Framing the Week

By: | May 19, 2020

Senate Republicans have no immediate plans to consider the HEROES Act (H.R. 6800) – the $3 trillion coronavirus relief package passed by House Democrats last Friday (May 15) – or present a counter offer to begin negotiations. Instead, the Senate will consider a slew of judicial nominees before adjourning for the Memorial Day recess. In the meantime, Democrats will continue to push for expeditious action, especially as some states seriously consider cuts to Medicaid in order to help balance their budgets.

Senate Majority Leader Mitch McConnell (R-KY) and Sen. John Cornyn (R-TX) are working on legislation to provide businesses with new liability protections – a “red line” for Republicans. Yesterday, House Speaker Nancy Pelosi (D-CA) stated, “we have no red lines” when asked what types of concessions Democrats would be willing to make to get what they want, appearing to indicate some room for compromise. President Trump’s demands for payroll tax and capital gains tax cuts, however, remain a nonstarter for Democrats and some Republicans.

In an effort to effectuate its 2019 hospital price transparency final rule (which has been mired in legal trouble), the White House wants Congress to codify requirements on hospitals to disclose prices negotiated with insurers for medical services in the next coronavirus relief package. The policy also aligns with the Trump administration’s recent proposal in the FY 2021 inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective payment system (PPS) proposed rule requiring hospitals to report by MS-DRG the median of the payer-specific negotiated charges for a hospital’s Medicare Advantage (MA) organization payers and all of its third-party payers.

Negotiations on a fifth coronavirus relief package will likely not begin in earnest until June, with the depletion of the Paycheck Protection Program a likely catalyst for lawmakers to come to the negotiating table. So far, the Small Business Administration (SBA) has approved nearly $189 billion in its second round of loans (April 27 through May 8) – more than half of the $310 billion appropriated under the Paycheck Protection Program and Health Care Enhancement Act (Public Law No: 116-139).

The Trump administration has until this Sunday (May 24) to deliver to Congress its COVID-19 strategic testing plan, which public health experts stress is critical as most states have begun to reopen their economies and ease social distancing requirements. The Paycheck Protection Program and Health Care Enhancement Act requires the Department of Health and Human Services (HHS) to detail how it will assist states and localities, estimates of testing production, available federal resources, among other strategies. At the Senate Health, Education, Labor and Pensions (HELP) Committee hearing, HHS Testing Czar Admiral Brett Giroir dodged questions from Ranking Member Patty Murray (D-WA) on whether the mandated strategy would include “specific numeric targets for testing capacity, supply chain capacity, and project of shortage.”

On Wednesday, the House Education and Labor Subcommittee on Workforce Protections will examine the federal government’s actions to protect workers from COVID-19. Democrats will likely advocate for the COVID-19 Every Worker Protection Act of 2020, which was included in the House-passed HEROES Act. The legislation would direct the Occupational Safety and Health Administration (OSHA) to issue an emergency temporary standard that would require employers to develop and implement a comprehensive infectious disease exposure control plan to protect works from exposure to COVID-19. The bill would also require the Centers for Disease Control and Prevention (CDC), in collaboration with the National Institute for Occupational Safety and Health (NIOSH) to collect, and as needed, investigate reports of work-related transmission of COVID-19 to health care and other workers, and make recommendations on needed actions or guidance. Following the lead of Senate Republicans, House Republicans may use the hearing as an opportunity to push for liability protections for employers.

On Thursday, the Senate Special Committee on Aging will hold a hearing on caring for seniors during the COVID-1919 crisis. The disproportionate impact of coronavirus on seniors, especially those living in nursing homes, has been a major area of concern, with members in both parties demanding more transparency. In an interim final rule with comment period issued on May 8, the Centers for Medicare and Medicaid Services (CMS) codified explicit requirements for nursing homes to report confirmed or suspected COVID-19 cases to the CDC. CMS will soon take enforcement actions on facilities that fail to begin reporting by May 31, following the initial two-week grace period (which ends on May 24).

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Alyssa Llamas