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Doctors Want Suspended Medicare Loan Program Reinstated STAT

April 28, 2020, 7:36 PM

The nation’s doctors want the Trump administration to restart a Medicare loan payment program that provided more than $40 billion to help them weather revenue losses during the coronavirus pandemic.

More than 24,000 loans had been approved for doctors, other caregivers, and durable medical equipment suppliers since March 28 under Medicare’s Advance Payment Program. But the program, which was expanded to address cash flow problems early in the health emergency, was suspended April 26 without advance notice by the Centers for Medicare & Medicaid Services.

The CMS said a similar loan program for hospitals, Medicare’s Accelerated Payment Program, “is reevaluating the amounts” it will pay after providing nearly $60 billion in emergency loans.

The loan program suspension is opposed by the American Medical Association, the American College of Physicians, the American Academy of Family Physicians, and the American Medical Group Association, which represents multispecialty medical groups. They all say the voluntary loan program is needed more than ever as the pandemic pushes many physician practices to the brink of closing.

“CMS has not indicated the reasoning that led to this decision. We ask that CMS reverse this decision and instruct the Medicare Administrative Contractors to continue processing loan requests” for hospitals and doctors, Jerry Penso, the AMGA’s president and CEO, said in a Tuesday letter to CMS Administrator Seema Verma.

The CMS didn’t immediately respond to a request for comment.

Patrice A. Harris, president of the American Medical Association, issued a statement that said, “Speaking with Trump administration officials, we understand that CMS is pausing the program to evaluate how physicians and other providers are using it as well as the CARES Act Provider Relief Funding.”

She said the AMA urges “the administration to restart the program as soon as possible.”

Additional Funding Available

In its April 26 announcement, the CMS said that “significant additional funding” for hospitals, doctors, and other front-line responders is available through the remaining $20 billion in the CARES Act Provider Relief Fund. The fund has already provided $30 billion in emergency grants to doctors and hospitals.

In addition, Congress provided $75 billion through the Paycheck Protection Program and Health Care Enhancement Act, which physicians can also apply for.

But many doctors struggling with a slowdown in in-person visits worry they may not qualify for the relief fund grants. And those who do may not get the money in time or in the amount they need, said Robert Doherty, senior vice president for government affairs and public policy at the American College of Physicians.

All of which makes the loss of advance Medicare loans particularly problematic.

“To withdraw one of the ways that they can partially offset some of their revenue losses to keep the doors open is precisely the wrong direction for CMS to be going in,” Doherty said. “The advanced payment program, we believe, was one of the lifelines that physicians need and still need.”

Larger, more sophisticated medical practices will have the best shot of getting additional funding through the relief fund because the application process is more complex, said Shawn Martin, senior vice president for advocacy, practice advancement, and policy at the American Academy of Family Physicians.

“The bigger practices are going to have accountants and lawyers,” Martin said. “The smaller practices, it’s going to take them longer to get their financials together. And there’s a chance that the money could be gone by the time they do that.”

Even those who receive money may not be out of difficulty, Doherty cautioned.

“Our sense is even with those disbursements, it’s not going to come close to what is needed to sustain struggling practices, particularly smaller primary care practices,” Doherty added.

To contact the reporter on this story: Tony Pugh in Washington at tpugh@bloomberglaw.com

To contact the editors responsible for this story: Fawn Johnson at fjohnson@bloomberglaw.com; Andrew Childers at achilders@bloomberglaw.com

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