As Congress continues negotiations on additional COVID-19 supplemental funding packages, the AAMC urged Congress and the Trump administration to take key actions to further support the efforts of academic medicine related to COVID-19 in two letters providing recommendations on the federal government’s response.
AAMC President and CEO David J. Skorton, MD, sent a letter on April 17 asking congressional leaders and Vice President Mike Pence to consider a broad range of recommendations critical to ensuring that teaching hospitals, academic physicians, and medical schools can continue responding to the COVID-19 pandemic and successfully rebound as the national emergency subsides.
The letter comes in advance of an expected fourth comprehensive COVID-19 supplemental spending package, after Congress negotiates an “interim” package intended to provide immediate investments for a limited set of programs. In an April 9 letter, Dr. Skorton urged congressional leaders to include new resources for the newly established Provider Relief Fund and funding to mitigate COVID-19-related disruption on federally funded research as part of the interim COVID-19 funding package [see Washington Highlights, April 10].
The latest letter reiterates those two priorities and details a broader list of additional recommendations under the following categories:
Patient Care
- Ensure hospitals and faculty physicians have financial resources to continue providing quality care to COVID-19 and all patients.
- Establish a provider loan program.
- Temporarily increase the Medicare indirect medical education payment add-on adjustment.
- Clarify Centers for Medicare & Medicaid Services policy to ensure that hospitals that temporarily increase inpatient beds do not impact Intern and Resident to Bed ratio calculations, which otherwise would unfairly reduce teaching hospital payments.
- Eliminate scheduled Medicaid Disproportionate Share Hospital (DSH) cuts and provide a Medicaid DSH add-on during the COVID-19 emergency.
- Provide an additional increase in the Medicaid Federal Medical Assistance Percentage.
- Ensure health care coverage for vulnerable populations by using federal levers to expand health care coverage access and prevent the finalization of the Medicaid Fiscal Accountability Regulation.
- Expand the physician workforce to meet this and future health care challenges.
- Provide a temporary national license for physicians and other health care workers to allow them to practice across state lines for the duration of the public health emergency.
- Provide hazard pay for health care workers.
- Provide a technical fix for the accelerated loan program including a more lenient repayment timeline and a more reasonable interest rate.
- Protect providers responding to the COVID-19 crisis by expanding “Good Samaritan” protections.
- Avoid implementing potentially harmful policies in this time of crisis, such as requiring standards that could inadvertently encourage the rapid depletion of already scarce personal protective equipment resources.
Medical Research - Provide emergency supplemental funding to mitigate COVID-19-related disruptions to federally funded research.
- Allow period of disbursement extensions for RF1, UF1, and other multiyear grants to ensure awardees do not lose current funding or that their grant deadlines expire while labs are closed.
Testing and Public Health
- Invest in public health infrastructure.
- Support the academic medicine community’s efforts to maximize testing capacity.
- Enhance national COVID-19 data collection to better address health disparities.
Medical and Graduate Education
- Maintain the U.S. health and research workforce by extending visas, streamlining approval of new visas and changes of status, providing flexibility to sponsors in deploying visa holders where they are needed, expanding Conrad 30, and maintaining work authorization for Deferred Action for Childhood Arrivals recipients.
- Invest in health professions students and provide tax relief to students, medical schools, and hospitals.
The AAMC also shared additional recommendations to support the research enterprise in future COVID-19 supplemental funding packages through an April 14 letter to the House Science, Space, and Technology Committee. The letter focuses on the immediate COVID-19 impacts on research communities, including the need for supplemental appropriations for cost extensions on research grants and for core facilities that remain open to support COVID-19 research efforts. The letter also includes suggestions for future research needs, including support for a larger and more diverse Science, Technology, Engineering, Mathematics, and Medicine (STEMM) workforce and increased investments in data management and sharing infrastructure.