Continuing Resolution Passed by Congress:  On October 1, President Trump signed into law a continuing resolution (CR) that extends fiscal year (FY) 2020 federal funding for health programs like SORH and FLEX through December 11, 2020.  Congress will begin negotiations on passing a FY 2021 bill following the November elections. Congress largely avoided adding COVID-related measures onto the stopgap bill, a move which helped prevent a government shutdown. The bill did change the interest rate and terms for Medicare accelerated and advance payment programs and delays the start of $4 billion in FY ’21 Medicaid disproportionate share hospital cuts.

Senate Questions Provider Relief Fund reporting requirements: On October 9, a bipartisan group of senators wrote to HHS regarding the agencies reporting requirements and its impact on rural hospitals. The letter was signed by almost a third of the Senate and expressed concerns that HHS’ September 19 changes to COVID Provider Relief Fund reporting requirements will create uncertainty and financial hardship for hospitals throughout the U.S. but particularly in rural areas. 

Batch of Telehealth Bills Introduced in Congress:  Throughout the early fall, a number of telehealth-related bills were introduced in Congress. These measures coupled with the push to make the telehealth waivers included in the CARES Act permanent, speak to the increased interest in Congress to address telehealth. CMS has already taken steps in making telehealth permanent post-pandemic, proposing in August to make some telehealth provisions permanent for Medicare beneficiaries in rural areas. The recently introduced bills include:

-Rep. Lisa Rochester (D-DE) and Rep. Michael Burgess (R-TX) introduced H.R. 8476, a bill that seeks to provide guidance and strategies to states on effectively integrating telehealth into their Medicaid program and Children’s Health Insurance Program review the impact of telehealth on patient health and encourage better collaboration. A one-pager on the bill can be found here.

-Senator Tina Smith (D-MN) introduced S.4794 a bill that would make an additional $200 million in emergency supplemental appropriations for the COVID-19 Telehealth Program of the Federal Communications Commission for the fiscal year ending September 30, 2020.  Here is the press release on the Smith bill.

-Rep. Roger Williams (R-TX) introduced a bill, H.R.8528, which seeks to extend certain provisions relating to telehealth services.

-Rep. David Schweikert (R-AZ) introduced H.R.8642 to amend title XVIII to provide coverage and payment for certain tests and assistive telehealth consultations during the COVID-19 emergency period. Here is the Schweikert press release.

While it’s unlikely any of these bills will be signed into law before the end of 2020, the increase of telehealth legislation being introduced is the opening salvo to what will be a priority issue next Congress. With a Congressional Budget Office (CBO) estimate on the price of the telehealth waivers in the CARES act expected by spring of 2021, Congress will most likely look to pass the most substantive telehealth reform package in decades.

COVID Funding Package Update:  During September, the House passed a scaled back COVID-relief bill on a near party-line vote of 214-207 (18 Democrats voted no). This was not negotiated and will not move in the Senate. Majority Leader McConnell has not been part of the broader negotiations as the Senate focused on the Supreme Court confirmation process. Despite the Trump Administration and Speaker Pelosi maintaining ongoing negotiations, it appears the earliest a COVID-related funding bill gets signed into law is December, with early 2021 being most likely.