POLICY BRIEFINGS

House of Representatives Institutes Mask Mandate


The House of Representatives has moved to impose a mask mandate following the news that Rep. Louie Gohmert (R-Texas) tested positive for COVID-19. The directive was issued by House Speaker Nancy Pelosi (D-Calif.) on Wednesday and will require that any person entering the House office buildings or the Hall of the House in the Capitol wear a face covering. Exceptions are permitted for children age two or under, persons with disabilities preventing the wearing of a mask, or someone eating or giving a speech. Gohmert has questioned the need for face coverings and has been seen on the Hill without a mask in recent weeks. After coming in contact with Gohmert, Rep. Kay Granger (R-Texas) is self-quarantining, Rep. Raul Grijalva (D-Arizona) has tested positive for the virus, and Attorney General William Barr is getting tested. At least 81 front-line workers in the Capitol complex have tested positive since the start of the pandemic, and a longtime staff member for Rep. Vern Buchanan (R-Fla.) died last week from COVID-19. House Majority Leader Steny Hoyer (D-Md.) has written to the Director of the Office of Employee Assistance (OEA) asking if it has sufficient resources to meet the increased demand for staff counseling stemming from the current stressful working conditions. Majority Leader Mitch McConnell (R-Ky.) has stated that a mask mandate is not necessary in the Senate because all members are already wearing face coverings.


Lawmakers Probe Remdesivir Price, Government Contributions


House Oversight and Reform Committee Chair Carolyn Maloney (D-N.Y.) and Sen. Debbie Stabenow (D-Mich.) have written to the Government Accountability Office (GAO) requesting information about the discovery and development of the COVID-19 treatment remdesivir. The drug, which is made by Gilead, will cost government programs $390 per vial. The lawmakers ask that GAO investigate what legal rights federal agencies have related to their spending on and contributions to the discovery and development of remdesivir because of its high price tag.


Two House Panels Investigate Change to COVID-19 Data Reporting


House Ways and Means Committee Chair Richard Neal (D-Mass.) has sent a letter to U.S. Department of Health and Human Services (HHS) Secretary Alex Azar requesting information about the department’s decision to change the reporting process for COVID-19 data previously submitted to the Centers for Disease Control and Prevention (CDC). New guidance from HHS directs COVID-19 data to now be reported to a database administered by a private contractor, TeleTracking, as well as state websites and electronic health record (EHR) portals. Neal asks for details on the type of training or outreach provided to hospitals given the short five days’ notice of the change in reporting protocol and how HHS is working to ensure no gaps in reporting. House Select Subcommittee on the Coronavirus Chair Jim Clyburn (D-S.C.) sent a related letter to the CEO of TeleTracking last week, asking the company to explain how it won its contract and to provide more details about its relationship with the administration. Earlier this month, a letter to the Coronavirus Task Force leadership was sent by more than 100 public health, science, research and medical organizations urging that the administration reverse its decision.


Democrats Request Additional Community Health Center Support


A group of 50 congressional Democrats and Independents have sent a letter to the Trump administration asking for additional support for community health centers to counter the impact of the COVID-19 pandemic on providers caring for underserved communities. The letter, which was led by Rep. Ayanna Pressley (D-Mass.) and Sens. Elizabeth Warren (D-Mass.) and Bernie Sanders (I-Vt.), notes that community health centers have received a total of $2 billion from Congress to support COVID-19 testing and treatment but have not received a specific allocation from the Provider Relief Fund. The lawmakers also express support for including funding for health centers in the next coronavirus stimulus bill.


Provider Relief Fund Deadlines Extended


The CARES Act Provider Relief Fund has provided funding to assist providers who have increased expenses or revenue losses due to the COVID-19 pandemic. On Friday, the U.S. Department of Health and Human Services (HHS) announced the extension of key deadlines for the Fund. Specifically, Medicaid, CHIP, and dental providers, who previously had until August 3 to apply, now have an application deadline of August 28. In addition, starting the week of August 10, providers who previously missed the June 3 deadline for applying for the additional $20 billion distribution from the General Distribution can once again apply, with an application deadline of August 28. Finally, for providers who had a change of ownership such that they did not have tax documents for 2019 but have provided care to a potential COVID-19 case since the start of the public health emergency, those providers will also be eligible to apply for funding starting the week of August 10, with a deadline for the application of August 28. HHS also noted in its announcement that additional providers slated to receive funds include those that “may only bill commercially, or do not directly bill for the services they provide under the Medicare and Medicaid programs and thus did not receive any funding yet.”


HHS Clarifies Audit Requirements for the CARES Act Provider Relief Fund


I n implementing the CARES Act Provider Relief Fund, the U.S. Department of Health and Human Services (HHS) has clarified key polices in a series of frequently asked questions (FAQs). Recently, HHS updated its FAQs to provide clarity regarding the audit requirements for certain entities who received funds under the program.

In June 2020, the American Institute of Certified Public Accountant’s Governmental Audit Quality Center (GAQC) issued a document to summarize how Uniform Guidance applies (“Single Audit” or other audit requirements) to new federal programs established due to the COVID-19 pandemic (the Summary). In recent updates to the FAQs, HHS has clarified the application of the Single Audit for the Provider Relief Fund payments. Specifically, HHS notes that for all entities other than commercial, for-profit entities, the Single Audit applies if the entity otherwise expends $750,000 or more in federal awards. For the commercial, for-profit entities, the entity has two options – (1) Single Audit; or (2) “a financial audit conducted in accordance with Generally Accepted Government Auditing Standards (45 CFR 75.216).”

In general, the objectives of a financial audit conducted in accordance with Generally Accepted Government Auditing Standards are to provide an opinion on whether an entity’s financial statements are presented fairly and to report on the adequacy of internal controls. Single Audits have additional objectives, including a determination that the auditee has complied with federal statutes, regulations, and terms and conditions of federal awards.

In reviewing the audit processes, if a provider is subject to the requirements, it would be best to consult with an accountant about whether the audit should be limited to entity that received the funds or encompass the entire organization (i.e., parent and subsidiaries), given that the Provider Relief Fund FAQs are not clear on that matter.



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