Help for Medical Providers Under the CARES Act

The CARES Act, which was signed into law on March 27, 2020, provides a number of expanded sources of funding and some relaxed rules to help medical providers operate during the ongoing public health emergency.  The details of implementation of many of these provisions are still being hammered out, but here is a brief outline of some of the key points relating to medical providers:

  1. Group health plans and health insurance issuers will be required to cover (without cost-sharing) “any qualifying coronavirus preventative service”, which means an item, service or immunization to prevent or mitigate COVID-19.
  2. $1.32 billion has been appropriated for awards relating to detection of SARS-CoV-2 and the prevention, diagnosis and treatment of COVID-19.
  3. $100 billion has been appropriated to “prevent, prepare for, and respond to the coronavirus,” through grants or other mechanisms, to “eligible healthcare providers for healthcare related expense or lost revenues that are attributable to coronavirus”.
  4. $29 million per fiscal year 2021-2025 has been appropriated for telehealth network grants and telehealth resource center grants.
  5. Volunteer health care providers shall not be liable for any acts or omissions in the provision of health care services during and in response to the public health emergency which are within the scope of the license, certificate or registration of the volunteer and provided under the reasonable belief that the patient required the services, as long as the volunteer was not engaging in willful misconduct or gross negligence and was not under the influence of alcohol or intoxicating drugs.
  6. Within 180 days of the CARES Act being enacted, the Director of the Department of Health and Human Services will issue guidance on sharing patients’ protected health information during the public health emergency, including compliance with HIPAA and other laws.
  7. $125.5 million per fiscal year 2021-2025 has been appropriated for grants under the Healthy Start Initiative relating to infant health.
  8. $23.711 million per fiscal year 2021-2025 has been appropriated for grants for designated health professions schools, and additional funds have been appropriated for scholarships and financial aid for health professions students.
  9. Payment from the federal government shall be provided for certain telehealth services.
  10. There shall be a temporary waiver of the requirement for face-to-face visits between home dialysis patients and physicians.
  11. The Secretary of Health and Human Services shall encourage the use of telecommunications systems for home health services.
  12. Payments under Medicare can be made for home healthcare services certified by nurse practitioners, clinical nurse specialists, and physician assistants, rather than just physicians.
  13. The annual 2% Medicare sequester of payments to hospitals, physicians, and other providers is suspended for the rest of 2020.
  14. For Medicare patients, the amount that hospitals receive for treating COVID-19 patients shall be increased by 20%.
  15. For Medicare patients, certain rules have been relaxed regarding rehabilitation facilities and long term care hospitals.
  16. Medicare will cover the administration of a COVID-19 vaccine (when one exists) under Part B without any cost-sharing.
  17. The Medicare Hospital Accelerated Payment Program has been expanded during the public health emergency to include some additional types of hospitals.
  18. Several Medicaid programs and other health programs have been extended.
  19. Additional funding has been appropriated for Community Health Centers and the National Health Service Corps.
  20. There are provisions relating to loans to small business that are available to qualifying medical providers. These provisions are discussed in more detail in other TALG articles.

Additionally, as to testing for COVID-19 infections:

  1. As to the price of testing, if a health plan or insurer had a negotiated price for testing prior to the public health emergency, the price shall remain the same throughout the emergency.
  2. If no price for testing was negotiated prior to the emergency, the health insurance plan or provider shall pay the cash price publicly listed on the provider’s website or a lower negotiated price.
  3. Providers of testing are required to list the cash prices for testing on the provider’s public internet website.
  4. There are civil monetary penalties for failure to comply with these requirements.

There are many more aspects to the CARES ACT that TALG will analyze in detail in the coming days.  Our Team at TALG is standing by to assist.