When I left for maternity leave in February, I thought (perhaps naively) that I would have time to read more, exercise, clean out our garage, write thank you notes and just hit pause on the world for a brief moment. Alas, life is a funny thing, and as the world hit pause due to the pandemic, my current reality is a whirlwind of a toddler, a newborn baby, a husband working from home and, occasionally, some serene walks. I am a planner by nature and have several advocacy goals that I hope to accomplish while serving as the chair of the Government Affairs Committee (GAC). My predecessor, Angus Worthing, MD, FACR, FACP, did mention that sometimes issues will unexpectedly arise that we would have to deal with, though I don’t think he could have predicted something of this magnitude. He did set the stage for me to be open to change and be flexible. Thank goodness.
We have now (just!) finished our first ever virtual advocacy day and, despite it being our first foray into virtual Hill meetings, this event was a great success. We still have one eye set on our original priorities for the year, such as legislation targeting utilization management (step therapy for Employee Retirement Income Security Act (ERISA) plans, prior authorization for Medicare Advantage plans), medical research dollars and workforce deficits. However, we needed to adjust our asks to match our members’ needs in the tumultuous time of the pandemic. With the help of the GAC and our ACR advocacy staff team (Adam Cooper, Lennie Shewmaker, Amanda Grimm Wiegrefe, Dan Redinger and Joseph Cantrell), we pivoted the policy that we took to the Hill as the policies and member feedback changed rapidly.
This May, our outreach to Congress addressed provider solvency issues to maintain access to care for our patients. We discussed the need for additional funding through the CARES Act programs, including the Paycheck Protection Program, and the need for provider-specific grants to help support practices. We expressed our appreciation of the Centers for Medicare & Medicaid Services’ (CMS) support of providers with reimbursement of telehealth visits matching the rate for face-to-face visits (F2F), because this was all many of us could do. We asked Congress to guide CMS in supporting providers with a blanket adjustment for already submitted audio-only visits and to support legislation (H.R. 6644) that would have ERISA plans meet payment parity as well. Finally, we asked Congress to support the CMS 2020 Physician Fee Schedule, which recognized cognitive specialties and will result in an average increase in reimbursement of 15% for rheumatology.
For our virtual Advocacy Hill Day, ACR volunteer leaders called legislators’ Washington, D.C., offices from their homes to #Act4Arthritis. Many ACR/ARP members supported our efforts by emailing their legislators. You can amplify our message by visiting the Legislative Action Center to send letters to your representatives. Act now!
The GAC has also worked closely with the ACR’s Practice & Advocacy COVID-19 Task Force to make sure we are addressing all the needs coming from the College’s membership during the pandemic. This task force has been extremely productive, generating a large amount of guidance-rich content for providers and patients. Be sure to check it out if you haven’t already. Naturally, with all the changes that have occurred, many are already asking, “What’s next?” as it relates to funding for practice solvency, the future of telemedicine, the future of medicine and how physicians are paid. Your GAC team is already enthusiastically planning the next Hill Day in September and forecasting what members’ needs may be at that time.
As I jump back into the game, I am so grateful to those of you who are serving our patients, who took a few minutes to send a letter to Congress on behalf of your colleagues and who took a day to call legislators’ offices to describe how providers are faring on the front lines. Thank you!
Blair Solow, MD, is chair of the ACR Government Affairs Committee and an assistant professor of medicine in the Division of Rheumatic Diseases at UT Southwestern Medical Center in Dallas.
