March 18, 2020
Area(s) of Interest: Public Health
The U.S. Senate on Wednesday passed the far-reaching COVID-19 response package developed by U.S. House Speaker Nancy Pelosi and U.S. Treasury Secretary Steven Mnuchin. The U.S. House of Representatives previously passed the legislative package (H.R. 6201) early Saturday morning. Both houses of Congress passed the legislation with bipartisan votes. It is expected to be signed by the President within days. The legislative package will ensure free COVID-19 testing and expand the safety net to cope with the potentially catastrophic economic impact of the coronavirus outbreak. There are many provisions to help physician practices.
Specifically, the bill includes the following:
- Mandates coverage and waives all patient cost-sharing for COVID-19 tests, and associated physician visits for evaluating the need for testing. This mandate applies for patients who are privately insured, uninsured or enrolled in Medicare, Medicaid, SCHIP, TriCare, the Veterans Administration, the Indian Health Services or contract/referral services for Indians.
- Medicare will cover 100% of the payment amount for COVID-19 tests and associated physician visits. The bill also specifies that Medicare COVID-19 testing-related services is a medical visit in any of the following categories of HCPCS evaluation and management (E&M) service codes: office and other outpatient services, and services provided in hospital observation, emergency departments, nursing facilities, rest homes or custodial care, and home health. Outpatient payment includes hospital outpatient, the Medicare physician fee schedule, the prospective payment system and rural health clinic payments. CMS is also mandated to provide a modifier for physicians to include on claims to identify COVID-19 testing-related services.
- Prohibits prior authorization or utilization management requirements for COVID-19 testing and associated physician visits for all patients.
- Provides Medicaid eligibility to the uninsured for purposes of COVID-19 testing. The federal government will pay for 100% of the cost of COVID-19 testing and associated physician visits for these uninsured patients and will not require a state match.
- Increases federal matching funds for the Medicaid program overall by 6.2%
- Increases OSHA protections for health care workers.
- Provides $1 billion in funding for food assistance programs (school lunch, emergency food assistance, aging and disability programs, and the women, infants and children nutrition program)
- Provides up to two weeks of paid sick leave for workers who work for the government or employers with 500 employees or less.
- Provides 12 weeks of job-protected paid family and medical leave for government employees and employees who work for employers with less than 500 employees. The paid family and medical leave begins after the first 14 days of sick leave and is not less than two-thirds of the employee's regular payment rate. It will be provided to employees adhering to requirements or recommendations for quarantine; to care for a family member required or recommended for quarantine; or to care for a child whose school or child care is closed. Increases funding for state unemployment funds by $1 billion.
- Provides tax credits to employers to offset the costs of emergency sick leave.
This package comes on the heels of legislation that Congress enacted last week to provide $8.3 billion in funding to assist with COVID-19 vaccine development and treatment, public health preparedness, low-interest small business loans and financial assistance to help Americans afford the vaccine, and a broad Medicare telehealth waiver.
Congress has started work on a third bill to provide even broader economic relief of more than $1 trillion.
The California Medical Association (CMA) has set up a COVID-19 resource page, where you will find links to the latest news, research and developments on the COVID-19 outbreak for physicians and other health care providers