Capitol Court, N.E., Suite 300, Washington, D.C. 20002 507

(202) 544-7497 (202) 546-7105 - Fax WWW.DDNC.ORG

EXECUTIVE COMMITTEE:

Nancy Ginter, Chairperson Samir Shah, MD, President Cathy Griffith, Vice-Chairperson Bryan Green, MD, Vice-President Kim Foley, Secretary Jane Holt, Treasurer Members-at-Large: Ceciel Rooker Jonathan Rosenberg, MD Sarah Buchanan Jeanine Gleba Costas Kefalas, MD Andrew Spiegal, Esq. Maurice Cerulli, MD James Hobley, MD Immediate Past-Chairperson: Lynn Gardiner Seim, MSN, RN Immediate Past-President: Ralph McKibbin, MD Director of Development: James DeGerome, MD CONSTITUENT MEMBERS: American College of Gastroenterology American Gastroenterological Association American Liver Foundation American Neurogastroenterology and Motility Society American Pancreatic Association American Society for Gastrointestinal Endoscopy American Society for Parenteral and Enteral Nutrition Association of Gastrointestinal Motility Disorders, Inc. Beyond Celiac Celiac Disease Foundation Community Liver Alliance Crohn's & Colitis Foundation Fight Colorectal Cancer Florida Gastroenterologic Society Global Colon Cancer Alliance Global Healthy Living Foundation Global Liver Institute Griffith Family Foundation G-PACT International Foundation for Gastrointestinal Disorders Louisiana Gastroenterology Society Massachusetts Gastroenterology Association Megacystis Microcolon Intestinal Hypoperistalis Syndrome National Celiac Association National Pancreas Foundation New York Society for Gastrointestinal Endoscopy North American Society for Pediatric Gastroenterology, Hepatology and Nutrition North Carolina Society of Gastroenterology No Stomach for Cancer Ohio Gastroenterology Society Oley Foundation Pennsylvania Society of Gastroenterology Society of Abdominal Radiology Society of Gastroenterology Nurses and Associates, Inc. South Carolina Gastroenterology Association Texas Society for Gastroenterology and Endoscopy United Ostomy Associations of America VHL Alliance INSTITUTIONAL MEMBERS AbbVie Allergan, Inc. Amgen, Inc. Intercept Pharmaceuticals Janssen Pharmaceuticals Companies of Johnson & Johnson Pfizer, Inc. RedHill Biopharma Takeda Pharmaceuticals USA, Inc. United Chemical Companies of Belgium ADMINISTRATION

Health & Medicine Counsel DALE P. DIRKS JACKSON RAU LESIA GRIFFIN Founder & President Emeritus Suzanne Rosenthal

April 2, 2020

MEMORANDUM

TO: Digestive Disease National Coalition

FR: Dale Dirks & Jackson Rau

RE: DDNC COVID-19 Provisions

Over the past three weeks, Congress has been tasked with passing multiple

pieces of COVID-19 legislation, with the latest bill containing over $2 trillion in

emergency aid. Congress is currently eyeing a fourth bill to include more direct

payment for individuals and funding for state and local governments.

Throughout the process, the DDNC has fought and will continue to fight for key

provisions that will help patients and providers during this time of emergency.

Key provisions the DDNC has advocated for that have been addressed in enacted

legislation include:

Protecting Health Care Workers and Families

● DDNC Recommendation: Increase funding for and access to Personal

Protective Equipment (PPE) and activate the Defense Production Act

so health care workers can provide care as safely as possible.

○ COVID-19 Legislation & Policy Change: $16 billion approved

for the strategic national stockpile, which includes funding for

personal protective equipment.

○ COVID-19 Legislation & Policy Change: $1 billion allocated for

Defense Production Act Purchases.

…

DDNC Recommendation: Support hospitals, health care practices, ambulatory surgery

centers, and other health care facilities that have been financially devastated by the

crisis as they provide care to patients, including small businesses that are subject to

increased costs associated with the care of COVID-19 patients and lack needed

equipment such as PPE.

o COVID-19 Legislation & Policy Change: $100 billion appropriated to address lost

revenue and expenses for hospitals and healthcare providers responding to

COVID-19.

Bolster Continuity of Care

● DDNC Recommendation: Urge all public and private insurers to reimburse for telehealth

at adequate levels

○ COVID-19 Legislation & Policy Change: Health and Resource Service

Administration’s Telehealth Resource Center grant programs have been

reauthorized at $29 million a year through 2025

○ COVID-19 Legislation & Policy Change: $14.4 billion to VA to expand telehealth

services

○ COVID-19 Legislation & Policy Change: $1.032 billion to Indian Health Services for

telehealth

○ COVID-19 Legislation & Policy Change: $27 billion for Health and Human

Service’s Public Health and Social Services Emergency Fund for COVID-19

measures, which includes telehealth

● DDNC Recommendation: Provide patients and providers with the flexibility to choose

the site of the patient’s infusions based on their local resources, including by

temporarily waiving site-specific infusion authorization, providing temporary coverage

for out of network infusions, and making it easier for patients to switch the delivery

mechanism of their treatment from an infusion to a self-injectable if deemed medically

appropriate by the patient and provider

o COVID-19 Legislation & Policy Change: Centers for Medicare and Medicaid

Services (CMS) interim final rule in response to COVID-19 provides temporary

changes to physician supervision requirements that could— for some patients—

allow for drugs covered incident to physician services to be provided in a patient’s

home.

● DDNC Recommendation: Require all payers to allow the provision of an emergency

supply of medications and medical supplies, such as ostomy supplies and catheters that

patients rely on daily, by relaxing restrictions on the timing of refills and permitting

amounts to at least the CDC-recommended extra 30-day supply standard to prevent

disruption and ensure patient safety and health

○ COVID-19 Legislation & Policy Change: Restrictions extended to a 90-day supply

for a Part D covered drug

Invest in Emergency Preparedness

● DDNC Recommendation: Invest in research and public health interventions at the

National Institutes of Health (NIH), the Centers for Disease Control and Prevention

(CDC), and other agencies to ensure a vigorous federal pandemic team is in place both

now and in the future.

○ COVID-19 Legislation & Policy Change: $4.3 billion for CDC

○ COVID-19 Legislation & Policy Change: $1.78 billion for NIH when combined with

previous supplemental funding

○ COVID-19 Legislation & Policy Change: $10.5 billion toward the Department of

Defense

○ COVID-19 Legislation & Policy Change: $20 billion approved for Veterans Affairs

(VA)

The DDNC will seek to continue to build additional support for the above-stated

recommendations during subsequent COVID19 legislation and with federal agencies carrying

out and implementing policy changes.