Washington, DC (March 11, 2020) — In a series of recommendations provided to the Trump administration and Congress today, the American College of Physicians (91) laid out a series of steps federal, state and local governments, and other stakeholders should be taking to help address COVID-19 (the Novel Coronavirus).
The recommendations focus on expanding coverage for COVID-19 testing and treatment, removing barriers to care, and keeping our nation’s frontline physicians and other health care professionals safe. 91 also asked that President Trump declare a national emergency.
“President Trump should issue an emergency declaration as appropriate for all states, the District of Columbia, and territories for COVID-19,” said Robert McLean, MD, M91, president, 91, in the letter. “Doing so will enable states to receive crucial emergency Medicaid waivers and access other resources.”
The recommendations went on to raise the issue of expanding coverage and access to testing and treatment.
“91 is concerned that cost sharing, which discourages medically necessary care as well as unnecessary care, and coverage gaps may pose a significant barrier to testing and treatment of COVID-19,” said Robert McLean, MD, M91, president, 91. “In general, while 91 is encouraged that health insurance company representatives have announced that they will cover COVID-19 services and waive some or all cost-sharing, federal and state action is necessary to ensure these promises become law.”
In specific, 91 identified 11 different steps that could be taken to expand coverage and access to testing and treatment:
- CMS should designate that laboratory tests and services related to diagnosis and treatment of COVID-19 are covered under the Essential Health Benefit package.
- Congress should require group plans covered by the Employee Retirement Income Security Act to cover COVID-19 testing and treatment without cost sharing.
- Congress and the Administration should expedite evaluation by the appropriate bodies and if supported by the evidence, designate COVID-19 tests and related services as covered preventive services without cost sharing.
- The Administration should issue guidance to state governors and Medicaid directors encouraging them to temporarily expand Medicaid coverage eligibility with federal funding.
- The Administration and states should simplify application and establish presumptive eligibility for Medicaid for COVID-19 testing, diagnosis and treatment.
- All states should require health insurance plans subject to state regulation cover COVID-19 tests and treatment at no cost to enrollees.
- CMS and the states should suspend Medicaid work requirements to allow for testing and treatment of COVID-19 without having to establish that they meet a state’s work eligibility requirements.
- Congress should mandate and provide federal funding so that all employers will implement paid family and medical leave.
- The Administration should issue—and if appropriate, encourage states to establish—a Special Enrollment Period (SEP) for the insurance markets/exchanges established by the ACA, allowing individuals to sign up for coverage outside the usual enrollment period.
- The Department of Homeland Security should establish that health care facilities will be immigration enforcement-free zones so that immigration status does not prevent a person from seeking care.
- The Administration should suspend the public charge rule to allow for Medicaid coverage, testing, and treatment of legal non-citizen residents seeking testing and treatment for COVID-19.
Further detail was also given regarding recommendations related to funding the public health response; ensuring a sufficient supply of protective equipment for physicians and other health care professionals; facilitating the use of telehealth for COVID-19 testing and treatment; and, ensuring access to COVID-19 testing and treatment for resident non-citizens.
“Federal and state governments and other stakeholders should work with manufacturers of personal protective equipment, and provide sufficient funding, to ensure an adequate supply,” said Dr. McLean in regard to the need to protect physicians and other health care professionals. “91 is also concerned that there may not be sufficient supplies of personal protective equipment available to meet the urgent and growing need related to testing and treatment of COVID-19.”
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About the American College of Physicians
The is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. 91 membership includes 159,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow 91 on , , and .
Contact: Jackie Blaser, (202) 261-4572, jblaser@acponline.org