The downstream impact of COVID-19 has reached nearly every aspect of the health care delivery system. As the nation wades through this period of inherent instability, the American College of Radiology® (ACR®) has remained committed to engaging Congress and the Administration to identify and advance policies to mitigate the impact of this ongoing public health crisis.
Although the initial Coronavirus Aid, Relief, and Economic Security Act focused on providing immediate financial relief associated with the pandemic’s myriad impacts, discussions are now underway among Congressional leaders and key committee members to craft future legislation to further address issues of concern that are especially relevant now in this acute period. Discussions will continue to drive policymaking when the country turns to a more economic- and jobs-oriented recovery effort.
Given Congress’ interest in moving forward with another comprehensive COVID-19-related legislative package, the ACR’s government relations team continues to provide lawmakers with policy recommendations specifically focused on ensuring and/or promoting financial stability for physicians and their patients.
The ACR and others in the health care community believe aggressive action is necessary to ensure physician practices can resume and maintain routine patient care, address the need for ongoing COVID-19-related services and simultaneously recover from the negative economic impacts of the current public health emergency.
To help us achieve this goal, the ACR has urged Congress to include the following policy recommendations in forthcoming legislation:
Continue Direct Financial Support for Physicians
- Provide additional funding for the newly authorized and expanded small business loans under the Small Business Administration (SBA).
- Include the bipartisan Immediate Relief for Rural Facilities and Providers Act (H.R. 6365/S. 3559) in the next coronavirus relief package. This legislation would leverage the SBA to ensure access to low-rate, deferred-interest loans specifically for physicians and provide a one-time stabilization grant for physicians based on their payroll.
Promote Long-Term Financial Stability and Recovery
- Waive the budget neutrality requirements stipulated in Section 1848(c)(2) of the Social Security Act for the finalized, Evaluation and Management code proposal slated for implementation in the Medicare program on Jan. 1, 2021. This much-needed action by Congress will provide a critical reprieve for physician practices facing substantial payment reductions in the coming months, while also attempting to recover from the residual financial impact of the pandemic.
- Facilitate statutory changes to Section 218(b) of the Protecting Access to Medicare Act of 2014 (PAMA), which mandated consultation of appropriate use criteria (AUC) by ordering physicians prior to referring Medicare beneficiaries for advanced diagnostic imaging services. In this time of duress, it is extremely important to ensure the appropriate utilization of advanced imaging services, such as MRI and CT exams. The ACR recommends specific changes to the PAMA AUC program that would finally allow CMS to implement this critical utilization program without having to revert to the disruptions and delays of prior authorization programs.
- Extend sequestration relief through Dec. 31, 2021 to continue providing financial relief to physician practices as we resume normal operations.
- End the current six-year physician payment freeze by implementing a positive physician update like those that other Medicare providers received in 2020.
Ease Barriers for Providing Care
- Secure a moratorium on prior authorization for private and government payers to help radiology practices best serve their patients and assist in ensuring an efficient recovery effort. Congress should also include H.R. 3107, the Improving Seniors' Timely Access to Care Act of 2019, which seeks to increase transparency and streamline prior authorization in the Medicare Advantage program, in a forthcoming legislative package.
- Provide enhanced liability protections for physicians who are responding to the pandemic and continue to provide high-quality patient care while adhering to guidance and recommendations of the Centers for Disease Control and Prevention, the US Department of Health and Human Services, and other federal, state and local government directives.
This list may not be exhaustive, but the ACR believes the aforementioned policy recommendations represent critical and necessary steps toward establishing financial stability for physician practices and ensuring access to care for their patients. Although the timeline for additional legislative activity remains fluid, the ACR government relations team expects Congressional leaders to engage in substantive discussions relating to a broad package framework over the coming weeks.
To amplify the ACR’s policy recommendations, the government relations team will initiate a rolling advocacy campaign for ACR members through the month of May, including a comprehensive “Call to Action” and potential opportunities for direct engagement with lawmakers. Stay tuned for more information!