A timeline of the coronavirus pandemic: 12 key updates for physicians

Practice Management

A lot has happened since the first cases of the coronavirus emerged in the United States on Jan. 20, and accelerated in the past week.

Here is a timeline of events for physicians to know:

1. March 6: President Donald Trump signed an emergency funding bill in response to the coronavirus outbreak, including $500 million in waivers for Medicare telehealth restrictions. The bill included $7.76 billion for federal, state and local agencies and $2.2 billion devoted to preventing the spread of the virus. The benefit extended telehealth coverage to all Medicare beneficiaries regardless of location; it was previously restricted to those in rural areas.

2. March 13: President Trump announced $42 million in funding to expand resources, including telemedicine. The plan allowed HHS to waive federal licensing regulations, which would allow out-of-state physicians can treat patients through telemedicine in states with large outbreaks.

3. March 13: President Trump declared a national emergency over the coronavirus pandemic, which allowed him to increase federal aid to states.

4. March 16: ASCA urged ASCs to remain open for elective surgeries for patients who need care. It also offered guidelines for centers that continue to treat patients as an alternative setting for surgical care when patients would suffer from a delay in surgery.

5. March 17: President Trump further expanded telehealth capabilities for Medicare beneficiaries, allowing beneficiaries to have common office visits, mental health counseling and preventative healthcare screenings through telehealth. Clinicians can bill for dates of service starting March 6, and be paid under the Physician Fee Schedule the same amount as in-person services.

6. March 17: President Trump announced his administration would not enforce HIPAA penalties and suggested allowing providers to virtually communicate with patients via their personal phones. HHS Secretary Alex Azar waived sanctions and penalties including, including penalties for the violating these provisions:

• Obtaining the patient's agreement to speak with family members or friends involved in patient care
• Honoring the request to opt out of the facility directory
• Distribute a notice of privacy practices
• The patient's right to request privacy restrictions
• The patient's right to confidential communications

7. March 18: President Trump signed a $100 billion coronavirus relief package, including provisions for paid emergency leave and free COVID-19 testing. Private health plans must cover the diagnostic testing, including the cost of provider and urgent care visits. The bill also ensured businesses with fewer than 500 employees can offer two weeks of paid sick leave for workers that can be used for quarantine due to exposure to COVID-19 or the need to care for children whose schools are closed.

8. March 18: CMS Administrator Seema Verma urged all hospitals to comply with the American College of Surgeons' recommendation to cancel non-urgent elective procedures.

9. March 18: At a press briefing, Vice President Mike Pence said that HHS was working on regulation that will allow physicians and medical professionals to practice across state lines without additional licenses.

10. March 19: Hospital, physician and nursing groups asked Congress for $100 billion in funding to offset losses tied to the coronavirus pandemic. The letter said that hospitals are losing revenue due to the suspension of elective procedures not related to COVID-19 and asked Congress to allocate $100 billion to frontline healthcare personnel and providers.

11. March 19: Senate Republicans released a $1 trillion stimulus proposal that includes a freeze to the 2 percent reduction in Medicare payments mandated under federal sequestration, and would boost hospital payment by 15 percent for treating patients with COVID-19. It also includes $1.32 billion in supplemental funding for community health centers for detecting, preventing, diagnosing and treating COVID-19 and lifted requirements for physicians to have established relationships with patients before a telehealth visit.

12. March 20: During a press briefing, President Trump invoked the Defense Production Act in response to the coronavirus pandemic to compel companies to begin manufacturing particular materials in need instead of maintaining their typical production.

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