COVID-19 Federal Response Update – Wednesday, April 8, 2020

By Capitol Associates, Inc. 

• • President Trump wrote a letter to Congress that formally requests an additional $251 billion for the paycheck protection program’s small business loans. The CARES Act initially provided $350 billion for this program. Lenders began accepting applications for loans under the program on Friday. The loans can convert into grants that do not have to be repaid if certain conditions are met.
    • Democrats are supportive of the total funding figure and the need to move swiftly to approve more funding. However, Democrats want to ensure that some of the funding is directed to community-based financial institutions that serve farmers, family, women, minority and veteran-owned small businesses and nonprofits in rural, tribal, suburban and urban communities.
    • In addition to the $250 billion for small businesses, Democrats also want an extra $100 billion for the health care system, $150 billion for state and local governments and an increase to Supplemental Nutrition Assistance Program (SNAP) benefits.
    • Senate Majority Leader Mitch McConnell (R-KY) could seek unanimous consent by voice vote to approve the additional funding as early as tomorrow. This process would allow the quickest possible vote and it would not require many Senators to travel from their home states to the Capitol. The House could attempt to use the same unanimous consent process to pass a bill as soon as the following day. One House Member objected to the House’s attempt to pass the CARES Act by unanimous consent. It is not known if that Member would object to this package as well.
    • If the Senate (and subsequently the House) holds a unanimous consent vote, only one present legislator would need to object to prevent the bill from passing. Congress will need to work out all of these issues before holding a unanimous consent vote. Otherwise, legislators will need to return to D.C. for a roll call vote which could delay the process.
  • The Centers for Medicare and Medicaid Services (CMS) announced it will begin distributing the $100 billion in funding it received in the CARES Act. The funding will help hospitals that are on the front lines of the crisis but some of the funding will also go to physician practices that have had to cancel elective procedures during the public health emergency.
    • CMS is not distributing all of the $100 billion at once. For now, it is only distributing $30 billion and only for hospitals. This funding will be awarded as grants to hospitals that do not need to be paid back.
    • CMS is still determining a methodology for how to compensate providers who have had to cancel procedures for lost revenue. It also is not known how much of the $100 billion will go towards physician lost revenue.
  • CMS issued new guidance for how providers should bill Medicare for coronavirus testing services. Congress passed legislation that requires all payers to cover testing services without charging patients any cost-sharing. Medicare patients typically have a 20 percent coinsurance for Medicare services. CMS will compensate providers for that 20 percent that the patient normally would have paid. CMS is telling providers to use the CS modifier on applicable claim lines to identify the service as subject to the cost-sharing wavier for COVID-19 testing-related services. Medicare will pay for services billed with the CS modifier at 100 percent.
  • CMS also announced that it has made approximately $34 billion in accelerated and advanced Medicare payments over the last week. CMS often allows providers to request advanced payments based on previous months payments during natural disasters and other emergencies. The advance payments are used as emergency cash flow but are paid back at a later date.
  • CMS also issued new infection control guidelines based on Centers for Disease Control and Prevention (CDC) recommendations.
  • The White House is working on a plan to “reopen” parts of the country from the current lockdown status. The plan would combine wide-scale coronavirus testing with technology to track the results to pinpoint areas where restrictions can be lifted.
  • The Federal Emergency Management Agency (FEMA) issued a new regulation that prohibits domestic manufacturers from exporting certain personal protective equipment (PPE) items that are in short supply in many hospitals. The order applies to N95 masks, surgical masks, surgical gloves and other protective gloves.