Talking Points
This year, these important meetings focused on the many challenges practices and patients are facing in the new reality of life during the COVID-19 pandemic. Advocates discussed issues affecting patient access to care, including maintaining provider solvency so rheumatologists and rheumatology interprofessional team members can continue to care for the estimated 91 million Americans suffering from rheumatic disease.
Advocates highlighted the fact that a shortage of rheumatologists existed pre-COVID-19 and patients have already had difficulty accessing rheumatologic care.
They discussed provider solvency as a key issue during the pandemic, making it clear that practices are financially challenged due to the need for social distancing for patients, decreasing the number of patients seen and often requiring extended office hours to enhance patient safety. In addition, costs incurred for overtime payments and for the purchase of additional personal protective equipment increase the concern that practices may lose the ability to continue to provide adequate payment to staff.
Advocacy for the rheumatology community continues in these challenging times, & I hope you will add your voice as we continue this journey together.
Recognizing that many rheumatology providers and practices are suffering financially, advocates asked that additional financial assistance to providers to be included in the next Congressional package for COVID-19 relief. Although the funds designated for practices and institutions in the CARES Act were immensely helpful, these funds will clearly be inadequate to ensure patient access and provider solvency through the duration of the pandemic.
Hill offices were encouraged to press for the passage of healthcare provider-specific grant and loan programs, and support the American Medical Association’s request for an emergency, one-time grant for providers equal to their total payroll and overhead costs from Jan. 1–April 1, 2019.
For employed physicians, advocates also discussed the need for funds to be specifically directed to maintain provider and staff salaries, to prevent further job losses, furloughs and salary cuts.
Other advocacy issues raised with legislators included asking for universal parity for reimbursement of audio-only and audiovisual telehealth, and continued support for the evaluation and management (E/M) payment improvements set to go into effect in January 2021.
Offices on Capitol Hill heard from rheumatology advocates about their experiences with telehealth during the pandemic and the crucial need for flexibility in telehealth options to maintain access for patients. Rheumatology practices are relying on traditional telehealth, as well as telephone visits, to treat patients safely while in-person evaluation and treatment may be restricted.
A few months ago, we saw the Centers for Medicare & Medicare Services (CMS) respond to our advocacy efforts by acknowledging the importance of this access, including reimbursement for not only audiovisual telehealth, but also audio-only telephone visits for those patients who may not have access to the necessary technology to allow for traditional audiovisual visits. Lawmakers were asked to request the CMS have Medicare Administrative Contractors (MACs) issue blanket adjustments of payments for all audio-only CMS claims back to March 1, so individual providers don’t have to take time away from patient care to do the arduous resubmission of claims already filed.
Advocates also promoted H.R. 6644, the Healthcare at Home Act, which would have employer-based health plans also expand parity in reimbursement to audio-only telehealth visits, following the lead of the CMS.
Finally, advocates discussed the importance of the updates to E/M coding, finalized by the CMS and scheduled to go into effect in January 2021. These updates are estimated to result in an average 15% raise in pay, an important win for rheumatologists. These improvements are critical to ensure an adequate workforce of providers treating rheumatic diseases and the chronic illnesses that often ensue in our patients most in need of care.
