ACP Urges Congress to Pass Comprehensive Phase 4 Stimulus Legislation

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Specifically, ACP is seeking expansion of the Provider Relief Fund to enhance primary care practice

Aug. 14, 2020 (ACP) – The nation is eagerly awaiting action on the next round of coronavirus stimulus legislation, but Congress has still not reached agreement on a phase 4 bill. With the health of the U.S. medical system in mind, the American College of Physicians continues to push leaders to act quickly on a complete and comprehensive package.

“ACP is dedicated to improving the outlook for primary care in the dual interest of improved quality and lower cost in health care,” said Rich Trachtman, ACP director of legislative affairs. “We're especially focused on the expansion of the Provider Relief Fund, which has been a component of COVID-19 relief legislation. We see a real opportunity to enhance primary care practice for the benefit of patients, physicians and third-party payment programs.”

As of Aug. 11, Republican and Democratic leaders in the U.S. House and Senate had failed to reach an agreement on the fourth phase of stimulus legislation to help Americans get through the pandemic crisis. President Trump did sign executive orders in areas such as unemployment and evictions, but critics are raising questions about whether the president's actions will have any significant impact.

“Unfortunately, there is a potential for confusion about the true nature and effect of the executive orders on the part of large segments of the population who depend on the programs that the executive orders purport to help,” Trachtman said. “There are likely to be many patients in that category.”

On July 30, ACP wrote to Senate leaders about the Health, Economic Assistance, Liability Protection and Schools (HEALS) Act.

“While we are greatly appreciative of some of the provisions in the HEALS Act, the Senate still needs to take further action to support physicians and their practices so that they can continue to provide care on the frontlines at a time when they are needed most,” wrote Dr. Jacqueline W. Fincher, president of ACP. “Accordingly, Congress should develop and reach agreement on bipartisan legislation to address the ongoing public health emergency caused by the Coronavirus.”

Specifically, ACP calls for the following actions to improve upon the HEALS Act, which has not been approved by the Senate:

  • Increase spending for the Public Health and Social Services Emergency Fund, which includes the Provider Relief Fund, beyond the $25 billion allocated to reimburse hospitals and health care providers for health care-related expenses and lost revenue due to the coronavirus public health emergency.
    ACP believes more funds for the Provider Relief Fund should be prioritized and targeted directly to primary care. “We view the Provider Relief Fund as an opportunity, if properly utilized, to help move the primary care field closer to realizing its tremendous potential to facilitate the provision of high-quality health care at a lower cost,” Trachtman said.
    On a related front, ACP has endorsed bipartisan legislation in the House that would make the payments that physicians receive from the Provider Relief Fund tax-free. The bill would also guarantee that expenses attributable to the fund are tax-deductible.
  • Add a mandate that all payers pay for all audio-only phone calls and telehealth services that take place between patients and their physicians at the same rate as in-person visits. The Centers for Medicare & Medicaid Services has already done this for Medicare.
  • Extend Medicaid pay parity at Medicare rates for primary care services. “Ensuring this pay parity for vital primary care services during this national pandemic, when patients so desperately need access to their primary care physicians, but also beyond is absolutely necessary,” Fincher wrote.
  • Extend the CARES Act's deferment of student loan payments, principal and interest for six months, through Sept. 30, 2020, without penalty to the borrower for all federally owned loans at least through the end of 2020 or through the end of the public health emergency.
  • Include measures to forgive student loan debt for medical students, residents and physicians on the front lines of COVID-19; expand loan repayment and scholarship programs of the National Health Service Corps; permanently reauthorize the Conrad 30 J-1 visa program for international medical graduates; and authorize additional immigrant visas for physicians.
  • Include detailed requirements to allow certain economic and social activities to be resumed in a phased and prioritized way, based on the best available evidence, in a manner that mitigates risk from COVID-19.
  • Extend and/or increase the temporary 6.2 percent increase in the Federal Match Payment for certain Medicaid spending past the duration of the public health emergency caused by COVID-19.

Trachtman is hopeful that Congress and the president will agree on a stimulus package. “I believe there are sufficient numbers of Americans that are so adversely affected by job loss and the virus that the compulsion on members of Congress to act will ultimately be strong enough especially in an election year – even though it may not seem like it today,” he said.

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