The CARES Act Provider Relief Fund Payment Attestation Portal, signed into law on March 27, provides $100 billion in relief funds to healthcare providers on the front lines of the COVID-19 pandemic.

The funds can be distributed to any provider that received Medicare fee-for-service (FFS) reimbursements in 2019.

The CARES Act also updated federal confidentiality protections, making changes to 42 CFR Part 2. “Specifically, the CARES Act includes a provision to permanently align Part 2 with HIPAA [Health Insurance Portability and Accountability Act] for purposes of treatment, payment, and healthcare operations, with initial patient consent,” says Kathryn Spates, executive director of federal relations for The Joint Commission.

“As a member of the Partnership to Amend 42 CFR Part 2, a coalition of nearly 50 healthcare organizations that has worked to align Part 2 with HIPAA, The Joint Commission applauds the inclusion of the provision in the CARES Act,” Spates says. “This provision will help to reduce unintended treatment errors and ensure their substance use disorder patients receive safe, coordinated care.”

The CARES Act also carries a provision that requires the Department of Health and Human Services (HHS) to issue guidance on the sharing of protected health information during the COVID-19 crisis.

The Office for Civil Rights recently issued guidance for HIPAA-covered entities and associates on sharing protected health information during the public health emergency. Spates says both pieces of guidance will be helpful.

As Congress and the Trump administration consider future COVID-19 relief bills, it will be important to address the unique needs of rural healthcare facilities, Spates says.

“Prior to the coronavirus pandemic, rural healthcare facilities struggled with adequate staffing, medical equipment, and other medical supply needs,” she observes. “These resources are exacerbated by the coronavirus.”

For instance, rural hospitals might experience COVID-19 surges that result in these facilities receiving patient loads at a higher volume than they are accustomed. In turn, these facilities might not be able to deliver care to non-COVID-19 patients, which would reduce their revenue, Spates explains. “Future legislation must also address funding for the many challenges that skilled nursing facilities continue to face as they deal with the coronavirus,” Spates says. “Adequate supplies of personal protective equipment [PPE] is an issue for these facilities. Prior to the outbreak, they had the least PPE supplies relative to their patient populations.”

Rural facilities also do not have the resources, including appropriate experts, to handle major infectious disease outbreaks.

“Any future legislation must address maintaining a reserve of at last 60 days of supplies, including PPE, ventilators, and diagnostic supplies, so that healthcare facilities have resources to manage a second wave of coronavirus,” Spates argues. “The Joint Commission is advocating for future legislation to include funding a comprehensive, cross-facility, level-of-care, after-action report. Emergency preparedness experts consider it essential to conduct after-action reports to obtain lessons learned.”

An after-action report helps stakeholders avoid repeating future missteps and to incorporate best practices for dealing with similar disasters, she adds.

“Lastly, it will take a long time for the healthcare system to get back to business as usual,” Spates says. “There will be a backlog of surgical procedures and medical evaluations that will need to be scheduled, while the healthcare system continues to prepare for a potential second wave of the coronavirus. Healthcare organizations will need assistance during the tail end of the outbreak to recover to their normal operations and to deal with the backlog of deferred surgeries and other care.”