Although progress has been made, more needs to be done to fund physicians on the front lines, improve access to PPE and open insurance marketplaces
April 17, 2020 (ACP) – As the coronavirus 2019 (COVID-19) pandemic continues to grip the country, the American College of Physicians is sounding the alarm about actions that the federal government must take to protect patients and allow physicians to focus on their vital work.
“We're continuing to speak up and focus the attention of policymakers during this crisis,” said Bob Doherty, ACP senior vice president for governmental affairs and public policy. “While we appreciate the progress that's been made, more needs to be done.”
Here's a look at priority areas for ACP advocacy.
Funding for physicians and hospitals. ACP is pleased that doctors are starting to see money flow from a $100 billion coronavirus relief fund into their accounts. The money is intended to directly offset revenue that has been lost due to the pandemic.
“ACP supported that fund, and we've expressed to the Centers for Medicare & Medicaid Services on numerous occasions that it's important to get those dollars out the door as soon as possible,” Doherty said. “Physicians are struggling to make payroll, and some are weeks away from having to shutter their practices.”
However, he said, CMS is still determining how to distribute $70 billion of the $100 billion. “Physicians on the front lines of providing care should be prioritized,” he said.
According to Doherty, physicians are also starting to see money come in from a separate disbursement program that provides advances – which must be repaid – on Medicare revenue expected later this year.
Meanwhile, ACP is monitoring the rollout of the Small Business Administration Paycheck Protection Program, which provides loans to cover payroll costs. News reports have chronicled the rollout's delays and difficulties.
Looking ahead, ACP wrote a letter to congressional leaders on April 13 that laid out a series of steps that the federal government must take in its next coronavirus response bill.
“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,” Dr. Robert McLean, president of ACP, wrote in the letter. “While several of the programs created by the CARES (Coronavirus Aid, Relief, and Economic Security) Act and the decisions that the Centers for Medicare and Medicaid Services (CMS) has made to support physicians and their practices – such as partially paying for some phone calls and disbursing emergency funding to them – will certainly help, many still will not be able to survive a continued decline in practice revenue without more support.”
ACP calls for a series of actions by Congress:
- Increase funding for the Paycheck 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 Fund and direct the Department of Health and Human Services to ensure that a substantial portion of this funding is prioritized to support physicians and practices with the greatest need.
- Make improvements to the Medicare Accelerated and Advance Payment Program and extend the amount of time in which physicians would have to pay back Medicare for advance payments.
- 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.
- Provide loan forgiveness and tuition relief for medical students and residents.
Opening insurance marketplaces and allowing special enrollment periods. Some states have opened their insurance marketplaces to allow enrollment during the COVID-19 period, but the White House has refused to do so in states that are served by the federal marketplace program. “We've written to the president asking him to reconsider that decision,” Doherty said. “For now, it's important to let people know that current law allows those who lost their jobs and their current insurance to qualify for special enrollment outside the usual enrollment period.”
Improving access to personal protective equipment. “While there are some indications that things might have improved marginally in some parts of the country, we are hearing directly – and sometimes anonymously – that hospitals and clinics still don't have sufficient personal protective equipment,” Doherty said. “We think more can be done, and we have called on the president to more broadly invoke the emergency powers of the Defense Production Act to direct the manufacture of vital equipment and prevent price gouging.”
ACP believes that physicians should not be disciplined or terminated for speaking out publicly about conditions that affect patient care at their institutions. “As for us,” Doherty said, “we'll continue to speak out on behalf of medical professionals and patients.”
ACP also called on President Trump to reverse his decision earlier this week to cut U.S. funding to the World Health Organization.
In a statement reacting to that decision Dr. Robert McLean, president of ACP said, “We should be focusing on ways that we can encourage and improve global collaboration. We should be focusing on supporting science to allow us to make evidence-based decisions that will help us in our efforts to slow the spread of the virus, build up health system capacity, and save lives, in the United States and worldwide.”
More Information
Additional resources to help physicians and their practices deal with COVID-19 are available on the Practice Resources section of the ACP website
Back to the April 17, 2020 issue of ACP Advocate