ASTRO has joined the American Medical Association and 136 other organizations representing America’s physicians to urge Congress to take additional steps to preserve the viability of physician practices. The organizations call for extensive action on a variety of fronts in order to more comprehensively address the sacrifices being made by physicians on the front lines of the COVID-19 public health emergency, as well as those experiencing financial hardship due to decreased patient volumes.
Medicare Accelerated and Advanced Payments
In regards to this payment program, the organizations urge the postponement of payment recoupment until 365 days after the advance payment is made, a reduction of recoupment from 100% to 25%, an extension of the payment period for physicians to at least two years, a waiver of interest accrual during that extended payment period and allowances for more than one advance payment. The concern regarding the excessive 10.25% interest rate associated with the Accelerated and Advance Payment program has already generated Congressional attention. Congressional leadership issued a letter to the Department of Health and Human Services requesting that the Department address the burdensome interest rates associated with the program.
Medicare and Medicaid Payment
The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 established a 0% update for 2020 through 2025. The organizations urge Congress to establish a positive payment update during this period. They also call for an increase in Medicaid payment rates to assure parity, a waiver of the budget neutrality requirement for Medicare payment changes associated with the evaluation and management services that are to be implemented January 1, 2021, and an extension of sequestration relief through December 31, 2021.
Direct Financial Support
Given the decline in revenue experienced by physician practices deferring visits and procedures as part of the system-wide effort to preserve personal protective equipment (PPE) and curb community spread of the virus, the organizations urge Congress to authorize direct financial support, grants, interest free loans, and other mechanisms for physician practices of all sizes to ensure practice viability and continued access to care for patients.
Small Business Loans
The organizations urge Congress to establish an immediate influx of additional funding to meet the clear need demonstrated by the overwhelming number of applications to the Payroll Protection Program (PPP). Additionally, they call for physician practices to receive the same eligibility exception made for Accommodation and Food Services Industry companies that operate at more than one physical location with 500 or fewer employees per location.
The organizations urge Congress to require ERISA group health plans to provide coverage for the same telehealth and telephone services being provided by Medicare for the duration of the pandemic.
As the pandemic has altered the ability of physicians to continue to provide high-quality patient care, the organizations urge broader liability protections for physicians and other clinicians and the facilities in which they practice.