March 27, 2020
CARES ACT Health Provisions
Below is a summary of the health provisions contained in the CARES Act.
Supporting America’s Health Care System
To address medical supply shortages a number of actions were taken:
- Production of a National Academies report on America’s medical product supply chain security.
- Requires a strategic national stockpile of medical supplies.
- Providing liability protection for manufacturers of masks and respirators.
To mitigate emergency drug shortages a number of actions were taken:
- Requiring the FDA to expediate and prioritize drug application and inspection reviews
- Supplementary reporting requirements by drug manufacturers
To prevent medical device shortages:
- Requiring medical device manufacturers to submit information about a device shortage upon FDA request.
Providing access to health care for COVID-19 patients
- All COVID-19 tests will be covered under private insurance plans with no cost sharing. This includes tests without an EUA by the FDA.
- For COVID-19 tests that have no costs to patients, insurers will need to pay either a cash price that the provider provides, or a rate specified in a contract between the insurer and provider.
- Provides free coverage with no cost-sharing of vaccines that has in a rating of “A” or “B” from the United States Preventive Services Task Force or a recommendation from the Advisory Committee on Immunization Practices (ACIP).
Health Care Provider Support
- Community health centers will receive $1.32 Billion in supplemental funding.
- HRSA grant programs that promote the use of telehealth network and telehealth resources are reauthorized.
- HRSA grant programs that strengthen rural health care services outreach, small health care provider quality improvement programs, and rural health network development are reauthorized.
- Doctors that provide volunteer medical services during the COVID-19 outbreak are given liability protection
- A ready reserve corps is established to ensure we have trained nurses and doctors to combat public health emergencies
- Authorizes the Secretary of HHS to reassign members of the National Health Service Corps to respond to COVID-19
- The removal of the cap on other transaction authority during COVID-19 to allow the Biomedical Advanced Research and Development Authority to partner on research and development with the private sector.
- Allow breakthrough therapy designations for animal drugs to prevent human diseases.
Health Care Workforce
- The reauthorization of Title VII of the Public Health Service Act that pertains to health profession workforce programs.
- The Secretary of HHS is directed to have a coordinated and comprehensive plan for health workforce programs.
- Strengthens the health profession workforce to meet needs of certain populations.
- The reauthorization and update of Title VIII of the PHSA that pertains to the nurse workforce training programs.
- Aligns 42 CFR Part 2 regulations with HIPAA if given initial patient consent.
- Reauthorizes the Healthy Start Program that provides grants to give access to services for women and their families.
- Waives the nutrition requirements of the Older Americans Act meal programs during COVID-19.
- Allows the Secretary of HHS to issue guidance on what can be shared during the COVID-19 public health emergency.
- The Secretary of HHS is directed to improve awareness of safe blood donations.
Finance Committee Health Provisions
- High-deductible health plans along with health savings accounts (HSA) are allowed to cover telehealth services prior to patients reaching the deductible.
- Patients can use funds in HSAs and flexible saving accounts to purchase over-the-counter medical products.
- Medicare telehealth authority is expanded to allow patients to access telehealth from a broader range of providers.
- Medicare telehealth for dialysis patients is expanded by eliminating a requirement that nephrologists must conduct periodic evaluations face-to-face.
- Federally qualified health centers and rural health clinics are now allowed to serve as a distant site for telehealth consultations.
- Telehealth services can be used during the re-certification process of Hospice Care in Medicare.
- Requires HHS to issue guidance encouraging remote patient monitoring and the use of telecommunication systems.
- Allows Physician Assistants and Nurse Practitioners to order Medicare Home Health Services.
- Economic assistance would be provided to health care providers through the Medicare Sequester Relief.
- The Medicare Sequester Relief that had a 2% cut across the board would be temporarily lifted from May 1, 2020 until December 31,2020 leading towards a boost in payments for hospitals, physicians, home health workers, nursing homes, and other care.
- Hospitals would be provided with a Medicare add-on payment of 20% for treating a patient admitted with COVID-19.
- Medicare access to post-acute care would be increased giving acute care hospitals more flexibility.
- The Medicare Durable Medical Equipment Payment scheduled payment reductions are prevented through the COVID-19 emergency period.
- Medicare Part B beneficiaries are allowed to receive a vaccine with no cost-sharing.
- Medicare Part D plans can provide up to a 90-day supply of prescription medicine.
- State Medicaid are allowed to pay for direct caregivers and support professionals to assist disabled individuals.
- Clarifies that uninsured individuals would be able to receive a COVID-19 test with no cost-sharing in any state Medicaid program that offers such a program.
- Clarifies that beneficiaries can receive all tests for COVID-19 in Medicare Part B with no cost-sharing.
- Scheduled payment reductions for Medicare clinical laboratory test payment reductions are delayed to 2021 and delays by one year the upcoming reporting period for labs.
- Medicare Advanced Payments for hospitals are expanded allowing for up to a six-month advanced lump sum or periodic payment. These hospitals would not have to start paying down the loan for four months and would also have at least 1 year to complete repayment without a requirement to pay interest.
- Ensures that sates would be able to receive the Medicaid 6.2% FMAP increase.
Health and Human Services Extenders
- Increases payments for the work components of physician fees.
- Extends funding for beneficiary outreach and counseling for low-income programs through November 30, 2020
- Provides funding to HHS to the National Quality Forum to carry out quality measurement and performance improvement through November 30, 2020.
- Delays the Medicaid Disproportionate Share Hospital Reductions until November 30, 2020.
- The Medicaid Community Mental Health Services that provides coordinated care to patients with substance use disorders and mental health problems would be extended through November 30, 2020.
- Extends the Medicaid Money Follows the person demonstration program that seeks to help patients transition from the nursing home to a home setting through November 30, 2020.
- The Medicaid Spousal Impoverishment protections program that seeks to help the spouse of an individual that qualifies for nursing home care to live instead at home is extended through November 30,2020.
Human Services and other Health Programs
- The Temporary Assistance for Needy Families Program is extended through November 30, 2020
- The Health Professions Opportunity Grants Program is extended through November 30,2020.
- The Sexual Risk Avoidance Education Program is extended through November 30, 2020 at current funding levels.
- The Personal Responsibility Education Program is extended through November 30, 2020 at current funding levels.
Public Health Provisions
- Community health centers, the Teaching Health Centers that operate Graduate Medical Education Programs, and the National Health Service Corps mandatory funding has been extended through November 30, 2020.
- The Special Diabetes program for type I diabetes and the special diabetes program mandatory funding has been extended through November 30, 2020.
- Prevents duplicate appropriations for fiscal year 2020
- The regulatory process for certain nonprescription over-the-counter (OTC) drugs is modified by now allowing the FDA to approve OTC drugs administratively rather than going through a full notice and comment period.
- Clarifies that nothing in the bill applies to drugs that have been previously excluded by the FDA from the OTC drug review.
- Clarifies that a drug that fails to comply with monograph requirements is deemed misbranded.
- Clarifies that in accordance with the Sunscreen Innovation Act sponsors of sunscreen ingredients with pending orders have an option to see review in accordance with the Sunscreen innovation Act.
- The FDA is required to provide an annual update to Congress on the FDA’s progress in evaluating certain pediatric indications for cough and cold monograph drugs for kids under six.
- Technical Corrections to the Food and Drug reauthorization Act of 2017.
- A new FDA user fee for OTC drugs is established to allow the FDA to hire additional staff members.
- Provides $100 billion for the Public Health and Social Services Emergency Fund to provide for healthcare related expenses or lost revenues related to the coronavirus. Eligible entities include Medicare suppliers.
- Provides $45 billion for the Disaster Relief Fund for major disasters declared.
- Authorizes the Secretary of Health and Human Services to waive any legal or regulatory barriers for the provision of telehealth services.
- Provides $3.5 billion for the Child Care and Development Block Grant program to provide child care assistance to first responders.