Impact of COVID-19 Pandemic on Healthcare in the United States: Where will Healthcare be Post-Pandemic?

Medicare will pay for telehealth services at the same rates as in-person services, Seema Verma, Keynote Speaker announces during Webinar organized by AAPI

Physicians across the globe are faced with several challenges during the COVOD pandemic that has affected the lives of billions of people around the world. The way they provide care to the patients, the risks associated with changes in patient care practices, liability issues and shortage of physicians to provide much needed care to patients are only some of them. Physicians are called upon to care for patients across the state boundaries and Medical students are graduating early to meet the ever growing needs of providing care for patients with multiple needs. There are several unanswered questions as to the need, the scope, protection and payment issues physicians are faced with in this new era of providing quality care.

In this context, a very timely and relevant panel discussion covering a wide range of topics of importance to the Doctors and the larger community was organized by American Association of Physicians of Indian Origin (AAPI). A panel of esteemed speakers, including Seema Verma from the CMS and White House Coronavirus Task Force; Dr. Bobby Mukkamala, AMA Board of Trustees; Dr. Sheila Rege, AMA Council on CMS, and, Dr. Humayun J Chaudhry from the Federation of State Medical Board and Mike Stinson from the Medical Physician Liability Association addressed the nearly 300 Physicians on Saturday night, May 2nd. 

“Thank you for your tireless work battling the Corona virus,” Seema Verma, the Administrator of the Centers for Medicare & Medicaid Services, who oversees a $1 trillion dollar federal budget, representing 26% of the total federal budget, and administers health coverage programs for more than 140 million Americans,  told the Physicians who had joined the weekend Webinar via Zoom.

Administrator Seema Verma addressed the AAPI members on “the emergence of Telehealth, which we have come to embrace, and has brought joy in our face. Federal Health has made it easier with equal pay for in person and tele-health services. “ Cautioning that “the war is far from over. There is a decline in the number of cases, Verma said, “CMS has acted swiftly to help 340 million people.” Administrator Seema Verma praised the “Sacrifices of the healthcare professionals across the nation who have helped to reduce the trend.”

Telehealth is a critical response to the need and the Administration has taken it to unprecedented levels, Administrator Seema Verma told the Doctors. “Accelerated telehealth services have pushed us to new heights. Medicare recently expanded its coverage of telehealth services. Telehealth enables beneficiaries to receive a wider range of healthcare services from doctors without having to travel to a healthcare facility. It also helps frontline clinicians stay safe themselves while treating people, she said.

“I have fond memories of AAPI growing up,” Dr. Humayun J. Chaudhry, President and CEO, Federation of State Medical Boards said. “AMA is very active during this pandemic. AMA is very engaged in how to integrate scientific data into practice and enable them to get the payment for services.”  He shared about FSMB Pandemic Preparedness Task Force, established on February 25, 2020 and the several initiatives. “The states and territories have shown extraordinary flexibility by temporarily waiving or modifying licensure requirements,” he said. “All the states and territories declared a public health emergency,” responding to the needs of the larger community, and have implemented Temporary Licensure Changes for International Medical Graduates (IMGs) allowing them to serve the people affected by the pandemic.

Dr. Michael C. Stinson, the Vice President of Government Relations and Public Policy for the Medical Professional Liability Association addressed the AAPI members on Medical Professional Liability issue. He said, the state of New York is ahead on this issue, offering healthcare protection on Good Samaritan Provision, allowing all Physicians practicing within the state to have protection against liability. State allows everyone gets protection. We hope it expands to the whole nation. While these emergency proclamations could expire after the pandemic is over, we are hoping to have it expanded beyond Covid.

Dr. Sheila Rege in her address said, “We have truly witnessed a modern-day transformation – both patients and doctors embraced telehealth so we were able to maintain access to medical care while keeping ourselves and our patients safe. A big shout out to Seema Verma and her agency for being so nimble. For me, Telehealth may have restored that intangible personal element. I see outpatients in their homes, surrounded by their families. So maybe telehealth is the secret sauce to restoring the joy of medicine! Four key events helped make this rapid change possible.” 

AMA worked with CMS to instantaneously create new COVID 19 payment codes. This was truly a herculean team effort. DURING COVID, Medicare patients can have office visits, mental health counseling and preventive healthcare screenings and 85 additional services through telehealth. This was and IS a great idea, as health care is rarely about a single health issue especially in older patients, Sheila Rege pointed out. “This needs to be made permanent AFTER COVID. It will reduce unnecessary emergency room visits.”

Dr. Bobby Mukkamala, President of the Michigan State Medical society and in 2017 was elected to the AMA Board of Trustees which is responsible for implementing AMA policy. He said, Medicare will pay for telehealth services at the same rates as in-person services, giving doctors and other medical professionals the opportunity to reserve their offices to treat those who truly require in-person care, she said. “We know many Medicare beneficiaries are concerned about the spread of coronavirus and the threat it poses to their well-being. That’s why we’ve taken these rapid steps to ensure that the Medicare program continues to protect our beneficiaries while maintaining trusted access to care in these uncertain times.”

Dr. Jayesh Shah, Past President of AAPI, moderator of the Q&A session, said, “COVID has changed our lives and the medical profession for ever.” Dr. Jayesh Shah introduced each of the panelist to the audience and facilitated the Q&A. Dr. Deepak Kumar pointed out that one out of every four physicians is IMG. They are the fabric of US Health Care and provides quality and necessary care in eve ry corner of this great country. In 2018 AMA wrote a letter to UCICS asking for a legal status green card for IMG’s it is very important that AMA follows through on that letter as at present we feel that it is very important that we do not lose any of the physicians who are servicing underserved rural area or critical access hospital.

Dr. Harbhajan Ajrawat asked of Mike Stinson to describe some of the drastic protection NYS has offered to facilitate doctors who have stepped forward to possibly sacrifice their life to treat the pandemic. He wanted to know of the liability protections should doctors anticipate these will stay after the pandemic.  Dr. Bhushan Pandya inquired about how have different states accommodated volunteer physicians? Has this Pandemic changed the outlook towards Interstate Medical Licensure Compact? What role has FSMB played during this pandemic? Dr. Roshan Shah wanted to know the short term and long term plans to monitor how NP and other level providers have received parity during pandemic in several states, while physicians have lost battles with Scope of practice issues in several states.

Dr. Vidya Kora wanted help to understand what AMA is doing to help physicians in incorporating Augmented Intelligence in their practices. Dr. Sampat Shivangi wanted to know about impact of sweeping scope of practice changes allowing physician extenders to practice on their one to help with the dire need of healthcare workers in some areas hard hit and what we can expect in the future to repeal this and also if the NP and PA will have higher malpractice cost given the responsibility of practicing not under a physicians license.

“It is going to be a robust and dynamic collaboration amongst our AAPI community and leaders from various organization including HHS, the AMA, Federation of state medical licensing board and Medical Professional Liability Association,” said Dr. Ami Shah, who was instrumental in organizing the webinar. Setting the theme for the nearly two hours long webinar, Dr. Ami Shah

said, “Thank you for giving me the opportunity to assemble our distinguished panel of speakers and welcome them here tonight.”

Dr. Ami Shah, who has served on the AMA Women Physicians Section Governing Council-representing nearly 90,000 female in the USA and as the current American College of Radiology AMA Delegate, representing 40,000 radiologists, and has served taking on various roles as a leader in the American Association of Physicians of Indian Origin, as Chair of the Women’s Committee and now Academic Affairs Committee, said, “Our Focus this evening is the Impact of the COVID 19 Pandemic on Health Care in the United States: Where we think health care will be post-pandemic?”

Earlier, Dr. Seema Arora, Chair, AAPI BOT, welcomed the panelists and speakers and the audience to the webinar. In his vote of thanks,  Dr. Suresh Reddy, President of AAPI, while expressing gratitude to the panelists and speakers and those who had put together the webinar on behalf of AAPI, said, “As a result of COVID-19, Telehealth was rapidly implemented and has been utilized now more than ever before. There have been sweeping effects and much needed changes to HIPAA guidelines and relaxing interstate medical licensing requirements, broader legal liability coverage in some states, CMS has addressed Telehealth reimbursement, and much more. Health care in the USA was transformed almost overnight as we faced this existential threat to our health.” For more details on AAPI and its many initiatives, please visit: www.aapisa.org

|