HEROES Act: What physicians and medical students need to know

The AMA provides a summary of the "Health and Economic Recovery Omnibus Emergency Solutions Act” (HEROES Act). The HEROES Act is the next proposed coronavirus relief fund package offering assistance to state and local governments, hazard pay for front-line health care workers, forgiveness of student debt and increased funding to providers who lost revenue and provide Medicaid and Medicare services during the COVID-19 public health emergency.

For complete descriptions of each provision in the HEROES Act, download the AMA highlights of the H.R. 6800, the “Health and Economic Recovery Omnibus Emergency Solutions Act” (HEROES Act) (PDF).

A summary of the HEROES Act provisions follows.

• Health Care Provider Relief Fund
• Accelerated and advance payment programs under Medicare Part A and Part B, Modified
• Modifies the Paycheck Protection Program (PPP)
• Options for small businesses and nonprofits under the Main Street Lending Program
• Expands Economic Injury Disaster Loan (EIDL) Program
• Limitation on deduction of state and local taxes (SALT)
• Medicaid increase
• Expansion of rural health care program of FCC in response to COVID-19
• COVID–19 Price Gouging Prevention Act
• Special enrollment period through federal exchanges
• COBRA subsidies
• Dependents taken into account in determining credit and rebates
• Individuals providing taxpayer identification numbers taken into account in determining credit and rebates
• Temporary tax deductions for supplies/equipment of COVID-19 front-line employees
• Payroll credit for certain pandemic-related employee benefit expenses paid by employers
• Improvements to employee retention credit
• Payroll credit for certain fixed expenses of employers subject to closure due to COVID-19
• Business interruption credit for the self-employed
• Payroll tax deferral allowed for recipients of certain loan forgiveness
• Certain loan forgiveness/financial assistance not included in gross income
• Certain expenses paid with certain grants/loans not included in gross income
• Restrictions on collections of debt during a national disaster or emergency
• Pandemic premium pay for essential workers

• Federal student loan borrower relief
• Writing down balances for federal student loan borrowers
• Payments for private education loan borrowers
• Department of Education
• Emergency financial aid grants
• Extension of federal work study during a qualifying emergency
• Facilitating access to financial aid for recently unemployed students
• Special rules relating to public service loan forgiveness
• Public health workforce loan repayment program
• Grants for schools of medicine in diverse and underserved areas

• Expands PPP loan eligibility to all nonprofit organizations, not just 501(c)(3)
• Streamlining payment of emergency care claims to community providers during the COVID-19 public health emergency
• Activities to improve the delivery of home and community-based services
• Additional funding for Medical Reserve Corps
• Non-discrimination provision

Medicaid

• MFAR
• Home and community-based services
• No cost­-sharing for COVID­-19 treatment
• Covering the uninsured for COVID­-19 treatment
• Temporary extension of 100% FMAP to Indian health providers
• Increase DSH payments
• Allowance for medical assistance under Medicaid for inmates during 30­-day period preceding release

Private insurance provisions

• Ensuring access to COVID­-19 prevention care
• Coverage of COVID-­19 related treatment with no cost-sharing
• Reinstatement of ACA risk corridor program

COVID-19 testing, tracing and supply chain

• No copays for COVID-19 preventative services at VA medical facilities
• Coverage of COVID-19 related treatment at no cost sharing
• COVID-19 National Testing and Contact Tracing (CONTACT) Initiative
• Core public health infrastructure for state, local and tribal health departments
• Core public health infrastructure and activities for CDC
• Pilot program to improve laboratory infrastructure
• COVID-19 testing strategy
• Manufacturer reporting of test distribution
• Reporting of COVID–19 testing results
• State testing report
• Testing information websites
• Medical supply response coordinator
• Vaccine manufacturing and administration capacity
• Public health data system transformation
• Emergency medical supplies enhancement
• Strategy on securing supply chains for medical materials

Demographic data and supply reporting

• COVID-­19 reporting portal
• CDC reporting on demographic data
• Modernization for health inequities data
• Tribal funding to research health inequities, including COVID-­19
• Additional reporting to Congress on the race and ethnicity rates of COVID-­19

Domestic violence

• Grants to assist low-income women and survivors of domestic violence in obtaining qualified domestic relations orders

Medicare

• Hold harmless for specified COVID-19 treatment services
• Patient access to drugs intended to treat COVID-19 without cost-sharing
• Medicare special enrollment for individuals residing in COVID-19 emergency areas

Skilled nursing facilities

• Communication accessibility for skilled nursing facility residents during COVID-19
• Skilled nursing facility payment incentive program
• Strike team funding for skilled nursing facilities
• Infection control at skilled nursing facilities
• Reporting requirements on COVID-19 cases and deaths

Immigration provisions

• Extension of filing and other deadlines
• Rollover of unused visas
• Supplementing the COVID response workforce
• Expedited visa processing
• Applications or petitions for new employment or change of status
• Conrad 30 program
• Employment authorization card
• Maintenance of status
• Treatment of time spent engaging in COVID-19 related work
• Special immigrant status for non-immigrant COVID-19 workers and their families
• Protection for surviving spouses and children

Nutrition assistance

• SNAP
• Food distribution on Indian reservations
• WIC
• Child nutrition programs

Substance use and mental health

• Funding
• Research on the mental health impact of COVID–19
• Grants to address substance use and increased behavioral health needs during COVID-19

Tribal assistance

• Improving state, local and tribal public health security
• Native veterans
• Tribal fiscal relief
• Indian health service
• Congressional intent relating to tribal governments eligible for coronavirus relief fund payments
• Use of relief funds

With an increased number of people reporting worsening mental health in recent years, it is imperative that people are aware of the 988 Suicide & Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) telephone program.

People experiencing a suicidal, substance use, and/or mental health crisis, or any other kind of emotional distress can call, chat or text 988, and speak to trained crisis counselors. The national hotline is available 24 hours a day, 7 days a week.

The previous National Suicide Prevention Lifeline phone number (1-800-273-8255) will continue to be operational and route calls to 988 indefinitely.