Congress
The House Energy and Commerce (E&C) Committee hopes to include its bill to address unexpected out-of-network (OON) “surprise” medical bills in the next big COVID-19 relief bill.
- The E&C bill, which was introduced in the Senate by the Senate Health, Education, Labor and Pensions Committee, is one of three major proposals to address this issue. The House Ways and Means (W&M) Committee and the House Education and Labor (E&L) Committee both have proposals as well.
- Congress was originally trying to decide on a bill that can advance in time to include surprise billing legislation in a package of expiring temporary Medicare and Medicaid provisions that needed to be extended by May 22. The CARES Act extended those provisions, which means Congress needs to find a new legislative vehicle for surprise billing legislation.
Speaker of the House Nancy Pelosi (D-CA) is already working on a “Phase IV” bill. Her goal is to have a bill ready when Congress returns to the Capitol on April 20.
The Joint Committee on Taxation (JCT) estimates the CARES Act “recovery rebates” will cost the Government $591 billion. The recovery rebates are the $1,200 checks to individuals ($2,400 to families) that are adjusted based on income and number of children.
Speaker Pelosi is in favor of holding a vote by mail election in November instead of requiring voters to vote in person at their polling location unless they receive an absentee ballot.
White House and Federal Agencies
The Centers for Medicare and Medicaid Services (CMS) issued an interim final rule (IRF) that expands many Medicare regulatory flexibilities. It also codifies certain waivers CMS previously announced.
- The IRF changes certain Medicare billing requirements. Of particular note, Medicare telehealth claims should not use the telehealth POS 02. Telehealth claims should use the POS as if the service was provided face-to-face and should use modifier 95 to indicate it was a telehealth service. The purpose of this change is to provide a higher facility payment than telehealth claims with POS 02 would pay.
- CMS also added 80 services to its covered telehealth services list.
- The IRF also adds new telehealth codes that can be furnished by telephone (without a visual connection).
- CMS will also allow services that require direct supervision to occur over real-time, interactive telecommunications technology.
- CMS will pay hospitals for inpatient services that are provided outside of the hospital (e.g. ambulatory surgical centers or hotels). This is intended to reserve hospital capacity for COVID-19 patients.
- It also gives ambulance providers the discretion to transport patients to non-hospital settings that may be more appropriate for the patient.
CMS’ announcement of the interim final rule includes many important details, but not all were included in its factsheets and FAQs on its wavier actions. CMS’ fact sheets include:
- Summary of COVID-19 Emergency Declaration Waivers & Flexibilities for Health Care Providers (PDF)
- Blanket waivers of Section 1877(g) of the Social Security Act
- Provider Burden Relief Frequently Asked Questions (PDF)
- Provider Enrollment Relief Frequently Asked Questions (PDF)
- Physicians and Other Practitioners (PDF)
- Ambulances (PDF)
- Hospitals (PDF)
- Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) (PDF)
Read the interim final rule for more details.
The White House today announced the start date for the newly created Paycheck Protection Loan Program. This program was authorized under the recently passed Coronavirus Aid, Relief, and Economic Security (CARES) Act. The Paycheck Protection Loan Assistance program expands and modifies an existing Small Business Administration (SBA) Loan program. The purpose is to help ANY business that is struggling financially due to the COVID-19 pandemic.
- Treasury Department’s CARES Act Home Page
- Top-line overview of the program
- More information for lenders
- More information for borrowers
- Application for borrowers
- The CARES Act assists eligible businesses looking for payroll support to keep Americans working.
The U.S. Food and Drug Administration issued a new final guidance that updates what qualifies as personal protective equipment (PPE) such as surgical gowns, gloves and masks. The purpose of the guidance is to help manufacturers (either traditional or non-traditional manufacturers) produce more equipment.
The FDA also issued guidance about sterilizers, disinfectant devices and air purifiers.
Both guidance documents apply for the duration of the public health emergency.
