COVID-19: Federal Update (5/8)

House lawmakers are currently scheduled to return to Washington next week, yet the lack of a “CARES 2.0” proposal from House Democratic leadership suggests that this date could get pushed to the following week of May 18. House Democrats are still tying up loose ends on their forthcoming stimulus proposal and have cooled on their original timeline of producing legislative text by the end of this week. Intel from senior Democratic leadership sources suggests that the House majority could have a section-by-section outline of the package as soon as this weekend, with legislative text released toward the middle to late part of next week. Meanwhile, the two parties are currently far apart on the next round of relief efforts and will need to navigate deep policy schisms over the size and scope of the next package before a concrete timeline emerges.

COVID-19: What We’re Hearing

  • COVID 4.0. As the COVID-19 pandemic ensues, lawmakers are continuing to mull over policy items for another round of economic stimulus relief. TRP has compiled a list and summaries of the major priorities that have been discussed.
  • Supply Chain. Speaker Nancy Pelosi (D-CA) stated that the next round of COVID-19 relief next will include Energy & Commerce Health Subcommittee Chair Anna Eshoo’s (D-CA) bill that calls for an expert committee to assess the U.S. drug supply chain and recommend ways to reduce dependence on foreign drug manufacturing. Click here to read TRP’s comprehensive analysis of the federal actions taken to address pharmaceutical supply chain concerns.
  • PPP. Lawmakers on both sides of the aisle are mulling potential policy options that would bolster and reform the Paycheck Protection Program (PPP). Additional funding to shore up lending, as well as easing loan forgiveness requirements, are two key areas that currently enjoy bipartisan support.
  • State and Local Governments. GOP lawmakers have indicated that they support promoting flexibility for state and local governments to use CARES Act funding to replace lost revenue, but are lukewarm on providing new funding beyond the $150 billion fund established in the “Phase III” bill. A bipartisan group of Senators introduced a measure that would give states these flexibilities to offset losses.
  • House Ways and Means Chairman Richard Neal (D-MA) stated recently that House Democrats will soon detail plans to provide additional financial assistance to state and local governments. In addition to a set amount of money that could reach up to $800 billion, the plan will likely include provisions that seek to boost private activity bonds.
  • A bipartisan group of House lawmakers have introduced legislation that would allocate $250 billion in direct funding for local governments of all sizes. The measure would also allow governments to offset lost revenue due to the pandemic.
  • Postal Service. House Majority Leader Steny Hoyer (D-MD) indicated that Democrats are coalescing behind Oversight and Reform Chairwoman Carolyn Maloney’s (D-NY) proposal that would boost USPS by $25 billion. However, he recognized that the President’s current attitude toward Amazon could impede progress on that front. 
  • Liability. Leader McConnell emphasized that he willinsist” Congress limit the liabilities of health care workers, business owners, and employees from lawsuits pertaining to the COVID-19 outbreak, making it contingent in order for the Senate to consider any additional relief legislation. Democrats have been dismissive of this proposal, arguing that it would water down federal consumer protection efforts.
  • Senate Judiciary Chairman Lindsey Graham (R-SC) stated that he expects to hold a hearing on liability in the era of COVID-19 next week.
  • Payroll Tax. During a virtual town hall meeting over the weekend, President Donald Trump stated that he will not support another COVID-19 relief bill without a provision that provides payroll tax relief.
  • Infrastructure. President Trump reiterated his call for robust infrastructure provisions in the Phase IV bill during Sunday’s town hall. In a recent tweet, he specifically highlighted surface transportation and broadband infrastructure as areas he’d like to see addressed.
  • Despite support for infrastructure from Speaker Pelosi and President Trump, it remains to be seen whether both parties can strike an agreement on big-ticket legislative items such as infrastructure. Congressional Republicans have remained opposed to tacking on non-COVID related items to future relief packages.
  • Merger Ban. Several Democratic lawmakers have offered support of a plan sponsored by Sen. Elizabeth Warren (D-MA) and Alexandria Ocasio-Cortez (D-NY) that would place a ban on company mergers during the outbreak. However, Democratic leadership appears lukewarm on this suggestion as of now, and it’s unlikely to gain traction in the GOP-controlled Senate.
  • Surprise Billing. Energy and Commerce Ranking Member Greg Walden (R-OR) expects another push for action on surprise billing in the next round of relief. During the Phase III negotiations, Chairman Frank Pallone (D-NJ) and Senate Health, Education, Labor, and Pensions (HELP) Chairman Lamar Alexander (R-TN) were actively trying to tack their surprise billing legislation onto the package.
  • Provider Funding. On Apr. 22, the Department of Health and Human Services (HHS) announced new distributions from the $100 billion Provider Relief Fund created by the CARES Act (H.R. 748). On May 1, HHS began distributing $12 billion to 395 hospitals who provided inpatient care for 100 or more COVID-19 patients through April 10, 2020. HHS also provided additional detail on the $10 billion rural health care provider distribution. TRP’s comprehensive analysis of these distributions can be read here.
  • The first round of funding included $30 billion for Medicare hospitals and providers. 
  • The second round of funding includes an additional $20 billion for Medicare providers nationwide, $10 billion for hospitals in highly impacted areas, $10 billion for rural providers, and $400 million for the Indian Health Service. It also establishes a program to fund COVID-19 care for the uninsured.
  • HHS has published a list of frequently asked questions pertaining to the $50 billion general allocation of the COVID-19 provider relief fund. In addition, providers receiving funds must agree to a set of terms and conditions, including reporting and documentation requirements, charging only in-network rates for COVID-19 care, and certifying that the funds will only be used to prevent, prepare for, and respond to the outbreak. HHS announced yesterday that it has extended the deadline for providers to attest to the receipt of payments and accept the terms and conditions from 30 days to 45 days.
  • HRSA launched a separate portal allowing providers who have conducted COVID-19 testing or provided treatment for uninsured COVID-19 individuals on or after February 4, 2020 to request reimbursement.
  • HHS also cited providers who will receive further, separate funding, including skilled nursing facilities, dentists, and providers that solely take Medicaid.
  • Medicare Accelerated and Advanced Payments. The Centers for Medicare and Medicaid Services (CMS) announced that as of Apr. 27, the agency will not be accepting any new applications for Medicare’s Advance Payment Program (fact sheet). CMS also stated it will be reevaluating all pending and new applications for Accelerated Payments in light of payments made available through the HHS’ Provider Relief Fund.

COVID-19: What’s Happened

  • Legislative Response. TRP has published several in-depth policy memos that analyze actions that Congress and the federal government have taken to address the COVID-19 outbreak. Click here for the full list of memos.
  • Since the beginning of the COVID-19 outbreak, Congress and the Trump administration have issued a number of policies and waivers designed to lower restrictions on and encourage telehealth services. Click here to read TRP’s memo on these telehealth policies.
  • President Donald Trump signed the $483.4 billion “COVID-19 Phase 3.5” bill into law. TRP’s comprehensive analysis of the Phase 3.5 legislation can be read here.
  • TRP has published a memo explores the “health extenders” that the CARES Act reauthorized through Nov. 2020, what’s on the table for these programs in the fall, and the questions that will shape the conversation. Click here to read the memo.
  • SBA. The Small Business Administration (SBA) and Treasury Department updated their list of frequently asked questions on the PPP.
  • SBA provided an update on its PPP loan data.
  • SBA announced yesterday that agricultural businesses are now eligible for SBA’s Economic Injury Disaster Loan (EIDL) and EIDL Advance programs. 
  • SBA issued guidance on how to calculate PPP loans by business type.
  • SBA is temporarily restricting incoming applications for PPP loans to only those submitted by the country’s smallest lenders.
  • SBA published a list of all lenders participating in the PPP.
  • SBA issued an interim final rule clarifying the process of applying for PPP loans for individuals who report self-employed income on a 1040 Schedule C
  • SBA issued an interim final rule outlining additional guidance for the PPP. TRP’s comprehensive analysis of the small business provisions contained in COVID-19 response bills can be read here. The loan application form can be accessed here.
  • FDA. The Food and Drug Administration (FDA) published guidance on reporting requirements for medical device shortages.
  • FDA issued an emergency use authorization for the antiviral Remdesivir.
  • FDA issued guidance outlining an exemption and exclusion from certain requirements of the Drug Supply Chain Security Act during the public health emergency.
  • FDA issued guidance that will temporarily allow hospitals to compound certain sedatives used for COVID-19 patients during the public health emergency. Additional details on this policy from the FDA can be read here.
  • FDA has authorized the first at-home COVID-19 testing kit that will allow patients to self-collect samples.
  • FDA issued an update on steps the agency is taking to help mitigate supply interruptions of food and medical products.
  • FDA announced actions to increase U.S. supplies to support COVID-19 response efforts by providing instructions to manufacturers importing personal protective equipment (PPE) and other devices.
  • CMS. CMS published a new tranche of frequently asked questions for state Medicaid and CHIP programs regarding COVID-19 response efforts. These FAQs cover a variety of topics, including: (1) emergency preparedness and response; (2) eligibility and enrollment flexibilities; (3) benefit flexibilities; (4) cost-sharing and financing flexibilities; (5) managed care flexibilities; and (6) information technology and data reporting.
  • CMS issued an interim final rule with comment period and blanket waivers under Section 1135 of the Social Security Act. These new flexibilities provide for Medicare coverage of serology tests, new coverage for services provided by pharmacists, and a waiver of the limitation on the types of practitioner that may furnish Medicare telehealth services.
  • CMS also gave hospitals and other inpatient facilities new flexibilities that are intended to increase acute care hospitals’ capacity during the pandemic, as well as permitting off-campus hospital outpatient departments to apply to temporarily receive reimbursement under Medicare’s hospital outpatient prospective payment system, rather than under the physician fee schedule. TRP’s memo on the new flexibilities is available here.
  • CMS announced a new independent commission that will assess safety and quality in nursing homes.
  • CMS has updated its information related to COVID-19 guidance document for Medicare Advantage, Part D, and Medicare-Medicaid plans.
  • CMS has issued additional blanket waivers to promote flexibility for Long-Term Care Hospitals (LTCH), Rural Health Clinics (RHC), Federally Qualified Health Centers (FQHC), and Intermediate Care Facilities.
  • CMS issued recommendations that outline how certain health care systems can resume non-essential surgeries and medical procedures in areas with low incidence of COVID-19.
  • CMS has proposed to permanently codify a change to its inpatient rehabilitation facility (IRF) policy that dispenses with the requirement that IRFs provide and document a post-admission physician evaluation within 24 hours of admission.
  • A full list of the 1135 waiver approval letters can be accessed here.
  • Treasury. The Treasury Department has released a list of frequently asked questions pertaining to the Employee Retention Credit.
  • Treasury Secretary Steven Mnuchin issued guidance and frequently asked questions that provide examples of eligible and ineligible expenditures of the state, local, and tribal Coronavirus Relief Fund.
  • The Fed. The Federal Reserve and other bank regulatory agencies published an interim final rule that modifies the Liquidity Coverage Ratio to support banking organizations’ participation in the Money Market Mutual Fund Liquidity Facility and the PPP Liquidity Facility.
  • The Federal Reserve expanded access to its PPP Liquidity Facility for additional lenders, and also broadened the criteria for collateral that can be pledged.
  • The Federal Reserve will expand the scope and eligibility for the Main Street Lending Program.
  • The Federal Reserve expanded the scope and duration of its Municipal Liquidity Facility to offer up to $500 billion in lending to states and municipalities during the pandemic.
  • The Federal Reserve announced a series of emergency actions that would provide more than $2 trillion in COVID-19 loans to businesses, state, and local governments.
  • IRS. The Internal Revenue Service (IRS) published a list of frequently asked questions on COVID-related relief for retirement plans and IRAs.
  • FEMA. The Federal Emergency Management Agency (FEMA) published a fact sheet on how the agency will coordinate and distribute two shipments of PPE to 15,000 nursing homes across the country.
  • DOT. The Department of Transportation (DOT) announced more than $1 billion in grants to 439 airports across all 50 states.
  • DOT issued a final order on service obligations for air carriers receiving financial relief through the CARES Act.
  • DOT and the Federal Transit Administration (FTA) announced a total of $25 billion in federal funding allocations to help the public transit systems respond to the COVID-29 outbreak.
  • Testing. The Trump administration released a blueprint that seeks to bolster state testing plans and rapid response programs.
  • SAMHSA. The Substance Abuse and Mental Health Services Administration (SAMHSA) awarded grant funding to increase access and improve the quality of community mental and substance use disorder (SUD) treatment services through the expansion of Certified Community Behavioral Health Clinics (CCBHC). 
  • FCC. The Federal Communications Commission (FCC) and the Department of Education announced efforts to promote the use of $16 billion in funding for the CARES Act’s Education Stabilization Fund for remote learning.
  • In a move aimed at expanding access to Wi-Fi throughout the country, the FCC voted to adopt a report and order that would make 1,200 megahertz of spectrum in the 6 GHz band available for unlicensed use.
  • NIH. The National Institutes of Health issued its first guidance on COVID-19 treatment options that are currently under review.
  • NIH and the Foundation for the NIH (FNIH) announced that they will launch a new public-private partnership with more than a dozen biopharmaceutical companies aimed at speeding COVID-19 vaccine and treatment options.
  • USDA. The U.S. Department of Agriculture (USDA) and Department of Homeland Security (DHS) issued a temporary final rule allowing for flexibilities on certain agricultural-related employment regulations.
  • HUD. The Department of Housing and Urban Affairs (HUD) has begun allocating $3 billion in funding for communities through the Community Development Block Grant, Emergency Solutions Grant, and Housing Opportunities for Persons With AIDS programs to address COVID-19 issues.

COVID-19: Federal Update (5/7)

Senators will convene for legislative business this morning while House lawmakers continue to distance themselves from Capitol Hill due to health and safety concerns from the Attending Physician’s office. While House Democratic leadership indicated that members could return as soon as next week, that date could get pushed to the following week of May 18 if a vote on the next round of COVID-19 relief legislation does not get scheduled. The two parties are currently far apart on the next round of relief efforts and will need to navigate deep policy schisms over the size and scope of the next package before a concrete timeline for enactment emerges. Regardless of the level of bipartisan support, House Democrats are expected to push forward with a measure that mirrors Speaker Nancy Pelosi’s (D-CA) counteroffer to Senate Majority Leader Mitch McConnell’s (R-KY) original CARES Act proposal.

On the floor today, the Senate will vote to overturn President Donald Trump’s veto of a “War Powers” resolution that would block unauthorized military hostilities in Iran. Despite bipartisan support for restricting the President’s ability to engage in military offensives absent Congressional approval, the veto override is expected to fall short of the two-thirds threshold needed to override President Trump’s veto. The North Texas Commission will continue to monitor the vote.

COVID-19: What We’re Hearing

  • COVID 4.0. As the COVID-19 pandemic ensues, lawmakers are continuing to mull over policy items for another round of economic stimulus relief. TRP has compiled a list and summaries of the major priorities that have been discussed.
  • State and Local Governments. GOP lawmakers have indicated that they support promoting flexibility for state and local governments to use CARES Act funding to replace lost revenue, but are lukewarm on providing new funding beyond the $150 billion fund established in the “Phase III” bill. Sen. John Kennedy (R-LA) has introduced a measure that would give states these flexibilities to offset losses.
  • House Ways and Means Chairman Richard Neal (D-MA) stated recently that House Democrats will soon detail plans to provide additional financial assistance to state and local governments. In addition to a set amount of money that could reach up to $800 billion, the plan will likely include provisions that seek to boost private activity bonds.
  • A bipartisan group of House lawmakers have introduced legislation that would allocate $250 billion in direct funding for local governments of all sizes. The measure would also allow governments to offset lost revenue due to the pandemic.
  • Postal Service. House Majority Leader Steny Hoyer (D-MD) indicated that Democrats are coalescing behind Oversight and Reform Chairwoman Carolyn Maloney’s (D-NY) proposal that would boost USPS by $25 billion. However, he recognized that the President’s current attitude toward Amazon could impede progress on that front. 
  • Liability. Leader McConnell emphasized that he willinsist” Congress limit the liabilities of health care workers, business owners, and employees from lawsuits pertaining to the COVID-19 outbreak, making it contingent in order for the Senate to consider any additional relief legislation. Democrats have been dismissive of this proposal, arguing that it would water down federal consumer protection efforts.
  • Senate Judiciary Chairman Lindsey Graham (R-SC) stated yesterday that he expects to hold a hearing on liability in the era of COVID-19 next week.
  • Payroll Tax. During a virtual town hall meeting over the weekend, President Donald Trump stated that he will not support another COVID-19 relief bill without a provision that provides payroll tax relief.
  • Infrastructure. President Trump reiterated his call for robust infrastructure provisions in the Phase IV bill during Sunday’s town hall. In a recent tweet, he specifically highlighted surface transportation and broadband infrastructure as areas he’d like to see addressed.
  • Despite support for infrastructure from Speaker Pelosi and President Trump, it remains to be seen whether both parties can strike an agreement on big-ticket legislative items such as infrastructure. Congressional Republicans have remained opposed to tacking on non-COVID related items to future relief packages.
  • Merger Ban. Several Democratic lawmakers have offered support of a plan sponsored by Sen. Elizabeth Warren (D-MA) and Alexandria Ocasio-Cortez (D-NY) that would place a ban on company mergers during the outbreak. However, Democratic leadership appears lukewarm on this suggestion as of now, and it’s unlikely to gain traction in the GOP-controlled Senate.
  • Surprise Billing. Energy and Commerce Ranking Member Greg Walden (R-OR) expects another push for action on surprise billing in the next round of relief. During the Phase III negotiations, Chairman Frank Pallone (D-NJ) and Senate Health, Education, Labor, and Pensions (HELP) Chairman Lamar Alexander (R-TN) were actively trying to tack their surprise billing legislation onto the package.
  • Provider Funding. On Apr. 22, the Department of Health and Human Services (HHS) announced new distributions from the $100 billion Provider Relief Fund created by the CARES Act (H.R. 748). On May 1, HHS began distributing $12 billion to 395 hospitals who provided inpatient care for 100 or more COVID-19 patients through April 10, 2020. HHS also provided additional detail on the $10 billion rural health care provider distribution. TRP’s comprehensive analysis of these distributions can be read here.
  • The first round of funding included $30 billion for Medicare hospitals and providers. 
  • The second round of funding includes an additional $20 billion for Medicare providers nationwide, $10 billion for hospitals in highly impacted areas, $10 billion for rural providers, and $400 million for the Indian Health Service. It also establishes a program to fund COVID-19 care for the uninsured.
  • HHS has published a list of frequently asked questions pertaining to the $50 billion general allocation of the COVID-19 provider relief fund. In addition, providers receiving funds must agree to a set of terms and conditions, including reporting and documentation requirements, charging only in-network rates for COVID-19 care, and certifying that the funds will only be used to prevent, prepare for, and respond to the outbreak. Those that do not agree must contact HHS within 30 days to remit the payment.
  • HRSA launched a separate portal allowing providers who have conducted COVID-19 testing or provided treatment for uninsured COVID-19 individuals on or after February 4, 2020 to request reimbursement.
  • HHS also cited providers who will receive further, separate funding, including skilled nursing facilities, dentists, and providers that solely take Medicaid.
  • Medicare Accelerated and Advanced Payments. The Centers for Medicare and Medicaid Services (CMS) announced that as of Apr. 27, the agency will not be accepting any new applications for Medicare’s Advance Payment Program (fact sheet). CMS also stated it will be reevaluating all pending and new applications for Accelerated Payments in light of payments made available through the HHS’ Provider Relief Fund.
  • Appropriations. Appropriations leaders are delaying the start of their fiscal year (FY) 2021 funding work amid the uncertainty surrounding the COVID-19 outbreak. Senate Appropriations Chairman Richard Shelby (R-AL) stated that he expects to hold markups ahead of the Jul. 4 district work period.

COVID-19: What’s Happened

  • FDA. The Food and Drug Administration (FDA) published guidance on reporting requirements for medical device shortages.
  • FDA issued an emergency use authorization for the antiviral Remdesivir.
  • FDA issued guidance outlining an exemption and exclusion from certain requirements of the Drug Supply Chain Security Act during the public health emergency.
  • FDA issued guidance that will temporarily allow hospitals to compound certain sedatives used for COVID-19 patients during the public health emergency. Additional details on this policy from the FDA can be read here.
  • FDA has authorized the first at-home COVID-19 testing kit that will allow patients to self-collect samples.
  • FDA issued an update on steps the agency is taking to help mitigate supply interruptions of food and medical products.
  • FDA announced actions to increase U.S. supplies to support COVID-19 response efforts by providing instructions to manufacturers importing personal protective equipment (PPE) and other devices.
  • SBA. The Small Business Administration (SBA) and Treasury Department updated their list of frequently asked questions on the PPP.
  • SBA provided an update on its PPP loan data.
  • SBA announced yesterday that agricultural businesses are now eligible for SBA’s Economic Injury Disaster Loan (EIDL) and EIDL Advance programs. 
  • SBA issued guidance on how to calculate PPP loans by business type.
  • SBA is temporarily restricting incoming applications for PPP loans to only those submitted by the country’s smallest lenders.
  • SBA published a list of all lenders participating in the PPP.
  • SBA issued a interim final rule clarifying the process of applying for PPP loans for individuals who report self-employed income on a 1040 Schedule C
  • SBA issued an interim final rule outlining additional guidance for the PPP. TRP’s comprehensive analysis of the small business provisions contained in COVID-19 response bills can be read here. The loan application form can be accessed here.
  • CMS. CMS published a new tranche of frequently asked questions for state Medicaid and CHIP programs regarding COVID-19 response efforts. The new FAQs cover a variety of topics, including: (1) emergency preparedness and response; (2) eligibility and enrollment flexibilities; (3) benefit flexibilities; (4) cost-sharing and financing flexibilities; (5) managed care flexibilities; and (6) information technology and data reporting.
  • CMS issued an interim final rule with comment period and new blanket waivers under Section 1135 of the Social Security Act. These new flexibilities provide for Medicare coverage of serology tests, new coverage for services provided by pharmacists, and a waiver of the limitation on the types of practitioner that may furnish Medicare telehealth services.
  • CMS also gave hospitals and other inpatient facilities new flexibilities that are intended to increase acute care hospitals’ capacity during the pandemic, as well as permitting off-campus hospital outpatient departments to apply to temporarily receive reimbursement under Medicare’s hospital outpatient prospective payment system, rather than under the physician fee schedule. TRP’s memo on the new flexibilities is available here.
  • CMS announced a new independent commission that will assess safety and quality in nursing homes.
  • CMS has updated its information related to COVID-19 guidance document for Medicare Advantage, Part D, and Medicare-Medicaid plans.
  • CMS has issued additional blanket waivers to promote flexibility for Long-Term Care Hospitals (LTCH), Rural Health Clinics (RHC), Federally Qualified Health Centers (FQHC), and Intermediate Care Facilities.
  • CMS issued recommendations that outline how certain health care systems can resume non-essential surgeries and medical procedures in areas with low incidence of COVID-19.
  • CMS has proposed to permanently codify a change to its inpatient rehabilitation facility (IRF) policy that dispenses with the requirement that IRFs provide and document a post-admission physician evaluation within 24 hours of admission.
  • A full list of the 1135 waiver approval letters can be accessed here.
  • Legislative Response. TRP has published several in-depth policy memos that analyze actions that Congress and the federal government have taken to address the COVID-19 outbreak. Click here for the full list of memos.
  • Since the beginning of the COVID-19 outbreak, Congress and the Trump administration have issued a number of policies and waivers designed to lower restrictions on and encourage telehealth services. Click here to read TRP’s memo on these telehealth policies.
  • President Donald Trump signed the $483.4 billion “COVID-19 Phase 3.5” bill into law. TRP’s comprehensive analysis of the Phase 3.5 legislation can be read here.
  • TRP has published a memo explores the “health extenders” that the CARES Act reauthorized through Nov. 2020, what’s on the table for these programs in the fall, and the questions that will shape the conversation. Click here to read the memo.
  • The Fed. The Federal Reserve and other bank regulatory agencies published an interim final rule that modifies the Liquidity Coverage Ratio to support banking organizations’ participation in the Money Market Mutual Fund Liquidity Facility and the PPP Liquidity Facility.
  • The Federal Reserve expanded access to its PPP Liquidity Facility for additional lenders, and also broadened the criteria for collateral that can be pledged.
  • The Federal Reserve will expand the scope and eligibility for the Main Street Lending Program.
  • The Federal Reserve expanded the scope and duration of its Municipal Liquidity Facility to offer up to $500 billion in lending to states and municipalities during the pandemic.
  • The Federal Reserve stated that the central bank plans to disclose “substantial amounts of information” regarding borrowers from its emergency lending facilities.
  • The Federal Reserve announced a series of emergency actions that would provide more than $2 trillion in COVID-19 loans to businesses, state, and local governments.
  • The Federal Reserve announced the creation of a lending facility that will provide liquidity for lenders for the purposes of funding up to $349 billion authorized by the CARES Act. The interim final rule can be read here.
  • IRS. The Internal Revenue Service (IRS) published a list of frequently asked questions on COVID-related relief for retirement plans and IRAs.
  • FEMA. The Federal Emergency Management Agency (FEMA) published a fact sheet on how the agency will coordinate and distribute two shipments of PPE to 15,000 nursing homes across the country.
  • DOT. The Department of Transportation (DOT) announced more than $1 billion in grants to 439 airports across all 50 states.
  • DOT issued a final order on service obligations for air carriers receiving financial relief through the CARES Act.
  • DOT and the Federal Transit Administration (FTA) announced a total of $25 billion in federal funding allocations to help the public transit systems respond to the COVID-29 outbreak.
  • Ed. The Department of Education announced the availability of $1.4 billion in CARES Act funding for Historically Black Colleges and Universities (HBCU) and other minority-serving institutions.
  • The Department of Education announced the availability of more than $13 billion in emergency funds aimed at helping students K-12 whose schools were closed due to the outbreak.
  • Treasury. The Treasury Department has released a list of frequently asked questions pertaining to the Employee Retention Credit.
  • Treasury Secretary Steven Mnuchin issued guidance and frequently asked questions that provide examples of eligible and ineligible expenditures of the state, local, and tribal Coronavirus Relief Fund.
  • Testing. The Trump administration released a blueprint that seeks to bolster state testing plans and rapid response programs.
  • SAMHSA. The Substance Abuse and Mental Health Services Administration (SAMHSA) awarded grant funding to increase access and improve the quality of community mental and substance use disorder (SUD) treatment services through the expansion of Certified Community Behavioral Health Clinics (CCBHC). 
  • FCC. The Federal Communications Commission (FCC) and the Department of Education announced efforts to promote the use of $16 billion in funding for the CARES Act’s Education Stabilization Fund for remote learning.
  • In a move aimed at expanding access to Wi-Fi throughout the country, the FCC voted to adopt a report and order that would make 1,200 megahertz of spectrum in the 6 GHz band available for unlicensed use.
  • NIH. The National Institutes of Health issued its first guidance on COVID-19 treatment options that are currently under review.
  • NIH and the Foundation for the NIH (FNIH) announced that they will launch a new public-private partnership with more than a dozen biopharmaceutical companies aimed at speeding COVID-19 vaccine and treatment options.
  • USDA. The U.S. Department of Agriculture (USDA) and Department of Homeland Security (DHS) issued a temporary final rule allowing for flexibilities on certain agricultural-related employment regulations.
  • HUD. The Department of Housing and Urban Affairs (HUD) has begun allocating $3 billion in funding for communities through the Community Development Block Grant, Emergency Solutions Grant, and Housing Opportunities for Persons With AIDS programs to address COVID-19 issues.

COVID-19: Federal Update (5/6)

House Democratic leadership is formulating a strategy to bring another COVID-19 legislative package to the floor. Democrats have reportedly been working off of Speaker Pelosi’s counteroffer to Senate Majority Leader Mitch McConnell’s (R-KY) original CARES Act as a starting point for developing their forthcoming bill, prioritizing funding for state and local governments, election assistance, workforce protections, and reforms to the Paycheck Protection Program (PPP), among other things. While Democrats are pressing for a finalized bill by the end of this week — followed by a vote that would likely occur at some point next week — Leader McConnell offered lukewarm support for another round of COVID-19 legislation during a press conference yesterday, saying Congress should “take a pause” to evaluate the implementation of the previous relief efforts before moving onto another stimulus package.

Meanwhile, Senators convene for legislative business this morning to resume consideration of pending presidential nominations. For today, the Senate will hold a final confirmation vote on William Evanina’s nomination to be Director of the National Counterintelligence and Security Center. The North Texas Commission will continue to monitor for updates.

COVID-19: What We’re Hearing

  • COVID 4.0. As the COVID-19 pandemic ensues, lawmakers are continuing to mull over policy items for another round of economic stimulus relief. TRP has compiled a list and summaries of the major priorities that have been discussed.
  • Liability. Leader McConnell emphasized that he willinsist” Congress limit the liabilities of health care workers, business owners, and employees from lawsuits pertaining to the COVID-19 outbreak, making it contingent in order for the Senate to consider any additional relief legislation. Democrats have been dismissive of this proposal, arguing that it would water down federal consumer protection efforts.
  • Senate Judiciary Chairman Lindsey Graham (R-SC) stated this morning that he expects to hold a hearing on liability in the era of COVID-19.
  • State and Local Governments. House Ways and Means Chairman Richard Neal (D-MA) stated recently that House Democrats will soon detail plans to provide additional financial assistance to state and local governments. In addition to a set amount of money that will could reach up to $800 billion, the plan will likely include provisions that seek to boost private activity bonds.
  • A bipartisan group of House lawmakers have introduced legislation that would allocate $250 billion in direct funding for local governments of all sizes. The measure would also allow governments to offset lost revenue due to the pandemic.
  • Payroll Tax. During a virtual town hall meeting over the weekend, President Donald Trump stated that he will not support another COVID-19 relief bill without a provision that provides payroll tax relief.
  • Infrastructure. President Trump reiterated his call for robust infrastructure provisions in the Phase IV bill during Sunday’s town hall. In a recent tweet, he specifically highlighted surface transportation and broadband infrastructure as areas he’d like to see addressed.
  • Despite support for infrastructure from Speaker Pelosi and President Trump, it remains to be seen whether both parties can strike an agreement on big-ticket legislative items such as infrastructure. Congressional Republicans have remained opposed to tacking on non-COVID related items to future relief packages.
  • Merger Ban. Several Democratic lawmakers have coalesced behind a plan sponsored by Sen. Elizabeth Warren (D-MA) and Alexandria Ocasio-Cortez (D-NY) that would place a ban on company mergers during the outbreak. However, Democratic leadership appears lukewarm on this suggestion as of now, and it’s unlikely to gain traction in the GOP-controlled Senate.
  • Surprise Billing. Energy and Commerce Ranking Member Greg Walden (R-OR) expects another push for action on surprise billing in the next round of relief. During the Phase III negotiations, Chairman Frank Pallone (D-NJ) and Senate Health, Education, Labor, and Pensions (HELP) Chairman Lamar Alexander (R-TN) were actively trying to tack their surprise billing legislation onto the package.
  • Provider Funding. On Apr. 22, the Department of Health and Human Services (HHS) announced new distributions from the $100 billion Provider Relief Fund created by the CARES Act (H.R. 748). On May 1, HHS began distributing $12 billion to 395 hospitals who provided inpatient care for 100 or more COVID-19 patients through April 10, 2020. HHS also provided additional detail on the $10 billion rural health care provider distribution. TRP’s comprehensive analysis of these distributions can be read here.
  • The first round of funding included $30 billion for Medicare hospitals and providers. 
  • The second round of funding includes an additional $20 billion for Medicare providers nationwide, $10 billion for hospitals in highly impacted areas, $10 billion for rural providers, and $400 million for the Indian Health Service. It also establishes a program to fund COVID-19 care for the uninsured.
  • HHS has published a list of frequently asked questions pertaining to the $50 billion general allocation of the COVID-19 provider relief fund. In addition, providers receiving funds must agree to a set of terms and conditions, including reporting and documentation requirements, charging only in-network rates for COVID-19 care, and certifying that the funds will only be used to prevent, prepare for, and respond to the outbreak. Those that do not agree must contact HHS within 30 days to remit the payment.
  • HRSA launched a separate portal allowing providers who have conducted COVID-19 testing or provided treatment for uninsured COVID-19 individuals on or after February 4, 2020 to request reimbursement.
  • HHS also cited providers who will receive further, separate funding, including skilled nursing facilities, dentists, and providers that solely take Medicaid.
  • Medicare Accelerated and Advanced Payments. The Centers for Medicare and Medicaid Services (CMS) announced that as of Apr. 27, the agency will not be accepting any new applications for Medicare’s Advance Payment Program (fact sheet). CMS also stated it will be reevaluating all pending and new applications for Accelerated Payments in light of payments made available through the HHS’ Provider Relief Fund.
  • Appropriations. Appropriations leaders are delaying the start of their fiscal year (FY) 2021 funding work amid the uncertainty surrounding the COVID-19 outbreak. Senate Appropriations Chairman Richard Shelby (R-AL) stated that he expects to hold markups ahead of the Jul. 4 district work period.

COVID-19: What’s Happened

  • CMS. CMS published a new tranche of frequently asked questions for state Medicaid and CHIP programs regarding COVID-19 response efforts. The new FAQs cover a variety of topics, including: (1) emergency preparedness and response; (2) eligibility and enrollment flexibilities; (3) benefit flexibilities; (4) cost-sharing and financing flexibilities; (5) managed care flexibilities; and (6) information technology and data reporting.
  • CMS issued an interim final rule with comment period and new blanket waivers under Section 1135 of the Social Security Act. These new flexibilities provide for Medicare coverage of serology tests, new coverage for services provided by pharmacists, and a waiver of the limitation on the types of practitioner that may furnish Medicare telehealth services.
  • CMS also gave hospitals and other inpatient facilities new flexibilities that are intended to increase acute care hospitals’ capacity during the pandemic, as well as permitting off-campus hospital outpatient departments to apply to temporarily receive reimbursement under Medicare’s hospital outpatient prospective payment system, rather than under the physician fee schedule. TRP’s memo on the new flexibilities is available here.
  • CMS announced a new independent commission that will assess safety and quality in nursing homes.
  • CMS has updated its information related to COVID-19 guidance document for Medicare Advantage, Part D, and Medicare-Medicaid plans.
  • CMS has issued additional blanket waivers to promote flexibility for Long-Term Care Hospitals (LTCH), Rural Health Clinics (RHC), Federally Qualified Health Centers (FQHC), and Intermediate Care Facilities.
  • CMS issued recommendations that outline how certain health care systems can resume non-essential surgeries and medical procedures in areas with low incidence of COVID-19.
  • CMS has proposed to permanently codify a change to its inpatient rehabilitation facility (IRF) policy that dispenses with the requirement that IRFs provide and document a post-admission physician evaluation within 24 hours of admission.
  • A full list of the 1135 waiver approval letters can be accessed here.
  • The Fed. The Federal Reserve and other bank regulatory agencies published an interim final rule that modifies the Liquidity Coverage Ratio to support banking organizations’ participation in the Money Market Mutual Fund Liquidity Facility and the PPP Liquidity Facility.
  • The Federal Reserve expanded access to its PPP Liquidity Facility for additional lenders, and also broadened the criteria for collateral that can be pledged.
  • The Federal Reserve will expand the scope and eligibility for the Main Street Lending Program.
  • The Federal Reserve expanded the scope and duration of its Municipal Liquidity Facility to offer up to $500 billion in lending to states and municipalities during the pandemic.
  • The Federal Reserve stated that the central bank plans to disclose “substantial amounts of information” regarding borrowers from its emergency lending facilities.
  • The Federal Reserve announced a series of emergency actions that would provide more than $2 trillion in COVID-19 loans to businesses, state, and local governments.
  • The Federal Reserve announced the creation of a lending facility that will provide liquidity for lenders for the purposes of funding up to $349 billion authorized by the CARES Act. The interim final rule can be read here.
  • SBA. The Small Business Administration (SBA) and Treasury Department updated their list of frequently asked questions on the PPP.
  • SBA provided an update on its PPP loan data.
  • SBA announced yesterday that agricultural businesses are now eligible for SBA’s Economic Injury Disaster Loan (EIDL) and EIDL Advance programs. 
  • SBA issued guidance on how to calculate PPP loans by business type.
  • SBA is temporarily restricting incoming applications for PPP loans to only those submitted by the country’s smallest lenders.
  • SBA published a list of all lenders participating in the PPP.
  • SBA issued a interim final rule clarifying the process of applying for PPP loans for individuals who report self-employed income on a 1040 Schedule C
  • SBA issued an interim final rule outlining additional guidance for the PPP. TRP’s comprehensive analysis of the small business provisions contained in COVID-19 response bills can be read here. The loan application form can be accessed here.
  • IRS. The Internal Revenue Service (IRS) published a list of frequently asked questions on COVID-related relief for retirement plans and IRAs.
  • Legislative Response. TRP has published several in-depth policy memos that analyze actions that Congress and the federal government have taken to address the COVID-19 outbreak. Click here for the full list of memos.
  • Since the beginning of the COVID-19 outbreak, Congress and the Trump administration have issued a number of policies and waivers designed to lower restrictions on and encourage telehealth services. Click here to read TRP’s memo on these telehealth policies.
  • President Donald Trump signed the $483.4 billion “COVID-19 Phase 3.5” bill into law. TRP’s comprehensive analysis of the Phase 3.5 legislation can be read here.
  • TRP has published a memo explores the “health extenders” that the CARES Act reauthorized through Nov. 2020, what’s on the table for these programs in the fall, and the questions that will shape the conversation. Click here to read the memo.
  • FEMA. The Federal Emergency Management Agency (FEMA) published a fact sheet on how the agency will coordinate and distribute two shipments of PPE to 15,000 nursing homes across the country.
  • FDA. The Food and Drug Administration (FDA) issued an emergency use authorization for the antiviral Remdesivir.
  • FDA issued guidance outlining an exemption and exclusion from certain requirements of the Drug Supply Chain Security Act during the public health emergency.
  • FDA issued guidance that will temporarily allow hospitals to compound certain sedatives used for COVID-19 patients during the public health emergency. Additional details on this policy from the FDA can be read here.
  • FDA has authorized the first at-home COVID-19 testing kit that will allow patients to self-collect samples.
  • FDA issued an update on steps the agency is taking to help mitigate supply interruptions of food and medical products.
  • FDA announced actions to increase U.S. supplies to support COVID-19 response efforts by providing instructions to manufacturers importing personal protective equipment (PPE) and other devices.
  • DOT. The Department of Transportation (DOT) announced more than $1 billion in grants to 439 airports across all 50 states.
  • DOT issued a final order on service obligations for air carriers receiving financial relief through the CARES Act.
  • DOT and the Federal Transit Administration (FTA) announced a total of $25 billion in federal funding allocations to help the public transit systems respond to the COVID-29 outbreak.
  • Ed. The Department of Education announced the availability of $1.4 billion in CARES Act funding for Historically Black Colleges and Universities (HBCU) and other minority-serving institutions.
  • The Department of Education announced the availability of more than $13 billion in emergency funds aimed at helping students K-12 whose schools were closed due to the outbreak.
  • Treasury. The Treasury Department has released a list of frequently asked questions pertaining to the Employee Retention Credit.
  • Treasury Secretary Steven Mnuchin issued guidance and frequently asked questions that provide examples of eligible and ineligible expenditures of the state, local, and tribal Coronavirus Relief Fund.
  • Testing. The Trump administration released a blueprint that seeks to bolster state testing plans and rapid response programs.
  • SAMHSA. The Substance Abuse and Mental Health Services Administration (SAMHSA) awarded grant funding to increase access and improve the quality of community mental and substance use disorder (SUD) treatment services through the expansion of Certified Community Behavioral Health Clinics (CCBHC). 
  • FCC. The Federal Communications Commission (FCC) and the Department of Education announced efforts to promote the use of $16 billion in funding for the CARES Act’s Education Stabilization Fund for remote learning.
  • In a move aimed at expanding access to Wi-Fi throughout the country, the FCC voted to adopt a report and order that would make 1,200 megahertz of spectrum in the 6 GHz band available for unlicensed use.
  • NIH. The National Institutes of Health issued its first guidance on COVID-19 treatment options that are currently under review.
  • NIH and the Foundation for the NIH (FNIH) announced that they will launch a new public-private partnership with more than a dozen biopharmaceutical companies aimed at speeding COVID-19 vaccine and treatment options.
  • USDA. The U.S. Department of Agriculture (USDA) and Department of Homeland Security (DHS) issued a temporary final rule allowing for flexibilities on certain agricultural-related employment regulations.
  • HUD. The Department of Housing and Urban Affairs (HUD) has begun allocating $3 billion in funding for communities through the Community Development Block Grant, Emergency Solutions Grant, and Housing Opportunities for Persons With AIDS programs to address COVID-19 issues.

COVID-19: Federal Update (5/5)

House Democratic leadership is formulating a strategy to bring another COVID-19 legislative package to the floor. On a caucus call yesterday, Speaker Nancy Pelosi (D-CA) stated that she is pushing Committee chairs to finalize their portions of the “CARES 2.0” legislation as soon as possible in the hopes of finalizing the package by the end of the week. Should House Democrats release bill text by this week, the measure will likely be brought to the floor for a vote at some point next week. Democrats have reportedly been working off of Speaker Pelosi’s counteroffer to Senate Majority Leader Mitch McConnell’s (R-KY) original CARES Act as a starting point for developing their forthcoming bill, prioritizing funding for state and local governments, election assistance, workforce protections, and reforms to the Paycheck Protection Program (PPP), among other things.

Meanwhile, Senators convene for legislative business this morning to resume consideration of pending presidential nominations. For today, the Senate will consider the nomination of William Evanina to be Director of the National Counterintelligence and Security Center. The North Texas Commission will keep an eye on the happenings in Washington.

COVID-19: What We’re Hearing

  • COVID 4.0. As the COVID-19 pandemic ensues, lawmakers are continuing to mull over policy items for another round of economic stimulus relief. TRP has compiled a list and summaries of the major priorities that have been discussed.
  • Payroll Tax. During a virtual town hall meeting over the weekend, President Donald Trump stated that he will not support another COVID-19 relief bill without a provision that provides payroll tax relief.
  • Infrastructure. President Trump reiterated his call for robust infrastructure provisions in the Phase IV bill during Sunday’s town hall. In a recent tweet, he specifically highlighted surface transportation and broadband infrastructure as areas he’d like to see addressed.
  • Despite support for infrastructure from Speaker Pelosi and President Trump, it remains to be seen whether both parties can strike an agreement on big-ticket legislative items such as infrastructure. Congressional Republicans have remained opposed to tacking on non-COVID related items to future relief packages.
  • State and Local Governments. House Ways and Means Chairman Richard Neal (D-MA) stated yesterday that House Democrats will soon detail plans to provide additional financial assistance to state and local governments. In addition to a set amount of money that will likely fall within the $250-$500 billion range, the plan will include provisions that seek to boost private activity bonds.
  • A bipartisan group of House lawmakers have introduced legislation that would allocate $250 billion in direct funding for local governments of all sizes. The measure would also allow governments to offset lost revenue due to the pandemic.
  • Liability. Leader McConnell emphasized that he willinsist” Congress limit the liabilities of health care workers, business owners, and employees from lawsuits pertaining to the COVID-19 outbreak, making it contingent in order for the Senate to consider key Democratic priorities. Democrats have dismissed this proposal, arguing that it would water down federal consumer protection efforts.
  • Merger Ban. Several Democratic lawmakers have coalesced behind a plan sponsored by Sen. Elizabeth Warren (D-MA) and Alexandria Ocasio-Cortez (D-NY) that would place a ban on company mergers during the outbreak. However, Democratic leadership appears lukewarm on this suggestion as of now, and it’s unlikely to gain traction in the GOP-controlled Senate.
  • Surprise Billing. Energy and Commerce Ranking Member Greg Walden (R-OR) expects another push for action on surprise billing in the next round of relief. During the Phase III negotiations, Chairman Frank Pallone (D-NJ) and Senate Health, Education, Labor, and Pensions (HELP) Chairman Lamar Alexander (R-TN) were actively trying to tack their surprise billing legislation onto the package.
  • Provider Funding. On Apr. 22, the Department of Health and Human Services (HHS) announced new distributions from the $100 billion Provider Relief Fund created by the CARES Act (H.R. 748). On May 1, HHS began distributing $12 billion to 395 hospitals who provided inpatient care for 100 or more COVID-19 patients through April 10, 2020. HHS also provided additional detail on the $10 billion rural health care provider distribution. TRP’s comprehensive analysis of these distributions can be read here.
  • The first round of funding included $30 billion for Medicare hospitals and providers. 
  • The second round of funding includes an additional $20 billion for Medicare providers nationwide, $10 billion for hospitals in highly impacted areas, $10 billion for rural providers, and $400 million for the Indian Health Service. It also establishes a program to fund COVID-19 care for the uninsured.
  • HHS has published a list of frequently asked questions pertaining to the $50 billion general allocation of the COVID-19 provider relief fund. In addition, providers receiving funds must agree to a set of terms and conditions, including reporting and documentation requirements, charging only in-network rates for COVID-19 care, and certifying that the funds will only be used to prevent, prepare for, and respond to the outbreak. Those that do not agree must contact HHS within 30 days to remit the payment.
  • HRSA launched a separate portal allowing providers who have conducted COVID-19 testing or provided treatment for uninsured COVID-19 individuals on or after February 4, 2020 to request reimbursement.
  • HHS also cited providers who will receive further, separate funding, including skilled nursing facilities, dentists, and providers that solely take Medicaid.
  • Medicare Accelerated and Advanced Payments. The Centers for Medicare and Medicaid Services (CMS) announced that as of Apr. 27, the agency will not be accepting any new applications for Medicare’s Advance Payment Program (fact sheet). CMS also stated it will be reevaluating all pending and new applications for Accelerated Payments in light of payments made available through the HHS’ Provider Relief Fund.
  • Appropriations. Appropriations leaders are delaying the start of their fiscal year (FY) 2021 funding work amid the uncertainty surrounding the COVID-19 outbreak. Senate Appropriations Chairman Richard Shelby (R-AL) stated that he expects to hold markups ahead of the Jul. 4 district work period.

COVID-19: What’s Happened

  • SBA. The Small Business Administration (SBA) and Treasury Department updated their list of frequently asked questions on the Paycheck Protection Program (PPP).
  • SBA announced yesterday that agricultural businesses are now eligible for SBA’s Economic Injury Disaster Loan (EIDL) and EIDL Advance programs. 
  • SBA issued guidance on how to calculate PPP loans by business type.
  • SBA is temporarily restricting incoming applications for PPP loans to only those submitted by the country’s smallest lenders.
  • SBA published a list of all lenders participating in the PPP.
  • SBA issued an interim final rule clarifying the process of applying for PPP loans for individuals who report self-employed income on a 1040 Schedule C
  • SBA issued an interim final rule outlining additional guidance for the PPP. TRP’s comprehensive analysis of the small business provisions contained in COVID-19 response bills can be read here. The loan application form can be accessed here.
  • IRS. The Internal Revenue Service (IRS) published a list of frequently asked questions on COVID-related relief for retirement plans and IRAs.
  • Legislative Response. TRP has published several in-depth policy memos that analyze actions that Congress and the federal government have taken to address the COVID-19 outbreak. Click here for the full list of memos.
  • Since the beginning of the COVID-19 outbreak, Congress and the Trump administration have issued a number of policies and waivers designed to lower restrictions on and encourage telehealth services. Click here to read TRP’s memo on these telehealth policies.
  • President Donald Trump signed the $483.4 billion “COVID-19 Phase 3.5” bill into law. TRP’s comprehensive analysis of the Phase 3.5 legislation can be read here.
  • TRP has published a memo explores the “health extenders” that the CARES Act reauthorized through Nov. 2020, what’s on the table for these programs in the fall, and the questions that will shape the conversation. Click here to read the memo.
  • FEMA. The Federal Emergency Management Agency (FEMA) published a fact sheet on how the agency will coordinate and distribute two shipments of PPE to 15,000 nursing homes across the country.
  • FDA. The Food and Drug Administration (FDA) issued an emergency use authorization for the antiviral Remdesivir.
  • FDA issued guidance outlining an exemption and exclusion from certain requirements of the Drug Supply Chain Security Act during the public health emergency.
  • FDA issued guidance that will temporarily allow hospitals to compound certain sedatives used for COVID-19 patients during the public health emergency. Additional details on this policy from the FDA can be read here.
  • FDA has authorized the first at-home COVID-19 testing kit that will allow patients to self-collect samples.
  • FDA issued an update on steps the agency is taking to help mitigate supply interruptions of food and medical products.
  • FDA announced actions to increase U.S. supplies to support COVID-19 response efforts by providing instructions to manufacturers importing personal protective equipment (PPE) and other devices.
  • CMS. CMS issued an interim final rule with comment period and new blanket waivers under Section 1135 of the Social Security Act. These new flexibilities provide for Medicare coverage of serology tests, new coverage for services provided by pharmacists, and a waiver of the limitation on the types of practitioner that may furnish Medicare telehealth services.
  • CMS also gave hospitals and other inpatient facilities new flexibilities that are intended to increase acute care hospitals’ capacity during the pandemic, as well as permitting off-campus hospital outpatient departments to apply to temporarily receive reimbursement under Medicare’s hospital outpatient prospective payment system, rather than under the physician fee schedule. TRP’s memo on the new flexibilities is available here.
  • CMS announced a new independent commission that will assess safety and quality in nursing homes.
  • CMS has updated its information related to COVID-19 guidance document for Medicare Advantage, Part D, and Medicare-Medicaid plans.
  • CMS has issued additional blanket waivers to promote flexibility for Long-Term Care Hospitals (LTCH), Rural Health Clinics (RHC), Federally Qualified Health Centers (FQHC), and Intermediate Care Facilities.
  • CMS issued recommendations that outline how certain health care systems can resume non-essential surgeries and medical procedures in areas with low incidence of COVID-19.
  • CMS has proposed to permanently codify a change to its inpatient rehabilitation facility (IRF) policy that dispenses with the requirement that IRFs provide and document a post-admission physician evaluation within 24 hours of admission.
  • CMS’ list of FAQs for state Medicaid and CHIP agencies regarding COVID-19 response efforts can be read here.
  • A full list of the 1135 waiver approval letters can be accessed here.
  • The Fed. The Federal Reserve expanded access to its PPP Liquidity Facility for additional lenders, and also broadened the criteria for collateral that can be pledged.
  • The Federal Reserve will expand the scope and eligibility for the Main Street Lending Program.
  • The Federal Reserve expanded the scope and duration of its Municipal Liquidity Facility to offer up to $500 billion in lending to states and municipalities during the pandemic.
  • The Federal Reserve stated that the central bank plans to disclose “substantial amounts of information” regarding borrowers from its emergency lending facilities.
  • The Federal Reserve announced a series of emergency actions that would provide more than $2 trillion in COVID-19 loans to businesses, state, and local governments.
  • The Federal Reserve announced the creation of a lending facility that will provide liquidity for lenders for the purposes of funding up to $349 billion authorized by the CARES Act. The interim final rule can be read here.
  • DOT. The Department of Transportation (DOT) announced more than $1 billion in grants to 439 airports across all 50 states.
  • DOT issued a final order on service obligations for air carriers receiving financial relief through the CARES Act.
  • DOT and the Federal Transit Administration (FTA) announced a total of $25 billion in federal funding allocations to help the public transit systems respond to the COVID-29 outbreak.
  • Ed. The Department of Education announced the availability of $1.4 billion in CARES Act funding for Historically Black Colleges and Universities (HBCU) and other minority-serving institutions.
  • The Department of Education announced the availability of more than $13 billion in emergency funds aimed at helping students K-12 whose schools were closed due to the outbreak.
  • Treasury. The Treasury Department has released a list of frequently asked questions pertaining to the Employee Retention Credit.
  • Treasury Secretary Steven Mnuchin issued guidance and frequently asked questions that provide examples of eligible and ineligible expenditures of the state, local, and tribal Coronavirus Relief Fund.
  • Testing. The Trump administration released a blueprint that seeks to bolster state testing plans and rapid response programs.
  • SAMHSA. The Substance Abuse and Mental Health Services Administration (SAMHSA) awarded grant funding to increase access and improve the quality of community mental and substance use disorder (SUD) treatment services through the expansion of Certified Community Behavioral Health Clinics (CCBHC). 
  • FCC. The Federal Communications Commission (FCC) and the Department of Education announced efforts to promote the use of $16 billion in funding for the CARES Act’s Education Stabilization Fund for remote learning.
  • In a move aimed at expanding access to Wi-Fi throughout the country, the FCC voted to adopt a report and order that would make 1,200 megahertz of spectrum in the 6 GHz band available for unlicensed use.
  • NIH. The National Institutes of Health issued its first guidance on COVID-19 treatment options that are currently under review.
  • NIH and the Foundation for the NIH (FNIH) announced that they will launch a new public-private partnership with more than a dozen biopharmaceutical companies aimed at speeding COVID-19 vaccine and treatment options.
  • USDA. The U.S. Department of Agriculture (USDA) and Department of Homeland Security (DHS) issued a temporary final rule allowing for flexibilities on certain agricultural-related employment regulations.
  • HUD. The Department of Housing and Urban Affairs (HUD) has begun allocating $3 billion in funding for communities through the Community Development Block Grant, Emergency Solutions Grant, and Housing Opportunities for Persons With AIDS programs to address COVID-19 issues.

COVID-19: Federal Update (5/4)

Senators will return this afternoon to resume legislative business, but the House will remain away from Washington amid health and safety concerns from the Attending Physician’s office. As the floor and Committee schedules for coming days and weeks take shape, leadership officials stated that Congress is likely to consider another round of COVID-19 legislation as they look to stem emerging and existing issues pertaining to the outbreak. For now, the Senate is expected to primarily focus on clearing judicial nominees and presidential nominations, starting with consideration of Robert Feitel’s nomination to be Inspector General of the Nuclear Regulatory Commission.

Meanwhile, House Democratic leadership stated last week that members will return to Washington once a vote has been scheduled on the “CARES 2.0” legislation. Democrats are using Speaker Nancy Pelosi’s (D-CA) counteroffer to Senate Majority Leader Mitch McConnell’s (R-KY) original CARES Act as a starting point for developing their forthcoming bill, prioritizing funding for state and local governments, election assistance, workforce protections, and reforms to the Paycheck Protection Program (PPP), among other things. Bill text could be released by House Democrats as soon as this week, with a vote occurring the following week of May 11. However, it’s entirely possible that the vote could slip into late May or early June should lawmakers need more time to clinch a broader agreement. The North Texas Commission will continue to monitor the happenings in Washington.

COVID-19: What We’re Hearing

  • COVID 4.0. As the COVID-19 pandemic ensues, lawmakers are continuing to mull over policy items for another round of economic stimulus relief. TRP has compiled a list and summaries of the major priorities that have been discussed.
  • Payroll Tax. During a virtual town hall meeting last night, President Donald Trump stated that he will not support another COVID-19 relief bill without a provision that provides payroll tax relief.
  • Infrastructure. President Trump reiterated his call for robust infrastructure provisions in the Phase IV bill during Sunday’s town hall. In a recent tweet, he specifically highlighted surface transportation and broadband infrastructure as areas he’d like to see addressed.
  • Despite support for infrastructure from Speaker Pelosi and President Trump, it remains to be seen whether both parties can strike an agreement on big-ticket legislative items such as infrastructure. Congressional Republicans have remained opposed to tacking on non-COVID related items to future relief packages.
  • State and Local Governments. House Ways and Means Chairman Richard Neal (D-MA) stated yesterday that House Democrats will soon detail plans to provide additional financial assistance to state and local governments. In addition to a set amount of money that will likely fall within the $250-$500 billion range, the plan will include provisions that seek to boost private activity bonds.
  • A bipartisan group of House lawmakers have introduced legislation that would allocate $250 billion in direct funding for local governments of all sizes. The measure would also allow governments to offset lost revenue due to the pandemic.
  • Liability. Leader McConnell emphasized that he willinsist” Congress limit the liabilities of health care workers, business owners, and employees from lawsuits pertaining to the COVID-19 outbreak, making it contingent in order for the Senate to consider key Democratic priorities. Democrats have dismissed this proposal, arguing that it would water down federal consumer protection efforts.
  • Merger Ban. Several Democratic lawmakers have coalesced behind a plan sponsored by Sen. Elizabeth Warren (D-MA) and Alexandria Ocasio-Cortez (D-NY) that would place a ban on company mergers during the outbreak. However, Democratic leadership appears lukewarm on this suggestion as of now, and it’s unlikely to gain traction in the GOP-controlled Senate.
  • Surprise Billing. Energy and Commerce Ranking Member Greg Walden (R-OR) expects another push for action on surprise billing in the next round of relief. During the Phase III negotiations, Chairman Frank Pallone (D-NJ) and Senate Health, Education, Labor, and Pensions (HELP) Chairman Lamar Alexander (R-TN) were actively trying to tack their surprise billing legislation onto the package.
  • Provider Funding. On Apr. 22, the Department of Health and Human Services (HHS) announced new distributions from the $100 billion Provider Relief Fund created by the CARES Act (H.R. 748). On May 1, HHS began distributing $12 billion to 395 hospitals who provided inpatient care for 100 or more COVID-19 patients through April 10, 2020. HHS also provided additional detail on the $10 billion rural health care provider distribution. TRP’s comprehensive analysis of these distributions can be read here.
  • The first round of funding included $30 billion for Medicare hospitals and providers. 
  • The second round of funding includes an additional $20 billion for Medicare providers nationwide, $10 billion for hospitals in highly impacted areas, $10 billion for rural providers, and $400 million for the Indian Health Service. It also establishes a program to fund COVID-19 care for the uninsured.
  • HHS has published a list of frequently asked questions pertaining to the $50 billion general allocation of the COVID-19 provider relief fund. In addition, providers receiving funds must agree to a set of terms and conditions, including reporting and documentation requirements, charging only in-network rates for COVID-19 care, and certifying that the funds will only be used to prevent, prepare for, and respond to the outbreak. Those that do not agree must contact HHS within 30 days to remit the payment.
  • HRSA launched a separate portal allowing providers who have conducted COVID-19 testing or provided treatment for uninsured COVID-19 individuals on or after February 4, 2020 to request reimbursement.
  • HHS also acknowledges cited providers who will receive further, separate funding, including skilled nursing facilities, dentists, and providers that solely take Medicaid.
  • Medicare Accelerated and Advanced Payments. The Centers for Medicare and Medicaid Services (CMS) announced that as of Apr. 27, the agency will not be accepting any new applications for Medicare’s Advance Payment Program (fact sheet). CMS also stated it will be reevaluating all pending and new applications for Accelerated Payments in light of payments made available through the HHS’ Provider Relief Fund.
  • Appropriations. Appropriations leaders are delaying the start of their fiscal year (FY) 2021 funding work amid the uncertainty surrounding the COVID-19 outbreak. Senate Appropriations Chairman Richard Shelby (R-AL) stated that he expects to hold markups ahead of the Jul. 4 district work period.
  • Remote Voting. Members of the remote voting working group met last week to discuss how to conduct Committee business remotely with virtual hearings and markups. House Majority Leader Steny Hoyer (D-MD) emphasized the need to resume Committee business remotely in order to queue up legislation for when it’s safe for lawmakers to return. TRP’s analysis on the state of play for remote voting can be read here.  

COVID-19: What’s Happened

  • FEMA. The Federal Emergency Management Agency (FEMA) published a fact sheet on how the agency will coordinate and distribute two shipments of PPE to 15,000 nursing homes across the country.
  • FDA. The Food and Drug Administration (FDA) issued an emergency use authorization for the antiviral Remdesivir.
  • FDA issued guidance outlining an exemption and exclusion from certain requirements of the Drug Supply Chain Security Act during the public health emergency.
  • FDA issued guidance that will temporarily allow hospitals to compound certain sedatives used for COVID-19 patients during the public health emergency. Additional details on this policy from the FDA can be read here.
  • FDA has authorized the first at-home COVID-19 testing kit that will allow patients to self-collect samples.
  • FDA issued an update on steps the agency is taking to help mitigate supply interruptions of food and medical products.
  • FDA announced actions to increase U.S. supplies to support COVID-19 response efforts by providing instructions to manufacturers importing personal protective equipment (PPE) and other devices.
  • Legislative Response. TRP has published several in-depth policy memos that analyze actions that Congress and the federal government have taken to address the COVID-19 outbreak. Click here for the full list of memos.
  • President Donald Trump signed the $483.4 billion “COVID-19 Phase 3.5” bill into law last week. TRP’s comprehensive analysis of the Phase 3.5 legislation can be read here.
  • TRP has published a memo explores the “health extenders” that the CARES Act reauthorized through Nov. 2020, what’s on the table for these programs in the fall, and the questions that will shape the conversation. Click here to read the memo.
  • TRP has published a memo that looks at the substance use and mental health policies contained in the CARES Act. This includes new funding for SAMHSA, new funding for Certified Community Behavioral Health Centers, relaxed disclosure requirements for SUD-related health records, and more. Click here to read the memo.
  • CMS. CMS issued an interim final rule with comment period and new blanket waivers under Section 1135 of the Social Security Act. These new flexibilities provide for Medicare coverage of serology tests, new coverage for services provided by pharmacists, and a waiver of the limitation on the types of practitioner that may furnish Medicare telehealth services.
  • CMS also gave hospitals and other inpatient facilities new flexibilities that are intended to increase acute care hospitals’ capacity during the pandemic, as well as permitting off-campus hospital outpatient departments to apply to temporarily receive reimbursement under Medicare’s hospital outpatient prospective payment system, rather than under the physician fee schedule. TRP’s memo on the new flexibilities is available here.
  • CMS announced a new independent commission that will assess safety and quality in nursing homes.
  • CMS has updated its information related to COVID-19 guidance document for Medicare Advantage, Part D, and Medicare-Medicaid plans.
  • CMS has issued additional blanket waivers to promote flexibility for Long-Term Care Hospitals (LTCH), Rural Health Clinics (RHC), Federally Qualified Health Centers (FQHC), and Intermediate Care Facilities.
  • CMS issued recommendations that outline how certain health care systems can resume non-essential surgeries and medical procedures in areas with low incidence of COVID-19.
  • CMS has proposed to permanently codify a change to its inpatient rehabilitation facility (IRF) policy that dispenses with the requirement that IRFs provide and document a post-admission physician evaluation within 24 hours of admission.
  • CMS’ list of FAQs for state Medicaid and CHIP agencies regarding COVID-19 response efforts can be read here.
  • A full list of the 1135 waiver approval letters can be accessed here.
  • The Fed. The Federal Reserve expanded access to its PPP Liquidity Facility for additional lenders, and also broadened the criteria for collateral that can be pledged.
  • The Federal Reserve will expand the scope and eligibility for the Main Street Lending Program.
  • The Federal Reserve expanded the scope and duration of its Municipal Liquidity Facility to offer up to $500 billion in lending to states and municipalities during the pandemic.
  • The Federal Reserve stated that the central bank plans to disclose “substantial amounts of information” regarding borrowers from its emergency lending facilities.
  • The Federal Reserve announced a series of emergency actions that would provide more than $2 trillion in COVID-19 loans to businesses, state, and local governments.
  • The Federal Reserve announced the creation of a lending facility that will provide liquidity for lenders for the purposes of funding up to $349 billion authorized by the CARES Act. The interim final rule can be read here.
  • DOT. The Department of Transportation (DOT) announced more than $1 billion in grants to 439 airports across all 50 states.
  • DOT issued a final order on service obligations for air carriers receiving financial relief through the CARES Act.
  • DOT and the Federal Transit Administration (FTA) announced a total of $25 billion in federal funding allocations to help the public transit systems respond to the COVID-29 outbreak.
  • Ed. The Department of Education announced the availability of $1.4 billion in CARES Act funding for Historically Clack Colleges and Universities (HBCU) and other minority-serving institutions.
  • The Department of Education announced the availability of more than $13 billion in emergency funds aimed at helping students K-12 whose schools were closed due to the outbreak.
  • The Department of Education announced the availability of $3 billion in emergency education relief funding for states to allocate in support of institutions that have been adversely impacted by the outbreak. A breakdown of the funding allocations can be read here.
  • SBA. The Small Business Administration (SBA) is temporarily restricting incoming applications for Paycheck Protection program (PPP) loans to only those submitted by the country’s smallest lenders.
  • SBA issued guidance on how to calculate PPP loans by business type.
  • Following the enactment of the COVID Phase 3.5 legislation, the Small Business Administration’s (SBA) Paycheck Protection Program (PPP) resumed lending on Apr. 27.
  • SBA published a list of all lenders participating in the PPP.
  • The SBA and Treasury Department updated their list of frequently asked questions on the PPP.
  • SBA issued an interim final rule clarifying the process of applying for PPP loans for individuals who report self-employed income on a 1040 Schedule C
  • SBA issued an interim final rule outlining additional guidance for the PPP. TRP’s comprehensive analysis of the small business provisions contained in COVID-19 response bills can be read here. The loan application form can be accessed here.
  • Treasury. The Treasury Department has released a list of frequently asked questions pertaining to the Employee Retention Credit.
  • Treasury Secretary Steven Mnuchin issued guidance and frequently asked questions that provide examples of eligible and ineligible expenditures of the state, local, and tribal Coronavirus Relief Fund.
  • Testing. The Trump administration released a blueprint that seeks to bolster state testing plans and rapid response programs.
  • SAMHSA. The Substance Abuse and Mental Health Services Administration (SAMHSA) awarded grant funding to increase access and improve the quality of community mental and substance use disorder (SUD) treatment services through the expansion of Certified Community Behavioral Health Clinics (CCBHC). 
  • FCC. The Federal Communications Commission (FCC) and the Department of Education announced efforts to promote the use of $16 billion in funding for the CARES Act’s Education Stabilization Fund for remote learning.
  • In a move aimed at expanding access to Wi-Fi throughout the country, the FCC voted to adopt a report and order that would make 1,200 megahertz of spectrum in the 6 GHz band available for unlicensed use.
  • NIH. The National Institutes of Health issued its first guidance on COVID-19 treatment options that are currently under review.
  • NIH and the Foundation for the NIH (FNIH) announced that they will launch a new public-private partnership with more than a dozen biopharmaceutical companies aimed at speeding COVID-19 vaccine and treatment options.
  • USDA. The U.S. Department of Agriculture (USDA) and Department of Homeland Security (DHS) issued a temporary final rule allowing for flexibilities on certain agricultural-related employment regulations.
  • HUD. The Department of Housing and Urban Affairs (HUD) has begun allocating $3 billion in funding for communities through the Community Development Block Grant, Emergency Solutions Grant, and Housing Opportunities for Persons With AIDS programs to address COVID-19 issues.

COVID-19: Federal Update (5/1)

Senators will return on Monday to resume legislative business, but the House will remain away from Washington amid health and safety concerns from the Attending Physician’s office. As the floor and Committee schedules for coming days and weeks takes shape, leadership officials stated that Congress is likely to consider another round of COVID-19 legislation as they look to stem emerging and existing issues pertaining to the outbreak. For now, the Senate is expected to primarily focus on clearing presidential nominations, starting with consideration of Robert Feitel’s nomination to be Inspector General of the Nuclear Regulatory Commission.

COVID-19: What We’re Hearing

  • COVID 4.0. Democrats are using Speaker Nancy Pelosi’s (D-CA) counteroffer to Senate Majority Leader Mitch McConnell’s (R-KY) CARES Act as a starting point for developing the forthcoming COVID Phase IV legislation. While bill text on certain provisions could be released by House Democrats by next week.
  • State and Local Governments. House Ways and Means Chairman Richard Neal (D-MA) stated yesterday that House Democrats will soon detail plans to provide additional financial assistance to state and local governments. In addition to a set amount of money that will likely fall within the $250-$500 billion range, the plan will include provisions that seek to boost private activity bonds.
  • A bipartisan group of House lawmakers have introduced legislation that would allocate $250 billion in direct funding for local governments of all sizes. The measure would also allow governments to offset lost revenue due to the pandemic.
  • Liability. Leader McConnell emphasized that he willinsist” Congress limit the liabilities of health care workers, business owners, and employees from lawsuits pertaining to the COVID-19 outbreak, making it contingent in order for the Senate to consider key Democratic priorities. Democrats have dismissed this proposal, arguing that it would water down federal consumer protection efforts.
  • PPP. When asked how long he expects this next tranche of funding for the PPP to last, House Majority Leader Steny Hoyer (D-MD) expressed uncertainty as to how quickly the funding could dry up. He suggested that lawmakers could move on additional PPP funding in the forthcoming Phase IV effort. 
  • Merger Ban. Several Democratic lawmakers have coalesced behind a plan sponsored by Sen. Elizabeth Warren (D-MA) and Alexandria Ocasio-Cortez (D-NY) that would place a ban on company mergers during the outbreak. However, Democratic leadership appears lukewarm on this suggestion as of now, and it’s unlikely to gain traction in the GOP-controlled Senate.
  • Infrastructure. President Trump reiterated his call for robust infrastructure provisions in the Phase IV bill in a recent tweet, specifically highlighting surface transportation and broadband infrastructure as areas he’d like to see addressed.
  • Despite support for infrastructure from Speaker Pelosi and President Trump, it remains to be seen whether both parties can strike an agreement on big-ticket legislative items such as infrastructure. Congressional Republicans have remained opposed to tacking on non-COVID related items to future relief packages.
  • Surprise Billing. Energy and Commerce Ranking Member Greg Walden (R-OR) expects another push for action on surprise billing in the next round of relief. During the Phase III negotiations, Chairman Frank Pallone (D-NJ) and Senate Health, Education, Labor, and Pensions (HELP) Chairman Lamar Alexander (R-TN) were actively trying to tack their surprise billing legislation onto the package.
  • Provider Funding. On Apr. 22, the Department of Health and Human Services (HHS) announced new distributions from the $100 billion Provider Relief Fund created by the CARES Act (H.R. 748). TRP’s comprehensive analysis of these distributions can be read here.
  • The first round of funding included $30 billion for Medicare hospitals and providers. 
  • The second round of funding includes an additional $20 billion for Medicare providers nationwide, $10 billion for hospitals in highly impacted areas, $10 billion for rural providers, and $400 million for the Indian Health Service. It also establishes a program to fund COVID-19 care for the uninsured.
  • HHS has published a list of frequently asked questions pertaining to the $50 billion general allocation of the COVID-19 provider relief fund. In addition, providers receiving funds must agree to a set of terms and conditions, including reporting and documentation requirements, charging only in-network rates for COVID-19 care, and certifying that the funds will only be used to prevent, prepare for, and respond to the outbreak. Those that do not agree must contact HHS within 30 days to remit the payment.
  • HRSA launched a separate portal allowing providers who have conducted COVID-19 testing or provided treatment for uninsured COVID-19 individuals on or after February 4, 2020 to request reimbursement.
  • HHS also acknowledges cited providers who will receive further, separate funding, including skilled nursing facilities, dentists, and providers that solely take Medicaid.
  • Medicare Accelerated and Advanced Payments. The Centers for Medicare and Medicaid Services (CMS) announced that as of Apr. 27, the agency will not be accepting any new applications for Medicare’s Advance Payment Program (fact sheet). CMS also stated it will be reevaluating all pending and new applications for Accelerated Payments in light of payments made available through the HHS’ Provider Relief Fund.
  • Appropriations. Appropriations leaders are delaying the start of their fiscal year (FY) 2021 funding work amid the uncertainty surrounding the COVID-19 outbreak. Senate Appropriations Chairman Richard Shelby (R-AL) stated that he expects to hold markups ahead of the Jul. 4 district work period.
  • Remote Voting. Members of the remote voting working group met this week to discuss how to conduct Committee business remotely with virtual hearings and markups. House Majority Leader Steny Hoyer (D-MD) emphasized the need to resume Committee business remotely in order to queue up legislation for when it’s safe for lawmakers to return. TRP’s analysis on the state of play for remote voting can be read here.  

COVID-19: What’s Happened

  • CMS. CMS issued a new interim final rule with comment period and new blanket waivers under Section 1135 of the Social Security Act. These new flexibilities provide for Medicare coverage of serology tests, new coverage for services provided by pharmacists, and a waiver of the limitation on the types of practitioner that may furnish Medicare telehealth services.
  • CMS also gave hospitals and other inpatient facilities new flexibilities that are intended to increase acute care hospitals’ capacity during the pandemic, as well as permitting off-campus hospital outpatient departments to apply to temporarily receive reimbursement under Medicare’s hospital outpatient prospective payment system, rather than under the physician fee schedule. TRP’s memo on the new flexibilities is available here.
  • CMS announced a new independent commission that will assess safety and quality in nursing homes.
  • CMS approved a first-of-its-kind section 1115(a) demonstration that will permit the state of Washington to utilize waiver and expenditure authorities aimed at boosting access to care for Medicaid beneficiaries during the pandemic.
  • CMS has updated its information related to COVID-19 guidance document for Medicare Advantage, Part D, and Medicare-Medicaid plans.
  • CMS has issued additional blanket waivers to promote flexibility for Long-Term Care Hospitals (LTCH), Rural Health Clinics (RHC), Federally Qualified Health Centers (FQHC), and Intermediate Care Facilities.
  • CMS issued recommendations that outline how certain health care systems can resume non-essential surgeries and medical procedures in areas with low incidence of COVID-19.
  • CMS has proposed to permanently codify a change to its inpatient rehabilitation facility (IRF) policy that dispenses with the requirement that IRFs provide and document a post-admission physician evaluation within 24 hours of admission.
  • CMS’ list of FAQs for state Medicaid and CHIP agencies regarding COVID-19 response efforts can be read here.
  • A full list of the 1135 waiver approval letters can be accessed here.
  • The Fed. The Federal Reserve expanded access to its PPP Liquidity Facility for additional lenders, and also broadened the criteria for collateral that can be pledged.
  • The Federal Reserve will expand the scope and eligibility for the Main Street Lending Program.
  • The Federal Reserve expanded the scope and duration of its Municipal Liquidity Facility to offer up to $500 billion in lending to states and municipalities during the pandemic.
  • The Federal Reserve stated that the central bank plans to disclose “substantial amounts of information” regarding borrowers from its emergency lending facilities.
  • The Federal Reserve announced a series of emergency actions that would provide more than $2 trillion in COVID-19 loans to businesses, state, and local governments.
  • The Federal Reserve announced the creation of a lending facility that will provide liquidity for lenders for the purposes of funding up to $349 billion authorized by the CARES Act. The interim final rule can be read here.
  • FDA. The Food and Drug Administration (FDA) issued guidance outlining an exemption and exclusion from certain requirements of the Drug Supply Chain Security Act during the public health emergency.
  • FDA issued guidance that will temporarily allow hospitals to compound certain sedatives used for COVID-19 patients during the public health emergency. Additional details on this policy from the FDA can be read here.
  • FDA has authorized the first at-home COVID-19 testing kit that will allow patients to self-collect samples.
  • FDA issued an update on steps the agency is taking to help mitigate supply interruptions of food and medical products.
  • FDA announced actions to increase U.S. supplies to support COVID-19 response efforts by providing instructions to manufacturers importing personal protective equipment (PPE) and other devices.
  • DOT. The Department of Transportation (DOT) announced more than $1 billion in grants to 439 airports across all 50 states.
  • DOT awarded $10 billion in grant funding for airports to certain operating expenses during the COVID-19 pandemic. A breakdown of the disbursements can be read here. A list of frequently asked questions on this funding can be read here.
  • DOT issued a final order on service obligations for air carriers receiving financial relief through the CARES Act.
  • DOT and the Federal Transit Administration (FTA) announced a total of $25 billion in federal funding allocations to help the public transit systems respond to the COVID-29 outbreak.
  • Ed. The Department of Education announced the availability of $1.4 billion in CARES Act funding for Historically Black Colleges and Universities (HBCU) and other minority-serving institutions.
  • The Department of Education announced the availability of more than $13 billion in emergency funds aimed at helping students K-12 whose schools were closed due to the outbreak.
  • The Department of Education announced the availability of $3 billion in emergency education relief funding for states to allocate in support of institutions that have been adversely impacted by the outbreak. A breakdown of the funding allocations can be read here.
  • SBA. The Small Business Administration (SBA) is temporarily restricting incoming applications for Paycheck Protection program (PPP) loans to only those submitted by the country’s smallest lenders.
  • SBA issued guidance on how to calculate PPP loans by business type.
  • Following the enactment of the COVID Phase 3.5 legislation, the Small Business Administration’s (SBA) Paycheck Protection Program (PPP) resumed lending on Apr. 27.
  • SBA published a list of all lenders participating in the PPP.
  • The SBA and Treasury Department updated their list of frequently asked questions on the PPP.
  • SBA issued an interim final rule clarifying the process of applying for PPP loans for individuals who report self-employed income on a 1040 Schedule C
  • SBA issued an interim final rule outlining additional guidance for the PPP. TRP’s comprehensive analysis of the small business provisions contained in COVID-19 response bills can be read here. The loan application form can be accessed here.
  • Treasury. The Treasury Department has released a list of frequently asked questions pertaining to the Employee Retention Credit.
  • Treasury Secretary Steven Mnuchin issued guidance and frequently asked questions that provide examples of eligible and ineligible expenditures of the state, local, and tribal Coronavirus Relief Fund.
  • Legislative Response. TRP has published several in-depth policy memos that analyze actions that Congress and the federal government have taken to address the COVID-19 outbreak. Click here for the full list of memos.
  • President Donald Trump signed the $483.4 billion “COVID-19 Phase 3.5” bill into law last week. TRP’s comprehensive analysis of the Phase 3.5 legislation can be read here.
  • TRP has published a memo explores the “health extenders” that the CARES Act reauthorized through Nov. 2020, what’s on the table for these programs in the fall, and the questions that will shape the conversation. Click here to read the memo.
  • TRP has published a memo that looks at the substance use and mental health policies contained in the CARES Act. This includes new funding for SAMHSA, new funding for Certified Community Behavioral Health Centers, relaxed disclosure requirements for SUD-related health records, and more. Click here to read the memo.
  • Testing. The Trump administration released a blueprint that seeks to bolster state testing plans and rapid response programs.
  • SAMHSA. The Substance Abuse and Mental Health Services Administration (SAMHSA) awarded grant funding to increase access and improve the quality of community mental and substance use disorder (SUD) treatment services through the expansion of Certified Community Behavioral Health Clinics (CCBHC). 
  • FCC. The Federal Communications Commission (FCC) and the Department of Education announced efforts to promote the use of $16 billion in funding for the CARES Act’s Education Stabilization Fund for remote learning.
  • In a move aimed at expanding access to Wi-Fi throughout the country, the FCC voted to adopt a report and order that would make 1,200 megahertz of spectrum in the 6 GHz band available for unlicensed use.
  • Telehealth. CMS has released a telehealth toolkit aimed at accelerating the use of broader telehealth coverage policies in state Medicaid and CHIP programs. TRP’s analysis of COVID-19 telehealth policies can be read here.
  • The Federal Communications Commission (FCC) launched its COVID-19 Telehealth Program application portal. Click here for details.
  • NIH. The National Institutes of Health issued its first guidance on COVID-19 treatment options that are currently under review.
  • NIH and the Foundation for the NIH (FNIH) announced that they will launch a new public-private partnership with more than a dozen biopharmaceutical companies aimed at speeding COVID-19 vaccine and treatment options.
  • USDA. The U.S. Department of Agriculture (USDA) and Department of Homeland Security (DHS) issued a temporary final rule allowing for flexibilities on certain agricultural-related employment regulations.
  • DOL. The Department of Labor issued a temporary rule implementing the paid family and medical leave provisions of the Families First Coronavirus Response Act. TRP’s analysis of the rule can be read here.
  • HUD. The Department of Housing and Urban Affairs (HUD) has begun allocating $3 billion in funding for communities through the Community Development Block Grant, Emergency Solutions Grant, and Housing Opportunities for Persons With AIDS programs to address COVID-19 issues.

COVID-19: Federal Update (4/30)

House and Senate lawmakers are distancing themselves from Capitol Hill amid the COVID-19 outbreak. The Senate is scheduled to return on Monday, May 4, but the House will remain away from Washington amid health and safety concerns from the Attending Physician’s office. While the floor and Committee schedules for coming days and weeks have yet to be fully ironed out, leadership officials stated that Congress is likely to consider another round of COVID-19 legislation as they look to stem emerging and existing issues pertaining to the outbreak. The North Texas Commission will continue to monitor.

COVID-19: What We’re Hearing

  • Appropriations. Appropriations leaders are delaying the start of their fiscal year (FY) 2021 funding work amid the uncertainty surrounding the COVID-19 outbreak. Senate Appropriations Chairman Richard Shelby (R-AL) stated that he expects to hold markups ahead of the Jul. 4 district work period.
  • COVID 4.0. Bill text on certain provisions could be released by House Democrats as early as this week, but a vote is not expected until later next month, possibly into June. Democrats are using Speaker Nancy Pelosi’s (D-CA) counteroffer to Senate Majority Leader Mitch McConnell’s (R-KY) CARES Act as a starting point for developing the forthcoming COVID Phase IV legislation.
  • State and Local Governments. House Ways and Means Chairman Richard Neal (D-MA) stated yesterday that House Democrats will soon detail plans to provide additional financial assistance to state and local governments. In addition to a set amount of money that will likely fall within the $250-$500 billion range, the plan will include provisions that seek to boost private activity bonds.
  • A bipartisan group of House lawmakers have introduced legislation that would allocate $250 billion in direct funding for local governments of all sizes. The measure would provide funding for all local governments with fewer than 500,000 people, and would also allow governments to offset lost revenue due to the pandemic.
  • Liability. Leader McConnell emphasized that he willinsist” Congress limit the liabilities of health care workers, business owners, and employees from lawsuits pertaining to the COVID-19 outbreak, making it contingent in order for the Senate to consider key Democratic priorities. Democrats have dismissed this proposal, arguing that it would water down federal consumer protection efforts.
  • PPP. When asked how long he expects this next tranche of funding for the PPP to last, House Majority Leader Steny Hoyer (D-MD) expressed uncertainty as to how quickly the funding could dry up. He suggested that lawmakers could move on additional PPP funding in the forthcoming Phase IV effort. 
  • Merger Ban. Several Democratic lawmakers have coalesced behind a plan sponsored by Sen. Elizabeth Warren (D-MA) and Alexandria Ocasio-Cortez (D-NY) that would place a ban on company mergers during the outbreak. However, Democratic leadership appears lukewarm on this suggestion as of now, and it’s unlikely to gain traction in the GOP-controlled Senate.
  • Infrastructure. President Trump reiterated his call for robust infrastructure provisions in the Phase IV bill in a recent tweet, specifically highlighting surface transportation and broadband infrastructure as areas he’d like to see addressed.
  • Despite support for infrastructure from Speaker Pelosi and President Trump, it remains to be seen whether both parties can strike an agreement on big-ticket legislative items such as infrastructure. Congressional Republicans have remained opposed to tacking on non-COVID related items to future relief packages.
  • Surprise Billing. Energy and Commerce Ranking Member Greg Walden (R-OR) expects another push for action on surprise billing in the next round of relief. During the Phase III negotiations, Chairman Frank Pallone (D-NJ) and Senate Health, Education, Labor, and Pensions (HELP) Chairman Lamar Alexander (R-TN) were actively trying to tack their surprise billing legislation onto the package.
  • Provider Funding. On Apr. 22, the Department of Health and Human Services (HHS) announced new distributions from the $100 billion Provider Relief Fund created by the CARES Act (H.R. 748). TRP’s comprehensive analysis of these distributions can be read here.
  • The first round of funding included $30 billion for Medicare hospitals and providers. 
  • The second round of funding includes an additional $20 billion for Medicare providers nationwide, $10 billion for hospitals in highly impacted areas, $10 billion for rural providers, and $400 million for the Indian Health Service. It also establishes a program to fund COVID-19 care for the uninsured.
  • HHS has published a list of frequently asked questions pertaining to the $50 billion general allocation of the COVID-19 provider relief fund. In addition, providers receiving funds must agree to a set of terms and conditions, including reporting and documentation requirements, charging only in-network rates for COVID-19 care, and certifying that the funds will only be used to prevent, prepare for, and respond to the outbreak. Those that do not agree must contact HHS within 30 days to remit the payment.
  • HRSA launched a separate portal allowing providers who have conducted COVID-19 testing or provided treatment for uninsured COVID-19 individuals on or after February 4, 2020 to request reimbursement.
  • HHS also acknowledges cited providers who will receive further, separate funding, including skilled nursing facilities, dentists, and providers that solely take Medicaid.
  • Medicare Accelerated and Advanced Payments. The Centers for Medicare and Medicaid Services (CMS) announced that as of Apr. 27, the agency will not be accepting any new applications for Medicare’s Advance Payment Program (fact sheet). CMS also stated it will be reevaluating all pending and new applications for Accelerated Payments in light of payments made available through the HHS’ Provider Relief Fund.
  • Remote Voting. Members of the remote voting working group met this week to discuss how to conduct Committee business remotely with virtual hearings and markups. House Majority Leader Steny Hoyer (D-MD) emphasized the need to resume Committee business remotely in order to queue up legislation for when it’s safe for lawmakers to return. TRP’s analysis on the state of play for remote voting can be read here.  

COVID-19: What’s Happened

  • SBA. The Small Business Administration (SBA) is temporarily restricting incoming applications for Paycheck Protection program (PPP) loans to only those submitted by the country’s smallest lenders.
  • SBA issued guidance on how to calculate PPP loans by business type.
  • Following the enactment of the COVID Phase 3.5 legislation, the Small Business Administration’s (SBA) Paycheck Protection Program (PPP) resumed lending on Apr. 27.
  • SBA published a list of all lenders participating in the PPP.
  • The SBA and Treasury Department updated their list of frequently asked questions on the PPP.
  • SBA issued a interim final rule clarifying the process of applying for PPP loans for individuals who report self-employed income on a 1040 Schedule C
  • SBA issued an interim final rule outlining additional guidance for the PPP. TRP’s comprehensive analysis of the small business provisions contained in COVID-19 response bills can be read here. The loan application form can be accessed here.
  • Treasury. The Treasury Department has released a list of frequently asked questions pertaining to the Employee Retention Credit.
  • Treasury Secretary Steven Mnuchin issued guidance and frequently asked questions that provide examples of eligible and ineligible expenditures of the state, local, and tribal Coronavirus Relief Fund.
  • The Fed. The Federal Reserve will expand the scope and eligibility for the Main Street Lending Program.
  • The Federal Reserve expanded the scope and duration of its Municipal Liquidity Facility to offer up to $500 billion in lending to states and municipalities during the pandemic.
  • The Federal Reserve stated that the central bank plans to disclose “substantial amounts of information” regarding borrowers from its emergency lending facilities.
  • The Federal Reserve issued a statement saying that it is working to expand access to the PPP Liquidity Facility for qualified lenders as soon as possible.
  • The Federal Reserve announced a series of emergency actions that would provide more than $2 trillion in COVID-19 loans to businesses, state, and local governments.
  • The Federal Reserve announced the creation of a lending facility that will provide liquidity for lenders for the purposes of funding up to $349 billion authorized by the CARES Act. The interim final rule can be read here.
  • Legislative Response. TRP has published several in-depth policy memos that analyze actions that Congress and the federal government have taken to address the COVID-19 outbreak. Click here for the full list of memos.
  • President Donald Trump signed the $483.4 billion “COVID-19 Phase 3.5” bill into law last week. TRP’s comprehensive analysis of the Phase 3.5 legislation can be read here.
  • TRP has published a memo explores the “health extenders” that the CARES Act reauthorized through Nov. 2020, what’s on the table for these programs in the fall, and the questions that will shape the conversation. Click here to read the memo.
  • TRP has published a memo that looks at the substance use and mental health policies contained in the CARES Act. This includes new funding for SAMHSA, new funding for Certified Community Behavioral Health Centers, relaxed disclosure requirements for SUD-related health records, and more. Click here to read the memo.
  • TRP has published an analysis of the medical device-related provisions in the CARES Act, including new reporting requirements, a study on the security of the medical device supply chain, and storage requirements. Click here to read the memo.
  • CMS. CMS sent a letter to clinicians notifying them that those who participate in a COVID-19 clinical trial and report their findings can earn credit in the Merit-based Incentive Payment System (MIPS) by attesting to the new COVID-19 Clinical Trials improvement activity.
  • CMS is preparing to issue another interim final rule that will address additional policy and regulatory revisions in response to the COVID-19 public health emergency. The rule is expected to include narrow and technical changes to Medicare and Medicaid policies, and will be effective upon publication.
  • CMS approved a first-of-its-kind section 1115(a) demonstration that will permit the state of Washington to utilize waiver and expenditure authorities aimed at boosting access to care for Medicaid beneficiaries during the pandemic.
  • CMS has updated its information related to COVID-19 guidance document for Medicare Advantage, Part D, and Medicare-Medicaid plans.
  • CMS has issued additional blanket waivers to promote flexibility for Long-Term Care Hospitals (LTCH), Rural Health Clinics (RHC), Federally Qualified Health Centers (FQHC), and Intermediate Care Facilities.
  • CMS announced regulatory requirements that mandate nursing homes to report cases of COVID-19 directly to the Centers for Disease Control and Prevention (CDC).
  • CMS issued recommendations that outline how certain health care systems can resume non-essential surgeries and medical procedures in areas with low incidence of COVID-19.
  • CMS has proposed to permanently codify a change to its inpatient rehabilitation facility (IRF) policy that dispenses with the requirement that IRFs provide and document a post-admission physician evaluation within 24 hours of admission.
  • CMS published a list of frequently asked questions on the enhanced Medicaid Federal Medical Assistance Percentage (FMAP). A list of FAQs for state Medicaid and CHIP agencies regarding COVID-19 response efforts can be read here. A list of FAQs for state Medicaid and Children’s Health Insurance Program (CHIP) agencies can be read here.
  • CMS posted a transcript of its Mar. 31 national stakeholder call. A full list of CMS call transcripts and recordings can be found here.
  • CMS approved Medicaid Section 1135 Waivers for states in response to the COVID-19 outbreak. A full list of the 1135 waiver approval letters can be accessed here.
  • Testing. The Trump administration released a blueprint that seeks to bolster state testing plans and rapid response programs.
  • SAMHSA. The Substance Abuse and Mental Health Services Administration (SAMHSA) awarded grant funding to increase access and improve the quality of community mental and substance use disorder (SUD) treatment services through the expansion of Certified Community Behavioral Health Clinics (CCBHC). 
  • FCC. The Federal Communications Commission (FCC) and the Department of Education announced efforts to promote the use of $16 billion in funding for the CARES Act’s Education Stabilization Fund for remote learning.
  • In a move aimed at expanding access to Wi-Fi throughout the country, the FCC voted to adopt a report and order that would make 1,200 megahertz of spectrum in the 6 GHz band available for unlicensed use.
  • Telehealth. CMS has released a telehealth toolkit aimed at accelerating the use of broader telehealth coverage policies in state Medicaid and CHIP programs. TRP’s analysis of COVID-19 telehealth policies can be read here.
  • The Federal Communications Commission (FCC) launched its COVID-19 Telehealth Program application portal. Click here for details.
  • Ed. The Department of Education announced the availability of more than $13 billion in emergency funds aimed at helping students K-12 whose schools were closed due to the outbreak.
  • The Department of Education announced the availability of $3 billion in emergency education relief funding for states to allocate in support of institutions that have been adversely impacted by the outbreak. A breakdown of the funding allocations can be read here.
  • NIH. The National Institutes of Health issued its first guidance on COVID-19 treatment options that are currently under review.
  • NIH and the Foundation for the NIH (FNIH) announced that they will launch a new public-private partnership with more than a dozen biopharmaceutical companies aimed at speeding COVID-19 vaccine and treatment options.
  • FDA. The Food and Drug Administration (FDA) issued guidance that will temporarily allow hospitals to compound certain sedatives used for COVID-19 patients during the public health emergency. Additional details on this policy from the FDA can be read here.
  • FDA has authorized the first at-home COVID-19 testing kit that will allow patients to self-collect samples.
  • FDA issued an update on steps the agency is taking to help mitigate supply interruptions of food and medical products.
  • FDA announced actions to increase U.S. supplies to support COVID-19 response efforts by providing instructions to manufacturers importing personal protective equipment (PPE) and other devices.
  • FDA has provided new guidance on patient access to certain Risk Evaluation and Mitigation Strategy (REMS)-requited drugs during the COVID-19 public health emergency.
  • USDA. The U.S. Department of Agriculture (USDA) and Department of Homeland Security (DHS) issued a temporary final rule allowing for flexibilities on certain agricultural-related employment regulations.
  • DOT. The Department of Transportation (DOT) awarded $10 billion in grant funding for airports to certain operating expenses during the COVID-19 pandemic. A breakdown of the disbursements can be read here. A list of frequently asked questions on this funding can be read here.
  • DOT issued a final order on service obligations for air carriers receiving financial relief through the CARES Act.
  • DOT and the Federal Transit Administration (FTA) announced a total of $25 billion in federal funding allocations to help the public transit systems respond to the COVID-29 outbreak.
  • DOL. The Department of Labor issued a temporary rule implementing the paid family and medical leave provisions of the Families First Coronavirus Response Act. TRP’s analysis of the rule can be read here.
  • The Trump administration offered a broad definition of “health care providers” that may be excluded from paid sick and family leave, as well as broad exceptions to family leave for companies with fewer than 50 workers in the rule. This led some Members of Congress to say that the rule veers away from what Congress intended when it passed the law.
  • HUD. The Department of Housing and Urban Affairs (HUD) has begun allocating $3 billion in funding for communities through the Community Development Block Grant, Emergency Solutions Grant, and Housing Opportunities for Persons With AIDS programs to address COVID-19 issues.

COVID-19: Federal Update (4/29)

House and Senate lawmakers are distancing themselves from Capitol Hill amid the COVID-19 outbreak. The Senate is scheduled to return on Monday, May 4, but the House will remain away from Washington amid health and safety concerns from the Attending Physician’s office. While the floor and Committee schedules for coming days and weeks have yet to be fully ironed out, leadership officials stated that Congress is likely to consider another round of COVID-19 legislation as they look to stem emerging and existing issues pertaining to the outbreak. Even while Congress is on break, the North Texas Commission will continue to monitor for updates.

COVID-19: What We’re Hearing

  • Remote Voting. Members of the remote voting working group met yesterday to discuss how to conduct Committee business remotely with virtual hearings and markups. House Majority Leader Steny Hoyer (D-MD) emphasized the need to resume Committee business remotely in order to queue up legislation for when it’s safe for lawmakers to return. TRP’s analysis on the state of play for remote voting can be read here.
  • COVID 4.0. Bill text on certain provisions could be released by House Democrats as early as this week, but a vote is not expected until later next month, possibly into June. Democrats are using Speaker Nancy Pelosi’s (D-CA) counteroffer to Senate Majority Leader Mitch McConnell’s (R-KY) CARES Act as a starting point for developing the forthcoming COVID Phase IV legislation.
  • Liability. Leader McConnell emphasized that he willinsist” Congress limit the liabilities of health care workers, business owners, and employees from lawsuits pertaining to the COVID-19 outbreak, making it contingent in order for the Senate to consider key Democratic priorities. Democrats have dismissed this proposal, arguing that it would water down federal consumer protection efforts.
  • PPP. When asked how long he expects this next tranche of funding for the PPP to last, House Majority Leader Steny Hoyer (D-MD) expressed uncertainty as to how quickly the funding could dry up. He suggested that lawmakers could move on additional PPP funding in the forthcoming Phase IV effort. 
  • Merger Ban. Several Democratic lawmakers have coalesced behind a plan sponsored by Sen. Elizabeth Warren (D-MA) and Alexandria Ocasio-Cortez (D-NY) that would place a ban on company mergers during the outbreak. However, Democratic leadership appears lukewarm on this suggestion as of now, and it’s unlikely to gain traction in the GOP-controlled Senate.
  • State and Local Governments. While additional funding for states and local governments was not included in the Phase 3.5 measure, there is bipartisan agreement that this additional assistance should be included in COVID Phase IV.
  • A bipartisan group of House lawmakers have introduced legislation that would allocate $250 billion in direct funding for local governments of all sizes. The measure would provide funding for all local governments with fewer than 500,000 people, and would also allow governments to offset lost revenue due to the pandemic.
  • Infrastructure. President Trump reiterated his call for robust infrastructure provisions in the Phase IV bill in a recent tweet, specifically highlighting surface transportation and broadband infrastructure as areas he’d like to see addressed.
  • Despite support for infrastructure from Speaker Pelosi and President Trump, it remains to be seen whether both parties can strike an agreement on big-ticket legislative items such as infrastructure. Congressional Republicans have remained opposed to tacking on non-COVID related items to future relief packages.
  • Surprise Billing. Energy and Commerce Ranking Member Greg Walden (R-OR) expects another push for action on surprise billing in the next round of relief. During the Phase III negotiations, Chairman Frank Pallone (D-NJ) and Senate Health, Education, Labor, and Pensions (HELP) Chairman Lamar Alexander (R-TN) were actively trying to tack their surprise billing legislation onto the package.
  • Provider Funding. On Apr. 22, the Department of Health and Human Services (HHS) announced new distributions from the $100 billion Provider Relief Fund created by the CARES Act (H.R. 748). TRP’s comprehensive analysis of these distributions can be read here.
  • The first round of funding included $30 billion for Medicare hospitals and providers. 
  • The second round of funding includes an additional $20 billion for Medicare providers nationwide, $10 billion for hospitals in highly impacted areas, $10 billion for rural providers, and $400 million for the Indian Health Service. It also establishes a program to fund COVID-19 care for the uninsured.
  • HHS has published a list of frequently asked questions pertaining to the $50 billion general allocation of the COVID-19 provider relief fund. In addition, providers receiving funds must agree to a set of terms and conditions, including reporting and documentation requirements, charging only in-network rates for COVID-19 care, and certifying that the funds will only be used to prevent, prepare for, and respond to the outbreak. Those that do not agree must contact HHS within 30 days to remit the payment.
  • HRSA launched a separate portal allowing providers who have conducted COVID-19 testing or provided treatment for uninsured COVID-19 individuals on or after February 4, 2020 to request reimbursement.
  • HHS also acknowledges cited providers who will receive further, separate funding, including skilled nursing facilities, dentists, and providers that solely take Medicaid.
  • Medicare Accelerated and Advanced Payments. The Centers for Medicare and Medicaid Services (CMS) announced that as of Apr. 27, the agency will not be accepting any new applications for Medicare’s Advance Payment Program (fact sheet). CMS also stated it will be reevaluating all pending and new applications for Accelerated Payments in light of payments made available through the HHS’ Provider Relief Fund.  

COVID-19: What’s Happened

  • Legislative Response. TRP has published several in-depth policy memos that analyzes actions that Congress and the federal government have taken to address the COVID-19 outbreak. Click here for the full list of memos.
  • President Donald Trump signed the $483.4 billion “COVID-19 Phase 3.5” bill into law last week. TRP’s comprehensive analysis of the Phase 3.5 legislation can be read here.
  • TRP has published a memo explores the “health extenders” that the CARES Act reauthorized through Nov. 2020, what’s on the table for these programs in the fall, and the questions that will shape the conversation. Click here to read the memo.
  • TRP has published a memo that looks at the substance use and mental health policies contained in the CARES Act. This includes new funding for SAMHSA, new funding for Certified Community Behavioral Health Centers, relaxed disclosure requirements for SUD-related health records, and more. Click here to read the memo.
  • TRP has published an analysis of the medical device-related provisions in the CARES Act, including new reporting requirements, a study on the security of the medical device supply chain, and storage requirements. Click here to read the memo.
  • SBA. The Small Business Administration (SBA) issued guidance on how to calculate Paycheck Protection Program (PPP) loans by business type.
  • Following the enactment of the COVID Phase 3.5 legislation, the Small Business Administration’s (SBA) Paycheck Protection Program (PPP) resumed lending on Apr. 27.
  • SBA published a list of all lenders participating in the PPP.
  • The SBA and Treasury Department updated their list of frequently asked questions on the PPP.
  • SBA issued an interim final rule clarifying the process of applying for PPP loans for individuals who report self-employed income on a 1040 Schedule C
  • SBA issued an interim final rule outlining additional guidance for the PPP. TRP’s comprehensive analysis of the small business provisions contained in COVID-19 response bills can be read here. The loan application form can be accessed here.
  • CMS. CMS sent a letter to clinicians notifying them that those who participate in a COVID-19 clinical trial and report their findings can earn credit in the Merit-based Incentive Payment System (MIPS) by attesting to the new COVID-19 Clinical Trials improvement activity.
  • CMS is preparing to issue another interim final rule that will address additional policy and regulatory revisions in response to the COVID-19 public health emergency. The rule is expected to include narrow and technical changes to Medicare and Medicaid policies, and will be effective upon publication.
  • CMS approved a first-of-its-kind section 1115(a) demonstration that will permit the state of Washington to utilize waiver and expenditure authorities aimed at boosting access to care for Medicaid beneficiaries during the pandemic.
  • CMS has updated its information related to COVID-19 guidance document for Medicare Advantage, Part D, and Medicare-Medicaid plans.
  • CMS has issued additional blanket waivers to promote flexibility for Long-Term Care Hospitals (LTCH), Rural Health Clinics (RHC), Federally Qualified Health Centers (FQHC), and Intermediate Care Facilities.
  • CMS announced regulatory requirements that mandate nursing homes to report cases of COVID-19 directly to the Centers for Disease Control and Prevention (CDC).
  • CMS issued recommendations that outline how certain health care systems can resume non-essential surgeries and medical procedures in areas with low incidence of COVID-19.
  • CMS has proposed to permanently codify a change to its inpatient rehabilitation facility (IRF) policy that dispenses with the requirement that IRFs provide and document a post-admission physician evaluation within 24 hours of admission.
  • CMS published a list of frequently asked questions on the enhanced Medicaid Federal Medical Assistance Percentage (FMAP). A list of FAQs for state Medicaid and CHIP agencies regarding COVID-19 response efforts can be read here. A list of FAQs for state Medicaid and Children’s Health Insurance Program (CHIP) agencies can be read here.
  • CMS posted a transcript of its Mar. 31 national stakeholder call. A full list of CMS call transcripts and recordings can be found here.
  • CMS approved Medicaid Section 1135 Waivers for states in response to the COVID-19 outbreak. A full list of the 1135 waiver approval letters can be accessed here.
  • Testing. The Trump administration released a blueprint that seeks to bolster state testing plans and rapid response programs.
  • SAMHSA. The Substance Abuse and Mental Health Services Administration (SAMHSA) awarded grant funding to increase access and improve the quality of community mental and substance use disorder (SUD) treatment services through the expansion of Certified Community Behavioral Health Clinics (CCBHC). 
  • FCC. The Federal Communications Commission (FCC) and the Department of Education announced efforts to promote the use of $16 billion in funding for the CARES Act’s Education Stabilization Fund for remote learning.
  • In a move aimed at expanding access to Wi-Fi throughout the country, the FCC voted to adopt a report and order that would make 1,200 megahertz of spectrum in the 6 GHz band available for unlicensed use.
  • The Fed. The Federal Reserve expanded the scope and duration of its Municipal Liquidity Facility to offer up to $500 billion in lending to states and municipalities during the pandemic.
  • The Federal Reserve stated that the central bank plans to disclose “substantial amounts of information” regarding borrowers from its emergency lending facilities.
  • The Federal Reserve issued a statement saying that it is working to expand access to the PPP Liquidity Facility for qualified lenders as soon as possible.
  • The Federal Reserve announced a series of emergency actions that would provide more than $2 trillion in COVID-19 loans to businesses, state, and local governments.
  • The Federal Reserve announced the creation of a lending facility that will provide liquidity for lenders for the purposes of funding up to $349 billion authorized by the CARES Act. The interim final rule can be read here.
  • The Federal Reserve announced on Mar. 23 a series of emergency moves aimed at stemming the economic impact of the outbreak. These actions include three new emergency lending facilities, as well as a new program that will support lending to eligible small-and medium-sized
  • Telehealth. CMS has released a telehealth toolkit aimed at accelerating the use of broader telehealth coverage policies in state Medicaid and CHIP programs. TRP’s analysis of COVID-19 telehealth policies can be read here.
  • The Federal Communications Commission (FCC) launched its COVID-19 Telehealth Program application portal. Click here for details.
  • Ed. The Department of Education announced the availability of more than $13 billion in emergency funds aimed at helping students K-12 whose schools were closed due to the outbreak.
  • The Department of Education announced the availability of $3 billion in emergency education relief funding for states to allocate in support of institutions that have been adversely impacted by the outbreak. A breakdown of the funding allocations can be read here.
  • Treasury. Treasury Secretary Steven Mnuchin issued guidance and frequently asked questions that provide examples of eligible and ineligible expenditures of the state, local, and tribal Coronavirus Relief Fund.
  • NIH. The National Institutes of Health issued its first guidance on COVID-19 treatment options that are currently under review.
  • NIH and the Foundation for the NIH (FNIH) announced that they will launch a new public-private partnership with more than a dozen biopharmaceutical companies aimed at speeding COVID-19 vaccine and treatment options.
  • FDA. The Food and Drug Administration (FDA) issued guidance that will temporarily allow hospitals to compound certain sedatives used for COVID-19 patients during the public health emergency. Additional details on this policy from the FDA can be read here.
  • FDA has authorized the first at-home COVID-19 testing kit that will allow patients to self-collect samples.
  • FDA issued an update on steps the agency is taking to help mitigate supply interruptions of food and medical products.
  • FDA announced actions to increase U.S. supplies to support COVID-19 response efforts by providing instructions to manufacturers importing personal protective equipment (PPE) and other devices.
  • FDA has provided new guidance on patient access to certain Risk Evaluation and Mitigation Strategy (REMS)-requited drugs during the COVID-19 public health emergency.
  • USDA. The U.S. Department of Agriculture (USDA) and Department of Homeland Security (DHS) issued a temporary final rule allowing for flexibilities on certain agricultural-related employment regulations.
  • DOT. The Department of Transportation (DOT) awarded $10 billion in grant funding for airports to certain operating expenses during the COVID-19 pandemic. A breakdown of the disbursements can be read here. A list of frequently asked questions on this funding can be read here.
  • DOT issued a final order on service obligations for air carriers receiving financial relief through the CARES Act.
  • DOT and the Federal Transit Administration (FTA) announced a total of $25 billion in federal funding allocations to help the public transit systems respond to the COVID-29 outbreak.
  • DOL. The Department of Labor issued a temporary rule implementing the paid family and medical leave provisions of the Families First Coronavirus Response Act. TRP’s analysis of the rule can be read here.
  • The Trump administration offered a broad definition of “health care providers” that may be excluded from paid sick and family leave, as well as broad exceptions to family leave for companies with fewer than 50 workers in the rule. This led some Members of Congress to say that the rule veers away from what Congress intended when it passed the law.
  • HUD. The Department of Housing and Urban Affairs (HUD) has begun allocating $3 billion in funding for communities through the Community Development Block Grant, Emergency Solutions Grant, and Housing Opportunities for Persons With AIDS programs to address COVID-19 issues.

COVID-19: Federal Update (4/28)

Senators confirmed yesterday that they will return for legislative business next Monday, May 4, but House lawmakers have reversed course on their decision to return after consulting the attending physician’s office. While the floor and Committee schedules for coming days and weeks have yet to be fully ironed out, leadership officials stated that Congress is likely to consider another round of COVID-19 legislation as they look to stem emerging and existing issues pertaining to the outbreak. Despite their plans to continue distancing from Capitol Hill, House Democrats have indicated that work has already begun on their next response measure and will likely include: (1) more aid for state and local governments; (2) funding for unemployment insurance; (3) additional economic impact payments; and (4) provisions to address certain supply chain issues. However, it remains to be seen whether Senate Republicans coalesce around an aid package that omits their key legislative priorities — namely liability protections for business owners and employees and any actions needed to shore up the Paycheck Protection Program (PPP). The North Texas Commission is closely monitoring any updates to aid packages.

COVID-19: What We’re Hearing

  • COVID 4.0. House Democrats are using Speaker Nancy Pelosi’s (D-CA) counteroffer to Senate Majority Leader Mitch McConnell’s (R-KY) CARES Act as a starting point for developing the forthcoming COVID Phase IV bill. Bill text on certain provisions could be released by House Democrats as early as this week.
  • Liability. Leader McConnell emphasized that he willinsist” Congress limit the liabilities of health care workers, business owners, and employees from lawsuits pertaining to the COVID-19 outbreak. Democrats have dismissed this proposal, arguing that it would water down federal consumer protection efforts.
  • PPP. When asked how long he expects this next tranche of funding for the PPP to last, House Majority Leader Steny Hoyer (D-MD) expressed uncertainty as to how quickly the funding could dry up. He suggested that lawmakers could move on additional PPP funding in the forthcoming Phase IV effort. 
  • State and Local Governments. While additional funding for states and local governments was not included in the Phase 3.5 measure, there is bipartisan agreement that this additional assistance should be included in COVID Phase IV.
  • A bipartisan group of House lawmakers have introduced legislation that would allocate $250 billion in direct funding for local governments of all sizes. The measure would provide funding for all local governments with fewer than 500,000 people, and would also allow governments to offset lost revenue due to the pandemic.
  • Infrastructure. President Trump reiterated his call for robust infrastructure provisions in the Phase IV bill in a recent tweet, specifically highlighting surface transportation and broadband infrastructure as areas he’d like to see addressed.
  • Despite support for infrastructure from Speaker Pelosi and President Trump, it remains to be seen whether both parties can strike an agreement on big-ticket legislative items such as infrastructure, as Republicans on Capitol Hill are pushing back against using COVID-19 legislation as a vehicle to carry unrelated policy priorities.
  • Surprise Billing. Energy and Commerce Ranking Member Greg Walden (R-OR) expects another push for action on surprise billing in the next round of relief. During the Phase III negotiations, Chairman Frank Pallone (D-NJ) and Senate Health, Education, Labor, and Pensions (HELP) Chairman Lamar Alexander (R-TN) were actively trying to tack their surprise billing legislation onto the package.
  • Provider Funding. On Apr. 22, the Department of Health and Human Services (HHS) announced new distributions from the $100 billion Provider Relief Fund created by the CARES Act (H.R. 748). TRP’s comprehensive analysis of these distributions can be read here.
  • The first round of funding included $30 billion for hospitals and providers. 
  • The second round of funding includes an additional $20 billion for providers nationwide, $10 billion for hospitals in highly impacted areas, $10 billion for rural providers, and $400 million for the Indian Health Service. It also establishes a program to fund COVID-19 care for the uninsured.
  • HHS has published a list of frequently asked questions pertaining to the $50 billion general allocation of the COVID-19 provider relief fund. In addition, providers receiving funds must agree to a set of terms and conditions, including reporting and documentation requirements, charging only in-network rates for COVID-19 care, and certifying that the funds will only be used to prevent, prepare for, and respond to the outbreak. Those that do not agree must contact HHS within 30 days to remit the payment.
  • Today, HRSA is expected to launch a separate portal allowing providers who have conducted COVID-19 testing or provided treatment for uninsured COVID-19 individuals on or after February 4, 2020 to request claims reimbursement.
  • HHS also acknowledges cited providers who will receive further, separate funding, including skilled nursing facilities, dentists, and providers that solely take Medicaid.
  • Medicare Accelerated and Advanced Payments. The Centers for Medicare and Medicaid Services (CMS) announced that as of Apr. 27, the agency will not be accepting any new applications for Medicare’s Advance Payment Program (fact sheet). CMS also stated it will be reevaluating all pending and new applications for Accelerated Payments in light of payments made available through the HHS’ Provider Relief Fund.  

COVID-19: What’s Happened

  • Testing. The Trump administration released a blueprint that seeks to bolster state testing plans and rapid response programs.
  • SAMHSA. The Substance Abuse and Mental Health Services Administration (SAMHSA) awarded grant funding to increase access and improve the quality of community mental and substance use disorder (SUD) treatment services through the expansion of Certified Community Behavioral Health Clinics (CCBHC). 
  • FCC. The Federal Communications Commission (FCC) and the Department of Education announced efforts to promote the use of $16 billion in funding for the CARES Act’s Education Stabilization Fund for remote learning.
  • In a move aimed at expanding access to Wi-Fi throughout the country, the FCC voted to adopt a report and order that would make 1,200 megahertz of spectrum in the 6 GHz band available for unlicensed use.
  • Legislative Response. TRP has published several in-depth policy memos that analyzes actions that Congress and the federal government have taken to address the COVID-19 outbreak. Click here for the full list of memos.
  • President Donald Trump signed the $483.4 billion “COVID-19 Phase 3.5” bill into law last week. TRP’s comprehensive analysis of the Phase 3.5 legislation can be read here.
  • TRP has published a memo explores the “health extenders” that the CARES Act reauthorized through Nov. 2020, what’s on the table for these programs in the fall, and the questions that will shape the conversation. Click here to read the memo.
  • TRP has published a memo that looks at the substance use and mental health policies contained in the CARES Act. This includes new funding for SAMHSA, new funding for Certified Community Behavioral Health Centers, relaxed disclosure requirements for SUD-related health records, and more. Click here to read the memo.
  • TRP has published an analysis of the medical device-related provisions in the CARES Act, including new reporting requirements, a study on the security of the medical device supply chain, and storage requirements. Click here to read the memo.
  • The Fed. The Federal Reserve expanded the scope and duration of its Municipal Liquidity Facility to offer up to $500 billion in lending to states and municipalities during the pandemic.
  • The Federal Reserve stated that the central bank plans to disclose “substantial amounts of information” regarding borrowers from its emergency lending facilities.
  • The Federal Reserve issued a statement saying that it is working to expand access to the PPP Liquidity Facility for qualified lenders as soon as possible.
  • The Federal Reserve announced a series of emergency actions that would provide more than $2 trillion in COVID-19 loans to businesses, state, and local governments.
  • The Federal Reserve announced the creation of a lending facility that will provide liquidity for lenders for the purposes of funding up to $349 billion authorized by the CARES Act. The interim final rule can be read here.
  • The Federal Reserve announced on Mar. 23 a series of emergency moves aimed at stemming the economic impact of the outbreak. These actions include three new emergency lending facilities, as well as a new program that will support lending to eligible small-and medium-sized
  • SBA. Following the enactment of the COVID Phase 3.5 legislation, the Small Business Administration’s (SBA) Paycheck Protection Program (PPP) resumed lending yesterday.
  • SBA published a list of all lenders participating in the PPP.
  • The SBA and Treasury Department updated their list of frequently asked questions on the PPP.
  • SBA published a detailed breakdown of the PPP funding that has been distributed thus far.
  • SBA issued an interim final rule clarifying the process of applying for PPP loans for individuals who report self-employed income on a 1040 Schedule C
  • SBA issued an interim final rule outlining additional guidance for the PPP. TRP’s comprehensive analysis of the small business provisions contained in COVID-19 response bills can be read here. The loan application form can be accessed here.
  • CMS. CMS approved a first-of-its-kind section 1115(a) demonstration that will permit the state of Washington to utilize waiver and expenditure authorities aimed at boosting access to care for Medicaid beneficiaries during the pandemic.
  • CMS has updated its information related to COVID-19 guidance document for Medicare Advantage, Part D, and Medicare-Medicaid plans.
  • CMS has issued additional blanket waivers to promote flexibility for Long-Term Care Hospitals (LTCH), Rural Health Clinics (RHC), Federally Qualified Health Centers (FQHC), and Intermediate Care Facilities.
  • CMS announced regulatory requirements that mandate nursing homes to report cases of COVID-19 directly to the Centers for Disease Control and Prevention (CDC).
  • CMS issued recommendations that outline how certain health care systems can resume non-essential surgeries and medical procedures in areas with low incidence of COVID-19.
  • CMS has proposed to permanently codify a change to its inpatient rehabilitation facility (IRF) policy that dispenses with the requirement that IRFs provide and document a post-admission physician evaluation within 24 hours of admission.
  • CMS is preparing to issue another interim final rule that will address additional policy and regulatory revisions in response to the COVID-19 public health emergency. The rule is expected to include narrow and technical changes to Medicare and Medicaid policies, and will be effective upon publication.
  • CMS announced that they would nearly double Medicare payment for lab tests that use high-throughput technologies to rapidly diagnose large numbers of COVID-19 cases. 
  • CMS has issued a series of regulatory changes that seek to provide flexibility and bolster the health care system to address the COVID-19 outbreak. TRP’s analysis of the rule can be read here. A list of new frequently asked questions can be read here.
  • CMS published a list of frequently asked questions on the enhanced Medicaid Federal Medical Assistance Percentage (FMAP). A list of FAQs for state Medicaid and CHIP agencies regarding COVID-19 response efforts can be read here. A list of FAQs for state Medicaid and Children’s Health Insurance Program (CHIP) agencies can be read here.
  • CMS posted a transcript of its Mar. 31 national stakeholder call. A full list of CMS call transcripts and recordings can be found here.
  • CMS issued guidance for health care providers regarding the expansion of the accelerated and advance payments program for providers and suppliers during COVID-19 emergency.
  • CMS approved Medicaid Section 1135 Waivers for states in response to the COVID-19 outbreak. A full list of the 1135 waiver approval letters can be accessed here.
  • Telehealth. CMS has released a telehealth toolkit aimed at accelerating the use of broader telehealth coverage policies in state Medicaid and CHIP programs. TRP’s analysis of COVID-19 telehealth policies can be read here.
  • The Federal Communications Commission (FCC) launched its COVID-19 Telehealth Program application portal. Click here for details.
  • Ed. The Department of Education announced the availability of more than $13 billion in emergency funds aimed at helping students K-12 whose schools were closed due to the outbreak.
  • The Department of Education announced the availability of $3 billion in emergency education relief funding for states to allocate in support of institutions that have been adversely impacted by the outbreak. A breakdown of the funding allocations can be read here.
  • HHS. HHS announced a contract with General Electric and Ford under the Defense Production Act (DPA) that would allow for production of 50,000 ventilators by Jul. 13.
  • HHS announced that it will not penalize HIPAA-covered business associates for sharing patient information intended to assist the government combat COVID-19. 
  • HHS issued an emergency use authorization declaration stating that circumstances exist to justify the authorization of emergency use of drugs and biological products during the COVID-19 outbreak.
  • Treasury. Treasury Secretary Steven Mnuchin issued guidance and frequently asked questions that provide examples of eligible and ineligible expenditures of the state, local, and tribal Coronavirus Relief Fund.
  • NIH. The National Institutes of Health issued its first guidance on COVID-19 treatment options that are currently under review.
  • NIH and the Foundation for the NIH (FNIH) announced that they will launch a new public-private partnership with more than a dozen biopharmaceutical companies aimed at speeding COVID-19 vaccine and treatment options.
  • FDA. The Food and Drug Administration (FDA) issued guidance that will temporarily allow hospitals to compound certain sedatives used for COVID-19 patients during the public health emergency. Additional details on this policy from the FDA can be read here.
  • FDA has authorized the first at-home COVID-19 testing kit that will allow patients to self-collect samples.
  • FDA issued an update on steps the agency is taking to help mitigate supply interruptions of food and medical products.
  • FDA announced actions to increase U.S. supplies to support COVID-19 response efforts by providing instructions to manufacturers importing personal protective equipment (PPE) and other devices.
  • FDA has provided new guidance on patient access to certain Risk Evaluation and Mitigation Strategy (REMS)-requited drugs during the COVID-19 public health emergency.
  • FDA issued guidance allowing manufacturers of certain non-invasive, FDA-cleared devices to expand their use so that health care providers can use them to monitor patients remotely.  
  • USDA. The U.S. Department of Agriculture (USDA) and Department of Homeland Security (DHS) issued a temporary final rule allowing for flexibilities on certain agricultural-related employment regulations.
  • DOT. The Department of Transportation (DOT) awarded $10 billion in grant funding for airports to certain operating expenses during the COVID-19 pandemic. A breakdown of the disbursements can be read here. A list of frequently asked questions on this funding can be read here.
  • DOT issued a final order on service obligations for air carriers receiving financial relief through the CARES Act.
  • DOT and the Federal Transit Administration (FTA) announced a total of $25 billion in federal funding allocations to help the public transit systems respond to the COVID-29 outbreak.
  • DOL. The Department of Labor issued a temporary rule implementing the paid family and medical leave provisions of the Families First Coronavirus Response Act. TRP’s analysis of the rule can be read here.
  • The Trump administration offered a broad definition of “health care providers” that may be excluded from paid sick and family leave, as well as broad exceptions to family leave for companies with fewer than 50 workers in the rule. This led some Members of Congress to say that the rule veers away from what Congress intended when it passed the law.
  • HUD. The Department of Housing and Urban Affairs (HUD) has begun allocating $3 billion in funding for communities through the Community Development Block Grant, Emergency Solutions Grant, and Housing Opportunities for Persons With AIDS programs to address COVID-19 issues.
  • CFPB. The Consumer Financial Protection Bureau (CFBP) issued guidance urging lenders to provide information to credit reporting agencies about the work they are doing to provide relief to consumers during the COVID-19 emergency.

COVID-19: Federal Update (4/27)

After passage and enactment of the “Phase 3.5” measure last week, lawmakers have left Washington and are not expected to return until next week at the earliest. While leadership continues to deliberate whether it’s safe to return next Monday, officials formed a bipartisan working group to examine options for remote voting and virtual hearings moving forward should members need to extend their time away from Capitol Hill. TRP’s analysis on the state of play for remote voting in Congress can be read here.

Meanwhile, Congress is continuing to weigh various potential policy items that could be included in the next round of COVID-19 response legislation. Democratic leadership has outlined several of their priorities for the “Phase IV” legislation, including: (1) addressing additional health care needs and bolstering health infrastructure; (2) more funding for unemployment insurance and another round of direct payments; (3) stabilizing the U.S. postal service; (4) additional funding for state and local governments and election support; (5) strengthened oversight and protections for inspector generals; and (6) “technology modernization.” Bill text on certain provisions could be released by House Democrats as early as this week. The North Texas Commission is closely monitoring and will keep you posted.

COVID-19: What We’re Hearing

  • COVID 4.0. House Democrats are using Speaker Nancy Pelosi’s (D-CA) counteroffer to Senate Majority Leader Mitch McConnell’s (R-KY) CARES Act as a starting point for developing the forthcoming COVID Phase IV bill.
  • PPP. When asked how long he expects this next tranche of funding for the PPP to last, House Majority Leader Steny Hoyer (D-MD) expressed uncertainty as to how quickly the funding could dry up. He suggested that lawmakers could move on additional PPP funding in the forthcoming Phase IV effort. 
  • State and Local Governments. While additional funding for states and local governments was not included in the Phase 3.5 measure, there is bipartisan agreement that this additional assistance should be included in COVID Phase IV.
  • A bipartisan group of House lawmakers have introduced legislation that would allocate $250 billion in direct funding for local governments of all sizes. The measure would provide funding for all local governments with fewer than 500,000 people, and would also allow governments to offset lost revenue due to the pandemic.
  • Infrastructure. President Trump reiterated his call for robust infrastructure provisions in the Phase IV bill in a recent tweet, specifically highlighting surface transportation and broadband infrastructure as areas he’d like to see addressed.
  • Despite support for infrastructure from Speaker Pelosi and President Trump, it remains to be seen whether both parties can strike an agreement on big-ticket legislative items such as infrastructure, as Republicans on Capitol Hill are pushing back against using COVID-19 legislation as a vehicle to carry unrelated policy priorities.
  • Surprise Billing. Energy and Commerce Ranking Member Greg Walden (R-OR) expects another push for action on surprise billing in the next round of relief. During the Phase III negotiations, Chairman Frank Pallone (D-NJ) and Senate Health, Education, Labor, and Pensions (HELP) Chairman Lamar Alexander (R-TN) were actively trying to tack their surprise billing legislation onto the package.
  • Provider Funding. On Apr. 22, the Department of Health and Human Services (HHS) announced new distributions from the $100 billion Provider Relief Fund created by the CARES Act (H.R. 748). TRP’s comprehensive analysis of these distributions can be read here.
  • The first round of funding, which included $30 billion for hospitals and providers, was released over the past two weeks.
  • The second round of funding includes an additional $20 billion for providers nationwide, $10 billion for hospitals in highly impacted areas, $10 billion for rural providers, and $400 million for the Indian Health Service. It also establishes a program to fund COVID-19 care for the uninsured.
  • HHS has published a list of frequently asked questions pertaining to the $50 billion general allocation of the COVID-19 provider relief fund. In addition, providers receiving funds must agree to a set of terms and conditions, including reporting and documentation requirements, charging only in-network rates for COVID-19 care, and certifying that the funds will only be used to prevent, prepare for, and respond to the outbreak. Those that do not agree must contact HHS within 30 days to remit the payment.
  • Today, HRSA is expected to launch a separate portal allowing providers who have conducted COVID-19 testing or provided treatment for uninsured COVID-19 individuals on or after February 4, 2020 to request claims reimbursement.
  • HHS also acknowledges cited providers who will receive further, separate funding, including skilled nursing facilities, dentists, and providers that solely take Medicaid.
  • Medicare Accelerated and Advanced Payments. HHS announced over the weekend that as of today (4/27), the agency will not be accepting any new applications for Medicare’s Advance Payment Program (fact sheet). The Centers for Medicare and Medicaid Services also stated it will be reevaluating all pending and new applications for Accelerated Payments in light of payments made available through the HHS’ Provider Relief Fund.  

COVID-19: What’s Happened

  • SBA. Following the enactment of the COVID Phase 3.5 legislation, the Small Business Administration’s (SBA) Paycheck Protection Program (PPP) will resume lending today.
  • SBA published a list of all lenders participating in the PPP.
  • The SBA and Treasury Department updated their list of frequently asked questions on the PPP.
  • SBA published a detailed breakdown of the PPP funding that has been distributed thus far.
  • SBA issued a interim final rule clarifying the process of applying for PPP loans for individuals who report self-employed income on a 1040 Schedule C
  • SBA issued an interim final rule outlining additional guidance for the PPP. TRP’s comprehensive analysis of the small business provisions contained in COVID-19 response bills can be read here. The loan application form can be accessed here.
  • Legislative Response. TRP has published several in-depth policy memos that analyzes actions that Congress, and the federal government have taken to address the COVID-19 outbreak. Click here for the full list of memos.
  • President Donald Trump signed the $483.4 billion “COVID-19 Phase 3.5” bill into law last week. TRP’s comprehensive analysis of the Phase 3.5 legislation can be read here.
  • TRP has published a memo explores the “health extenders” that the CARES Act reauthorized through Nov. 2020, what’s on the table for these programs in the fall, and the questions that will shape the conversation. Click here to read the memo.
  • TRP has published a memo that looks at the substance use and mental health policies contained in the CARES Act. This includes new funding for SAMHSA, new funding for Certified Community Behavioral Health Centers, relaxed disclosure requirements for SUD-related health records, and more. Click here to read the memo.
  • TRP has published an analysis of the medical device-related provisions in the CARES Act, including new reporting requirements, a study on the security of the medical device supply chain, and storage requirements. Click here to read the memo.
  • CMS. CMS approved a first-of-its-kind section 1115(a) demonstration that will permit the state of Washington to utilize waiver and expenditure authorities aimed at boosting access to care for Medicaid beneficiaries during the pandemic.
  • CMS has updated its information related to COVID-19 guidance document for Medicare Advantage, Part D, and Medicare-Medicaid plans.
  • CMS has issued additional blanket waivers to promote flexibility for Long-Term Care Hospitals (LTCH), Rural Health Clinics (RHC), Federally Qualified Health Centers (FQHC), and Intermediate Care Facilities.
  • CMS announced regulatory requirements that mandate nursing homes to report cases of COVID-19 directly to the Centers for Disease Control and Prevention (CDC).
  • CMS issued recommendations that outline how certain health care systems can resume non-essential surgeries and medical procedures in areas with low incidence of COVID-19.
  • CMS has proposed to permanently codify a change to its inpatient rehabilitation facility (IRF) policy that dispenses with the requirement that IRFs provide and document a post-admission physician evaluation within 24 hours of admission.
  • CMS is preparing to issue another interim final rule that will address additional policy and regulatory revisions in response to the COVID-19 public health emergency. The rule is expected to include narrow and technical changes to Medicare and Medicaid policies, and will be effective upon publication.
  • CMS announced that they would nearly double Medicare payment for lab tests that use high-throughput technologies to rapidly diagnose large numbers of COVID-19 cases. 
  • CMS has issued a series of regulatory changes that seek to provide flexibility and bolster the health care system to address the COVID-19 outbreak. TRP’s analysis of the rule can be read here. A list of new frequently asked questions can be read here.
  • CMS published a list of frequently asked questions on the enhanced Medicaid Federal Medical Assistance Percentage (FMAP). A list of FAQs for state Medicaid and CHIP agencies regarding COVID-19 response efforts can be read here. A list of FAQs for state Medicaid and Children’s Health Insurance Program (CHIP) agencies can be read here.
  • CMS posted a transcript of its Mar. 31 national stakeholder call. A full list of CMS call transcripts and recordings can be found here.
  • CMS issued guidance for health care providers regarding the expansion of the accelerated and advance payments program for providers and suppliers during COVID-19 emergency.
  • CMS approved Medicaid Section 1135 Waivers for states in response to the COVID-19 outbreak. A full list of the 1135 waiver approval letters can be accessed here.
  • Telehealth. CMS has released a telehealth toolkit aimed at accelerating the use of broader telehealth coverage policies in state Medicaid and CHIP programs. TRP’s analysis of COVID-19 telehealth policies can be read here.
  • The Federal Communications Commission (FCC) launched its COVID-19 Telehealth Program application portal. Click here for details.
  • FCC. In a move aimed at expanding access to Wi-Fi throughout the country, the Federal Communications Commission (FCC) voted to adopt a report and order that would make 1,200 megahertz of spectrum in the 6 GHz band available for unlicensed use.
  • Ed. The Department of Education announced the availability of more than $13 billion in emergency funds aimed at helping students K-12 whose schools were closed due to the outbreak.
  • The Department of Education announced the availability of $3 billion in emergency education relief funding for states to allocate in support of institutions that have been adversely impacted by the outbreak. A breakdown of the funding allocations can be read here.
  • HHS. HHS announced a contract with General Electric and Ford under the Defense Production Act (DPA) that would allow for production of 50,000 ventilators by Jul. 13.
  • HHS announced that it will not penalize HIPAA-covered business associates for sharing patient information intended to assist the government combat COVID-19. 
  • HHS issued an emergency use authorization declaration stating that circumstances exist to justify the authorization of emergency use of drugs and biological products during the COVID-19 outbreak.
  • The Fed. The Federal Reserve stated that the central bank plans to disclose “substantial amounts of information” regarding borrowers from its emergency lending facilities.
  • The Federal Reserve issued a statement saying that it is working to expand access to the PPP Liquidity Facility for qualified lenders as soon as possible.
  • The Federal Reserve announced a series of emergency actions that would provide more than $2 trillion in COVID-19 loans to businesses, state, and local governments.
  • The Federal Reserve announced the creation of a lending facility that will provide liquidity for lenders for the purposes of funding up to $349 billion authorized by the CARES Act. The interim final rule can be read here.
  • The Federal Reserve announced on Mar. 23 a series of emergency moves aimed at stemming the economic impact of the outbreak. These actions include three new emergency lending facilities, as well as a new program that will support lending to eligible small-and medium-sized
  • Treasury. Treasury Secretary Steven Mnuchin issued guidance and frequently asked questions that provide examples of eligible and ineligible expenditures of the state, local, and tribal Coronavirus Relief Fund.
  • NIH. The National Institutes of Health issued its first guidance on COVID-19 treatment options that are currently under review.
  • NIH and the Foundation for the NIH (FNIH) announced that they will launch a new public-private partnership with more than a dozen biopharmaceutical companies aimed at speeding COVID-19 vaccine and treatment options.
  • FDA. The Food and Drug Administration (FDA) issued guidance that will temporarily allow hospitals to compound certain sedatives used for COVID-19 patients during the public health emergency. Additional details on this policy from the FDA can be read here.
  • FDA has authorized the first at-home COVID-19 testing kit that will allow patients to self-collect samples.
  • FDA issued an update on steps the agency is taking to help mitigate supply interruptions of food and medical products.
  • FDA announced actions to increase U.S. supplies to support COVID-19 response efforts by providing instructions to manufacturers importing personal protective equipment (PPE) and other devices.
  • FDA has provided new guidance on patient access to certain Risk Evaluation and Mitigation Strategy (REMS)-requited drugs during the COVID-19 public health emergency.
  • FDA issued guidance allowing manufacturers of certain non-invasive, FDA-cleared devices to expand their use so that health care providers can use them to monitor patients remotely.  
  • USDA. The U.S. Department of Agriculture (USDA) and Department of Homeland Security (DHS) issued a temporary final rule allowing for flexibilities on certain agricultural-related employment regulations.
  • DOT. The Department of Transportation (DOT) awarded $10 billion in grant funding for airports to certain operating expenses during the COVID-19 pandemic. A breakdown of the disbursements can be read here. A list of frequently asked questions on this funding can be read here.
  • DOT issued a final order on service obligations for air carriers receiving financial relief through the CARES Act.
  • DOT and the Federal Transit Administration (FTA) announced a total of $25 billion in federal funding allocations to help the public transit systems respond to the COVID-29 outbreak.
  • DOL. The Department of Labor issued a temporary rule implementing the paid family and medical leave provisions of the Families First Coronavirus Response Act. TRP’s analysis of the rule can be read here.
  • The Trump administration offered a broad definition of “health care providers” that may be excluded from paid sick and family leave, as well as broad exceptions to family leave for companies with fewer than 50 workers in the rule. This led some Members of Congress to say that the rule veers away from what Congress intended when it passed the law.
  • HUD. The Department of Housing and Urban Affairs (HUD) has begun allocating $3 billion in funding for communities through the Community Development Block Grant, Emergency Solutions Grant, and Housing Opportunities for Persons With AIDS programs to address COVID-19 issues.
  • CFPB. The Consumer Financial Protection Bureau (CFBP) issued guidance urging lenders to provide information to credit reporting agencies about the work they are doing to provide relief to consumers during the COVID-19 emergency.