The Headlines
- Congress approved a second emergency funding package in response to the COVID-19 virus, and a third stimulus package is already in development.
- CMS eases telehealth rules to respond to the national emergency.
- Implementation of HHS data sharing rules may be delayed due to COVID-19 virus.
The Details
1. Federal COVID-19 virus updates
The President declared a national health emergency on Friday, March 13, authorizing at least $50 billion in emergency support funds and enhancing coordination between federal partners with state and local responses to the COVID-19 virus. Staff for Senator Richard Burr (R-NC) and Rep. GK Butterfield (D-NC-01) are in regular contact with Duke Health experts on the health system's preparedness plans, testing capabilities, and supply chain.
Congress completed work this week on a second coronavirus-related relief package as the Senate passed and the president signed into law the Families First Coronavirus Response Act (H.R. 6201) on March 18, following House passage on March 14. The legislation eliminates patient cost-sharing for COVID-19 testing and related services, establishes an emergency paid leave program, and expands unemployment and nutrition assistance. Moreover, the package provides a temporary increase in the Medicaid Federal Medical Assistance Percentage (FMAP), enabling states to apply for temporary waivers to cover COVID-19 testing for the uninsured through the Medicaid program, and provides $1 billion in testing for the uninsured. The President signed the bill on March 19.
Congressional leaders and the White House have now quickly turned their attention to crafting a third, broad-scale economic relief and health community support legislative package. On March 19, Senate Republicans, consulting with the White House, released a $1 trillion proposal that includes direct financial assistance to individuals and businesses, assistance for airlines and other industries, credit resources for small businesses, and boosts to telehealth and health care resources. Senate Democrats have also released their own proposal of at least $750 billion in relief, including funding for additional medical equipment, expanded paid family and sick leave, direct assistance to individuals, and unemployment insurance. The draft legislation would also suspend the 2 percent Medicare sequester for hospitals and provide an increased add-on payment. The American Hospital Association, American Medical Association, and American Nurses Association are requesting $100 billion in federal assistance before the full force of the public health emergency hits.
While the House is out of session this week and may not return next week, Speaker Nancy Pelosi (D-CA) said that leaders are working by phone to provide input. A timeline for when a finalized third package will be ready for consideration is unclear, but both GOP and Democratic leaders want negotiations to proceed quickly.
2. CMS eases telehealth rules for COVID-19 response
On March 17, the Centers for Medicare and Medicaid Services (CMS) announced several waivers and policy changes to broaden access to telehealth services for Medicare beneficiaries during the COVID-19 public health emergency. Duke Health Government Relations continues to urge members of the NC congressional delegation to address licensure flexibility to allow clinicians to legally provide telehealth services in another state if they have an equivalent license in their home state.
The recent changes include:
- Waivers for geographic site restrictions so that Medicare telehealth services can be delivered in all areas of the country in all locations, including patients' homes.
- Ability for providers to use expanded telehealth authority for new and established patients for diagnosis and treatment of COVID-19, as well as unrelated conditions.
- Permission for providers to use everyday communications technologies, including Skype and smartphones, during the current emergency without violating HIPAA.
As a companion to the Medicare guidance, CMS also released Medicaid telehealth guidance to states. The guidance is intended to help identify options for reimbursement for Medicaid programs, as Medicaid did not require additional permission from the federal government to expand its telehealth coverage.
3. HHS may delay final rules on data sharing
On March 18, a member of CMS's Health IT Advisory Board acknowledged that HHS's sweeping new rules on health information access may be delayed due to the COVID-19 national emergency. The new interoperability rules require compliance work from hospitals, EHR vendors, and insurers to make data, including admissions, discharges and transfers information available.
While some providers have called for the delay due to the need to direct resources to better respond to the ongoing emergency, other industry experts report that patients need access to their personal data now more than ever. A final decision on a potential delay has not been made, but officials say it is under consideration.