Rachel Cohrs
Senate leadership and Trump administration officials announced early Wednesday morning that they reached an agreement on a $2 trillion COVID-19 economic stimulus deal that includes billions of dollars to bolster the healthcare system.
“There is much more money for our hospitals, for our nurses and physicians, for our nursing homes, for our community health centers to do the job they need to do—over $130 billion,” Senate Minority Leader Chuck Schumer (D-N.Y.) said.
Lawmakers put $100 billion in a fund to reimburse providers for COVID-19 related expenses and lost revenue. Providers had sounded the alarm that they needed funding to support operations, expand surge capacity and buy protective equipment in this package.
The American Hospital Association, American Nurses Association and American Medical Association had asked for $100 billion to support operations, while the Federation of American Hospitals had asked for $225 billion. Their efforts were largely successful, as the first draft of Senate Republicans’ legislation did not include any such emergency fund, and a later draft included $75 billion.
Congress also set aside $16 billion for buying medical supplies for the Strategic National Stockpile and $1 billion for purchases under the Defense Production Act, which the Trump administration has resisted using so far despite the calls of hospitals, doctors and governors.
The legislation would suspend the Medicare sequester to boost provider payments. The sequester, which reduced spending for most benefits by 2% starting in 2013, would be suspended from May 1 to December 31, 2020. However, the sequestration would be extended an additional year past its original end date. The suspension was a top priority for hospital and physician groups.
Hospitals would also get a 20% add-on payment for inpatient care for COVID-19 patients.
The deal would extend Medicare and Medicaid programs that were set to expire on May 22 until Nov. 30, setting up a potential vehicle for legislation to ban surprise medical bills and address prescription drug prices after the 2020 election.
Cuts to Medicaid disproportionate-share hospital payments would be delayed through November, though hospitals had aimed for a two-year delay.
Community health centers would get $1.3 billion in emergency funding, but their main funding stream was only extended until Nov. 30. The National Association of Community Health Centers had asked for at least a two-year extension of federal funding.
The bill would also allow more hospitals, including critical access hospitals, to request advance Medicare payments based on prior years’ payments and pay them back over at least 12 months. Premier, which pushed for the change, said the upfront payments could help with hospitals’ cash-flow issues as elective surgeries are delayed.
Other funding provisions would funnel $14 billion to pay medical expenses at the Department of Veterans Affairs, $250 million for increasing hospitals’ surge capacity, $200 million to the Federal Communications Commission to support telehealth efforts, and $45 billion to the Federal Emergency Management Administration.
The bill would require the HHS secretary to develop and implement a new payment rule for federally qualified health centers and rural health clinics that provide telehealth services to eligible patients. Payment rates would be based on payment that currently applies to comparable telehealth services under the physician fee schedule. HHS would also have to issue guidance on using telehealth for home health services.
The package also mandates more reporting requirements about where drugmakers source their materials and allows the FDA to prioritize drug applications that could help address a shortage.
FDA policy would be amended so that laboratory developed tests and diagnostic kits could be used, and covered by private insurance plans, before receiving an emergency use authorization.
Insurers would be required to pay either a negotiated price with a provider or a cash price posted by the provider for the test. Vaccines that meet certain effectiveness standards would also have to be covered with no cost-sharing.
The Senate is expected to vote to pass the measure Wednesday, Senate Majority Leader Mitch McConnell (R-Ky.) said. House Speaker Nancy Pelosi (D-Calif.) said House Democrats are still reviewing the bill, and they are not expected to vote on Wednesday.