6 steps physicians want Congress to take to keep practices solvent with COVID-19 financial aid

Editor's note: News update. The U.S. Senate voted unanimously late Wednesday to pass a $2.2 trillion economic stimulus package that includes aid to healthcare facilities. The House is expected to take up the bill on Friday and approve it, sending it to President Doanld Trump for his signature. 

As the clock ticks on the final coronavirus legislation being developed in Congress, physicians are recommending steps they hope are included in the stimulus package to protect and support their practices.

The latest group to add to a doctors’ wish list is the American College of Physicians (ACP), which sent a letter (PDF) to congressional leaders Tuesday.

The Senate is expected to convene at noon today and vote on a $2 trillion coronavirus stimulus package that will include help for affected companies and workers, direct payments to low- and middle-income families and incentives for employers to keep paying employees who are not able to currently work because of the pandemic.

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“We know that Congress has little time to negotiate the remaining details of this package and we urge you to incorporate the views of internal medicine physicians to ensure that patients have access to needed care and can afford it and that U.S. healthcare professionals have the funding, manufacturing, supply and distribution capacity needed to address this growing national health emergency,” wrote Robert McLean, M.D., the group’s president.

The ACP earlier joined with four other healthcare organizations—the Medical Group Management Association (MGMA), the American Medical Association, the American Academy of Family Physicians and the American College of Surgeons—that urged congressional leaders in a letter (PDF) to include provisions in the stimulus package including tax relief, no-interest loans, direct payments, payment for telephone calls with patients and other measures.

“Practices are experiencing huge reductions in revenue while still having to pay rent, meet payroll and meet other expenses without patients coming into their practices,” that letter said. Many practices have eliminated elective patient visits and procedures to minimize patient exposure to the highly contagious virus.

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Among the recommendations from the internist group:

1. Pay physicians and hospitals 110% of the Medicare rates for providing COVID-19-related treatment for uninsured patients, and increase Medicare Physician Fee Schedule payments to physicians for the duration of the public health emergency.

2. Require all payers to cover and pay physicians for audio-only telephone consultations with patients. The Department of Health and Human Services (HHS) has agreed to waive certain Medicare telehealth payment requirements, allowing doctors to treat patients in their homes via telehealth services and be paid under the Physician Fee Schedule at the same amount as in-person services. Many practices have had their phone lines flooded with patients concerned about coronavirus, but advising patients via the telephone is typically not a paid service.

3. Support and sustain physician practices by providing emergency grant programs and low-interest loan programs to offset lost revenue related to coronavirus.

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4. Use all possible means to ensure there is sufficient funding, manufacturing, supply and distribution capacity to get personal protective equipment (PPE) immediately to every physician, nurse and health worker on the front lines of caring for patients who may have COVID-19. Securing PPE remains a top priority for the physician community. A recent MGMA Stat poll revealed that a staggering 89% of healthcare leaders say their practice is facing a PPE shortage amid the COVID-19 pandemic.

5. Ensure Medicaid parity for the duration of the COVID-19 national emergency. Doctors hope for the renewal of application of the Medicare payment rate floor to primary care services furnished under Medicaid. That will ensure that primary care physicians and internal medicine and pediatric subspecialists are paid no less than they would be paid under Medicare for the duration of the public health emergency.

6. Reauthorize and increase funding for critical health programs including community health centers, the National Health Service Corps, Teaching Health Center Graduate Medical Education, the Centers for Disease Control and Prevention and the Public Health and Social Services Emergency Fund.

HHS announced Tuesday that the country’s federally funded community health centers, which serve some of its most vulnerable populations, will receive $100 million in federal funding to boost their role in responding to the coronavirus pandemic.