ASHA Supported Provisions Included in Legislation Responding to COVID-19

President Trump has signed the Coronavirus Aid, Relief, and Economic Security (CARES) Act. This legislation is the third bill that Congress has passed to provide critical assistance to help America respond to the COVID-19 pandemic, and ensure the longer-term financial stability for individuals and employers.

ASHA worked to ensure this critical legislation allows audiologists and SLPs to serve patients to the greatest extent possible. Under the bill, reimbursement for telepractice services provided to Medicare beneficiaries could be expanded at the discretion of the U.S. Health and Human Services (HHS) Secretary. Schools are given resources with which to continue educating and supporting students during the COVID-19 pandemic. In addition, key provisions will help procure additional personal protective equipment for health care providers, and provide financial stability to small business owners, contractors, and self-employed individuals. 

Below are some of the key highlights of the legislation

Key Schools Provisions

• $30.75 billion for an Education Stabilization Fund to provide grants to states and local districts, for governors to disburse to hard hit communities, and for colleges and universities. 
• Authorizes the U.S. Department of Education (ED) to grant certain waivers for provisions of the Elementary and Secondary Schools Act (ESSA) upon request of a state or local district.
• Requires ED to report to Congress on possible additional waivers that may be necessary with respect to the Individuals with Disabilities Education Act, the Rehabilitation Act, ESSA, and the Perkins Career and Technical Education Act.

Key Health Care Provisions

• Allows the HHS Secretary to waive restrictions on the types of providers who can provide telehealth services during the emergency period, potentially to include audiologists and SLPs. Waives originating site requirements for telehealth services during this period and removes a clause from a previous coronavirus supplemental that limited Medicare payments for telehealth to doctors who had existing relationships with patients.
• $100 billion for HHS to support health care providers related expenses and lost revenue; $100 million for the Centers for Medicare & Medicaid Services for survey and certification of health care facilities to support additional infection control surveys for facilities with populations vulnerable to severe illness from coronavirus; and $955 million for the Administration for Community Living for aging and disability services programs, including senior nutrition, home and community-based supportive services, family caregivers, elder justice, and independent living
• Allows, during the emergency period, Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to serve as a distant sites for telehealth consultations and furnish telehealth services to beneficiaries in their homes.
• Requires HHS to issue clarifying guidance encouraging the use of telecommunications systems, including remote patient monitoring, to furnish home health services consistent with the beneficiary care plan during the emergency period.
• Provides acute care hospitals flexibility, during the emergency period, to transfer patients out of their facilities and into alternative care settings in order to prioritize treating patients with COVID-19. Waives the Inpatient Rehabilitation Facility (IRF) 3-hour rule, which requires that a beneficiary be expected to participate in at least 3 hours of intensive rehabilitation at least 5 days per week to be admitted to an IRF. 

Key Professional Practice/Workforce Provisions

• Allows colleges and universities to provide direct support to impacted students, and ensures that students can maintain eligibility for financial aid (e.g., Pell grants and subsidized student loans). The legislation also suspends all federal loan repayments and requires that the period waived counts toward loan forgiveness programs.

Key Patient, Client, and Student Provisions

• Allows high-deductible health plans (HDHP) with health savings accounts (HSA) to cover telehealth services prior to a patient reaching the deductible. This increases access for patients who may have the COVID-19 and protects other patients from potential exposure. 

Relief for Small Businesses, Independent Contractors and Individuals 

• Federally guaranteed loans of up to $10 million for small employers with 500 or fewer employees, sole proprietors or independent contractors, and eligible self-employed individuals to cover payroll, mortgage, rent, and utility payments, as well as other debt obligations.
• Expands unemployment insurance, including an additional $600/week for up to four months, even for those not eligible for unemployment benefits (self-employed, independent contractors, those with limited work history, and others) who are unable to work as a direct result of the COVID-19 emergency.
• Cash-flow assistance through 100% federally guaranteed loans to employers who maintain their payroll during the emergency, including those who bring back workers who may have already been laid off since February 15, 2020.

Questions?

For questions related to schools, professional practice, and small business, please contact Eric Masten, ASHA’s director of federal affairs for education, at emasten@asha.org. For questions on health care and patient, client, and student issues, contact Jerry White, ASHA’s director of federal affairs for health care, at jwhite@asha.org.

For ASHA resources for members related to COVID-19, visit ASHA’s website for the latest updates and resources, including telepractice.