Advocacy Update

Aug. 7, 2020: National Advocacy Update

. 3 MIN READ

As the AMA has urged, the Department of Health and Human Services (HHS) has addressed a significant problem with distribution of the CARES Act Provider Relief Fund to physicians with patients insured by Medicaid. Previously, physicians who received even very small amounts from the General Distribution in April were deemed ineligible to apply for CARES Act funds targeted at physicians who rely significantly more on revenue from the Medicaid program than from Medicare.

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HHS has now reversed that decision and, beginning the week of Aug. 10, will allow physicians who faced challenges with the General Distribution funding a new opportunity to receive funding. HHS is also extending the deadline for physicians who have received no funds from the CARES Act but who treat patients insured by Medicaid until Aug. 28. Once the portal is reopened, physicians can submit their revenue information to receive CARES Act funds equal to two percent of their total revenues prior to the pandemic. Additional information is available here.

On July 31, the AMA sent a letter urging the Centers for Medicare & Medicaid Services (CMS) to delay the start of repayments associated with the Medicare Accelerated and Advance Payment Program to allow physicians to respond to COVID-19 and continue to provide the vital care expected by patients and their communities. The expanded Medicare Advance Payment Program offered an important lifeline to cash-strapped physician practices in the early weeks of the pandemic. Physicians who participated are scheduled to start repaying these advance payments soon. While the AMA remains hopeful there will be improvements to the program as part of the next COVID-19 relief package, it is uncertain whether Congress will pass this legislation before the repayment period begins. The letter makes clear that the current crisis is not over, and physician practices are still struggling and in need of support.

CMS and the Centers for Disease Control and Prevention (CDC) announced CMS will leverage existing evaluation and management (E/M) codes to pay physicians to counsel patients at the time of COVID-19 testing about the importance of self-isolation after they are tested and prior to receiving test results. According to CDC models, when individuals who are tested for the virus are separated from others, there can be up to an 86% reduction in the transmission of the virus compared to a 40% decrease in viral transmission if the person isolates after symptoms arise. CMS and CDC encourage counseling patients about the signs and symptoms of COVID-19, the immediate need to separate from others, informing close contacts about being tested, participating in contact tracing efforts and services available to assist the patient while quarantining. Additional information, including a Q&A document, a check list and CDC guidance, is available in this MLN Matters fact sheet.

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