Press Releases

WASHINGTON – U.S. Sens. Mark R. Warner (D-VA) and Cory Booker (D-NJ) introduced legislation to reduce prescription drug costs for children, while bringing in savings for states. The Fair Drug Prices for Kids Act would give states the ability to purchase prescription drugs at the lowest price possible, lowering the cost of prescription drugs for children and saving state dollars.

“This commonsense legislation will improve health care for our nation’s children by allowing states that have standalone Children’s Health Insurance Programs get the same prescription drug discounts as traditional State Medicaid programs,” said Sen. Warner. “There’s no reason we should pay more for the drugs our kids depend on. This bill will fix that and improve care for the more than four million children nationally enrolled in a standalone CHIP program.”

“Health care – including access to affordable prescriptions drugs – is a fundamental right, but skyrocketing prescription drug prices drive up costs and threaten to limit access to coverage and care, including for our nation’s children,” said Sen. Booker. “Our bill will make important changes to bring down prescription drug costs for standalone CHIP programs, therefore strengthening these programs for the families who rely on them.”

The Children’s Health Insurance Program (CHIP) provides low-cost health coverage to low-income children who would otherwise be uninsured. Currently, states can either have a standalone CHIP that is separate from Medicaid, or they can expand Medicaid eligibility to achieve the same goal of providing health insurance to low-income children. States can also have a combination CHIP, where they receive federal funding to implement both, a Medicaid expansion program and a separate CHIP.

However, states that have a standalone CHIP are not allowed to participate in the Medicaid Drug Rebate program (MDRP), which allows state Medicaid programs to purchase products from drug manufacturers at “Medicaid best price” – the lowest price offered to any other commercial payer. This means that these states are forced to pay higher prices for the same prescription drugs, which can result in higher costs for families and reduced access to medicines and other forms of needed care.  

The CHIPS for Kids Act would give states the option of purchasing prescription drugs for their standalone CHIP through the Medicaid Drug Rebate Program. This would generate immediate savings for individual CHIP programs and the federal government, opening the door for states to use those excess dollars to ensure additional families and children have access to essential medical care and prescription drugs.

This legislation has the support of Patients for Affordable Drugs Now as well as Little Lobbyists.

“States and families across the country are suffering from the high prices of prescription drugs. Medicaid and CHIP make it possible for some families to get the medication they need to live,” said Sarah Kaminer Bourland, Legislative Director, Patients For Affordable Drugs Now. “The Fair Drug Prices for Kids Act will extend basic drug pricing provisions so all CHIP programs get the medication patients need at the lowest possible price. We are grateful to Senators Warner and Booker for introducing this important legislation.”

“All children have a right to the health care they need to survive and thrive. The Fair Drug Prices for Kids Act offers the 4.1 million children covered under separate CHIP programs more affordable access to the medications they need. Additionally, it frees up CHIP funds so that this critical program can be expanded to cover all families who are struggling to afford their children's health care. Little Lobbyists is proud to support the swift passage of the Fair Drug Prices for Kids Act,” said Erin Gabriel, Director of Advocacy, Little Lobbyists.

A one-page summary of the bill is available here, and bill text can be found here.

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WASHINGTON – Today, the Senate unanimously approved a bipartisan bill introduced by U.S. Sens. Mark R. Warner (D-VA) and John Boozman (R-AR) to help address the alarming rate of veteran suicide. Provisions of the IMPROVE Well-Being for Veterans Act, a bill to expand veterans’ access to mental health services, were included as part of the Commander John Scott Hannon Veterans Mental Health Care Improvement Act to help the Department of Veterans Affairs (VA) reduce veteran suicides.

“Today, Congress came together in a bipartisan fashion to make sure our veterans receive the tools and resources they need to heal from the invisible wounds of war. Right now, too many veterans still die by suicide long after having completed their tours of duty. This important legislation will help tackle the alarming rate of veteran suicide by ensuring our military heroes have the support they need after faithfully serving our country. It’s my hope that the President quickly signs this critical life-saving bill into law,” said Sen. Warner.

“We can’t take our focus off the veteran suicide crisis even with all that is going on in the world right now. In recent years, Congress has increased funding to reach at-risk veterans, yet the number who commit suicide each day has remained largely unchanged. It’s clear a new strategy is necessary and the approach that Senator Warner and I have proposed in this bill is a key part of that. Coordinating and sharing information between the VA and veteran-serving organizations that have the common goal to save lives will have a positive impact,” said Sen. Boozman.

The IMPROVE Well-Being for Veterans Act creates a new grant program to enable the VA to conduct additional outreach through veteran-serving non-profits in addition to state and local organizations. Additionally, the bipartisan bill enhances coordination and planning of veteran mental health and suicide prevention services and better measures the effectiveness of those programs in order to reduce the alarming number of veteran suicides.

The VA estimates that around 20 veterans die by suicide each day. Unfortunately that number has remained unchanged despite Congress more than tripling the VA’s funding for suicide prevention efforts over the last ten years to nearly $222 million in FY20.

Only six of the 20 veterans who die by suicide each day receive healthcare services from the VA before their death. That’s why Sens. Warner and Boozman are empowering the VA to share information with veteran-serving non-profits and requiring it to develop a tool to monitor progress so that resources can be concentrated on successful programs.

The IMPROVE Well-Being for Veterans Act was introduced in June 2019. Days later, at a committee hearing, VA Secretary Robert Wilkie called the bill “key” to unlocking the veteran suicide crisis. In January, provisions of the Warner-Boozman legislation were included in the Commander John Scott Hannon Veterans Mental Health Care Improvement Act, and the bill was unanimously approved by the Senate Veterans Affairs Committee. Additionally, the IMPROVE Well-being for Veterans Act was included as part of the President’s Roadmap to Empower Veterans and End a National Tragedy of Suicide (PREVENTS) Act, which was unveiled last month.

Sen. Warner has been a strong advocate of improving care for Virginia’s veterans. In January, he  sent a letter to the four VA medical facilities providing care for Virginia’s veterans requesting an update on their suicide prevention efforts. He’s also recently met with senior leadership at the Hunter Holmes McGuire VA Medical Center and Hampton VA Medical Center (VAMC) to discuss wait time reduction at their facilities and suicide prevention efforts.

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WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA) took to the Senate floor to request immediate passage of the States Achieve Medicaid Expansion (SAME) Act to allow states – including Virginia – to further benefit from expanding Medicaid, and to further incentivize states who have not yet expanded to do so. Immediately after Sen. Warner requested to pass the SAME Act by unanimous consent, Senate Republican objected and thereby blocked the immediate passage of this crucial legislation, which would have brought in additional federal Medicaid dollars for states during the greatest public health crisis in generations.

Sen. Warner’s request comes as the nation surpasses four million COVID-19 cases and Americans find themselves increasingly without health care after having lost their jobs and their employment-connected benefits.

“I can think of no better time to pass this legislation than right now, when more than 5 million Americans find themselves having lost their health care coverage in the last three months alone. In fact, some reports actually estimate that nearly 27 million Americans have lost their employer-sponsored health insurance and are now in jeopardy of becoming uninsured,” Sen. Warner said on the Senate floor. “Estimates show that if every state were to expand its Medicaid program, about 3 million additional Americans would have health care coverage. This is not a political argument nor a philosophical exercise – this legislation has a real-world impact and it’s clear that Americans want and need this legislation to pass.”

He continued, “Across our nation, Americans are making clear they want expanded access to health coverage – and Congress needs to listen. With all due respect to my Republican colleagues, you can’t say you want to help Americans in this devastating time and simultaneously oppose this bill, which would do just that. As we stand here in this chamber, we have the privilege of knowing that we and our families have access to the health care coverage we need. That if anything were to go wrong, we would be covered. So why shouldn’t we ensure that same access for more Americans?” 

The SAME Act would allow states like Virginia that expanded Medicaid after 2014 to receive the same full federal matching funds as states that expanded earlier under the terms of the Affordable Care Act. Under this legislation, the 14 states that have not expanded Medicaid would also be eligible for increased federal funds once they choose to expand the program. 

The Affordable Care Act provides financial support to states that have expanded their existing Medicaid programs to provide healthcare coverage to all individuals up to 138 percent of the federal poverty level. The federal government covers the full cost of expansion for three years, phasing down to a 90 percent match rate for the sixth year of the expansion and in subsequent years. Currently, states choosing to expand coverage after 2014 do not receive the same federal matching rates as those that expanded immediately. This is due to the Supreme Court’s holding in National Federation of Independent Business (NFIB) v. Sebelius, which made expansion optional for states, despite intentions to make Medicaid expansion national in 2014. The SAME Act would ensure that any states that expand Medicaid receive an equal level of federal funding for the expansion, regardless of when they chose to expand.

In his remarks, Sen. Warner noted the $14,000 median cost of a COVID-19-related hospitalization and stressed this cost could mean bankruptcy for the 30 million Americans without health insurance.  

“I know my colleagues on the other side of the aisle want to do right by their constituents and the millions of Americans that need help. So today, I ask you to come together to support the SAME Act,” stressed Sen. Warner. “No one should go bankrupt because they got sick and sought medical care. But more importantly, no one should go bankrupt when this legislative body has the opportunity to act. Let’s do the right thing here – put politics aside and pass this commonsense legislation.”

 

Sen. Warner’s floor remarks as originally prepared for delivery are available below:

Madam President, I rise today to talk about an issue that is weighing on too many American families right now, and that’s access to health care coverage. 

We’re in the midst of the greatest public health crisis in generations. And this unprecedented time calls for equally unprecedented action from this Congress.  

Today, I come to the floor to pass legislation I introduced along with Senator Doug Jones and several of our colleagues – legislation that could provide access to quality and affordable health care coverage for millions of Americans.

To be clear, the SAME Act is the bill I’ve been pushing for more than three years. This bill was a good idea before this pandemic, but the need for it has become even greater in light of the COVID-19 outbreak.

The SAME Act would ensure that states like Virginia – that have expanded their Medicaid programs to serve more Americans – can get their fair share of federal matching dollars. It would also incentivize additional states – who haven’t yet expanded Medicaid – to expand this critical program to millions more Americans. 

I can think of no better time to pass this legislation than right now, when more than 5 million Americans find themselves having lost their health care coverage in the last three months alone.

In fact, some reports actually estimate that nearly 27 million Americans have lost their employer-sponsored health insurance and are now in jeopardy of becoming uninsured.

My legislation would provide much-needed financial support to states that are seeing an increase in Medicaid enrollment, as folks face the fallout of this crisis. And for those millions of people, the SAME Act would provide a significant lifeline.

Estimates show that if every state were to expand its Medicaid program, about 3 million additional Americans would have health care coverage.

This is not a political argument nor a philosophical exercise – this legislation has a real-world impact and it’s clear that Americans want and need this legislation to pass. 

Take Oklahoma, for example. Just a few weeks ago, Oklahomans voted to expand their Medicaid program to provide broader access to coverage. We have seen similar actions from citizens in Utah, Maine, Idaho, and others. 

Across our nation – Americans are making clear they want expanded access to health coverage – and Congress needs to listen.

With all due respect to my Republican colleagues, you can’t say you want to help Americans in this devastating time and simultaneously oppose this bill, which would do just that.  

As we stand here in this chamber, we have the privilege of knowing that we and our families have access to the health care coverage we need. That if anything were to go wrong, we would be covered. So why shouldn’t we ensure that same access for more Americans? 

The median cost of a hospitalization due to COVID-19 is $14,000. For Americans without health insurance – the nearly 30 million and growing – that could mean losing their house or their car… It could mean bankruptcy. 

I know my colleagues on the other side of the aisle want to do right by their constituents and the millions of Americans that need help. So today, I ask you to come together to support the SAME Act.

No one should go bankrupt because they got sick and sought medical care. But more importantly, no one should go bankrupt when this legislative body has the opportunity to act.  

Let’s do the right thing here – put politics aside and pass this commonsense legislation. Thank you. 

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WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA) and Sen. Richard Blumenthal (D-CT), along with Sens. Michael Bennet (D-CO), Mazie Hirono (D-HI), Angus King (I-ME), Bob Menendez (D-NJ), Kamala Harris (D-CA), Ed Markey (D-MA), Cory Booker (D-NJ), Tammy Baldwin (D-WI), Elizabeth Warren (D-MA), Amy Klobuchar (D-MN), and Dick Durbin (D-IL), sent a letter to Senate leaders urging them to include the Public Health Emergency Privacy Act in the next coronavirus relief package as negotiations between Senate Republicans and Democrats are underway. Inclusion of the legislation will help strengthen the public’s trust to participate in critical screening and contact tracing efforts to aid in the fight against COVID-19.

“As you begin negotiations on another coronavirus stimulus package, we write to urge inclusion of commonsense privacy protections for COVID health data. Building public trust in COVID screening tools will be essential to ensuring meaningful participation in such efforts. With research consistently showing that Americans are reluctant to adopt COVID screening and tracing apps due to privacy concerns, the lack of health privacy protections could significantly undermine efforts to contain this virus and begin to safely re-open – particularly with many screening tools requiring a critical mass in order to provide meaningful benefits,” the Senators wrote in a letter to Senate Majority Leader Mitch McConnell, Senate Minority Leader Chuck Schumer, and the Chairman and Ranking Member of the Senate Committee on Health, Education, and Labor.

According to a recent survey, 84 percent of Americans feel uneasy about sharing their personal health information for COVID-19 related mitigation efforts. Public reluctance can be attributed to a myriad of investigative reports and congressional hearings that have exposed widespread secondary use of Americans data over the years. The Senators noted that with the inclusion of their bill, Congress can establish commonsense targeted rules to ensure the collection, retention, and use of data by COVID screening tools are focused on combatting COVID and not for extraneous, invasive, or discriminatory purposes.

“Our urgent and forceful response to COVID-19 can coexist with protecting and even bolstering our health privacy. If not appropriately addressed, these issues could lead to a breakdown in public trust that could ultimately thwart successful public health surveillance initiatives. Privacy experts, patient advocates, civil rights leaders, and public interest organizations have resoundingly called for strong privacy protections to govern technological measures offered in response to the COVID-19 crisis. In the absence of a federal privacy framework, experts and enforcers – including the Director of the Bureau of Consumer Protection of Federal Trade Commission – have encouraged targeted rules on this sensitive health data. The Public Health Emergency Privacy Act meets the needs raised by privacy and public health communities, and has been resoundingly endorsed by experts and civil society groups,” the Senators continued.

A copy of the letter can be found here and below.

 

Dear Leader McConnell, Leader Schumer, Chairman Alexander, and Ranking Member Murray,

As you begin negotiations on another coronavirus stimulus package, we write to urge inclusion of commonsense privacy protections for COVID health data. Building public trust in COVID screening tools will be essential to ensuring meaningful participation in such efforts. With research consistently showing that Americans are reluctant to adopt COVID screening and tracing apps due to privacy concerns, the lack of health privacy protections could significantly undermine efforts to contain this virus and begin to safely re-open – particularly with many screening tools requiring a critical mass in order to provide meaningful benefits. According to one survey, 84% of Americans “fear that data collection efforts aimed at helping to contain the coronavirus cost too much in the way of privacy.”

Public health experts have consistently pointed to health screening and contact tracing as essential elements of a comprehensive strategy to contain and eradicate COVID. Since the onset of the pandemic, employers, public venue operators, and consumer service providers have introduced a range tools and resources to engage in symptom monitoring, contact tracing, exposure notification, temperature checks, and location tracking. Increasingly, we have seen higher education institutions mandate the use of these applications for incoming students and employers mandate participation in these programs among employees.

Health data is among the most sensitive data imaginable and even before this public health emergency, there has been increasing bipartisan concern with gaps in our nation’s health privacy laws. While a comprehensive update of health privacy protections is unrealistic at this time, targeted reforms to protect health data – particularly with clear evidence that a lack of privacy protections has inhibited public participation in screening activities – is both appropriate and necessary.

Our legislation does not prohibit or otherwise prevent employers, service providers, or any other entity from introducing COVID screening tools. Rather, it provides commonsense and widely understood rules related to the collection, retention, and usage of that information – most notably, stipulating that sensitive data collected under the auspices of efforts to contain COVID should not be used for unrelated purposes. As a litany of investigative reports, Congressional hearings, and studies have increasingly demonstrated, the widespread secondary use of Americans’ data – including sensitive health and geolocation data – has become a significant public concern. The legislation also ensures that Americans cannot be discriminated against on the basis of COVID health data – something particularly important given the disproportionate impact of this pandemic on communities of color.

Efforts by public health agencies to combat COVID-19, such as manual contract tracing, health screenings, interviews, and case investigations, are not restricted by our bill. And the legislation would allow for the collection, use, and sharing of data for public health research purposes and makes clear that it does not restrict use of health information for public health or other scientific research associated with a public health emergency.

Our urgent and forceful response to COVID-19 can coexist with protecting and even bolstering our health privacy. If not appropriately addressed, these issues could lead to a breakdown in public trust that could ultimately thwart successful public health surveillance initiatives. Privacy experts, patient advocates, civil rights leaders, and public interest organizations have resoundingly called for strong privacy protections to govern technological measures offered in response to the COVID-19 crisis. In the absence of a federal privacy framework, experts and enforcers – including the Director of the Bureau of Consumer Protection of Federal Trade Commission – have encouraged targeted rules on this sensitive health data. The Public Health Emergency Privacy Act meets the needs raised by privacy and public health communities, and has been resoundingly endorsed by experts and civil society groups.

Providing Americans with assurance that their sensitive health data will not be misused will give Americans more confidence to participate in COVID screening efforts, strengthening our common mission in containing and eradicating COVID-19. For this reason, we urge you to include the privacy protections contained in the Public Health Emergency Privacy Act in any forthcoming stimulus package.

Thank you for your attention to this important matter.                                                                       

Sincerely,

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WASHINGTON – U.S. Senators Mark Warner (D–Va.) and Tim Scott (R–S.C.) introduced the Long-Term Care (LTC) Pharmacy Definition Act of 2020. This bipartisan legislation, if passed, will ensure seniors requiring long-term care have access to the medication and treatments they need. This bill would also codify an adaptable definition for “long-term care pharmacy” to enhance clarity and consistency across diverse programs and agencies. Without adding new costs to the healthcare system, a clear federal definition for LTC pharmacy would provide policymakers and regulators with the tools needed to facilitate the unique supports that these pharmacies offer, within both current models and the innovative models of the future.  

 "Long-term care pharmacies are essential to providing quality care to millions of our nation’s seniors. Unfortunately, under existing rules, they are regulated in the same way as more traditional retail pharmacies, which has created unnecessary bureaucracy around providing life-saving medication and services for a vulnerable population," said Sen. Warner. “That’s why we’re introducing legislation that will create a distinct definition for long-term care pharmacies to better reflect the specialized care they provide for the senior population they serve."

"This commonsense legislation would ensure clarity and consistency for our long-term care pharmacies without adding costs to our healthcare system," said Sen. Scott. “I urge my colleagues to support this bipartisan bill, which will make it easier for this important sector to navigate regulatory confusion and allow them to care and provide for our nation’s seniors."

Congressmen Markwayne Mullin (R-OK) and Kurt Schrader (R-OR) introduced companion legislation in the House of Representatives.

"Long Term Care Pharmacies provide critical services for seniors, who often require multiple prescriptions to maintain their health. Because there is no statuary definition for LTC Pharmacies, they must negotiate a patchwork of vague, inconsistent provisions, which could disrupt services and impact care for seniors. This commonsense legislation will help agencies give more consistent regulatory direction as well as streamline services to residents,” said Rep. Mullin.

"The personal services that long term care pharmacies provide seniors, many who take upwards of 10 medications per day, are critical for the health and wellness of millions of Americans,” said Rep. Schrader. "COVID-19 has had a disproportionate effect on this vulnerable population and now more than ever a consistent regulatory framework that defines long term care pharmacies is crucial. This bipartisan legislation will offer greater governmental oversight and create regulatory consistency across multiple federal agencies."

"Now more than ever, as the nation’s LTC community copes with the unprecedented impact of COVID-19, establishing a clear and consistent regulatory framework for LTC pharmacies is essential,” said Alan G. Rosenbloom, President and CEO of the Senior Care Pharmacy Coalition. “We commend Senators Scott and Warner as well as Congressmen Schrader and Mullin for recognizing the unique value proposition LTC pharmacies offer seniors in nursing homes and other LTC facilities by introducing this much-needed legislation. The patient care services LTC pharmacies provide, including the 12 prescriptions per day per person on average, are crucial to the health and safety of our most vulnerable citizens."

Full text of the bill is available here.

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WASHINGTON, D.C. – U.S. Sen. Mark R. Warner (D-Va.) joined Sens. Bob Menendez (D-N.J.), Ben Cardin (D-Md.) and group of Senate colleagues in introducing the COVID-19 Health Disparities Action Act to address the disproportionate impact of COVID-19 on communities of color. The bill would require  targeted testing, contract tracing, public awareness campaigns and outreach efforts specifically directed at racial and ethnic minority communities and other populations that have been made vulnerable to the COVID-19 pandemic.

“COVID-19 has had a particularly devastating impact on racial minorities across America,” said Sen. Menendez. “The fact is black and brown Americans suffer higher rates of chronic disease, inequitable access to health care, fewer economic opportunities, and in some cases real language barriers. Add to that the lack of testing, tracing and education efforts by the Trump Administration targeting communities of color during this pandemic and the impact is deadly. The COVID-19 Health Disparities Action Act would create a much needed plan of action specifically designed to address this issue at the federal, state and local levels.”

“COVID-19 has disproportionately impacted communities of color and the Trump administration’s response has failed to address the needs of these vulnerable populations,” said Sen. Cardin. “Health disparities for people of color is rooted in systemic racism, racial discrimination, and record-high levels of income inequality. The COVID-19 Health Disparities Action Act will ensure that future public health response efforts, including testing, contact tracing, and potential vaccine distributions are tailored for diverse communities. Our bill will help racial and ethnic minorities in the ongoing fight against this pandemic, and will help inform future reform efforts to reverse long-standing systemic racism in medical research, testing and delivery of care.”

According to the COVID Racial Data Tracker, the pandemic has a disproportionate impact on communities of color. Nationwide, African Americans are dying from COVID-19 at approximately 2.5 times the rate of white people. American Indian, Alaska Native, Hispanic, and Asian American communities are also facing disproportionate rates of COVID-19.

In New Jersey, 21.3 percent of COVID-19 deaths involve African Americans, although they make up just 14 percent of the state’s population. Hispanics account for 25.7 percent of COVID-19 cases despite making up 20.6 percent of the state’s population.

In Maryland, 40.6 percent of COVID-19 deaths involve African Americans, although they make up 30 percent of the state’s population. Hispanics account 25.9 percent of COVID-19 cases despite making up just 10 percent of the state’s population.

The bill is supported by Families USA, the National Hispanic Medical Association (NHMA), the National Alliance against Disparities in Patient Health (NADPH) the Friends of the National Institute on Minority Health and Health Disparities (NIMHD), the National Council of Urban Indian Health (NCUIH) and UnidosUS.

“Families USA thanks Senator Menendez and Senator Cardin for their leadership at such a critical time in our country and for championing health equity. The COVID-19 Health Disparities Action Act of 2020 centers the needs of historically marginalized communities who have been disproportionately impacted by COVID-19,” said Amber A. Hewitt, Ph.D., Director of Health Equity, Families USA. “This bill addresses the need for complete and accurate data collection on COVID-19 health outcomes, to better inform and tailor testing and contact tracing efforts, and eventually equitable distribution of a COVID-19 vaccine, which will be dependent upon culturally and linguistically appropriate messaging. This pandemic has not only exacerbated disparities in health and health care outcomes, but also health inequities, which are unjust and avoidable.”

“Latino communities continue to have high rates of infections, hospitalizations, and deaths from COVID-19. NHMA strongly supports the COVID-19 Health Disparities Action Act because it will support targeted strategies to reduce health disparities for COVID-19 and future public health emergencies,” said Elena Rios, MD, MSPH, FACP, President & CEO of the National Hispanic Medical Association.

“As the impact of COVID-19 health disparities has shown all too well, whether from a public health or an economic perspective, the effect of health disparities is a National crisis,” said Alex J. Carlisle, Ph.D.; Founder, Chair, & CEO, National Alliance against Disparities in Patient Health (NADPH). “By allocating resources to the communities most severely impacted by COVID-19, and the agencies and stakeholders with recognized and demonstrated commitments to serving these communities, the COVID-19 Health Disparities Action Act of 2020 provides the National leadership and response needed to help our Nation overcome this crisis.” 

The COVID-19 Health Disparities Action Act would:

  • Require the Trump Administration to develop an action plan to address the disproportionate impact of COVID-19 among racial and ethnic minority, rural, and other vulnerable populations.
  • Require states to revise testing and contact tracing plans to address racial and ethnic minority, rural, and other vulnerable populations experiencing health disparities related to COVID-19.
  • Authorize the development of targeted public awareness campaigns about COVID-19 symptoms, testing, and treatment directed at racial and ethnic minority, rural, and other socially vulnerable populations disproportionately impacted by COVID-19.
  • Ensure that federally funded contact-tracing efforts are tailored to the racial and ethnic diversity of local communities.  

Joining Sens. Warner, Menendez and Cardin as co-sponsors of the legislation are Sens. Elizabeth Warren (D-Mass.), Chris Van Hollen (D-Md.), Ed Markey (D-Ore.), Tina Smith (D-Minn.), Cory Booker (D-N.J.), Catherine Cortez Masto (D-Nev.), Jeff Merkley (D-Ore.), Mazie K. Hirono (D-Hawaii), Bernie Sanders (I-Vt.), Jeanne Shaheen (D-N.H.), Richard Blumenthal (D-Conn.), Jacky Rosen (D-Nev.), Kamala Harris (D-Calif.), Maggie Hassan (D-N.H.), and Amy Klobuchar (D-Minn.).

“We’ve seen that communities of color all over the country have been disproportionately affected by this pandemic. In many cases, these disparities have been exacerbated by factors like overrepresentation in front-line jobs, higher rates of chronic health conditions, inequitable access to health care, and bias within the health care system itself. That’s why we need to be doing everything possible to make sure the hardest hit communities have access to the targeted tools they need to respond to the COVID-19 crisis,” said Sen. Mark R. Warner.  

“Structural racism continues to plague our country, and its impact can be seen in the pandemic’s disproportionate toll on Black and Latino neighborhoods and in Indian Country,” said Sen. Warren. “Addressing the public health impacts of systemic racism must be at the very heart of the federal government's response to this pandemic, and that starts with quickly passing the COVID-19 Health Disparities Action Act.”

“COVID-19 has ravaged communities of color in Maryland and throughout our country. This pandemic has laid bare the deep-seated health and socioeconomic inequities that many Black and Latino Americans face and their deadly impacts. As they experience higher rates of COVID-19 and are disproportionately working on the front lines of the COVID response, it is unacceptable that the Trump Administration has no plan to tackle this crisis. Our bill will concentrate resources where they’re needed most and ensure that our response to COVID-19 is tailored to best reach these communities,” said Sen. Van Hollen.

“The coronavirus pandemic is a public health and economic crisis without precedent in our lifetimes, and it is abundantly clear that this virus has not only exposed, but also exacerbated, the deep, structural racial inequalities that have been taking the lives and livelihoods of people of color and Black Americans in particular for centuries,” said Sen. Booker. “Our bill seeks to create a much-needed national strategy for addressing the deadly disparities exacerbated by COVID-19 and any future public health crises by directing resources that are accessible and responsive to the communities that need them the most.”    

“Growing data on COVID-19 is making one thing clear: communities of color are being disproportionately affected by this pandemic,” said Sen. Cortez Masto. “Many are frontline workers who don’t have the luxury of working from home and for those who live in multigenerational homes, social distancing is nearly impossible. We cannot hope to get ahead of the curve without addressing the racial inequities that exist in how COVID-19 spreads and how we respond. This bill does exactly that by developing a different approach to COVID-19 to address the health disparities that exist in our communities.”

“The COVID-19 pandemic has laid bare the grim reality of persistent disparities in our health care system. Nationwide, racial and ethnic minorities have experienced higher rates of infection and worse health outcomes, and in Hawaii, our Pacific Islander community has been disproportionately impacted by the virus,” said Sen. Hirono. “This legislation takes important steps to address COVID-19 health disparities with a clear strategy to tailor testing, contact tracing, and outreach to communities of color.”

“COVID-19 has taken a particularly devastating toll on communities of color while the administration has failed at remedying this tragedy,” said Sen. Blumenthal. “I’m proud to co-sponsor this legislation to help address existing health disparities which have acutely exacerbated this crisis. This bill will ensure a robust investment in a public health approach tailored to communities of color and help combat deeply-rooted racism in medical research and the health care delivery system, strengthening our public health system for generations to come.”

“Longstanding inequities have caused communities of color to be disproportionately affected by the coronavirus,” said Sen. Rosen. “In Nevada, our state’s Latino population is being devastatingly impacted at a higher rate from COVID-19 than any other group. This legislation will help address racial and ethnic health disparities by increasing testing, contact tracing, and outreach to our most affected communities. We must take concrete steps to overcome these health inequalities now and for the future. I will continue working to protect the well-being of all Nevadans.”

“People of color represent 10 percent of New Hampshire’s population, but 25 percent of our COVID-19 cases – and similar health care disparities have existed for far too long,” Sen. Hassan said. “I recently spoke with public health leaders in New Hampshire about the racial disparities in health care outcomes and this legislation is a good first step to help address these unacceptable inequities in our health care system.” 

Earlier this year, Sen. Menendez called on the Trump Administration to do more to help minority communities that are seeing a disproportionately higher impact from the COVID-19 pandemic, and also urged pharmaceutical companies to include patients from diverse backgrounds in clinical trials for a COVID-19 vaccine.

The text of the bill can be downloaded here and a one pager is available here.

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Today, U.S. Sen. Mark R. Warner joined Sen. Patty Murray (D-WA) and 44 of her Democratic Senate colleagues in writing to Vice President Mike Pence, and Coronavirus Task Force Coordinator Dr. Deborah Birx, urging the Trump Administration to reverse recent changes requiring hospitals to report data to a new system set up by the Department of Health and Human Services instead of the National Healthcare Safety Network (NHSN) which is run by the Centers for Disease Control and Prevention (CDC) and has been in use for over a decade.

 “We write today to urge you to withdraw your confusing and harmful changes to hospital reporting requirements for Coronavirus Disease 2019 (COVID-19). In the midst of a global pandemic, these changes pose serious challenges to the nation’s response by increasing the data management burden for hospitals, potentially delaying critical supply shipments, compromising access to key data for many states, and reducing transparency for the public. The Trump Administration’s mismanagement of the COVID-19 response and refusal to heed public health expertise continue to put the country in a dangerous position,” write the Senators.

The letter the Senators sent today details how the sudden switch to the new system could undermine the COVID-19 response on several fronts: hospitals unable to switch within 48 hours could lose access to critical supplies; states who have built their own response and data systems on the NHSN could lose access to critical information; and the decision to circumvent CDC could lead to disruption in the data collected, questions about its accuracy, and hampered access for public health experts and the general public.

Before posing several questions to Administration about the shift, the Senators’ letter concludes, “Without adequate data, the country has been unable to appropriately adjust our response to COVID-19—a reality highlighted by the dearth of reliable data on the heavy burden of COVID-19 on communities of color and other vulnerable populations. The American people deserve to know the true scope of the pandemic, and that can only happen if public health experts lead in collecting and reporting data accurately and transparently. By abruptly changing the reporting process by requiring hospitals to report to HHS and circumventing CDC, we are concerned there will be a disruption in the data collected and questions about the accuracy of that data.”

The letter was also signed by Sens. Gary Peters (D-MI), Chuck Schumer (D-NY), Amy Klobuchar (D-MN), Richard Blumenthal (D-CT), Robert Menendez (D-NJ), Michael Bennet (D-CO), Sherrod Brown (D-OH), Tom Carper (D-DE), Bob Casey (D-PA), Dick Durbin (D-IL), Tammy Baldwin (D-WI), Ed Markey (D-MA), Tom Udall (D-NM), Jack Reed (D-RI), Ron Wyden (D-OR), Debbie Stabenow (D-MI), Tim Kaine (D-VA), Martin Heinrich (D-NM), Patrick Leahy (D-VT), Ben Cardin (D-MD), Jeanne Shaheen (D-NH), Elizabeth Warren (D-MA), Tina Smith (D-MN), Sheldon Whitehouse (D-RI), Angus King (I-ME), Bernie Sanders (I-VT), Cory Booker (D-NJ), Maria Cantwell (D-WA), Catherine Cortez Masto (D-NV), Kirsten Gillibrand (D-NY), Maggie Hassan (D-NH), Doug Jones (D-AL), Kamala Harris (D-CA), Chris Van Hollen (D-MD), Mazie Hirono (D-HI), Brian Schatz (D-HI), Chris Coons (D-DE), Jeff Merkley (D-OR), Chris Murphy (D-CT), Tammy Duckworth (D-IL), Jacky Rosen (D-NV), Jon Tester (D-MT), Dianne Feinstein (D-CA), and Joe Manchin (D-WV).

 

See the full text of the letter below. A PDF is available HERE.

July 17, 2020

The Honorable Michael R. Pence

Vice President of the United States

The White House

1600 Pennsylvania Avenue, NW

Washington, DC 20500

The Honorable Deborah Birx, M.D.

Coronavirus Task Force Coordinator

The White House

1600 Pennsylvania Avenue, NW

Washington, DC 20500

Dear Vice President Pence and Ambassador Birx,

We write today to urge you to withdraw your confusing and harmful changes to hospital reporting requirements for Coronavirus Disease 2019 (COVID-19). In the midst of a global pandemic, these changes pose serious challenges to the nation’s response by increasing the data management burden for hospitals, potentially delaying critical supply shipments, compromising access to key data for many states, and reducing transparency for the public. The Trump Administration’s mismanagement of the COVID-19 response and refusal to heed public health expertise continue to put the country in a dangerous position.

The Centers for Disease Control and Prevention (CDC) is the primary repository of the nation’s public health data, including data on COVID-19. Leading public health groups agree that CDC is “uniquely qualified to collect, analyze and disseminate information regarding infectious diseases.”[1] The agency’s National Healthcare Safety Network (NHSN), which has played a critical role in collecting public health data for fifteen years, is used in over 25,000 health care facilities across the United States for mandatory reporting of infection-related data and for voluntary use for quality improvement. NHSN’s COVID-19 reporting module for hospitals, which launched on March 27, 2020, enables facilities to submit data on cases, personnel, and supply shortages. Following the launch of the COVID-19 module, Vice President Pence and the Centers for Medicare and Medicaid Services (CMS) required both hospitals and nursing homes to report to NHSN. Within six weeks of its launch, over 60 percent of the nation’s hospitals were reporting daily through the NHSN COVID-19 module. As a result, many states have built their own COVID-19 data management systems on this NHSN data feed. 

Despite the CDC’s well-established reporting mechanism, in early April, the Assistant Secretary for Preparedness and Response (ASPR) issued a six-month contract for $10 million on a non-competitive basis to TeleTracking to create an alternate hospital reporting pathway to the Department of Health and Human Services (HHS).  The new system inexplicably created a second, duplicative mechanism through which hospitals could report the same information already collected through NHSN – this time managed by a private contractor.

On July 13, 2020, you directed hospitals to cease reporting data to NHSN and instead report to HHS via the newly established TeleTracking or HHS Protect systems within 48 hours, splitting out hospital reporting and nursing home reporting into separate systems. Your request states “[a]s of July 15, 2020, hospitals should no longer report the COVID-19 information in this document to the National Healthcare Safety Network site. Please select one of the above methods to use instead.” [2] You further unreasonably urged states to consider deploying the National Guard to the nation’s hospitals to support this data reporting change.[3]

The change in reporting mechanism that you have ordered will only exacerbate ongoing challenges to tracking COVID-19 data, which is already hampered by serious limitations in how data is collected, managed, reported, and disseminated.  Combined with insufficient testing capacity, this has led to an incomplete picture of the scope and impact of the COVID-19 pandemic in the United States. The CDC has indicated it believes the true number of cases in the country is 10 times higher than the official counts.[4]

The CARES Act, signed into law by President Trump on March 27, 2020, included $500 million for the CDC Data Modernization Initiative, to help CDC update, streamline, and scale up data collection. Rather than focusing on these critical efforts, however, the Trump Administration has chosen to instead reorganize and redirect data flow. This decision by the Administration to change the reporting process in the midst of a pandemic is deeply troubling. While there are certainly steps needed to improve public health data collection, waging interdepartmental jurisdictional battles to sideline our nation’s leading public health agency in the middle of an historic pandemic is bad management at best and malpractice at worst.

Rather than focusing on emergency response and patient care, hospitals must now spend precious time and resources changing their processes for reporting data.  You also announced that as soon as next week shipments of critical supplies that are in shortage, including personal protective equipment (PPE), will be based on data collected from these new systems. That means hospitals that are unable to change their reporting in under 48 hours may lose out on access to those critical supplies. Furthermore, the lack of transparency under the new data reporting requirements raises major concerns regarding their distribution. An opaque data collection mechanism invites political interference in processes and decisions that must be driven by data and public health.

Moreover, the abrupt change in data collection mechanisms threatens to leave states that rely on the NHSN data feeds in the dark about the spread of COVID-19 in their communities. By eliminating NHSN as the data source, and moving all federal hospital reporting to two systems that do not automatically share data or analytic reports created by CDC medical epidemiologists with states, the federal government is significantly undermining states’ ability to effectively respond to this crisis. This is unacceptable at any point in a pandemic – it is especially dangerous in a moment where cases are surging to unprecedented levels, with more than 66,000 new cases reported in the U.S. on July 15.[5] This Administration has repeatedly underscored the role and responsibility of states in responding to COVID-19, yet steps like these actively undermine states’ responses.

Without adequate data, the country has been unable to appropriately adjust our response to COVID-19—a reality highlighted by the dearth of reliable data on the heavy burden of COVID-19 on communities of color and other vulnerable populations. The American people deserve to know the true scope of the pandemic, and that can only happen if public health experts lead in collecting and reporting data accurately and transparently. By abruptly changing the reporting process by requiring hospitals to report to HHS and circumventing CDC, we are concerned there will be a disruption in the data collected and questions about the accuracy of that data.

The federal government must ensure data collection is led by public health experts, remains transparent and accurate, and is appropriately safeguarded. We urge that these changes to COVID-19 hospital reporting requirements be halted immediately.

Additionally, we request answers to the questions below about the decision to change data reporting requirements for hospitals. Please respond to the questions by July 31, 2020:

  1. What is the justification for requiring hospitals to change their reporting within 48 hours?
  2. What is the public health rationale for moving data collection from the CDC to HHS?
  3. Will HHS or TeleTracking now provide analytic reports of the hospital data to other federal government agencies, state health departments, and hospital facilities as CDC previously did?
  4. Will HHS or TeleTracking publicly report a portion of the hospital data as CDC previously did?
  5. To the extent HHS is limiting access to data or analytic reports for federal agencies, state health departments, hospital facilities, and/or the public, what is the justification for such limitations?
  6. How will data reported to HHS be transmitted to CDC to support ongoing holistic public health surveillance and analysis efforts of COVID-19 infections?
  7. Please detail any differences between the NHSN, TeleTracking, and HHS Protect systems on the basis of technological capability or data collected.
    1. Please explain why NHSN is insufficient to effectively collect and report relevant COVID-19 data.
    2. Is NHSN unable to determine any resource allotments or response activities for which TeleTracking or HHS Protect offers new capabilities?

                                                              i.      If so, what would be required to update NHSN in order to allow it to perform this function? Why was this not pursued?

                                                            ii.      If not, please explain the stated justification for these changes.

  1. Which office or entity will be in charge of managing the data at HHS?
  2. Please describe the steps the Administration is taking to ensure data is both accurate and readily available for CDC, states, public health departments, Congress, the research community, and the public.
  3. How will the Administration ensure a transparent data collection process?
  4. How will the Administration ensure improved collection of demographic data, including data broken down by race ethnicity, age, geography, disability status, sex (including sexual orientation and gender identity), and socioeconomic status?
  5. What funding is being used to support the new HHS data collection system?  Please include details about which COVID-19 emergency supplemental bill appropriated this funding and the justification for HHS to use it for this purpose.  Please also include estimated costs for developing and implementing this new system as well as any other related expenses, the plans for its long-term use, and projections for its annual costs. 

We look forward to your responses.

Sincerely,

 ###

 

WASHINGTON - Today, U.S. Sen. Mark R. Warner (D-VA) joined Sen. Patty Murray (D-WA), ranking member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, and 44 of their Democratic Senate colleagues in writing to Vice President Mike Pence, and Coronavirus Task Force Coordinator Dr. Deborah Birx, urging the Trump Administration to reverse recent changes requiring hospitals to report data to a new system set up by the Department of Health and Human Services instead of the National Healthcare Safety Network (NHSN) which is run by the Centers for Disease Control and Prevention (CDC) and has been in use for over a decade.  

“We write today to urge you to withdraw your confusing and harmful changes to hospital reporting requirements for Coronavirus Disease 2019 (COVID-19). In the midst of a global pandemic, these changes pose serious challenges to the nation’s response by increasing the data management burden for hospitals, potentially delaying critical supply shipments, compromising access to key data for many states, and reducing transparency for the public. The Trump Administration’s mismanagement of the COVID-19 response and refusal to heed public health expertise continue to put the country in a dangerous position,” write the Senators.

Earlier this year, Senator Murray wrote to the Trump Administration questioning its decision to award a $10 million non-competitive contract to develop a duplicative data system—the system which the Administration is now requiring hospitals switch to in place of NHSN, justifying the change as necessary to reduce duplicative hospital reporting that this Administration itself created. The Administration has yet to respond to her letter or explain how the new system differs from NHSN or improves reporting.

The letter the Senators sent today details how the sudden switch to the new system could undermine the COVID-19 response on several fronts: hospitals unable to switch within 48 hours could lose access to critical supplies; states who have built their own response and data systems on the NHSN could lose access to critical information; and the decision to circumvent CDC could lead to disruption in the data collected, questions about its accuracy, and hampered access for public health experts and the general public.

Before posing several questions to Administration about the shift, the Senators’ letter concludes, “Without adequate data, the country has been unable to appropriately adjust our response to COVID-19—a reality highlighted by the dearth of reliable data on the heavy burden of COVID-19 on communities of color and other vulnerable populations. The American people deserve to know the true scope of the pandemic, and that can only happen if public health experts lead in collecting and reporting data accurately and transparently. By abruptly changing the reporting process by requiring hospitals to report to HHS and circumventing CDC, we are concerned there will be a disruption in the data collected and questions about the accuracy of that data.”

The letter was also signed by Senators Gary Peters (D-MI), Chuck Schumer (D-NY), Amy Klobuchar (D-MN), Richard Blumenthal (D-CT), Robert Menendez (D-NJ), Michael Bennet (D-CO), Sherrod Brown (D-OH), Tom Carper (D-DE), Bob Casey (D-PA), Dick Durbin (D-IL), Tammy Baldwin (D-WI), Ed Markey (D-MA), Tom Udall (D-NM), Jack Reed (D-RI), Ron Wyden (D-OR), Debbie Stabenow (D-MI), Tim Kaine (D-VA), Martin Heinrich (D-NM), Patrick Leahy (D-VT), Ben Cardin (D-MD), Jeanne Shaheen (D-NH), Elizabeth Warren (D-MA), Tina Smith (D-MN), Sheldon Whitehouse (D-RI), Angus King (I-ME), Bernie Sanders (I-VT), Cory Booker (D-NJ), Maria Cantwell (D-WA), Catherine Cortez Masto (D-NV), Kirsten Gillibrand (D-NY), Maggie Hassan (D-NH), Doug Jones (D-AL), Kamala Harris (D-CA), Chris Van Hollen (D-MD), Mazie Hirono (D-HI), Brian Schatz (D-HI), Chris Coons (D-DE), Jeff Merkley (D-OR), Chris Murphy (D-CT), Tammy Duckworth (D-IL), Jacky Rosen (D-NV), Jon Tester (D-MT), Dianne Feinstein (D-CA), and Joe Manchin (D-WV).

See the full text of the letter below. A PDF is available HERE.

July 17, 2020

The Honorable Michael R. Pence

Vice President of the United States

The White House

1600 Pennsylvania Avenue, NW

Washington, DC 20500

The Honorable Deborah Birx, M.D.

Coronavirus Task Force Coordinator

The White House

1600 Pennsylvania Avenue, NW

Washington, DC 20500 

Dear Vice President Pence and Ambassador Birx,

We write today to urge you to withdraw your confusing and harmful changes to hospital reporting requirements for Coronavirus Disease 2019 (COVID-19). In the midst of a global pandemic, these changes pose serious challenges to the nation’s response by increasing the data management burden for hospitals, potentially delaying critical supply shipments, compromising access to key data for many states, and reducing transparency for the public. The Trump Administration’s mismanagement of the COVID-19 response and refusal to heed public health expertise continue to put the country in a dangerous position.

The Centers for Disease Control and Prevention (CDC) is the primary repository of the nation’s public health data, including data on COVID-19. Leading public health groups agree that CDC is “uniquely qualified to collect, analyze and disseminate information regarding infectious diseases.”[1] The agency’s National Healthcare Safety Network (NHSN), which has played a critical role in collecting public health data for fifteen years, is used in over 25,000 health care facilities across the United States for mandatory reporting of infection-related data and for voluntary use for quality improvement. NHSN’s COVID-19 reporting module for hospitals, which launched on March 27, 2020, enables facilities to submit data on cases, personnel, and supply shortages. Following the launch of the COVID-19 module, Vice President Pence and the Centers for Medicare and Medicaid Services (CMS) required both hospitals and nursing homes to report to NHSN. Within six weeks of its launch, over 60 percent of the nation’s hospitals were reporting daily through the NHSN COVID-19 module. As a result, many states have built their own COVID-19 data management systems on this NHSN data feed. 

Despite the CDC’s well-established reporting mechanism, in early April, the Assistant Secretary for Preparedness and Response (ASPR) issued a six-month contract for $10 million on a non-competitive basis to TeleTracking to create an alternate hospital reporting pathway to the Department of Health and Human Services (HHS).  The new system inexplicably created a second, duplicative mechanism through which hospitals could report the same information already collected through NHSN – this time managed by a private contractor.

On July 13, 2020, you directed hospitals to cease reporting data to NHSN and instead report to HHS via the newly established TeleTracking or HHS Protect systems within 48 hours, splitting out hospital reporting and nursing home reporting into separate systems. Your request states “[a]s of July 15, 2020, hospitals should no longer report the COVID-19 information in this document to the National Healthcare Safety Network site. Please select one of the above methods to use instead.” [2] You further unreasonably urged states to consider deploying the National Guard to the nation’s hospitals to support this data reporting change.[3] 

The change in reporting mechanism that you have ordered will only exacerbate ongoing challenges to tracking COVID-19 data, which is already hampered by serious limitations in how data is collected, managed, reported, and disseminated.  Combined with insufficient testing capacity, this has led to an incomplete picture of the scope and impact of the COVID-19 pandemic in the United States. The CDC has indicated it believes the true number of cases in the country is 10 times higher than the official counts.[4]

The CARES Act, signed into law by President Trump on March 27, 2020, included $500 million for the CDC Data Modernization Initiative, to help CDC update, streamline, and scale up data collection. Rather than focusing on these critical efforts, however, the Trump Administration has chosen to instead reorganize and redirect data flow. This decision by the Administration to change the reporting process in the midst of a pandemic is deeply troubling. While there are certainly steps needed to improve public health data collection, waging interdepartmental jurisdictional battles to sideline our nation’s leading public health agency in the middle of an historic pandemic is bad management at best and malpractice at worst.  

Rather than focusing on emergency response and patient care, hospitals must now spend precious time and resources changing their processes for reporting data.  You also announced that as soon as next week shipments of critical supplies that are in shortage, including personal protective equipment (PPE), will be based on data collected from these new systems. That means hospitals that are unable to change their reporting in under 48 hours may lose out on access to those critical supplies. Furthermore, the lack of transparency under the new data reporting requirements raises major concerns regarding their distribution. An opaque data collection mechanism invites political interference in processes and decisions that must be driven by data and public health. 

Moreover, the abrupt change in data collection mechanisms threatens to leave states that rely on the NHSN data feeds in the dark about the spread of COVID-19 in their communities. By eliminating NHSN as the data source, and moving all federal hospital reporting to two systems that do not automatically share data or analytic reports created by CDC medical epidemiologists with states, the federal government is significantly undermining states’ ability to effectively respond to this crisis. This is unacceptable at any point in a pandemic – it is especially dangerous in a moment where cases are surging to unprecedented levels, with more than 66,000 new cases reported in the U.S. on July 15.[5]This Administration has repeatedly underscored the role and responsibility of states in responding to COVID-19, yet steps like these actively undermine states’ responses.

Without adequate data, the country has been unable to appropriately adjust our response to COVID-19—a reality highlighted by the dearth of reliable data on the heavy burden of COVID-19 on communities of color and other vulnerable populations. The American people deserve to know the true scope of the pandemic, and that can only happen if public health experts lead in collecting and reporting data accurately and transparently. By abruptly changing the reporting process by requiring hospitals to report to HHS and circumventing CDC, we are concerned there will be a disruption in the data collected and questions about the accuracy of that data.

The federal government must ensure data collection is led by public health experts, remains transparent and accurate, and is appropriately safeguarded. We urge that these changes to COVID-19 hospital reporting requirements be halted immediately. 

Additionally, we request answers to the questions below about the decision to change data reporting requirements for hospitals. Please respond to the questions by July 31, 2020:

1.       What is the justification for requiring hospitals to change their reporting within 48 hours?

2.      What is the public health rationale for moving data collection from the CDC to HHS?

3.      Will HHS or TeleTracking now provide analytic reports of the hospital data to other federal government agencies, state health departments, and hospital facilities as CDC previously did?

4.      Will HHS or TeleTracking publicly report a portion of the hospital data as CDC previously did?

5.      To the extent HHS is limiting access to data or analytic reports for federal agencies, state health departments, hospital facilities, and/or the public, what is the justification for such limitations? 

6.      How will data reported to HHS be transmitted to CDC to support ongoing holistic public health surveillance and analysis efforts of COVID-19 infections?

7.      Please detail any differences between the NHSN, TeleTracking, and HHS Protect systems on the basis of technological capability or data collected.

a.      Please explain why NHSN is insufficient to effectively collect and report relevant COVID-19 data.

b.      Is NHSN unable to determine any resource allotments or response activities for which TeleTracking or HHS Protect offers new capabilities?

                                                              i.      If so, what would be required to update NHSN in order to allow it to perform this function? Why was this not pursued?

                                                           ii.      If not, please explain the stated justification for these changes.

8.     Which office or entity will be in charge of managing the data at HHS?

9.      Please describe the steps the Administration is taking to ensure data is both accurate and readily available for CDC, states, public health departments, Congress, the research community, and the public.

10.  How will the Administration ensure a transparent data collection process?

11.   How will the Administration ensure improved collection of demographic data, including data broken down by race ethnicity, age, geography, disability status, sex (including sexual orientation and gender identity), and socioeconomic status?

12.  What funding is being used to support the new HHS data collection system?  Please include details about which COVID-19 emergency supplemental bill appropriated this funding and the justification for HHS to use it for this purpose.  Please also include estimated costs for developing and implementing this new system as well as any other related expenses, the plans for its long-term use, and projections for its annual costs. 

We look forward to your responses.

Sincerely,

###

WASHINGTON – U.S. Sen. Mark R. Warner (D-Va) joined Sen. Tammy Baldwin (D-WI) in an amendment to the National Defense Authorization Act of 2021 (NDAA) that would require President Trump to unlock the full authority and power of the Defense Production Act to scale up nation-wide production of the testing supplies, personal protective equipment, and medical equipment needed at the local level to address the ongoing COVID-19 pandemic.

“New coronavirus cases are rising in states across the country, which means we need more testing supplies, more testing, and more personal protective equipment for workers on the frontlines of this pandemic,” said Senator Baldwin. “President Trump’s response to this pandemic has been a failure of leadership, so this amendment will force action to increase national production of testing supplies, personal protective equipment, and medical equipment needed to save lives.”

The amendment includes legislation she introduced in April with Senator Chris Murphy (D-CT). The Medical Supply Transparency and Delivery Act requires the president to utilize all available authorities under the Defense Production Act to mobilize a federal response to the pandemic through an equitable and transparent process. Key parts of Baldwin’s legislation are included in the House-passed HEROES Act, but the Republican majority in the Senate has failed to take action on the legislation.

In addition to Sen. Warner, the amendment is cosponsored by Senate Democratic Leader Chuck Schumer (D-NY) and Senators Chris Murphy (D-CT), Michael Bennet (D-CO), Richard Blumenthal (D-CT), Cory Booker (D-NJ), Sherrod Brown (D-OH), Tammy Duckworth (D-IL), Dick Durbin (D-IL), Kamala D. Harris (D-CA), Maggie Hassan (D-NH), Mazie Hirono (D-HI), Doug Jones (D-AL), Tim Kaine (D-VA), Amy Klobuchar (D-MN), Joe Manchin (D-WV), Ed Markey (D-MA), Jeff Merkley (D-OR), Bob Menendez (D-NJ), Brian Schatz (D-HI), Jeanne Shaheen (D-NH), Debbie Stabenow (D-MI), Jacky Rosen (D-NV), and Elizabeth Warren (D-MA). 

The NDAA is being considered on the Senate floor this week.

The full amendment is available here.

 

###

WASHINGTON, D.C. – U.S. Senators Mark R. Warner and Tim Kaine cosponsored an amendment to the National Defense Authorization Act of 2021 (NDAA) that would require President Trump to unlock the full authority and power of the Defense Production Act to scale up nationwide production of the testing supplies, personal protective equipment, and medical equipment needed at the local level to address the ongoing COVID-19 pandemic.

“As coronavirus cases continue to rise throughout Virginia and the country, it’s vital that we continue pushing for more testing and personal protective equipment,”  the Senators said. “Several months into this crisis, the Administration has failed to protect Americans. This amendment will help ensurewe have the resources needed to save American lives."   

The amendment includes the Medical Supply Transparency and Delivery Act, legislation the Senators cosponsored to require the president to utilize all available authorities under the Defense Production Act to mobilize a federal response to the pandemic through an equitable and transparent process. Key parts of the legislation are included in the House-passed HEROES Act, but the Republican majority in the Senate has failed to take action on the legislation.

The amendment, led by U.S. Senator Tammy Baldwin, is also cosponsored by Senate Democratic Leader Chuck Schumer (D-NY) and Senators Chris Murphy (D-CT), Michael Bennet (D-CO), Richard Blumenthal (D-CT), Cory Booker (D-NJ), Sherrod Brown (D-OH), Tammy Duckworth (D-IL), Dick Durbin (D-IL), Kamala D. Harris (D-CA), Maggie Hassan (D-NH), Mazie Hirono (D-HI), Doug Jones (D-AL), Amy Klobuchar (D-MN), Joe Manchin (D-WV), Ed Markey (D-MA), Jeff Merkley (D-OR), Bob Menendez (D-NJ), Brian Schatz (D-HI), Jeanne Shaheen (D-NH), Debbie Stabenow (D-MI), Jacky Rosen (D-NV), and Elizabeth Warren (D-MA).

The NDAA is being considered on the Senate floor this week. 

The full amendment is available here.

###

WASHINGTON – Today, U.S. Sens. Mark R. Warner and Tim Kaine (both D-VA) joined Sen. Jon Tester (D-MT) and 44 Senate colleagues in introducing a resolution officially condemning the Trump Administration’s “reckless” effort to dismantle the Affordable Care Act (ACA), which provides coverage for millions of Americans. The Senate resolution also demands that the Department of Justice (DOJ) defend existing law in court and halt its efforts to repeal the health care protections for millions – including 133 million Americans with pre-existing conditions— in the middle of a public health emergency.

“The Trump Administration has made it clear that it will not stop its assault on our nation’s health care law until millions of Americans have lost the protections and coverage they desperately need,” said Sen. Warner. “This resolution affirms what we have said for years – that this Administration’s efforts to dismantle the Affordable Care Act are despicable and put too many vulnerable Virginians at risk. The Department of Justice must immediately put a stop to these efforts and fight to increase access to health care during the largest public health crisis in a generation.” 

“To rip health care away from millions of people during a pandemic would be like dousing a fire with gasoline,” said Kaine. “For the sake of the more than 431,000 Virginians benefiting from Medicaid expansion, more than 3 million Virginians with pre-existing conditions, and all else who rely on the ACA for affordable coverage and consumer protections, I oppose this administration’s latest display of inept cruelty.” 

Last week, the DOJ and a group of Republican Attorneys General submitted a brief to the U.S. Supreme Court urging it to invalidate the ACA and pull the rug out from underneath the millions of Americans with preexisting conditions who depend on the law for health care coverage. This move would take away health care coverage for more than 23 million Americans who receive health care coverage through the ACA marketplaces.

Additionally, if the Supreme Court agrees to overturn the ACA, it could sabotage protections for more than 3 million Virginians living with a preexisting condition such as COVID-19, diabetes, asthma, or cancer, potentially exposing them to annual or lifetime caps, medical underwriting for their insurance coverage, or denials for the care they need. Across the board, the Commonwealth could lose needed federal funds, causing significant job losses and jeopardizing the viability of Virginia’s rural hospitals in the midst of a global health crisis.

The resolution urges DOJ to reverse its position and instead protect the millions of people who rely on the ACA for health care coverage amid the COVID-19 pandemic that has infected more than 2.4 million Americans.

In addition to Sens. Warner, Kaine and Tester, the resolution is also backed by Sens. Jeanne Shaheen (D-NH), Joe Manchin (D-WV), Doug Jones (D-AL), Tina Smith (D-MN), Mazie Hirono (D-HI), Jack Reed (D-RI), Chris Van Hollen (D-MD), Catherine Cortez Masto (D-NV), Tammy Baldwin (D-WI), Sherrod Brown (D-OH), Michael Bennet (D-CO), Tom Carper (D-DE), Dick Blumenthal (D-CT), Ed Markey (D-MA), Dick Durbin (D-IL), Kamala Harris (D-CA), Ben Cardin (D-MD), Patty Murray (D-WA), Jacky Rosen (D-NV), Debbie Stabenow (D-MI), Chris Murphy (D-CT), Ron Wyden (D-OR), Maggie Hassan (D-NH), Gary Peters (D-MI), Amy Klobuchar (D-MN), Martin Heinrich (D-NM), Elizabeth Warren (D-MA), Kyrsten Sinema (D-AZ), Angus King (I-ME), Tom Udall (D-NM), Sheldon Whitehouse (D-RI), Bob Menendez (D-NJ), Dianne Feinstein (D-CA), Brian Schatz (D-HI), Chris Coons (D-DE), Patrick Leahy (D-VT), Bernie Sanders (I-VT), Cory Booker (D-NJ), Kirsten Gillibrand (D-NY), Jeff Merkley (D-OR), Maria Cantwell (D-WA), Bob Casey (D-PA), Tammy Duckworth (D-IL) and Chuck Schumer (D-NY).

In the Senate, Sens. Warner and Kaine have fought for expanded access to health care and have spoken out against the Trump Administration’s attempts to overturn the ACA. Last year, Sen. Warner led and Sen. Kaine joined a legislative maneuver to protect health coverage for Americans with preexisting conditions. The Senators have also demanded that the Trump Administration stop the health care sabotage that has undermined our preparedness and ability to respond to COVID-19. Recently, Sen. Warner penned an op-ed sounding the alarm of the devastating effects the health and economic crisis caused by COVID-19 has had on record high uninsured rates across the country.  

The full text of the resolution is available here.

###

WASHINGTON – After the Trump Administration filed its brief in the Texas v US lawsuit to strike down the Affordable Care Act (ACA), U.S. Sen. Mark R. Warner (D-VA) released the following statement blasting the Trump Administration for its efforts to take away health care coverage for more than 23 million Americans who receive health care coverage through the ACA marketplaces and sabotage protections for more than 3 million Virginians living with a preexisting condition in the middle of a health pandemic: 

“The President has completely failed to contain the virus, and now he is asking the Supreme Court to make the consequences as painful as possible for millions of Americans.  

“The Trump Administration's lawsuit would kick millions of Americans off their insurance and end protections for preexisting conditions in the middle of a pandemic. This deadly mixture of cruelty and Presidential incompetence puts the lives of countless Americans at risk.

Since taking office, President Trump has sought to undermine the success of the Affordable Care Act, which protects more than 3 million Virginians with preexisting conditions like COVID-19, diabetes, asthma, or cancer from discrimination or being kicked off of their insurance. In the Senate, Sen. Warner has been a longtime champion of access to health care, and has been outspoken about the Trump Administration’s efforts to overturn the Affordable Care Act in court. Last year, Sen. Warner led the entire Senate Democratic Caucus in a legislative maneuver to protect health coverage for Americans with preexisting conditions from the Trump Administration’s attempts to undermine those safeguards. Amid the coronavirus health crisis, Sen. Warner has been a fierce advocate in demanding that the Trump Administration stop its health care sabotage that has undermined our preparedness for and ability to respond to COVID-19. Recently, Sen. Warner penned an op-ed sounding the alarm of the devastating effects the health and economic crisis caused by COVID-19 has had on record high uninsured rates across the country. 

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WASHINGTON, D.C. – U.S. Senators Mark R. Warner and Tim Kaine (both D-VA) joined Senators Brian Schatz (D-HI) and Roger Wicker (R-MS) in calling for the expansion of access to telehealth services during the COVID-19 pandemic to be made permanent. Provisions from the CONNECT for Health Act, legislation cosponsored by Senators Warner and Kaine, that have allowed Medicare beneficiaries in all areas of the country to utilize telehealth services from home, as well as more types of health care providers to provide telehealth, were included in previous COVID-19 legislation. However, without urgent congressional action to make these measures permanent, these telehealth services are at risk of expiring when the pandemic ends.  

“Americans have benefited significantly from this expansion of telehealth and have come to rely on its availability,” the Senators wrote in a letter to Senator Majority Leader Mitch McConnell (R-KY) and Senate Minority Leader Chuck Schumer (D-NY). “Congress should expand access to telehealth services on a permanent basis so that telehealth remains an option for all Medicare beneficiaries both now and after the pandemic. Doing so would assure patients that their care will not be interrupted when the pandemic ends. It would also provide certainty to health care providers that the costs to prepare for and use telehealth would be a sound long-term investment.” 

In their letter, the Senators highlight the growing use and benefits of telehealth during the ongoing coronavirus pandemic, as patients seek to avoid traveling to hospitals and other providers and instead receive care at home. New data shows that the number of Medicare beneficiaries using telehealth services increased by 11,718 percent in just a month and a half during the pandemic.

The full text of the letter is below and available here. 

Dear Majority Leader McConnell and Minority Leader Schumer:

As you continue your work on critical legislation to respond to the COVID-19 crisis, we write to ask that you make permanent the provisions from our bipartisan CONNECT for Health Act that were included in previous COVID-19 legislation.  These provisions have resulted in an important expansion of access to telehealth services for Medicare beneficiaries during the pandemic. 

We have long advocated for increasing access to telehealth because of its potential to expand access to health care, reduce costs, and improve health outcomes.  Telehealth has proven to be pivotal for many patients during the current pandemic, ensuring they receive the care they need while reducing the risk of infection and the further spread of COVID-19.  We have all heard from our constituents about how effective and convenient it is.  Expanded Medicare coverage of telehealth services on a permanent basis—where clinically appropriate and with appropriate guardrails and beneficiary protections in place—would ensure that telehealth continues to be an option for all Medicare beneficiaries after the pandemic ends.

As you know, the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 and the Coronavirus Aid Relief and Economic Security Act included provisions from the CONNECT for Health Act to increase access to telehealth services for Medicare beneficiaries during the COVID-19 pandemic.  Specifically, these laws provide the Secretary of Health and Human Services the authority to waive telehealth requirements under Section 1834(m) of the Social Security Act, allow Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to provide distant site telehealth services, and allow for the use of telehealth to conduct the face-to-face visit required to recertify a patient’s eligibility for hospice care. 

Because of these new authorities provided by Congress, Medicare has expanded coverage of telehealth services for the duration of the pandemic to include all areas of the country—as well as allowing a patient’s home to serve as an originating site for telehealth.  In addition, more types of health care providers—including FQHCs and RHCs that provide primary care in rural and underserved areas—are able to furnish and bill Medicare for telehealth services.  These changes have already contributed to a dramatic increase in the use of telehealth services in Medicare.  Available data show that the number of Medicare beneficiaries using telehealth services during the pandemic increased 11,718 percent in just a month and a half.

Americans have benefited significantly from this expansion of telehealth and have come to rely on its availability.  Congress should expand access to telehealth services on a permanent basis so that telehealth remains an option for all Medicare beneficiaries both now and after the pandemic.  Doing so would assure patients that their care will not be interrupted when the pandemic ends.  It would also provide certainty to health care providers that the costs to prepare for and use telehealth would be a sound long-term investment. 

In addition, given the recent flexibilities provided by both Congress and the Centers for Medicare & Medicaid Services and the increased use of telehealth during the pandemic, we believe now is an important time to measure the impact of telehealth on Medicare.  Specifically, the federal government should collect and analyze data on the impact of telehealth on utilization, quality, health outcomes, and spending during the COVID-19 pandemic.  There is currently a scarcity of data available regarding the impact of telehealth on the Medicare program.  This data would assist Congress in crafting additional policies to improve health outcomes and use resources more effectively.

Thank you for your continued leadership during the present crisis.  We look forward to continuing to work together to increase access to telehealth.

Sincerely, 

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WASHINGTON – Today, U.S. Sens. Mark R. Warner (D-VA), Doug Jones (D-AL), Richard J. Durbin (D-IL) and Jeanne Shaheen (D-NH), led 35 of their Senate colleagues in urging House and Senate leaders to ensure that any upcoming COVID-19 relief bill include strong provisions to expand access to quality and affordable health care coverage in the wake of this public health crisis. In their letter, the Senators called for a bipartisan effort to increase the federal government’s share of Medicaid dollars as well as reduce premiums for individuals who are eligible for coverage in the Affordable Care Act (ACA) exchanges. 

This letter follows the May 15th House passage of the Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act, which creates critical pathways to health care coverage by ensuring newly unemployed Americans can remain in their previously elected employer-sponsored plans, and strengthens states’ ability to provide Medicaid coverage and other key provisions.

“The COVID-19 pandemic has had an extraordinary impact on every facet of our society and resulted in tremendous job loss, financial uncertainty and reduced access to health care coverage at a time when Americans can least afford it,” wrote the Senators. “We strongly believe that an unprecedented global health crisis of this nature deserves equally unprecedented action from Congress to ensure that Americans have continued access to the health care services they need.”

“We strongly encourage Republicans and Democrats to work together to build upon efforts in the HEROES Act by further enhancing the Medicaid federal medical assistance percentages (FMAP) to ensure continued and comprehensive coverage for enrollees, sustain Medicaid programs in states that have expanded their program, incentivize additional states to expand their Medicaid programs and provide payment to states that have already expanded their Medicaid programs, but have not received their full share of enhanced payments in the past,” they continued. “Prior to the COVID-19 pandemic, an estimated 2.3 million Americans were without health care coverage because their states had not expanded Medicaid – a number that is sure to grow in the coming months. Targeting additional funding to the Medicaid expansion population could ensure health care insurance for millions of additional Americans that might otherwise not have access to it.”

According to a Kaiser Family Foundation study, nearly 27 million people could lose their employer-sponsored health insurance as a result of losing their job – adding to the existing 27 million Americans who were already uninsured prior to the COVID-19 crisis.

In their letter, the Senators also called for House and Senate leaders to secure provisions that reduce premium payments for individuals who are eligible for coverage under the Affordable Care Act (ACA) exchanges – a move that would help middle-income Americans find a quality insurance plan on the exchange and increase health care enrollment by more than 1 million Americans, according to the Commonwealth Fund

Sens. Warner, Jones, Durbin and Shaheen were joined in this letter by Sens. Thomas R. Carper (D-DE), Michael F. Bennet (D-CO), Tammy Baldwin (D-WI), Tina Smith (D-MN), Sheldon Whitehouse (D-RI), Richard Blumenthal (D-CT), Tim Kaine (D-VA), Jeffrey A. Merkley (D-OR), Margaret Wood Hassan (D-NH), Debbie Stabenow (D-MI), Christopher S. Murphy (D-CT),  Jacky Rosen (D-NV), Benjamin L. Cardin (D-MD), Robert Menendez (D-NJ), Chris Van Hollen (D-MD), Catherine Cortez Masto (D-NV), Sherrod Brown (D-OH), Angus S. King, Jr. (I-ME), Kamala D. Harris (D-CA), Jack Reed (D-RI), Robert P. Casey, Jr. (D-PA), Jon Tester (D-MT), Christopher A. Coons (D-DE), Tom Udall (D-NM), Amy Klobuchar (D-MN), Tammy Duckworth (D-WI), Cory A. Booker (D-NY), Dianne Feinstein (D-CA), Joe Manchin III (D-WV), Gary C.  Peters (D-MI), Kyrsten Sinema (D-AZ), Martin Heinrich (D-NM), Kirsten Gillibrand (D-NY), Brian Schatz (D-HI), and Mazie Hirono (D-HI). 

Throughout the COVID-19 crisis, Sen. Warner has remained a strong advocate for health coverage. In April, he led his colleagues in pressing congressional leaders to ensure that that those who have lost their employer-based benefits do not have to face this health crisis without access to health insurance. In addition, that April letter similarly urged Congressional leaders to take swift action to strengthen Medicaid coverage and reduce premium costs on the Affordable Care Act exchange. Sen. Warner has also previously joined his colleagues in releasing a plan to expand health care coverage during the COVID-19 pandemic and has introduced legislation to allow any state that expanded Medicaid after 2014 to receive the same full federal matching funds as states that expanded earlier under the terms of the Affordable Care Act.   

A copy of today’s letter is available here and below. 

 

Dear Leader McConnell, Speaker Pelosi, Leader Schumer and Leader McCarthy:

We write to reiterate the importance of ensuring that any future COVID-19 related legislation passed by Congress include strong provisions to ensure Americans have access to quality and affordable health care coverage. 

The COVID-19 pandemic has had an extraordinary impact on every facet of our society and resulted in tremendous job loss, financial uncertainty and reduced access to health care coverage at a time when Americans can least afford it. A recent report estimates that nearly 27 million people have lost their employer-sponsored health care insurance and have to find another way to get health insurance due to their job loss . This is an astounding number on its own and is even more concerning given an additional 27 million Americans were already uninsured before the COVID-19 pandemic .

We strongly believe that an unprecedented global health crisis of this nature deserves equally unprecedented action from Congress to ensure that Americans have continued access to the health care services they need. 

On Friday, May 15, 2020, the U.S. House of Representatives took an important step by passing H.R. 6800, the Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act. This legislation creates critical pathways to health care coverage by providing premium reimbursement to help newly unemployed Americans continue coverage in their previously elected employer-sponsored plans. In addition, the legislation provides critical support to state Medicaid programs to ensure states can afford to cover additional individuals. We welcome these significant and much needed provisions, and hope there will be bipartisan work done to ensure that millions of additional Americans will be provided with a pathway to health care coverage. 

We strongly encourage Republicans and Democrats to work together to build upon efforts in the HEROES Act by further enhancing the Medicaid federal medical assistance percentages (FMAP) to ensure continued and comprehensive coverage for enrollees, sustain Medicaid programs in states that have expanded their program, incentivize additional states to expand their Medicaid programs and provide payment to states that have already expanded their Medicaid programs, but have not received their full share of enhanced payments in the past. Prior to the COVID-19 pandemic, an estimated 2.3 million Americans were without health care coverage because their states had not expanded Medicaid – a number that is sure to grow in the coming months . Targeting additional funding to the Medicaid expansion population could ensure health care insurance for millions of additional Americans that might otherwise not have access to it.

In addition, we ask that you add provisions to reduce premium payments for Americans eligible for coverage in the Affordable Care Act (ACA) exchanges. As you know, current law caps ACA advance premium tax credits (APTCs) at approximately 10 percent of household income for individuals earning up to 400 percent of the federal poverty line (FPL). Removing this cap and increasing subsidies will help millions more middle-income Americans to find a comprehensive and affordable plan on the health care exchange. A 2017 study found that improving the ACA’s premium assistance payments could increase health care enrollment by more than 1 million Americans.  It will also be important to bolster support from APTCs for working families and individuals who are already eligible, but will need more financial support for the cost of coverage during this public health and economic crisis.

As Americans traverse this extremely uncertain and unprecedented time – the last thing they should worry about is them or their family members going without health care coverage. We ask that you strongly consider the recommendations we have listed above and work with us to develop solutions that meet the true scope and scale of the public health emergency we face. Thank you for your consideration of this request and we look forward to working with you on these issues. 

Sincerely, 

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WASHINGTON - U.S. Sen. Mark R. Warner (VA) joined Sens. Debbie Stabenow (MI), Roger Wicker (MS), and 38 of their colleagues in urging Congress to support community health centers that provide Americans with critical health care, including testing and treatment of COVID-19. 

“We write to express our support for additional emergency funding for community health centers in the next COVID-19 relief package. Community health centers are vital to our response to the coronavirus pandemic and need appropriate funding to continue their front-line health care work,” wrote the Senators. “Community health centers provide affordable care to more than 29 million patients, including 385,000 veterans and 8.7 million children nationwide. These centers play a critical role in responding to the pandemic, offering coronavirus testing, primary care, dental care, behavioral health care, and other services to our nation’s most vulnerable patients.” 

In the letter, the Senators asked Senator Roy Blunt (MO) and Senator Patty Murray (WA), Chairman and Ranking Member of the Senate Appropriations Committee Subcommittee on Labor-HHS-Education, to support additional emergency funding for community health centers across the country. Over 2,000 centers have already had to close their doors, and many more remain concerned about how long they will be able to stay open. 

Full text of the letter can be found here and below:  

Dear Chairman Blunt and Ranking Member Murray: 

We write to express our support for additional emergency funding for community health centers in the next COVID-19 relief package. Community health centers are vital to our response to the coronavirus pandemic and need appropriate funding to continue their front-line health care work. 

 Community health centers provide affordable care to more than 29 million patients, including 385,000 veterans and 8.7 million children nationwide.  These centers play a critical role in responding to the pandemic, offering coronavirus testing, primary care, dental care, behavioral health care, and other services to our nation’s most vulnerable patients.  This care helps keep individuals out of emergency rooms, where beds are currently in particularly high need.  It also helps manage chronic conditions that may exacerbate the symptoms of COVID-19.

Over the next six months, community health centers will see 34 million fewer appointments as Americans cancel primary and preventive care appointments or delay non-essential care.  Health centers are anticipating $7.6 billion in lost revenue and 105,000 lost jobs.  Over 2,000 centers have already had to close their doors and many more remain concerned about how long they will be able to stay open. 

We appreciate the additional $2 billion in emergency funding provided to community health centers in recent COVID-19 response and relief packages, including $600 million dedicated to testing.  However, despite this funding, health centers are still worried about how to keep their doors open to serve their patients.  These valuable providers will continue to lose more revenue as the pandemic continues.  Additional funding is critical for these centers to continue providing quality, affordable health care and front-line response efforts.  

We look forward to working with you to reach a bipartisan agreement to enact legislation and ensure community health centers can continue to provide high quality and affordable care to those in need. 

Sincerely,

 

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WASHINGTON – Today U.S. Sens. Mark R. Warner and Tim Kaine (both D-VA) applauded $6,914,080 in federal funding through the U.S. Department of Health and Human Services (HHS) to help support health centers across the Commonwealth as they combat the COVID-19 crisis. 

“We are glad to see this funding go towards helping support these health centers as they continue to work around the clock to provide crucial care for members of the community during this pandemic,” said the Senators.  

The funding for health centers was awarded as follows:

  • $1,021,822 for Portsmouth Community Health Center
  • $1,205,773 for Eastern Shore Rural Health System
  • $2,573,599 for Central Virginia Health Services
  • $1,026,353 for Southwest Virginia Community Health Systems
  • $1,086,533 for Piedmont Access to Health Services (PATHS)

This funding was awarded through the Health Resources and Services Administration’s Health Center Program, which provides funds to community-based health care providers that provide primary care services in underserved areas. These health centers must meet a stringent set of requirements, including providing care on a sliding fee scale based on ability to pay and operating under a governing board that includes patients.

Additionally, $2,648,079 was awarded to the Virginia Hospital & Healthcare Association for COVID-19 preparedness and response activities. This funding was awarded through HHS’ Hospital Preparedness Program (HPP), which seeks to promote a consistent national focus to improve patient outcomes during emergencies and disasters and enable rapid recovery.

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WASHINGTON, D.C. – Today, U.S. Senators Mark R. Warner and Tim Kaine joined Senator Maggie Hassan and 14 of their colleagues in calling on the Centers for Disease Control and Prevention (CDC) to address the declining rate of routine child immunizations for measles and other dangerous viruses amid the COVID-19 pandemic.

“The administration of routine pediatric immunizations remains critical throughout the duration of this public health emergency,” wrote the Senators. “The decline in immunizations is largely attributable to efforts by families to adhere to social distancing guidelines to reduce both their exposure to, and the spread of COVID-19. But if this trend ofdecreased immunization rates among children continues, the United States could face yet another public health crisis: increased risk of outbreaks of vaccine-preventable diseases.”

The Senators continued, “Such outbreaks would put lives at risk, and place additional stress on our health care system and public health infrastructure at a time when these systems are struggling to respond to the COVID-19 pandemic.”

The Senators called for CDC to develop and execute a comprehensive plan to address the decline in immunization rates, including measures such as increased public outreach and education and best practices for parents and families to visit doctors while limiting their risk of contracting COVID-19. The Senators also asked for details on what CDC is doing to ensure sufficient supply of immunization doses and medical devices to administer them.

In addition to Senators Warner, Kaine, and Hassan, the letter was signed by Senators Patty Murray (D-WA), Bernie Sanders (I-VT), Jeff Merkley (D-OR), Tammy Baldwin (D-WI), Bob Casey (D-PA), Chris Van Hollen (D-MD), Mazie Hirono (D-HI), Richard Blumenthal (D-CT), Tina Smith (D-MN), Jacky Rosen (D-NV), Elizabeth Warren (D-MA), Amy Klobuchar (D-MN), Jack Reed (D-RI), and Doug Jones (D-AL).

Read the Senators’ full letter here or below. 

 

Dear Dr. Redfield,

We write to express significant concern regarding the recent decline in routine childhood immunization rates in the United States during the novel coronavirus (COVID-19) pandemic, and urge you to take immediate action to encourage and support routine pediatric immunizations through the duration of the COVID-19 pandemic.

According to recent data published by the Centers for Disease Control and Prevention (CDC), a decline in provider orders for non-influenza childhood vaccines, and measles-containing vaccines including the measles-mumps-rubella (MMR) vaccine, began one week after President Trump declared a national emergency on March 13, 2020 due to the COVID-19 pandemic. [1] In May, the Michigan Care Improvement Registry found a drastic decrease in vaccination rates among children across nearly every age group. The percentage of children five months and younger who remain up-to-date on recommended vaccines declined from 67.9 percent in 2019, to 49.7 percent in May 2020.[2] The New York City health department reported a 63 percent drop in the number of vaccine doses administered to children between March 23 and May 9, including a 91 percent drop for children ages 2 and above.[3]

The administration of routine pediatric immunizations remains critical throughout the duration of this public health emergency. The decline in immunizations is largely attributable to efforts by families to adhere to social distancing guidelines to reduce both their exposure to, and the spread of COVID-19. But if this trend of decreased immunization rates among children continues, the United States could face yet another public health crisis: increased risk of outbreaks of vaccine-preventable diseases. Such outbreaks would put lives at risk, and place additional stress on our health care system and public health infrastructure at a time when these systems are struggling to respond to the COVID-19 pandemic.

To avoid this potential crisis, we urge the CDC to immediately develop an action plan that incorporates targeted public outreach and education efforts on addressing vaccine hesitancy and emphasizing the importance of pediatric immunizations; resources for communities that have seen reductions in their immunization rates since the start of the COVID-19 pandemic; and guidance for parents and families on how to safely access pediatric immunizations during the COVID-19 pandemic, including best practices regarding personal protective equipment (PPE) use and other precautions to limit the risk of exposure to COVID-19 in health care settings; and necessary efforts to ensure rapid catch-up for children who are not up to date on critical pediatric vaccines.

In addition to developing the plans described above, we request that you respond to the following questions no later than July 1, 2020 to help us better understand how the federal government is working to address the alarming drop in pediatric immunization rates:

  1. What specific steps is CDC taking to reverse the dramatic drop in vaccinations since mid-March?
    1. How does CDC plan to capture accurate real-time data on pediatric immunization rates and identify potential solutions, particularly in vulnerable communities?
  1. What outreach and education efforts are underway at CDC to address fears among parents and families related to bringing children into health care settings during the COVID-19 crisis? 
    1. Is CDC planning a public information campaign to address vaccine hesitancy, and if so, how will CDC ensure that the necessary communication on the importance of routine immunizations is reaching parents and families?
    1. How will CDC ensure that families receive guidance on safe access to care for children during the COVID-19 pandemic, including the appropriate use of PPE?
    1. How will CDC communicate with health care workers, and provide the necessary tools to inform communities about the importance of receiving pediatric immunizations during the COVID-19 pandemic? 
    1. What guidance is CDC providing to pediatricians and other health care workers on procedures to ensure that they can safely provide and promote routine pediatric immunizations?
    1. Given the significant increase in unemployment due to COVID-19, many families are finding themselves uninsured. How will CDC raise awareness of the Vaccines for Children (VFC) program to ensure that families know their children can still access routine immunizations, and how does CDC plan to support participating VFC providers as they work to catch up VFC-eligible children on missed vaccinations, while also preparing for the upcoming flu season?
  1. How will CDC monitor the ongoing availability and ordering of pediatric immunizations, including doses and other essential medical devices, PPE, and other supplies needed to store, transport and administer vaccines, and what plans are in place to address any supply chain disruptions?
    1. Is CDC taking steps now to ensure that the availability of pediatric immunizations, and necessary medical devices and supplies, is not impacted when production and domestic distribution of a COVID-19 vaccine is underway?
  1. Has CDC developed or reviewed modeling or projections that predict the potential impact on future vaccine-preventable outbreaks if the current pediatric immunization rate continues throughout the duration of the COVID-19 pandemic? 
  1. Does CDC require additional resources from Congress in order to support efforts to reverse the decline in pediatric immunizations? If so, what level of funding would be sufficient?

We appreciate your timely response and look forward to working with you on this critical issue.

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WASHINGTON - Today, U.S. Sen. Mark R. Warner (D-VA) joined Sens. Jeanne Shaheen (D-NH), Tina Smith (D-MN), Ron Wyden (D-OR) and Patty Murray (D-WA) in releasing a Senate Democratic plan to expand health care coverage and affordability during the COVID-19 pandemic. In a white paper, the senators outline a series of common sense legislative priorities that the Senate should take up immediately, including expanding premium support through subsidies and tax credits, incentivizing Medicaid expansion in hold-out states, and a special open enrollment period. Their proposal also calls for all COVID-19 treatment costs to be covered, including for the uninsured.

“Access to health care has never been more important,” said Senator Shaheen. “As our country faces the worst public health crisis in a century, millions are facing furloughs and job losses that make affordable health care coverage an even greater struggle. Americans are sick and tired of the partisan excuses for why health care can’t be more affordable and accessible. There is absolutely no reason why Republicans can’t join Democrats to get this done. This crisis demands bipartisan cooperation – the American people will accept nothing less.” 

“We need to rise to the challenge of solving America’s health care coverage and affordability problems, which have only been exacerbated by the pandemic,” said Senator Smith. “This plan will help more people access comprehensive health care coverage, and at a more affordable cost. We need to move this plan forward because these investments are critical—especially at a time when millions of Americans are on furlough or have lost their jobs."

“Families across the nation are struggling with the economic consequences of the pandemic, and that includes disruption to their health care access,” Senator Wyden said. “The last thing Americans need right now is to face questions about where they will get health care if they get sick. This proposal outlines practical steps that Congress could pass immediately and give families peace of mind during the pandemic.”

“For families in need, access to quality, affordable health care isn’t a partisan issue—it’s a life and death one. It shouldn’t take a historic global pandemic for Republicans to understand that, but for them to continue ignoring the health care needs of families in the middle of this crisis would be truly inexcusable,” said Senator Murray. “The absolute least we can do in the middle of an unprecedented public health crisis is help people get the health care they need—and Republicans have no excuse to continue playing politics or dragging their feet on getting these common-sense steps done. We need to act now.”

A brief overview of the policies included in the proposal:

·       Cover all costs for COVID-19 treatment, including for the uninsured;

·       Deliver subsidies for the cost of COBRA premiums for the newly unemployed;

·       Expand and increase access to premium tax credits that help families afford monthly premiums;

·       Incentivize Medicaid expansion in remaining states that have not yet expanded;

·       Establish a federal special enrollment period;

·       Ban the sale of junk plans;  

·       Restore funding for marketplace outreach and enrollment support;

In addition to Sen. Warner, the proposal is also supported by Sens. Debbie Stabenow (D-MI), Chris Van Hollen (D-MD), Michael Bennet (D-CO), Tom Carper (D-DE), Richard J. Durbin (D-IL), Maggie Hassan (D-NH), Sherrod Brown (D-OH), Richard Blumenthal (D-CT), Senate Minority Leader Charles Schumer (D-NY), Sheldon Whitehouse (D-RI), Dianne Feinstein (D-CA), Ben Cardin (D-MD), Patrick Leahy (D-VT), Tim Kaine (D-VA), Jack Reed (D-RI), Jacky Rosen (D-NV), Jeff Merkley (D-OR), Kamala Harris (D-CA), Robert Menendez (D-NJ), Tammy Baldwin (D-WI), Bob Casey (D-PA), Amy Klobuchar (D-MN), Tammy Duckworth (D-IL), Martin Heinrich (D-NM), Chris Coons (D-DE), Doug Jones (D-AL), Tom Udall (D-NM) and Catherine Cortez Masto (D-NV).

The proposal can be read in full here. 

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WASHINGTON — U.S. Sen. Mark R. Warner (D-Va.) joined Sens. Chris Coons (D-Del.), Susan Collins (R-Maine) and nine of their colleagues on a bipartisan letter to Senate Leadership encouraging additional support for first responders in the next COVID-19 relief package. 

In addition to Sens. Warner, Coons and Collins, the letter was joined by Senators Tom Carper (D-Del.), Dick Durbin (D-Ill.), Richard Blumenthal (D-Conn.), Angus King (I-Maine), Jon Tester (D-Mont.), Chris Van Hollen (D-Md.), Ron Wyden (D-Ore.), Bob Casey (D-Pa.), and Amy Klobuchar (D-Minn.). 

The lawmakers detailed the following priorities for first responders:

  • Bolster Assistance to Firefighter Grant, Staffing for Adequate Fire and Emergency Response (SAFER), and Department of Justice grant funding, including for the Community Oriented Policing Services program, so that state and local police, fire, and EMS departments can access resources to purchase and be reimbursed for PPE and other COVID-19 related expenses, recruit and retain employees and volunteers, and cover overtime, backfill costs, authorized hazard pay, and COVID-19-related paid sick leave during the crisis.
  • Require that the Secretary of the Department of Homeland Security waive the cost share and maintenance of expenditure requirements for Assistance to Firefighter Grants for reimbursement of COVID-19-related expenses through FY21. 
  • Require that the Secretary of the Department of Homeland Security grant waivers to SAFER grant recipients for employee retention to aid staffing shortages through FY21.  In addition, any legislation should retroactively require that the Secretary grant such waivers for FY19 and FY20 SAFER funds. 
  • Waive the prohibition on hazard pay for federal firefighters under 5 U.S.C. §?5545b(d)(1) for purposes of COVID-19 response, provide funding to federal agencies sufficient to cover hazard pay to frontline federal firefighters and law enforcement officers when appropriate, extend overtime pay to U.S. Probation Officers, and waive the federal firefighter and law enforcement officer overtime cap under 5 U.S.C. §?5547.
  • Address the gap in paid sick leave coverage for first responders by requiring that the employing agency, not the employee, provide up to 80 hours of paid sick leave should these departments order the employee to self-quarantine in accordance with Centers for Disease Control and Prevention guidelines due to potential COVID-19 exposure.
  • Create a presumption in the Public Safety Officers’ Benefits Program that a public safety officer’s infection of COVID-19 resulted from their employment to clearly establish eligibility for benefits due to the pandemic.
  • Prevent the taxation of state and local incentives for volunteer firefighters and EMS personnel beyond 2020 in order to help departments continue to recruit and retain volunteer personnel.

The lawmakers’ effort is supported by the Fraternal Order of Police, the National Association of Police Organizations, the Federal Law Enforcement Officers Association, the International Association of Fire Fighters, the National Volunteer Fire Council, and the Congressional Fire Services Institute.

The full text of the letter is available here and below. 

 

Dear Leader McConnell and Leader Schumer: 

We appreciate your work to provide support for our nation’s police officers, firefighters, and emergency medical services (EMS) personnel in the Coronavirus Aid, Relief, and Economic Security Act.  However, additional assistance is needed during this crisis.  As Congress considers further legislation in response to the COVID-19 pandemic, we urge you to include additional support for our nation’s first responders who work in some of the highest risk occupations for COVID-19 exposure.[i]  First responders are routinely in physical contact with potentially infected persons and are facing unprecedented volumes of dispatch calls in severely impacted areas.[ii]

A short supply of personal protective equipment (PPE) for first responders to guard against disease exposure has left many police officers, firefighters, and EMS personnel exposed to the dangers of this crisis.  This has resulted in too many first responders across our nation contracting COVID-19 and being forced to self-quarantine, which has led to staffing shortages.[iii]  As of April 1, more than 1,400 New York City Police Department employees have contracted COVID-19, with 6,100 in total in quarantine, and 282 New York City Fire Department employees have contracted COVID-19, with 950 in total in quarantine.[iv]  While New York City is the current epicenter of the U.S. outbreak, many other cities and states with developing outbreaks such as New Jersey, Florida, Detroit, Seattle, Washington D.C., and several additional states and cities across the nation[v] have reported a significant number of first responders contracting COVID-19 or requiring self-quarantine.

As this outbreak continues, many more first responders will undoubtedly contract COVID-19 or be forced to self-quarantine.  To support our nation’s police officers, firefighters, and EMS personnel serving on the front lines of this pandemic, we urge action on the below items.  

  • Bolster Assistance to Firefighter Grant, Staffing for Adequate Fire and Emergency Response (SAFER), and Department of Justice grant funding, including for the Community Oriented Policing Services program, so that state and local police, fire, and EMS departments can access resources to purchase and be reimbursed for PPE and other COVID-19 related expenses, recruit and retain employees and volunteers, and cover overtime, backfill costs, authorized hazard pay, and COVID-19-related paid sick leave during the crisis.
  • Require that the Secretary of the Department of Homeland Security waive the cost share and maintenance of expenditure requirements for Assistance to Firefighter Grants for reimbursement of COVID-19-related expenses through FY21. 
  • Require that the Secretary of the Department of Homeland Security grant waivers to SAFER grant recipients for employee retention to aid staffing shortages through FY21.  In addition, any legislation should retroactively require that the Secretary grant such waivers for FY19 and FY20 SAFER funds. 
  • Waive the prohibition on hazard pay for federal firefighters under 5 U.S.C. §?5545b(d)(1) for purposes of COVID-19 response, provide funding to federal agencies sufficient to cover hazard pay to frontline federal firefighters and law enforcement officers when appropriate, extend overtime pay to U.S. Probation Officers, and waive the federal firefighter and law enforcement officer overtime cap under 5 U.S.C. §?5547.
  • Address the gap in paid sick leave coverage for first responders by requiring that the employing agency, not the employee, provide up to 80 hours of paid sick leave should these departments order the employee to self-quarantine in accordance with Centers for Disease Control and Prevention guidelines due to potential COVID-19 exposure.
  • Create a presumption in the Public Safety Officers’ Benefits Program that a public safety officer’s infection of COVID-19 resulted from their employment to clearly establish eligibility for benefits due to the pandemic.
  • Prevent the taxation of state and local incentives for volunteer firefighters and EMS personnel beyond 2020 in order to help departments continue to recruit and retain volunteer personnel. 

During a time of crisis, communities rely on local first responders as the first line of defense for protection and emergency response.  As you continue to develop further legislation in response to the COVID-19 pandemic, we urge you to include the above items so that our nation’s first responders can operate at full capacity as we fight the COVID-19 pandemic. 

Sincerely, 

###

WASHINGTON – U.S. Sens. Mark R. Warner (D-VA) and Lamar Alexander (R-TN) introduced bipartisan legislation to ensure rural hospitals in Virginia can keep up with the cost of providing care amid the novel coronavirus (COVID-19) outbreak. The Fair Medicare Hospital Payments Act would help curb the trend of hospital closures in rural areas by making sure hospitals are fairly reimbursed for their services by the federal government. This legislation comes at a crucial time as hospitals in Virginia continue to lose needed revenue despite playing an essential role in serving their communities and providing lifesaving care during the biggest public health crisis in a century.

“The current payment policy has long placed some of Virginia’s most rural hospitals at a disadvantage and made it more difficult to provide quality care in communities that need it most,” said Sen. Warner. “The COVID-19 public health emergency has made it more important than ever to do everything we can to support our rural hospitals and this legislation is absolutely critical in doing that.” 

“Last year, the Trump Administration updated the formula that determines how much Medicare will reimburse hospitals for patient care, taking into account, among other things, the cost of labor in that geographic area – called the Medicare Area Wage Index. And because of this change, Alan Levine, who leads Ballad, announced a $10 million investment in pay increases to nurses. However, these changes are temporary and will expire in three years, and many hospitals are concerned that hospital reimbursements could revert to the lower rates,” said Sen. Alexander. “Given COVID-19 impacts on rural hospitals, any changes that lower reimbursement would have significant impact. Tennessee has the second highest rate of hospitals closures in the country, with 13 hospitals having closed since 2010, and this is, in large part, due to lower reimbursements. This legislation will help keep up with the cost of providing care and help curb the trend of Tennessee rural hospital closures by setting an appropriate national minimum for the Medicare Area Wage Index.” 

The Medicare Area Wage Index, a formula used by Medicare to reimburse hospitals, is much lower for states like Virginia and Tennessee, due to the fact that the formula is based on labor costs, which vary across the country. This flawed formula often results in disproportionately low Medicare reimbursement payments to hospitals in rural and low-wage areas.

Specifically, the legislation would establish an appropriate national minimum (0.85) for the Medicare Area Wage Index and ensure that rural hospitals are paid for the care they provide, while preserving the existing reimbursements for urban hospitals. This legislation would also help ensure fairness in reimbursements for hospitals across the country – including the many hospitals that are facing closures in rural areas – and fix severe and disproportionate disadvantages that unfairly penalize hundreds of communities and hospitals across the United States.

At a minimum, 14 Virginia hospitals would benefit from this legislation, with the number of beneficiaries growing in future years. The 14 hospitals that would immediately benefit include:

Locality:

Hospital:

Buchanan County

Buchanan General Hospital

Franklin

Southampton Memorial Hospital

Galax

Twin County Regional Hospital

Halifax County

Sentara Halifax Regional Hospital

Mecklenburg County

Community Memorial Hospital

Norton

Norton Community Hospital

Pulaski County

Lewisgale Hospital Pulaski

Russell County

Russell County Hospital

Smyth County

Smyth County Community Hospital

Tazewell County

Clinch Valley Medical Center

Tazewell County

Carilion Tazewell Community Hospital

Washington County

Johnston Memorial Hospital

Wise County

Lonesome Pine Hospital

Wythe County

Wythe County Community Hospital

According to the American Hospital Association, Medicare accounts for about 43 percent of reimbursements for hospitals nationally, underscoring the role that Medicare payments play in keeping hospitals open and functioning – particularly in Virginia’s underserved and economically-struggling regions.

In addition to Sens. Warner and Alexander, the legislation was introduced by Sens. John Cornyn (R-TX), Doug Jones (D-AL), Marsha Blackburn (R-TN), Tim Kaine (D-VA), David Perdue (R-GA) and Richard Shelby (R-AL).

###

WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA) joined Sen. Chris Van Hollen (D-MD) and seven of their Senate colleagues in urging the President to expand his use of Title III of the Defense Production Act (DPA) in order to dramatically increase domestic production capacity for personal protective equipment (PPE) and COVID-19 testing supplies. 

“An analysis by Harvard University researchers found that the United States must, at minimum and under the best-case scenario, double the number of tests being conducted each week,” wrote the Senators. “In many cases, even when state and local governments are able to get some supplies into the hands of their frontline medical personnel, they go unused because of shortages in other key supplies.” 

They continued, “Congress appropriated $57.6 billion to address critical needs such as these, including $16 billion to purchase medical supplies for distribution through the Strategic National Stockpile and at least $11 billion to support efforts to expand testing by states, localities, and tribes. But it is clear that these widespread shortages will not be fully resolved until the nation’s production capacity can be dramatically scaled up, and despite unprecedented global demand, private sector companies have been reticent to expand production capacity without support and direction from the federal government. For that reason, is imperative that the federal government fully use its authority to support and expand production of PPE and testing supplies.”

Section 301 and 302 of Title III authorize the President to reduce current or projected shortfalls of industrial resources, critical technology items, or essential materials needed for national defense purposes. Meanwhile, Section 303 gives the President the authority to create, maintain, protect, expand, or restore domestic industrial base capacity, which includes purchasing or making purchase commitments of industrial resources or critical technology items, making subsidy payments for domestically produced materials, and installing and purchasing equipment for government and privately-owned industrial facilities to expand their production capacity.

In their letter, the Senators note that Title III has only been used twice by the government to respond to this health crisis and urge the President to immediately expand production and deliveries of PPE and testing supplies by using Title III of the Defense Production Act and any other appropriate authority.

Sen. Warner has long called for an increase in testing and PPE production in the Commonwealth. In March, he joined his colleagues in introducing the Free COVID-19 Testing Act, legislation that would expand free tests to confirm coronavirus (COVID-19) infections. He has also introduced legislation to require the president to utilize all available authorities under the Defense Production Act to mobilize a federal response to the pandemic through an equitable and transparent process. Additionally, he has pressed the Administration to outline how it plans to use Defense Production Act powers to increase production of testing supplies and equipment needed for the pandemic response. 

Joining Sens. Warner and Van Hollen on the letter are Sens. Angus King (I-ME), Gary Peters (D-MI), Kamala Harris (D-CA), Mazie Hirono (D-HI, Patrick Leahy (D-VT), Debbie Stabenow (D-MI), and Jack Reed (D-RI).

The full text of the letter is available here and below.

 

Dear President Trump: 

We write in response to the release of your administration’s blueprint for State testing plans and rapid response programs to urge you to broaden your use of Title III of the Defense Production Act (DPA) and other appropriate authorities to expand domestic production capacity for personal protective equipment (PPE) and COVID-19 testing supplies.

On April 27, you announced that your administration had “successfully scaled a robust testing regime that is able to meet the massive needs of a nationwide pandemic.” On the same day, an analysis by Harvard University researchers found that the United States must, at minimum and under the best-case scenario, double the number of tests being conducted each week. Nationwide shortages continue to prevent the United States from conducting enough tests to safely reopen.

In many cases, even when state and local governments are able to get some supplies into the hands of their frontline medical personnel, they go unused because of shortages in other key supplies. In Maryland, for example, the state has secured a large number of testing kits, but the kits cannot be used without the necessary swabs and viral transport media—both of which have been in short supply.

Similarly, the nation continues to face critical shortages of PPE. This has led to dangerous rationing and efforts by medical providers to disinfect, reuse, or fashion their own equipment. Reports from across the country paint a bleak picture: staff at the Henry Ford Health System in Michigan made their own face shields using plastic sheets, elastic bands, and tongue depressors. Providence Health in Washington did the same using supplies from Home Depot. Elsewhere, medical staff are soliciting donations of homemade cloth masks and constructing makeshift decontamination systems to reuse their PPE.

Before any state in the country can reopen responsibly, PPE and testing needs must be met. Congress appropriated $57.6 billion to address critical needs such as these, including $16 billion to purchase medical supplies for distribution through the Strategic National Stockpile and at least $11 billion to support efforts to expand testing by states, localities, and tribes. But it is clear that these widespread shortages will not be fully resolved until the nation’s production capacity can be dramatically scaled up, and despite unprecedented global demand, private sector companies have been reticent to expand production capacity without support and direction from the federal government. For that reason, is imperative that the federal government fully use its authority to support and expand production of PPE and testing supplies.

Section 301 and 302 of Title III authorize you to issue loan guarantees and direct loans to reduce current or projected shortfalls of industrial resources, critical technology items, or essential materials needed for national defense purposes. Section 303 grants you a range of authorities to create, maintain, protect, expand, or restore domestic industrial base capacity. These include purchasing or making purchase commitments of industrial resources or critical technology items, making subsidy payments for domestically produced materials, and installing and purchasing equipment for government and privately owned industrial facilities to expand their production capacity. In short, these authorities allow you to provide a company the financing and equipment they need to expand their production capacity and guarantee a buyer for their products once that capacity comes online. 

As part of the CARES Act, Congress appropriated $1 billion for the primary purpose of expanding domestic production of medical supplies to respond to COVID-19. We appreciated your executive order on March 27, 2020 to delegate authority to the Secretaries of Health and Human Services and Homeland Security, allowing each to make use of DPA Title III to expand production capacity. However, to date, Title III has been used just twice as part of the government’s response to the COVID-19 pandemic. On April 11, 2020, the Department of Defense announced that it would use Title III to secure a $133 million investment resulting in the production of 39 million additional N95 masks. On April 29, DOD announced a Title III award to expand the production of swabs by Puritan Medical Supplies in Maine.

These measures are totally inadequate to meeting the challenge we face. This crisis requires faster, more coordinated action to limit loss of life in the near term and over the next year. We urge you to act immediately to expand production and deliveries of PPE and testing supplies using Title III of the Defense Production Act and any other appropriate authority.

Sincerely,

###

WASHINGTON - Following reports of escalating foreign cyber espionage and cybercrime targeting American health institutions amid the COVID-19 pandemic, U.S. Sens. Mark R. Warner (D-VA), Richard Blumenthal (D-CT), Tom Cotton (R-AR), David Perdue (R-GA), and Edward J. Markey (D-MA) called on top U.S. cybersecurity officials to take immediate steps to bolster defenses, coordinate with hospitals, and engage in deterrence against such attacks. 

The bipartisan group of Senators wrote to the Cybersecurity and Infrastructure Security Agency (CISA) and United States Cyber Command after reports that Russia, China, Iran, North Korea, and criminal groups have launched hacking campaigns targeting the U.S. health care and medical research sectors in recent weeks. These malicious campaigns included ransomware attacks hitting hospitals, disinformation about health related to COVID-19, and spying on U.S. medical response and research. 

“[O]ur country’s healthcare, public health, and research sectors are facing an unprecedented and perilous campaign of sophisticated hacking operations from state and criminal actors amid the coronavirus pandemic,” wrote the Senators in a letter to CISA Director Christopher Krebs and Cyber Command Commander Paul Nakasone. “Disinformation, disabled computers, and disrupted communications due to ransomware, denial of service attacks, and intrusions means critical lost time and diverted resources. During this moment of national crisis, the cybersecurity and digital resilience of our healthcare, public health, and research sectors are literally matters of life-or-death.”

The Senators urged the agencies to make cyber threat information public to enable better defensive efforts, as well as raise public alarm and issue statements putting adversaries on notice. The Senators also called on the agencies to provide technical assistance to help states in their cybersecurity efforts, convene stakeholders in the medical sector to make sure they have the necessary resources, and engage in deterrence actions as necessary. 

The full text of the letter is available here and copied below.

 

 

Dear Mr. Krebs and General Nakasone,

We write to raise our profound concerns that our country’s healthcare, public health, and research sectors are facing an unprecedented and perilous campaign of sophisticated hacking operations from state and criminal actors amid the coronavirus pandemic. These hacking attempts pose an alarming risk of disrupting or undermining our public health response at this time of crisis. We write to urge the Cybersecurity and Infrastructure Security Agency (CISA), in coordination with United States Cyber Command, and its partners to issue guidance to the health care sector, convene stakeholders, provide technical resources, and take necessary measures to deter our adversaries in response to these threats.

In recent weeks, Russian, Chinese, Iranian, and North Korean hacking operations have targeted the health care sector and used the coronavirus as a lure in their campaigns.  In March, the cyber security firm FireEye reported that a Chinese hacking group, APT41, carried out one of the broadest hacking campaigns from China in recent years, beginning at the onset of the pandemic.[1] According to researchers, APT41 is a sophisticated Chinese state sponsored group that specializes in espionage against healthcare, high-tech, and political interests.[2] This latest campaign sought to exploit several recent vulnerabilities in commonplace networking equipment, cloud software, and office IT management tools—the same systems that we are now more reliant on for telework and telehealth during this pandemic. Included in the new Chinese espionage campaign are the healthcare and pharmaceutical nonprofits and companies bracing to respond to the coronavirus. APT41’s campaign also appears to reflect a broader escalation from Chinese groups in recent weeks.[3]

China is not alone in exploiting the coronavirus pandemic against our interests. Russian, Iranian, and North Korean government hackers have reportedly targeted international health organizations and the public health institutions of U.S. allies.[4] Additionally, the State Department has identified disinformation operations from Russia, Iran, and China that sought to spread false information about coronavirus to undermine the nation’s response to the pandemic.[5] Unless we take forceful action to deny our adversaries success and deter them from further exploiting this crisis, we will be inviting further aggression from them and others.

The cybersecurity threat to our stretched and stressed medical and public health systems should not be ignored. Prior to the pandemic, hospitals had already struggled to defend themselves against an onslaught of ransomware and data breaches. Our hospitals are dependent on electronic health records, email, and internal networks that often heavily rely on legacy equipment. Even a minor technical issue with the email services of the Department of Health and Human Services meaningfully frustrated efforts to coordinate the federal government’s service.[6] Disinformation, disabled computers, and disrupted communications due to ransomware, denial of service attacks, and intrusions means critical lost time and diverted resources. During this moment of national crisis, the cybersecurity and digital resilience of our healthcare, public health, and research sectors are literally matters of life-or-death.

The Cybersecurity and Infrastructure Security Agency and Cyber Command are on the frontlines of our response to cybersecurity threats to our critical infrastructure. Hospitals, medical researchers, and other health institutions need the expertise and resources your agencies have developed defending against these same sophisticated threats. We urge you to take all necessary measures to protect these institutions during the coronavirus pandemic, including:           

1.)    Provide private and public cyber threat intelligence information, such as indicators of compromise (IOCs), on attacks against the healthcare, public health, and research sectors, including malware and ransomware.

2.)    Coordinate with the Department of Health and Human Services, the Federal Trade Commission, and the Federal Bureau of Investigation on efforts to increase public awareness on cyberespionage, cybercrime, and disinformation targeting employees and consumers, especially as increased telework poses new risks to companies.

3.)    Provide threat assessments, resources, and additional guidance to the National Guard Bureau to ensure that personnel supporting state public health departments and other local emergency management agencies are prepared to defend critical infrastructure from cybersecurity breaches.

4.)    Convene and consult partners in the healthcare, public health, and research sectors, including its government and private healthcare councils, on what resources and information are needed to reinforce efforts to defend healthcare IT systems, such as vulnerability detection tools and threat hunting.

5.)    Consider issuing public statements regarding hacking operations and disinformation related to the coronavirus for public awareness and to put adversaries on notice, similar to the joint statement on election inference issued on March 2nd.

6.)    Evaluate further necessary action to defend forward in order to detect and deter attempts to intrude, exploit, and interfere with the healthcare, public health, and research sectors.

 We stand ready to work with you to provide any further resources necessary in this effort. Thank you for your attention to this urgent matter.

 Sincerely,

###

 

WASHINGTON – Today, U.S. Sens. Mark R. Warner (D-VA), Tim Kaine (D-VA), Michael Bennet (D-CO), Sherrod Brown (D-OH), and Jack Reed (D-RI) sent a letter to the U.S. Department of Veterans Affairs (VA) pushing for more information regarding the personal protective equipment (PPE) available to its employees at hospitals, clinics and other facilities during the COVID-19 health crisis, as well as whether the Centers for Disease Control (CDC) guidelines are sufficient enough to protect its employees. The Senators are raising the alarm following reporting that indicates a serious shortage of PPE at VA facilities across the country, directly contradicting VA leadership’s claim that they have enough PPE at their facilities. In addition, the Senators have heard directly from their constituents who are VA facility employees concerned for their well-being while on-the-job.

“We write to request information about the use of personal protective equipment (PPE) by Department of Veterans Affairs (VA) employees at hospitals, clinics, and other facilities, and whether the VA’s guidance to its employees, based on guidelines from the Centers for Disease Control and Prevention (CDC), is sufficiently robust in safeguarding staff. With more than 1,600 positive COVID-19 cases among VA staff nationwide, and more than a dozen employee deaths, the Department must take every possible action to protect staff and veterans,” the Senators wrote in a letter to VA Secretary Robert Wilkie.

According to the VA, they have instructed their employees to adhere to the CDC guidelines, which allows for the reuse of single-use masks for multiple days, as well as the ability to disinfect and reuse those masks. However, some VA staff who are not interacting directly with COVID-19 patients are working without PPE.

“The Wall Street Journal reports that VA internal memos caution that a ‘serious shortage’ of PPE masks exists and rationing may be reduced to one mask per day for providers. Additional Wall Street Journal reporting suggests that the Department has only a two-week PPE supply and workers must use the same mask as they move from patient to patient. We have also heard from a number of our constituents who are employees at VA facilities, who think they are not being provided adequate PPE in their jobs and fear for their personal health and safety. Employees report being asked to use one N95 mask for up to a week, which manufacturers recommend be changed each shift at a minimum. These employees report that they are being asked to store surgical or procedural masks in paper bags, and that some masks begin disintegrating after too many days of use,” they continued.

In their letter, the Senators underscored the need for VA medical facility staff, as well as clinical and administrative employees, to have the appropriate PPE to protect their health and the health of the veterans they serve during the current health crisis. Following recent reporting that some VA employees are being penalized for following guidance from public health authorities, the Senators are also calling on the VA to allow flexibility for their employees by providing administrative leave if required to self-quarantine.

Additionally, the Senators requested answers to the following questions:

  • Are VA healthcare providers using the same PPE for multiple encounters with patients, even though these devices are not approved by the Food and Drug Administration for reuse?
  • How many medical facilities have instituted PPE rationing processes that require providers to use single-use PPE for multiple patients?
  • How often are employees being provided new PPE, including masks, at these facilities?
  • Are VA facilities relying on CDC guidance regarding the extended use of PPE to modify standards, ration equipment, or determine that adequate PPE supplies exist?
  • If single-use masks are used for multiple patients, what procedures are in place to protect both provider and patient health?
  • What is the maximum number of patients that providers are permitted to care for while using the same single-use PPE?
  • If sufficient essential supplies are present, do providers need to reuse single-use PPE or use PPE for extended periods?
  • If single-use PPE must be reused, what methods for decontamination and reuse are being followed?
  • Of the $14.4 billion included in the CARES Act for PPE, please provide us with a breakdown of how much has VA spent on  PPE supplies and equipment. And if additional funding is required, has Congress been explicitly notified of this need?
  • Have multiple-use face masks or other alternatives designed for routine decontamination been considered instead of single-use PPE?
  • If PPE levels are not sufficient, what is the VA’s plan to ensure large-scale national-level PPE purchases and distribution to facilities in-need?

A copy of the letter can be found here and below.

 

The Honorable Robert Wilkie

Secretary of Veterans Affairs

U.S. Department of Veterans Affairs

810 Vermont Avenue NW

Washington, D.C. 20420

Dear Secretary Wilkie: 

We write to request information about the use of personal protective equipment (PPE) by Department of Veterans Affairs (VA) employees at hospitals, clinics, and other facilities, and whether the VA’s guidance to its employees, based on guidelines from the Centers for Disease Control and Prevention (CDC), is sufficiently robust in safeguarding staff. With more than 1,600 positive COVID-19 cases among VA staff nationwide, and more than a dozen employee deaths, the Department must take every possible action to protect staff and veterans. 

We understand from media reports, as well as discussions with VA employees and leadership, that the VA is adhering to CDC guidelines, which allows for the reuse of single-use masks for multiple days, disinfecting and reusing masks, and no masks for some staff who are not interacting directly with COVID-19 patients. VA leadership has asserted that they have enough PPE at their facilities and that their employees have access to the necessary PPE, given these guidelines. We are concerned that this guidance may be driven not by best practices for VA staff and patients, but by PPE shortages throughout the system. 

The Wall Street Journal reports that VA internal memos caution that a “serious shortage” of PPE masks exists and rationing may be reduced to one mask per day for providers. Additional Wall Street Journal reporting suggests that the Department has only a two-week PPE supply and workers must use the same mask as they move from patient to patient. We have also heard from a number of our constituents who are employees at VA facilities, who think they are not being provided adequate PPE in their jobs and fear for their personal health and safety. Employees report being asked to use one N95 mask for up to a week, which manufacturers recommend be changed each shift at a minimum. These employees report that they are being asked to store surgical or procedural masks in paper bags, and that some masks begin disintegrating after too many days of use.

In addition, Government Executive recently reported that some VA medical facility staff are not permitted to wear masks. A medical support assistant was placed on absent without leave status when she stayed home with symptoms consistent with COVID-19 while waiting several weeks for test results. Upon being able to return to work she was prohibited from wearing a mask until the VA later provided one mask per week.

Ensuring that VA medical facility staff, as well as clinical and administrative employees, have the appropriate PPE to protect their health and the health of the veterans they serve is essential to countering the pandemic. Additionally, when staff take the appropriate steps to self-quarantine, VA should provide them with administrative leave and not require them to deplete their own sick leave bank.

To ensure VA staff are protected and that transparent information is available about PPE supplies, we ask that you provide a response to the following questions:

  • Are VA healthcare providers using the same PPE for multiple encounters with patients, even though these devices are not approved by the Food and Drug Administration for reuse?
  • How many medical facilities have instituted PPE rationing processes that require providers to use single-use PPE for multiple patients?
  • How often are employees being provided new PPE, including masks, at these facilities?
  • Are VA facilities relying on CDC guidance regarding the extended use of PPE to modify standards, ration equipment, or determine that adequate PPE supplies exist?
  • If single-use masks are used for multiple patients, what procedures are in place to protect both provider and patient health?
  • What is the maximum number of patients that providers are permitted to care for while using the same single-use PPE?
  • If sufficient essential supplies are present, do providers need to reuse single-use PPE or use PPE for extended periods?
  • If single-use PPE must be reused, what methods for decontamination and reuse are being followed?
  • Of the $14.4 billion included in the CARES Act for PPE, please provide us with a breakdown of how much has VA spent on  PPE supplies and equipment. And if additional funding is required, has Congress been explicitly notified of this need?
  • Have multiple-use face masks or other alternatives designed for routine decontamination been considered instead of single-use PPE?
  • If PPE levels are not sufficient, what is the VA’s plan to ensure large-scale national-level PPE purchases and distribution to facilities in-need?

We ask that you take all necessary steps to ensure that VA employees have the resources and guidance required for their safety and the safety of our veterans. We stand ready to help and appreciate your candor and consideration.   

Sincerely,

###

WASHINGTON – U.S. Sen. Mark R. Warner (D-VA) joined Sen. Dick Durbin (D-IL) and 16 Senators in a letter to Senate Majority Leader Mitch McConnell (R-KY) and Senate Democratic Leader Chuck Schumer (D-NY) to ensure that any forthcoming COVID-19 legislation includes robust federal subsidies so that individuals who lose their job as a result of this pandemic can maintain their employer-sponsored health coverage. 

One option for Americans who lose their jobs, or drop below the hours necessary to be eligible for employer-sponsored health coverage, is COBRA. COBRA allows people to keep the employer-sponsored coverage that they selected for up to 18 months.  However, instead of having employers contribute to the premium costs, individuals are responsible for having to pay the full insurance premium themselves—an average of $1,700 a month for a family plan—which is often unaffordable for those newly unemployed.  In today’s letter, the Senators called on Congress to craft a bill that provides a robust federal COBRA premium subsidy for individuals who would otherwise lose their employer-sponsored coverage as a result of the COVID-19 pandemic.

“Allowing families to maintain the coverage they previously selected will help ensure continuity of care and limit disruption for both families and employers as our economy gets back on track,” the Senators wrote.  “We stand ready and eager to work with you to ensure that the next COVID-19 relief package includes this important policy, which will ensure that millions of people losing their jobs as a result of this pandemic will not also suddenly become uninsured and at risk for catastrophic health care costs.” 

In the U.S., over half of Americans receive their health coverage through their employer.  Depending on the extent of unemployment as a result of the coronavirus pandemic, between 23 to 35 million workers could end up losing their employer-based health care coverage. 

Along with Durbin, today’s letter is also signed by Senators Amy Klobuchar (D-MN), Tom Carper (D-DE), Jeanne Shaheen (D-NH), Sherrod Brown (D-OH), Jacky Rosen (D-NV), Catherine Cortez Masto (D-NV), Bob Menendez (D-NJ), Jack Reed (D-RI), Doug Jones (D-AL), Jeff Merkley (D-OR), Dianne Feinstein (D-CA), Michael Bennet (D-CO), Tammy Duckworth (D-IL), Debbie Stabenow (D-MI), Richard Blumenthal (D-CT), and Brian Schatz (D-HI). 

Full text of the letter is available here and below:

 

April 16, 2020
           
Dear Leaders McConnell and Schumer: 

Thank you for your efforts to date to ensure swift passage of multiple bipartisan pieces of legislation vital to helping our nation’s families, health care providers, and small businesses cope with the ongoing COVID-19 pandemic. Looking forward, we recognize that additional legislation will be necessary to improve the public health and America’s ailing economy. To that end, we strongly urge you to ensure that any forthcoming COVID-19 package include robust federal subsidies so that individuals can maintain on their employer-sponsored health coverage when they lose their jobs.

Over the last three weeks, approximately seventeen million people have filed unemployment claims in their state. However, this unprecedented number of filings only reflects claims filed through April 4. Many more Americans are likely out of work, or soon will be, because of the COVID-19 pandemic. Forecasters predict that as many as 20 million people could lose their jobs by the end of April. Compounding this problem is the fact that unemployment for these individuals and their families will also mean they will lose their existing employer-sponsored health insurance. 

In the U.S., over half of Americans receive their health coverage through their employer. Of the seventeen million Americans who have recently lost their jobs due to COVID-19, it is estimated that more than six million of these individuals have also lost their employer-sponsored health care. Depending on the extent of unemployment, between 23 to 35 million workers could lose their coverage.  

One option for Americans who lose their jobs, or drop below the hours necessary to be eligible for employer-sponsored health coverage, is COBRA. COBRA allows people to keep the employer-sponsored coverage that they selected for up to 18 months. However, people have to pay the full insurance premium—an average of $1,700 a month for a family plan—which is often unaffordable for those newly unemployed. Congress must step in and assist these individuals and families.

Following the 2008 financial crisis, the American Recovery and Reinvestment Act of 2009 (ARRA) was signed into law, which made COBRA continuation coverage more affordable and accessible to those who unexpectedly became unemployed. The law offered a 65 percent COBRA premium subsidy to individuals from September 1, 2008 to May 31, 2010. While well-intentioned and helpful to some, many individuals were unable to participate in the program because the remaining 35 percent insurance costs were still too expensive for them to cover.

We have heard from our constituents, as we know you have too. They are in dire economic circumstances. Despite government relief—in the form of extending monthly bill deadlines and increasing unemployment insurance—it will not be enough for most Americans to continue affording the health insurance policy they and their families elected through their employer’s plan. Allowing families to maintain the coverage they previously selected will help ensure continuity of care and limit disruption for both families and employers as our economy gets back on track. In order to provide our constituents adequate relief and to improve upon ARRA’s COBRA provision, we believe Congress must craft a bill that provides a robust federal COBRA premium subsidy for individuals who would otherwise lose their employer-sponsored coverage as a result of the COVID-19 pandemic.

We stand ready and eager to work with you to ensure that the next COVID-19 relief package includes this important policy, which will ensure that millions of people losing their jobs as a result of this pandemic will not also suddenly become uninsured and at risk for catastrophic health care costs. 

Sincerely,

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WASHINGTON – U.S. Sens. Mark R. Warner (D-VA) and Tim Scott (R-SC) are calling to protect at-risk Medicare beneficiaries and ensure access to potentially life-saving services by allowing for the full participation of CDC-recognized virtual suppliers in the Medicare Diabetes Prevention Program (MDPP) for at least the duration of the COVID-19 emergency.

A letter to the U.S. Department of Health and Human Services and the Centers for Medicare & Medicaid Services states in part, “We continue to strongly support permanent eligibility for these providers, who have the potential to dramatically expand access to beneficiaries in need, and we urge you to ensure their eligibility for at least the duration of the COVID-19 public health emergency. This step would both enable access for millions of eligible beneficiaries and provide key foundational data on the effectiveness and integrity of virtual programs within the MDPP. 

According to the CDC and emerging research from across the globe, older individuals and those suffering from serious medical conditions, such as diabetes, are at a higher risk of experiencing severe illness, and even death, after contracting COVID-19. While all Americans should adhere to the instructions of health professionals and practice social distancing, these directives are all the more important for at-risk populations, including those whom the MDPP aims to serve.”

Also signing the letter were Sens. Cindy Hyde-Smith (R-MS), Gary Peters (D-MI), Roger Wicker (R-MS), Jeanne Shaheen (D-NH), Kevin Cramer (R-ND), Tina Smith (D-MN), Joni Ernst (R-IA), Kyrsten Sinema (D-AZ), Shelley Moore Capito (R-WV), and Martha McSally (R-AZ).

Last year, Sens. Warner and Scott sent a letter to the agencies requesting that virtual providers be fully integrated in the MDPP expanded model, but the Administration has not yet facilitated their inclusion. CMS’s recent interim final rule with comment period (IFC) provided modest flexibilities for some existing suppliers regarding virtual make-up sessions, but these temporary changes will prove insufficient to ensure meaningful access. 

Read the letter in its entirety here and below. Also, a list of COVID-19 resources can be found here.
 

April 16, 2020 

The Honorable Alex M. Azar II
Secretary
Department of Health and Human Services
200 Independence Avenue, SW 
Washington, DC 20201 

The Honorable Seema Verma, M.P.H. Administrator
Centers for Medicare & Medicaid Services
7500 Security Boulevard 
Baltimore, MD 21244


Dear Secretary Azar and Administrator Verma: 

In light of the ongoing COVID-19 pandemic, we are writing to request that you build upon the steps taken in your recent interim final rule with comment period (IFC) by making CDC- recognized virtual Diabetes Prevention Program (DPP) providers eligible for reimbursement in the Medicare DPP (MDPP) expanded model. We continue to strongly support permanent eligibility for these providers, who have the potential to dramatically expand access to beneficiaries in need, and we urge you to ensure their eligibility for at least the duration of the COVID-19 public health emergency. This step would both enable access for millions of eligible beneficiaries and provide key foundational data on the effectiveness and integrity of virtual programs within the MDPP. 

According to the CDC and emerging research from across the globe, older individuals and those suffering from serious medical conditions, such as diabetes, are at a higher risk of experiencing severe illness, and even death, after contracting COVID-19. While all Americans should adhere to the instructions of health professionals and practice social distancing, these directives are all the more important for at-risk populations, including those whom the MDPP aims to serve. 

Even before this pandemic began to spread in the United States, many Medicare beneficiaries faced considerable access challenges that prevented them from participating in this potentially life-saving program. The COVID-19 pandemic, however, has exacerbated those gaps. In-person sessions risk life-threatening viral exposure, and yet beneficiaries cannot readily turn to virtual programs as a viable alternative, given persistent reimbursement barriers. While CMS’s recent IFC took an important step forward in recognizing the value of certain types of virtual sessions from a subsection of providers, the parameters outlined in the rule create barriers to entry for many high-quality virtual providers and potential new participants, in addition to substantially 

constraining options for beneficiaries currently participating in the program. In contrast with a number of other flexibilities included in the IFC and waivers released by CMS, which leverage innovative technological tools to improve access and care quality, the agency’s temporary policy changes for the MDPP leave significant opportunities for further development and enhancement. 

The COVID-19 public health emergency exemplifies the importance of integrating virtual health technology solutions into our healthcare system on a sustainable, long-term basis, and we will continue to work to ensure that CDC-recognized virtual providers are full participants in the MDPP expanded model. In the near term, however, we ask that you protect at-risk populations and preserve and bolster access to a proven program by allowing for robust and meaningful virtual provider reimbursement eligibility during this public health emergency. 

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