After significant, multi-day negotiations between House and Senate leadership and the Administration, the third COVID-19 emergency supplemental has been signed into law by President Trump. The $2.2 trillion bill is the largest financial and health care recovery package in U.S. history.

This legislation passed after significant advocacy efforts from ACC. Roughly 6,000 ACC grassroots members contacted their legislators to voice their knowledge and concerns about necessary COVID-19 measures, and ACC President Richard J. Kovacs, MD, FACC, and other health care leaders met with the Administration. Additionally, ACC sent a letter to Congressional leadership and joined the House of Medicine in asking for help to "sustain physicians and their practices during this unprecedented national emergency through tax relief, no-interest loans, direct payments, payment for virtual visits including phone calls, and other measures."

The following provisions included in the legislation address key ACC priorities:

• $16 billion to procure personal protective equipment, ventilators and other medical supplies for federal and state response efforts; when combined with the first supplemental, Congress has provided approximately $17 billion for the Strategic National Stockpile
• Medicare telehealth flexibilities
  • After expansion of telehealth services included in the first COVID-19 package, this provision allows the secretary to waive originating site, video and other requirements during COVID-19 emergency period
• $100 billion to create a "Public Health and Social Services Emergency Fund" controlled by the secretary of the U.S. Department of Health and Human Services (HHS) to be distributed to "eligible health care providers for health care related expenses or lost revenues that are attributable to coronavirus"
• $349 billion in Small Business Administration (SBA) loans to businesses with fewer than 500 employees (or larger if SBA designates a larger size is typical for that industry) that can be used for payroll costs, group health, sick leave, family leave, salaries, mortgage interest, rent, utilities, debt interest; loans are forgivable under certain conditions, mainly if employees are retained through June 30
• Limitation on liability for volunteer health care professionals during COVID-19 emergency response
  • Makes clear that clinicians who provide volunteer medical services during the public health emergency have liability protections
• $150 billion from the "Coronavirus Relief Fund" to be distributed to state, tribal and local governments in fiscal year 2020
• Coverage of diagnostic testing for COVID-19 by private insurance without cost sharing
• Allows PAs, nurse practitioners, and other professionals to order home health services for Medicare beneficiaries
• Cancellation of the Medicare sequester from May 1 through Dec. 31, 2020
• Extension of Physician Work Geographic Index Floor through Dec. 31, 2020
• Extension of funding for quality measure endorsement and selection through Nov. 20, 2020
• $945.5 million for the National Institutes for Health (NIH) for vaccine, therapeutic and diagnostic research to increase the understanding of COVID-19, including underlying risks to cardiovascular and pulmonary conditions; when combined with the first supplemental, Congress has provided $1.78 billion for NIH research

The College is already communicating with senior policymakers in the Administration to ensure swift and helpful implementation, and will continue to keep members apprised as eventual regulatory guidance is released. ACC Members can continue to take grassroots action here, and stay on top of COVID-19 updates and more on ACC's COVID-19 Hub.

Clinical Topics: COVID-19 Hub

Keywords: Coronavirus, COVID-19, Severe Acute Respiratory Syndrome, Public Health, Protective Devices, Protective Clothing, Coronavirus Infections

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