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1 1 (October 27, 2020)

handle is hein.crs/govdcjg0001 and id is 1 raw text is: SConr essional Research Servik COVID-19 and the Uninsured: Federal Funding Options to Pay Providers for Testing and Treatment October 27, 2020 Congress enacted provisions to increase access to Coronavirus Disease 2019 (COVID-19) testing and treatment (including, for some programs, an eventual vaccine) under the Families First Coronavirus Response Act (FFCRA; P.L. 116-127), as amended by the Coronavirus Aid, Relief, and Economic Security Act (CARES Act; P.L. 116-136). Separately, Congress provided funding to support testing infrastructure in the Paycheck Protection Program and Health Care Enhancement Act (PPPHCEA; P.L. 116-139). In addition, these laws appropriated funding to government agencies that provide health services (e.g., the Department of Veterans Affairs) and for specific health providers (e.g., health centers). These laws largely focus on COVID-related modifications for individuals who have public or private health care coverage; however, this Insight discusses federal funding options under these laws that can be used to pay providers for COVID-19-related testing and treatment for uninsured individuals through funding distributed under an administrative construct referred to as the Uninsured Fund (UF) and a newly created Medicaid option for testing. Testing Congress provided additional funding for health centers, which are obligated to provide care to all individuals regardless of their ability to pay, to expand access to testing for uninsured individuals. It also appropriated $1 billion in both FFCRA and PPHCEA to reimburse providers for diagnostic and antibody testing and for associated costs (e.g., specimen collection), which is being administered as the UF. Under the UF, providers must seek reimbursement for testing uninsured individuals, where uninsured is defined in FFRCA as individuals who are not covered by a federal health program or are not enrolled in specified types of private health insurance coverage. Except in a few instances (e.g., testing sites supported by the Federal Emergency Management Agency) providers are not obligated to seek reimbursement from the UF). However, those that do must comply with certain terms and conditions that include accepting the fund's reimbursement, at the Medicare rate, as full payment. These requirements may mean that some providers will instead choose to pursue payment from individuals, which may be higher than the Medicare rate. Congressional Research Service https://crsreports.congress. gov IN11526 CRS INS GHT Prepared for Members and Cornmttees oi Conqres3-----------------------------------------------------------------------------------

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