Senate Republicans' COVID-19 economic stimulus bill would suspend the Medicare sequester until the end of 2020, increase inpatient hospital add-on payments for treating COVID-19 patients, reduce restrictions on telehealth and boost funding to community health centers.
Negotiations on the legislation are ongoing, and Republicans need Democratic support to pass the legislation. House Speaker Nancy Pelosi (D-Calif.) and House Minority Leader Chuck Schumer (D-N.Y.) said in a statement Thursday that they want to see more stringent conditions placed on corporations that receive relief funds.
Suspending the Medicare sequester was a top priority of the American Hospital Association, Federation of American Hospitals, Association of American Medical Colleges, Greater New York Hospital Association and American Medical Association. The sequester, which reduced spending for most benefits by 2% starting in 2013, would be suspended from May 1 to December 31, 2020, according to the draft text.
"This action alone will provide immediate, significant relief across-the-board, and will signal continued congressional support for the hard work that lies ahead for all of us," AHA, AAMC and FAH said in a joint letter asking congressional leaders to suspend the Medicare sequester on March 15.
However, the sequestration would be extended an additional year past its original end date to avoid "worsening Medicare's long-term financial outlook," according to background materials.
Senate Republicans also proposed a 15% inpatient hospital add-on payment for treating patients admitted with COVID-19.
Community health centers would receive $1.32 billion in supplemental funding for prevention, diagnosis and treatment of patients with COVID-19.
The text did not include provisions that would provide long-term funding that community health centers have called for, delay cuts to Medicaid disproportionate-share hospital payments or fund other Medicare and Medicaid programs that will expire May 22. Senate Majority Leader Mitch McConnell (R-Ky.) said Thursday that he wanted Congress to immediately start work on a fourth bill, which could be a vehicle for the healthcare policies.
"Immediately after we pass this legislation, Congress must begin a bipartisan, bicameral appropriations process to address the administration's new supplemental funding request so we can keep funding healthcare and other priorities," McConnell said.
The package temporarily waives requirements that home dialysis patients conduct visits with their physicians face-to-face.
The draft text would also allow the HHS secretary to develop and implement a new payment rule for federally qualified health centers and rural health clinics that provide telehealth services to eligible patients. Payment rates would be based on payment that currently applies to comparable telehealth services under the physician fee schedule, according to the text.
It's a continuation of recent efforts from lawmakers and the Trump administration to reduce telehealth restrictions in the wake of the COVID-19 outbreak.
In an appropriations bill earlier this month lawmakers waived some Medicare restrictions on payment for telehealth so that seniors could use remote services for coronavirus treatment, and the Trump administration on Monday announced that Medicare would pay doctors and hospitals for a broad range of telehealth services on a temporary basis, effective March 6.
The package puts the HHS assistant secretary for preparedness and response in charge of managing the strategic national stockpile and requires medical supplies, including swabs used in diagnostic tests for COVID-19, to be stockpiled.
FDA policy would be amended so that laboratory developed tests and diagnostic kits could be used, and covered by private insurance plans, before receiving an emergency use authorization.
Insurers would be required to pay either a negotiated price with a provider or a cash price posted by the provider for the test. Vaccines that meet certain effectiveness standards would also have to be covered with no cost-sharing.
Senate Republicans proposed allowing physician assistants and nurse practitioners to order home health services and allowing Medicaid to pay for additional support to disabled individuals in the hospital to reduce length of stay.