President Signs $2.3 Trillion Stimulus CARES Act

President Donald Trump signed a $2 trillion bipartisan stimulus package Friday that is intended to address the threat of economic disaster posed by the coronavirus pandemic.

The largest stimulus in U.S. history stimulus package aimed at resuscitating the economy following several weeks of severe, acute economic downturn.  Senate and House passed the bill unanimously after a week. The following are the healthcare related provisions:

Hospitals

Hospitals will receive the $100 billion in federal assistance they initially requested be in the FFCRA along with a 20 percent bump in Medicare payments for treating COVID-19 patients. Experts expect rural hospitals to be hit especially hard during this pandemic, since they already operate on thin margins with limited staff.

Insurance Companies

Unlike the providers, insurers were not so lucky. Carriers requested an emergency fund to offset losses from the pandemic, including premium subsidies to help fund temporary COBRA coverage, but received nothing.

The bill expands coverage beyond what was in last week’s Families First bill by requiring health insurers to pay for coronavirus testing beyond those that are FDA-approved to include those provided by labs, state-developed tests, and any other tests approved by HHS.

Telehealth Expanded to HSA (Health Savings Accounts)

Accessibility for telehealth is also expanded. High deductible health plans with HSAs may now allow pre-deductible coverage for telehealth and other remote services, as well as allowing the use of HSAs for the purchase of over-the-counter medications without a prescription. In the past, the HSA Deductibel would have to first be met.

OTC items bought with pre-tax funds

After the Affordable Care Act, over-the-counter (OTC) drugs and medicines required a prescription in order to be eligible for reimbursement from an HSA, FSA or HRA. The CARES Act would allow individuals enrolled in these pre-tax accounts to pay for OTC drugs and medicines without a prescription. This action helps to reduce additional strain from an already overwhelmed healthcare system. This is a permanent chang

Surprise Bills

Very limited action was also taken to address surprise medical bills. Under the CARES Act, all health insurance plans would reimburse a COVID-19 test provider at the in-network rate put in place prior to the breakout. If the provider is out of network, the health plan is to fully reimburse the provider based on the provider’s own “cash price” which must be made publically available while the public health emergency is still declared. Providers that do not post their test price publically could be fined up to $300 a day. States like NYS in 2015 and NJ in 2018 have already passed Surprise Medical Bill Laws.

NYS

Will the Empire State see relief with the passage of the CARES Act? Governor Cuomo is not so sure, claiming that the $3.8 billion New York will receive is “a drop in the bucket as to need,” and that a previous House bill would have given his state $17 billion. Cuomo’s budget office predicted on Tuesday that state revenue losses could be as high as $15 billion.

Additionally, NYS Department of Labor received over one million calls from recently unemployed individuals in a single week, while the country as a whole reported 3.3 million jobs lost. The governor had already implemented several executive orders and moratoriums to provide relief for New Yorkers, including a 90-day pause on evictions as well as a halt on both medical debt and student loan debt collection. This week, the governor announced that utility companies will postpone rate increases that were set to go into effect on April 1.

State Funding