COVID-19: Federal Update (4/24)

House lawmakers overwhelmingly passed (388-5-1) the $483.4 billion Phase 3.5 bill yesterday, placing the bill on President Donald Trump’s desk for signature at some point today. The bill provides $310 billion to replenish the Small Business Administration’s (SBA) Paycheck Protection Program (PPP) that would allow it to resume lending as soon as Monday. The measure also allocates: (1) $75 billion for hospitals; (3) $25 billion to boost testing capacity; and (3) $60 billion for the SBA’s Economic Injury Disaster Loan (EIDL) program. TRP’s instant, comprehensive analysis of the Phase 3.5 legislation can be read here.

Under the current legislative schedule, Congress is not expected to return to Washington until May 4 at the earliest. After canceling the lower chamber’s previously-scheduled vote on a resolution that would’ve instituted an emergency, 60-day proxy voting authority, House Speaker Nancy Pelosi (D-CA) instead opted to form 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. The North Texas Commission will continue to monitor any updates from Congress.

COVID-19: What We’re Hearing

  • COVID 4.0. Congress has floated several potential policy priorities that could be addressed in the next round of COVID-19 response legislation. Bill text on certain provisions could be released by House Democrats as early as next week.
  • House Democrats. Leadership has outlined numerous priorities for the COVID-19 “Phase IV” legislation. Specific policy items include: (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 election support; (5) strengthened oversight and protections for inspector generals; and (6) “technology modernization.” 
  • 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 Pelsoi 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.
  • 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.
  • HHS is expected to release a list of frequently asked questions to clarify that the intention for this funding is to support providers that have lost revenue. Providers who ceased operation as a result of the pandemic will likely still be eligible to receive funds if they provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19.
  • HHS also acknowledges cited providers who will receive further, separate funding, including skilled nursing facilities, dentists, and providers that solely take Medicaid.

COVID-19: What’s Happened

  • Telehealth. The Centers for Medicare and Medicaid Services (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 yesterday 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.
  • The Fed. The Federal Reserve stated yesterday that the central bank plans to disclose “substantial amounts of information” regarding borrowers from its emergency lending facilities.
  • The Federal Reserve issued a statement yesterday 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. 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 paycheck protection program. 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. 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 Treasury Department issued a statement clarifying that Social Security recipients will not need to file an abbreviated tax return to receive direct payment relief.
  • 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.
  • 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.
  • 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.
  • 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’s 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.
  • TRP has published a memo on the Medicare and Medicaid provisions in the CARES Act and other COVID-19-related legislation. This analysis examines new telehealth policies, emergency payment provisions, new flexibilities on prescription drug fills, and more. Click here to read the memo.
  • 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.  
  • FDA is suspending routine surveillance inspections for food, drugs, medical devices and tobacco to protect its workers from COVID-19 and because of industry concerns about visitors. Inspections triggered by specific reasons, like contamination, outbreaks or other emergencies, will continue.
  • businesses that support efforts by the Small Business Administration (SBA).
  • HHS. HHS announced a new contract with General Electric and Ford under the Defense Production Act (DPA) that would allow for production of 50,000 ventilators by Jul. 13.
  • TRP’s memo on the bill’s provisions pertaining to the PHSSEF can be read here.
  • 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.
  • 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 (4/23)

House lawmakers will convene for legislative business today to consider the $483.4 billion Phase 3.5 funding measure (updated text; small business summary; health care summary) that will bolster support for small businesses and address other pressing COVID-19 related needs. The bill provides $310 billion replenish the Small Business Administration’s (SBA) Paycheck Protection Program (PPP) — plus an additional $10 billion to cover certain administrative costs — as well as: (1) $75 billion for hospitals; (3) $25 billion to boost testing capacity; and (3) $60 billion for the SBA’s Economic Injury Disaster Loan (EIDL) program. Republicans are expected to object to unanimous consent passage in the lower chamber in favor of a roll call vote, but the measure is ultimately expected to pass with strong bipartisan support and be swiftly signed into law by President Donald Trump. TRP’s instant, comprehensive analysis of the Phase 3.5 legislation can be read here.

Meanwhile, House Speaker Nancy Pelosi (D-CA) has cancelled the lower chamber’s previously-scheduled vote on a resolution that would institute an emergency, 60-day proxy voting authority. Designed to quell concerns about members returning to Washington for future votes during the pandemic, the rule change would permit members to submit votes by proxy only on legislation that pertains to the COVID-19 pandemic, and would also allow House committees to convene hearings and mark up legislation remotely. Lawmakers will instead consider a resolution that would establish a Select Investigative Committee on the COVID-19 pandemic. TRP’s analysis on the state of play for remote voting in Congress can be read here. The North Texas Commission will continue to monitor and keep you up to date.

COVID-19: What We’re Hearing

  • Provider Funding. Yesterday, 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 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.
  • 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.
  • HHS is expected to release a list of frequently asked questions to clarify that the intention for this funding is to support providers that have lost revenue. Providers who ceased operation as a result of the pandemic will likely still be eligible to receive funds if they provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19.
  • HHS also acknowledges cited providers who will receive further, separate funding, including skilled nursing facilities, dentists, and providers that solely take Medicaid.
  • COVID 4.0. Lawmakers on both sides of the aisle have floated potential policy priorities that they would like to see addressed in the next round of COVID-19 response legislation.
  • House Democrats. Leadership has outlined numerous priorities for the COVID-19 “Phase IV” legislation. Specific policy items include: (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 election support; (5) strengthened oversight and protections for inspector generals; and (6) “technology modernization.” 
  • 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 Pelsoi 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.

COVID-19: What’s Happened

  • SBA. The SBA and Treasury Department updated their list of frequently asked questions on the Paycheck Protection Program earlier this morning.
  • 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 paycheck protection program. 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. Treasury Secretary Steven Mnuchin issued guidance and frequently asked questions that provide examples of eligible and ineligible expenditures of the state, local, an tribal Coronavirus Relief Fund.
  • The Treasury Department issued a statement clarifying that Social Security recipients will not need to file an abbreviated tax return to receive direct payment relief.
  • The Treasury Department has issued guidance for airlines to apply for up to $58 billion in grants and loans as mandated by the Phase III COVID-19 legislative response bill.
  • CMS. The Centers for Medicare & Medicaid Services (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.
  • 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.
  • 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.
  • TRP’s latest COVID-19 policy 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 a memo that examines the provider-related provisions contained in the CARES Act. This includes critical funding for hospitals and providers impacted by the COVID-19 pandemic, greatly expanded flexibilities for providers to operate through the pandemic, and mandated coverage of coronavirus-related therapies and testing. 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.
  • TRP has published a memo on the Medicare and Medicaid provisions in the CARES Act and other COVID-19-related legislation. This analysis examines new telehealth policies, emergency payment provisions, new flexibilities on prescription drug fills, and more. Click here to read the memo.
  • 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.  
  • FDA is suspending routine surveillance inspections for food, drugs, medical devices and tobacco to protect its workers from COVID-19 and because of industry concerns about visitors. Inspections triggered by specific reasons, like contamination, outbreaks or other emergencies, will continue.
  • The Fed. The Federal Reserve announced that its PPP Liquidity Facility is fully operational and able to provide liquidity to eligible financial institutions.
  • 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 businesses that support efforts by the Small Business Administration (SBA).
  • HHS. HHS announced a new contract with General Electric and Ford under the Defense Production Act (DPA) that would allow for production of 50,000 ventilators by Jul. 13.
  • TRP’s memo on the bill’s provisions pertaining to the PHSSEF can be read here.
  • 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.
  • 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.
  • Ed. 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.
  • Telehealth. The Federal Communications Commission (FCC) launched its COVID-19 Telehealth Program application portal. Click here for details.
  • TRP has published a comprehensive analysis of the telehealth policies for the COVID-19 national emergency. Click here to read the telehealth memo.
  • 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.
  • Trade. The Office of the United States Trade Representative (USTR) published a list of exemptions on certain medical items from the tariffs imposed by President Donald Trump on Chinese goods.
  • USTR opened a comment docket for members of the public, businesses, and government agencies to submit comments if they believe further modifications to the 301 tariffs may be necessary in response to the outbreak. 

COVID-19: Federal Update (4/22)

Yesterday afternoon, Senators passed a $483.4 billion funding measure (updated text; small business summary; health care summary) after officials struck a bipartisan agreement to bolster the Small Business Administration’s (SBA) Paycheck Protection Program (PPP) and address other pressing COVID-19 related needs. The bill provides $310 billion to the PPP — plus an additional $10 billion to cover certain administrative costs — as well as: (1) $75 billion for hospitals; (3) $25 billion to boost testing capacity; and (3) $60 billion for the SBA’s Economic Injury Disaster Loan (EIDL) program. The North Texas Commission and TRP’s instant, comprehensive analysis of the Phase 3.5 legislation can be read here.

Meanwhile, lawmakers are traveling back to Washington for tomorrow’s legislative business day to vote on the Phase 3.5 measure. Republicans are expected to object to unanimous consent passage in the lower chamber in favor of a roll call vote, but the measure is ultimately expected to pass with strong bipartisan support. Additionally, House Democrats will also queue up a vote on a resolution that would institute an emergency, 60-day proxy voting authority. Designed to quell concerns about members returning to Washington for future votes during the pandemic, the rule change would permit members to submit votes by proxy only on legislation that pertains to the COVID-19 pandemic, and would also allow House committees to convene hearings and mark up legislation remotely. A “Dear Colleague” letter and list of frequently asked questions from the Rules Committee can be read here.

COVID-19: What We’re Hearing

  • COVID 4.0. Lawmakers on both sides of the aisle have floated potential policy priorities that they would like to see addressed in the next round of COVID-19 response legislation.
  • House Democrats. Leadership has outlined numerous priorities for the COVID-19 “Phase IV” legislation. Specific policy items include: (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 election support; (5) strengthened oversight and protections for inspector generals; and (6) “technology modernization.” 
  • 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. Sens. Bill Cassidy (R-LA) and Bob Menendez (D-NJ) announced they have crafted bipartisan legislation that would create a $500 billion fund for state and local governments. The bill would expand aid eligibility to include local governments with populations of 50,000 or greater, and allow funds to be used to offset lost revenue. Further, the bill would also ensure that no state receives less than $2.5 billion. 
  • 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 Donald Trump reiterated his call for robust infrastructure provisions in the Phase IV bill in a tweet yesterday, specifically highlighting surface transportation and broadband infrastructure as areas he’d like to see addressed.
  • Despite support for infrastructure from Speaker Nancy Pelosi (D-CA) 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. Health officials in the Trump administration are deliberating next steps on allocating the second tranche of CARES Act health care provider funding. Recent reports out of the Centers for Medicare and Medicaid Services (CMS) suggests that the next tranche of the $100 billion Public Health and Social Services Relief Fund (PHSSEF) will likely be distributed later this week or early next week. 
  • Health and Human Services Secretary Alex Azar told lawmakers on the House Appropriations Committee last week that the next wave of emergency funding to health care providers could take another week and a half to calculate and distribute. House Labor-HHS-Education Appropriations Chairwoman Rosa DeLauro (D-CT) highlighted this development in her April 16th letter to the Secretary. This news comes after CMS Administrator Seema Verma stated on Wednesday that this second tranche of relief funding would start going out last week. 
  • Verma stated that a portion of the $70 billion will be targeted at providers in areas that have been hit hardest by COVID-19 and aim to help providers that might not have benefited from the first round of funding. 
  • The first round of funding, which included $26 billion for hospitals and providers, was released via electronic transfer. The remaining $4 billion will be disbursed by paper check for providers for whom that is how they normally receive payment.
  • 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.
  • HHS is expected to release a list of frequently asked questions to clarify that the intention for this funding is to support providers that have lost revenue. Providers who ceased operation as a result of the pandemic will likely still be eligible to receive funds if they provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. 
  • The Administration had also previously announced that an additional chunk in the neighborhood of $30 billion will be set aside from the $100 billion to fund COVID-19 care for the uninsured. Kaiser Family Foundation estimated that care for the uninsured, reimbursed at Medicare rates, would run between $13.9 and $41.8 billion.
  • $34 billion has already started flowing to providers via the Accelerated/Advance Payment Program. These payments are separate from the PHSSEF funding and must be returned and carry a 10.25 percent interest rate, which CMS says it cannot change unilaterally.

COVID-19: What’s Happened

  • CMS. TheCenters for Medicare & Medicaid Services (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 sent a letter to hospitals on behalf of Vice President Mike Pence requesting they report data in connection with their efforts to fight the COVID-19.
  • 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.
  • 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.
  • 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.
  • TRP’s latest COVID-19 policy 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 analyses telehealth and rural health policies in the COVID-19 legislative response packages. This includes expanded capabilities and funding for telehealth, funding for community health centers and other rural health supports, backing for telehealth and rural health infrastructure, and more. 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 a memo that examines the provider-related provisions contained in the CARES Act. This includes critical funding for hospitals and providers impacted by the COVID-19 pandemic, greatly expanded flexibilities for providers to operate through the pandemic, and mandated coverage of coronavirus-related therapies and testing. Click here to read the memo.
  • TRP’s 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.
  • TRP has published a memo on the Medicare and Medicaid provisions in the CARES Act and other COVID-19-related legislation. This analysis examines new telehealth policies, emergency payment provisions, new flexibilities on prescription drug fills, and more. Click here to read the memo.
  • 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.  
  • FDA is suspending routine surveillance inspections for food, drugs, medical devices and tobacco to protect its workers from COVID-19 and because of industry concerns about visitors. Inspections triggered by specific reasons, like contamination, outbreaks or other emergencies, will continue.
  • Social Distancing. The Trump administration issued new federal guidelines entitled “Opening Up America Again,” outlining a three-phase process for when states can begin restarting their economies once the outbreak begins to slow.
  • The Fed. The Federal Reserve announced that its PPP Liquidity Facility is fully operational and able to provide liquidity to eligible financial institutions.
  • 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 businesses that support efforts by the Small Business Administration (SBA).
  • HHS. HHS announced a new contract with General Electric and Ford under the Defense Production Act (DPA) that would allow for production of 50,000 ventilators by Jul. 13.
  • TRP’s memo on the bill’s provisions pertaining to the PHSSEF can be read here.
  • 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.
  • 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.
  • SBA. 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
  • The SBA and Treasury Department updated their list of frequently asked questions on the Paycheck Protection Program.
  • SBA issued an interim final rule outlining additional guidance for the paycheck protection program. 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.
  • 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.
  • Ed. 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. Secretary Mnuchin announced that the Treasury Department reached an agreement in principle with ten airlines on grant funding to cover certain operating expenses.
  • The Treasury Department released eligibility guidance for State, Local, and Tribal government funding from the CARES Act.
  • The Treasury Department issued a statement clarifying that Social Security recipients will not need to file an abbreviated tax return to receive direct payment relief.
  • The Treasury Department has issued guidance for airlines to apply for up to $58 billion in grants and loans as mandated by the Phase III COVID-19 legislative response bill.
  • Telehealth. The Federal Communications Commission (FCC) launched its COVID-19 Telehealth Program application portal. Click here for details.
  • TRP has published a comprehensive analysis of the telehealth policies for the COVID-19 national emergency. Click here to read the telehealth memo.
  • 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.
  • Trade. The Office of the United States Trade Representative (USTR) published a list of exemptions on certain medical items from the tariffs imposed by President Donald Trump on Chinese goods.
  • USTR opened a comment docket for members of the public, businesses, and government agencies to submit comments if they believe further modifications to the 301 tariffs may be necessary in response to the outbreak. 

COVID-19: Federal Update (4/21)

Officials are finalizing negotiations on an agreement for the next round of COVID-19 legislation after funding for the Small Business Administration’s (SBA) Paycheck Protection Program (PPP) lapsed late last week. While lawmakers were hopeful that the Senate would clear the bill during yesterday’s pro forma session, talks on the “Phase 3.5” legislation extended into the late hours yesterday on key details pertaining to COVID-19 testing and final funding figures. As of now, the deal is expected to include a boost in funding for the PPP as well as additional funding to support health care providers and COVID-19 testing. However, more financial support for state and local governments, as well as a hike in Supplemental Nutrition Assistance Program (SNAP) benefits, appears to be off the table as of right now.

Once a deal has been formally announced, the Senate will look to pass the bill by unanimous consent during its pro forma session this afternoon, with the House following suit on Thursday to place it on President Donald Trump’s desk. While Rep. Thomas Massie (R-KY) is expected to object to unanimous consent passage in the lower chamber over concerns about moving a large package of funding absent a quorum, Democratic leadership is expected to push for a change in the House rules that would institute a temporary emergency remote voting plan during the pandemic. Additional details on the House Democrats’ remote voting strategy can be read here. The North Texas Commission is closely monitoring and will share updates with you.

COVID-19: What We’re Hearing

  • COVID 4.0. Sens. Bill Cassidy (R-LA) and Bob Menendez (D-NJ) announced they have crafted bipartisan legislation that would create a $500 billion fund for state and local governments. The bill would expand aid eligibility to include local governments with populations of 50,000 or greater, and allow funds to be used to offset lost revenue. Further, the bill would also ensure that no state receives less than $2.5 billion. 
  • Democrats have outlined numerous priorities for the COVID-19 “Phase IV” legislation. Specific policy items include: (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 election support; (5) strengthened oversight and protections for inspector generals; and (6) “technology modernization.” 
  • 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.
  • 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.
  • 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. Health officials in the Trump administration are deliberating next steps on allocating the second tranche of CARES Act health care provider funding. Recent reports out of the Centers for Medicare and Medicaid Services (CMS) suggests that the next tranche of the $100 billion Public Health and Social Services Relief Fund (PHSSEF) will likely be distributed later this week or early next week. 
  • Health and Human Services Secretary Alex Azar told lawmakers on the House Appropriations Committee last week that the next wave of emergency funding to health care providers could take another week and a half to calculate and distribute. House Labor-HHS-Education Appropriations Chairwoman Rosa DeLauro (D-CT) highlighted this development in her April 16th letter to the Secretary. This news comes after CMS Administrator Seema Verma stated on Wednesday that this second tranche of relief funding would start going out last week. 
  • Verma stated that a portion of the $70 billion will be targeted at providers in areas that have been hit hardest by COVID-19 and aim to help providers that might not have benefited from the first round of funding. 
  • The first round of funding, which included $26 billion for hospitals and providers, was released via electronic transfer. The remaining $4 billion will be disbursed by paper check for providers for whom that is how they normally receive payment.
  • 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.
  • HHS is expected to release a list of frequently asked questions to clarify that the intention for this funding is to support providers that have lost revenue. Providers who ceased operation as a result of the pandemic will likely still be eligible to receive funds if they provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. 
  • The Administration had also previously announced that an additional chunk in the neighborhood of $30 billion will be set aside from the $100 billion to fund COVID-19 care for the uninsured. Kaiser Family Foundation estimated that care for the uninsured, reimbursed at Medicare rates, would run between $13.9 and $41.8 billion.
  • $34 billion has already started flowing to providers via the Accelerated/Advance Payment Program. These payments are separate from the PHSSEF funding and must be returned and carry a 10.25 percent interest rate, which CMS says it cannot change unilaterally.

COVID-19: What’s Happened

  • 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.  
  • FDA is suspending routine surveillance inspections for food, drugs, medical devices and tobacco to protect its workers from COVID-19 and because of industry concerns about visitors. Inspections triggered by specific reasons, like contamination, outbreaks or other emergencies, will continue.
  • CMS. The Centers for Medicare & Medicaid Services announced new regulatory requirements that mandate nursing homes to report cases of COVID-19 directly to the Centers for Disease Control and Prevention (CDC).
  • CMS issued new 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 and the Departments of Labor and Treasury issued guidance that ensures Americans with private health insurance have access to free COVID-19 testing.
  • 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 sent a letter to hospitals on behalf of Vice President Mike Pence requesting they report data in connection with their efforts to fight the COVID-19.
  • 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.
  • Legislative Response. TRP’s newest COVID-19 policy 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 analyses telehealth and rural health policies in the COVID-19 legislative response packages. This includes expanded capabilities and funding for telehealth, funding for community health centers and other rural health supports, backing for telehealth and rural health infrastructure, and more. 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 a memo that examines the provider-related provisions contained in the CARES Act. This includes critical funding for hospitals and providers impacted by the COVID-19 pandemic, greatly expanded flexibilities for providers to operate through the pandemic, and mandated coverage of coronavirus-related therapies and testing. 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.
  • TRP has published a memo on the Medicare and Medicaid provisions in the CARES Act and other COVID-19-related legislation. This analysis examines new telehealth policies, emergency payment provisions, new flexibilities on prescription drug fills, and more. Click here to read the memo.
  • TRP’s memo on the COVID-19 relief packages dives into how the pharmaceutical industry may be impacted by provisions on therapy and vaccine development, drug supply chain transparency, over-the counter drug regulation reform and more. Click here to read the memo.
  • President Donald Trump signed the Phase III legislation into law on Mar. 27. TRP’s analysis of the Phase III legislation can be read here. Our memo on the bill’s provisions pertaining to the Public Health and Social Services Emergency Fund (PHSSEF) can be read here.
  • The Phase II legislative response bill was signed into law on Mar. 18. TRP’s full analysis of the Phase II bill can be read here.
  • An $8.3 billion emergency supplemental appropriations bill cleared both chambers and was signed into law on Mar. 6. TRP’s analysis of the Phase I legislation can be read here.
  • The Treasury Department and IRS announced the implementation of certain paid sick and family leave requirements mandated by the second COVID-19 legislative response package. TRP’s breakdown of the paid leave provisions can be found here.
  • NIH. The National Institutes of Health (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.
  • Social Distancing. The Trump administration issued new federal guidelines entitled “Opening Up America Again,” outlining a three-phase process for when states can begin restarting their economies once the outbreak begins to slow.
  • The Fed. The Federal Reserve announced that its PPP Liquidity Facility is fully operational and able to provide liquidity to eligible financial institutions.
  • 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.
  • Federal regulators announced they will temporarily allow community banks with a lower leverage ratio to skirt certain prescriptive capital requirements.
  • The Federal Reserve and four other financial agencies announced they will consider comments on Volcker rule modifications until May 1.
  • 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 businesses that support efforts by the Small Business Administration (SBA).
  • HHS. HHS announced a new contract with General Electric and Ford under the Defense Production Act (DPA) that would allow for production of 50,000 ventilators by Jul. 13.
  • TRP’s memo on the bill’s provisions pertaining to the PHSSEF can be read here.
  • 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.
  • 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.
  • SBA. 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
  • The SBA and Treasury Department updated their list of frequently asked questions on the Paycheck Protection Program.
  • SBA issued an interim final rule outlining additional guidance for the paycheck protection program. 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.
  • 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.
  • Ed. 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. Secretary Mnuchin announced that the Treasury Department reached an agreement in principle with ten airlines on grant funding to cover certain operating expenses.
  • The Treasury Department released eligibility guidance for State, Local, and Tribal government funding from the CARES Act.
  • The Treasury Department issued a statement clarifying that Social Security recipients will not need to file an abbreviated tax return to receive direct payment relief.
  • The Treasury Department has issued guidance for airlines to apply for up to $58 billion in grants and loans as mandated by the Phase III COVID-19 legislative response bill.
  • Telehealth. The Federal Communications Commission (FCC) launched its COVID-19 Telehealth Program application portal. Click here for details.
  • TRP has published a comprehensive analysis of the telehealth policies for the COVID-19 national emergency. Click here to read the telehealth memo.
  • 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.
  • Trade. The Office of the United States Trade Representative (USTR) published a list of exemptions on certain medical items from the tariffs imposed by President Donald Trump on Chinese goods.
  • USTR opened a comment docket for members of the public, businesses, and government agencies to submit comments if they believe further modifications to the 301 tariffs may be necessary in response to the outbreak. 

COVID-19: Federal Update (4/20)

Congressional leadership and White House officials are closing in on an agreement for the next round of COVID-19 legislation after funding for the Small Business Administration’s (SBA) Paycheck Protection Program (PPP) lapsed late last week. Following days of tense negotiations and partisan messaging exercises, the deal is expected to include a boost in funding for the PPP with language that aims to offset Democratic concerns about access to the loan program for minority owned and disadvantaged small businesses. The two sides have also coalesced around additional funding for health care providers and COVID-19 testing. However, more financial support for state and local government, as well as a hike in Supplemental Nutrition Assistance Program (SNAP) benefits, appears to be off the table as of right now.

Once lawmakers strike a deal on this next round of funding, the Senate would likely move to pass the bill by unanimous consent during its pro forma session this afternoon, with the House convening as soon as Wednesday to pass the bill and place it on President Donald Trump’s desk. However, a path forward in the House is clouded by the fact that Rep. Thomas Massie (R-KY) is expected to object to unanimous consent passage in the lower chamber over concerns about moving a large package of funding absent a quorum. As such, the timing for consideration and enactment on the Phase 3.5 measure remains in flux. The North Texas Commission is monitoring this closely and will keep you up to date.

COVID-19: What We’re Hearing

  • Provider Funding. Health officials in the Trump administration are deliberating next steps on allocating the second tranche of CARES Act health care provider funding. Recent reports out of the Centers for Medicare and Medicaid Services (CMS) suggests that the next tranche of the $100 billion Public Health and Social Services Relief Fund (PHSSEF) will likely be distributed later this week or early next week. 
  • Health and Human Services Secretary Alex Azar told lawmakers on the House Appropriations Committee last week that the next wave of emergency funding to health care providers could take another week and a half to calculate and distribute. House Labor-HHS-Education Appropriations Chairwoman Rosa DeLauro (D-CT) highlighted this development in her April 16th letter to the Secretary. This news comes after CMS Administrator Seema Verma stated on Wednesday that this second tranche of relief funding would start going out last week. 
  • Verma stated that a portion of the $70 billion will be targeted at providers in areas that have been hit hardest by COVID-19 and aim to help providers that might not have benefited from the first round of funding. 
  • The first round of funding, which included $26 billion for hospitals and providers, was released via electronic transfer. The remaining $4 billion will be disbursed by paper check for providers for whom that is how they normally receive payment.
  • 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.
  • HHS is expected to release a list of frequently asked questions to clarify that the intention for this funding is to support providers that have lost revenue. Providers who ceased operation as a result of the pandemic will likely still be eligible to receive funds if they provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. 
  • The Administration had also previously announced that an additional chunk in the neighborhood of $30 billion will be set aside from the $100 billion to fund COVID-19 care for the uninsured. Kaiser Family Foundation estimated that care for the uninsured, reimbursed at Medicare rates, would run between $13.9 and $41.8 billion.
  • $34 billion has already started flowing to providers via the Accelerated/Advance Payment Program. These payments are separate from the PHSSEF funding and must be returned and carry a 10.25 percent interest rate, which CMS says it cannot change unilaterally.
  • COVID 4.0. Democrats have outlined numerous priorities for the COVID-19 “Phase IV” legislation. Specific policy items include: (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 election support; (5) strengthened oversight and protections for inspector generals; and (6) “technology modernization.” 
  • 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.
  • 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.
  • 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.
  • Appropriations. House Appropriators are working to draft fiscal year (FY) 2021 spending bills by the first week of May. Markups and full consideration of the bills are not expected to occur until Congress returns to Washington.
  • House Appropriations Chairwoman Nita Lowey (D-NY) has sent each of the 12 Appropriations Subcommittee the preliminary 302(b) allocations for FY 2021.
  • Appropriators have pushed their expectations for completing FY 2021 spending work past the late spring-early summer dates that leadership targeted earlier this year. 
  • Leader Hoyer expects the House to take up fiscal year (FY) 2021 bills in June so long as lawmakers are able to return to Washington.

COVID-19: What’s Happened

  • CMS. The Centers for Medicare & Medicaid Services announced new regulatory requirements that mandate nursing homes to report cases of COVID-19 directly to the Centers for Disease Control and Prevention (CDC).
  • CMS issued new 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 and the Departments of Labor and Treasury issued guidance that ensures Americans with private health insurance have access to free COVID-19 testing.
  • 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 sent a letter to hospitals on behalf of Vice President Mike Pence requesting they report data in connection with their efforts to fight the COVID-19.
  • 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.
  • Legislative Response. TRP’s newest COVID-19 policy 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 analyses telehealth and rural health policies in the COVID-19legislative response packages. This includes expanded capabilities and funding for telehealth, funding for community health centers and other rural health supports, backing for telehealth and rural health infrastructure, and more. 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 a memo that examines the provider-related provisions contained in the CARES Act. This includes critical funding for hospitals and providers impacted by the COVID-19 pandemic, greatly expanded flexibilities for providers to operate through the pandemic, and mandated coverage of coronavirus-related therapies and testing. 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.
  • TRP has published a memo on the Medicare and Medicaid provisions in the CARES Act and other COVID-19-related legislation. This analysis examines new telehealth policies, emergency payment provisions, new flexibilities on prescription drug fills, and more. Click here to read the memo.
  • TRP’s memo on the COVID-19 relief packages dives into how the pharmaceutical industry may be impacted by provisions on therapy and vaccine development, drug supply chain transparency, over-the counter drug regulation reform and more. Click here to read the memo.
  • President Donald Trump signed the Phase III legislation into law on Mar. 27. TRP’s analysis of the Phase III legislation can be read here. Our memo on the bill’s provisions pertaining to the Public Health and Social Services Emergency Fund (PHSSEF) can be read here.
  • The Phase II legislative response bill was signed into law on Mar. 18. TRP’s full analysis of the Phase II bill can be read here.
  • An $8.3 billion emergency supplemental appropriations bill cleared both chambers and was signed into law on Mar. 6. TRP’s analysis of the Phase I legislation can be read here.
  • The Treasury Department and IRS announced the implementation of certain paid sick and family leave requirements mandated by the second COVID-19 legislative response package. TRP’s breakdown of the paid leave provisions can be found here.
  • NIH. The National Institutes of Health (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.
  • Social Distancing. The Trump administration issued new federal guidelines entitled “Opening Up America Again,” outlining a three-phase process for when states can begin restarting their economies once the outbreak begins to slow.
  • The Fed. The Federal Reserve announced that its PPP Liquidity Facility is fully operational and able to provide liquidity to eligible financial institutions.
  • 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.
  • Federal regulators announced they will temporarily allow community banks with a lower leverage ratio to skirt certain prescriptive capital requirements.
  • The Federal Reserve and four other financial agencies announced they will consider comments on Volcker rule modifications until May 1.
  • 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 businesses that support efforts by the Small Business Administration (SBA).
  • 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.
  • 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.  
  • FDA is suspending routine surveillance inspections for food, drugs, medical devices and tobacco to protect its workers from COVID-19 and because of industry concerns about visitors. Inspections triggered by specific reasons, like contamination, outbreaks or other emergencies, will continue.
  • HHS. HHS announced a new contract with General Electric and Ford under the Defense Production Act (DPA) that would allow for production of 50,000 ventilators by Jul. 13.
  • TRP’s memo on the bill’s provisions pertaining to the PHSSEF can be read here.
  • 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.
  • 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.
  • SBA. 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
  • The SBA and Treasury Department updated their list of frequently asked questions on the Paycheck Protection Program.
  • SBA issued an interim final rule outlining additional guidance for the paycheck protection program. 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.
  • 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.
  • Ed. 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. Secretary Mnuchin announced that the Treasury Department reached an agreement in principle with ten airlines on grant funding to cover certain operating expenses.
  • The Treasury Department released eligibility guidance for State, Local, and Tribal government funding from the CARES Act.
  • The Treasury Department issued a statement clarifying that Social Security recipients will not need to file an abbreviated tax return to receive direct payment relief.
  • The Treasury Department has issued guidance for airlines to apply for up to $58 billion in grants and loans as mandated by the Phase III COVID-19 legislative response bill.
  • Telehealth. The Federal Communications Commission (FCC) launched its COVID-19 Telehealth Program application portal. Click here for details.
  • TRP has published a comprehensive analysis of the telehealth policies for the COVID-19 national emergency. Click here to read the telehealth memo.
  • 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.
  • Trade. The Office of the United States Trade Representative (USTR) published a list of exemptions on certain medical items from the tariffs imposed by President Donald Trump on Chinese goods.
  • USTR opened a comment docket for members of the public, businesses, and government agencies to submit comments if they believe further modifications to the 301 tariffs may be necessary in response to the outbreak. 
  • REAL ID. President Trump announced that the federal government would be extending the compliance deadline for REAL ID, responding to concern from the travel industry as well as lawmakers, who have been increasingly worried that a rush to DMVs to meet the Oct. 1 deadline could put people at risk.

COVID-19: Federal Update (4/17)

Capitol Hill Update

Negotiations between Congressional leadership and White House officials on the next round of COVID-19 legislation will continue throughout this weekend after funding for the Small Business Administration’s (SBA) Paycheck Protection Program (PPP) lapsed yesterday. While Treasury Secretary Steven Mnuchin and Senate Minority Leader Chuck Schumer (D-NY) have expressed optimism on the prospects of reaching a deal over the course of the coming days, Senate Majority Leader Mitch McConnell (R-KY) has remained steadfast in his position that the “Phase 3.5” effort should only address funding for the PPP and that funding for other Democratic priorities — such as health care providers, states, and local governments — should be taken up in the “Phase IV” legislation. The PPP will no longer be able to process applications and issue loans until Congress can reach a deal that would appropriate additional funds to the SBA’s signature COVID-19 response program.

Should lawmakers strike a deal on this next round of funding, the Senate would likely move to pass the bill by unanimous consent during one of its forthcoming pro forma sessions. However, a path forward in the House on this next round of funding is clouded by the fact that Rep. Thomas Massie (R-KY) is expected to object to unanimous consent passage in the lower chamber over concerns about moving a large package of funding absent a quorum. As such, the timing for consideration and enactment on the Phase 3.5 measure remains in flux.

Meanwhile, House Rules Committee Chairman James McGovern (D-MA) outlined a plan yesterday that would allow for emergency remote voting aimed at quelling concerns about bringing lawmakers back to Washington during the pandemic. Designed as a temporary change to the House rules during the outbreak, the plan would require the lower chamber to gavel into session and officially vote to change its rules. As of now, it’s unclear whether the Democrats’ plan enjoys bipartisan support — a key factor that will ultimately determine the feasibility of remote voting moving forward.

The North Texas Commission continues to monitor the news coming out of Washington and will keep you posted.

COVID-19: What We’re Hearing

  • Provider Funding. Health and Human Services Secretary Alex Azar held a call with lawmakers on the House Appropriations Committee this week during which he stated the next wave of emergency funding to health care providers could take another week and a half to calculate and distribute. House Labor-HHS-Education Appropriations Chairwoman Rosa DeLauro (D-CT) highlighted this development in her April 16th letter to the Secretary. This news comes after CMS Administrator Seema Verma stated on Wednesday that this second tranche of relief funding would start going out this week. 
  • Approximately $70 billion of the currently available $100 billion remains in the fund. Verma stated that a portion of the money will be targeted at providers in areas that have been hit hardest by COVID-19 and aim to help providers that might not have benefited from the first round of funding. 
  • This first tranche is drawn from the CARES Act’s $100 billion Public Health and Social Services Emergency Relief Fund (PHSSEF). The first $26 billion of funding for hospitals and providers was released via electronic transfer, and the remaining $4 billion will be disbursed by paper check for providers for whom that is how they normally receive payment.
  • 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.
  • HHS is expected to release a list of frequently asked questions to clarify that the intention for this funding is to support providers that have lost revenue. Providers who ceased operation as a result of the pandemic will likely still be eligible to receive funds if they provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. 
  • The Administration had also previously announced that an additional chunk in the neighborhood of $30 billion will be set aside from the $100 billion to fund COVID-19 care for the uninsured. Kaiser Family Foundation estimated that care for the uninsured, reimbursed at Medicare rates, would run between $13.9 and $41.8 billion.
  • $34 billion has already started flowing to providers via the Accelerated/Advance Payment Program. These payments are separate from the PHSSEF funding and must be returned and carry a 10.25 percent interest rate, which CMS says it cannot change unilaterally.
  • COVID 4.0. House Majority Leader Steny Hoyer (D-MD) outlined a host of priorities that Democrats are pushing for in the forthcoming Phase IV legislation in a call yesterday. Specific policy items he listed include: (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 election support; (5) strengthened oversight and protections for inspector generals; and (6) “technology modernization.” 
  • 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.
  • 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.
  • 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.
  • Appropriations. House Appropriators are working to draft fiscal year (FY) 2021 spending bills by the first week of May. Markups and full consideration of the bills are not expected to occur until Congress returns to Washington.
  • House Appropriations Chairwoman Nita Lowey (D-NY) has sent each of the 12 Appropriations Subcommittee the preliminary 302(b) allocations for FY 2021.
  • Appropriators have pushed their expectations for completing FY 2021 spending work past the late spring-early summer dates that leadership targeted earlier this year. 
  • Leader Hoyer expects the House to take up fiscal year (FY) 2021 bills in June so long as lawmakers are able to return to Washington.

COVID-19: What’s Happened

  • Legislative Response. TRP’s newest COVID-19 policy 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 analyses telehealth and rural health policies in the COVID-19legislative response packages. This includes expanded capabilities and funding for telehealth, funding for community health centers and other rural health supports, backing for telehealth and rural health infrastructure, and more. 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 a memo that examines the provider-related provisions contained in the CARES Act. This includes critical funding for hospitals and providers impacted by the COVID-19 pandemic, greatly expanded flexibilities for providers to operate through the pandemic, and mandated coverage of coronavirus-related therapies and testing. 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.
  • TRP has published a memo on the Medicare and Medicaid provisions in the CARES Act and other COVID-19-related legislation. This analysis examines new telehealth policies, emergency payment provisions, new flexibilities on prescription drug fills, and more. Click here to read the memo.
  • TRP’s memo on the COVID-19 relief packages dives into how the pharmaceutical industry may be impacted by provisions on therapy and vaccine development, drug supply chain transparency, over-the counter drug regulation reform and more. Click here to read the memo.
  • President Donald Trump signed the Phase III legislation into law on Mar. 27. TRP’s analysis of the Phase III legislation can be read here. Our memo on the bill’s provisions pertaining to the Public Health and Social Services Emergency Fund (PHSSEF) can be read here.
  • The Phase II legislative response bill was signed into law on Mar. 18. TRP’s full analysis of the Phase II bill can be read here.
  • An $8.3 billion emergency supplemental appropriations bill cleared both chambers and was signed into law on Mar. 6. TRP’s analysis of the Phase I legislation can be read here.
  • The Treasury Department and IRS announced the implementation of certain paid sick and family leave requirements mandated by the second COVID-19 legislative response package. TRP’s breakdown of the paid leave provisions can be found here.
  • CMS. The Centers for Medicare & Medicaid Services (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 yesterday 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 and the Departments of Labor and Treasury issued guidance that ensures Americans with private health insurance have access to free COVID-19 testing.
  • CMS has temporarily suspended a series of rules for health care facilities in a move aimed at bolstering frontline medical staffs.
  • 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 sent a letter to hospitals on behalf of Vice President Mike Pence requesting they report data in connection with their efforts to fight the COVID-19.
  • 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.
  • CMS announced that it is granting exemptions from reporting requirements and granting extensions for clinicians, providers, and facilities participating in Medicare quality reporting programs.
  • NIH. The National Institutes of Health (NIH) and the Foundation for the NIH (FNIH) announced today 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.
  • Social Distancing. The Trump administration issued new federal guidelines entitled “Opening Up America Again,” outlining a three-phase process for when states can begin restarting their economies once the outbreak begins to slow.
  • The Fed. The Federal Reserve announced that its PPP Liquidity Facility is fully operational and able to provide liquidity to eligible financial institutions.
  • 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.
  • Federal regulators announced they will temporarily allow community banks with a lower leverage ratio to skirt certain prescriptive capital requirements.
  • The Federal Reserve and four other financial agencies announced they will consider comments on Volcker rule modifications until May 1.
  • 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 businesses that support efforts by the Small Business Administration (SBA).
  • FDA. The Food and Drug Administration (FDA) issued guidance yesterday that will temporarily allow hospitals to compound certain sedatives used for COVID-19 patients during the public health emergency.
  • 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.  
  • FDA is suspending routine surveillance inspections for food, drugs, medical devices and tobacco to protect its workers from COVID-19 and because of industry concerns about visitors. Inspections triggered by specific reasons, like contamination, outbreaks or other emergencies, will continue.
  • HHS. HHS announced a new contract today with General Electric and Ford under the Defense Production Act (DPA) that would allow for production of 50,000 ventilators by July 13.
  • TRP’s memo on the bill’s provisions pertaining to the PHSSEF can be read here.
  • 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.
  • 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.
  • SBA. 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
  • The SBA and Treasury Department updated their list of frequently asked questions on the Paycheck Protection Program.
  • SBA issued an interim final rule outlining additional guidance for the paycheck protection program. 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.
  • 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.
  • Ed. 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. Secretary Mnuchin announced that the Treasury Department reached an agreement in principle with ten airlines on grant funding to cover certain operating expenses.
  • The Treasury Department released eligibility guidance for State, Local, and Tribal government funding from the CARES Act.
  • The Treasury Department issued a statement clarifying that Social Security recipients will not need to file an abbreviated tax return to receive direct payment relief.
  • The Treasury Department has issued guidance for airlines to apply for up to $58 billion in grants and loans as mandated by the Phase III COVID-19 legislative response bill.
  • Telehealth. The Federal Communications Commission (FCC) launched its COVID-19 Telehealth Program application portal. Click here for details.
  • TRP has published a comprehensive analysis of the telehealth policies for the COVID-19 national emergency. Click here to read the telehealth memo.
  • 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.
  • USTR. The Office of the United States Trade Representative (USTR) published a list of exemptions on certain medical items from the tariffs imposed by President Donald Trump on Chinese goods.
  • USTR opened a comment docket for members of the public, businesses, and government agencies to submit comments if they believe further modifications to the 301 tariffs may be necessary in response to the outbreak. 
  • REAL ID. President Trump announced that the federal government would be extending the compliance deadline for REAL ID, responding to concern from the travel industry as well as lawmakers, who have been increasingly worried that a rush to DMVs to meet the Oct. 1 deadline could put people at risk.

COVID-19: Federal Update (4/16)

Lawmakers are scrambling to reach a deal on the next tranche of COVID-19 response legislation amid growing concerns about the lapse in funding for the Small Business Administration’s (SBA) Paycheck Protection Program (PPP). Treasury Secretary Steven Mnuchin and SBA Administrator Jovita Carranza issued a statement last night urging Congress to appropriate additional funds for the PPP, noting that the program will no longer be able to process applications and issue loans under its current funding allocation. While Treasury Secretary Steven Mnuchin and Senate Minority Leader Chuck Schumer (D-NY) suggested that an agreement could be struck by the end of this week, Senate Republicans have remained steadfast in their position that the “Phase 3.5” effort should only address funding for the PPP and that funding for other Democratic priorities — such as health care providers, states, and local governments — should be taken up in the forthcoming “Phase IV” legislation.

Negotiations between Congressional leadership and White House officials are expected to continue throughout the day ahead of the Senate’s pro forma session at 3 PM this afternoon. Should lawmakers strike a deal on the Phase 3.5 legislation, the Senate would likely move to pass the bill by unanimous consent ahead of the House pro forma session tomorrow at 10 AM. However, a path forward for this next round of funding is clouded by the fact that Rep. Thomas Massie (R-KY) is expected to object to unanimous consent passage in the lower chamber over concerns about moving a large package of funding absent a quorum. As such, timing on consideration, passage, and enactment of this next round of COVID-19 legislation remains in flux.

The North Texas Commission continues to monitor the Phase 3.5 legislation and will keep you apprised of any updates.

COVID-19: What We’re Hearing

  • COVID 4.0. House Majority Leader Steny Hoyer (D-MD) outlined a host of priorities that Democrats are pushing for in the forthcoming Phase IV legislation in a call yesterday. Specific policy items he listed include: (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 election support; (5) strengthened oversight and protections for inspector generals; and (6) “technology modernization.” 
  • 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.
  • 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.
  • 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 a call with reporters on Wednesday, April 15, CMS Administrator Seema Verma stated that a second tranche of emergency relief grants to health care providers will start going out this week. Approximately $70 billion of the currently available $100 billion remains in the fund. Verma stated that a portion of the money will be targeted at providers in areas that have been hit hardest by COVID-19 and aim to help providers that might not have benefited from the first round of funding. 
  • This first tranche is drawn from the CARES Act’s $100 billion Public Health and Social Services Emergency Relief Fund (PHSSEF). The first $26 billion of funding for hospitals and providers was released via electronic transfer, and the remaining $4 billion will be disbursed by paper check for providers for whom that is how they normally receive payment.
  • 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 coronavirus. Those that do not agree must contact HHS within 30 days to remit the payment.
  • The Department of Health and Human Services (HHS) is expected to release a list of frequently asked questions to clarify that the intention for this funding is to support providers that have lost revenue. Providers who ceased operation as a result of the pandemic will likely still be eligible to receive funds if they provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. 
  • The Administration had also previously announced that an additional chunk in the neighborhood of $30 billion will be set aside from the $100 billion to fund COVID-19 care for the uninsured. Kaiser Family Foundation estimated that care for the uninsured, reimbursed at Medicare rates, would run between $13.9 and $41.8 billion.
  • $34 billion has already starting flowing to providers via the Accelerated/Advance Payment Program. These payments are separate from the PHSSEF funding and must be returned and carry a 10.25 percent interest rate, which CMS says it cannot change unilaterally.
  • Appropriations. House Appropriators are working to draft fiscal year (FY) 2021 spending bills by the first week of May. Markups and full consideration of the bills are not expected to occur until Congress returns to Washington.
  • House Appropriations Chairwoman Nita Lowey (D-NY) has sent each of the 12 Appropriations Subcommittee the preliminary 302(b) allocations for FY 2021.
  • Appropriators have pushed their expectations for completing FY 2021 spending work past the late spring-early summer dates that leadership targeted earlier this year. 
  • Leader Hoyer expects the House to take up fiscal year (FY) 2021 bills in June so long as lawmakers are able to return to Washington.

COVID-19: What’s Happened

  • The Fed. The Federal Reserve announced today that its PPP Liquidity Facility is fully operational and able to provide liquidity to eligible financial institutions.
  • 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.
  • Federal regulators announced they will temporarily allow community banks with a lower leverage ratio to skirt certain prescriptive capital requirements.
  • The Federal Reserve and four other financial agencies announced they will consider comments on Volcker rule modifications until May 1.
  • 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 businesses that support efforts by the Small Business Administration (SBA).
  • CMS. The Centers for Medicare & Medicaid Services (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 yesterday 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 and the Departments of Labor and Treasury issued guidance that ensures Americans with private health insurance have access to free COVID-19 testing.
  • CMS has temporarily suspended a series of rules for health care facilities in a move aimed at bolstering frontline medical staffs.
  • 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 sent a letter to hospitals on behalf of Vice President Mike Pence requesting they report data in connection with their efforts to fight the COVID-19.
  • 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.
  • CMS announced that it is granting exemptions from reporting requirements and granting extensions for clinicians, providers, and facilities participating in Medicare quality reporting programs.
  • FDA. The Food and Drug Administration (FDA) issued guidance today that will temporarily allow hospitals to compound certain sedatives used for COVID-19 patients during the public health emergency.
  • 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.  
  • FDA is suspending routine surveillance inspections for food, drugs, medical devices and tobacco to protect its workers from COVID-19 and because of industry concerns about visitors. Inspections triggered by specific reasons, like contamination, outbreaks or other emergencies, will continue.
  • HHS. HHS announced a new contract today with General Electric and Ford under the Defense Production Act (DPA) that would allow for production of 50,000 ventilators by Jul. 13.
  • TRP’s memo on the bill’s provisions pertaining to the PHSSEF can be read here.
  • 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.
  • 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.
  • Legislative Response. TRP’s newest COVID-19 policy memo analyzes telehealth and rural health policies in the relief legislation. This includes expanded capabilities and funding for telehealth, funding for community health centers and other rural health supports, backing for telehealth and rural health infrastructure, and more. 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 a memo that examines the provider-related provisions contained in the CARES Act. This includes critical funding for hospitals and providers impacted by the COVID-19 pandemic, greatly expanded flexibilities for providers to operate through the pandemic, and mandated coverage of coronavirus-related therapies and testing. 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.
  • TRP has published a memo on the Medicare and Medicaid provisions in the CARES Act and other COVID-19-related legislation. This analysis examines new telehealth policies, emergency payment provisions, new flexibilities on prescription drug fills, and more. Click here to read the memo.
  • TRP’s memo on the COVID-19 relief packages dives into how the pharmaceutical industry may be impacted by provisions on therapy and vaccine development, drug supply chain transparency, over-the counter drug regulation reform and more. Click here to read the memo.
  • President Donald Trump signed the Phase III legislation into law on Mar. 27. TRP’s analysis of the Phase III legislation can be read here. Our memo on the bill’s provisions pertaining to the Public Health and Social Services Emergency Fund (PHSSEF) can be read here.
  • The Phase II legislative response bill was signed into law on Mar. 18. TRP’s full analysis of the Phase II bill can be read here.
  • An $8.3 billion emergency supplemental appropriations bill cleared both chambers and was signed into law on Mar. 6. TRP’s analysis of the Phase I legislation can be read here.
  • The Treasury Department and IRS announced the implementation of certain paid sick and family leave requirements mandated by the second COVID-19 legislative response package. TRP’s breakdown of the paid leave provisions can be found here.
  • SBA. SBA published a detailed breakdown of the PPP funding that has been distributed thus far.
  • SBA issued a new interim final rule clarifying the process of applying for PPP loans for individuals who report self-employed income on a 1040 Schedule C
  • The SBA and Treasury Department updated their list of frequently asked questions on the Paycheck Protection Program.
  • SBA issued an interim final rule outlining additional guidance for the paycheck protection program. 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.
  • 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.
  • Ed. 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. Secretary Mnuchin announced that the Treasury Department reached an agreement in principle with ten airlines on grant funding to cover certain operating expenses.
  • The Treasury Department released eligibility guidance for State, Local, and Tribal government funding from the CARES Act.
  • The Treasury Department issued a statement clarifying that Social Security recipients will not need to file an abbreviated tax return to receive direct payment relief.
  • The Treasury Department has issued guidance for airlines to apply for up to $58 billion in grants and loans as mandated by the Phase III COVID-19 legislative response bill.
  • Telehealth. The Federal Communications Commission (FCC) launched its COVID-19 Telehealth Program application portal. Click here for details.
  • TRP has published a comprehensive analysis of the telehealth policies for the COVID-19 national emergency. Click here to read the telehealth memo.
  • Census. Officials are pushing to delay deadlines for completing the 2020 Census. Field Operations from the U.S. Census Bureau have been postponed until Jun. 1, and the deadline to finish the count has been delayed until Oct. 31.
  • 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.
  • USTR. The Office of the United States Trade Representative (USTR) published a list of exemptions on certain medical items from the tariffs imposed by President Donald Trump on Chinese goods.
  • USTR opened a comment docket for members of the public, businesses, and government agencies to submit comments if they believe further modifications to the 301 tariffs may be necessary in response to the outbreak. 
  • REAL ID. President Trump announced that the federal government would be extending the compliance deadline for REAL ID, responding to concern from the travel industry as well as lawmakers, who have been increasingly worried that a rush to DMVs to meet the Oct. 1 deadline could put people at risk.
  • Tech. The White House announced the launch of a COVID-19 High Performance Computing Consortium aimed at providing researchers with access to computing resources needed to bolster scientific research on the virus.
  • The Trump administration issued a call to action urging the tech industry to collaborate and utilize data on COVID-19 and related viruses using artificial intelligence (AI). It includes curated articles and data compiled by the Allen Institute for AI. Additional information on this database can be found here.

COVID-19: Federal Update (4/15)

Capitol Hill Update

Congressional leadership and White House officials are continuing negotiations on the next round of COVID-19 response legislation, eyeing a compromise solution on the next tranche of funding for pressing response efforts. While Treasury Secretary Steven Mnuchin and Senate Minority Leader Chuck Schumer (D-NY) suggested that an agreement could be struck by the end of this week, Senate Republicans have remained steadfast in their position that the “Phase 3.5” effort should only address funding for the Small Business Administration’s (SBA) Paycheck Protection Program (PPP), and that funding for other priorities — such as health care response efforts, states, and local governments — should be taken up in the forthcoming “Phase IV” legislation. As such, timing on consideration and passage of the next round of COVID-19 legislation remains in flux. Lawmakers will not convene for legislative business until May 4 at the earliest. The Senate will convene for its next pro forma session tomorrow at 3 PM EST, with the House convening on Friday at 10 AM EST. The North Texas Commission will continue to monitor and keep you apprised of any updates.

COVID-19: What We’re Hearing

  • Appropriations. House Appropriators are working to draft fiscal year (FY) 2021 spending bills by the first week of May. Markups and full consideration of the bills are not expected to occur until Congress returns to Washington.
  • House Appropriations Chairwoman Nita Lowey (D-NY) has sent each of the 12 Appropriations Subcommittee the preliminary 302(b) allocations for FY 2021.
  • Appropriators have pushed their expectations for completing FY 2021 spending work past the late spring-early summer dates that leadership targeted earlier this year. 
  • Provider Funding. On Friday April 10, CMS began to disburse an initial $30 billion tranche of emergency relief funding to health care providers based on their Medicare fee-for-service revenue in 2019. 
  • This first tranche is drawn from the CARES Act’s $100 billion Public Health and Social Services Emergency Relief Fund (PHSSEF). The first $26 billion of funding for hospitals and providers was released via electronic transfer, and the remaining $4 billion will be disbursed by paper check for providers for whom that is how they normally receive payment.
  • 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 coronavirus. Those that do not agree must contact HHS within 30 days to remit the payment.
  • The Department of Health and Human Services (HHS) is expected to release a list of frequently asked questions to clarify that the intention for this funding is to support providers that have lost revenue. Providers who ceased operation as a result of the pandemic will likely still be eligible to receive funds if they provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. 
  • The administration is reaching out to providers with a lower percentage of their revenue coming from Medicare fee-for-service to gather feedback on how best to distribute additional funds from the $100 billion fund. 
  • Administrator Verma foreshadowed a second round of CMS distributions with first priority going to providers such as nursing homes and children’s hospitals that do not derive a large portion of their revenue from Medicare fee-for-service.
  • An additional chunk in the neighborhood of $30 billion will be set aside from the $100 billion to fund COVID-19 care for the uninsured. Kaiser Family Foundation estimated yesterday that care for the uninsured, reimbursed at Medicare rates, would run between $13.9 and $41.8 billion.
  • $34 billion has already starting flowing to providers via the Accelerated/Advance Payment Program. These payments are separate from the PHSSEF funding and must be returned and carry a 10.25 percent interest rate, which CMS says it cannot change unilaterally.
  • COVID-19 3.5. In a joint statement, Speaker Nancy Pelosi (D-CA) and Senate Minority Leader Chuck Schumer (D-NY) called for further changes to the PPP, saying that many eligible small businesses are unable to access these loans. A summary of the Democrats’ updated counteroffer can be read here.
  • Additional Democratic priorities in this proposal include: (1) $100 billion for health care providers; (2) $150 billion for state and local governments; (3) a 15 percent increase in SNAP benefits; and (4) technical fixes to election assistance funding from the CARES Act.
  • While President Donald Trump and Senate Majority Leader Mitch McConnell (R-KY) have expressed the desire to address additional funding for health care, states, and local governments in the “Phase IV” legislation, Speaker Nancy Pelosi (D-CA) has remained steadfast in her position that the “Phase 3.5” effort must include these priorities in order for the bill to pass by unanimous consent in the House.
  • Treasury Secretary Steven Mnuchin and Leader Schumer have opened talks on the next round of response legislation and have expressed optimism about the possibility of reaching a compromise before the end of the week.
  • COVID 4.0 Policies that currently enjoy bipartisan support include funding for health care needs, additional money for the PPP, more unemployment insurance and direct payment relief, and a fix for struggling pension programs. 
  • 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.
  • 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.
  • 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.
  • Speaker Pelosi penned a “Dear Colleague” letter to members outlining her priorities for the Phase IV legislation. She has been advocating for additional health care provider funding, election support, stronger workforce protections, and repealing the 2017 tax law provision that caps the State and Local Tax deduction. The Speaker hopes to craft and consider the legislation by the end of this month. 

COVID-19: What’s Happened

  • SBA. SBA published a detailed breakdown of the PPP funding that has been distributed thus far.
  • SBA issued a new interim final rule clarifying the process of applying for PPP loans for individuals who report self employed income on a 1040 Schedule C
  • The SBA and Treasury Department updated their list of frequently asked questions on the Paycheck Protection Program.
  • SBA issued an interim final rule outlining additional guidance for the paycheck protection program. 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.
  • 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 regarding 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 $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. Secretary Mnuchin announced that the Treasury Department reached an agreement in principle with ten airlines on grant funding to cover certain operating expenses.
  • The Treasury Department released eligibility guidance for State, Local, and Tribal government funding from the CARES Act.
  • The Treasury Department issued a statement clarifying that Social Security recipients will not need to file an abbreviated tax return to receive direct payment relief.
  • The Treasury Department has issued guidance for airlines to apply for up to $58 billion in grants and loans as mandated by the Phase III COVID-19 legislative response bill.
  • Legislative Response. TRP’s newest COVID-19 policy memo analyzes telehealth and rural health policies in the relief legislation. This includes expanded capabilities and funding for telehealth, funding for community health centers and other rural health supports, backing for telehealth and rural health infrastructure, and more. 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 a memo that examines the provider-related provisions contained in the CARES Act. This includes critical funding for hospitals and providers impacted by the COVID-19 pandemic, greatly expanded flexibilities for providers to operate through the pandemic, and mandated coverage of coronavirus-related therapies and testing. 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.
  • TRP has published a memo on the Medicare and Medicaid provisions in the CARES Act and other COVID-19-related legislation. This analysis examines new telehealth policies, emergency payment provisions, new flexibilities on prescription drug fills, and more. Click here to read the memo.
  • TRP’s memo on the COVID-19 relief packages dives into how the pharmaceutical industry may be impacted by provisions on therapy and vaccine development, drug supply chain transparency, over-the counter drug regulation reform and more. Click here to read the memo.
  • President Donald Trump signed the Phase III legislation into law on Mar. 27. TRP’s analysis of the Phase III legislation can be read here. Our memo on the bill’s provisions pertaining to the Public Health and Social Services Emergency Fund (PHSSEF) can be read here.
  • The Phase II legislative response bill was signed into law on Mar. 18. TRP’s full analysis of the Phase II bill can be read here.
  • An $8.3 billion emergency supplemental appropriations bill cleared both chambers and was signed into law on Mar. 6. TRP’s analysis of the Phase I legislation can be read here.
  • The Treasury Department and IRS announced the implementation of certain paid sick and family leave requirements mandated by the second COVID-19 legislative response package. TRP’s breakdown of the paid leave provisions can be found here.
  • Telehealth. The Federal Communications Commission’s (FCC) COVID-19 Telehealth Program application portal officially launched yesterday. Click here for details.
  • TRP has published a comprehensive analysis of the telehealth policies for the COVID-19 national emergency. Click here to read the telehealth memo.
  • Census. Officials are pushing to delay deadlines for completing the 2020 Census. Field Operations from the U.S. Census Bureau have been postponed until June 1, and the deadline to finish the count has been delayed until Oct. 31.
  • CMS. The Centers for Medicare & Medicaid Services has published a list of frequently asked questions on the enhanced Medicaid Federal Medical Assistance Percentage (FMAP).
  • CMS and the Departments of Labor and Treasury issued guidance that ensures Americans with private health insurance have access to free COVID-19 testing.
  • CMS has temporarily suspended a series of rules for health care facilities in a move aimed at bolstering frontline medical staffs.
  • 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 has issued a series of updated guidance documents focused on infection control to prevent the spread of the COVID-19 for certain inpatient and outpatient care settings. 
  • CMS has published additional frequently asked questions for state Medicaid and CHIP agencies regarding COVID-19 response efforts. 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 sent a letter to hospitals on behalf of Vice President Mike Pence requesting they report data in connection with their efforts to fight the COVID-19.
  • 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.
  • CMS announced that it is granting exemptions from reporting requirements and granting extensions for clinicians, providers, and facilities participating in Medicare quality reporting programs.
  • HHS. TRP’s memo on the bill’s provisions pertaining to the PHSSEF can be read here.
  • 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 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.
  • Federal regulators announced they will temporarily allow community banks with a lower leverage ratio to skirt certain prescriptive capital requirements.
  • The Federal Reserve and four other financial agencies announced they will consider comments on Volcker rule modifications until May 1.
  • On Mar. 24, The Federal Reserve will be scaling back its examination of banks to focus more intently on the potential risks that arise from the outbreak.
  • 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 businesses that support efforts by the Small Business Administration (SBA).
  • The Federal Reserve announced that it will establish a Primary Dealer Credit Facility to support dealers’ market-making as the economy continues to slow due to the COVID-19 pandemic.
  • The Federal Reserve, Federal Deposit Insurance Corporation (FDIC), and Office of the Comptroller of the Currency (OCC) outlined actions aimed at providing banks additional flexibility to support households and businesses during the outbreak. Details on these steps can be read here.
  • Social Distancing. The Trump administration has recommended the use of cloth masks for those who need to go out in public.
  • Surgeon General Jerome Adams stated that he anticipates the Trump administration’s social distancing guidelines to be extended past Apr. 30.
  • President Trump announced that the administration will be extending its social distancing guidelines through Apr. 30.
  • The guidance outlines a series of steps — including avoiding social gatherings of 10 or more people — aimed at mitigating the spread of the virus.
  • Centers for Disease Control and Prevention (CDC) issued guidance on Mar. 16 recommending that Americans cancel or postpone gatherings of 50 more people for the next eight weeks.
  • 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.
  • USTR. The Office of the United States Trade Representative (USTR) published a list of exemptions on certain medical items from the tariffs imposed by President Donald Trump on Chinese goods.
  • USTR opened a comment docket for members of the public, businesses, and government agencies to submit comments if they believe further modifications to the 301 tariffs may be necessary in response to the outbreak. 
  • FDA. The Food and Drug Administration (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.  
  • FDA is suspending routine surveillance inspections for food, drugs, medical devices and tobacco to protect its workers from COVID-19 and because of industry concerns about visitors. Inspections triggered by specific reasons, like contamination, outbreaks or other emergencies, will continue.
  • EO on Medical Resources. President Trump signed an executive order that seeks to stymie hoarding of health and medical resources to respond to the spread of COVID-19.
  • President Trump issued an executive order on prioritizing and allocating resources to respond to the spread of COVID-19.
  • REAL ID. President Trump announced that the federal government would be extending the compliance deadline for REAL ID, responding to concern from the travel industry as well as lawmakers, who have been increasingly worried that a rush to DMVs to meet the Oct. 1 deadline could put people at risk.
  • Tech. The White House announced the launch of a COVID-19 High Performance Computing Consortium aimed at providing researchers with access to computing resources needed to bolster scientific research on the virus.
  • The Trump administration issued a call to action urging the tech industry to collaborate and utilize data on COVID-19 and related viruses using artificial intelligence (AI). It includes curated articles and data compiled by the Allen Institute for AI. Additional information on this database can be found here.

COVID-19: Federal Update

Capitol Hill Update

Despite eyeing the next week for a possible return to Washington, lawmakers are not expected to convene for legislative business beyond pro forma sessions this month. House Majority Leader Steny Hoyer (D-MD) issued a statement yesterday saying that members are not expected back until May 4 at the earliest unless there are pressing circumstances that would require the lower chamber to convene. Meanwhile, Congressional leadership and White House officials are continuing negotiations on the next round of COVID-19 response legislation, eyeing a compromise on funding for the Small Business Administration’s (SBA) Paycheck Protection Program (PPP) and other pressing priorities by the end of this week. The Senate will convene for its next pro forma session on Thursday at 3 PM EST, with the House convening the following day at 10 AM EST. The North Texas Commission will keep you updated on any news.

COVID-19: What We’re Hearing

  • Provider Funding. On Friday April 10, CMS began to disburse an initial $30 billion tranche of emergency relief funding to health care providers based on their Medicare fee-for-service revenue in 2019. 
  • This first tranche is drawn from the CARES Act’s $100 billion Public Health and Social Services Emergency Relief Fund (PHSSEF). The first $26 billion of funding for hospitals and providers was released via electronic transfer, and the remaining $4 billion will be disbursed by paper check for providers for whom that is how they normally receive payment.
  • 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 coronavirus. Those that do not agree must contact HHS within 30 days to remit the payment.
  • The Department of Health and Human Services (HHS) is expected to release a list of frequently asked questions to clarify that the intention for this funding is to support providers that have lost revenue. Providers who ceased operation as a result of the pandemic will likely still be eligible to receive funds if they provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. 
  • The administration is reaching out to providers with a lower percentage of their revenue coming from Medicare fee-for-service to gather feedback on how best to distribute additional funds from the $100 billion fund. 
  • Administrator Verma foreshadowed a second round of CMS distributions with first priority going to providers such as nursing homes and children’s hospitals that do not derive a large portion of their revenue from Medicare fee-for-service.
  • An additional chunk in the neighborhood of $30 billion will be set aside from the $100 billion to fund COVID-19 care for the uninsured. Kaiser Family Foundation estimated yesterday that care for the uninsured, reimbursed at Medicare rates, would run between $13.9 and $41.8 billion.
  • $34 billion has already starting flowing to providers via the Accelerated/Advance Payment Program. These payments are separate from the PHSSEF funding and must be returned and carry a 10.25 percent interest rate, which CMS says it cannot change unilaterally.
  • COVID-19 3.5. In a joint statement, Speaker Nancy Pelosi (D-CA) and Senate Minority Leader Chuck Schumer (D-NY) called for further changes to the PPP, saying that many eligible small businesses are unable to access these loans. A summary of the Democrats’ updated counteroffer can be read here.
  • Additional Democratic priorities in this proposal include: (1) $100 billion for health care providers; (2) $150 billion for state and local governments; (3) a 15 percent increase in SNAP benefits; and (4) technical fixes to election assistance funding from the CARES Act.
  • While President Donald Trump and Senate Majority Leader Mitch McConnell (R-KY) have expressed the desire to address additional funding for health care, states, and local governments in the “Phase IV” legislation, Speaker Nancy Pelosi (D-CA) has remained steadfast in her position that the “Phase 3.5” effort must include these priorities in order for the bill to pass by unanimous consent in the House.
  • Treasury Secretary Steven Mnuchin and Leader Schumer have opened talks on the next round of response legislation, and have expressed optimism about the possibility of reaching a compromise before the end of the week.
  • COVID 4.0 Policies that currently enjoy bipartisan support include funding for health care needs, additional money for the PPP, more unemployment insurance and direct payment relief, and a fix for struggling pension programs. 
  • 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.
  • 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.
  • 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.
  • Speaker Pelosi penned a “Dear Colleague” letter to members outlining her priorities for the Phase IV legislation. She has been advocating for additional health care provider funding, election support, stronger workforce protections, and repealing the 2017 tax law provision that caps the State and Local Tax deduction. The Speaker hopes to craft and consider the legislation by the end of this month. 

COVID-19: What’s Happened

  • Treasury. The Treasury Department released eligibility guidance for State, Local, and Tribal government funding from the CARES Act.
  • The Treasury Department is requesting that major airlines pay back 30% of the payroll grant relief provided to them under the CARES Act. The Department is also pushing for stock warrants equal to 10 percent of the loans that would need to be repaid in five years.
  • The Treasury Department issued a statement clarifying that Social Security recipients will not need to file an abbreviated tax return to receive direct payment relief.
  • The Treasury Department has issued guidance for airlines to apply for up to $58 billion in grants and loans as mandated by the Phase III COVID-19 legislative response bill.
  • Telehealth. The Federal Communications Commission’s (FCC) COVID-19 Telehealth Program application portal officially launched yesterday. Click here for details.
  • TRP has published a comprehensive analysis of the telehealth policies for the COVID-19 national emergency. Click here to read the telehealth memo.
  • Census. Officials are pushing to delay deadlines for completing the 2020 Census. Field Operations from the U.S. Census Bureau have been postponed until Jun. 1, and the deadline to finish the count has been delayed until Oct. 31.
  • Legislative Response. TRP’s newest COVID-19 policy memo analyzes telehealth and rural health policies in the relief legislation. This includes expanded capabilities and funding for telehealth, funding for community health centers and other rural health supports, backing for telehealth and rural health infrastructure, and more. 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 a memo that examines the provider-related provisions contained in the CARES Act. This includes critical funding for hospitals and providers impacted by the COVID-19 pandemic, greatly expanded flexibilities for providers to operate through the pandemic, and mandated coverage of coronavirus-related therapies and testing. 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.
  • TRP has published a memo on the Medicare and Medicaid provisions in the CARES Act and other COVID-19-related legislation. This analysis examines new telehealth policies, emergency payment provisions, new flexibilities on prescription drug fills, and more. Click here to read the memo.
  • TRP’s memo on the COVID-19 relief packages dives into how the pharmaceutical industry may be impacted by provisions on therapy and vaccine development, drug supply chain transparency, over-the counter drug regulation reform and more. Click here to read the memo.
  • President Donald Trump signed the Phase III legislation into law on Mar. 27. TRP’s analysis of the Phase III legislation can be read here. Our memo on the bill’s provisions pertaining to the Public Health and Social Services Emergency Fund (PHSSEF) can be read here.
  • The Phase II legislative response bill was signed into law on Mar. 18. TRP’s full analysis of the Phase II bill can be read here.
  • An $8.3 billion emergency supplemental appropriations bill cleared both chambers and was signed into law on Mar. 6. TRP’s analysis of the Phase I legislation can be read here.
  • The Treasury Department and IRS announced the implementation of certain paid sick and family leave requirements mandated by the second COVID-19 legislative response package. TRP’s breakdown of the paid leave provisions can be found here.
  • CMS. The Centers for Medicare & Medicaid Services has published a list of frequently asked questions on the enhanced Medicaid Federal Medical Assistance Percentage (FMAP).
  • CMS and the Departments of Labor and Treasury issued guidance that ensures Americans with private health insurance have access to free COVID-19 testing.
  • CMS has temporarily suspended a series of rules for health care facilities in a move aimed at bolstering frontline medical staffs.
  • 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 has issued a series of updated guidance documents focused on infection control to prevent the spread of the COVID-19 for certain inpatient and outpatient care settings. 
  • CMS has published additional frequently asked questions for state Medicaid and CHIP agencies regarding COVID-19 response efforts. 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 sent a letter to hospitals on behalf of Vice President Mike Pence requesting they report data in connection with their efforts to fight the COVID-19.
  • 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.
  • CMS announced that it is granting exemptions from reporting requirements and granting extensions for clinicians, providers, and facilities participating in Medicare quality reporting programs.
  • HHS. TRP’s memo on the bill’s provisions pertaining to the PHSSEF can be read here.
  • 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.
  • SBA. The SBA and Treasury Department updated their list of frequently asked questions on the Paycheck Protection Program.
  • SBA issued an interim final rule outlining additional guidance for the paycheck protection program. 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.
  • The Fed. 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 to $349 billion authorized by the CARES Act. The interim final rule can be read here.
  • Federal regulators announced they will temporarily allow community banks with a lower leverage ratio to skirt certain prescriptive capital requirements.
  • The Federal Reserve and four other financial agencies announced they will consider comments on Volcker rule modifications until May 1.
  • On Mar. 24, The Federal Reserve will be scaling back its examination of banks to focus more intently on the potential risks that arise from the outbreak.
  • 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 businesses that support efforts by the Small Business Administration (SBA).
  • The Federal Reserve announced that it will establish a Primary Dealer Credit Facility to support dealers’ market-making as the economy continues to slow due to the COVID-19 pandemic.
  • The Federal Reserve, Federal Deposit Insurance Corporation (FDIC), and Office of the Comptroller of the Currency (OCC) outlined actions aimed at providing banks additional flexibility to support households and businesses during the outbreak. Details on these steps can be read here.
  • DOT. The Department of Transportation (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.
  • Social Distancing. The Trump administration has recommended the use of cloth masks for those who need to go out in public.
  • Surgeon General Jerome Adams stated that he anticipates the Trump administration’s social distancing guidelines to be extended past Apr. 30.
  • President Trump announced that the administration will be extending its social distancing guidelines through Apr. 30.
  • The guidance outlines a series of steps — including avoiding social gatherings of 10 or more people — aimed at mitigating the spread of the virus.
  • Centers for Disease Control and Prevention (CDC) issued guidance on Mar. 16 recommending that Americans cancel or postpone gatherings of 50 more people for the next eight weeks.
  • 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.
  • USTR. The Office of the United States Trade Representative (USTR) published a list of exemptions on certain medical items from the tariffs imposed by President Donald Trump on Chinese goods.
  • USTR opened a comment docket for members of the public, businesses, and government agencies to submit comments if they believe further modifications to the 301 tariffs may be necessary in response to the outbreak. 
  • FDA. The Food and Drug Administration (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.  
  • FDA is suspending routine surveillance inspections for food, drugs, medical devices and tobacco to protect its workers from COVID-19 and because of industry concerns about visitors. Inspections triggered by specific reasons, like contamination, outbreaks or other emergencies, will continue.
  • EO on Medical Resources. President Trump signed an executive order that seeks to stymie hoarding of health and medical resources to respond to the spread of COVID-19.
  • President Trump issued an executive order on prioritizing and allocating resources to respond to the spread of COVID-19.
  • REAL ID. President Trump announced that the federal government would be extending the compliance deadline for REAL ID, responding to concern from the travel industry as well as lawmakers, who have been increasingly worried that a rush to DMVs to meet the Oct. 1 deadline could put people at risk.
  • Tech. The White House announced the launch of a COVID-19 High Performance Computing Consortium aimed at providing researchers with access to computing resources needed to bolster scientific research on the virus.
  • The Trump administration issued a call to action urging the tech industry to collaborate and utilize data on COVID-19 and related viruses using artificial intelligence (AI). It includes curated articles and data compiled by the Allen Institute for AI. Additional information on this database can be found here.

COVID-19: Federal Update (4/13)

Capitol Hill Update

Congressional leadership and White House officials are engaged in negotiations on another round of funding for COVID-19 response efforts after an effort to provide $250 billion for the Small Business Administration’s Paycheck Protection Program (PPP) stalled out last week. While President Donald Trump and Senate Majority Leader Mitch McConnell (R-KY) have expressed the desire to address additional funding for health care, states, and local governments in the “Phase IV” legislation, Speaker Nancy Pelosi (D-CA) has remained steadfast in her position that the “Phase 3.5” effort must include these priorities in order for the bill to pass by unanimous consent in the House. Treasury Secretary Steven Mnuchin and Senate Minority Leader Chuck Schumer (D-NY) have opened talks on the next round of response legislation, and have expressed optimism about the possibility of reaching a compromise before the end of the week. NTC will continue to monitor changes in D.C. and will keep you apprised.

COVID-19: What We’re Hearing

  • COVID-19 3.5. In a joint statement this morning, Speaker Pelosi and Leader Schumer called for further changes to the PPP, saying that many eligible small businesses are unable to access these loans. A summary of the Democrats’ updated counteroffer can be read here.
  • Additional Democratic priorities in this proposal include: (1) $100 billion for health care providers; (2) $150 billion for state and local governments; (3) a 15 percent increase in SNAP benefits; and (4) technical fixes to election assistance funding from the CARES Act.
  • COVID 4.0 Policies that currently enjoy bipartisan support include funding for health care needs, additional money for the Paycheck Protection Program, more unemployment insurance and direct payment relief, and a fix for struggling pension programs. 
  • 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.
  • 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.
  • 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.
  • Speaker Pelosi penned a “Dear Colleague” letter to members outlining her priorities for the Phase IV legislation. She has been advocating for additional health care provider funding, election support, stronger workforce protections, and repealing the 2017 tax law provision that caps the State and Local Tax deduction. The Speaker hopes to craft and consider the legislation by the end of this month. 
  • Provider Funding. On Friday April 10, CMS began to disperse approximately $26 billion in emergency relief funding to health care providers based on their Medicare fee-for-service revenue in 2019. 
  • This first dispersal is drawn from the CARES Act’s $100 billion Public Health and Social Services Emergency Relief Fund (PHSSEF). The first wave of funding for hospitals and providers is being released via electronic transfer or a paper check if that is that is how a provider normally receives payment.
  • The administration is reaching out to providers with a lower percentage of their revenue coming from Medicare fee-for-service to gather feedback on how best to distribute additional funds from the $100 billion fund. 
  • Administrator Verma foreshadowed a second round of CMS distributions with first priority going to providers such as nursing homes and children’s hospitals that do not derive a large portion of their revenue from Medicare fee-for-service.
  • An additional chunk in the neighborhood of $30 billion will be set aside from the $100 billion to fund COVID-19 care for the uninsured. Kaiser Family Foundation estimated yesterday that care for the uninsured, reimbursed at Medicare rates, would run between $13.9 and $41.8 billion.
  • $34 billion has already starting flowing to providers via the Accelerated/Advance Payment Program. These payments must be returned and carry a 10.25 percent interest rate, which CMS says it cannot change unilaterally.
  • Congressional Schedule. Despite eyeing the week Apr. 20 as a potential return date, lawmakers are not expected to convene for legislative business beyond the pro forma sessions this month. The Senate will convene for its next pro forma session on Thursday at 3 PM EST.
  • Majority Leader Steny Hoyer (D-MD)has urged members asking them to remain flexible with their schedules for the balance of the 2020 work session. This includes the possibility of coming into session during previously-scheduled district work periods and convening for five-day work weeks.
  • Appropriations leaders are delaying the start of their fiscal year (FY) 2021 funding work amid the uncertainty surrounding the COVID-19 outbreak. Congressional appropriators have pushed their expectations for completing FY 2021 spending work past the late spring-early summer dates that leadership targeted earlier this year.

COVID-19: What’s Happened

  • Legislative Response. TRP’s newest COVID-19 policy memo analyzes telehealth and rural health policies in the relief legislation. This includes expanded capabilities and funding for telehealth, funding for community health centers and other rural health supports, backing for telehealth and rural health infrastructure, and more. 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 a memo that examines the provider-related provisions contained in the CARES Act. This includes critical funding for hospitals and providers impacted by the COVID-19 pandemic, greatly expanded flexibilities for providers to operate through the pandemic, and mandated coverage of coronavirus-related therapies and testing. 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.
  • TRP has published a memo on the Medicare and Medicaid provisions in the CARES Act and other COVID-19-related legislation. This analysis examines new telehealth policies, emergency payment provisions, new flexibilities on prescription drug fills, and more. Click here to read the memo.
  • TRP’s memo on the COVID-19 relief packages dives into how the pharmaceutical industry may be impacted by provisions on therapy and vaccine development, drug supply chain transparency, over-the counter drug regulation reform and more. Click here to read the memo.
  • President Donald Trump signed the Phase III legislation into law on Mar. 27. TRP’s analysis of the Phase III legislation can be read here. Our memo on the bill’s provisions pertaining to the Public Health and Social Services Emergency Fund (PHSSEF) can be read here.
  • The Phase II legislative response bill was signed into law on Mar. 18. TRP’s full analysis of the Phase II bill can be read here.
  • An $8.3 billion emergency supplemental appropriations bill cleared both chambers and was signed into law on Mar. 6. TRP’s analysis of the Phase I legislation can be read here.
  • The Treasury Department and IRS announced the implementation of certain paid sick and family leave requirements mandated by the second COVID-19 legislative response package. TRP’s breakdown of the paid leave provisions can be found here.
  • CMS. The Centers for Medicare & Medicaid Services (CMS) and the Departments of Labor and Treasury issued guidance that ensures Americans with private health insurance have access to free COVID-19 testing.
  • CMS has temporarily suspended a series of rules for health care facilities in a move aimed at bolstering frontline medical staffs.
  • 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 has issued a series of updated guidance documents focused on infection control to prevent the spread of the COVID-19 for certain inpatient and outpatient care settings. 
  • CMS has published additional frequently asked questions for state Medicaid and CHIP agencies regarding COVID-19 response efforts. 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 sent a letter to hospitals on behalf of Vice President Mike Pence requesting they report data in connection with their efforts to fight the COVID-19.
  • 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.
  • CMS announced that it is granting exemptions from reporting requirements and granting extensions for clinicians, providers, and facilities participating in Medicare quality reporting programs.
  • Telehealth. The Federal Communications Commission’s (FCC) COVID-19 Telehealth Program application portal is set to open at 12:00 PM EST today. Click here for details.
  • TRP has published a comprehensive analysis of the telehealth policies for the COVID-19 national emergency. Click here to read the telehealth memo.
  • SBA. The SBA and Treasury Department updated their list of frequently asked questions on the Paycheck Protection Program.
  • SBA issued an interim final rule outlining additional guidance for the paycheck protection program. 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.
  • The Fed. 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 to $349 billion authorized by the CARES Act. The interim final rule can be read here.
  • Federal regulators announced they will temporarily allow community banks with a lower leverage ratio to skirt certain prescriptive capital requirements.
  • The Federal Reserve and four other financial agencies announced they will consider comments on Volcker rule modifications until May 1.
  • On Mar. 24, The Federal Reserve will be scaling back its examination of banks to focus more intently on the potential risks that arise from the outbreak.
  • 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 businesses that support efforts by the Small Business Administration (SBA).
  • The Federal Reserve announced that it will establish a Primary Dealer Credit Facility to support dealers’ market-making as the economy continues to slow due to the COVID-19 pandemic.
  • The Federal Reserve, Federal Deposit Insurance Corporation (FDIC), and Office of the Comptroller of the Currency (OCC) outlined actions aimed at providing banks additional flexibility to support households and businesses during the outbreak. Details on these steps can be read here.
  • DOT. The Department of Transportation (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.
  • Social Distancing. The Trump administration has recommended the use of cloth masks for those who need to go out in public.
  • Surgeon General Jerome Adams stated that he anticipates the Trump administration’s social distancing guidelines to be extended past Apr. 30.
  • President Trump announced that the administration will be extending its social distancing guidelines through Apr. 30.
  • The guidance outlines a series of steps — including avoiding social gatherings of 10 or more people — aimed at mitigating the spread of the virus.
  • Centers for Disease Control and Prevention (CDC) issued guidance on Mar. 16 recommending that Americans cancel or postpone gatherings of 50 more people for the next eight weeks.
  • 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.
  • HHS. The Department of Health and Human Services (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.
  • 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.
  • Treasury. The Treasury Department issued a statement clarifying that Social Security recipients will not need to file an abbreviated tax return to receive direct payment relief.
  • The Treasury Department has issued guidance for airlines to apply for up to $58 billion in grants and loans as mandated by the Phase III COVID-19 legislative response bill.
  • 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.
  • USTR. The Office of the United States Trade Representative (USTR) published a list of exemptions on certain medical items from the tariffs imposed by President Donald Trump on Chinese goods.
  • USTR opened a comment docket for members of the public, businesses, and government agencies to submit comments if they believe further modifications to the 301 tariffs may be necessary in response to the outbreak. 
  • FDA. The Food and Drug Administration (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.  
  • FDA is suspending routine surveillance inspections for food, drugs, medical devices and tobacco to protect its workers from COVID-19 and because of industry concerns about visitors. Inspections triggered by specific reasons, like contamination, outbreaks or other emergencies, will continue.
  • EO on Medical Resources. President Trump signed an executive order that seeks to stymie hoarding of health and medical resources to respond to the spread of COVID-19.
  • President Trump issued an executive order on prioritizing and allocating resources to respond to the spread of COVID-19.
  • REAL ID. President Trump announcedthat the federal government would be extending the compliance deadline for REAL ID, responding to concern from the travel industry as well as lawmakers, who have been increasingly worried that a rush to DMVs to meet the Oct. 1 deadline could put people at risk.
  • Tech. The White House announced the launch of a COVID-19 High Performance Computing Consortium aimed at providing researchers with access to computing resources needed to bolster scientific research on the virus.
  • The Trump administration issued a call to action urging the tech industry to collaborate and utilize data on COVID-19 and related viruses using artificial intelligence (AI). It includes curated articles and data compiled by the Allen Institute for AI. Additional information on this database can be found here.