The Paycheck Protection Program and Health Care Enhancement Act: Summary of Key Health Provisions
Kellie Moss
Published:
On April 24, 2020, the Paycheck Protection Program and Health Care Enhancement Act was signed into law, marking the fourth major legislative initiative to address COVID-19. The three earlier initiatives include:
- the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020, which was signed on March 6 and provided emergency funding relief for domestic and global efforts;
- the Families First Coronavirus Response Act, which was signed on March 18 and provided emergency funding relief for domestic efforts; and
- the Coronavirus Aid, Relief, and Economic Security (CARES) Act, which was signed into law on March 27 and provided emergency funding relief for domestic and global efforts.
The Paycheck Protection Program and Health Care Enhancement Act includes a number of health provisions to address the domestic outbreak, which are summarized in the table below. This summary does not include other aspects of the domestic response addressed by the Act, such as additional funding provided for the paycheck protection program under the Small Business Administration.
Among the areas addressed is $100 billion for the Public Health and Social Services Emergency Fund at the Department of Health and Human Services (HHS), including $75 billion for additional funding to reimburse hospitals and other health care entities for health care related-expenses or lost revenues attributable to coronavirus (referred to as the CARES Act Provider Relief Fund, which now totals $175 billion overall) and $25 billion for necessary expenses related to COVID-19 testing. The testing funding includes:
- Not less than $11 billion for states, localities, territories, tribes, tribal organizations, urban Indian health organizations, or health service providers to tribes, of which:
- Not less than $750 million shall be allocated to tribes and tribal organizations, and
- Not less than $4.25 billion shall be allocated to States, localities, and territories according to a formula based on the relative number of COVID-19 cases;
- Not less than $1 billion for the Centers for Disease Control and Prevention (CDC);
- Not less than $1.8 billion for the National Institutes of Health (NIH);
- Not less than $1 billion for HHS’ Biomedical Advanced Research and Development Authority (BARDA);
- $22 million for the Food and Drug Administration (FDA);
- $600 million for the Health Resources and Services Administration (HRSA);
- $225 million for rural health clinics; and
- Up to $1 billion to cover the cost of testing for the uninsured.
Table 1: Division B of the Paycheck Protection Program and Health Care Enhancement Act – Summary of Key Health and Related Provisions | |||||
Department | Operating Division/ Office |
Key Provisions | Fund/ Account |
Funding Available |
Period |
DIVISION B–ADDITIONAL EMERGENCY APPROPRIATIONS FOR CORONAVIRUS RESPONSE | |||||
Title I | |||||
DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS)
|
Office of the Secretary
|
Reimbursement for Hospitals and Other Eligible Health Care Providers for Coronavirus-Related Expenses or Lost Revenues: For an additional amount for “Public Health and Social Services Emergency Fund” to prevent, prepare for, and respond to coronavirus, domestically or internationally, for necessary expenses to reimburse, through grants or other mechanisms, hospitals and other eligible health care providers for health care related expenses or lost revenues that are attributable to coronavirus (this pool of funding is known now as the “CARES Act Provider Relief Fund”).
Of the funds provided:
|
Public Health and Social Services Emergency Fund
(including transfer of funds)
|
$75,000,000,000 | To remain available until expended |
Office of the Secretary | COVID-19 Testing: For an additional amount for “Public Health and Social Services Emergency Fund” to prevent, prepare for, and respond to coronavirus, domestically or internationally, for necessary expenses to research, develop, validate, manufacture, purchase, administer, and expand capacity for COVID-19 tests to effectively monitor and suppress COVID-19, including tests for both active infection and prior exposure, including molecular, antigen, and serological tests, the manufacturing, procurement and distribution of tests, testing equipment and testing supplies, including personal protective equipment needed for administering tests, the development and validation of rapid, molecular point-of-care tests, and other tests, support for workforce, epidemiology, to scale up academic, commercial, public health, and hospital laboratories, to conduct surveillance and contact tracing, support development of COVID-19 testing plans, and other related activities related to COVID-19 testing.
Of the funds provided:
|
Public Health and Social Services Emergency Fund
(including transfer of funds)
|
$25,000,000,000 | To remain available until expended | |
General Provisions (including transfer of funds) | Section 101. Applies certain requirements, authorities, and conditions described in Division B of the CARES Act (specifically, sections 18108 (allows the HHS Secretary to appoint candidates needed for positions to perform critical work relating to coronavirus), 18109 (allows these funds to be used to enter into contracts with individuals for the personal services to prevent, prepare for, and respond to coronavirus, within the U.S. and abroad), and 18112 (requires the HHS Secretary to provide a detailed spend plan to certain committees not later than 30 days after enactment)) to these HHS funds. | ||||
Section 102. Funds, except for the $75 billion provided for hospitals and other eligible health care providers’ reimbursement and the $11 billion provided for States and certain others for COVID-19 testing, may be transferred to, and merged with, other appropriation accounts under the headings “Centers for Disease Control and Prevention,” “Public Health and Social Services Emergency Fund,” “Food and Drug Administration”, and “National Institutes of Health” to prevent, prepare for, and respond to coronavirus following consultation with the Office of Management and Budget and provided that the Committees on Appropriations of the House of Representatives and the Senate shall be notified 10 days in advance of any such transfer. Upon a determination that all or part of the funds transferred are not necessary, such amounts may be transferred back. | |||||
Section 103. Of the funds provided, up to $6,000,000 shall be transferred to, and merged with, funds made available under the heading “Office of the Secretary, Office of Inspector General” for oversight of activities supported with funds appropriated to HHS to prevent, prepare for, and respond to coronavirus, domestically or internationally. | Office of the Secretary/Office of the Inspector General
|
Funds transferred from Public Health and Social Services Emergency Fund within amounts above | To remain available until expended | ||
Title III | |||||
GENERAL PROVISIONS | Section 304. Funds made available in this Act, or transferred pursuant to authorization granted in this Act, may only be used to prevent, prepare for, and respond to coronavirus. | ||||
SOURCE: KFF analysis of the Paycheck Protection Program and Health Care Enhancement Act (P.L. 116-139). |