Coronavirus Disease (COVID-19) Update

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• CMS pushing private Medicare plans to shelve prior authorization requirements during pandemic
• Secretary DeVos Makes Available Over $13 Billion in Emergency Coronavirus Relief to Support Continued Education for K-12 Students
• OIG FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency
• USDA Increases Monthly SNAP Benefits by 40%

Key Updates:

• The Department of Health and Human Services (HHS) updated its Provider Relief Fund website in a way that better organizes the information and includes updated hyperlinks.
  • Today, HHS began distributing the $20 billion it added to the “general allocation” provider relief fund. HHS recently completed distributing the initial $30 billion allocation from this fund. That distribution was based on 2019 Medicare Payments.
  • The new $20 billion will be distributed in a way to “augment their allocation so that the whole $50 billion general distribution is allocated proportional to providers' share of 2018 net patient revenue.” HHS will base this calculation on cost report data. Some providers already submit cost report data to HHS but many do not. Providers who do not submit their cost report data to HHS must do so via the new General Distribution Portal.
  • Recipients must attest that they agree to the terms and conditions. If they do not attest HHS will assume acceptance of those terms. If a provider disagrees with the terms and conditions, they must refund what they received through the provider relief fund website.
  • HHS believes aggregate 2018 patient revenue for all Medicare providers and facilities was $2.5 trillion. CMS is using the following formula to calculate how it will distribute the $20 billion so that the total $50 billion distribution is reflective of 2018 net patient revenue: (Individual Provider Revenues/$2.5 Trillion) X $50 Billion = Expected Combined General Distribution.
  • UnitedHealth Group will distribute the $20 billion by automatic deposit. The automatic payments will come via Optum Bank with “HHSPAYMENT” as the payment description. Payments are sent to the group’s central billing office. All relief payments are made to provider billing organizations based on their Taxpayer Identification Numbers (TINs).
  • The deadline is extended for hospitals to submit information to determine how the $10 billion allocated for a targeted distribution to hospitals in areas that have been particularly impacted by the COVID-19 outbreak. The deadline is now 3:00 PM ET, Saturday, April 25, 2020.
• President Trump signed the new Small Business Administration (SBA) and healthcare system funding bill into law. The bill replenishes funding for SBA and HHS programs that were funded by the CARES Act.
  • With funding for these programs now restored, the SBA will begin processing applications under the Paycheck Protection Program (PPP), Economic Injury Disaster Loans (EIDL) program and the Disaster Loan Program on Monday.
  • The SBA updated the terms and conditions of the PPP funding to prevent publicly traded companies from receiving PPP funding. The SBA is asking publicly traded companies to return PPP funding they received. That returned funding will be made available to new applicants.
• The Congressional Budget Office (CBO) issued an updated projection for several key economic indicators. According to the CBO:
  • Inflation-adjusted gross domestic product (real GDP) is expected to decline by about 12 percent during the second quarter, equivalent to a decline at an annual rate of 40 percent for that quarter.
  • The unemployment rate is expected to average close to 14 percent during the second quarter.
  • Interest rates on 3-month Treasury bills and 10-year Treasury notes are expected to average 0.1 percent and 0.6 percent, respectively, during that quarter.
  • The federal budget deficit is projected to be $3.7 trillion.
  • Federal debt held by the public is projected to be 101 percent of GDP by the end of the fiscal year.
• The Internal Revenue Service (IRS) says it has distributed Economic Impact Payments to 88 million individuals, worth nearly $158 billion, in the program's first three weeks. The IRS expects to make up to 150 million payments in total.
• The U.S. Food and Drug Administration (FDA) is officially recommending against the use of malaria drugs hydroxychloroquine or chloroquine to treat COVID-19 due to concerns the drugs can cause heart rhythm problems. However, clinical trials on the safety and efficacy of the drugs for COVID-19 are ongoing. 
• The Centers for Medicare and Medicaid Services is asking Medicare Advantage and Medicare Part D plans to temporarily waive prior authorization requirements during the public health emergency.
• The Department of Education distributed $13 billion in funding to K-12 schools. The Department received this funding from the CARES Act.
• The HHS Office of Inspector General (OIG) published new FAQs on how it is applying discretion with its enforcement authorities – particularly for the antikickback statute – during the public health emergency. If you have a question regarding how OIG would view an arrangement that is directly connected to the public health emergency and implicates these authorities, please submit your question to OIGComplianceSuggestions@oig.hhs.gov.
• The U.S. Department of Agriculture (USDA) will increase monthly Supplemental Nutrition Assistance Program (SNAP) benefits by 40 percent.