On March 25, 2020, by a vote of 96-0, the Senate passed the $2 trillion Coronavirus Aid, Relief, and Economic Security Act (CARES Act), The bill contains several provisions intended to help individuals and businesses affected by the coronavirus crisis, including direct payments to taxpayers, an expansion of unemployment insurance, funding to small businesses that retain employees, loans to large businesses, and grants to airline companies. These provisions have been widely covered by the media.

There are also several provisions in the bill of particular interest to providers. These include:

  • A requirement that health insurers pay contracted providers the contract rate to those who perform COVID-19 tests, or the posted cash price to non-contracted providers. This provision is intended to ensure that providers are paid for performing these tests even though other provisions of the bill require that patients not be required to pay any cost-sharing amounts for these tests.
  • Expansion of existing Medicare accelerated payment program to provide hospitals, particularly in rural areas, with needed cash flow. Qualified facilities may request up to six-months advanced payment, either in a lump sum or in periodic payments.
  • An increase in 20% in Medicare payments to hospitals under the Hospital Inpatient PPS system for their treatment of COVID-19 payments during the national health emergency.
  • $1.3 billion in support to community health centers on the front lines of testing and treating patients with COVID-9.
  • Temporary lifting of the sequester provisions that reduce Medicare payments by 2% to provide immediate relief. The suspension will be in effect from May through December 2020. To ensure the financial viability of the Medicare program, however, the sequester period will be extended by one year beyond the period in current law.
  • Immunity from liability for health care providers acting within the scope of their licenses who provide voluntary medical services during the time of the coronavirus national emergency.
  • No cost-sharing for a COVID-19 vaccine under Medicare Part B and Medicare Advantage plans, beginning the day after a vaccine is licensed.

Several of the bill’s provisions expand the availability of telehealth services, including:

  • Allowing federally qualified health centers and rural health clinics to serve as distinct sites for the provision of Medicare telehealth services. Payment will be made at the national average payment rates for telehealth services under the Medicare physicians’ fee schedule.
  • A requirement that the Secretary of Health and Human Services issue guidance encouraging the use of telecommunications systems, including for remote patient monitoring.
  • A safe harbor for high deductible health plans paired with a health savings account to allow them to provide pre-deductible coverage for telehealth and other remotely provided services for plans that begin on or before December 31, 2021.

The House of Representatives is expected to vote on the CARES Act on March 27, 2020. The text of the CARES Act is linked here.

The attorneys at Whatley Kallas, LLP will continue to follow the CARES Act and all subsequent legislative and regulatory efforts to address COVID-19.