The Headlines
- The Trump Administration continued work on implementing the emergency funding packages enacted by Congress in March.
- The Duke Clinical Research Institute was awarded up to $50 million to set up a national healthcare worker registry and a trial to evaluate the effectiveness of hydroxycholoroquine as a preventive drug for coronavirus.
- Congressman David Price (D-NC-04) will meet with Internal Medicine residents by phone to discuss his work in DC and their work in patient care.
The Details
1. Federal COVID-19 virus updates
As the Administration implements the $2 trillion COVID-19 relief package signed into law last week, staff for Senator Richard Burr (R-NC), Senator Thom Tillis (R-NC) Rep. GK Butterfield (D-NC-01), and Rep. David Price (D-NC-04) remain in regular contact with Duke Health experts on the health system's preparedness plans, testing capabilities, and supply chain needs. Duke Health Government Relations continues to work with the American Hospital Association (AHA), the Association of American Medical Colleges (AAMC), and our congressional delegation in support of robust funding for our health system and medical research enterprise.
On March 28, the Centers for Medicare and Medicaid Services (CMS) expanded the Medicare accelerated payment program, which is intended to provide necessary funds to providers when there is a disruption in claims submission and/or claims processing. The agency will provide accelerated or advance payments during the COVID-19 public health emergency to any Medicare provider/supplier who submits a request to the appropriate Medicare Administrative Contractor (MAC) and meets the required qualifications. The funds will be recouped by CMS after a certain timeframe.
On March 29, Vice President Mike Pence sent a letter to the nation's hospitals requesting that all hospitals report certain data on COVID-19 testing results, bed and ventilator capacity on a daily basis.
On March 30, CMS released a substantial number of new waivers related to the COVID-19 virus. The waivers apply nationwide and are retroactive to March 1, 2020. Among other areas, the waivers include:
- Allowing hospitals to establish additional treatment locations;
- Expanding access to telehealth (including more than 80 additional telehealth services for Medicare patients);
- Removing self-referral barriers to responding to COVID-19;
- Allowing for additional workforce capacity; and
- Eliminating certain administrative requirements.
On March 31, the AHA sent a letter asking HHS and CMS to directly and expediently distribute to rural and urban hospitals and health systems funds from the $100 billion Public Health and Social Services Emergency Fund that were designated for providers in Phase Three of emergency spending (the Coronavirus Aid, Relief, and Economic Security, or CARES, Act). In its request, the AHA urged HHS and CMS to direct MACs to immediately distribute relief funds to every hospital in the U.S. at the rate of $25,000 per bed, and $30,000 per bed for hot spots. The AAMC sent a similar letter to HHS on April 1 on behalf of teaching hospitals and provider practices, emphasizing that funding should be prioritized for major teaching hospitals and physician practices that do not qualify for small business loans and are experiencing lost revenue.
On April 2, President Trump, under the Title I authority of the Defense Production Act, directed the HHS Secretary, in consultation with the Secretary of Homeland Security, to facilitate the supply of materials for General Electric Company, Hill-Rom Holdings Inc., Medtronic Public Limited Company, ResMed Inc., Royal Philips N.V., and Vyaire Medical Inc to begin production of ventilators to meet increased need during the national health emergency.
Also on April 2, House Speaker Nancy Pelosi (D-CA) announced the formation of a bipartisan House committee to oversee the Trump Administration's distribution of more than $2 trillion in coronavirus relief funds over the next several months. The committee aims to streamline the House's efforts to hold the president accountable for implementation of recently-enacted legislation. House Majority Whip Jim Clyburn (D-SC) will lead the panel.
Congress is not scheduled to reconvene until April 20 at the earliest. House Democrats are working to prepare for a fourth phase of economic stimulus policies in response to the COVID-19 emergency. Among other priorities, House Democrats are calling for greater oversight of the medical equipment supply chain within the White House, the elimination of the limit on state and local tax deductions, and the inclusion of stronger OSHA standards to protect at-risk workers in hospitals and other settings. The President is also calling for infrastructure investments in phase four legislation.
While Republican leadership on the Senate Health, Education, Labor, and Pensions (HELP) Committee and House Energy and Commerce Committee have also expressed interest in adding surprise billing to a fourth stimulus bill, Senate Majority Leader Mitch McConnell (R-KY) has said he prefers to hold back to see the impact of the first three stimulus bills before beginning work on another effort.
2. DCRI awarded $50 million to study health of frontline workers
On April 1, the Patient-Centered Outcomes Research Institute (PCORI) Board of Governors approved up to $50 million – to be led by the Duke Clinical Research Institute – to fund a registry and randomized clinical trial of the effectiveness of hydroxychloroquine (HCQ) in preventing COVID-19 infections in U.S. healthcare workers. More information from the DCRI is available here.
3. Rep. David Price visits with the ACLT track
On April 3, Rep. David Price will meet by phone with residents in the Advocacy in Clinical Leadership Track (led by Dr. Dani Zipkin in the Duke University School of Medicine's Department of Medicine, Division of Internal Medicine) about his work in DC and their patient care experience.