The top priority is preserving patient access by supporting provider solvency, she says. Discussion topics in this area will include:
Healthcare Provider-Specific Grant & Loan Programs
The ACR asks that Congress authorize more direct financial support to preserve vulnerable specialty practices and supports the AMA’s request for an emergency, one-time grant for providers equal to their total payroll and overhead costs from Jan. 1–Apr. 1, 2019. The ACR is also asking that any additional CARES Act funding stipulate recipient medical practices, healthcare systems and organizations first use the funds to protect the jobs and salaries of their providers and staff, and that future legislation include grant and forgivable loan programs.
Parity for Telehealth
Rheumatology practices are relying on telehealth and telephone visits to treat patients safely while in-person evaluation and treatment is restricted during the pandemic. “Parity also increases access to care for those in rural and underserved areas,” Ms. Shewmaker notes. The ACR appreciates CMS acknowledging the value of these services by reimbursing for audio-only E/M visits at the same rate as audio-visual and in-person evaluations, and is asking that ERISA plans follow the lead of CMS in reimbursing audio-only visits at parity for as long as in-person evaluations and treatment of patients are restricted by COVID-19.
Continued Support for Complex Care
Looking ahead, ACR rheumatology advocates will also be emphasizing the need to implement important updates to the Physician Fee Schedule slated to take effect in January 2021, including an estimated 15% E/M services reimbursement increase, Ms. Shewmaker notes. “These updated reimbursements for complex office visits boost specialties on the front lines of treating chronic illness and patients most in need of specialty care.”
Sharing Unique Perspectives
The virtual Hill Day will also give individual providers a chance to share unique challenges they are facing during the pandemic. For GAC member Jessica Farrell, PharmD, a clinical pharmacist in a private rheumatology practice in Albany, N.Y., the COVID-19 crisis has significantly reduced the number of support staff her practice was able to keep working.
“In normal situations, I serve as a drug information resource to my providers and their patients and offer some administrative support for insurance authorizations,” she explains. “However, over the past few weeks I’ve spent a significant amount of time serving as a patient advocate with more administrative burden, having to liaise with local pharmacy administrators, organizations and local governmental officials to secure access to hydroxychloroquine for our patient population.”
