The NCSL Blog


By Haley Nicholson

Congress passed the Coronavirus Aid, Relief and Economic Security (CARES) Act, HR 748, that includes $2.2 trillion in funding to address the health, human services, educational and economic impacts of the coronavirus (COVID-19).

The law will provide $150 billion in direct aid to states, territories and tribal governments. Of that $150 billion at least $8 billion will go to tribal governments and at least $3 billion to the District of Columbia and the territories.

The bill also provides funds to state and local governments through more than 50 other federal programs. NCSL has released a summary of major provisions included in this legislation and developed a resource page of funding and daily announcements from the federal government.

Some of the bill’s health-related provisions also clarify and update previous provisions from the second emergency surplus package (HR 6201). Read more on the health provisions included below, and  for more details on the bill.

For Medicare, there will be a suspension of automatic Medicare payment cuts to hospitals and doctors from May 1 through Dec. 31, 2020. The sequestration was a requirement under the Budget Control Act that would have reduced Medicare payments by 2% annually.

Hospitals will also receive a 20% increase in their Medicare payments for treating those with COVID-19 during the emergency period. Medicaid programs received a few extensions, including one for the Money Follows the Person demonstration program until Nov. 30, 2020, and continued protection against spousal impoverishment.

The law will also delay, by 30 days, a requirement from the second COVID-19 response package that a state maintain premiums to receive the 6.2 percentage point increase in Federal Medical Assistance Percentage funding. There will also be a delay in Disproportionate Share Hospitals payments until Dec. 1, 2020.

As more patients seek COVID-19 testing and services, Congress passed several allowances for using telehealth. Now, federally qualified health centers and rural health clinics can use telehealth to provide care in a different location during the COVID-19 emergency and be reimbursed at a rate similar to the national average for similar services.

The law will also expand the Strategic National Stockpile to include protective equipment and supplies such as swabs used for COVID-19 testing.

One of the communities feeling the biggest impact from the COVID-19 is U.S. health care providers and hospitals. Some provider support measures include:

  • Modifying a previous authorization that had not yet been implemented for the Ready Reserve Corps.
  • Exempting health care professionals from liability for providing volunteer services during the COVID-19 emergency.
  • Allowing Health and Human Services (HHS) to assign the National Health Service Corps with a voluntary agreement to provide services to help respond to the pandemic if close to their original assignments.

There is also an additional $1.32 billion in supplemental awards to community health centers. Funding will be expanded to $4 billion through fiscal year 2020, with an additional $668.5 million appropriated between Oct. 1 and Nov. 30, 2020. This funding is part of a package along with other programs known as health care extenders that were scheduled to be reauthorized this May for five years.

The law also provides information and backing for the guidance that the Trump administration released a few weeks ago regarding 42 CFR Part 2. It allows health care providers to share patient information after obtaining initial consent from patients while still following Health Insurance Portability and Accountability Act requirements. Under the CARES Act, the information may not be used in civil, criminal, administrative or legislative proceedings against the patient or to discriminate against patients in employment, housing, court or public benefits.

This third package offers relief for many states, territories, tribal nations and their communities. However, as COVID-19 cases increase in the U.S., many questions still remain unanswered:

  • When will this funding go out to states and communities?
  • What does relief mean for rural hospitals and underserved areas?
  • When can providers expect to receive supplies?
  • If states have to be reimbursed for costs, what kind of lag time should they expect?

As federal partners work to get resources out to states and expand flexibilities for HHS programs, they should be mindful of the unique needs of each state and their communities during this time.

Haley Nicholson is senior policy director in NCSL's State-Federal Relations Division.

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Posted in: Health, COVID-19
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About the NCSL Blog

This blog offers updates on the National Conference of State Legislatures' research and training, the latest on federalism and the state legislative institution, and posts about state legislators and legislative staff. The blog is edited by NCSL staff and written primarily by NCSL's experts on public policy and the state legislative institution.