Also urging federal government to collect and provide data on racial disparities seen in COVID-19 cases
May 15, 2020 (ACP) – While the nation's leaders work on phase 4 coronavirus relief legislation, the American College of Physicians is providing a list of priorities to aid physician practices and patients during this difficult time.
“As the organization representing the largest medical specialty in the United States, we understand how important it is for us to speak out about the fourth phase of stimulus efforts. They are so crucial to the well-being of our practices and our patients,” said Bob Doherty, ACP senior vice president for governmental affairs and public policy. “Our reputation as a trusted resource will help our message get through to the decision-makers and influence public debate.”
In a May 7 letter to congressional leaders and the Centers for Medicare & Medicaid Services (CMS), ACP urged the following:
- Increase funding for the Provider Relief Fund and ensure that a substantial portion is prioritized to support physicians and their practices based on need. Ensure that sufficient and direct funding is provided to help primary care practices recoup lost revenue and account for increased expenses related to COVID-19 through the end of 2020. “Primary care practices are under enormous financial stress,” Doherty said. “Many physician practices are weeks from closing, even with the monies dispersed to some of them.”
- Restore the Medicare Advance Payment Program and improve it so that the payback period is extended and the interest rate is lowered to zero. “ACP is greatly concerned about CMS's decision to suspend this effective program, and the rationale offered does not support suspending it,” Dr. Jacqueline W. Fincher, president of ACP, wrote in the letter to congressional leaders.
- Mandate that all payers pay for audio-only phone calls and telehealth at the same rate as in-person visits, as CMS has done for Medicare.
- Mandate Medicaid physician pay parity with the Medicare payment rate floor, especially for primary care physicians. “Such pay parity should last at least for the duration of the COVID-19 emergency, although we strongly believe it should be made permanent thereafter,” Fincher wrote.
- Support the physician workforce by enacting legislation to provide loan forgiveness for frontline medical students, residents and physicians. Reauthorize the Conrad State 30 J-1 visa waiver program and provide a pathway to immigrant visas for international medical graduates (IMGs).
- Ensure access to Medicaid by increasing the federal contribution. “State economies are sustaining a massive decrease in revenues during the COVID-19 public health emergency and the Federal Matching Assistance Percentage increase provides a welcome cash infusion,” Fincher wrote.
- Fund the public health capacity needed to partially and safely resume certain economic and social activities at a state and community level, as laid out in ACP's new guidance on Partial Resumption of Economic, Health Care and Other Activities While Mitigating COVID-19 Risk and Expanding System Capacity.
On May 12 the House of Representatives released its version of the phase 4 legislation, the Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act. The HEROES Act would provide additional relief to physician practices, and incorporate many of the recommendations from ACP. It would add $100 billion in emergency funding to physicians and their practices and hospitals for lost revenue and increased expenses, restore and make improvements to the Medicare Accelerated and Advance Payment Program including lowering the interest rate and providing more time for repayment, makes it easier for IMGs to get visas to help in the efforts to fight COVID-19 and attend residency programs, and fund testing and contact tracing.
“ACP is strongly supportive of increasing emergency funding to physicians for lost revenue and increased expenses” said Doherty. “We will continue to urge that primary care practices, internal medicine subspecialists, and smaller practices be prioritized. We also are greatly encouraged by the provisions to help IMGs enter the U.S. and to fund the testing and tracing needed to begin resuming economic activities.”
Doherty cautioned, however, that it remains unclear when and if the Senate will consider similar legislation. “Our advocacy must continue to ensure both the House and Senate, and the White House, agree on a plan to help physicians and their patients in this unprecedented emergency.”
In addition to listing its priorities regarding the fourth phase of stimulus efforts, ACP is weighing in on the importance of collecting data related to racial disparities in COVID-19.
In an April 28 letter to Alex Azar, secretary of the U.S. Department of Health and Human Services, Fincher urged the federal government to “begin immediately collecting and publicly releasing racial, ethnic, and patient's preferred language data around COVID-19 testing, hospitalizations, and death.”
Writing on behalf of ACP, Fincher explained that “such action is imperative in order to equip physicians, researchers, and policymakers with sufficient information to better understand the circumstances and characteristics unique to treating and caring for racial and ethnic minority communities and those with limited English proficiency.”
Current data are not likely to be fully accurate, she warned. “ACP strongly believes more research and data collection related to racial and ethnic health disparities is needed to empower stakeholders to better understand and address the problem of disparities,” Fincher wrote.
