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New COVID-19 Legislation Spells Relief for Primary Care Physicians and Patients

Advocate Masthead

Legislation increases Medicare payments, funds COVID-19 testing, contact tracing and vaccine distribution

Jan. 8, 2021 (ACP) – There are some big wins for primary care tucked into the newest $900 billion COVID-19 relief package, including increased Medicare payments, more slots for residents and funding to support COVID-19 testing, contact tracing and vaccine distribution.

“The American College of Physicians believes the emergency relief legislation enacted by Congress … advances critically important policies to support patients and their physicians during the COVID-19 pandemic,” Dr. Jacqueline W. Fincher, ACP president, said in a statement.

For starters, the new legislation raised Medicare relative values for office visits and other related evaluation and management codes, effective Jan. 1, 2021. “Higher relative values translate into higher payments,” said Bob Doherty, ACP senior vice president for governmental affairs and public policy.

The new bill also offsets budget neutrality cuts and provides an across-the-board 3.75 percent increase in Medicare payments to physicians in all specialties. “Congress did not pick winners and losers by holding some services harmless from the cuts while allowing others to be affected by them,” Doherty said. Unfortunately, Congress delayed action on a new add-on code (G2211) for three years. This code would allow physicians to bill additional amounts to reflect the complexity of a visit.”

The new legislation also establishes 1,000 more Medicare-supported Graduate Medical Education positions. “This is a big win as residency slots have been capped for a long time,” Doherty said. “There aren't enough residency positions to go around, and this is the first time in a long time that Congress agreed we are facing shortages of physicians and need to increase residency positions.”

More Money for COVID-19 Relief, End to Surprise Medical Billing

The legislation will expand the Paycheck Protection Program and provide funding for vaccines, testing and contact tracing, including $9 billion to the Centers for Disease Control and Prevention for vaccine distribution, about $42 billion to the U.S. Department of Health and Human Services for purchasing vaccines and to help states with testing and contact tracing, and $3 billion to the National Strategic Stockpile.

In another victory, Congress agreed to ban surprise medical billing and hold patients harmless from unfair and excessive charges, which ACP has long advocated for, Doherty said. “It also allows physicians the ability to seek arbitration with the insurer, and rates will not be pegged to unrealistically low in-network or Medicare payment rates,” he said.

Congress will also fund key public health and workforce programs, such as Community Health Centers and the National Health Service Corps, through 2023. “The three-year period is important because when people go into a program, they want to make sure the money is there for loan repayment and forgiveness in exchange for service, and communities need stability,” Doherty said.

Congress will also fund Title VII Primary Care Training and Enhancement for fiscal year 2021. “This has been put on the chopping block each year to be defunded, so this is good news,” Doherty said.

“The public health crisis forced Congress to take action that they otherwise would not have taken and to spend more money than they otherwise would have,” he said. “The pandemic has shown us how fundamentally broken our health care system is, and while these are huge wins, there is still a lot of work to do.”

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Back to the January 8, 2021 issue of ACP Advocate