REGULATORY REVIEW


rier for patients by eliminating cost sharing for coronavirus testing and increased federal support for Medic- aid programs.


The Third Bill: The Coronavirus Aid, Relief, and Economic Security (CARES) Act As the second bill was wrapping up, it was becoming clear that ASCs would need significant financial support to survive the pandemic. The day after the second bill was signed into law, ASCA sent a letter to the administra- tion and Congress outlining the need for targeted financial support. ASCA also was working behind the scenes to help draft legislation to provide targeted financial relief to ASCs and other specified types of providers. This bill, the Immediate Relief for Rural Facilities and Provid- ers Act, was introduced by Senators John Barrasso (R-WY) and Michael Bennet (D-CO) in the Senate, and Congressmen Phil Roe (R-TN-1) and Raul Ruiz (D-CA-36) in the House. The bill, however, was not included in the CARES Act, but ASCA’s work was an important part of elevating the crit- ical need for federal financial support for healthcare providers. Toward the end of March, con- gressional work focused solely on responding to the coronavirus, and all other efforts had reached a stand- still. Members of the House had to return to Washington, DC, to vote on this bill but otherwise members of each chamber were not working in- person in the Capitol Complex. Only 10 days passed between the signing of the second bill and the signing of the CARES Act on March 27. The CARES Act created the PPP, added $100 billion to the Provider Relief Fund and made changes to the tax code to give ASCs and oth- ers needed financial support. The bill provided additional flexibility for telehealth services, extended pro- grams under Medicare and Medicaid


22 ASC FOCUS AUGUST 2020| ascfocus.org PPP loans were being adminis-


tered over the same course of time as the advocacy work took place. Ultimately, the PPP ran out of fund- ing the week of April 12, necessitat- ing a funding extension, which could be authorized and appropriated only by Congress. The need for this addi- tional funding and a desire to modify some of the programs in the CARES Act both set the stage for the devel- opment of the fourth bill.


Over a two-month period from March to April, Congress created, and the executive branch administered, new and expansive federal initiatives, like the Paycheck Protection Program.”


—Steve Selde, ASCA


and waived sequestration through the end of the calendar year. CARES also included rebate checks from the Internal Revenue Service to indi- viduals and families and expanded unemployment insurance, among other provisions.


The Fourth Bill: The Paycheck Protection Program and Health Care Enhancement Act Work to resolve issues with the CARES Act began soon after it was signed into law. ASCA sent a salvo of letters to the administration and Congress regarding the PPP, urg- ing that more ASCs be eligible to access this lifeline of financial sup- port. ASCA also worked with mem- bers of the Senate and the adminis- tration to provide input and ideas on how future allocations from the Pro- vider Relief Fund could be allocated in an attempt to make centers whole.


It took almost a month to formal- ize and pass H.R. 266, the Paycheck Protection Program and Health Care Enhancement Act. The President signed it into law on April 24. This legislation provided more than $300 billion in additional fund- ing for the PPP, $75 billion in addi- tional funding for the Provider Relief Fund and $25 billion for COVID-19 testing. Despite ASCA’s efforts, this legislation did not modify the appli- cability of affiliation rules under the PPP for ASCs.


Steve Selde is ASCA’s assistant director of Government Affairs. Write him at sselde@ascassociation.org.


TRACK THE LATEST REGULATORY AND LEGISLATIVE NEWS FOR ASCs


Visit ASCA’s website every week to stay up to date on the latest government affairs news affecting the ASC industry. Every week, ASCA’s Government Affairs Update newsletter is posted online for ASCA members to read. The weekly newsletter tracks and analyzes the latest legislative and regulatory developments concerning ASCs.


ascassociation.org/ GovtAffairsUpdate


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