Provider Relief Fund Improvement Act
This bill extends deadlines, expands the uses of, and makes other changes pertaining to the Provider Relief Fund. The fund reimburses health care providers for increased expenses or lost revenue attributable to COVID-19.
Specifically, the bill extends the deadline by which providers must use any reimbursements they received in 2020 from the fund to the end of the COVID-19 emergency. Providers must use reimbursements received in the first half of 2021 by the end of the emergency or June 30, 2022, whichever is later.
Additionally, the Department of Health and Human Services must distribute the remaining provider relief funds by March 31, 2022. Providers must use these funds by June 30, 2023.
The bill also allows the use of the funds for workplace safety activities, such as hiring additional security personnel.
To provide for improvements in the reimbursement of eligible health 
    care providers through the Provider Relief Fund, and for other 
                               purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Provider Relief Fund Improvement 
Act''.

SEC. 2. COVID-19 PROVIDER RELIEF FUND IMPROVEMENTS.

    (a) Findings.--Congress makes the following findings:
            (1) The most recent distribution made from the Provider 
        Relief Fund to eligible health care providers began in 2020.
            (2) No distributions from the Provider Relief Fund have 
        been made or announced to account for the surge in COVID-19 
        cases caused by the Delta variant.
            (3) That surge, at its peak, saw 7-day averages of about 
        175,000 daily COVID-19 cases, over 100,000 daily hospitalized 
        patients, and almost 2,100 daily deaths in the United States.
            (4) The COVID-19 pandemic, and the Delta variant surge in 
        particular, has taken a heavy toll on our frontline health care 
        heroes, who have been on the front lines of the pandemic for 
        over a full year and a half, with many suffering from trauma, 
        burnout, and increased behavioral health challenges.
            (5) Many hospitals have experienced critical staffing and 
        infrastructure issues due to the surge demands of very ill 
        patients infected with the Delta variant of COVID-19, forcing 
        some to make difficult patient care choices, such as postponing 
        non-emergent surgeries or transferring certain patients, 
        including children and expectant mothers, to other hospitals.
            (6) These challenges are being exacerbated by threats of 
        violence against hospitals and their workforce, so much so that 
        a domestic terror alert has been issued for health care 
        facilities.
            (7) COVID-19-related expenses are skyrocketing, as 
        demonstrated in a recent study showing that hospitals and 
        health systems are paying $24,000,000,000 more per year for 
        qualified clinical labor than they did before the beginning of 
        the COVID-19 pandemic.
            (8) Hospitals and other eligible health care providers need 
        additional funding, and continued access to Provider Relief 
        Fund funding already received, to prevent, prepare for, and 
        respond COVID-19, as intended under the law, and to protect 
        their facilities and workforce.
    (b) Extension of Deadline for Eligible Health Care Providers To Use 
Certain Funds Received From the COVID-19 Provider Relief Fund.--
            (1) Payment received periods 1 and 2.--Effective June 29, 
        2021, the deadline by which an eligible health care provider is 
        required to use reimbursements from the Provider Relief Fund 
        received by such eligible health care provider during a covered 
        payment received period is extended until the end of the COVID-
        19 emergency period.
            (2) Adjustment of reporting time period.--The Secretary 
        shall make appropriate adjustments to the reporting time period 
        (as specified in the Provider Relief Fund guidance) that 
        corresponds to a covered payment received period to reflect the 
        extension of the applicable deadline under paragraph (1).
            (3) Refund of amounts returned to prf.--Not later than 30 
        days after the date of the enactment of this section, the 
        Secretary shall reimburse an eligible health care provider the 
        total amount of payments such eligible health care provider 
        returned to the Secretary by reason of the deadline referred to 
        in paragraph (1).
            (4) Modification of deadline for period 3.--The deadline by 
        which an eligible health care provider is required to use 
        reimbursements from the Provider Relief Fund received by such 
        eligible health care provider during the Payment Received 
        Period referred to in the Provider Relief Fund Guidance as the 
        Period 3 specified in table 1 of such guidance (beginning on 
        January 1, 2021, and ending on June 30, 2021) shall be the 
        later of--
                    (A) the end of the COVID-19 emergency period; or
                    (B) June 30, 2022.
    (c) Requirement To Distribute Remaining COVID-19 Provider Relief 
Funds by March 31, 2022.--
            (1) Requirement for distributions.--
                    (A) In general.--Not later than March 31, 2022, the 
                Secretary shall distribute to eligible health care 
                providers for health care related expenses or lost 
                revenues that are attributable to coronavirus, any 
                remaining funds appropriated to the Provider Relief 
                Fund as of the date of the enactment of this section 
                for reimbursements.
                    (B) Deadline to use funds.--The deadline by which 
                an eligible health care provider is required to use 
                reimbursements received pursuant to subparagraph (A) is 
                June 30, 2023.
            (2) Accounting for health care related expenses or lost 
        revenues in the second, third, and fourth quarters of 2021.--
        Notwithstanding any other provision of law, distributions made 
        under paragraph (1) to eligible health care providers shall 
        account for financial losses and changes in operating expenses 
        occurring in the second, third, or fourth quarter of calendar 
        year 2021, that are attributable to coronavirus.
    (d) Clarification of Use of Funds for Workplace Safety and 
Security.--
            (1) In general.--Funds appropriated to the Provider Relief 
        Fund for eligible health care providers and funds appropriated 
        under section 1150C of the Social Security Act (42 U.S.C. 
        1320b-26) for eligible health care providers (as defined in 
        subsection (e)(1) of such section) before, on or after the date 
        of the enactment of this section may be used to reimburse an 
        eligible health care provider for expenses incurred by the 
        eligible health care provider for measures taken to establish 
        or improve the security of the workplace of such eligible 
        health care provider and improve the safety of personnel of 
        such eligible health care provider present at such workplace.
            (2) Additional clarification of permissible expenses.--
        Expenses for workplace security and safety of personnel of an 
        eligible health care provider described in paragraph (1) shall 
        include the following:
                    (A) Mitigation of risk of violence at the workplace 
                of such eligible health care provider, including the 
                employment of additional security personnel, conduct of 
                risk assessment activities, implementation of response 
                plans, implementation of small-scale changes to 
                physical plant (such as the addition of more secure 
                locks, the use of key card access, altering ingress and 
                egress points, and the installation of additional 
                security cameras), and staff education and training.
                    (B) Measures to prevent violence at the workplace 
                and against personnel of such eligible health care 
                provider, including education and training of personnel 
                on de-escalation protocols and installation of panic 
                buttons and other similar, required equipment.
                    (C) Trauma support for personnel with respect to 
                violence in the workplace, such as counseling and other 
                supports in the event of significant workplace safety 
                episodes, which may include events that do not result 
                in violence but may have significant impacts on 
                personnel and the operations of the eligible health 
                care provider (commonly referred to as near-misses).
    (e) Definitions.--In this section:
            (1) Coronavirus.--The term ``coronavirus'' means severe 
        acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or 
        another coronavirus with pandemic potential. 
            (2) Covered payment received period.--The term ``covered 
        payment received period'' means, with respect to Payment 
        Received Periods referred to in the Provider Relief Fund 
        Guidance--
                    (A) the ``Period 1'' specified in table 1 of such 
                guidance (beginning on April 10, 2020, and ending on 
                June 30, 2020); and
                    (B) the ``Period 2'' specified in such table 
                (beginning on July 1, 2020, and ending on December 31, 
                2020).
            (3) COVID-19 emergency period.--The term ``COVID-19 
        emergency period'' means the emergency period described in 
        section 1135(g)(1)(B) of the Social Security Act (42 U.S.C. 
        1320b-5(g)(1)(B)).
            (4) Eligible health care provider.--The term ``eligible 
        health care provider'' has the meaning given such term in the 
        third proviso of the third paragraph under the heading 
        ``Department of Health and Human Services--Office of the 
        Secretary--Public Health and Social Services Emergency Fund'' 
        in division B of the CARES Act (Public Law 116-136).
            (5) Provider relief fund.--The term ``Provider Relief 
        Fund'' means the funding appropriated to prevent, prepare for, 
        and respond to coronavirus, domestically or internationally, 
        for necessary expenses to reimburse, through grants or other 
        mechanisms, eligible health care providers for health care 
        related expenses or lost revenues that are attributable to 
        coronavirus for which appropriations are made under--
                    (A) the third paragraph under the heading 
                ``Department of Health and Human Services--Office of 
                the Secretary--Public Health and Social Services 
                Emergency Fund'' in division B of the CARES Act (Public 
                Law 116-136);
                    (B) the first paragraph under the heading 
                ``Department of Health and Human Services--Office of 
                the Secretary--Public Health and Social Services 
                Emergency Fund'' in division B of the Paycheck 
                Protection Program and Health Care Enhancement Act 
                (Public Law 116-139); and
                    (C) the third paragraph under the heading 
                ``Department of Health and Human Services--Office of 
                the Secretary--Public Health and Social Services 
                Emergency Fund'' of the Coronavirus Response and Relief 
                Supplemental Appropriations Act, 2021 (division M of 
                the Consolidated Appropriations Act, 2021 (Public Law 
                116-260)).
            (6) Provider relief fund guidance.--The term ``Provider 
        Relief Fund Guidance'' refers to the guidance entitled 
        ``Provider Relief Fund General and Targeted Distribution Post-
        Payment Notice of Reporting Requirements'' issued by the 
        Secretary of Health and Human Services on June 11, 2021.
            (7) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services, acting through the Administrator 
        of the Health Resources and Services Administration.
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Provider Relief Fund Improvement Act
To provide for improvements in the reimbursement of eligible health care providers through the Provider Relief Fund, and for other purposes.
Provider Relief Fund Improvement Act
Rep. Spanberger, Abigail Davis