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Internists Commend Congress for Steps to Improve Health Security, Urge Actions to Keep Physician Practices Open during COVID-19 Emergency

Washington, DC (March 26, 2020) —The American College of Physicians (ACP) believes that the Coronavirus Aid, Relief, and Economic Security Act or the ‘‘CARES Act” nearing enactment by Congress is an essential step forward in providing for the health and economic security of our nation during a national crisis, yet is concerned it may not do enough to support struggling physician practices.

ACP expressed its appreciation for several priorities that were included in the legislation.  This includes:

  • Funding for the manufacturing, supply, and distribution capacity for Personal Protective Equipment (PPE). ACP continues to stress that all possible means are used to ensure that there is sufficient PPE immediately available to every physician, nurse, and health worker on the front lines of caring for patients who may have COVID-19 without delay.
  • The establishment of an emergency program that would help sustain physician practices through reimbursements to eligible health care “providers” for health care related expenses or lost revenues that are attributable to coronavirus.ACP urged Congress and the Administration to ensure physician practices will be able to qualify for funding in time to sustain them. Without immediate and direct support, practices may not be able to meet payroll and will be at risk of closing, at a time when they are needed most.
  • Provisions to provide payroll tax relief, loans, and other programs to help smaller businesses that may help physicians in practices that qualify.
  • Providing a Paycheck Protection Loan Program and loan forgiveness.These need to be implemented quickly, and in a way that helps physician practices.
  • Including advance tax credits. ACP believes the advance tax credits for expanded paid sick and family leave will be helpful to many physician practices.This provision too will need to be implemented in a way that is readily accessible to smaller physician practices.
  • Suspension of the Medicare sequester throughout the rest of 2020. This will provide appropriate relief to physicians and hospitals from scheduled cuts.
  • Reauthorization of funding for critical health programs.
  • Protection for patients from some out-of-pocket expenses associated with COVID-19 testing and treatment.

“We are concerned that while the CARES Act advances several key priorities as recommended by ACP in our previous communications, there still may not be sufficient or timely enough support for physician practices to sustain them during this national emergency,” wrote Robert McLean, MD, MACP, president, ACP in a letter to congressional leadership. “We are hearing from many smaller primary care practices in particular that they soon may not be able to make payroll without more direct support and could even be forced to close their doors.“

In the letter ACP detailed what else needs to be done to ensure that physician practices are able to remain in operation, including:

  • Require that all payers cover and pay for audio-only telephone consultations between physicians and their patients, and urge CMS to require such payments. While virtual telehealth visits may be covered in some cases by insurers, they typically are paid far less than in-person visits, and do not include traditional audio-only phone calls with patients, only video-enabled telehealth applications.
  • Congress should exercise oversight and provide direction to the Administration to ensure that the provisions in the CARES Act to provide emergency grant funding and direct payments to physicians and their practices, and to provide low-interest loans, tax credits, and tax relief to businesses, are implemented in a way that expressly provides needed support to physician practices as quickly as possible.
  • Ensure Medicaid parity throughout the duration of the COVID-19 national emergency.This 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 COVID-19 public health emergency. ACP strongly supports the renewal of applying the Medicare payment rate floor to primary care services furnished under Medicaid and is very disappointed that this did not make it into the final bill.
  • Enact a grant program expressly to support and sustain physician practices. ACP expressed disappointment that bill did not include the Immediate Relief for Rural Facilities and Providers Act of 2020 as an amendment, which would provide direct grants and low-interest loans to physicians during this crisis.
  • Require that the administration pay physicians and hospitals 110 percent of the Medicare rates for providing COVID-19-related treatment for uninsured persons.
  • Increase Medicare physician fee schedule payments to physicians for the duration of the public health emergency (and retroactively to the date of the national emergency declaration).

“We offer the above recommendations for additional steps in the hope they will be addressed in subsequent COVID-19 legislation, by effective and timely implementation by the administration of the provisions in the bill in a way that expressly supports physician practices, and through congressional oversight,” Dr. McLean concluded the letter.

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About the American College of Physicians

The American College of Physicians is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. ACP membership includes 159,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter, Facebook, and Instagram.

Contact: Jackie Blaser, (202) 261-4572, jblaser@acponline.org