This Week’s Dose
Senate Republicans deliberate to introduce their proposed coronavirus (COVID-19) reduction invoice however, as of this writing, haven’t resolved variations with the White Home. The Trump Administration gained two federal appeals court docket circumstances associated to short-term, limited-duration insurance policy and site-neutral hospital funds. The Secretary of Well being and Human Providers (HHS) prolonged the COVID-19 public well being emergency.
Negotiations Proceed on Subsequent Aid Invoice.
Rumors proceed to fly as to what can be included within the subsequent COVID-19 reduction and stimulus bundle, and when a deal will finally come collectively. On July 23, a draft topline abstract settlement between Senate Republicans and the White Home surfaced, and included an extra $25 billion for testing, $26 billion for vaccine analysis, distribution and use, $25 billion for the Supplier Aid Fund (PRF), and an extension of the recoupment interval for the Advance and Accelerated Fee Program. The draft additionally prolonged a few of the telehealth flexibilities made accessible through the pandemic via 2021, although the proposal didn’t specify which flexibilities can be prolonged. That is nonetheless very a lot a draft and topic to alter earlier than being formally unveiled. Even then, it is going to be reflective of Republican priorities solely. Count on negotiations on this invoice to proceed via early August as Home Democrats push to have their priorities, as mirrored within the HEROES Act, included.
Lawmakers Eye Telehealth Growth.
Home Methods and Means Committee Republicans launched draft laws to make everlasting a few of the COVID-19 telehealth waivers and flexibilities. The invoice would completely take away restrictions that restrict sufferers’ capability to entry telehealth providers from dwelling, elevate restrictions on the usage of telehealth for Federally Certified Well being Facilities and Rural Well being Clinics, increase the varieties of suppliers who can supply telehealth providers and permit for Medicare reimbursement of audio-only telehealth visits. Senator Ron Wyden (D-OR), Rating Member of the Senate Finance Committee, additionally launched a invoice this week that might increase the power to supply routine medical care and psychological well being providers by way of telehealth along with lifting restrictions across the location of the affected person. The proposals add to a rising listing of bipartisan payments geared toward broadening use of and entry to telehealth providers. There are on-going efforts to incorporate a few of these modifications within the subsequent reduction bundle. Moreover, stakeholders expect the Facilities for Medicare and Medicaid (CMS) to incorporate proposed telehealth coverage modifications within the upcoming Medicare Doctor Charge Schedule replace rule. Extra info on the present telehealth waivers underneath the authority of CMS and people requiring congressional motion is obtainable on this McDermottPlus evaluation.
HELP Committee Chairman Launched Pandemic Preparedness Invoice.
The Making ready for the Subsequent Pandemic Act (S. 4231) was launched by Senate Well being, Training, Labor and Pensions (HELP) Committee Chairman Lamar Alexander (R-TN). The invoice gives $5 billion over the following 10 years to assist the advance and growth of home manufacturing throughout public well being emergencies. It additionally gives $10 billion over the following 10 years to assist states create and preserve their very own stockpiles of provides, and permits the Secretary of HHS to enter into agreements with non-public corporations for the procurement, upkeep and storage of provides for the nationwide stockpile. The invoice comes on the heels of a Request for Info, and a HELP Committee listening to a number of weeks in the past, looking for suggestions on coverage options for acceptable preparation for a future pandemic. Senator Alexander plans to retire after this Congress and can doubtless struggle onerous to get his invoice over the end line this yr, both as a part of the following reduction bundle or as stand-alone laws.
Supplier Aid Fund Updates
HHS introduced that it’s now distributing $10 billion in a second spherical of funding from the PRF to hospitals in areas extremely affected by COVID-19 (“hotspots”). HHS beforehand distributed $12 billion for hotspot hospitals on Might 1. For the second spherical, hospitals should have over 161 COVID-19 admissions between January 1 and June 10, 2020, have not less than one COVID-19 admission per day, or have skilled a disproportionate depth of COVID-19 admissions (exceeding the common ratio of COVID-19 admissions/mattress). Eligible hospitals can count on to obtain $50,000 per eligible admission. HHS will proceed to publicly report the hospitals that obtain funding via the high-impact distributions.
HHS posted a discover of reporting necessities for suppliers who obtained greater than $10,000 from the PRF. The discover has few particulars however does point out that detailed reporting directions can be launched by August 17, 2020, and that the reporting system will go reside on October 1, 2020. As well as, 2020 expenditures have to be reported inside 45 days of the top of calendar yr, and 2021 expenditures have to be reported in a second and remaining report no later than July 31, 2021. Nevertheless, all through the PRF course of, HHS has revised timelines and suppliers ought to proceed to watch the web site for up to date info.
HHS prolonged the PRF software deadline for Medicaid and dental suppliers to August 3, 2020.
CMS introduced that it’ll direct $5 billion from the PRF to nursing properties to rent extra workers, implement an infection management applications, improve testing, and supply further providers, equivalent to communication expertise to assist residents join with their households remotely. Amenities should take part in a Nursing Residence COVID-19 Coaching to obtain the funding. As well as, the company will start requiring all nursing properties in states with a 5% positivity charge or higher to check all workers weekly.
For extra detailed info on the PRF, see our Toolkit.
Federal Appeals Court docket Issued Two Wins for Trump Administration.
The primary choice upheld the Administration’s 2018 rule increasing the usage of short-term, limited-duration insurance coverage (STLDI) plans. Affected person advocates and security web well being plans challenged the rule, arguing that STLDI plans supply inadequate protection and undermine the Inexpensive Care Act (ACA). A federal district court docket held in July 2019 that the Administration was inside its authority when it expanded STLDI plans, and the federal appeals court docket affirmed that ruling. Individually, a federal appeals court docket dominated that CMS acted inside its authority when in 2019 and 2020 it applied site-neutral funds for sure off-campus provider-based hospital departments. This ruling reverses a 2019 choice by a federal district court docket and means the fee coverage stands except the choice is reversed by the US Supreme Court docket. The plaintiff hospitals haven’t introduced plans to attraction the choice. After the decrease court docket ruling in favor of hospitals, CMS acknowledged that it might repay hospitals impacted by the site-neutral fee lower. With the appeals court docket now ruling within the company’s favor, CMS could return to those hospitals to recoup these funds.
The Home Power and Commerce and Training and Laborcommittees held hearings on COVID-19 vaccine growth efforts and obstacles to securely reopening colleges, respectively. The Senate Growing older Committee held a listening to on racial well being disparities amongst seniors.
Senators Roger Wicker (R-MS) and Tina Smith (D-MN) launched the PPP Entry for Rural Hospitals Act, which might permit not-for-profit vital entry and rural hospitals to qualify for the Paycheck Safety Program. An identical invoice was launched within the Home in June.
HHS Secretary Alex Azar prolonged the COVID-19 public well being emergency till October 23, 2020. This extension is critical as many regulatory waivers and flexibilities issued through the pandemic are tied to this deadline.
HHS launched a brand new public knowledge system that may home knowledge from the nation’s hospitals on COVID-19 circumstances, deaths, inpatient and intensive care unit mattress capability, staffing capability and private protecting tools provide.
CMS launched the Early 2020 Effectuated Enrollment Report for the Federally-facilitated Well being Insurance coverage Alternate.
The Well being Sources and Providers Administration will maintain a technical help webinar relating to the PRF fee portal for Medicaid and dental suppliers on July 27, 2020 at 3:00pm ET.
A bunch of 23 Democratic attorneys basic filed swimsuit towards a remaining rule from HHS that eliminates sure non-discrimination protections underneath the ACA, arguing the rule violates the Administrative Process Act in addition to the Equal Safety Clause of the Structure.
The Workplace of Administration and Price range started overview of two along-awaited remaining guidelines relating to doctor self-referraland the federal anti-kickback statute.
The federal response to COVID-19 contains a number of monetary reduction alternatives for healthcare suppliers. Our chart highlights the most important funding streams accessible.
The COVID-19 pandemic will form well being coverage conversations for months and years to return. Our report delves into a number of coverage discussions that intertwine with COVID-19 response efforts and are more likely to dominate the well being coverage agenda for the stability of 2020 and perhaps past.
The most recent episode of the Well being Coverage Breakroom discusses the function of personal fairness within the healthcare business.
Discover all our evaluation associated to COVID-19 on our COVID-19 Useful resource Heart.
Subsequent Week’s Prognosis
Count on to see textual content of the Republican COVID-19 reduction bundle and for negotiations on the invoice to start in earnest as lawmakers work to succeed in an settlement earlier than the scheduled August recess. The Senate Finance Committee will maintain a listening to on the US medical provide chain.