Congress' big stimulus package will provide more than $100 billion and several favorable payment policies to hospitals, doctors and others in the health care system as they grapple with the coronavirus outbreak.
The big picture: Hospitals, including those that treat a lot of rural and low-income patients, are getting the bailout they asked for — and then some.
The cornerstone provision is a no-strings-attached $100 billion fund for hospitals and other providers so they "continue to receive the support they need for COVID-19 related expenses and lost revenue," according to a summary of the legislation.
- It's unclear how that money would be divvied up. One lobbyist speculated the funds would go to the "hardest-hit areas first and those areas that are next expected to get hit," but that has not been clarified.
The bill provides many other incentives for the industry.
- Hospitals that treat Medicare patients for COVID-19 will get a 20% payment increase for all services provided. That means Medicare's payment for these types of hospital stays could go from $10,000 to $12,000, depending on the severity of the illness.
- Employers and health insurers will be required to pay hospitals and labs whatever their charges are for COVID-19 tests if a contract is not in place. By comparison, Medicare pays $51.33 for a commercial coronavirus test.
- Medicare's "sequestration," which cuts payments to providers by 2%, will be lifted until the end of this year.
- Labs won't face any scheduled Medicare cuts in 2021, and won delays in future payment cuts as well.
What's missing: Patients who are hospitalized with COVID-19 could still be saddled with large, surprise bills for out-of-network care.
- There also are no subsidies for COBRA coverage, which employers wanted for people who lost their jobs. However, people who are laid off are able to sign up for a health plan on the Affordable Care Act's marketplaces or could qualify for Medicaid.
