Podcasts about protecting access

Send us a textWelcome to Hunter's Brief, your weekly roundup of hunting and fishing news from across the globe. I'm your host, bringing you the latest updates to keep your boots on the ground and your lines in the water.• US expands hunting on 87,000+ acres of National Wildlife Refuge and Fish Hatchery land• Protecting Access for Hunters and Anglers Act under congressional review• Conservation Reserve Program (CRP) faces potential elimination, concerning conservationists• AI technology revolutionizing biodiversity conservation through data analysis• Lesser prairie chicken protections threatened despite significant population decline• Department of Interior renews Colorado River conservation agreements targeting 321,000 acre-feet water storage• Amendment proposed to expedite federal public land sales in Utah and Nevada• Bipartisan Explore Act enhances access to federal public lands• North Dakota enacts 14 new outdoor-related laws effective August 1stDon't forget to tune in on Monday for our storytelling episode, where we share tales from the field. Subscribe, leave a review, and share the podcast with your fellow outdoor enthusiasts. If there's a story we missed or something you think we should cover, let us know.Support the showHunting Stories InstagramHave a story? Click here!

AP correspondent Donna Warder reports on a new poll on the rights of a fertilized egg.

Dr. Philip Chenette, a fertility doctor with over 20 years of experience, talks with Deepak Puri, CEO of Democracy Labs, about misunderstandings about reproductive health and the political ramifications. They discuss the role of doctors in educating patients and politicians about fertility treatments and the importance of the patient's voice and vote to protect reproductive rights.   Deepak sets the stage, "Patients often don't connect the dots. So, having a doctor explain, these are the complications, this is what's happening, this is why I cannot treat IVF for you because regulations and politicians are interfering with the process. As a physician, there's only so much I can do. But if you, as an individual, as a mother, and as a father, want to bring about change, you have to get involved and vote. So, that's where the connection happens. And Dr. Chenette articulates this really well." Philip explains, "In the early days, it was just people who were trying, and trying, and trying at home and just couldn't get it done, couldn't accomplish the goal of conceiving a pregnancy. I was impressed by the drive that they showed. These were new techniques. Our office was brand new at the time. The ideas of using fertility techniques, of using fertility medications, and laboratory techniques to manage human embryos were all brand new at the time. But people were so driven, patients were so driven to accomplish this goal of building a family that they were willing to engage in those new techniques, and try new ideas, and push, and push, and push until they could get it done." "As you get older, it gets harder and harder to find that good embryo. Just to illustrate that, in our data, at age 25, 1 in three of your embryos is a healthy one, a third. At age 40, that number is one in 10. At age 44, that number is one in 100. 1% of the embryos you can produce have the chromosomes it takes to produce a baby at age 44. That problem is really what we dealt with and what created the fertility world we know today, in vitro fertilization, and the busy practices that we have taking care of patients." #DrPhilipChenette @TheDemLabs #FertilityTreatments #ReproductiveRights #IVF #WomensHealth #ReproductiveHealth #WomensRights TheDemLabs.org Download the transcript here  

Dr. Philip Chenette, a fertility doctor with over 20 years of experience, talks with Deepak Puri, CEO of Democracy Labs, about misunderstandings about reproductive health and the political ramifications. They discuss the role of doctors in educating patients and politicians about fertility treatments and the importance of the patient's voice and vote to protect reproductive rights.   Deepak sets the stage, "Patients often don't connect the dots. So, having a doctor explain, these are the complications, this is what's happening, this is why I cannot treat IVF for you because regulations and politicians are interfering with the process. As a physician, there's only so much I can do. But if you, as an individual, as a mother, and as a father, want to bring about change, you have to get involved and vote. So, that's where the connection happens. And Dr. Chenette articulates this really well." Philip explains, "In the early days, it was just people who were trying, and trying, and trying at home and just couldn't get it done, couldn't accomplish the goal of conceiving a pregnancy. I was impressed by the drive that they showed. These were new techniques. Our office was brand new at the time. The ideas of using fertility techniques, of using fertility medications, and laboratory techniques to manage human embryos were all brand new at the time. But people were so driven, patients were so driven to accomplish this goal of building a family that they were willing to engage in those new techniques, and try new ideas, and push, and push, and push until they could get it done." "As you get older, it gets harder and harder to find that good embryo. Just to illustrate that, in our data, at age 25, 1 in three of your embryos is a healthy one, a third. At age 40, that number is one in 10. At age 44, that number is one in 100. 1% of the embryos you can produce have the chromosomes it takes to produce a baby at age 44. That problem is really what we dealt with and what created the fertility world we know today, in vitro fertilization, and the busy practices that we have taking care of patients." #DrPhilipChenette @TheDemLabs #FertilityTreatments #ReproductiveRights #IVF #WomensHealth #ReproductiveHealth #WomensRights TheDemLabs.org Listen to the podcast here  

In this episode of “Answers From the Lab,” host Bobbi Pritt, M.D., chair of the Division of Clinical Microbiology at Mayo Clinic, is joined by William Morice II, M.D., Ph.D., CEO and president of Mayo Clinic Laboratories. They discuss important industry updates and legislative insights gathered from Dr. Morice's recent trip to Washington, D.C.Their discussion includes:The status of current laboratory-related legislative efforts, including the Protecting Access to Medicare Act (PAMA), the Saving Access to Laboratory Services Act (SALSA), and the Pandemic and All Hazards Preparedness Act (PAHPA).Current issues facing the laboratory industry, including prior authorization, coding, and potential FDA oversight of laboratory-developed tests.The importance of advocating on behalf of laboratories, clinicians, and patients, and engagement opportunities through professional societies like the College of American Pathologists and the American Clinical Laboratory Association.

In this episode of "Democracy Nerd," host Jefferson Smith engages in a crucial discussion with Paul Smith, the Senior Vice President at the Campaign Legal Center, shedding light on the mounting legal challenges surrounding ballot access heading into the 2024 election year. The conversation begins with the recent federal court action in North Dakota, where a judge dismissed a challenge regarding the validity of counting absentee ballots postmarked by Election Day. Smith provides insightful analysis on the significance of this ruling and its implications for preserving the integrity of the electoral process. Other topics discussed include the alarming trend of voter purges, prompting Smith to offer guidance to listeners on what steps to take if they suspect they've been incorrectly removed from voter rolls, ensuring their ability to participate in the electoral process. This episode also addresses the disturbing escalation in threats of violence targeting election workers. Smith addresses the implications of such threats and underscores the urgent need to ensure the safety and security of those tasked with administering elections. Overall, Paul Smith from the Campaign Legal Center underscores the critical importance of upholding voter rights, combating voter suppression tactics, and fortifying the foundations of democracy in the face of mounting challenges.

This week we are joined by Amanda Sellers Smith, legal counsel for 340B Health. Amanda tracks and responds to 340B state legislative and regulatory actions. She discusses recent developments in state-based legislation, including 340B reporting requirements, nondiscrimination prohibitions, and bans on drugmaker restrictions. She also looks ahead to what hospitals and their government relations departments can expect in 2024. Before the interview, we give an update on a set of unprecedented changes to a major drugmaker's restrictive contact pharmacy policy, and we share the news that four of the five drugmakers that HRSA audited last fiscal year for 340B compliance received findings for overcharging covered entities. 340B Nondiscrimination LawsAmanda shares with us the importance of protecting 340B from discriminatory practices by pharmacy benefit managers (PBMs) and other payers when it comes to reimbursing providers for 340B drugs. More than half of the states have enacted such laws, including California, whose law will affect many providers and patients. Protecting Access to Contract Pharmacies Amanda discusses two states that have implemented laws against drugmaker restrictions on drugs dispensed at community and specialty pharmacies. Arkansas enacted its law in 2021 and Louisiana did so earlier this year, leading some drugmakers to suspend their restrictive policies in both states. However, the pharmaceutical industry is challenging these laws in federal courts, where the legal process can take years to play out. Hospital Reporting and Looking Ahead to 2024Amanda explains an increased interest in 340B hospital reporting requirements, with states such as Maine and Minnesota enacting new laws and Connecticut, Indiana, and Virginia considering legislation. As hospitals and their government relations team prepare for the 2024 session, she explains how 340B Health is monitoring legislation and supporting our members in their advocacy efforts. Check out all of our episodes on the 340B Insight podcast website. You also can stay updated on all 340B Health news and information by visiting our homepage. If you have any questions you'd like us to cover in this podcast, email us at podcast@340bhealth.org.Resources 340B Health Analyzes Potential Implications of Unprecedented Provisions in BMS Contract Pharmacy Policy Update HRSA Issues Findings for a Fourth Drugmaker Audit in FY 2023

The American Library Association observed Banned Books Week at the beginning of October — an especially poignant marker this year. A report by PEN America found more than 1,200 books were censored or removed from U.S. public school classrooms and libraries during the 2022-23 school year, compared to only 333 in the previous school year. That's an increase of almost 400 percent.Authors whose books are most frequently targeted are usually female, people of color or LGBTQ+. This week, Big Books and Bold Ideas commends the freedom to read by talking with three young adult authors whose books are frequently found on the targeted lists. Kelly Yang is the author of many young adult and children's books, including “Front Desk,” which is based on her own memories of working at her family's motel business after they immigrated to California from Hong Kong. As she tells MPR News host Kerri Miller, the first few years after “Front Desk” was published, it was a huge success. But then it started to get pushback. “I guess people started to question why kids should learn about the immigrant experience. Like: I don't want my kid to feel sad or uncomfortable,” said Yang. “But if we airbrush our nation's history and ignore the experiences of millions of people, what is the difference between this country and where my parents came from, which is China?”“The freedom to read is what makes this country great,” Yang told Miller. Matt de la Peña is also a writer of children and young adult books. He won the Newbery Medal in 2016 for his picture book “Last Stop on Market Street.” But it is “Mexican Whiteboy,” the novel inspired his own experience of growing up mixed race in San Diego, that has faced the most criticism. “When you're a new writer, you sometimes glorify the idea of getting banned,” laughed de la Peña. “But then you don't have the context for who is unable to have access to your book.” “I wrote [‘Mexican White Boy'] because I'm mixed — my dad is Mexican, my mom is white — and I wanted to write about sometimes not feeling Mexican enough growing up.” But then it got caught up in a political battle in Arizona. De la Peña met with students at Tucson High School who had the book taken out of their hands as they were reading. And why? “There is no context for the banning,” de la Peña told Miller. “It's a rumor. ‘Oh, I heard this book has a scene about such and such.' Or, ‘I heard this book leans into racial identity too much.' ‘Maybe it fits into that critical race stuff.'” “Book banning has nothing to do with young people. It has everything to do with parents,” he said. “And I understand this instinct. I'm a parent of two young kids, and I'm very cognizant of what goes into their brains. But we run into trouble when parents are trying to eliminate that content for other people's children.”Samira Ahmed writes stories about “revolutionary girls” for middle grade students and young adults. Several of her books have been challenged, including “Internment,” published in 2019, and her newest novel, “Hollow Fires.” Ahmed said her earliest experience with book banning was “soft banning.” Librarians told her they were hesitant to put her first book on their shelves because they had no Muslim students in their community. A Kansas teacher told her a school staff member continually delayed putting in a purchase order for Ahmed's “Internment.” Book ban attempts on the rise in Minnesota schools “You might not read about this in the newspaper. It's not even getting to a school board meeting,” Ahmed said to Miller. “But this is happening — not just to my books, but to queer authors and authors of color, where there's this soft banning, almost this pre-banning, where people are not allowing the books to come into schools.” But Ahmed, like de la Peña and Yang, is not deterred.“The voices of those who want to challenge books or censor books or ban books are very loud,” she said. “But I assure you, they are the minority. Find your community who is willing to advocate to ensure that our children have freedom to read.” And if you want proof that authors are willing to fight being silenced, Ahmed's next novel comes out in 2024. It's called, “This Book Won't Burn.”

Allie Bohm of the New York Civil Liberties Union joined Elizabeth Press (EP) to talk about protecting access to gender-affirming care in New York State. In related news, The Hospital Transparency Act passed in the New York State Senate, and the Assembly will have the opportunity to move it forward if they come back for special session. This bill will allow people to know where they can receive gender-affirming care in New York.

Mark Houck, Pro-Life Activist

In this episode: We'll discuss the major stresses and challenges facing rural hospitals, including geography, patient mix, a growing workforce crisis, and funding shortfalls.   Since 2010, 140 rural hospitals have closed, including 25 since the start of the pandemic. Congressional support helped keep that number from being even higher, but what happens now as COVID-19 relief runs out? What's the impact on a small, rural community when a hospital closes? Congress needs to take actions to preserve funding for rural hospitals during Lame Duck session. What will be the impact on access to care if Medicare Dependent Hospital and Low-Volume Hospital programs aren't extended and lawmakers don't waive PAYGO? How will divided government affect rural hospital policy moving forward in 2023? Is there room for bipartisan compromise?  Guest: Brock Slabach, Chief Operating Officer, National Rural Health Association.

The ACLJ sent a letter to Secretary Alejandro Mayorkas, Biden's Secretary for the Department of Homeland Security (DHS) regarding Executive Order 14076, the so-called "Protecting Access to Reproductive Healthcare Services" which as we explained in detail, poses a significant legal threat to Pregnancy Resource centers across the nation. The DHS just responded to our letter. Jay, Jordan, and the Sekulow team break down the reason for our concern and what the DHS had to say in their response. In the second half of the show we discuss Biden's surprise speech last night. This and more today on Sekulow.

Mallory McMorrow is a Democratic star in Michigan & tells Bonnie Fuller how she has effectively Combatted MAGA-led culture wars against women and minorities.

Podcast host and ASA Vice President of Government Affairs, Mike Leonard, provides an update on federal legislative activity, highlighting two recently introduced bills: The Youth Coastal Fishing Program Act and the Protecting Access for Hunters and Anglers Act. After the update, Leonard talks with ASA Southeast Fisheries Policy Director, Martha Guyas, about South Atlantic red snapper. Guyas gives a rundown of a recent South Atlantic Fishery Management Council meeting, where bottom fishing closures for red snapper were discussed. Take action of the issues mentioned in this episode: Voice your support for Youth Coastal Fishing Program Act here. Voice your support for the Protecting Access for Hunters and Anglers Act here. Learn more about red snapper here. For more ways to get involved in sportfishing policy visit https://keepamericafishing.org/ and https://asafishing.org/

William Morice II, M.D., Ph.D., chair of the Department of Laboratory Medicine and Pathology at Mayo Clinic and CEO and president of Mayo Clinic Laboratories, joins "Answers From the Lab" for his weekly leadership update with host Bobbi Pritt, M.D. In this episode, Dr. Pritt and Dr. Morice discuss the Saving Access to Laboratory Services Act (SALSA), how it is designed to mitigate harmful effects of the Protecting Access to Medicare Act (PAMA), where the legislation stands today, and how to get involved in advocacy.

Jason Snead, Executive Director of the Honest Elections Project, gives an overview of the trends and proposals that he says could undermine the accuracy and integrity of our voting process. Among those are proposed legislation to essentially put all elections under federal oversight, expansion of drop off ballot boxes outside of polling places, increased mail in voting, and a lack of a photo ID requirement in many areas. Learn more at https://www.honestelections.org/

Listen to legal and policy experts for a discussion of the post-Dobbs national landscape and creative strategies and policy responses to help protect and promote access to abortion in the absence of a federal constitutional right.  (July 27, 2022)     Questions? Inquiries about program materials? Contact Alan I. Johnson at ajohnson@bostonbar.org

Dan discusses President Biden's Executive Order on "Protecting Access to Reproductive Healthcare Services," and the recent decision by the U.S. Supreme Court to overturn Roe v. Wade.

President Biden issue an executive order to help the way for Women's Reproductive Rights and ask all women to show for a election and vote

In Let's Talk About This, Father McTeigue asks why it is that we want what is not good for us? What happens to the appetites of a society ruled by crafty men? Is evil really inevitable? Father finishes with Weekend Readiness to help you prepare for Sunday Mass. Celebrating Abnormal Behavior The Lost Symbolism of the Liturgy Why Do We Desire What's Bad for Us? Worship in a Time of War Executive Order on Protecting Access to Reproductive Healthcare Services

In this episode, Gabriel Scott and Darlene Davis analyze the private payor rates reporting requirements under the Protecting Access to Medicare Act. They discuss the type of entities required to report, potential penalties for failing to report, and provide some suggestions for how to initiate the reporting process.

Today, we'll be talking about protecting access to abortion and reporductive health care. Even though abortions are such a controvertial topic, they are both important and prevelant, specifically becayse right now, the Supreme Court is hearing a case called Dobbs vs Jackson Women's Health Organization, which is a direct challenge to Roe V Wade. So to talk about this case, about how states make it harder to get aboritons even if they're allegedly legal, and about how young people can protect the right to abortions and full reproductive care, we've invited two lawyers from the National Women's Law Center: Leila Jade Levi and Anna Rodriguez. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

Host Tom Foley talks to Tom Leary, SVP of Government Relations at HIMSS. Tom is at the forefront engaging government and stakeholders to advance legislative efforts. not only do they discuss current legislation having bipartisan support for reconciling legislation such as: Protecting Access to Post COVID-19 Telehealth Act, the Telehealth Modernization Act, and the CONNECT for Health Act, the conversation further explores pre-COVID challenges and objectives coupled with looking forward in regard to the call for a national strategy, necessary interoperability, and ensuring that digital health is provided to the underserved and rural communities. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play HealthcareNOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

The Protecting Access to Medicare Act (PAMA) ties imaging reimbursement to using clinical decision support (CDS) to help ensure medical necessity. But why stop there? On today’s show, Dr. Ryan Lee with the Einstein Healthcare Network in Philadelphia shares how Einstein has gone beyond compliance to embrace a broad and collaborative use of CDS. Dr. Ryan Lee is an Associate Professor of Radiology at Thomas Jefferson University and leads radiology, quality, and safety programs at the Einstein Healthcare Network in Philadelphia. Greg Mogel is the Chief Medical Officer for CareSelect at Change Healthcare. They discuss: CDS's impact on compliance, cost, and quality Substituting medical evidence for anecdotal judgment Going beyond radiology Lessons learned (the hard way) about the keys to CDS success Determining the best study, the wrong study, or no study Streamlining preauthorization for commercial insurers and Medicare Applying CDS to pediatric cases Reducing unnecessary imaging, costs, and exposure to radiation Episode Resources Ryan Lee’s bio Greg Mogel’s bio CareSelectTM Imaging Bringing Clinical Decision Support to Imaging to Assure PAMA Compliance Audiobook: Aligning the Lab with the Hospital’s Strategic Priorities Your PAMA Questions Answered Audiobook: The New PAMA Math Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

Consumer Watchdog’s Carmen Balber and Harvey Rosenfield ring in the New Year with a conversation about big victories to protect homeowners’ access to insurance in 2020, new rules in 2021 to reward homeowners who take steps to protect their homes from wildfires, and the fight to protect Californians from insurers’ use of Big Data to impose arbitrary rate hikes.

Welcome solo and group practice owners! We are Liath Dalton and Roy Huggins, your co-hosts of Person Centered Tech. In our latest episode, we’re talking about constructive things that you can do to positively impact the future, especially in terms of access to behavioral health care.  We discuss why we decided to record this week, the increased need for therapy services right now, advocating with insurance companies for telehealth, clarity and parity around telehealth payment, toxic positivity, legislative advocacy, direct to client care, getting the attention of your representatives, and group practice office hours. Listen here: https://personcenteredtech.com/group/podcast/ Stay tuned for future episodes! For more, visit our website. Resources H.R.7663 - Protecting Access to Post-COVID-19 Telehealth Act of 2020 Help Protect Telehealth Access for Our Seniors - Urge your Representatives to Cosponsor H.R. 7663! Episode 126: [The Teletherapy Lawyer] How Are We Going to Get Teletherapy Payment Parity After COVID? Group Practice Office Hours (direct support and consultation service from PCT and Eric Strom, JD PhD LMHC) (with special celebratory launch offer)

The Protecting Access to Medicare Act (PAMA) requires providers to consult a clinical decision support mechanism when ordering advanced imaging tests. While the CMS has extended the PAMA compliance deadline to Jan. 1, 2022, some providers–such as St. Charles Health System–are wasting no time to ensure compliance. Samantha Waldrop and Elizabeth Zobel join Nick Geyer to share how St. Charles implemented imaging clinical decision support (CDS), including their goals, challenges encountered, their approach, and the results. Nick Geyer, product marketing manager at Change Healthcare, leads a discussion with Samantha Waldrop, applications analyst at St. Charles Health System, and Elizabeth Zobel, senior customer success strategist at Change Healthcare. Here what they talked about: Overview of PAMA Requirements around imaging Clinical Decision Support (CDS) Impact of PAMA on St. Charles How St. Charles evaluated imaging CDS options Why St. Charles decided to work with Change Healthcare How St. Charles defined implementation goals, plan, and timeline Team members involved How the rollout went Challenges encountered during the rollout and how St. Charles addressed them Impact of the new imaging CDS on providers and workflows Methods to drive CDS training and adoption Issues around providers using free text vs. structured indications Radiologists’ reaction to the new system CDS usage levels at St. Charles Next steps for St. Charles’ CDS roadmap Implementation lessons learned Advice for other healthcare providers on complying with PAMA and implementing imaging CDS Benefits of imaging CDS, beyond PAMA compliance Episode Resources Samantha Waldrop’s bio Elizabeth Zobel’s bio Nick Geyer’s bio Your PAMA Questions Answered The New PAMA Math Laboratory Data Key to Overcoming Medicare Cuts Aligning the Lab with the Hospital’s Strategic Priorities Predicted Indications (AI) in CareSelect Imaging CareSelectTM Imaging CareSelectTM Imaging – AI Indication Selection Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

Protecting citizens' ability to vote is as important as ever in this election cycle. Allison Riggs joins us to talk about types of voter suppression that she and her team at the Southern Coalition for Social Justice are working to prevent.

Join Health Affairs Insider.Several states attempted to deem abortions nonessential during the COVID-19 pandemic, leaving some women with difficult choices. Read by author Maryl Sackeim, originally published in August 2020.

In this episode we discuss the newly signed Cares Act aimed at providing aid to businesses and individuals that have been impacted by the Coronavirus and the resulting economic shut-down. The application process for the Cares Act loans will take the form of a modified 7a SBA loan and will be processed through SBA approved lenders. On this episode, we have bank representatives, employment attorney, FSU Economics professor and business leaders in the restaurant industry. A recent post re: the summary of the Cares Act:Senate Passes the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”)26 March 2020  Coronavirus Resource Center  BlogAuthors: Frank S. Murray Jr Jared B. Rifis Leah R. Imbrogno Jamie N. Class Matthew E. Sierawski Julia Di Vito Kaitlyn M. Foley As the coronavirus outbreak continues to wreak havoc on markets and industries in the United States and around the world, businesses are now confronting significant and unique challenges. Successful navigation of these challenges will require thoughtful and comprehensive planning. Foley has created a multi-disciplinary and multi-jurisdictional team, which has prepared a wealth of topical client resources (see Foley’s Coronavirus Resource Center) and is prepared to help our clients meet the legal and business challenges that the coronavirus outbreak is creating for stakeholders across a range of industries, including manufacturing, technology, solar, hospitality and travel, healthcare, food, fashion and apparel, and sports and entertainment. The Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”) – Summary of Bill Language and Key TakeawaysOn March 25, 2020, the Senate unanimously passed (96-0) the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”), commonly known as “Phase Three” of coronavirus economic relief. The CARES Act provides much needed stimulus to individuals, businesses, and hospitals in response to the economic distress caused by the coronavirus (COVID-19) pandemic. The bill passed on March 25 is not yet law. Until the CARES Act is passed by the House of Representatives and signed into law by the President, it is subject to revisions. The bill will now go to the House, which is currently not in session. The House may reconvene to address the bill or pass the bill by unanimous consent agreement. The House is expected to pass the bill without changes on March 27, and it will then be presented to the President for his signature.Additional information, updates, and analysis regarding the CARES Act will be posted on Foley’s Coronavirus Resource Center. Please check back frequently for updates. Foley is available to assist in interpretation of the CARES Act for your business and can help you find ways to claim and/or use available funding for your company. The CARES ActTop 10 Takeaways:Provides stimulus to individuals, businesses, and hospitals in response to the economic distress caused by the coronavirus (COVID-19) pandemic.Creates a $349 billion loan program for small businesses, including 501(c)(3) non-profits and physician practices. These loans can be forgiven through a process that incentivizes companies to retain employees.Allocates $500 billion for assistance to businesses, states, and municipalities, with no more than $25 billion designated for passenger air carriers, $4 billion for air cargo carriers, and $17 billion for businesses critical to maintaining national security. The remaining $454 billion may be used to support lending to eligible businesses, states, and municipalities.Allocates $130 billion in relief to the medical and hospital industries, including for medical supplies and drug and device shortages.Expands telehealth services in Medicare, including services unrelated to COVID-19 treatments.Provides $1,200 to Americans making $75,000 or less ($150,000 in the case of joint returns and $112,500 for head of household) and $500 for each child, to be paid “as rapidly as possible.”Expands eligibility for unemployment insurance and provides people with an additional $600 per week on top of the unemployment amount determined by each state.Expands the Defense Production Act, allowing for a period of two years when the government may correct any shortfall in resources without regard to the current expenditure limit of $50 million.Provides the Secretary of the Treasury with the authority to make loans or loan guarantees to states, municipalities, and eligible businesses and loosens a variety of regulations prior legislation imposed through the Dodd-Frank Wall Street Reform and Consumer Protection Act, the Economic Stabilization Act of 2008, and others.Accompanied by supplemental appropriations to help the government respond to this pandemic.Summary of the CARES Act:Division A - Keeping American Workers Paid and Employed, Healthcare System Enhancements, and Economic Stabilization   Title I – Keeping American Workers Paid and Employed Act     Foley Title I Contacts: Jamie Class, Erin Toomey, Jessica Glatzer Mason, and Frank MurrayPaycheck Protection ProgramThe Paycheck Protection Loan Program, at a price tag of $349 billion, covers the period February 15, 2020 through June 30, 2020 and greatly expands SBA loan eligibility.  The loan program will allow businesses suffering due to the coronavirus outbreak to borrow money for a variety of qualified costs related to employee compensation and benefits, including (i) payroll costs, (ii) continuation of health care benefits, (iii) employee compensation (of those making less than $100K), (iv) mortgage interest obligations, (v) rent, (vi) utilities and (vii) interest on debt incurred before the covered period.The legislation greatly expands the number of businesses (including non-profits) that are eligible for SBA loans and raises the maximum amount for such a loan by 2.5 x the average total monthly payroll costs, or up to $10 million.  The interest rate may not to exceed 4%.Companies that employ no more than 500 employees are (or a greater number based on the size standard applicable to the industry) may be eligible.  Certain companies in the Accommodation and Food Services Industry (NAICS Code 72) may be eligible if they have no more than 500 employees per physical location. In most cases, the number of employees is counted together with all affiliates.Waives affiliation rules under 13 C.F.R.  121.103 for any business with less than 500 employees in the Accommodation and Food Services Industry, certain franchise businesses and small businesses that receive financing through the Small Business Investment Company Act.  Affiliation rules otherwise apply to determine eligibility.Waives the credit available elsewhere, personal guaranty and collateral requirements.For eligibility purposes, requires lenders to determine whether a business was operational on February 15, 2020, and had employees for whom it paid salaries and payroll taxes, or a paid independent contractor. (This is likely to be interpreted to replace the determination of repayment ability which is not possible during the crisis.)All or a portion of the loan may be forgivable and debt service payments may be deferred for up to 1 year.Entrepreneurial DevelopmentProvides funding to educate small businesses and their employees regarding (i) Federal resources available during this time, (ii) Hazards of COVID-19 and (iii) best practices around teleworking to prevent the spread of COVID-19.iii.  State Trade Expansion ProgramAllows for federal grant funds appropriated to support the State Trade Expansion Program (STEP) in FY 2018 and FY 2019 to remain available for use through FY 2021.Waiver of Matching Funds Requirement under the Women’s Business Center ProgramEliminates the non-federal match requirement for Women’s Business Centers for a period of three months. Loan Forgiveness Establishes that the borrower under the Paycheck Protection Program shall be eligible for loan forgiveness equal to the amount spent by the borrower during an 8-week period after the origination date on (i) rent, (ii) payroll costs for workers making less than $100K, (iii) interest on a mortgage, and (iv) utility payments. The amount forgiven may not exceed the principal of the loan. Incentivizes companies to retain employees by reducing the amount forgiven proportionally by any reduction in employees retained compared to the prior year.To encourage employers to rehire any employees who have already been laid off due to the COVID-19 crisis, borrowers that re-hire workers previously laid off will not be penalized for having a reduced payroll at the beginning of the period.Minority Business Development Agency Empowers the Department of Commerce, through the Minority Business Development Agency, to provide grants to minority business centers and minority chambers of commerce to provide education, training and advising related to accessing federal resources.vii. United States Treasury Program Management Authority The Department of the Treasury, consulting with the Small Business Administration and the Chairman of the Farm Credit Administration shall establish criteria to allow other lenders to participate in the Paycheck Protection Program, so long as such participation does not threaten the safety and soundness of the lender, as determined in consultation with the relevant federal banking agencies.viii.  Emergency Economic Injury Disaster Loans (“EIDLs”) For the period between January 31, 2020 and December 31, 2020 (the “covered period”) EIDL eligibility is greatly expanded to include any business with not more than 500 employees operating under a sole proprietorship or as an independent contractor, and any cooperative, ESOP and tribal small business concern with not more than 500 employees. The number of employees is determined together with affiliates.Furthermore, EIDLs may be approved solely on the bases of an applicant’s credit score or by use of alternative methods to gauge the applicant’s ability to repay. Additionally, applicants may request an advance of up to $10,000 within three days after the Administrator receives the application, subject to verification that the entity is eligible under this program. The advance may be used for any allowable purposes under §7(b)(2) of the Small Business Act and is not subject to repayment, even if the loan request is ultimately denied.Importantly, the CARES Act waives: (1) the requirement of personal guarantees for loans up to $200,000, (2) the requirement that the applicant must be in business for a year (but must be in operation on January 31, 2020), and (3) the credit elsewhere test.Establishes that an emergency involving Federal primary responsibility determined to exist by the President under Section 501(b) of the Stafford Disaster Relief and Emergency Assistance Act qualifies as a new trigger for EIDLs.Importantly, the CARES Act waives: (1) the requirement of personal guarantees for loans up to $200,000, (2) the requirement that the applicant must be in business for a year (but must be in operation on January 31, 2020), and (3) the credit elsewhere test.Subsidy for Certain Loan PaymentsFor loans under §7(a) of the Small Business Act, Title V of the Small Business Investment Act, and for loans made by an intermediary using §7(m) loans or grants, the Administrator shall pay the principal, interest, and fees owed for loans in regular servicing status for any such loans, whether on deferment or not, that were made before the enactment of the Act for the following 6-month period, and for any such loans that were made between the date of enactment of the Act and six months from such date. This does not apply to Payroll Protection loans or EIDL loans which have separate subsidy and repayment requirements.The payments shall be made not later than 30 days from when the first payment is due and shall be applied such that the borrower is relieved of any obligation to pay that amount. The Administrator shall coordinate with relevant banking agencies to request that lenders not be required to increase reserves because of these payments.The Administrator will waive limits on the maximum loan maturities for loans given deferral and extended maturity during the year following enactment. The Administrator will extend lender site visit requirement timelines as necessary because of COVID-19, to within 60 days of a non-default adverse event, and 90 days of a default. $17 billion is appropriated for the foregoing.BankruptcySection 1182(1) of Title 11 is amended to define “debtor” as persons engaged in commercial or business activities and their affiliates (excluding persons who primarily own single asset real estate) that have aggregate, noncontingent, liquidated secured and unsecured debts (at the date of petition filing or the order for relief) of $7,500,000 or less (excluding debts owed to affiliates or insiders), half or more of which arose from those activities.  Exempt from this new definition are any members of a group of affiliated debtors that has aggregate, noncontingent, liquidated secured and unsecured debts over $7,500,000 (excluding debt owed to affiliates or insiders); corporations subject to 1934 Act reporting requirements; and affiliates of an issuer under the 1934 Act.  National Emergency Act payments for COVID-19 by the President are exempted from “current monthly income” and “disposable income” when determining the power of courts to approve debtor plans rejected by trustees or claim holders. Debtors that have experienced material financial hardship due to COVID-19 can modify a plan confirmed prior to this Act’s enactment date if approved after notice and hearing, but only if that plan doesn’t provide payments more than seven years after the first payment was due under the original plan, and follows requirements of 1322(a)-(c) and 1325(a). This modification terminates one year after the enactment of this Act.Title II – Assistance for American Workers, Families, and Businesses      Foley Title II Contacts: Julie Lutfi, Ashley May, and Dick RileySubtitle A: Unemployment Insurance ProvisionsEligibilityThe law expands the scope of individuals who are eligible for unemployment benefits, including those who are furloughed or out of work as a direct result of COVID-19, self-employed or gig workers, and those who have exhausted existing state and federal unemployment benefit provisions.The only individuals expressly excluded from coverage are those who have the ability to telework with pay and those who are receiving paid sick leave or other paid benefits (even if they otherwise satisfy the criteria for unemployment under the new law).Administration of BenefitThe benefits are administered by each state and upon the state’s written agreement with the Secretary of Labor to provide the specific benefits.  States that enter into such an agreement with the Secretary of Labor will be reimbursed in whole or in part for the cost of the benefits plus administrative expensesTypes of Benefits ProvideThe law provides an increase of $600 per week in the amounts customarily available for unemployment under state law.  This increase applies for unemployment payments made from the date of the law’s enactment through July 31, 2020 (approximately four months).States can agree to provide pandemic emergency unemployment compensation to individuals who have either exhausted all of the benefits available to them under existing state and federal law or who are not otherwise eligible for benefits under existing state and federal law.  Individuals must be able and available to work and actively seeking work, unless they are unable to do so as a result of COVID-19 illness, quarantine, or movement restriction.States can agree to waive the waiting period for receipt of benefits so that individuals do not experience gaps in income.The federal government will temporarily fund short-time compensation under existing state plans.  States that do not yet have short-time compensation plans in place may agree to implement a plan, provided that employers who enter into short-time compensation plans must be required to pay to the state half of the short-time compensation paid under the planTime Periods for Expanded BenefitsThe law provides unemployment benefit assistance to covered individuals who are not otherwise entitled to benefits under existing state or federal law for weeks of unemployment, partial unemployment, or inability to work caused by COVID-19 during the period January 27, 2020 through December 31, 2020.  This includes any waiting periods for benefits under applicable state law.The total benefit may not extend beyond 39 weeks (including any unemployment benefits or extended benefits received under existing state or federal law), unless, after the law is enacted, the duration of extended benefits is extended, in which case the total benefit may extend beyond 39 weeks by that same additional period of extended benefits.The $600 weekly benefit increase will be applicable to weekly payments made through the end of July 2020.Protections Against Fraud and OverpaymentAny fraudulent intent or misrepresentations to obtain payments to which an individual is not entitled will result in ineligibility for any other unemployment compensation benefits under the new law as well as criminal prosecution. Overpayments may be clawed back by the state agencies.Social Security TreatmentThe additional unemployment compensation provided is not considered “income” for purposes of Medicaid and CHIP.Subtitle B: Rebates and Other Individual ProvisionsTax CreditsBeginning in 2020, "eligible individual" taxpayers can benefit from a tax credit equal to the sum of: (i) $1,200 for single filers ($2,400 for those filing a joint return) plus (ii) an amount equal to th eproduct of (a) $500 multiplied by (b) the number of qualifying children. However, the aforementioned tax credits will be “phased-out” by 5% (but not below 0) when such eligible taxpayer’s adjusted gross income exceeds: (i) $150,000 for joint-filers, (ii) $112,500 for heads of household, and (iii) $75,000 for all other types of filers.This means, for example, the tax credit will phase out entirely at $198,000 for joint-filers with no children.“Coronavirus-Related Distribution”A “coronavirus-related distribution,” as defined under the CARES Act, is generally defined as any distribution from an eligible retirement plan made: (i) on or after January 1, 2020 and before December 31, 2020, (ii) to an individual (a) who is diagnosed with COVID-19, (b) whose spouse or dependent is diagnosed with COVID-19, or (c) who experiences adverse financial consequences as a result of being quarantined, furloughed, laid off, had hours reduced, or other factors as determined by the Secretary of the Treasury during the COVID-19 pandemic.Tax Treatment of Coronavirus-Related DistributionsIndividuals who elect to receive a “coronavirus-related distribution” will not be subject to the traditional 10% tax penalty imposed under the Internal Revenue Code of 1986, as amended (the “Code”) for early withdrawals from eligible retirement accounts,unless the aggregate amount of such distributions from all plans maintained by the employer (and any member of any “controlled group” which includes the employer) to such individual exceeds $100,000. Coronavirus-related distributions made from both traditional eligible employer sponsored retirement plans and individual retirement accounts (“IRAs”) may be excluded from gross income.Repayments of Coronavirus-Related DistributionsAny individual who receives a coronavirus-related distribution may generally, at any time during the three (3) year period beginning on the day after the date such coronavirus-related distribution was received, make one (1) or more contributions in an aggregate amount not to exceed the amount of such distribution to an eligible retirement plan of which such individual is a beneficiary . The aforementioned repayments of coronavirus-related distributions for eligible retirement plans, will, to the extent of the amount of the contribution, be treated as having received the coronavirus-related distribution in an eligible rollover distribution,” and as having transferred the amount to the eligible retirement plan in a direct trustee to trustee transfer within sixty (60) days of distribution.Effects on the Limits on Loans from Qualified Employer PlansThe limitation on loans from any qualified employer plan made to qualified individuals will be increased from $50,000 to $100,000, and should the due date of any such loan occur between the date of enactment of the CARES Act and December 31, 2020, it will be delayed for one (1) year.Effects on Minimum Distribution ThresholdThe CARES Act temporarily waives the minimum distribution requirements for all “eligible deferred compensation plans.” This includes: (i) certain contribution plans (e.g. an employer purchased annuity contract), (ii) deferred compensation plans that are maintained by an eligible employer, or (iii) IRAs.  This applies for all distributions made on or after January 1, 2020.However, if this section applies to any pension plan or contract amendments, such pension plan or contract amendments will not fail to be treated as being operated in accordance with the terms of the plan during such period, solely because the plan operates in accordance with the CARES Act, so long as the amendment or contract in question has been in effect from its effective date until December 31, 2020.Any plan or contract amendments to which Section 2203 of the CARES Act (the section on temporary waiver of required minimum distribution rules) applies will not fail to meet the requirements of either the Internal Revenue Code or the Employee Retirement Income Security Act as a result of making such an amendment. However, this provision only applies to those amendments which are in effect during the period beginning on the effective date of the amendment until December 31, 2020.Tax Treatment of Charitable DonationThe CARES Act allows taxpayers to take an above-the-line tax deduction for charitable contributions of up to $300 for the tax year beginning in 2020.Additionally, except for certain exclusions specified below, the percentage and excess carryover restrictions on charitable and other “qualified contributions” (e.g. a contribution to a corporation, trust, a state, or an organization of war veterans, etc.) are disregarded.Exceptions to the CARES Act General Disregard of the Percentage and Excess Carryover Restrictions on Qualified ContributionsThe CARES Act treats individuals and corporations differently regarding the aforementioned exceptions, and such different treatments are described below.Qualified contributions for individuals will be allowed as deductions to the extent that the combined contributions do not exceed (i) the excess of the taxpayer’s adjusted gross income over (ii) the amount of the charitable contributions made by the individual under certain other provisions of the CARES Act (e.g., donations to a church, educational organization, private foundation, etc.). If such contributions exceed the foregoing limitation, they will be added to the qualified contribution excess, which is eligible to be treated as charitable deductions for up to the next five (5) successive tax years. Any qualified contributions made by corporations will be allowed as deductions only if these contributions do not exceed 25% of the taxable income of the corporation over the amount of all other charitable contributions allowed under the CARES Act. To the extent a corporation exceeds this limit, it will carry over the excess which will be eligible to be applied as charitable contribution deductions for the subsequent five tax years. This is provided that the excess qualified contribution amounts in question meet certain other restrictions, specifically, they must not exceed the lesser of: (i) 10% of the corporation’s taxable income or the total charitable deductions taken by the corporation during the taxable year over the sum of the contributions made in such year plus the aggregate of the excess contributions which were made in taxable years before the contribution year and which are deductible under this subparagraph for such succeeding taxable year; or (ii) in the case of the first succeeding taxable year, the amount of such excess contribution, and in the case of the second, third, fourth, or fifth succeeding taxable year, the portion of such excess contribution not deductible under this subparagraph for any taxable year intervening between the contribution year and such succeeding taxable year.iii.  Subtitle C: Business ProvisionsEmployee Retention Credit for Employer Subject to Closure Due to COVID-19Eligible employers will receive a credit against applicable employment taxes for each calendar quarter in an amount equal to 50% of the qualified wages with respect to each employee. The amount of qualified wages taken into account for each eligible employee, however, will not exceed $10,000 per calendar quarter and the credit will not exceed the applicable employment taxes owed for such calendar quarter. The aforementioned credit is not applicable if the employer is alto taking advantage of the small business interruption loan. An eligible employer is defined as any employer: (i) which was carrying on a trade or business during calendar year 2020, and (ii) with respect to any calendar quarter for which, (a) the operation of their trade or business was fully or partially suspended due to governmental order as a result of COVID-19, or (b) the  calendar quarter is within the period beginning with (1) the calendar quarter after December 31, 2019 for which gross receipts for the calendar quarter are less than 50% of the gross receipts for the same calendar quarter of the prior year and the ending with (2) the calendar quarter following the first calendar quarter beginning after the calendar quarter described in (1) for which gross receipts of the employer are greater than 80% gross receipts for the same calendar quarter in the prior year.Delay of Payment of Employer Payroll TaxesThe CARES Act will allow for most employers to defer paying their share of applicable employment taxes from the time the CARES Act is signed into law through December 31, 2020. Half of this deferred amount would be due on December 31, 2021 and the other half by December 31, 2022.Modifications for Net Operating Losses (“NOL”)There will generally be a temporary repeal of taxable income limitation including (i) in the case of a taxable year beginning before January 1, 2021, the aggregate of the net operating loss (“NOL”) carryovers to such year, plus the NOL carrybacks to such year, and (ii) in the case of a taxable year beginning after December 31, 2020, the sum of (a) the aggregate amount of NOLs arising in taxable years beginning before January 1, 2018, carried to such taxable year, plus (b) the lesser of (1) the aggregate amount of NOLs beginning after December 31, 2017, carried to such taxable year, or (2) 80% of the excess of certain taxable income.In the case of any NOL arising in a taxable year beginning after December 31, 2017, and before January 1, 2021, whereby (i) such NOL will be a net operating loss carryback to each of the five (5) taxable years preceding the taxable year of such loss and (ii) certain rules applicable to farming losses and insurance companies shall not apply.  There are additional rules that apply specifically to “real estate investment trusts” and life insurance companies.Modification of Limitation on Losses for Taxpayers Other Than CorporationsFor any taxpayer other than a corporation:For a taxable year beginning after December 31, 2017 and before January 1, 2026, subsection (j) (relating to a limitation on excess farm losses of certain taxpayers) would not apply; and ii.  For any taxable year beginning after December 31, 2020 and before January 1, 2026, any excess business loss of the taxpayer for the taxable year will not be allowed.In regard to treatment of capital gains and losses for purposes of calculating “excess business losses”: Deductions for losses from sales or exchanges of capital assets will not be taken into account.The amount of gains from sales or exchanges of capital assets taken into account will not exceed the lesser of (1) the capital gain net income determined by taking into account only gains and losses attributable to a trade or business, or (2) the capital gain net income.The amendments made in the aforementioned section shall apply to taxable years beginning after December 31, 2017.Modification of Credit for Prior Year Minimum Tax Liability of CorporationsThe corporate alternative minimum tax (AMT) was repealed as part of the Tax Cuts and Jobs Act, but corporate AMT credits were made available as refundable credits over several years, ending in 2021.  The CARE Act accelerates the ability of companies to recover those AMT credits, permitting companies to claim a refund now and obtain additional cash flow during the COVID-19 emergency.  Modification of Limitation on Business InterestThe CARES Act temporarily increases the amount of interest expense businesses are allowed to deduct on their tax returns, by increasing the 30-percent limitation (as imposed under the Tax Cuts and Jobs Act) to 50 percent of taxable income (with adjustments) for 2019 and 2020.  As businesses look to weather the storm of the current crisis, this provision will allow them to increase liquidity with a reduced cost of capital, so that they are able to continue operations and keep employees on payroll.Qualified Improvement PropertyThe CARES Act enables businesses, especially in the hospitality industry, to write off immediately costs associated with improving facilities instead of having to depreciate those improvements over the 39-year life of the building. The provision, which corrects an error in the Tax Cuts and Jobs Act, not only increases companies’ access to cash flow by allowing them to amend a prior year return, but also incentivizes them to continue to invest in improvements as the country recovers from the COVID-19 emergency. Temporary Exception from Excise Tax for Alcohol Used to Produce Hand SanitizerFor distilled spirits removed after December 31, 2019 and before January 1, 2021, such distilled spirits will be free of tax for use in or contained in hand sanitizer produced and distributed in a manner consistent with any guidance issued by the FDA related to the outbreak of COVID-19.Title III – Supporting America’s Health Care System in the Fight Against the Coronavirus      Foley Title III Contacts: Rachel O’Neil, Erin Horton, Anil Shankar, and Paul JosephSubtitle A, Part I:  Addressing Supply ShortagesProvides for the National Academies to examine and report on the security of the U.S. medical product supply chain in order to assess U.S. dependence on critical drugs and devices sourced outside of the U.S., and to develop recommendations to improve resiliency of the U.S. supply chain for critical drug and devices.Requires the Strategic National Stockpile to include certain types of medical supplies, including personal protective equipment (PPEs), and identifies respiratory protective devices as covered countermeasures for use during a public health emergency.Prioritizes the review of drug applications to mitigate emergency drug shortages.Creates additional reporting requirements for drug manufacturers to report a discontinuation and disruption of the sourcing of active pharmaceutical ingredients.Requires manufacturers of certain drugs and medical devices critical to public health during a public emergency to develop, maintain, and implement risk management plans related to shortages, creating an annual notification requirement of the same. Such manufacturers are also subject to shortage-related inspections by the Secretary of Health and Human Services (HHS).Subtitle A, Part II: Access to Health Care for COVID-19 Patients Permits group health plans and insurers to cover and reimburse providers of diagnostic testing relating to COVID-19 at pre-emergency-period negotiated rates, and sets reimbursement rates in instances without previously negotiated rates equal to the cash price for services listed on a publicly-available website or the plan or insurer can negotiate with a provider for a rate lower than such cash price. All providers of a diagnostic test for COVID-19 are required to publicize cash price for such tests. Failure to comply with these requirements could result in HHS assessing a civil monetary penalty of up to $300 per day.Requires health plans and issuers to provide for rapid coverage of “qualifying coronavirus preventative services” – an item, service, or immunization intended to prevent or mitigate coronavirus—and vaccines for coronavirus.Appropriates $1.3 billion for FY 2020 for supplemental awards to health care centers for the prevention, diagnosis, and treatment of COVID-19.Amends Section 330I of the Public Health Service Act, relating to Telehealth Network and Telehealth Resource Centers Grant Programs, and Section 330A of the Public Health Service Act, relating to the Rural Health Care Services Outreach, Rural Health Network Development, and Small Healthcare Provider Quality Improvement Grant Programs—an individual or entity affected by these grant programs should seek out an attorney to examine the effect of such amendments.Limits potential state and federal liability for volunteer health care professionals—who provide services without compensation or other thing of value—for harm caused to patients relating to the diagnosis, prevention, or treatment of COVID-19. This provision expressly preempts more restrictive state or local law.Amends certain federal regulations governing the confidentiality and disclosure of substance use disorder patient records (Part 2), including allowing certain re-disclosures to covered entities, business associates, or other programs subject to HIPAA after obtaining the patient’s prior written consent.Permits a state agency or area agency on aging to transfer, without prior approval, not more than 100% of the funds received by the agency to meet the needs of the state or area served, and provides that the same meaning shall be given to an individual unable to obtain nutrition due to social distancing as one who is homebound due to illness.Provides that within 180 days of the passage of the Act, the Secretary of HHS shall issue guidance on the sharing of patients’ protected health information (PHI) related to COVID-19, including guidance on compliance with HIPAA regulations and applicable policies.Provides that the Secretary of HHS shall carry out a national awareness campaign relating to the importance and safety of blood donation, and the need of for donations for the blood supply during a public health emergency.iii.  Subtitle A, Part III:  Innovation Provides for using competitive procedures to enter into transactions to carry out public-health emergency health related projects and prohibits canceling those contracts solely because the emergency ends.Includes new provisions to expedite the development and approval of drugs to prevent or treat diseases in animals that are could have significant adverse consequences for humans.Subtitle A, Part IV:  Health Care WorkforceApproves appropriations for a variety of health professions-related programs, with particular focus on programs serving medically underserved populations (rural and geriatric).Subtitle B:  Education ProvisionsWaives requirement for certain higher education institutions to match federal funding and allows certain institutions to transfer unexpended allotment.Permits certain higher education institutions to use their allocations of Supplemental Educational Opportunity Grants for emergency financial aid for students.Permits certain higher education loan borrowers flexibility in repaying loans or returning grants during a qualified emergency.Permits certain students to complete distance education and certain students of foreign institutions to take classes in the United States.Allows the Secretary of Education to issue waivers upon request relating to assessments, accountability, and related reporting requirements, and requirements for state and local educational agencies and Indian Tribes to receive funding.Allows the Secretary of Education to grant a deferment to an institution that received a loan under Part D of Title III of the Higher Education Act.Payments on student loans held by the Department of Education are suspended for 6 months, and the Secretary of Education shall suspend all involuntary collection activities during the period of payment suspension.The Corporation for National and Community Service can allow individuals to accrue service hours and may permit certain grants funds.Not more than 20% of the total amount allocated to a local area under 29 U.S.C. 3151 et seq. may be used for administrative costs.For the program year 2019, not more than 20% of the total amount allocated to a local area under 29 U.S.C. 3151 et seq., may be used for administrative costs of carrying out certain local workforce investment activities, if the portion of the total amount that exceeds 10% of the total amount is used to respond to qualifying emergency.  For the program year 2019, certain unobligated funds reserved by a governor for statewide activities under the Workforce Innovation Opportunity Act may be used for statewide rapid response activities, or in certain circumstances, released to local boards impacted by the coronavirus.Gives the Secretary of Education authority to waive certain eligibility requirements, wait periods, and allotment requirements under the Higher Education Act for a period of time.Authorizes the Secretary of Education to modify the required and allowable uses of funds for grants and to modify any federal share or other financial matching requirement for a grant awarded under certain provisions of the Higher Education Act to an institution of higher education or other grant recipient (not including an individual recipient of Federal student financial assistance) as a result of a qualifying emergency.Allows the Secretary of Education to modify the categories of extenuating circumstances under which a grant recipient may be excused from fulfilling a portion of a service obligation under title IV of the Higher Education Act and must consider teaching service that is part-time or temporarily interrupted due to the emergency to be full-time service.  Requires the Secretary of Education to waive certain years of teaching service requirements under the Higher Education Act in certain circumstances.Subtitle C: Labor ProvisionsPaid Public Health Emergency Leave MinimumsEmployers may, but are not required to, pay any more than $200 per day and $10,000 in the aggregate for each employee for public health emergency leave under section 110(b)(2)(B) of the Family & Medical Leave Act of 1993 as amended by the Emergency Family and Medical Leave Expansion Act.Rehire Eligibility for Paid Public Health Emergency Leave EmployersFor purposes of public health emergency leave under the Emergency Family and Medical Leave Expansion Act, an eligible employee is an employee who has been employed for at least 30 calendar days by an employer with respect to whom leave is requested. The employee must be employed for at least 30 calendar days, which includes an employee who was laid off by that employer on or after March 1, 2020, had worked for employer for not less than 30 of the last 60 calendar days prior to the employees layoff, and was rehired by the employer.Emergency Paid Sick Leave MinimumsEmployers may, but are not required to, pay any more than:$511 per day or $5,110 in the aggregate for each employee when taking emergency paid sick leave if the employee is subject to a federal, state or local quarantine or isolation order related to COVID-19, the employee has been advised by a health care provider to self-quarantine due to concerns related to COVID-19, or the employee is experiencing symptoms of COVID-19 and seeking medical diagnosis; or $200 per day or $2,000 in the aggregate for each employee when taking emergency paid sick leave if the employee is caring for an individual who is subject to a federal, state or local quarantine order, or is caring for an individual who has been advised to self-quarantine due to concerns related to COVID-19, the employee is caring for the employee's son or daughter, if the child’s school or childcare facility has been closed or the child’s care provider is unavailable due to COVID-19 precautions, or the employee is experiencing any other substantially similar condition specified by HHS in consultation with the Department of the Treasury and the Department of Labor.Advance Refunding of Payroll Credits for Required Paid Sick Leave and Required Paid Family LeaveEmployers can apply a credit in the amount calculated under subsection (a) of section 7001 or 7003 of the Family First Coronavirus Response Act, subject to the limitations placed by subsection (b) of section 7001 and 7003, both calculated through the end of the most recent payroll period in the quarter. In anticipation of a credit, the credit may be advanced according to forms and instructions to be provided by the Secretary of Labor. The Act ensures employers that the Secretary of Treasury shall waive any penalty under section 6656 of the Internal Revenue Code of 1986 for failure to make a deposit of the tax imposed under section 3111 (a) or 3221(a) of such Code if failure was due to anticipation of credit allowed.vii. Subtitle D: Finance CommitteeAn additional safe harbor provision is added to section 223(c)(2) of the Internal Revenue Code, providing that a plan shall not fail to be treated as a high deductible health plan (HDHP) by reason of failing to have a deductible for telehealth and other remote care services.  Section 223(c)(1)(B) of the Internal Revenue Code is adjusted to include “telehealth and other remote care.” This addition allows an individual to have an insurance plan (for plan years beginning on or before December 31, 2021) that includes telehealth and other remote care without disqualifying the individual from owning an HDHP.Inclusion of Certain Over-the-Counter Medical Products as Qualified Medical ExpensesMenstrual care products are now included under the term “qualified medical expenses.” Increasing Medicare Telehealth Flexibilities During Emergency Period The amendment removes some limiting qualifications to section 1320b-5(b)(8), which allows for the Secretary of HHS to temporarily waive or modify the application of portions of the Social Security Act in the case of a telehealth service furnished in any emergency area during an emergency period.  The provision that sets out the defined term “qualified provider,” which limited 1320b-5(b)(8), is removed in its entirety. Enhancing Medicare Telehealth Services for Federally Qualified Health Centers and Rural Health Clinics During Emergency PeriodA new provision is added under Section 1834(m) of the Social Security Act (42 USC 1395m(m)), enhancing payment for telehealth services furnished via a telecommunications system by a federally qualified health center (FQHC) or rural health clinic (RHC) during an “emergency period” notwithstanding that the FQHC or the RHC providing the telehealth service is not at the same location as the beneficiary.  Payment methods for FQHCs or RHCs that serve as distant sites shall be based on payment rates similar to the national average payment rates for comparable telehealth services under the physician fee schedule under section 1848.Temporary Waiver of Requirement for Face-to-Face Visits Between Home Dialysis Patients and PhysiciansAmended section 1395rr(b)(3)(B) to allow the Secretary of HHS to waive the requirement that individuals with end stage renal disease receiving home dialysis must receive certain periodic face-to-face (non-telehealth) clinical assessments in order to be eligible to receive end stage disease-related clinical assessments via telehealth. Use of Telehealth to Conduct Face-to-Face Encounter Prior to Recertification of Eligibility for Hospice Care During Emergency PeriodSection 1395f(a)(7)(D)(i) is amended to allow a hospice physician or hospice nurse practitioner during an “emergency period” to conduct a face-to-face encounter via telehealth to determine recertification for continued eligibility for hospice care.Encouraging Use of Telecommunications Systems for Home Health Services Furnished During Emergency PeriodDuring an emergency period, the Secretary of HHS shall consider ways to encourage the use of telecommunications systems.Improving Care Planning for Medicare Home Health ServicesCertain Medicare sections are expanded from being limited to the services of a physician to include services of nurse practitioners, clinical nurse specialists, and physician assistants that provide home health services.Adjustment of SequestrationA temporary suspension of Medicare sequestration put into effect during the period of May 1, 2020 through December 31, 2020. The Medicare programs under title XVIII of the Social Security Act shall be exempt from reduction under any sequestration order during the period.Medicare Hospital Inpatient Prospective Payment System Add-On Payment for COVID-19 Patients During Emergency PeriodThe Secretary of HHS will increase the weighting factor for coronavirus-diagnosed patients discharged during the emergency period. The weighting factor is used by the Secretary of HHS to reflect the relative hospital resources used with respect to discharges for a particular group compared to discharges within other groups.Increasing Access to Post-Acute Care During Emergency PeriodDuring the emergency period, the Secretary of HHS will waive the requirement that patients of inpatient rehabilitation facilities receive at least 15 hours of therapy per week.  For long-term care hospitals furnishing services during the emergency period, the Secretary of HHS will further waive discharge percent requirements and the general application of site neutral payment rates.Revising Payment Rates for Durable Medical Equipment Under the Medicare Program Through Duration of Emergency PeriodThe Secretary of HHS shall apply the transition rule, described in 42 C.F.R. § 414.210(g)(9)(iii), to items and services furnished in rural areas and noncontiguous areas as planned through December 31, 2020, and through the duration of the emergency period.  For areas other than rural and noncontiguous areas, the Secretary of HHS shall apply the transition rule described in 42 C.F.R. § 414.210(g)(9)(iv) through the remainder of the emergency period.Coverage of the COVID-19 Vaccine Under Part B of the Medicare Program Without Any Cost-SharingThe term “medical and other health services” is expanded to include “COVID-19 vaccine and administration.”  The deductible described in section 1395l(b) shall not apply with respect to a COVID-19 vaccine and its administration.Requiring Medicare Prescription Drug Plans and MA-PD Plans to Allow for Fills and Refills of Covered Part D Drugs for up to a 3-Month SupplyDuring the emergency period, a prescription drug plan or MA-PD plan shall permit a part D eligible individual reenrolled in such plan to obtain a single fill or refill the total day supply prescribed for such individual for a covered part D drug.Providing Home and Community-Based Services in Acute Care HospitalsThe prohibition that nothing in section 1395a allows the Secretary of HHS authorization to limit the amount of payment that may be made under a plan for home-and-community care is expanded to include home and community-based services, self-directed personal assistance services, or home and community-based attendant services.  The provision is also expanded to clarify that the section shall not be construed to prohibit receipt of any care or services specified in paragraph (1) in an acute care hospital, provided certain requirements are met.Clarification Regrading Uninsured Individuals The Families First Coronavirus Response Act, enacted last week, added subsection (ss) to section 1396a, which defined “uninsured individual” as those not described in section 1396a(a)(10)(A)(i) and not enrolled in certain health care programs. The CARES Act amends this definition to exclude subsection VIII if the individual is a resident of a state that does not furnish medical assistance as described.    Clarification Regarding Coverage of COVID-19 Testing ProductsThe Families First Coronavirus Response Act, enacted last week, added COVID-19 testing to section 1396d, which provides medical assistance payments under certain conditions. The CARES Act amends this section by removing the requirement that the in-vitro diagnostic products administered are approved, cleared, or authorized under sections 510(k), 513, 514, or 564 of the Federal Food, Drug, and Cosmetic Act.Amendment Relating to Reporting Requirements with Respect to Clinical Diagnostic Laboratory TestsThe CARES Act extends the dates by one year for the reporting periods in section 1395m-1(a)(1)(B).  The applicable prohibition that payment amounts determined under section 1395m-1 shall not result in a reduction in payments, as defined by the subsection, for a clinical diagnostic laboratory test is expanded to 2017 through 2024.   The applicable percentages used to determine the limits on reductions in payment defined in 1395m-1(b)(3)(A) are adjusted to include a new clause for 2021, which makes the new applicable percentage zero (0) for 2021.Expansion of Medicare Hospital Accelerated Payment Program During the COVID-19 Public Health EmergencyMandates that the Secretary of HHS expand the accelerated payment program to hospitals experiencing significant cash flow problems during the “emergency period.” Exception for Certain States from Enhanced FMAP Requirements Provides that states may receive the temporary increase of Medicaid Federal Medical Assistance Percentage (FMAP) (authorized under the Families First Act enacted last week) notwithstanding the requirement to not impose premiums on beneficiaries, for a period of 30 days.viii.  Subtitle E, Part I: Medicare ProvisionsExtension of Funding for Quality Measure Endorsement, Input, and SelectionThe Social Security Act is amended to increase the amount allotted for this fiscal year ending on October 1, 2020 from $4,830,000 to $20,000,000 and for the period beginning on October 1, 2020 and ending on November 30, 2020, the amount equal to the pro rata portion of $20,000,000. Extension of Funding Outreach and Assistance for Low-Income ProgramsThe amount allocated for state health insurance programs shall be $13,000,000 for this fiscal year. For the period beginning on October 1, 2020 and ending on November 30, 2020, the amount available will be equal to the pro rata portion of $13,000,000.The amount allocated for area agencies on aging shall be $7,500,000 for the fiscal year of 2020. For the period beginning on October 1, 2020 and ending on November 30, 2020, the amount available will be equal to the pro rata portion of $7,500,000.The amount allocated for aging and disability resource centers shall be $5,000,000 for fiscal year 2020. For the period beginning on October 1, 2020 and ending on November 30, 2020, the amount available will be equal to the pro rata portion of $5,000,000.The amount allocated for grant or contract with national center for benefits and outreach enrollment is now $12,000,000 for the 2020 fiscal year ending on October 1, 2020. For the period beginning on October 1, 2020 and ending on November 30, 2020, the amount available will be equal to the pro rata portion of $12,000,000.Subtitle E, Part II: Medicaid ProvisionsExtension of the Money Follows the Person Rebalancing Demonstration ProgramThe Deficit Reduction Act of 2005 section 6071(h)(1)(G) is amended to allocate $337,500,000 for the period beginning on January 1, 2020 and ending on September 30, 2020. For the period beginning on October 1, 2020 and ending on November 30, 2020, the amount available will be equal to the pro rata portion of $337,500,000.Extension of Spousal Impoverishment ProtectionsExtends the protections through November 30, 2020.Allows the State to disregard the income of a spouse and conduct an analysis solely on an individual’s eligibility for medical assistance on the basis of reduction of income.Delay of DSH ReductionsThis section removes the $4 billion DSH reductions for federal fiscal year 2020 and delays the cuts from taking effect December 1, 2020. Extension and Expansion of Community Mental Health Services Demonstration ProgramExpands the Protecting Access to Medicare Act of 2014.According to this section not later than 6 months after the date of enactment, the Secretary shall select two states, in addition to the eight States already listed, to participate in two-year demonstration programs that meet the requirements of this subsection.The requirements are states that:Were awarded planning grants, Applied to participate in the demonstration programs under this subsection but were not selectedThe Secretary shall use the results of its evaluation of the state’s original application and shall not require the submission of any additional application.If a state is selected it is required to: Submit a plan to monitor certified community behavioral health clinics under the demonstration program to ensure compliance with certified community behavioral health criteria during the demonstration period; and Commit to collecting data, notifying the Secretary of any planned changes that would deviate from the prospective payment system methodology outlined in the state’s demonstration application, and obtaining approval from the Secretary of any such change before implementing change.The Federal matching percentage applicable to amounts expended by states participating in the demonstration program under this subsection shall apply to amounts expended by the state during the fiscal period that begins on January 1, 2020 if the state was participating in the demonstration program as of January 1, 2020 and shall apply to amount expensed by the state during the first fiscal period the state participates if the state was selected pursuant to the expansion. Subtitle E, Part III: Human Services and Other Health ProgramsExtension of Sexual Risk Avoidance Education ProgramSection 510 of the Social Security Act is amended to extend the time through 2020 instead of ending in May 22, 2020 and to change the fiscal year to 2021. Extension of Demonstration Projects to Address Health Professions Work-Force NeedsActivities authorized by section 2008 of the Social Security Act shall continue through November 30, 2020. Extension of the Temporary Assistance for Needy Families Program and Related ProgramsActivities authorized by part 1 of title IV and section 1108(b) of the Social Security Act shall continue through November 30, 2020. Subtitle E, Part IV: Public Health ProvisionsExtension for Community Health Centers, the National Health Service Corps, and Teaching Health Centers that Operate GME ProgramsThe amount allocated for community health centers under the Patient Protection and Affordable Care Act is increased to $4,000,000,000 for fiscal year 2020 and $668,493,151 for the period beginning on October 1, 2020 and ending on November 30, 2020.The amount allocated for the National Health Service Corps is now $310,000,000 for fiscal year 2020 and $51,808,219 for the period beginning on October 1, 2020 and ending in November 30, 2020.The amount allocated for teaching health centers that operate graduate medical education programs now extends through fiscal year 2020 and $21,141,096 is allocated for the period beginning on October 1, 2020 and ending on November 30, 2020.Diabetes ProgramsThe amount allocated under the Public Health Service Act for Type I will extend through the fiscal year of 2020 and $25,068,493 will be allocated for the period beginning on October 1, 2020 and ending on November 30, 2020.The amount allocated under the Public Health Services Act for Indians will extend through the 2020 fiscal year and $25,068,493 will be allocated for the period beginning on October 1, 2020 and ending on November 30, 2020.xii. Subtitle F, Part I: Over-the-Counter DrugsAmends Chapter V of the Federal Food, Drug, and Cosmetic Act (FD&C Act) to insert a new section regulating certain nonprescription drugs that are marketed without an approved drug application under section 505 of the FD&C Act.  This new section primarily achieves two goals: (1) reforms the regulatory process for over-the-counter (OTC) drug approvals permitting the FDA more flexibility to make changes administratively, rather than through the time-consuming full notice and comment rulemaking process; and (2) incentivizes pharmaceutical companies to research and manufacture innovative drug products by providing an 18-month market-exclusivity period to reward investments for new OTC drugs.Amends Section 502 of the FD&C Act, to clarify that an OTC drug which does not comply with the requirements of its OTC monograph, which is essentially an approved recipe for a drug product, is considered misbranded.  The FD&C Act prohibits the introduction of misbranded drugs into interstate commerce.Clarifies that nothing in the CARES Act will apply to drugs previously excluded by the FDA from the Over-the-Counter Drug Review under the original 1972 Federal Register document.Clarifies that sponsors of sunscreen ingredients with pending orders have the option to see review in accordance with the Sunscreen Innovation Act (SIA) or to see review under the new monograph review process.  The election must be made within 180 calendar days of the date of enactment of the CARES Act. Provides an annual procedure to update Congress on the appropriate pediatric indication for certain OTC cough and cold drugs for children under the age of six.  The evaluation consists of conditions under which nonprescription drugs are generally recognized as safe and effective.Makes technical corrections to the FDA Reauthorization Act of 2017 (Public Law 115-52).xiii. Subtitle F, Part II: User FeesDeclares that the fees paid pursuant to this section will be dedicated to FDA review of over-the-counter monograph drugs as set forth in the goals section and in letters from the Secretary of HHS to certain congressional committees.Establishes a new FDA user fee to allow the agency to hire additional staff members to ensure there is adequate agency oversight to approve changes to OTC drugs.Title IV – Economic Stabilization and Assistance to Severely Distressed Sectors of the United States Economy      Foley Title IV Contact: Christopher SwiftTitle IV of the Coronavirus Aid, Relief, and Economic Securities Act provides the Secretary of the Treasury with the authority to make loans or loan guarantees to states, municipalities, and eligible businesses and loosens a variety of regulations created in the Dodd-Frank Wall Street Reform and Consumer Protection Act, the Economic Stabilization Act of 2008, and others.ii.Subtitle A – Coronavirus Stabilization Act of 2020Emergency Relief and Taxpayer ProtectionsThe Act authorizes the Treasury Secretary to make up to $500 billion worth of loans and loan guarantees to eligible businesses, states, and municipalities. The term “eligible business” includes passenger air carriers or any other business that has not already received adequate economic relief in the form of loans or loan guarantees under other provisions of the Act. The Act reserves $46 billion to support passenger air carriers, air cargo carriers, and businesses important to maintaining national security. The Act establishes a $454 billion credit facility for Federal Reserve programs designed to support lending to eligible businesses, states, and municipalities. This program contemplates various loans and loan guarantees for distressed businesses.Businesses that receive loans through these Federal Reserve programs are prohibited from paying dividends or repurchasing stock (or other outstanding equity interests) while the loan or loan guarantee is outstanding, as well as for the 12 months following repayment. These businesses are subject to the same employee compensation restrictions as listed for air carriers, air cargo carriers, and businesses deemed important to maintaining national security. Although the Treasury Secretary can waive these restrictions, he must identify and explain the rationale for such waivers in testimony before Congress.Businesses that receive loans or loan guarantees through these Federal Reserve programs can only make loans (or other advances) to business that are incorporated in the United States. Transfers to subsidiaries and affiliates incorporated outside the United States are prohibited.The Act directs the Treasury Secretary to establish a program to provide low-interest loans for eligible businesses (including nonprofit organizations) with between 500 and 10,000 employees. Although these loans will require no repayment for at least six months, businesses and non-profit organizations seeking this support must provide a good-faith certification that they meet the following criteria:The company intends to maintain at least 90 percent of their current workforce;The company will not pay dividends or repurchase stock (or other equity securities);The company will not outsource or offshore jobs during the loan period or two years thereafter;The company will not abrogate existing collective bargaining agreements with labor unions; and The company will remain neutral regarding current or future union organizing activity.Limitation on Certain Employee CompensationThe Act also imposes certain compensation caps for officers and employees at companies  receiving loans or loan guarantees.  Under these caps, officers or employees that received $425,000 or more in total compensation in 2019 will have their future compensation capped at the amount they received that year.  This cap applies while the loan or loan guarantee is in effect, as well as to the 12 consecutive months after the loan or loan guarantee is no longer outstanding. The same restriction also applies to severance payments or other compensation received upon termination from businesses participating on the loan and loan guarantee programs.Additional caps apply for officers and employees whose total compensation exceeded $3,000,000 in 2019.  Under the Act, these individuals may receive compensation up to $3,000,000 plus 50 percent of the excess over $3,000,000 of the total compensation received by the officer or employee in 2019. For example, an officer or employee whose total 2019 compensation was $3,000,010 would be restricted to total compensation of $3,000,005 in subsequent years. Like the lower cap discussed above, this restriction applies while the loan or loan guarantee is in effect, as well as to the 12 consecutive months after the loan or loan guarantee is no longer outstanding.Continuation of Certain Air ServicesThe Secretary of Transportation may require any air carrier receiving loans or loan guarantees under Section 4003 to maintain scheduled air transportation services as the Secretary deems necessary to maintain service to any destination the carrier served before March 1, 2020. The Secretary of Transportation is to consider the needs of “small and remote communities” and “health care and pharmaceutical supply chains” when enforcing this portion of the Act.Suspension of Certain Aviation Excise TaxesThe Act suspends the imposition of aviation excise taxes as otherwise required under the Internal Revenue Code through December 31, 2020.Debt Guarantee AuthorityIn order to backstop solvent depository institutions, it appears that the CARES ACT allows the FDIC to establish a program to insure these institutions without regard to a maximum amount.  All such guarantees are to last at least until December 31, 2020.Temporary Government in the Sunshine Act ReliefIn the event that unusual and exigent circumstances continue to exist, the Board of Governors of the Federal Reserve System may conduct meetings with less restrictive and formal meeting notification and record-keeping requirements until December 31, 2020.  Temporary Hiring FlexibilityWithout regard to certain statutory hiring requirements, the Secretary of Housing and Urban Development and the Securities Exchange Commission are given flexibility to recruit and appoint candidates for temporary and term appointments as necessary to prevent, prepare for, or respond to COVID-19 during the “covered period” of the CARES Act.Temporary Lending Limit WaiverEnlarges exception to requirement on the maximum amount of loans and extensions of credit by a national banking association to include a nonbank financial company (as defined in Section 102 of the Financial Stability Act of 2010) and allows the Comptroller o

The Protecting Access to Medicare Act (PAMA) becomes mandatory in 2020. It promotes evidence-based medicine by requiring consultation of appropriate use criteria (AUC) when ordering Medicare part B advanced imaging, and evidence of such consultations in order for claims to be paid by the CMS. On today's podcast, Change Healthcare's Bob Cooke discusses PAMA with Sean McCormick, MD, and Natasha Stjepanovic, Care Select Imaging team product manager. Here's what ground they covered. PAMA requirements Why PAMA legislation was needed Integrating decision support into the EHR workflow How to meet PAMA's AUC requirements Inside PAMA consultation requirements Episode Resources Bob Cooke's bio Dr. Sean McCormick's bio Natasha Stjepanovic's bio PAMA regulations PAMA portal CareSelect Lab Change Healthcare announces CareSelect Imaging Open Access Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Get the iOS app Get the Android app Suggest or become a guest Contact Change Healthcare

In 2014, the U.S. Congress passed the Protecting Access to Medicare Act (PAMA) which required CMS, the Centers for Medicare & Medicaid Services, to revise the clinical laboratory fee schedule to reflect private sector payment rates.  Many in the laboratory community believed that the cuts are too deep and have urged CMS to recalculate fees to more accurately reflect the spectrum of laboratories that provide testing for patients. To gain greater insight on the potential impact of PAMA, a Q&A feature in the June 2019 issue of Clinical Chemistry asked six experts with different roles in this field to give their opinions on several of the key issues pertaining to the new reimbursement rates, particularly its potential impact on the laboratory marketplace and patient care.

Today’s guest is 11th-district State Representative Zack Hudgins, and the topic is voting. More to the point, we’ll talk about plans that Zack and others have to make it easier for qualified voters to cast their votes, and to make sure those votes count. As chair of the House Committee on State Government, Elections, and Information Technology, he’s in a pretty good position to achieve those goals.

We've paid a lot of attention this year to the bill that would “Repeal and Replace” the Affordable Care Act but that is not the only bill related to health care that is moving through Congress. In this episode, learn about the other health care bills that have made it just as far as the Repeal and Replace bill, including one that is already law. Also in this episode, we laugh at the Senate for inventing holidays and doing so in the dumbest way possible. Please support Congressional Dish: Click here to contribute using credit card, debit card, PayPal, or Bitcoin Click here to support Congressional Dish for each episode via Patreon Mail Contributions to: 5753 Hwy 85 North #4576 Crestview, FL 32536 Thank you for supporting truly independent media! Recommended Congressional Dish Episodes CD123: Health or Profits CD145: Price of Health Care CD151: AHCA - The House Version Bills Outline Laws H.J. Res. 430: Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the final rule submitted by Secretary of Health and Human Services relating to compliance with title X requirements by project recipients in selecting subrecipients. Overturns a rule finalized by the Obama Administration that would have prevented States from cutting off Federal funds for "family-planning services". Bills In Progress H.R. 372: Competitive Health Insurance Reform Act of 2017 Repeals an antitrust exemption that currently applies to health and dental insurance Allows antitrust exemptions for life insurance, and property or casualty insurance H.R. 1101: Small Business Health Fairness Act of 2017 Orders the Executive Branch to use regulations to create a procedure for certifying Association Health Plans (AHPs), which are not regulated like the state small group health insurance markets. Association Health Plans and the insurance companies that provide coverage will select the services included and their decisions are exempt from State laws. Creates a fund that will pay insurers to continue coverage if the plans disappears. The fund can be raided by the Executive Branch to pay for other things "whenever the Secretary determines that the moneys of the fund are in excess of current needs." A working group would be created to write the regulations. The applications for plans will include the States in which the plan intends to do business. If the association plan becomes insolvent, the government will become the trustee and can try to fix the plan, cancel the plan entirely, and can invest the plans assets. Would become effective one year after being signed into law and enactment regulations would be created by the Secretary of Labor. H.R. 1215: Protecting Access to Care Act of 2017 Enacts a statue of limitations on filing health care lawsuits which would be one year after the injury is discovered but never more than three years after the malpractice occurred The states can make the statue of limitations shorter Limits non-economic damages (such as pain, suffering, physical impairment, disfigurement, and mental anguish) to $250,000, "regardless of the number of parties against whom the action is brought or the number of separate claims or actions brought with respect to the same injury." "The jury shall note be informed about the maximum award for noneconomic damages." States will have the ability to adjust this number, up or down. Actual economic losses (such as medical expenses, past and future earnings losses, and loss of employment) in health care lawsuits will remain unlimited. Each guilty party in a health care lawsuit will only be held liable for the percentage of the damages in direct proportion to that party's percentage of responsibility. Doctors who prescribe a medicine that has been approved by the FDA can't be sued along with manufacturers, distributors, or sellers in product liability lawsuits Any statements or conduct expressing "fault" (along with apology, sympathy, etc.) made by a health care provider in regards to an unexpected medical outcome "shall be inadmissible" for any purpose as evidence of an admission of liability. States are allowed to make other communications inadmissible too. The statute of limitations would be effective immediately upon enactment and the limits on damages will be for all lawsuits started after the law is signed. Additional Reading Document: H.R. 1628 Obamacare Repeal Reconciliation Act of 2017 Cost Estimate, Congressional Budget Office, July 19, 2017. Article: The Washington Post's New Social Media Policy Forbids Disparaging Advertisers by Andrew Beaujon, Washingtonian, June 27, 2017. Document: H.R. 1628 Better Care Reconciliation Act of 2017 Cost Estimate, Congressional Budget Office, June 26, 2017. Document: H.R. 1628 American Health Care Act of 2017 Cost Estimate, Congressional Budget Office, May 24, 2017. Article: Examining The Final Market Stabilization Rule: What's There, What's Not, And How Might It Work? by Timothy Jost, Health Affairs Blog, April 14, 2017. Document: Guidance to States on Review of Qualified Health Plan Certification Standards in Federally-facilitated Marketplaces for Plan Years 2018 and Later, Centers for Medicare & Medicaid Services, April 13, 2017. Article: Treasury Inspector General Assesses ACA-Related Tax Issues by Timothy Jost, Health Affairs Blog, April 11, 2017. Document: Compliance With Title X Requirements by Project Recipients in Selecting Subrecipients by Department of Health and Human Services, Federal Register, Vol. 81, No. 243, December 19, 2016. Article: Is the ACA the GOP health care plan from 1993? by Jon Greenberg, Politifact, November 15, 2013. References American Civil Liberties Union: Public Funding for Abortion GovTrack: Health Bills Tracker Cornell Law School: 15 U.S. Code § 1013 Kevin McCarthy Majority Leader website: Health Care Phase 3: The Small Business Health Fairness Act ConsumersUnion: Letter to the House Opposing the Small Business Health Fairness Act OpenSecrets: Clients lobbying on H.R. 1215 American Medical Association: Support for House-Passed Bill on Medical Liability Google: UnitedHealth Group Stock US Senate Financial Disclosure: James Inhofe Stock Purchases American Health Insurance Plans: Letter to President Trump Dept of Health and Human Services: Letter to Governor regarding Medicaid Medicaid: About Section 1115 Demonstrations Washington Post: About WP Brandstudio Videos CSPAN: Pres. Trump Remarks on Senate Republican Health Care Bill YouTube: Hell to the Nah! Sound Clip Sources Hearing: Rules Committee Hearing, House of Representatives Committee on Rules, February 14, 2017. Timestamps & Transcripts 6:40 Rep. Jim McGovern (MA): I’ll make the point I continue to make about the process. Both of these rules, or protections, went through a long process, and whether you agree with them or not, there was a process. Here we are; the committees with jurisdiction did no hearings on this, have basically—there’ll be no opportunity for review. We know what the outcome is going to be: two more closed rules. So it’s kind of this whole hearing is kind of pointless because, again, the process is going to be the most restrictive that it can be. 9:40 Rep. Tim Walberg (MI): As you know, Title X is the only domestic federal program that provides grants for family-planning services. Grants go directly to states and non-governmental organizations, which then distribute money among healthcare providers. Over half of the grantees are state and local governmental agencies, which serve as intermediaries to distribute funding to subgrantees. Prior to this rule, states were free to direct their Title X funds to healthcare providers that did not participate in abortion. When states had this freedom, they were able to choose to invest in women’s health care instead of abortion. The new rule blocks states from restricting grants to potential recipients for reasons other than the ability to provide Title X services. Under this rule, states are prevented from establishing criteria that would eliminate abortion providers from receiving Title X grant money. Hearing: H.R. 372, the "Competitive Health Insurance Reform Act of 2017", House of Representatives Judiciary Committee, February 16, 2017. Timestamps & Transcripts 10:15 Rep. John Conyers (MI): I am pleased that the subcommittee’s first hearing of this new Congress is on H.R. 372, the Competitive Health Insurance Reform Act of 2017, which repeals the antitrust exemption in the McCarran-Ferguson Act for the health insurance business. For many years I’ve advocated for such a repeal, so I’m heartened to see the bipartisan nature of the support for this position. 11:50 Rep. John Conyers (MI): Congress passed McCarran-Ferguson Act in response to a 1944 Supreme Court decision, finding that antitrust laws applied to the business of insurance, like everything else. Both insurance companies and the states expressed concern about that decision. Insurance companies worried that it would jeopardize certain collective practices like joint-rate setting and a pooling of historical data, and the states were concerned about losing their authority to regulate and tax the business of insurance. To address these concerns, McCarran-Ferguson provided the federal antitrust laws apply to the business of insurance only to the extent that it is not regulated by state law, which has resulted in a broad antitrust exemption. Industry and state revenue concerns, rather than the key goals of protecting competition and consumers, were the primary drivers of the Act. In passing McCarran-Ferguson, Congress, however, initially intended to provide only a temporary exemption and, unfortunately, gave little to consideration to ensuring competition. 26:15 Rep. Austin Scott (GA): Be definition, health care and health insurance are not the same thing. But when one insurance company controls such significant portions of the cash flow of all of the providers in a region, no provider can stay in business without a contract with that carrier. Therefore, the insurance company gets to determine who is and who is not able to provide health care: sign a contract with a competing carrier, and we’ll cancel your contract. Accept the lower reimbursement, or we’ll cancel your contract. It’s closer to extortion than negotiation. Hearing: Legislative Proposals to Improve Health Care Coverage, House Committee on Education and Workforce, March 1, 2017. Witnesses Allison Klausner: American Benefits Council, which represents Fortune 500 companies Lydia Mitts: Associate Director of Affordability at Families USA, a consumer advocate org. Jay Ritchie: Executive VP of Toko Marine HCC-Stop Loss Group & Chairman of the Self-Insurance Institute of America Jon Hurst: President of the Retailers Association of Massachusetts Timestamps & Transcripts 25:50 Rep. Virginia Foxx (NC): Ultimately, they are fighting to maintain government control—government control over the kind of health insurance you can buy, government control over the kind of health insurance employers can and cannot offer workers, government control over the doctors you can see and the doctors you can’t see, and government control over certain healthcare benefits that many individuals may not need. Yet despite the cost and pain inflicted on so many Americans by Obamacare, the answer for some is still more government control. 47:35 Lydia Mitts: The second bill I would like to speak to is the Small Business Health Fairness Act. This bill would exempt association health plans from adhering to critical state and federal requirements for small-group coverage. These requirements have benefited small employers and their workers alike. They include protections that prevent plans from charging small employers exorbitantly higher premiums because their employees have poor health, are older, or are disproportionately women. They also include requirements that plans cover comprehensive benefits that meet the needs of a diverse workforce. By allowing association health plans to ignore these key protections, this bill would increase premiums and threaten stable access to comprehensive coverage for many small employers and their workers. Employers with a young workforce that is in pristine health may be able to get lower premiums. However, the rest of small businesses would see coverage become less affordable, whether they sought it through an association or the existing small-group market. On top of this, employees move to association plans would be at risk of facing skimpier coverage that doesn’t cover the care they need. 1:41:20 Rep. Suzanne Bonamici (OR): Ms. Mitts, the ACA included, as we know, unprecedented new consumer protections for patients, such as eliminating annual and lifetime limits, preventing insurers from dropping people when they get sick, charging women higher premiums. What will happen to these protections in association health plans? Lydia Mitts: Under the bill put forth to you today, those association health plans would no longer have to comply with so many of those rating protections that have been a huge benefit to many small businesses that prior before the Affordable Care Act actually had a really hard time finding affordable coverage for their employees because they employed employees who actually had healthcare needs, who were maybe older, and the market didn’t work for them before. And so we would move back to a situation where we’d have a segmented market, and people who are healthy, in pristine health, could move into an association health plan. I think the thing that’s important to keep in mind is that that doesn’t mean that association health plan would always be there and work for that small employer. If their workforce got older, claims went up, they might find that that association health plan charges them more, and it’s not a viable option for them anymore. Bonamici: Can you address—I know there’ve been some solvency concerns about some of the association health plans. Can you address that concern as well? Mitts: Yeah, there’s historically been concerns about association health plans not having adequate solvency funds. They have leaner, less rigid requirements than typical health insurance coverage. Partially state oversight was added to that to help address some of these problems, bigger problems, where they were just under ERISA. And when an association plan goes insolvent, their employers and their workers are still left with all of those unpaid medical claims and then on the hook for them. And if the plans are not under state jurisdiction, they won’t be able to benefit from state guaranty funds that help pay those claims, so they’ll be left on the hook for them. Hearing: H.R. 1215 Hearing-Part 1, House Committee on the Judiciary, February 28, 2017. Timestamps & Transcripts 44:20 Rep. Steve King (IA): One of the drivers of higher healthcare spending is defensive medicine. It’s a very real phenomenon confirmed by countless studies in which healthcare workers conduct many additional costly tests and procedures with no medical value that are charged to the federal taxpayers and to other consumers simply to avoid excessive litigation costs. 45:25 Rep. Steve King (IA): They include the following: a bedside sonogram with an “official sonogram” because it’s easier to defend yourself to a jury if you’ve ordered the second sonogram; a CT scan for every child who bumped his head, or her head, to rule out things that can be diagnosed just fine by observation; x-rays that do not guide treatment such as for a simple broken arm; or CT scans for suspected appendicitis that has been perfectly well diagnosed without it. In fact, I have an orthopedic surgeon who has said to me that when he has a knee injury, 97% of the tests that he orders are protection from malpractice. He knows what he’s going to operate on before he actually starts the surgery. 51:55 Steve Cohen: And if we want to make health care cheaper, which we should, and make it more affordable, we ought to have a single-payer system. That would make it more affordable. And if that’s the nexus that makes this law applicable for the federal government to usurp the states, and the Chairman said that the nexus was that it makes things cheaper and anything makes health care cheaper is so important that we need to take it away from the states, well, if you’re concerned about cost, you should be for a single-payer system, and that would make it cheaper and take profits away from insurance companies that right now are paying for ads to get people to buy drugs and making immense profits and having their executives draw salaries in the areas of 40 and 50 million dollars. This bill takes away from people who are hurt by medical malpractice in ways that are artificial and wrong, and we should not be on the side of those people who commit medical malpractice and cause injuries to others. With all of that said, I respectfully suggest that the agenda we’re following is not the agenda of the American people at the present time, and it’s the agenda of the American Medical Association, who’s here today, and this is the bill du jour. Hearing: Tom Price, HHS Fiscal Year 2018 Budget Request, Senate Finance Committee, June 8, 2017. Timestamps & Transcripts 44:37 Sen. Tom Carper (DE): And I like those ideas. I studied a little bit of economics at Ohio State as navy ROTC midshipman. I like market forces. I like trying to harness market forces and make them work. You came up with a good idea in 1993, and I just wish to heck that you would work with us to try to make sure that those good ideas have a chance of working. And the reason why the marketplaces are failing in places, like you mentioned Ohio in your statement, Mr. Chairman, the reason why they’re not working, we’ve basically undermined the individual mandate so that people will know if they really have to get coverage. Young people aren’t. We’ve taken off the training wheels, so to stabilize the marketplaces and insurance companies. They lost their shirts in 2014 because of it. They lost less money in 2015. Got better. They raised their premiums, they raised their copays, they raised their deductibles, and they did better in it. And tells that rather than the marketplaces being a death spiral at the end of 2016, they’re actually recovering, until a new administration came in and said, well, we’re not sure if we’re going to enforce the individual mandate, and, by the way, we don’t know for sure whether they’re going to extend the cost-sharing arrangements. That provides unpredictable lack of certainty for the insurance companies. What do they do? They say, we’re going to raise our premiums more. What you’re destabilizing, the very idea that these guys came up with 24 years ago. Sen. Orrin Hatch (UT): Well, if I could just interrupt for a second. Those were ideas that were against—it was part of the anti-Hillary care bill, and it— Carper: They were good ideas. Tom Price: Well— Carper: And I commend you for them. If my life depended on telling what Hillary care did, I couldn’t tell you. But I know what your bill did, and, frankly, there were good ideas, and now we’re undermining undercutting them. Why? Dr. Price, why? Price: Senator, I appreciate the observation. I would add to that that there are significant challenges out there, and there were so before this administration started. In your state alone, premiums were up 108% before this administration started. In your state alone, there were fewer insurance companies offering coverage on the exchange before this administration started. So what we’re trying to do is to address especially that individual and small-group market that is seeing significant increases in premiums, increases in deduct— Carper: What are you doing? What are you doing to doing? How are you stabilizing the marketplaces? Price: Well, we— Carper: Just give us some ideas. The three Rs. What are you doing on those? Reinsurance, risk adjustment, risk corridors. What are you doing there? Price: We passed it—or we put in place a market-stabilization rule earlier this year that identified the special enrollment periods and the grace periods to make certain that they were more workable for both individuals and for insurance companies. We allowed the states greater flexibility in determining what a qualified health plan was, to try to provide greater stability for the market. We put out word to all governors across this nation on both 1115 and 1332 waivers and suggestions regarding what they can do to allow for greater market stabilization in their states, and we look forward to working with you and other senators to try to make certain that all those individuals, not just in the individual and small-group market but every single American has the opportunity to gain access to the kind of coverage that works for them and their families. Sen. Mazie Hirono designated February 3rd as "National Wear Red Day." This is what she wore. Music Presented in This Episode Intro & Exit: Tired of Being Lied To by David Ippolito (found on Music Alley by mevio) Cover Art Design by Only Child Imaginations

In this episode, we look at all the important bills that become laws since the start of 2014, including a law that might cost you thousands of dollars per year, a law that ends public financing of political party nominating conventions, and a law that President Obama openly intends to ignore. We also discuss the resignation of Rep. Rob Andrews of New Jersey from the House of Representatives.  Laws Discussed in This Episode  S. 25: “South Utah Valley Electric Conveyance Act” Introduced by Senator Orrin Hatch This law has nothing to do with the South Utah Valley Electric Service District. S.25 changes the cost of living adjustment included in the budget agreement that was created after the shutdown ended which cut cost of living adjustments to pensions paid to veterans by 1%, which would short them each tens of thousands of dollars over the course of their lives. Now, we’re going to short change military members who enroll on or after January 1, 2014. Makes changes to which fund we use to pay Medicare doctors. Pays for all of this by extending the sequester for another year. It’ll now go through 2024. HR 4302: "Protecting Access to Medicare Act" Introduced by Rep. Joe Pitts of Pennsylvania In 1997, Congress invented the “Sustainable Growth Rate” (SGR) system for paying Medicare doctors. It tied the amount of money doctors get for Medicare doctors to projected growth of the economy. Since health care costs have skyrocketed at the same time that the economy has gone sour, doctors would see a huge pay cut of 24% if the SGR system of payment were used. H.R. 4302 delays the cuts to Medicare doctors for another year. Section 213 repeals the limitation on cost-sharing (deductibles) for employer-sponsored health plans for companies with 100 employees or fewer. It is retroactive to March 2010. HR 2019: “Gabriella Miller Kids First Research Act” Introduced by Gregg Harper of Mississippi Eliminates all public funding of “any major or minor” political party nominating convention. Authorizes - but does not appropriate - the money to go towards a ten year pediatric research fund NPR segment on H.R. 2019 S. 2195: Denys US admission to UN Reps who were spies or terrorists Introduced by Senator Ted Cruz of Texas and Rep. Doug Lamborn of Colorado Denies visas to United Nations representatives who have been “found to have been engaged in espionage activities or a terrorist activity.” This new law was designed to keep Iran’s representative to the United Nations out of the United States. The United States says that Hamid Aboutalebi was involved in the Iran hostage crisis in 1979. President Obama called the new law “advisory”, basically saying he has the right to waive it using his power to receive or reject ambassadors. President Obama claims that Bush set the precedent for waiving laws in this manner. S. 404: Green Mountain Lookout Heritage Protection Act Introduced by Patty Murray of Washington Green mountain lookout can’t be moved except for safety reasons S. 2183: Propaganda for Ukraine Introduced by Mitch McConnell of Kentucky Radio Free Europe/ Radio Liberty Incorporated and Voice of America will provide “news and information” to Ukraine & Ukraine’s neighboring countries We will conduct a “programming surge” broadcasting 24-7 to “target populations" We will “highlight inconsistencies and misinformation provided by Russian or pro-Russian media outlets” We will focus on areas dominated by Russian media We will put more reporters and “organizational presence” in eastern Ukraine We will “partner with private sector broadcasters” to create content and spread the word. We can use “jamming and circumvention technology to overcome any disruptions to service.” Congress is allowed to use $10 million of our money for this, if they appropriate the funds. Emergency Declarations President Obama continued national emergency declarations for "the situations" in: Cuba Zimbabwe Iran Somalia President Obama declared new national emergencies for situations in: Ukraine South Sudan Rob Andrews Resigns from Congress On February 18, Rep. Rob Andrews of New Jersey resigned from Congress, citing his family has the reason when the real reason was because he was under investigation by the House Ethics Committee. Read the House Ethics Committee Report Rob Andrews under investigation for, among other things: Spending over $16,000 of campaign funds to fly his family to a wedding in Scotland. Using campaign funds to fly himself and his daughter to Los Angeles six times in 2011 so that she could pursue an acting career in Hollywood. Using campaign funds to donate thousands of dollars to theaters that hired his daughter to appear in their productions. Earmarking over $1.5 million to the Rutgers University School of Law, where his wife is an Associate Dean. By resigning, Andrews made all these investigations go away because the House Ethics Committee said it lacks jurisdiction over ex-members. On May 5, Rob Andrews registered as a lobbyist based out of a Philadelphia law firm where his wife used to work. He will be lobbying on behalf of Merit Inc., which provides IT and security for private and public institutions including the EPA, National Park Services, U.S. Corps of Engineers, US Navy, US Army, the FAA, the Dept. of Justice, and the Dept. of Veterans Affairs. He will also be lobbying on behalf of the National Coordinating Committee for Multi-employer Plans, which proudly proclaims on it's website that “NCCMP influences virtually every piece of employee benefit legislation for the benefit of multi-employer plans.” Representatives Quoted in This Episode Rep. Adam Smith of Washington Rep. Joe Pitts of Pennsylvania Rep. Doug Lamborn of Colorado Music Presented in this Episode Working for America by Olio (found on Music Alley by mevio) None of the Above by David Ippolito (found on Music Alley by mevio) Intro and Exit Music: Tired of Being Lied To by David Ippolito (found on Music Alley by mevio)