Senate Introduces Virus Funding Proposal:
On July 27, Senate Majority Leader Mitch McConnell (R-KY) introduced the Health, Economic Assistance, Liability Protection and Schools (HEALS) Act. The HEALS Act is a package of COVID-related funding bills and represents the Senate’s opening offer on passing the next round of emergency funding. Similar to the House proposal passed in May, the Senate package has not drawn bipartisan support. The deadlock will most likely mean a narrow agreement is eventually passed before the Senate leaves town on August 7. Some of the must-fund items which could be included in a narrow package are extending Unemployment Insurance, school funding and additional PPP and hospital funding.
Included in the HEALS Act is an appropriations section which includes more than $118 billion in emergency funding for HHS. Of that amount, $225 million would be allocated for Rural Health Clinics from the Public Health and Social Services Fund; $7.6 billion would go towards community health centers out of the Public Health and Social Services Emergency Fund; and $25 billion would go to hospitals out of the provider relief fund.
The Senate proposal also included language extending Medicare telehealth waivers through December 31, 2021, unless the public health emergency gets extended beyond that date. Telehealth expansion for FQHCs and RHCs would last for five years. The bill would continue the telehealth expansion from the CARES Act for five years beyond the end of the public health emergency, enabling beneficiaries to receive telehealth from those providers – which could act as a distant site – regardless of where beneficiaries are located. The bill would also have a MedPAC report on the impact of telehealth flexibilities on access, quality, and cost by July 1, 2021. HHS would be required to post data on telehealth use during the pandemic and give Congress recommendations on how to handle such coverage.
The Senate proposal also addresses the Medicare advanced and accelerated payments provided to hospitals through CARES. The Senate bill would delay until January 1, 2021, the date when providers would need to start repaying Medicare Part A and B loans. It also would provide additional time until the loans must be repaid in full prior to having to pay interest.
The HEALS Act contains liability reforms for providers and health care facilities. It seeks to create an exclusive cause of action for personal injury caused by the treatment, diagnosis, or care directly affected by COVID-19. The cause of action would apply to all COVID-19 related injuries from last December through October 1, 2024 – including cases already pending. Under the bill, plaintiffs in these cases would need to show their injuries were caused by the defendants’ gross negligence or willful misconduct. Damages would also be limited to economic losses and punitive damages would be prohibited.
FY 2021 Appropriations Moves in the House:
On July 30, the House passed H.R. 7617, which is an omnibus package of Fiscal Year (FY) 2021 appropriation bills including funding for the Department of Health and Human Services. The House passed bill would fund the State Offices of Rural Health grant program at $12,500,000 for FY 2021, which begins October 1, 2020. The bill also funds the Flex Program at $55,609,000 and the Small Rural Hospital Improvement Grant program at $21,942,000 for FY ’21.
The Senate has not begun their appropriation process which means a Continuing Resolution will most likely be passed to extend FY 2020 funding through the November election.