Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


The Team At Hart Health Strategies Would Like To Express Our Sincerest Gratitude To Our Medical Heroes

The team at Hart Health Strategies would like to express our sincerest gratitude to our Medical Heroes, many of whom are subscribers to this newsletter - for your efforts in caring for the ill, finding a treatment and vaccine, working toward new and innovative testing modalities, and helping the most sick find comfort and peace. Your efforts are what will bring us to the other side of this pandemic. More than ever, Thank You!

President Signs $2 Trillion COVID-19 Relief Bill

President Trump has signed into law the largest stimulus package in U.S. history in response to the coronavirus disease (COVID-19) pandemic. The $2 trillion Coronavirus Aid, Relief, and Economic Security (CARES) Act (H.R. 748) was passed by the Senate by a vote of 96-0 on Wednesday. The House of Representatives passed the bipartisan deal by voice vote on Friday. It is the third major bill passed by Congress to address the coronavirus outbreak. The bill was the result of intense negotiations between the Trump administration and congressional leaders. It overcame a few last-minute obstacles, including opposition from several GOP senators to a jobless benefits-related provision and Rep. Thomas Massie’s (R-Ky.) attempt to force a roll call vote on the legislation at a time when the full House was unable to return to D.C.

The CARES Act includes $1,200 one-time payments to Americans making up to $75,000 per year, with an additional $500 given to each household per child. Payments will decrease for those with incomes above $75,000, and will not be provided to those making more than $99,000. The legislation will provide $500 billion in loans and other assistance for corporations, as well as states and cities, impacted by the virus; an additional $377 billion will be provided to small businesses. Eligibility for unemployment insurance will be expanded under the law, and the maximum unemployment benefit will be increased by $600 per week for four months. States will receive $400 million in election assistance for 2020 to expand voting by mail, early voting, and online voter registration. The CARES Act will also allow student loan payments to be deferred for six months. Federal excise taxes for distillers that are currently using their facilities to produce certain hand sanitizers during the outbreak will be temporarily eliminated.

The rescue package largely aims to curtail the economic impact of the crisis, but it includes public health-related provisions as well. The National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) will receive an additional $945 million to combat the virus. It provides for $16 billion to replenish the Strategic National Stockpile (SNS), $1 billion for additional medical supplies through the authority of the Defense Production Act (DPA), and $3.5 billion to expand production and development of COVID-19 related vaccines and tests. It also allocates $500 million for public health modernization. The bill will require the U.S. Department of Health and Human Services (HHS) to report on the nation’s dependence on foreign countries for certain drugs and medical supplies, and mandates that providers of coronavirus diagnostic testing publish their cash price for the tests. Hospitals and health care providers will receive $100 billion in support, though the distribution logistics of such funds are not spelled out in the legislation. CARES temporarily lifts the Medicare sequester, which reduces payments to providers by two percent, from May 1 through December 31, 2020. It also extends funding for several public health programs, including community health centers, through November.

The CARES Act includes several provisions to expand the provision of telehealth, including providing additional flexibility for telehealth services and allowing hospice providers to certify and re-certify patients through telehealth (rather than requiring face-to-face visits). It allows for patients with health savings accounts (HSAs) and high-deductible health plans to use telehealth before they meet their deductibles and expands Medicare payments for certain health centers and clinics using telehealth.

House Speaker Nancy Pelosi (D-Calif.) stated that while the focus of the third phase of COVID-19 legislation was largely on mitigating the economic fallout from the pandemic, phase four would be recovery-focused, specifically addressing job creation and infrastructure building. Democrats are also promising to include measures to strengthen the Occupational Safety and Health Administration’s (OSHA) ability to protect health care providers and improve worker safety. House Democratic leadership introduced the Take Responsibility for Workers and Families Act (H.R. 6379) earlier in the week. The proposal would require that OSHA issue an emergency temporary rule to mandate that health care providers, fire departments, and other emergency responders institute infection-prevention programs. It would provide $30 million to OSHA for enforcement and education actions through fiscal year (FY) 2021. Education and Labor Committee Chairman Bobby Scott (D-Va.) has also called for expanding paid sick and family and medical leave for workers and aid for student borrowers. Additionally, lawmakers are considering the expansion of coverage for health care services beyond testing for those who have contracted the virus. Republicans have signaled that they would support the inclusion of additional aid for rural providers in the fourth stimulus bill; Vice President Mike Pence has also indicated his support for an additional relief measure to support states with more resources to respond to the outbreak.

It remains unclear when lawmakers will begin considering a fourth coronavirus response package. The Senate has adjourned until April 20 amid concerns about the virus, though leadership has said that lawmakers could be reconvened on short notice.

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