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SHM Joins Multi-Stakeholder Letter on COVID-19 Stimulus Relief


March 25, 2020

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SHM supports legislation that affects hospital medicine and general healthcare, advocating for hospitalists and the patients they serve.

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March 25, 2020

The Honorable Nancy Pelosi
Speaker of the House of Representatives
U.S. Capitol Building, H-222
Washington, DC 20515

The Honorable Kevin McCarthy
House Republican Leader
U.S. Capitol Building, H-204
Washington, DC 20515

The Honorable Mitch McConnell
Senate Majority Leader
U.S. Capitol Building, H-230
Washington, DC 20510

The Honorable Charles Schumer
Senate Democratic Leader
U.S. Capitol Building, S-221
Washington, DC 20510

Dear Speaker Pelosi, Leader McConnell, Leader McCarthy, and Leader Schumer:

The undersigned organizations urge Congress to include in the final “stimulus” legislation specific provisions to help physicians sustain their practices and provide their patients with the best possible care during the COVID-19 emergency. Specifically, the legislation should support and sustain physicians and their practices during this unprecedented national emergency through tax relief, no-interest loans, direct payments, payment for virtual visits including phone calls, and other measures.

To protect patients from exposure to the virus and conserve resources for the epidemic, physicians are heeding the call to suspend most elective in-person visits and replace them with virtual visits to the extent possible as requested by the CDC, other public health authorities, and their own professional societies.

This is putting severe financial pressure on physicians and their practices, in all types of practice and in all specialties, because most payers including Medicare pay physicians based mostly on the number of in-person visits and procedures they provide, with only limited coverage for telehealth visits. 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. Accordingly, we recommend that the stimulus legislation:

  1. Require all payers, including ERISA plans, to provide coverage and payment for audio-only telehealth visits with patients, at the same level as in-person visits. 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. Many patients, especially seniors, have access to phones but not video-enabled telehealth apps.
  2. Provide dedicated and direct financial support to physicians and their practices on the front lines of testing, diagnosing, and treating patients at risk of COVID-19, recognizing the increased costs they are incurring in the care of such patients. These costs include acquiring personal protection equipment (PPE) and other supplies, even as they are experiencing reduced practice revenue. Some are even incurring the expense of temporarily relocating their residences to reduce the risk of spreading the virus.
  3. Provide dedicated financial support to all physicians and their practices who are experiencing adverse economic impact on their practices from suspending elective visits and procedures.

We also strongly urge that Congress take all possible actions to ensure that every physician, and every health care worker, has access to critically needed PPE. The lack of such supplies is placing both physicians and patients at great risk of acquiring COVID-19 and spreading it to others. Eighty-nine percent of physician practices in a March 19 MGMA survey reported experiencing shortages of critical PPE. The funding that Congress has already approved must be increased, and all possible actions must be taken to increase the capacity to manufacture, acquire, and distribute PPE.

The above steps, combined with other measures to make care affordable for patients at risk of COVID-19 are essential to slowing the spread of the virus, and supporting physicians as they honor their sacred obligation to provide care to patients in need, including doing no harm to patients by eliminating elective visits and procedures to minimize patient exposure to the virus.

Sincerely,

Academy of Physicians in Clinical Research
AMDA - The Society for Post-Acute and Long-Term Medicine
American Academy of Allergy, Asthma and Immunology
American Academy of Dermatology Association
American Academy of Emergency Medicine
American Academy of Facial Plastic and Reconstructive Surgery
American Academy of Family Physicians
American Academy of Hospice and Palliative Medicine
American Academy of Ophthalmology
American Academy of Otolaryngic Allergy
American Academy of Otolaryngology - Head and Neck Surgery
American Academy of Pain Medicine
American Academy of Pediatrics
American Academy of Physical Medicine and Rehabilitation
American Association for Hand Surgery
American Association of Child and Adolescent Psychiatry
American Association of Clinical Urologists
American Association of Hip and Knee Surgeons
American Association of Orthopaedic Surgeons
American Association of Public Health Physicians
American College of Allergy, Asthma and Immunology
American College of Cardiology
American College of Chest Physicians
American College of Emergency Physicians
American College of Medical Genetics and Genomics
American College of Obstetricians and Gynecologists
American College of Osteopathic Surgeons
American College of Physicians
American College of Radiation Oncology
American College of Radiology
American College of Rheumatology
American College of Surgeons
American Epilepsy Society
American Gastroenterological Association
American Geriatrics Society
American Medical Association
American Medical Group Association
American Medical Women’s Association
American Orthopaedic Foot & Ankle Society
American Osteopathic Association
American Psychiatric Association
American Society for Dermatologic Surgery Association
American Society for Gastrointestinal Endoscopy
American Society for Radiation Oncology
American Society for Surgery of the Hand
American Society of Addiction Medicine
American Society of Anesthesiologists
American Society of Cataract and Refractive Surgery
American Society of Dermatopathology
American Society of Echocardiography American Society of Hematology
American Society of Laser Medicine and Surgery
American Society of Neuroradiology
American Society of Nuclear Cardiology
American Society of Plastic Surgeons
American Society of Retina Specialists
American Thoracic Society
American Urological Association
American Vein & Lymphatic Society
Association for Clinical Oncology
Association of American Medical Colleges
Endocrine Society
Heart Rhythm Society
International College of Surgeons – United States Section
International Society of Hair Restoration Surgery
Medical Group Management Association
National Association of Spine Specialists
National Medical Association
Outpatient Endovascular and Interventional Society
Renal Physicians Association
Society for Cardiovascular Angiography and Interventions
Society of American Gastrointestinal Endoscopic Surgeons
Society of Cardiovascular Computed Tomography
Society of Critical Care Medicine
Society of Hospital Medicine
Society of Interventional Radiology
Society of Nuclear Medicine and Molecular Imaging
Spine Intervention Society
Medical Association of the State of Alabama
Alaska State Medical Association
Arizona Medical Association
Arkansas Medical Society
California Medical Association
Colorado Medical Society
Connecticut State Medical Society
Medical Society of Delaware
Medical Society of the District of Columbia
Florida Medical Association Inc
Medical Association of Georgia
Hawaii Medical Association
Idaho Medical Association
Illinois State Medical Society
Indiana State Medical Association
Iowa Medical Society
Kansas Medical Society
Kentucky Medical Association
Louisiana State Medical Society
Maine Medical Association
MedChi, The Maryland State Medical Society
Massachusetts Medical Society
Michigan State Medical Society
Minnesota Medical Association
Mississippi State Medical Association
Missouri State Medical Association
Montana Medical Association
Nebraska Medical Association
Nevada State Medical Association
New Hampshire Medical Society
Medical Society of New Jersey
New Mexico Medical Society
Medical Society of the State of New York
North Carolina Medical Society
North Dakota Medical Association
Ohio State Medical Association
Oklahoma State Medical Association
Oregon Medical Association
Pennsylvania Medical Society
Rhode Island Medical Society
South Carolina Medical Association
South Dakota State Medical Association
Tennessee Medical Association
Texas Medical Association
Utah Medical Association
Vermont Medical Society
Medical Society of Virginia
Washington State Medical Association
West Virginia State Medical Association
Wisconsin Medical Society
Wyoming Medical Society