Title III – Supporting America’s Health Care System in the Fight Against Coronavirus, Subtitle E – Health and Human Services Provisions

Early in the morning on Thursday, March 26, 2020, the Senate passed the Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”). On Friday, March 27, 2020, the House of Representatives also passed the CARES Act and President Trump quickly signed it in to law the same day. In this continuing series of blogs by lawyers at Forrest Firm, P.C., we will examine the most important, relevant, and impactful provisions of the CARES Act.

Our goal is not to provide you with a granular level examination of each provision of the CARES Act, but rather to provide a macro view of the CARES Act in clear, concise, and understandable language that will enable readers to move forward with their businesses and lives with confidence. These are trying times ,and here at Forrest Firm we want these articles to support our clients, positively impact our communities, and be available to help you with questions and concerns raised by the CARES Act.

This Subtitle of the CARES Act has five part, each dealing with specific programs authorized and overseen by the Department of Health and Human Services: Medicare, Medicaid, human services and other programs, public health provisions, and miscellaneous provisions. 

Part 1 – Medicare Provisions

Extension of the Work Geographic Index Floor Under the Medicare Program.  Section 3801 of the CARES Act extends until December 1, 2020 the work geographic index floor of 1.00 for any locality with a work geographic index less than 1.00, which positively impacts the difference between the relative value of physicians’ work effort in each of the different fee schedule areas and the national average of such work effort.

Extension of Funding for Quality Measure Endorsement, Input, and Selection.  Section 3802 of the CARES Act amends the appropriation for quality measurement endorsement, input and selection from $4,830,000 to $20 million for the fiscal year ending on October 1, 2020 and for October and November of 2020, on a pro-rata basis.

Extension of Funding Outreach and Assistance for Low-Income Programs.  Section 3803 of the CARES Act increases and extends funding for low income programs, including state health insurance programs, area agencies on aging, aging and disability resource centers, and for grants or contracts with the National Center for Benefits and Outreach Enrollment. 

Part 2 – Medicaid Provisions

Extension of the Money Follows the Person Rebalancing Demonstration Program.  Section 3811 of the CARES Act allocates $337,500,000 for the Money Follows the Person Rebalancing Demonstration Program from January 1, 2020 and ending on September 30, 2020, and for October and November of 2020, on a pro-rata basis.

Extension of Spousal Impoverishment Protections.  Section 3812 of the CARES Act extends funding for Spousal Impoverishment programs, which allow a State to disregard the income of a spouse and conduct an analysis solely on an individual’s eligibility on the basis of reduction of income for medical assistance and home and community-based services, through November 30, 2020.

Delay of DSH Reductions.  Section 3813 of the CARES Act delays decreases in funding for disproportionate share hospitals until December 1, 2020.

Extension and Expansion of Community Mental Health Services Demonstration Program.  Section 3814 of the CARES Act provides an extension and expansion of the Protecting Access to Medicare Act of 2014.

Part 3 – Human Services and Other Health Programs

Extension of Sexual Risk Avoidance Education Program.  Section 3821 of the CARES Actextends the ending of the Sexual Risk Avoidance Education program from May 22, 2020 through December 31, 2020 and to change the fiscal year to 2021.

Extension of Personal Responsibility Education Program.  Section 3822 of the CARES Act extends the Personal Responsibility Education program from May 22, 2020 through September 30, 2020 and allocates $48,287,671 for the 2020 fiscal year,. and for October and November of 2020, on a pro-rata basis.

Extension of Demonstration Projects to Address Health Professions Work-Force Needs.  Section 3823 of the CARES Act extends through November 30, 2020 the demonstration projects designed to provide eligible individuals with the opportunity to obtain education and training for occupations in the health care field that pay well and are expected to either experience labor shortages or be in high demand. 

Extension of the Temporary Assistance for Needy Families Program and Related Programs.  Section 3824 of the CARES Act provides for the extension through November 30, 2020 of activities authorized by Part 1 of Title IV and Section 1108(b) of the Social Security Act.

Part 4 – Public Health Provisions

Extension for Community Health Centers, the National Health Service Corps, and Teaching Health Centers that Operate GME Programs.  Section 3831 of the CARES Act increases funding for (1) community health centers under the Patient Protection and Affordable Care Act to $4,000,000,000 through September 30, 2020 and allocates $668,493,151 for October and November, 2020, and (2) the National Health Service Corps to $310,000,000 through September 30, 2020 and allocates $51,808,219 for October and November, 2020.  It also extends the amount allocated for teaching health centers that operate graduate medical education programs through September 30, 2020 and allocates $21,141,096 for October and November, 2020

Diabetes Programs.  Section 3832 of the CARES Act extends funding under (1) the Public Health Service Act for Type I Diabetes through September 30, 2020 and allocates $25,068,493 for October and November, 2020 (2) the Public Health Service Act for Indians through September 30, 2020 and allocates $25,068,493 for October and November, 2020.

Part 5 – Miscellaneous Provisions

Prevention of Duplicate Appropriations for Fiscal Year 2020.  Section 3841 of the CARES Act insures that funding and allocations under any law amended in Title III of the CARES Act  are appropriately charged to the appropriation and/or authorization bills for the correct fiscal year(s).

If you have any questions, please do not hesitate to contact Brian Bernhardt for more information.