COVID-19 Federal Responses: Monday, March 16, 2020

COVID-19 Federal Responses: Monday, March 16, 2020

On Friday, March 13, President Trump declared a National Emergency under the Stafford Act for the COVID-19 pandemic. The declaration immediately makes available about $40-$50 billion in federal funds to address the situation.

  • President Trump also asked hospitals to activate their emergency preparedness plans which could result in hospitals delaying elective procedures to make sure they have enough beds to handle an influx of COVID-19 patients.
  • The declaration also waives the Medicare Part A three-day inpatient requirement for Skilled Nursing Facility (SNF) Coverage.
  • CMS can ease parts of the Medicare provider enrollment process such as suspending application fees, criminal background checks, and site visit requirements.
  • Under the emergency declaration, CMS will pay for Medicare telehealth services in situations where a state authorizes telehealth services to be provided across state lines.

President Trump recommended that people avoid social gatherings of more than 10 people for the next 15 days.

Agency Action

The Centers for Medicare and Medicaid Services (CMS) is providing information about the authorities it now has from the Emergency Declaration.

  • CMS created a new CPT code for Coronavirus testing.
  • The Centers for Disease Control and Prevention’s (CDC) dedicated COVID-19 web page is the best place to find information about the situation and resources for what you can do (as a provider or individual) in response to the situation.
  • The CDC continues to recommend social distancing as the most effective means of preventing the spread of COVID-19. The CDC issued a new guidance recommending against public gatherings of more than 50 people for the next eight weeks.
  • The U.S. Food and Drug Administration (FDA) is allowing more labs to provide COVID-19 testing services.
  • The CDC maintains a list of labs that are offering COVID-19 testing.
  • On Sunday, the Federal Reserve announced it would take actions to help stimulate the economy. The Fed will reduce interest rates to almost 0 and will increase its purchase of U.S. Government bonds and mortgage backed securities. 

Congressional Action

On Friday, March 13, the House of Representatives passed legislation to help empower federal agencies to respond to the situation. The House needs to make technical corrections but will soon send the bill to the Senate which is expected to also pass the bill. President Trump announced he will sign the bill into law if it reaches his desk. 

The bill, H.R.6201, Families First Coronavirus Response Act:

  • Requires private sector employers with fewer than 500 workers to offer 12 weeks of job-protected leave under the Family and Medical Leave Act (FMLA) to employees who are quarantining as a result of exposure to or the presentation of symptoms or a confirmed diagnosis. The leave would also apply to employees who are providing care to a family member who is quarantining for those reasons and for employees who must care for their children (under age 18) whose school or daycare closed due to the COVID-19 situation.
    • The first 14 days of leave can be unpaid, however for the following 14 day period of leave, employers would have to pay employees at least two-thirds of their normal pay rate.
    • The Department of Labor (DOL) is authorized to issue exceptions to small businesses with fewer than 50 employees from these requirements. The DOL is also authorized to exclude healthcare providers and emergency responders from these requirements.
  • Separate from FMLA, the bill would require private sector employers with fewer than 500 workers to provide their full-time employees with 80 hours of paid emergency sick leave if they self-quarantine, receive a COVID-19 diagnosis, care for a family member who is quarantined or diagnosed, or have a child whose school or daycare is closed due to the virus. Part-time workers would get paid sick leave that is equivalent to how many hours they typically work over a two-week period.
    • Employers cannot require workers to find a replacement to cover their work while they are on leave. Employers also cannot fire employees who request paid sick leave for situations related to the virus.
  • Provides tax credits to employers to help compensate for the cost of providing emergency sick leave to their employees.
  • Requires all health insurers to make testing free.
    • Requires CMS to designate a modifier code to identify claims where cost sharing should not be charged to the patient.
    • Provides $1 billion to the National Disaster Medical System to reimburse providers for the costs of testing for uninsured individuals. 
  • Provides 100% federal match rate to states that cover tests for uninsured residents under their Medicaid programs. Increases the federal Medicaid match rate by 6.2 percent for states to provide free testing to its Medicaid population.
  • Bolsters funding for public benefit programs such as SNAP benefits and unemployment in anticipation of an increased utilization of those programs.

Congress already passed a supplemental appropriations bill that provides $8.3 billion in new and redirected funding to help federal agencies and state and local governments respond to the virus.

  • The Supplemental Appropriations Bill gives CMS the authority to waive certain Medicare telehealth billing requirements including:
    • Suspending the requirement that telehealth services can only be provided in rural areas.
    • Suspending the originating site requirement which will allow patients to receive telehealth services from their home instead of in a doctor’s office.
    • CMS gave Medicare Advantage and Medicare Part D plans increased flexibilities for telehealth coverage
  • States already have significant flexibility to cover telehealth services under Medicaid. On March 12, CMS issued an FAQ that reinforces these flexibilities.

Congress is already beginning to work on a new piece of legislation to help address the virus and strengthen industries that are most affected.