Coronavirus Impacts for Health Centers: New HRSA Funding and Telehealth Flexibility

By , , Published On: March 17, 2020

A new law, the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 (the Act) was enacted on March 6, 2020, and on March 13, 2020, President Trump declared a national emergency relating to the novel coronavirus known as COVID-19.   

Key highlights of the Act relevant to health centers include the following:

Funding

  • The Act provides $8.3 billion in emergency funding for federal agencies to support efforts to respond to the outreach of coronavirus. Of the $8.3 billion, $6.7 billion is designated to support the domestic response, and $1.6 billion is designated to support the international response.
  • A majority of the domestic response funds ($6.2 billion) is directed to the Department of Health and Human Services (HHS). This includes $100 million for the Health Resources and Services Administration (HRSA) for grants under the Health Center Program to “prevent, prepare for, and respond to coronavirus.” 
According to HRSA’s Novel Coronavirus (COVID-19) Frequently Asked Questions, which was posted on March 15, 2020, “HRSA is working quickly to develop a spend plan and will expedite the awarding of funds.”  FTLF will provide updates as additional information regarding funding becomes available.

Telehealth

The Act grants the Secretary of HHS authority to waive certain Medicare requirements specific to furnishing services via telehealth to Medicare beneficiaries, for services rendered in an emergency area and during an emergency period.  Now that a national emergency relating to COVID-19 has been declared, the Act allows HHS to ease certain current Medicare telehealth requirements.

Specifically, under the emergency waiver authority, HHS may relax the requirements regarding where the patient is located (also known as the “originating site”). Under the existing law, only certain types of facilities may serve as originating sites, and in general, they must be located in remote or shortage areas as defined in the law. The Act will allow HHS to waive all the originating site requirements, except that the originating site facility fee will only be available for facilities recognized in existing law as originating sites. The Act also allows HHS to waive the regulatory Medicare prohibition on telehealth services being furnished by telephone; however, even under the emergency waiver, the telephone must have audio and video capabilities used for interactive communication.

Unfortunately, the Act does not give the Secretary of HHS authority to relax the requirements relating to the distant site provider (i.e., the individual rendering remote care) during the emergency. Under the existing law, only physicians and practitioners may serve as distant site telehealth providers. The Centers for Medicare & Medicaid Services (CMS) has stated repeatedly that federally qualified health centers (FQHCs) and rural health clinics (RHCs) are prohibited from billing Medicare for telehealth services as distant site providers.  The Act does not remove or otherwise modify this prohibition specific to FQHCs and RHCs, even when the services are provided during a national emergency.

The Act does not directly affect the use of telehealth to deliver care under the Medicaid program. Notably, the telehealth restrictions that apply under Medicare do not control state Medicaid programs, and as CMS noted in a March 12, 2020 Medicaid COVID-19 FAQ, states have flexibility to pay providers for telehealth services in the same manner and at the same rate they would pay for face-to-face services, without seeking federal approval. (A Medicaid State Plan Amendment is necessary, however, if a State wishes to use a specific payment methodology for telehealth or to furnish via telehealth services that were not previously covered under the State Plan.)

If you have any questions about this update or other matters, please contact Susannah Vance Gopalan (Partner), Carrie Bill Riley (Partner), Brittney Rudolph (Associate), or call (202) 466-8960.