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March 18, 2020 04:31 PM

Trump signs second major COVID-19 relief package

Rachel Cohrs
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    Modern Healthcare Illustration / Getty Images

    President Donald Trump has signed Congress' second major COVID-19 relief package which includes an increase in state Medicaid funding that hospitals liked and a requirement that insurers do not charge cost-sharing for services related to coronavirus testing.

    Here's a rundown of the major provisions of the Families First Coronavirus Response Act relevant to the healthcare industry. The Senate passed the bill 90-8, and President Trump immediately signed it.

    Increase in Medicaid matching funds

    The federal government's Medicaid matching funds will increase across the board by 6.2%. Hospital groups including the Greater New York Hospital Association, Federation of American Hospitals and America's Essential Hospitals supported the payment bump. Similar policies were enacted in two previous bailout packages in the 2000s.

    Padding states' Medicaid budget could help head off provider reimbursement cuts in a time when providers will be squeezed by having to delay high-margin procedures and an increase in uncompensated care. States receiving the funds will not be able to change eligibility requirements or raise premiums.

    Free testing

    Private health plans, Medicare, Medicaid, Medicare Advantage and other public insurance plans have to cover testing for COVID-19 and related hospital or physicians' office visits at no cost to consumers with no prior authorization. Members of America's Health Insurance Plans had made a patchwork of commitments to cover or waive costs for aspects of the testing process, but federal lawmaking will ensure coverage is uniform across plans.

    AHIP declined to comment on the provision.

    The bill also includes $1 billion in funds from the National Disaster Medical System to reimburse providers for costs of testing uninsured individuals.

    Family and sick leave benefits

    Employers with less than 500 employees will be required to provide more comprehensive paid sick leave and family leave benefits related to COVID-19. The benefits will be paid for by the federal government using refundable tax credits within three months.

    The sick leave includes two weeks of fully paid leave to self-quarantine or seek treatment or testing for COVID-19, and two weeks at two-thirds pay to care for a child if schools or child care facilities are closed.

    The family leave allows workers to take at least 10 weeks of leave at at least two-thirds original pay after a two-week unpaid period.

    The Department of Labor may exempt companies with less than 50 employees, healthcare workers and first responders from the requirements. Employers can also choose on their own to exempt healthcare workers and emergency responders.

    Sarah-Lloyd Stevenson, a former White House Domestic Policy Council advisor and current consultant at Faegre Drinker Consulting, said the exception was likely added to ensure a stable healthcare workforce in the face of a pandemic.

    "They want those workers available as much as possible right now," Stevenson said.

    House Speaker Nancy Pelosi (D-Calif.) said in a statement that she will be working to ensure subsequent legislation "balances the workforce needs on the frontlines of the coronavirus crisis while ensuring that first responders and health care workers have access to the paid leave that they need."

    Telehealth clarification

    The bill makes a minor change to the telehealth provisions that were included in Congress' first aid package. The provision relaxes a requirement that a provider would have had to bill Medicare for services for a patient in the past three years to take advantage of the telehealth waiver. Instead, a provider has to have seen a patient for services that could have been billed to Medicare in the past three years.

    Stevenson said the edit was likely made to accommodate for the case that a 65-year-old Medicare beneficiary may have received services from a provider, but they were not billed to Medicare specifically.

    Liability protections for masks

    Personal respiratory protective devices will be treated as covered countermeasures under a Public Readiness and Emergency Preparedness Act declaration, which means that manufacturers are immune to liability except for cases of "willful misconduct." HHS Secretary Alex Azar previously extended liability protection to a wide range of healthcare providers, suppliers, drugmakers and other entities while they help address the COVID-19 pandemic.

    Unemployment and food security funding

    States will receive grants to bolster funding for unemployment insurance, and the bill allocates more funding to food security programs for low-income women and children, seniors and students while schools are closed.

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