Washington DC Update 3/13/2020
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Greetings from Washington!
This issue of the Update is devoted in large part to coronavirus-related policy and information, including information about insurance coverage for testing and treatment for COVID-19, the illness that results from the virus.
Top line message:
It is time to start practicing “social distancing
,” especially for
individuals at high risk
of serious illness from the virus.
Quote of the week:
“No matter our politics, no matter our race, creed, or color, it is at moments such as this that everything that divides us falls away, and we realize what unites every last one of us as human beings: None of us can stop touching our face.”
From
Preparing for the Coronavirus Disruption
(National Review, 3/9/20).
IMPORTANT REMINDER:
Please see the “Your Input Sought” section below for details and information about how to submit comments on
Out-of-State Provision of Medicaid Services for Children with Medically Complex Conditions
(part of implementing the ACE Kids Act),
due March 23.
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IN THIS ISSUE
- Coronavirus News, Information, and Resources
- Administration Actions and Proposals
- Federal Legislation
- State Actions
- Public and Private Insurance Coverage for Coronavirus Testing and Treatment
- Courts
- Medicaid/CHIP News, Information, and Resources
- Medicaid Waivers
- TRICARE
- Other News, Information, and Resources
- Your Input Sought
- Upcoming Webinars and Calls
- Additional Coronavirus Resources
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CORONAVIRUS NEWS, INFORMATION, AND RESOURCES
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ADMINISTRATIVE ACTIONS AND PROPOSALS
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The President’s Remarks and Proposals
On March 11, President Trump addressed the nation about the coronavirus. As summarized by the White House, he proposes a number of measures to protect Americans’ health and the economy. See
White House Fact Sheet (3/11/20), which clarifies some of the statements the president made during the
live remarks.
Other Administration Actions
Among other actions to facilitate appropriate responses to the coronavirus outbreak, the administration has taken the following action:
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Coronavirus Bill Enacted
As reported in the
March 5 Update
, the House passed (by a vote of 415-2 on March 4) the
Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020
, (
H.R. 6074
), a bipartisan $8.3 billion supplemental funding bill to respond to the coronavirus outbreak. The funding includes:
- $2.2 billion for prevention, preparedness, and response, of which $950 million is for state local health departments;
- Over $3 billion for research and development of vaccines, therapeutics, and diagnostics; and nearly $1 billion “for procurement of pharmaceuticals and medical supplies, to support healthcare preparedness and Community Health Centers, and to improve medical surge capacity.”
As reported in
an article from The Hill
, the bill requires that any vaccines, drugs, or tests developed by private companies using taxpayer dollars be made available for purchase by the federal government at a “fair and reasonable price,” a weakened version of a provision that had been sought by Democrats. See
How the Drug Industry Got Its Way on The Coronavirus
(Politico, 3/5/20). In addition, the bill authorizes Medicare reimbursement for telehealth consultations. The Senate approved the bill without amendment on March 5, by a vote of 96-1, and the president signed it on March 6. See
Trump Signs $8.3 Billion Coronavirus Package
(The Hill, 03/06/20). Read more about the law in the House Appropriations Committee
press release
, and the committee’s
section-by-section summary
.
Congress Working on Legislation to Address Economic Impact of Coronavirus
House and Senate Democrats are working on bills to address the economic impact of the coronavirus outbreak. The 124-page
House bill
(H.R. 6021, the
Families First 5 Coronavirus Response Act
will be taken up on the House Floor as early as March 12. As summarized in the
House Speaker’s press release
, the bill provides for:
- Free coronavirus testing for everyone who needs a test, including the uninsured
- Paid emergency leave with both 14 days of paid sick leave and up to three months of paid family and medical leave
- Enhanced Unemployment Insurance, a first step that will extend protections to furloughed workers
- Strengthened food security initiatives, including SNAP, student meals, seniors nutrition and food banks
- Clear protections for frontline workers, including health care workers and other workers who are in contact with those who have been exposed or are responsible for cleaning at-risk places
- Increased federal funds for Medicaid, as states face increased costs
Senate Democrats
reportedly
are considering legislation focusing on grants for community economic development and small businesses, public transit agencies, and rental assistance for low-income households. The president has proposed suspending the payroll tax that funds Social Security and Medicare, but that proposal is considered a “non-starter” by Democrats, and is not necessarily supported by Republicans either; Senate Finance Committee Chairman Chuck Grassley (R-IA) declined to endorse that proposal. See
Coronavirus Stimulus Talks Ramp Up as White House Mulls Options
(Roll Call, 3/11/20).
On March 11, the House Committee on Oversight and Reform held a
hearing
on the federal government’s coronavirus response. The government’s top health officials testified, including Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, and Dr. Robert Redfield, Director of the Centers for Disease Control and Prevention (CDC). You can watch a video of the hearing
here
.
(Senate HELP Committee Press release, 3/6/20)
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A blog post from the Association of State and Territorial Health Officials (ASTHO) —
State Emergency Declarations and COVID-19
— discusses state declarations of emergencies, and what they empower states to do.
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PUBLIC AND PRIVATE INSURANCE COVERAGE FOR CORONAVIRUS TESTING AND TREATMENT
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Private Insurance:
Several states have taken action to address the financial barriers that may deter people from seeking medical advice and treatment for COVID-19.
California
,
Nevada
,
New York
,
Oregon
, and
Washington
are all requiring private insurance companies regulated by the state to waive cost-sharing for COVID-19 testing. It should be noted that state insurance commissioners do not have any legal authority over self-insured plans, which include those of many large employers; those plans are governed by federal law (ERISA).
The trade association of some of the country’s largest private health insurers, America’s Health Insurance Plans (AHIP), has announced that its members will relax certain policy provisions in order to make it easier for policyholders to obtain testing and treatment for COVID-19. According to a
March 5 statement from the AHIP Board of Directors
—
"We will cover needed diagnostic testing when ordered by a physician. We will take action to ease network, referral, and prior authorization requirements and/or waive patient cost sharing. We will also take action so that patients will have continuous access to their regular prescription medications while at the same time avoiding potential problems such as drug shortages.
"We will develop solutions for state and federal policymakers to provide more guidance and more flexibility so that changes to preventive services, benefit design, and treatment options can help people immediately."
Public Insurance (Medicaid, CHIP, Medicare):
Under Medicaid, testing and diagnostic services are an optional benefit category for adults, and can vary by state, but most states cover them. (Children are eligible to receive all medically necessary testing and diagnostic services.) Laboratory and X-ray services are a mandatory benefit in Medicaid and these services are covered and reimbursed in all states.
The Association for Community-Affiliated Plans – non-profit Medicaid managed care organizations – has
announced
that, “…all 74 ACAP-member Safety Net Health Plans and Marketplace Partners will offer coverage for appropriate tests of COVID-19 consistent with FDA guidance ordered by their members’ health care provider.”
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(Press release from the National Health Law Program, 3/4/20):
“St. Louis, MO – Nine children with complex medical needs and their families, along with a coalition of parents and caregivers, have filed a lawsuit against the Missouri Department of Social Services to compel the State to ensure coverage of the in-home nursing care that it has found the children need.”
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MEDICAID/CHIP NEWS, INFORMATION, AND RESOURCES
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WORTH REPEATING: Guidance to States on Behavioral Health Coverage Benefit for Separate Children Health Insurance Programs (CHIPs)
From Medicaid.gov bulletin, 3/2/20:
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To track state waiver requests, see:
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Congressman Tom Cole (R-OK) and Congresswoman Elaine Luria (D-VA) introduced the bipartisan TRICARE ECHO Improvement Act, which would make commonsense changes to TRICARE’s existing Extended Care Health Option (ECHO) program.
If you feel sick or need health advice, the
Military Health System Nurse Advice Line
is available 24/7, by phone, web chat, or video chat to eligible TRICARE beneficiaries. Nurses are able to screen patients for potential or suspected exposure or infection.
You can bookmark the TRICARE
coronavirus page
for updates about COVID-19. A DoD
spotlight page
also shares the latest information on the outbreak, and highlights coordination efforts with other government agencies.
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OTHER NEWS, INFORMATION, AND RESOURCES
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From CMS Press Release, 3/9/20, which includes links to
fact sheet
and final rules:
“A coalition of 17 attorneys general across the country, led by Washington State’s Bob Ferguson, have signed a letter asking the Trump administration to delay the
new public charge rule for immigrants while the coronavirus outbreak is ongoing. Ferguson is co-leading the multi-state coalition challenging the rule.”
WORTH REPEATING: IEP Season
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Please pay special attention to the items marked with
***
The National Library of Medicine (NLM) is asking for public comment in its current effort to modernize
ClinicalTrials.gov
, the world’s largest public clinical research registry and results database. The focus of the modernization includes improving website functionality, submission processes, and use of data standards. For more information on the project in submitting a comment,
click here
. Send submissions to NLM by no later than Saturday, March 14, 2020, to Patient Affairs Staff (PAS), Office of the Commissioner, U.S. Food and Drug Administration, or
fill out this form
. (Tel: 301-796-8460.)
***
Request for Information on Out-of-State Provision of Medicaid Services for Children with Medically Complex Conditions – due March 23
***
On January 21, the Centers for Medicare and Medicaid Services (CMS) published a
Request for Information
on “Coordinating Care from Out-of-State Providers for Children with Medically-Complex Conditions.” CMS is seeking public comments on:
- Best practices for using out-of-state providers in coordinating care for children with medically complex conditions
- How care is coordinated for such children when that care is provided by out-of-state providers including when care is provided in emergency and non-emergency situations
- Processes for screening and enrolling out-of-state providers, including efforts to streamline these processes or reduce the burden of these processes on such providers and states
Comments are due on March 23, no later than 11:59 pm EST, and can be submitted
HERE
.
Traveling by Air with Service Animals – due April 6
On January 22, the Department of Transportation issued a
proposed rule
on traveling by air with service animals. As explained in the
department’s press release
, and
this news article
, the proposed rule would, among other things: define a service animal as a dog that is individually trained to do work or perform tasks for the benefit of a person with a disability; no longer consider an emotional support animal to be a service animal; consider a psychiatric service animal to be a service animal and require the same training and treatment of psychiatric service animals as other service animals.
Comments are due on April 6 and can be submitted
here
.
CMS has issued a
Request for Information
(RFI) to seek public comments about ways to improve healthcare access, quality, and outcomes for women and infants in rural communities before, during, and after pregnancy, as well as information regarding the readiness of providers, including emergency medical services (EMS), to handle obstetric emergencies (i.e., emergencies related to pregnancy, birth, and after birth) in rural areas. Comments are due by 11:59 pm EST on April 12, 2020, and can be submitted by sending an email to
ruralmaternalrfi@cms.hhs.gov
.
Submit Stories about How Medicaid Has Helped You to “That’s Medicaid”
Through its “
That’s Medicaid
” initiative, the Robert Wood Johnson Foundation is publicizing stories about how Medicaid has helped people in various situations. These stories might be helpful as you educate policymakers and the public about Medicaid. People can submit their own Medicaid stories
here
(scroll down).
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UPCOMING WEBINARS AND CALLS
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Friday, March 13, 12:00-1:00 pm ET
National Health Council
Monday, March 16, 12:00 pm ET
National Academy for State Health Policy (NASHP)
Thursday, March 19 at 3:00-4:30 pm ET
Tuesday, March 24, 2:00-3:00 pm ET
Justice in Aging
Thursday, March 26, 2:00 pm ET
The Child and Family Policy Center
Friday, April 3, 2-3 pm ET
New Date! Wednesday, April 8, 2-3:30 pm ET
SAMHSA
Tuesday, April 14, 1:00-2:00 pm ET
Public Health Foundation
Monday, June 1, 1:00-3:30 pm ET [last in a
series
]
National Quality Forum/Administration for Community Living; Centers for Medicare and Medicaid Services
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ADDITIONAL CORONAVIRUS RESOURCES
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COVID-19 Resources Page from ADvancing States
(formerly the National Association of States United for Aging and Disabilities)
Resources on Accessing Emergency or Extra Prescription Medications
You May Have a Legal Right to Emergency Refills of Life-Essential Prescription Drugs
,
which explains that 20 states have passed
Kevin's Law
(fact sheet), which allows a pharmacist to dispense an emergency supply of a chronic maintenance drug if a doctor cannot be reached to authorize a prescription. States that have passed Kevin’s Law include: Ohio and Florida in 2016; Arkansas, Arizona, Illinois, and Wisconsin in 2017; Idaho, Oregon, Pennsylvania, South Carolina, and Tennessee in 2018; and Colorado, Indiana, Kentucky, Oklahoma, Utah, and West Virginia in 2019.
Healthcare Ready
When a state governor declares an emergency or public health emergency, it triggers certain changes to laws or regulations, or gives the governor power to waive them. For example, in
Florida
in counties where a state of emergency has been declared, or in certain other circumstances, any health insurer, managed care organization or other entities licensed by the Office of Insurance Regulation must waive the "refill too soon" restrictions on prescriptions.
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Thank you for subscribing to the Washington DC Update newsletter. Please feel free to contact Family Voices Policy Director,
Janis Guerney
, with any questions. Past issues of the Update appear on the
Family Voices website
. If you wish to unsubscribe, you can do so via the "SafeUnsubscribe" link below.
Family Voices
is a national organization and grassroots network of families and friends of children and youth with special health care needs and disabilities that promotes partnership with families--including those of cultural, linguistic and geographic diversity--in order to improve healthcare services and policies for children.
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