The continued efforts to increase funding for COVID-19 relief, along with the Biden administration’s ambitious policy agenda, have sparked a wave of change impacting the healthcare landscape. This GT Alert contains notable updates, including unprecedented funding opportunities and healthcare budget proposals.
Plan of American families
On April 28, 2021, President Biden released details of the “Plan of American familiesThe long-awaited second phase of the largest federal infrastructure set in the administration. The plan includes $ 1 trillion in new spending and $ 800 billion in new tax credits. Prior to the plan’s release, there was speculation on whether the healthcare proposals would be included in the package and, if so, to what extent. Some Democrats have pushed the president in recent weeks to include sweeping healthcare policy changes in the plan, including tackling drug prices and lowering the age of Medicare eligibility. However, the current version of the plan does not include drug pricing or Medicare updates, but only addresses health care reform by permanently implementing the Temporary Grant Extensions of the Act. affordable care that was included in the “American rescue planThe COVID-19 relief package released on March 11, 2021 (discussed in more detail below).
American Rescue Plan Act of 2021
On March 11, 2021, President Biden signed the American Rescue Plan Act of 2021 (ARPA or the Act), a $ 1.9 trillion COVID-19 relief program designed to strengthen support for hospitals, healthcare systems health, rural health care providers, state and local governments. and those affected by COVID-19 across the country. The Act creates substantial funding flows, and qualifying entities should consider seizing these opportunities as soon as possible while providing for ongoing and sometimes new review and oversight of regulatory enforcement. The key categories follow below.
Financial support for health care providers
A significant amount of funding under the Act is allocated to affected healthcare providers during COVID-19, due to the influx of COVID-19 patients requiring treatment, increased demand for personal protective equipment and other supplies, and loss of income due to a moratorium on elective procedures. While the CARES law (Coronavirus Aid, Relief and Economic Security), adopted in March 2020, included financial support for providers who lost income or incurred increased expenses due to COVID-19 (i.e. the Provider Relief Fund (PRF)), ARPA goes further, adding even more direct financial support to providers beyond the funds available under the FRP.
Notably, ARPA is creating an $ 8.5 billion funding pool for rural Medicare and Medicaid providers to help address the specific challenges these providers face in combating COVID-19 and serving often vulnerable populations. . Similar to the FRP requirements, these additional funds are available to reimburse both health care expenses and lost income due to COVID-19. ARPA directs the US Department of Health and Human Services (HHS) to create a process to apply for funding, and requests must include a statement justifying the supplier’s need for payment, the supplier’s tax identification number and assurance that the supplier will maintain and make available reports to ensure compliance with all requirements imposed by the HHS. However, HHS has not yet finalized the application process.
In addition to the $ 8.5 million for rural vendors, ARPA is providing $ 500 million in grants to eligible rural entities through the U.S. Department of Agriculture, including municipalities and public counties, for cover expenses related to COVID-19. Eligible expenses include increased telehealth capacity, vaccine administration costs, and the purchase of necessary medical supplies.
ARPA also includes additional funding for mental health and addiction treatment, an area of particular concern during the COVID-19 pandemic. The law provides approximately $ 4 billion in funding to address behavioral health and addiction issues, including funding through grants or contracts for professional health schools, academic health centers, state or local governments, Indian tribes and tribal organizations, and other public or private not-for-profit organizations. entities to support behavioral health treatment, as well as behavioral health workforce issues.
Additional funding for vaccines and testing capacity
ARPA is also allocating significant sums to increase immunization and testing capacity, including $ 7.66 billion for state, local and territorial health departments to increase public health workforce and procure equipment and other supplies needed to support testing and vaccinations. More so, the law also provides $ 10 billion to conduct activities under the Defense Production Act to strengthen the vaccine supply to the United States, including the expansion of domestic vaccine manufacturing and personal protective equipment.
Expanded access to health care
The law also focuses on expanding health care coverage to ensure vulnerable people have access to COVID-19 vaccines and treatment, as well as continued health care coverage. Provisions to extend coverage include:
- Mandatory Medicaid coverage of COVID-19 vaccines and treatment without cost sharing of registrants.
- Elimination of the Medicaid drug rebate cap and inclusion of ambulatory drugs used for the prevention or treatment of COVID-19 to be included in the Medicaid drug rebate program.
- Expansion of health care coverage for individuals, including a two-year increase in grants in scholarships above 400% of the Federal Poverty Level (FPL), with a premium contribution capped at 8.5 % and the federal government subsidizing 100% of COBRA insurance premiums for employees who lose their jobs due to the pandemic and for their covered loved ones.
- Option for states to extend Medicaid and CHIP eligibility to pregnant women for 12 months postpartum.
Overview of the 2022 discretionary budget
In addition to the funds allocated under ARPA, on April 9, President Biden released the Overview of the 2022 discretionary budget which expanded the priorities included in ARPA, as well as the proposed US Jobs Plan. The proposal includes additional funding for home and community-based services (HCBS), rural health, and behavioral health and substance abuse treatment, among other priorities.
Key elements of the proposal include:
- $ 551 million for HCBS, which would be in addition to the $ 400 billion already included in the administration’s proposed infrastructure plan.
- $ 6.5 billion to launch the Advanced Health Research Projects Agency, which would increase direct federal spending on health research and development. The focus would be on cancer and other diseases, such as diabetes and Alzheimer’s disease.
- $ 10.7 billion to address the opioid crisis, including investments in medical treatment, research and development of the behavioral health workforce. This funding would be intended to support communities with specific needs, including Native Americans, older Americans and rural populations.
- More than $ 200 million to reduce maternal mortality and morbidity across the country, including strengthening maternal mortality review committees, expanding the program of mid-term maternity and obstetrics management strategies rural, implementing implicit bias training for health care providers and establishing state home programs for pregnant women.
The changes summarized in this GT Alert present significant opportunities in healthcare. Expert advice can help eligible entities identify and navigate new avenues open to them.
© 2021 Greenberg Traurig, LLP. All rights reserved. National Law Review, Volume XI, Number 123