Source: https://www.schwabe.com/industries-cares-act-title-3
Timestamp: 2020-08-04 00:38:22
Document Index: 364326049

Matched Legal Cases: ['§ 3212', '§ 3213', '§ 3214', '§ 3215', '§ 3221', '§ 3222', '§ 3225', '§ 3226', '§ 3601', '§ 3605', '§ 3602', '§ 3603', '§ 3608', '§ 3701', '§ 3702', '§ 3704', '§ 3706', '§ 3707', '§ 3709', '§ 3710', '§ 3711', '§ 3712', '§ 3713', '§ 3714', '§ 3715', '§ 3716', '§ 3719', '§ 3801', '§ 3802', '§ 3803', '§ 3811', '§ 3812', '§ 3813', '§ 3814', '§ 3831', '§ 3832', '§ 3216']

CARES Act Title III: Supporting America's Health Care System in the Fight Against the Coronavirus
CARES Act, Title III:
Supporting America's Health Care System in the Fight Against the Coronavirus
Subtitle B - Support for Healthcare Providers
Telehealth Network and Telehealth Resource Center Grant Programs § 3212
Rural Health Care Services Outreach, Rural Health Network Development, And Small Health Care Provider Quality Improvement Grant Programs § 3213
United States Public Health Service Modernization § 3214
Limitation On Liability For Volunteer Health Care Professionals During COVID-19 Emergency Response § 3215
Supplemental Awards For Health Centers § 3221
Nutrition Services § 3222
Reauthorization Of Healthy Start Program § 3225
Importance of the Blood Supply § 3226
Clarification of Emergency Family and Medical Leave Expansion Act § 3601 and § 3605
Clarification of Emergency Paid Sick Leave Act § 3602
Unemployment Insurance Accessibility § 3603
Single-Employer Plan Funding Rules § 3608
Exemption for Telehealth Services § 3701
Inclusion Of Certain Over-The-Counter Medical Products As Qualified Medical Expenses § 3702
Enhancing Medicare Telehealth Services For Federally Qualified Health Centers And Rural Health Clinics During Emergency Period § 3704
Use Of Telehealth To Conduct Face-To-Face Encounter Prior To Recertification Of Eligibility For Hospice Care During Emergency Period § 3706
Encouraging Use Of Telecommunications Systems For Home Health Services Furnished During Emergency Period § 3707
Adjustment of Sequestration § 3709
Medicare Hospital Inpatient Prospective Payment System Add-On Payment For COVID–19 Patients During Emergency Period § 3710
Increasing Access to Post-Acute Care During Emergency Period § 3711
Revising Payment Rates For Durable Medical Equipment Under The Medicare Program Through Duration Of Emergency Period § 3712
Coverage of the COVID–19 Vaccine Under Part B of the Medicare Program Without Any Cost-Sharing § 3713
Requiring Medicare Prescription Drug Plans and MA–PD Plans to Allow During the COVID–19 Emergency Period for Fills And Refills of Covered Part D Drugs for up to a 3-Month Supply § 3714
Providing Home and Community-Based Services in Acute Care Hospitals § 3715
Clarification Regarding Uninsured Individuals § 3716
Expansion Of The Medicare Hospital Accelerated Payment Program During The COVID–19 Public Health Emergency § 3719
Subtitle E - Health And Human Services Extenders
Extension Of The Work Geographic Index Floor Under The Medicare Program § 3801
Extension Of Funding For Quality Measure Endorsement, Input And Selection § 3802
Extension Of Funding Outreach And Assistance For Low-Income Programs § 3803
Extension Of Funding Outreach And Assistance For Low-Income Programs § 3811
Extension Of Funding Outreach And Assistance For Low-Income Programs § 3812
Delay of DSH Reductions § 3813
Extension And Expansion Of Community Mental Health Services Demonstration Program § 3814
Extension For Community Health Centers, The National Health Service Corps, And Teaching Health Centers That Operate GME Programs § 3831
Diabetes Programs § 3832
This section expands the types of entities that may apply for grants to develop and implement telehealth technology, including grants available outside the context of COVID-19 needs. Notable changes to the program are:
Substance use disorder treatment centers are now included as entities eligible for telehealth grants;
Requires that at least 50 percent of funds awarded are for projects in rural areas;
Changes the maximum grant funding period from 4 years to 5 years; and
Establishes funding of $29 million for each fiscal year from 2021 through 2025.
This section expands the types of entities that may participate in developing, implementing, and maintaining health care services in rural areas. These programs are to be available outside the context of COVID-19 needs. Notable provisions for rural health outreach and development are:
Participating entities are no longer required to be rural public or not-for-profit entities. Now, entities may participate if they can show they are experienced in serving, or have the capacity to serve, rural populations;
Changes the maximum grant funding period from 3 years to 5 years;
Supports development of integrated networks and community participation; and
Increases available funding from $45 million to $79.5 million for each fiscal year from 2021 through 2025.
Currently, the law permits Public Health Service personnel to be deployed for service “in time of national emergency.” This section expands possible deployment to include “in time of a public health or national emergency.”
Specifics for deployment of Public Health Service personnel are broadly described in Section 3216, described below.
This section limits potential state and federal liability for volunteer health care professionals—who provide services without compensation or other thing of value—for harm caused to patients relating to the diagnosis, prevention, or treatment of COVID-19. This provision expressly preempts more restrictive state or local law, and sunsets at the end of the COVID-19 public health emergency.
Flexibility For Members Of National Health Service Corps During Emergency Period § 3216
This section places the following limitations on deployment of Public Health Service personnel during times of public health or national emergency.
Public Health Service personnel must:
voluntarily agree to provide health care services during the emergency;
provide services at places the Secretary of Health and Human Services deems appropriate, and for the number of hours assigned, provided that:
the places are a reasonable distance from the members’ original assignment; and
the total hours required are the same as required of the member prior to the date of enactment of the applicable emergency.
Health Centers are entities that provide services to underserved populations and in medically underserved areas. Section 3211 of the CARES Act augments existing programs for grant funding available to Health Centers by adding $1.32 billion in funding. The additional funds are to be used to develop programs for the detection of SARS-CoV-2 and the prevention, diagnosis, and treatment of COVID-19.
De-identified health information, as contemplated by 45 CFR 164.514(b), concerning substance use disorder patients may be disclosed to public health authorities. Health care providers must revise their notice of privacy practices within one year to reflect the permissibility of such disclosures. While patients in substance use disorder treatment may still request restrictions on otherwise permissible disclosures for health care operations, they will not be able to request such restrictions with respect to reporting de-identified COVID-19 testing information to public health authorities.
Providers treating drug use disorders will need to acquaint themselves with HIPAA’s de-identification requirements. Such providers must be prepared to provide de-identified COVID-19 testing information to local, state, and federal public health authorities.
State agencies or contracted private organizations operating as area agencies on aging may transfer federal funds received for specified uses to other uses deemed appropriate by the agency. Persons in isolation who are unable to obtain nutrition, but would not otherwise qualify for meal delivery, will qualify for delivery services during the pendency of the national emergency.
Substantial appropriations are authorized for the Healthy Start meal program and other programs addressing high rates of infant mortality, poor birth outcomes, and unfavorable social determinants of newborn and infant health.
In addition to reauthorizing the Health Start program, $125 million is appropriated in each of the next four years for other programs devoted to improving neonatal, perinatal, and infant health.
The Secretary of the Department of Health and Human Services (DHHS) is directed to conduct a campaign promoting awareness of the importance of our national blood supply during the pendency of the public health emergency. The Secretary will report to Congress in two years concerning the campaign’s success.
The Emergency Paid Sick Leave Act (effective April 1, 2020) provides that employees who are unable to work or telework may take paid sick leave under six enumerated circumstances.
The CARES Act clarifies that the employers will not be required to pay more than $511 per day or $5,110 in aggregate for an employee taking leave (1) under a government quarantine or isolation order, (2) because he/she has been advised by a health care provider to self-quarantine, or (3) because he/she is experiencing symptoms of COVID-19 and seeking medical attention.
The CARES Act directs states to ensure that applications for unemployment compensation and assistance with the process is accessible, to the extent possible, in at least two of the following manners: in person, by phone, or online.
Employers sponsoring single-employer defined benefit pension plans may delay contributions otherwise due in 2020 until January 1, 2021, and may elect to use the plan’s funding status as of the plan year ending in 2019 to determine whether the plan is subject to funding-based restrictions on lump-sum benefits and amendments increasing benefits for plan years that include the 2020 calendar year.
[1] Under these circumstances, the employee would likely be entitled to use the Emergency Paid Sick Leave for the first two weeks of leave, or they can use prior accrued, unused paid leave through their employer.
The Internal Revenue Code is amended to permit deductibles and coverage of telehealth services by Health Savings Account (HSA) high-deductible plans.
Over the counter menstrual care products purchased after December 31, 2019 now qualify as “qualified medical care expenses” that may be reimbursed under Health Savings Accounts (HSAs), Health Reimbursement Arrangements (HRAs), Health Flexible Spending Accounts (FSAs) and other reimbursement arrangements.
Health insurers offering HSAs and MSAs do not currently recognize deductible amounts for menstrual care products. FSAs similarly do not provide coverage. Given that open enrollment for 2021 has passed, insurers will need to consider whether existing offerings might be adjusted mid-year or provision made for special enrollment periods.
Medicare Part B (physician) coverage during the emergency period is extended to telehealth services provided by Federally Qualified Health Centers (FQHCs) and rural clinics that are not co-located with the covered individual. Payment rates will be enhanced to match national average payment rates under the physician fee schedule. Telehealth costs, however, will not be figured into payments under the prospective payment system for FQHCs or the methodology for all-inclusive rates for rural health centers.
Expanded Medicare and Medicaid Home Health Services by certified nurse practitioners, nurse specialists, nurse midwives, and physician assistants, practicing within the scope of their licenses under state law, is authorized. This authorization includes clinical assessments required for certification of eligibility for services. Further regulation for such certification by the Secretary of DHHS is required within the six months following enactment of the CARES Act.
During the emergency period, payments for inpatient Medicare hospital services under the Prospective Payment System will be increased for discharged COVID-19 patients. The weighting factor used for calculation of discharge Diagnostic Related Groups for such patients will be enhanced by 20%.
During the emergency period, reimbursement for inpatient rehabilitation facility patients will not require the patient to receive 15 hours of therapy per week. Similarly, requirements of long-term care hospitals concerning a minimum 50% discharge payment percentage and site neutral discharge payment rates will be waived.
Medicare transition rules in 42 CFR 414.210(g)(9) for reimbursement of durable medical equipment (DME) expenses in rural and noncontiguous areas are extended during the emergency period, or through December 31, 2020, whichever is longer. The transition rules for reimbursement of DME in other areas are changed for the duration of the emergency period beginning March 6, 2020, and thereafter will be 75% of adjusted payments and 25% of the unadjusted fee amount.
Effective upon approval of a COVID-19 vaccine under federal law, cost-sharing deductibles under Part B (physician services) will not be imposed for a COVID-19 vaccine or its administration. Similarly, Medicare Advantage plans will not require cost-sharing for a COVID-19 vaccine or its administration.
During the emergency period, Medicare Part D and Medicare Advantage drug plans must allow refills of covered drugs for up to 90 days, save those prescriptions with a safety edit.
Medicaid coverage for home and community based care in acute care settings, including personal assistance and attendant services, is authorized in specified circumstances.
During the emergency period, the Medicare hospital accelerated payment program is expanded to include additional hospitals: those whose inpatients are predominantly individuals under 18 years of age, cancer centers, clinical cancer research centers, and critical access hospitals. Reimbursement for such hospitals also may be increased by the Secretary upon request. The Secretary is required to permit an additional grace time of 120 days before recouping accelerated payments and not less than 12 months from the date of the first accelerated payment before recovery in full.
Payments to physicians under the Medicare program are calculated using a complex formula that considers the physician’s expertise, efforts, time, location, and other factors. This CARES Act section ensures that one of those factors, the Work Geographic Index Floor, remains at its current level until December 1, 2020. The level was previously scheduled to change on May 23, 2020.
This section increases existing funding for certain low-income programs.
The amount allocated for state health insurance programs is $13 million for this fiscal year. For the period beginning on October 1, 2020, and ending on November 30, 2020, the amount available will be equal to the pro rata portion of $13 million.
The amount allocated for area agencies on aging will be $7.5 million for the fiscal year of 2020. For the period beginning on October 1, 2020, and ending on November 30, 2020, the amount available will be equal to the pro rata portion of $7.5 million.
The amount allocated for aging and disability resource centers will be $5 million for fiscal year 2020. For the period beginning on October 1, 2020, and ending on November 30, 2020, the amount available will be equal to the pro rata portion of $5 million.
The amount allocated for grants or contracts with national centers for benefits and outreach enrollment is now $12 million for the 2020 fiscal year ending on October 1, 2020. For the period beginning on October 1, 2020, and ending on November 30, 2020, the amount available will be equal to the pro rata portion of $12 million.
The Money Follows the Person (MFP) project supports state efforts so that individuals have a choice of where they live and receive services. Specifically, the program encourages states to “rebalance” long-term care services so that individuals can move out of nursing homes and into less intensive, but equally supportive, environments, including assisted living centers, senior housing, or an individual’s home. This section increases funding for this project to $337.5 million for the period beginning on January 1, 2020, and ending on September 30, 2020. For the period beginning on October 1, 2020, and ending on November 30, 2020, the amount available will be equal to the pro rata portion of $337.5 million.
The expense of nursing home care can rapidly deplete the lifetime savings of elderly couples. In 1988, Congress enacted provisions to prevent what has come to be called “spousal impoverishment,” leaving the spouse who is still living at home in the community with little or no income or resources. These spousal impoverishment provisions help ensure that this situation will not occur and that community spouses are able to live out their lives with independence and dignity.
This CARES Act section expands that project. According to this section, not later than six months after the date of enactment, the Secretary must select two states, in addition to the eight states already chosen, to participate in two-year demonstration programs that meet the requirements of this subsection.
This section increases the amounts allocated for these programs as follows:
For Community Health Centers, funding is increased to $4 billion for fiscal year 2020 and $668,493,151 for the period beginning on October 1, 2020, and ending on November 30, 2020.
For the National Health Service Corps, funding is now $310 million for fiscal year 2020 and $51,808,219 for the period beginning on October 1, 2020, and ending in November 30, 2020.
For teaching health centers that operate graduate medical education programs, funding now extends through fiscal year 2020 and $21,141,096 is allocated for the period beginning on October 1, 2020, and ending on November 30, 2020.
CARES Act Questions for the Manufacturing, Distribution and Retail Industry (Updated 07/13/2020)
CARES Act Questions for the Agricultural Industry (Updated 07/13/2020)
CARES Act Questions for the Transportation, Ports, and Maritime Industries (Updated 07/13/2020)
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