With the world turning to teleconnections during the COVID-19 pandemic, the ACR’s annual fly-in advocacy event in Washington, D.C., is going virtual. On May 22, ACR volunteer leaders and staff will meet with Congressional leaders in a series of more than 100 teleconferences to share rheumatology perspectives on the pressing challenge of maintaining provider solvency and the need for long-term solutions, including reimbursement and workforce support.
This virtual Hill Day is designed to ensure the rheumatology voice rings loud and clear on Capitol Hill, according to ACR Government Affairs Committee (GAC) Chair Blair Solow, MD, assistant professor, Rheumatic Diseases Division, UT Southwestern Medical Center, Dallas. “Our central message to legislators is that rheumatology providers need to remain financially solvent to provide ongoing care to their patients with chronic diseases. We also want to guide discussions on using disease-modifying anti-rheumatic drugs to treat COVID-19 and on maintaining the workforce for post-pandemic healthcare.”
Parity in audio-only telehealth reimbursement and maintaining updates to the CMS Physician Fee Schedule for 2021, including a higher reimbursement for evaluation and management (E/M) services, are also important issues to be discussed, Dr. Solow says. “We plan to deliver on-the-ground, real-time feedback to Congressional members and their staff, as well as outline what our providers need to continue doing their jobs.”
Making Virtual Connections on the Hill
Dr. Solow and members of the GAC have been working closely with ACR advocacy staff members to successfully deliver this digital advocacy event. Virtual Hill Day participants will include members of the ACR’s Board of Directors, GAC, Committee on Rheumatologic Care (CORC), Insurance Subcommittee of CORC, RheumPAC and Affiliate Society Council, who will connect via teleconference with legislators and their staff members.
In the week leading up to the event, the ACR will host training webinars to help virtual Hill Day participants feel comfortable with the issues and the format, according to Dan Redinger, manager of the ACR’s advocacy and political affairs.
The broader membership will also be able to get involved in grassroots advocacy by sending messages up to Capitol Hill, Mr. Redinger explains. He encourages all ACR/ARP members to use social media and Voter Voice during the May 22 virtual Hill meetings “to help further advance rheumatology legislative priorities.” Send emails to your legislators and post on social media with the hashtag #Act4Arthritis throughout the Hill Day to amplify the ACR’s voice and visibility.
Know What’s at Stake
All the items on the virtual Hill Day agenda will focus on issues facing rheumatologists and patients during and after the COVID-19 pandemic, according to Lennie Shewmaker, JD, ACR director of congressional affairs. The crisis has highlighted the precarious financial state of cognitive care specialists who treat complex conditions. Ms. Shewmaker stresses, “Practices and providers are needed more than ever, and we must ensure they can keep their doors open to serve patients.”
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.”
Dr. Farrell says the ACR’s advocacy efforts play a crucial role in communicating stories from the front lines to the people who make the decisions. “Without our advocacy team and our virtual Hill Day, our voices may not be heard, and decisions may be made without us at the table. Having diverse membership on the GAC has shown me how important all of our individual perspectives are in working toward similar goals.”
Dr. Solow hopes that organizing a virtual advocacy day will be the beginning of a new avenue of advocacy for ACR members. She says GAC members, in conjunction with the ACR’s COVID-19 Practice and Advocacy Task Force and the Committee on Rheumatologic Care’s Insurance Subcommittee, are diligently working on many fronts to amplify the rheumatology community’s voice in ongoing decisions related to COVID-19 response.
Add Your Voice
All rheumatologists and rheumatology interprofessional team members can share their experiences during the COVID-19 pandemic and voice practice concerns through emails to their legislators and on social media during the May 22 virtual Hill meetings.
Most members of Congress are now on Facebook and Twitter and monitor social media interactions very closely. Reach out to your legislators about rheumatology issues by tagging them in your posts or posting on their sites. Follow the ACR on Facebook and Twitter @ACRheum to see what is trending and repost messages, and use the hashtag #Act4Arthritis in your tweets.
Carina Stanton is a freelance science journalist based in Denver.
