More Important COVID-19 Updates for ACG Members and GI Practices

From ACG Legislative and Public Policy Council Chair, Whitfield L. Knapple, MD, FACG

In an effort to keep ACG members and GI practices up-to-date on important updates for patients and members in the wake of the 2019 Novel Coronavirus (COVID-19) outbreak, please find below the latest information tailored for GI practices. Please also visit ACG's COVID-19 resources page for important updates.

Trump Administration Announcements

Last Friday, President Trump declared a national emergency under the Stafford Act, which allows the federal government to marshal additional resources and authorize greater regulatory flexibility to respond to the coronavirus outbreak.

President Trump this week invoked the Defense Production Act to prioritize and expand the nation’s ability to produce key medical supplies such as ventilators and personal protective equipment. In addition, the Department of Defense announced the release of five million masks and other supplies from its reserves. What’s the Defense Production Act (DPA)?

  • The DPA is a 1950's law that authorizes the President to force commercial entities to prioritize and accept contracts for materials and services deemed necessary to promote the national defense. While initially passed to ensure the nation’s wartime readiness following the Korean War, Congress has greatly expanded the scope of the law to include – within the meaning of “national defense” – emergency declarations under the Stafford Act.

President Trump has delegated some of this authority to federal agencies. Thus, on March 18, the Centers for Medicare & Medicaid Services (CMS) further announced that all elective surgeries and non-essential medical procedures be delayed during the COVID-19 outbreak. This announcement specifically included common GI procedures, such as EGD and colonoscopy.  ACG and the GI societies have already begun educating Congress and policymakers on the significant impact this CMS announcement (and various state announcements) has on GI practices and ACG members.

CMS Expands Telehealth Services for Medicare and Medicaid Beneficiaries

On Tuesday, CMS announced expanded Medicare telehealth coverage in order to enable Medicare beneficiaries to receive a wider range of healthcare services from their doctors without having to travel to a healthcare facility. Beginning on March 6, 2020, Medicare will temporarily pay clinicians to provide more telehealth services for beneficiaries. The telehealth waiver will be effective until the public health emergency declared on January 31, 2020 ends. Some notables from the waiver:

  • The waiver temporarily eliminates the requirement that the originating site must be a physician’s office or other authorized healthcare facility and allows Medicare to pay for telehealth services when beneficiaries are in their homes or any setting of care. This will now allow telehealth services to be provided in all settings – including at a patient’s home.
  • The Department of Health and Human Services (HHS) announced a policy of enforcement discretion for Medicare telehealth services. HHS will not conduct audits to ensure that such a prior relationship existed for claims submitted during this public health emergency.
  • The waiver explicitly allows the Secretary to authorize use of telephones that have audio and video capabilities.
  • The waiver is not limited to services related to patients with COVID-19, but allows other services as well.

CMS Chart Describing the Updates

Click here to read the ACG, AASLD, AGA, and ASGE joint guidance on telehealth services.

Click here to read the Fact Sheet on this announcement.

Click here to read the Frequently Asked Questions.

Congress Passes Emergency Funding Supplemental

On Wednesday, Congress passed the second Coronavirus Response Bill, H.R. 6201, with large majorities in both bodies. This so called “2.0 bill,” followed on the heels of the $8.3 billion Emergency Supplemental package passed two weeks ago.  Some notable provisions:

  • Clarifies that health care provider office visits during which COVID-19 testing takes place can include in-person and telehealth visits
  • Waives cost-sharing under Medicare for certain visits relating to testing for COVID-19
  • Adds online digital evaluation and management services as COVID-19 testing-related services

The first bill passed two weeks ago focused on additional funding for key federal agencies responding to the coronavirus epidemic.

The second bill, H.R. 6201, includes provisions on low-income food/nutrition assistance, unemployment insurance, expansion of paid leave, and employer tax credits to partially offset the costs of required leave.

Congress is moving quickly to pass a third bill, a so-called 3.0 stimulus, which focuses on financial assistance for individuals and businesses hardest hit by COVID-19. ACG and the GI societies are advocating on your behalf, urging Congress to immediately help GI practices, ambulatory surgical centers (ASCs), as physician practices are also small businesses that are critical to helping communities during this global healthcare crisis.

ACG will continue to update membership on important COVID-19 updates that occur throughout each week.

From ACG Board of Governors Chair Neil Stollman MD, FACG and Vice Chair Patrick Young, MD, FACG: Remember to contact your ACG Governor on important state and local issues impacting you and your practice.

Advocating on your behalf: It is a very crucial time for our patients and practices. The ACG Governors will be advocating for you in early April. It is imperative that Congress step in immediately and help GI practices and ASCs.

The ACG Board of Governors is one of the most unique aspects of the American College of Gastroenterology. Governors are ACG Fellows that are elected from the membership of a particular state or region. The Board of Governors acts as a two-way conduit between College leadership and the membership at-large. This helps the College make certain it is meeting the evolving needs of the membership.

Practice Management Toolbox Article: Developing an Infection Control Plan for Your Office

What is the Practice Management Toolbox?

Gastroenterologists in private practice find themselves working in a time of unprecedented transformation. Pressures are high as they make important management decisions that profoundly affect their business future, their private lives, and their ability to provide care to patients. The ACG Practice Management Committee has a mission to bring practicing colleagues together to explore solutions to overcome management challenges, to improve operations, enhance productivity, and support physician leadership. It was in this spirit that the Practice Management Toolbox was created.

The Toolbox is a series of short articles, written by practicing gastroenterologists, that provide members with easily accessible information to improve their practices. Each article covers an issue important to private practice gastroenterologists and physician-lead clinical practices. They include a brief introduction, a topic overview, specific suggestions, helpful examples and a list of resources or references. Each month a new edition of the Toolbox will be released and will then remain available here along with all previous editions. The Practice Management Committee is confident this series will a provide valuable resource for members striving to optimize their practices.