/117th-congress/house-bill/1868/text/enr#H978962FAFAE841CCB602ED466A9774A8:~:text=1.%20Extension%20of%20temporary%20suspension%20of%20medicare"}},{"text":"Amends section 1833(f)(3) of the Social Security Act to set the payment limit for a rural health clinic that had a per visit payment amount established for 2020 by reference to that 2020 amount, increased by the MEI percentage increase for primary care services, or the limit in paragraph (2)(A).","cite":{"label":"Sec. 2","href":"https://www.congress.gov/bill/117th-congress/house-bill/1868/text/enr#H6481920A05F44F148769BF0BCEB20BC3:~:text=2.%20Technical%20corrections"}},{"text":"Sets the payment limit for a rural health clinic that had no per visit payment amount established for 2020 by reference to its per visit payment amount for 2021 or the limit in paragraph (2)(A).","cite":{"label":"Sec. 2","href":"https://www.congress.gov/bill/117th-congress/house-bill/1868/text/enr#H6481920A05F44F148769BF0BCEB20BC3:~:text=2.%20Technical%20corrections"}},{"text":"Rewrites the description of the rural health clinics covered, to include clinics in a hospital with less than 50 beds as of December 31, 2020 that were enrolled, or applied or requested temporary enrollment, by December 31, 2020; effective as if included in the Consolidated Appropriations Act, 2021.","cite":{"label":"Sec. 2","href":"https://www.congress.gov/bill/117th-congress/house-bill/1868/text/enr#H6481920A05F44F148769BF0BCEB20BC3:~:text=2.%20Technical%20corrections"}},{"text":"Adds a paragraph to section 1923(g) of the Social Security Act that continues to apply the earlier version of paragraph (2) in deciding whether certain hospital payment adjustments in States referenced in section 4721(e) of the Balanced Budget Act of 1997 are consistent with subsection (c).","cite":{"label":"Sec. 2","href":"https://www.congress.gov/bill/117th-congress/house-bill/1868/text/enr#H6481920A05F44F148769BF0BCEB20BC3:~:text=2.%20Technical%20corrections"}}],"unexpected":[{"category":"narrow_beneficiary","items":[{"cite":{"label":"Sec. 2","href":"https://www.congress.gov/bill/117th-congress/house-bill/1868/text/enr#H6481920A05F44F148769BF0BCEB20BC3:~:text=2.%20Technical%20corrections"},"heading":"Technical corrections","effect":"Continues to apply an earlier version of the Medicaid disproportionate share hospital rule when deciding whether payment adjustments are consistent with subsection (c), for hospitals in States referenced in section 4721(e) of the Balanced Budget Act of 1997.","amount":null,"quote":"a payment adjustment for a hospital in a State referenced in section 4721(e) of the Balanced Budget Act of 1997 during a State fiscal year"}]}],"version":{"type":"Enrolled Bill","date":null,"rule":"enrolled","href":"https://www.congress.gov/bill/117th-congress/house-bill/1868/text/enr"},"current":true,"model":"claude-sonnet-5-5","approved":"2026-10-15","approved_by":"checks"},"changes":{"first":{"chamber":"House","type":"Engrossed in House","date":"2021-03-19","href":"https://www.congress.gov/bill/117th-congress/house-bill/1868/text/eh"},"final":{"type":"Enrolled Bill","date":null,"href":"https://www.congress.gov/bill/117th-congress/house-bill/1868/text/enr"},"kept":0.3,"replaced":false,"removed":[{"cite":{"label":"Sec. 1","href":"https://www.congress.gov/bill/117th-congress/house-bill/1868/text/eh#H2B0155984881421B9B5CED3864A8E993"},"heading":"Preventing PAYGO sequestration","effect":"Provides that the budgetary effects of this Act and the American Rescue Plan Act of 2021 (Public Law 117–2) are not counted on either Statutory PAYGO scorecard, and that this Act's effects are not counted on any Senate PAYGO scorecard.","partly":null,"part":null}],"added":[{"cite":{"label":"Sec. 1","href":"https://www.congress.gov/bill/117th-congress/house-bill/1868/text/enr#H978962FAFAE841CCB602ED466A9774A8:~:text=1.%20Extension%20of%20temporary%20suspension%20of%20medicare"},"heading":"Extension of temporary suspension of medicare sequestration","effect":"Extends the CARES Act suspension of medicare sequestration from March 31, 2021 to December 31, 2021, effective as if enacted in the CARES Act, and changes the medicare payment reduction percentages and periods in section 251A(6)(C) of the Balanced Budget and Emergency Deficit Control Act of 1985.","partly":{"label":"Sec. 2","href":"https://www.congress.gov/bill/117th-congress/house-bill/1868/text/eh#H0C6FED91A610460FAFEF543A249FB2F2"},"part":"Amends section 251A(6)(C) of the Balanced Budget and Emergency Deficit Control Act of 1985 to set a 2.0 percent medicare payment reduction for the first 5 1/2 months, 4.0 percent for the next 6 months, and 0.0 percent for the remaining 1/2 month."}],"added_count":1,"approved":"2026-10-15","approved_by":"checks"},"sources":{"congress_gov":"https://www.congress.gov/bill/117th-congress/house-bill/1868","text":"https://www.congress.gov/bill/117th-congress/house-bill/1868/text"},"card":{"image":"card/item/117-hr-1868.png","v":"87c78a3afc98","alt":"Votes on Record. H.R. 1868, 117th Congress: To prevent across-the-board direct spending cuts, and for other purposes. House: 384 Yea, 38 Nay. Senate: 90 Yea, 2 Nay. Outcome: Became law, 14 Apr 2021."}}