Lawmakers decided to leave hospital reimbursement for their response to the COVID-19 outbreak to federal agencies and states in an $8.3 billion emergency aid package announced Wednesday.
The U.S. House of Representatives overwhelmingly passed the funding bill on Wednesday, and the Senate could also vote as soon as Thursday to send the funding bill to President Donald Trump's desk.
The package provides $2.2 billion to support federal and local state health agencies, including $950 million for state and local governments to conduct testing and other response activities. Lawmakers set aside $500 million for purchasing medical supplies, an unspecified amount for increasing medical surge capacity, and $100 million in grants for community health centers.
The American Hospital Association and American Nurses Association last Thursday asked leaders in Congress for $1 billion in new emergency funding to implement quarantines, test patients, expand laboratory capacity, increase staffing, provide telehealth services and buy protective equipment. Neither group immediately responded to a request for comment on the appropriations package.
Hospitals could get some of the federal money funneled through federal agencies and state governments, said Sen. Roy Blunt (R-Mo.), who is the chair of the Senate Appropriations health subcommittee.
"The state government, whenever they get some block grants, which they'll get under this, they'll have to develop in many cases their own allocation formula, both to their hospitals and deciding which hospitals to include," Blunt said Tuesday.
The Greater New York Hospital Association told members on Wednesday that it sees several opportunities for hospitals to obtain federal funding through money set aside for preparedness, protective equipment, and training. GNYHA also highlighted a provision of the emergency funding bill that reads: "Funds may be used for grants for the construction, alteration, or renovation of non-federally owned facilities to improve preparedness and response capability at the state and local level."
New York Gov. Andrew Cuomo (D) on Tuesday signed a $40 million emergency funding package in response to the COVID-19 outbreak.
"We will continue to work in the coming days to ensure that the New York congressional delegation and others in Congress understand the enormous financial undertaking the COVID-19 response will require from GNYHA members," GNYHA said.
The Missouri Hospital Association is working with the Missouri Department of Health and Senior Services to coordinate preparedness response across different hospitals, said spokesman Dave Dillon.
"We're working with our state partners to understand the situation and work on resource allocation," Dillon said.
The Federation of American Hospitals applauded Congress' "swift and timely action" on funding. It took lawmakers seven months to pass emergency funding to fight Zika in 2016, another presidential election year.
"This bill will provide essential assistance to caregivers and communities on the front lines of this battle," FAH President and CEO Chip Kahn said in a statement.
The appropriations bill also provides $500 million for the use of telehealth services and allows seniors to access telemedicine services for coronavirus treatment after the Connected Health Initiative and American Medical Association asked lawmakers to lift cost-sharing requirements and restrictions on telehealth service provision. The request was first reported by Morning Consult.
"This bipartisan supplemental legislation would expand the use of telehealth services to allow Medicare patients access to their physicians from their homes during the current COVID-19 outbreak, and aligns with the AMA's belief that the appropriate use of telehealth can greatly improve access to quality care," the American Medical Association said in a statement.
Lawmakers chose to allocate around $3 billion for research and development of vaccines, therapeutics and diagnostics. Ensuring affordability for an eventual coronavirus vaccine was a sticking point in negotiations, and the final deal allows the HHS secretary to take measures "authorized under current law" to ensure vaccines, treatments and tests developed using federal funds are affordable in the commercial market as long as those actions do not delay development of the products.
The Trump administration is considering using funds to reimburse providers from the National Disaster Medical System definitive care program, which was established to transfer patients to hospitals outside disaster zones, an HHS spokesperson said Tuesday. Providers that participate in the program would mostly be reimbursed at 110% of their Medicare rates for certain patients who are uninsured, covered only by Medicaid, or covered only by another state or local payer of last resort. The reimbursement is subject to the availability of funds.
HHS also announced on Wednesday that it plans to transfer funds to the Centers for Disease Control and Prevention to provide $35 million to certain states and localities that have been disproportionately affected by the COVID-19 outbreak so far. HHS said the CDC would reach out through existing networks to distribute the initial funding.
The CMS on Wednesday encouraged providers to ensure they are following proper infection control procedures, noting that accrediting organizations will be focusing on those protocols during any facility inspections.