National Response to the COVID-19 Outbreak
Federal Laws Passed:
Phase 1 - Coronavirus Preparedness and Response Supplemental Appropriations Act
(Signed by President Trump March 6, 2020)
$8.3 Billion in Total Funding
$4 Billion for Agency Funding
$2 Billion for the Centers for Disease Control (CDC)
$20 Million for Disaster Loans
Waived Medicare Telemedicine Restrictions
Kaiser Family Foundation Summary
Phase 2 - Families First Coronavirus Response Act
(Signed by President Trump March 18, 2020)
Expanded the Family Medical Leave Act*
Requirement for Emergency Paid Sick Leave*
Required Government and Private Payers to Cover COVID-19 Testing Costs
$3.471 Billion Initial Cost - $100 Billion Total
$192 Billion Cost in Deficit Spending
*Detailed Explanation of Employer Requirements
Phase 3 - Coronavirus Aid, Relief, and Economic Security Act (CARES Act)
(Signed by President Trump March 27, 2020)
$2.2 Trillion in Total Funding
$349 Billion Paycheck Protection Program
Extended and Expanded Unemployment Benefits
$1,200 Tax Rebate per Adult / $500 per child
$500 Million Public Health Surveillance and Analytics Infrastructure
Loosened Consent Requirements for Substance Abuse Disorder Patients
Deferred Student Loan Payments During Emergency
Expanded Telehealth Services
$500 Billion for Economic Stability Business Loans
$150 Billion Relief Funds to States, Territories, Tribal Governments
$340 Billion in Emergency Appropriations
(and more)
Executive Orders and Agency Action:
Federal, state and local governments/agencies have provided additional flexibility by waiving or suspending various rules. The following are a few noteworthy examples: (see an extensive list below)
- Expansion of Telehealth with 1135 Waiver
- Medicare Telehealth Visits
- Virtual Check-Ins
- E-Visits
- Relaxing HIPAA / OCR Enforcement for Telehealth Technology
"To facilitate the nation’s response to COVID-19, until further notice, HHS will not take enforcement action against any health insurance issuer that amends its catastrophic plans to provide pre-deductible coverage for services associated with the diagnosis and/or treatment of COVID-19."
BlanketWaivers for Health Care Providers:
"The Trump Administration is taking aggressive actions and exercising regulatory flexibilities to help healthcare providers contain the spread of 2019 Novel Coronavirus Disease (COVID-19)." (26 pages of waivers)
FDA Emergency Use Authorization (examples)
- Hydroxychloroquin (HCQ)
- Antibody Testing
- Personal Protective Equipment
- Medical Devices (such as Ventilators)
- Licensed Pharmacists Authorized to Order and Administer COVID-19 Tests
Sharing of Patient Data:
- No penalties for sharing patient data with family members without patient consent during the pandemic (HHS HIPAA Bulletin)
- No penalties on business associates for sharing patient data with government agencies without contractual permission of the hospital, doctor, health plan or other "covered entity" with whom the business associate has a contractual data-sharing agreement. (OCR Announcement)
The federal HIPAA rule regulates the use of protected health information (PHI), which is identifiable patient data. Although Americans believe HIPAA protects their privacy, HIPAA permits sharing and use of PHI—without consent. HIPAA is considered a permissive data-sharing rule.
As Health IT Security notes, HIPAA already permits covered entities (e.g. doctors, hospitals, health plans) to share PHI with government agencies. However, HIPAA business associates (BAs) are only allowed to use and disclose PHI with the government for public health and health oversight purposes if the business associate data-sharing agreement says they can.
The new announcement by the HHS Office for Civil Rights (OCR) allows BAs to share data with the government without HIPAA penalties during the pandemic.
- OCR Announcement
- 1.5 million business associates (BAs) listed by HHS in 2010
- Google receives medical records of 50 million people under a "business associate agreement"
List of Federal and State Regulations that have been waived.