Here is more detail on the issues covered by the updated and new FAQS:
President Joe Biden released his $1.9 Trillion “American Rescue Plan: Emergency Legislative Package to Fund Vaccinations, Provide Immediate, Direct Relief to Families Bearing the Brunt of the COVID-19 Crisis, and Support Struggling Communities.” The Plan provides a roadmap to guide America out of the COVID-19 pandemic. The package is organized around seven goals to address the healthcare, economic, and societal harms caused by the COVID-19 pandemic.
The following explains the reasons why some providers are missing out on funds. It is based upon information LeadingAge has gleaned through discussions with the outgoing HHS Secretary’s office staff and updated PRF FAQs.
Why Phase 2 payments have not been received yet
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An interactive and informative listening session, hosted by CDC’s Dr. Carolyn Bridges, explored current issues in the COVID vaccination roll-out for older adults in the community and in residential settings. Dr. Bridges began the call with what she called ‘ground level’ facts and known issues related to the organization and distribution of vaccines to those in the 1A category across states.
In summary, these facts and known issues included:
Initially, the proposed new requirements will only apply to Medicaid and CHIP managed care plans, state Medicaid and CHIP fee-for-service programs, and some health insurance exchange plans. CMS indicates that nothing in the proposed rules precludes Medicare Advantage organizations from also implementing these policies but for now CMS will continue to evaluate whether to extend these requirements to MA organizations. LeadingAge encouraged them to do so noting the issues providers encounter with getting MA plans to timely approve prior authorizations.
The mandate to provide paid sick leave and FMLA leave for employees that met the requirements set out in FFCRA and updated in September 2020 ended December 31, 2020. HOWEVER, the Consolidated Appropriations Act (HR 133), signed into law on December 27, 2020, extended the paid leave provisions to March 31, 2021 but the extension is voluntary. Click on our FAQ document to learn the latest, and refresh your memory about the paid provisions and how the employer is compensated through payroll tax reductions.
On December 21, Congress passed legislation that included an Omnibus Spending Bill, which allocates funding for the 12 fiscal year 2021 appropriations bills. The spending package also contains a $900 billion emergency coronavirus relief package to protect the lives of the American people. The approximately 6,000 page bill, The Consolidated Appropriations Act, 2021 (Omnibus and Coronavirus Relief Bill) directly or indirectly impacts most every part of the aging services continuum.
The bill, if passed and signed into law, would appropriate an additional $3 billion to the PRF, bringing the total to roughly $38 - 43 billion. There had been some previous discussions in Congress to target some of the new allocations for rural and Indian Health Service providers but these did not make it into the final bill after the appropriation was reduced to a much smaller number.
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