H.R. 6144House117th Congress (2021-2023)In Committee

Removing Waste and Protecting Medicare Act

Introduced December 7, 2021

AI-Generated Summary

Updated February 8, 2026 at 8:25 AM UTC

The Removing Waste and Protecting Medicare Act delays the 2022 PAYGO sequester and offsets its cost by reinstating several rules and rescinding unused pandemic funds. It also adjusts Medicare payment reductions and extends support for physicians, while adding reporting changes. The bill impacts the federal budget, Medicare beneficiaries, taxpayers, immigration and SNAP program participants.

Key Provisions

  • Prohibits any sequester in calendar year 2022 after Congress adjourns the first session, effectively delaying the PAYGO sequester.
  • Reinstates the 2019 public‑charge immigration rule and the 2020 SNAP work‑requirement rule as of enactment.
  • Requires taxpayers to provide Social Security numbers for themselves, spouses and qualifying children to claim the child tax credit.
  • Permanently rescinds $53.5 billion of unused coronavirus state‑and‑local fiscal recovery funds and all unobligated capital projects funds under the Social Security Act.
  • Extends the CARES Act Medicare payment reduction deadline to March 31 2022 and sets a 1 % reduction for payments from April 1 to June 30 2022.
  • Extends and adjusts Medicare physician payment support for services in 2021 and 2022, changing the reduction rates to 3.75 % for 2021 and 3.0 % for 2022.
  • Delays the implementation of the radiation oncology model under Medicare to January 1 2023 and pushes private‑payer rate reporting deadlines to December 31 2022 and March 31 2023.
  • Increases the Medicare Improvement Fund allocation for fiscal year 2021 to $102 million.

Legislative Activity

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4 earlier actions
HouseCommittee Latest Action

Referred to the Subcommittee on Immigration and Citizenship.

November 1, 2022

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HouseIntro Referral

Introduced in House

December 7, 2021

HouseIntro Referral

Referred to the Committee on Ways and Means, and in addition to the Committees on the Budget, Energy and Commerce, the Judiciary, Agriculture, and Oversight and Reform, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

December 7, 2021

HouseCommittee

Referred to the Subcommittee on Health.

December 8, 2021

HouseCommittee

Referred to the Subcommittee on Nutrition, Oversight, and Department Operations.

January 4, 2022

HouseCommittee

Referred to the Subcommittee on Immigration and Citizenship.

November 1, 2022

Bill Text

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Introduced in HouseIssued December 7, 2021

I

117th CONGRESS

1st Session

H. R. 6144

IN THE HOUSE OF REPRESENTATIVES

December 7, 2021

Mr. Smith of Missouri (for himself, Mr. Brady, Mrs. Rodgers of Washington, Mr. Burgess, Mr. Wenstrup, Mr. Bucshon, Mr. Carter of Georgia, Mr. Harris, Mr. Van Drew, Mr. Murphy of North Carolina, and Mr. Joyce of Pennsylvania) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committees on the Budget, Energy and Commerce, the Judiciary, Agriculture, and Oversight and Reform, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

A BILL

To delay and offset the sequester to occur in January 2022 under the Statutory Pay-As-You-Go Act of 2010, and for other purposes.

1.

Short title

This Act may be cited as the Removing Waste and Protecting Medicare Act.

2.

PAYGO Act sequester delay

No sequester shall be ordered during calendar year 2022 after Congress adjourns to end the 1st session of the 117th Congress under section 5 of the Statutory Pay-As-You-Go Act of 2010.

3.

Offset of sequester delay

(a)

Reinstatement of public charge rule

The rule relating to inadmissibility on public charge grounds (84 Fed. Reg. 41292, published on August 14, 2019) as in effect on October 15, 2019, shall be considered to be in effect as of the date of enactment of this Act, and the Department of Homeland Security shall reimplement such rule as soon as may be practicable.

(b)

Social security number requirements for child tax credit

(1)

In general

Section 24(e) of the Internal Revenue Code of 1986 is amended to read as follows:

(e)

Social security number requirements

(1)

Taxpayer

No credit shall be allowed under this section to any taxpayer who does not include on the return of tax for the taxable year—

(A)

such individual’s social security number, and

(B)

if the individual is married, the social security number of such individual’s spouse.

(2)

Qualifying children

No credit shall be allowed under this section to a taxpayer with respect to any qualifying child unless the taxpayer includes the social security number of such child on the return of tax for the taxable year.

(3)

Social security number

For purposes of this subsection, the term social security number means a social security number issued to an individual by the Social Security Administration, but only if the social security number is issued—

(A)

to a citizen of the United States or pursuant to subclause (I) (or that portion of subclause (III) that relates to subclause (I)) of section 205(c)(2)(B)(i) of the Social Security Act, and

(B)

before the due date of the return of tax referred to in paragraph (1) or (2), as the case may be.

.

(2)

Conforming amendment

Section 24(h) of such Code is amended by striking paragraph (7).

(3)

Effective date

The amendments made by this subsection shall apply to taxable years beginning after December 31, 2021.

(c)

Reinstatement of SNAP work requirement rule

The rule relating to work requirements under the Supplemental Nutrition Assistance Program (84 Fed. Reg. 66782, published on December 5, 2019) as in effect on April 1, 2020, shall be considered to be in effect as of the date of enactment of this Act, and the Department of Agriculture shall reimplement such rule as soon as may be practicable.

(d)

Rescission of coronavirus State and local fiscal recovery funds

Of the total amount of unobligated amounts available under sections 602 and 603 of title VI of the Social Security Act, $53,500,000,000 are hereby permanently rescinded.

(e)

Rescission of capital projects funds

The total amount of unobligated amounts available under section 604 of title VI of the Social Security Act are hereby permanently rescinded.

4.

Adjustments to Medicare program sequestration reduction with respect to fiscal year 2022

(a)

Extension

(1)

In general

Section 3709(a) of division A of the CARES Act (2 U.S.C. 901a note) is amended by striking December 31, 2021 and inserting March 31, 2022.

(2)

Effective date

The amendments made by paragraph (1) shall take effect as if enacted as part of the CARES Act (Public Law 116–136).

(b)

Adjustment

Section 251A(6) of the Balanced Budget and Emergency Deficit Control Act of 1985 (2 U.S.C. 901a(6)) is amended—

(1)

by redesignating subparagraph (C) as subparagraph (D); and

(2)

by inserting after subparagraph (B) the following:

(C)

Notwithstanding the 2 percent limit specified in subparagraph (A) for payments for the Medicare programs specified in section 256(d), the sequestration order of the President under such subparagraph for fiscal year 2022 shall be applied to such payments so that with respect to the period beginning on April 1, 2022, and ending on June 30, 2022, the payment reduction shall be 1.0 percent.

.

5.

Extension of support for physicians and other professionals in adjusting to Medicare payment changes

(a)

In general

Section 1848 of the Social Security Act (42 U.S.C. 1395w–4) is amended—

(1)

in subsection (c)(2)(B)(iv)(V), by striking 2021 and inserting 2021 or 2022; and

(2)

in subsection (t)—

(A)

in the subsection header, by striking 2021 and inserting 2021 and 2022;

(B)

in paragraph (1)—

(i)

by striking during 2021 and inserting during 2021 and 2022; and

(ii)

by striking for such services furnished on or after January 1, 2021, and before January 1, 2022, by 3.75 percent. and inserting

for—

(A)

such services furnished on or after January 1, 2021, and before January 1, 2022, by 3.75 percent; and

(B)

such services furnished on or after January 1, 2022, and before January 1, 2023, by 3.0 percent.

; and

(C)

in paragraph (2)(C)—

(i)

in the subparagraph header, by striking 2021 and inserting 2021 and 2022;

(ii)

by inserting for services furnished in 2021 or 2022 after under this subsection; and

(iii)

by inserting or 2022, respectively before the period at the end.

(b)

Report

Section 101(c) of division N of the Consolidated Appropriations Act, 2021 (Public Law 116–260) is amended—

(1)

in the first sentence—

(A)

by striking April 1, 2022 and inserting each of April 1, 2022, and April 1, 2023; and

(B)

by striking , as added by subsection (a) and inserting furnished during 2021 or 2022, respectively; and

(2)

in the second sentence—

(A)

by striking Such report and inserting Each such report; and

(B)

by inserting with respect to 2021 or 2022, as applicable after under such section.

6.

Preserving patient access to critical clinical lab services

(a)

Revised phase-In of reductions from private payor rate implementation

Section 1834A(b)(3) of the Social Security Act (42 U.S.C. 1395m–1(b)(3)) is amended—

(1)

in subparagraph (A), by striking through 2024 and inserting through 2025; and

(2)

in subparagraph (B)—

(A)

in clause (ii), by striking for 2021 and inserting for each of 2021 and 2022; and

(B)

in clause (iii), by striking 2022 through 2024 and inserting 2023 through 2025.

(b)

Revised Reporting Period for Reporting of Private Sector Payment Rates for Establishment of Medicare Payment Rates

Section 1834A(a)(1)(B) of the Social Security Act (42 U.S.C. 1395m–1(a)(1)(B)) is amended—

(1)

in clause (i), by striking December 31, 2021 and inserting December 31, 2022; and

(2)

in clause (ii)—

(A)

by striking January 1, 2022 and inserting January 1, 2023; and

(B)

by striking March 31, 2022 and inserting March 31, 2023.

7.

Delay to the implementation of the radiation oncology model under the Medicare program

Section 133 of Division CC of the Consolidated Appropriations Act, 2021 (Public Law 116–260) is amended by striking January 1, 2022 and inserting January 1, 2023.

8.

Medicare Improvement Fund

Section 1898(b)(1) of the Social Security Act (42 U.S.C. 1395iii(b)(1)) is amended by striking fiscal year 2021 and all that follows through the period at the end and inserting fiscal year 2021, $102,000,000..