- The American Medical Association and scores of other clinician groups are asking HHS to provide one month revenue to each physician, nurse practitioner and physician assistant enrolled in Medicare or Medicaid to account for financial losses and non-reimbursable expenses incurred during the COVID-19 pandemic.
- In light of widespread revenue loss at practices that have closed or canceled elective procedures, the funds would go toward paying workers’ salaries, benefits and overhead, and making necessary investments to continue providing care such as telehealth, according to a letter sent Monday to HHS Secretary Alex Azar.
- The money would come from the Coronavirus Aid, Relief and Economic Security Act, which offers little detail about how it will be distributed and gives significant discretion to HHS. While the legislation does include small business assistance, large practices with 500 or more employees won’t qualify.
While frontline healthcare workers are being hailed as heroes in treating COVID-19 patients, many in the sector are under pressure financially. Many workers at doctor's offices or involved in elective surgeries put on hold to stem community spread and preserve potentially needed medical resources are getting their hours cut back and struggling to stay afloat.
The letter signed by groups representing cardiologists, spine specialists and scores of others urged Azar to "support them against financial peril while they put their lives and businesses at risk." Specifically, it asks HHS to give physicians enrolled in Medicare or Medicaid one months’ revenue to make up for financial losses.
To determine pre-pandemic monthly revenue, the agency would use an individual’s average monthly payment amount from October to December 2019, which has been provided to the Medicare Administrative Contractors (MACs), AMA said.
Medicare patients account for 35% of all patients in most specialties, and to extrapolate for all patients, HHS should use three times the pre-coronavirus monthly average as the basis for issuing payments, AMA said. Certain specialties however, such as psychiatry, pediatrics and obstetrics and gynecology, see fewer Medicare patients, and their payments should be adjusted upward accordingly.
The CARES Act permits HHS to provide funding through a grant or other mechanism, which the the group wants it to provide by issuing funds via the MACs.
"We believe it will be expedient to administer, while also allowing proper oversight as funding would be based on Medicare claims data and utilize existing enrollment and payment protocols," the letter said.
Physician practices across all locations and specialties are facing hardships that the doctors believes qualifies them for monetary help. Small practices could be particularly vulnerable to financial ruin, given their razor-thin margins and limited access to capital, it said.
At the same time, large practices and faculty practice plans that have over 500 employees will not qualify for the small business assistance in the CARES Act. Many are faced with having to furlough or lay off staff in order to lower costs.
Another example is frontline workers treating COVID-19 patients, who are often staying in hotels or renting apartments to protect loved ones and maintain proper social distancing, thus incurring other personal costs in order to perform their jobs and help slow community spread, the AMA said.