COVID-19 Federal Responses: Thursday, March 19, 2020

COVID-19 Federal Responses: Thursday, March 19, 2020


Senate Majority Leader released the text of the Phase III stimulus legislation. The bill provides more than $1 trillion to help stimulate the economy. This is very much a first draft of Phase III. Senate Minority Leader Chuck Schumer has his own list of priorities. Also, some Senators have disagreements about what is in the package. In summary:

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Economic Stimulus

  • The bill indeed includes loans to small businesses.
  • It authorizes the Treasury Department to make payments to American taxpayers equal to $1,200 individual or $2,400 joint tax filers that will be reduced by up to five dollars for every $100 of the taxpayer’s adjusted gross income that exceeds $75,000 (individual) or $150,000 (joint) filers based on 2018 tax filings.
  • Under this formula, individuals who earn more than $99,000 will not receive a check.
  • The payment also includes $500 for every child.
  • Delays the deadline for filing individual tax returns from April 15th to July 15th.
  • Delays the employer portion of the payroll tax. Employers can pay their 2020 portion in two installments of 50% each. One would be due by the end of 2021 and the other is due by the end of 2022.
  • The bill provides the Secretary of the Treasury with the authority to determine when the payments are made.
  • The bill temporarily waives the penalty for early withdrawals from retirement accounts up to $100,000.
  • Provides over $208 billion for loans and loan guarantees to business from “distressed” sectors of the economy.
    • $50 billion is reserved for airlines.
    • $8 billion of which can be used for air cargo carriers.
    • $150 billion is available for other types of businesses.
    • Provides federal loans and loan guarantees to the airline industry. The bill authorizes the Department of Transportation to require airlines to maintain scheduled air transportation service as a condition of the financial assistance.
  • Changes the limit an employer must pay for FMLA from $200 per day with a $10,000 aggregate cap:
    • Raises limit to $511 per day with a $5,110 aggregate cap if the employee is self-quarantining due to COVID-19 diagnoses or potential exposure to someone who tested positive.
    • Maintains $200 per day and decreases the aggregate limit to $2,000 for employees who are caregivers for someone who is in self-isolation or if they are home caring for children because their school was canceled.

Healthcare System and Medicare

  • Activates the Strategic National Stockpile of medical equipment and transfers it to HHS and DHS.
  • Requires a report from the National Academies on U.S. Medical Product Supply Chain Security.
  • Authorizes and expedites the process for approving lab developed tests for COVID-19.
  • Requires ACA health plans to:
    • Cover – not charge cost-sharing and not impose prior authorization requirements on COVID-19 testing.
    • Reimburse diagnostic testing services to test for COVID-19 at the provider’s list price if the service is out of network. Providers must publicize that price on the internet.
  • Provides $1.3 billion to Community Health Centers.
  • Suspends the two percent sequestration payment cuts for Medicare services for the remainder of 2020 beginning on May 1st. However, it extends the 2029 expiration of the sequestration payments for an additional year, until 2030.
  • Allows Rural Health Clinics (RHC) and Federally Qualified Health Centers (FQHC) to serve as a distant site for Medicare telehealth visits.
  • Provides a temporary waiver of the Medicare requirement for a face-to-face interaction between home dialysis patients and a physician.
  • Increases diagnostic related grouping (DRG) payments to hospitals for COVID-19-related services by 15% for the duration of the emergency.

Two Members of the House of Representatives tested positive for the Coronavirus and many others are self-quarantining due to exposure to those two Members or to others who tested positive for the virus.

  • Rep. Mario Diaz-Balart (R-FL) and Rep. Ben McAdams (D-UT) both tested positive.
  • In the Senate, Senator Cory Gardner (R-CO) is self-quarantining. There is more self-quarantining occurring on the House side with House Majority Whip Steve Scalise (R-LA), Rep Jason Crow (D-CO), Rep. Drew Ferguson (R-GA), Rep. Ann Wagner (R-MS) and Rep. Stephanie Murphy (D-FL) all self-isolating due to contact with someone who was diagnosed with COVID-19.

Some House Members are asking for a change in the House rules to allow remote voting on legislation. The House currently requires physical presence in the House Chamber for voting.

Those Members are concerned that having 435 Members in the Chamber is not consistent with guidelines from the Centers for Disease Control (CDC) and other public health officials to avoid large gatherings. Concerned Members also cite the news that two Members tested positive and others are self-isolating as well as the noted risks of travelling back and forth between their districts and the Capitol.

  • House Leadership is entertaining the idea to the point where it is gauging interest from both House Democrats and Republicans. However, there are questions about how remote voting would disrupt Floor procedures. The work-arounds Congress is proposing also could face legal challenges which would jeopardize any legislation passed by Congress using the remote voting system.
  • A solution could be holding votes open for longer and limiting the number of Members who are allowed into the Chamber to vote to a few at a time.

White House and Federal Agencies

The Centers for Medicare and Medicaid Services (CMS) is asking hospitals to indefinitely postpone all elective procedures. CMS is also urging a similar postponement for all non-essential dental procedures. The purpose of this guidance is to preserve supplies of personal protective equipment (PPE) and to maintain an availability of hospital beds.

CMS is encouraging catastrophic health plans to offer COVID-19 related coverage. Those plans normally are not allowed to offer this type of coverage, but CMS will issue an exception during this public health emergency.

President Trump signed an Executive Order authorizing HHS to take control of the U.S. medical supply chain if the Coronavirus situation worsens.

The U.S. State Department issued a Global Level 4- Do Not Travel warning. This is the highest-level travel advisory that the State Department issues.

  • According to the warning: “The Department of State advises U.S. citizens to avoid all international travel due to the global impact of COVID-19. In countries where commercial departure options remain available, U.S. citizens who live in the United States should arrange for immediate return to the United States, unless they are prepared to remain abroad for an indefinite period. U.S. citizens who live abroad should avoid all international travel.”
  • The Transportation Safety Administration (TSA) reported that airport travel declined to below 1 million.

CMS updated its FAQ to states on available flexibilities for their Medicaid programs.

The FDA is suspending routine facility inspections.