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Internists to Congress: More Needed to Support and Protect Physicians and Patients during COVID-19

Washington, DC (April 13, 2020) —In a letter sent to congressional leadership this afternoon the American College of Physicians outlined what more needs to be done to ensure the strength of our health care system during the COVID-19 national emergency. The letter laid out priorities that should be included in the next COVID-19 response bill as Congress is working on putting together the legislation.

“We ask that the needs of physician practices be prioritized because they are critical to testing, diagnosing and treating COVID-19 patients, as well as taking care of all of the other medical conditions that patients may have, through virtual visits in most cases,” wrote Robert McLean, MD, MACP, president of ACP in the letter.   

The letter reiterated a concern that ACP has raised with both Congress and the administration, the dire situation facing physician practices as they have suspended almost all in-person office visits to help protect public health. While some visits are being converted to telehealth or telephone calls, those services typically pay only a fraction of what an in-person visit would.

“As physicians convert in-person visits to virtual ones, 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,” continued Dr. McLean. “While several of the programs enacted by Congress in the CARES Act are beginning to help, much more will need to be done to prioritize and support physician practices. Otherwise, many could be forced to close in a matter of weeks.”

The recommendations for Congress outlined in the letter fell into five different categories:

  • Ensure the financial viability of physicians on the front lines of treating patients, both those with COVID-19 as well as other medical conditions that place patients at greater risk.
  • Reduce administrative burdens that may delay care for patients during this time.
  • Ensure that physicians and health care professionals have access to personal protective equipment to shield them from harm.
  • Expand coverage for treatment of COVID-19.
  • Expand health system capacity.

To provide needed assistance to keep practices open, ACP recommends that Congress:

  • Increase funding for the Payroll Protection Program to ensure that physician practices will receive the funds needed to sustain their business;
  • Increase funding for the Public Health and Social Service Emergency and direct HHS to ensure that a substantial portion of this is prioritized to support physicians and practices with the greatest need;
  • Make improvements to the Medicare Accelerated and Advance Payment Program;
  • Increase Medicare and Medicaid payments to physicians;
  • Require all payers to pay for phone calls at the same rate as in-person visits;
  • Create a new program to provide interest free loans and other mechanisms specifically for physician practices; and
  • Provide loan forgiveness and tuition relief for medical students and residents.

ACP also called for expansion of liability protection for physicians as they take on new roles during the COVID-19 emergency.

As states and facilities increasingly adopt “crisis standards of care” to prioritize treatment and allocation of resources, ACP noted that such standards could inappropriately discriminate against classes or categories of patients.  The letter called on Congress to prohibit federal programs, or in facilities receiving federal funding, any crisis standards of care that are discriminatory against any category of patients based on age, race, ethnicity, disability, sex, gender identity, social status or other personal characteristics. 

The letter also recommended improving the public health surveillance and analytics infrastructure, as well as improving the ability of public health departments to address future public health emergencies.

“We offer these recommendations in the spirit of improving the next COVID-19 response bill so that it provides the support needed to both physicians and patients, and urge that they be included in any final legislation,” concluded Dr. McLean.  “We urge Congress to work in a bipartisan manner to ensure that these policies are enacted without further delay to meet the health care and economic challenges that we face during this crisis.”

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


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.