HHS Should Make Immediate Emergency Payments, AAFP Says

In an April 7 letter to the agency, the AAFP joined some 130 fellow medical groups in urging HHS to use its broad power under the CARES Act to deliver immediate financial relief -- starting with one month of revenue to every physician enrolled in Medicare or Medicaid.

The letter was sent to HHS Secretary Alex Azar. Among the AAFP's co-signatories were the AMA, numerous specialty organizations and the medical associations of all 50 states and Washington, D.C.

The CARES Act, wrote the groups, compels HHS to wield the law's Public Health and Social Services Emergency Fund to assist all physicians who are experiencing revenue losses and nonreimbursable expenses as a result of the COVID-19 pandemic and to interpret eligibility for such aid broadly.

"Specifically, we urge HHS to provide one month of revenue to each physician (M.D. or D.O.), nurse practitioner and physician assistant enrolled in Medicare or Medicaid, to account for financial losses and nonreimbursable expenses," the letter said.

The letter outlined several hardships now being experienced by physicians, including those who operate small practices and are "particularly vulnerable to financial ruin, as they have less ready access to capital and are already operating on razor-thin margins."

The Academy has made such small or rural practices a priority in its telehealth and payment advocacy as the pandemic has unfolded.

At the same time, the organizations said, many large physician practices and faculty practices with more than 500 employees "will not qualify for the small business assistance in the CARES Act" -- even as they must lay off physicians and staff while preparing for possible COVID-19 patient surges.

To push back against these trends and ensure a sufficient physician workforce, the Academy and its co-signers advised HHS to "use an individual's average monthly payment amount from October to December 2019, which has been provided to the Medicare Administrative Contractors, as the basis for determining pre-pandemic monthly revenue."

"For most specialties, Medicare patients account for 35% of all patients, so to extrapolate to all patients, HHS should use three times the October-December 2019 average as the basis for issuing a payment. … The funds are for the purpose of supporting physician practices in light of lost revenue, such as for paying salaries, benefits and overhead, and making necessary investments to continue providing care such as telehealth."

Under the CARES Act, the Academy said, Azar can direct HHS to provide such funding through grants or other mechanisms. The letter asked him to immediately issue the called-for relief 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.