Massachusetts Medical Society: State Medical Association Letter to Senate Regarding Next COVID-19 Relief Package

State Medical Association Letter to Senate Regarding Next COVID-19 Relief Package

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, D.C. 20510

Dear Senators McConnell and Schumer:

The undersigned large state medical associations, representing tens of thousands of physicians across the nation, thank you for supporting physicians and helping us continue to care for patients during the COVID-19 pandemic. As the Senate considers another vital COVID-19 response package, we ask that you prioritize the stability of our state-federal partnerships that form the foundation of our health care delivery system. Addressing the needs of states and physicians on the frontlines combating the virus will ensure that our health care system and our economy recover from this crisis.

Additional Aid to States and the Medicaid Program

With millions of Americans losing their jobs and employer-sponsored health insurance coverage, Medicaid has become an essential safety net for families and enrollment is rapidly growing. Half of America’s children and people with disabilities were already enrolled in Medicaid prior to COVID-19. The growth in unemployment has also significantly reduced state tax revenues as states have been forced to commit substantial additional resources to fight the economic and health care impact of COVID-19. As a result, states are in serious financial trouble and they do not have the same financing options that are readily available to the federal government. Thus, states will be forced to cut health care funding. Moreover, states have little flexibility and will be forced to impose cuts on physicians and hospitals that are on the frontlines now already reeling financially from the COVID outbreak, and who will be needed during the second surge caused by months of delayed care. Medicaid physicians have yet to receive any federal assistance and they will not be able to sustain state cuts during the pandemic to remain accessible to patients enrolled in Medicaid and other federal, state, and local health care programs. Medicaid patients (children, pregnant women, the elderly and disabled) are already among our most vulnerable patients and during the national emergency, more must be done to protect them. We cannot afford to lose our current health care workforce during this crisis.

While we appreciate the support Congress provided in the Families First Coronavirus Response Act with the temporary 6.2% increase in Medicaid matching funds for states, more help is needed for states and physicians to meet the increasing Medicaid enrollment demands and our patient’s health care needs.

Therefore, we urge Congress to

  • Provide additional aid to the states to protect the health care workforce and to prevent irreversible health care cuts.
  • Increase Medicaid matching funds by 14% consistent with the Heroes Act.
  • Direct HHS to release Provider Relief Funds to Medicaid physicians immediately.

Additional HHS Emergency Provider Relief Funding and A More Equitable Distribution Formula

We greatly appreciate the funding that Congress provided to physicians through the HHS Provider Relief Fund. It is helping to sustain some physician practices that are facing increased health care expenses and severe 50-70% revenue losses caused by the public health emergency, social distancing, efforts to conserve personal protective equipment (PPE) and public health orders to refrain from providing non-urgent care. However, physician practices will need additional funding to remain accessible to patients in their communities given the substantial revenue losses, the extended timeframe for reopening, the ability to only operate at 50% capacity in the future because of social distancing, safety measures, and limited PPE. Moreover, physicians are essential to the health of their communities, as well as their economic well-being. Physicians contribute to their local economies and are important employers. The fall-out from this crisis threatens to fundamentally alter the long-term stability of physician practices, and could lead to increased consolidation, which hurts competition and drives up costs for patients and employers. Additional Congressional help is needed to sustain our nation’s health care delivery system.

We also urge adoption of the Provider Relief Fund distribution methodology in the House “Heroes Act,” H.R. 6800. To date, only heavy Medicare-participating physicians have received funding and only 11% of the $50 billion allocation has gone to physicians. We believe the House formula ensures a transparent, equitable distribution of funding to all providers based on their own proportionate share of expenses and revenue losses caused by the pandemic. Moreover, it would ensure that pediatricians, obstetricians, and Medicaid-dependent providers receive funding. These physicians are in the greatest need of funding because their traditionally lower reimbursement rates don’t provide the reserves to sustain their practices through the emergency.

We strongly urge Congress to increase funding to the HHS Provider Relief Fund by another $100 billion to sustain physician practices and protect patient access to care; and to ensure the funds are distributed commensurate with each provider’s COVID-19 related expenses and revenue loss from all payers.

Require all ERISA Health Plans, Medicare Advantage, and TriCare for Military Families to Cover and Pay for Telehealth and Telephone Audio-Only Services

Giving physicians the capability to provide services to patients via telehealth and telephone is essential to preventing the spread of the virus to the public, vulnerable patients, physicians, and their staff. However, many elderly and low-income patients either don’t have access to telehealth or experience difficulty navigating virtual visits with both audio and video capabilities. Therefore, it is essential that telephone visits also be covered and paid for at in-person rates by all payers. Recognizing that it is vital for the elderly to be in contact with their physicians and receive timely care, the Centers for Medicare and Medicaid Services (CMS) approved audio-only visits for the Medicare fee-for-service program but have not provided payment for it under the risk-adjusted Medicare Advantage program payments.

We ask Congress to protect the public health and include telehealth video and audio-only services in all federally regulated programs and plans, for our more vulnerable low-income patients and elderly Medicare Advantage patients.

Increase Support for the Production, Distribution, and Availability of PPE and Testing, and Accelerate Contact Tracing

There continue to be massive shortages of PPE and testing, as well as barriers to conducting COVID-19 contract tracing. We urge Congress to prioritize the production, distribution, and availability of PPE and testing, and accelerate efforts to conduct contact tracing. All of these are essential to the safe reopening of medical practices and the economy and must be prioritized for all health care workers.


Sincerely,

California Medical Association
Florida Medical Association
Massachusetts Medical Society
Medical Association of Georgia
Medical Society State of New York
North Carolina Medical Society
Texas Medical Association



This letter was also sent to the U.S. Senators representing Massachusetts, California, Florida, Georgia, New York, North Carolina, and Texas.  

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