Federal Announcements and Guidance Related to COVID-19

Various federal agencies, including the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the National Institutes of Health (NIH), and the Centers for Medicare & Medicaid Services (CMS), have been continually providing new COVID-19 guidance.

CMS has released the most regulatory guidance.  To find more information about all the waivers and flexibilities CMS has granted during the COVID-19 public health emergency, please click here.  CMS also continually updates frequently asked questions on these waivers and flexibilities and other Medicare billing issues.

Please click on any of the category cards below to find the latest guidance and government requirements you should be following.

For information on the Provider Relief Fund and other financial relief options, click the Financial Support for Health Care Practitioners category card below. 

ACEP will continue to track federal agency announcements and will update this page with information that impact emergency physicians. You can find ACEP's current federal policy priorities here.

In May, ACEP published a detailed summary of the rapid federal and regulatory developments that happened during the initial onslaught of COVID-19. Also, you can read the weekly Regs & Eggs blog for up-to-date information on the key issues that are affecting you and your patients.

What ACEP is doing

• On March 8, 2021, ACEP and the Emergency Department Practice Management Association (EDPMA) sent a letter to the Small Business Administration (SBA) regarding the eligibility criteria for the second draw of the Paycheck Protection Program (PPP). To be eligible for a second draw, an applicant must be able to demonstrate at least a 25 percent reduction in gross receipts between comparable calendar year quarters in 2019 and 2020. Unfortunately, we have heard that this particular timing does not align with when most emergency physician practices experienced a drop in revenue during 2020. Most group practices saw their greatest drops in volume in April and May 2020 but did not realize their drops in revenue until June and July—which does not correspond to a calendar year quarter. Given that some groups are being denied loans for this reason, ACEP and EDPMA requested that the SBA provide some flexibility in allowing group practices to report losses in three contiguous months rather than a defined calendar year quarter.
• On November 24, ACEP sent a letter to President-Elect Joe Biden congratulating him and Vice President-Elect Kamala Harris and thanking him for his ongoing work to ensure that his incoming administration is prepared to take over the federal response to the COVID-19 public health emergency as soon as he takes office on January 20, 2021. In the letter, we discuss key policy gaps and challenges that we hope the incoming Biden Administration will prioritize going forward. Addressing these issues will give frontline health care workers the resources and flexibility they need to protect themselves and treat their patients during the difficult weeks and months that lie ahead.
• On August 27, ACEP sent a letter to the Administrator of the Health Resources and Services Administration (HRSA) outlining concerns with the implementation of the COVID-19 Uninsured Program. This important program provides reimbursement at Medicare rates for COVID-19 treatment and testing and testing-related services delivered to patients who are uninsured. ACEP has received numerous reports from emergency physicians that seemingly legitimate claims under the Uninsured Program are being denied. As outlined in the letter, ACEP is requesting that HRSA make programmatic changes to the Uninsured Program to address the underlying issues that are causing these denials.
• ACEP has had weekly conversations with the Centers for Disease Control and Prevention (CDC) to discuss best clinical practices, share experiences from the ground, and hear more about current or upcoming guidance that could impact you and your patients. We have shared the insights we have gleaned from CDC on ACEP’s COVID-19 website and our COVID-19 communications hub. Most recently, on July 22, ACEP talked to the CDC about our concerns related to the change in how states and hospitals are to report critical data about the COVID-19 pandemic.
• On July 16, ACEP President, Dr. William Jaquis, and ACEP staff met with officials from the Occupational Safety and Health Administration (OSHA). During the meeting, ACEP shared de-identified stories from emergency physicians who have been penalized by their hospitals for wearing their own personal protective equipment (PPE) or for speaking out publicly about PPE shortages or other issues. We strongly urged OSHA to revise their standards and guidance to better protect emergency physicians and re-enforce their right to wear PPE that they believe keeps them safe. We also asked OSHA to respond as quickly as possible to formal complaints filed by emergency physicians. OSHA appreciated hearing directly from ACEP on these issues. The agency told Dr. Jaquis and ACEP staff that it is already working on additional guidance around the appropriate use of respirators and, in light of our comments, will start examining other guidance documents around PPE to try to address our concerns. OSHA is also actively responding to complaints and encourages emergency physicians to continue filing a complaint if they feel that their rights have been violated. To file an OSHA complaint, please click here.
• On July 13, ACEP met with the Food and Drug Administration (FDA) to relay the concerns we have heard from our members on testing, especially issues around sensitivity and specificity and the long wait time our patients are experiencing to receive results. While the FDA did not have any major breakthroughs or announcements they could share, we were pleased that the FDA acknowledged all the issues we raised and is actively working on addressing them. The FDA is routinely gathering information from the field and updating their emergency use authorizations (EUAs). The agency is also interested in continuing to talk to ACEP going forward and hearing about key issues that are affecting emergency physicians. If you want to learn more about the test (and its associated EUA) that your institution is using, please click here.
• On July 2, the House Select Subcommittee on the Coronavirus Crisis held a hearing, “The Administration’s Efforts to Procure, Stockpile, and Distribute Critical Supplies,” to examine efforts to acquire personal protective equipment (PPE), COVID-19 testing supplies, and other critical supplies needed to respond to the coronavirus pandemic. ACEP submitted a letter for the record to highlight ongoing shortages of these supplies and how they affect emergency physicians’ ability to effectively treat patients during the pandemic.
• On June 26, ACEP submitted its response to the Senate Health, Education, Labor, and Pensions (HELP) Committee regarding its “Preparing for the Next Pandemic” white paper. The document focused on five recommended areas where Congress should work with federal departments and agencies, states, and the private sector to address related issues and newly identified gaps.
• On June 18, the “Coronavirus Health Care Worker Wellness Act” (H.R. 7255) was introduced in the House of Representatives by Representatives Raja Krishnamoorthi (D-IL), John Katko (R-NY), and Frederica Wilson (D-FL). ACEP worked closely with Congressman Krishnamoorthi and his staff to develop and inform this bill that establishes a grant program to ensure emergency physicians and other frontline health care providers have access to the mental health resources they need during the COVID-19 pandemic ACEP’s letter of support for the legislation can be found here.
• On June 2, ACEP sent a letter to Congressional leadership calling for urgently needed action on a number of priorities for emergency physicians and patients related to COVID-19.
• On June 1, ACEP sent another letter to HHS Secretary Alex Azar about the distribution of the Provider Relief Fund, the $175 billion pot of funding appropriated by Congress to cover health care providers’ lost revenues and increased expenses due to COVID-19. This letter follows up on previous letters we sent on March 27, April 3, and April 14 to the HHS Secretary. In the most recent letter, we reiterate our previous request for $3.6 billion from the Provider Relief Fund to be specifically allocated towards emergency medicine groups and to the emergency physicians who practice within them. Thus far, we estimate that emergency physician groups have received approximately 7 to 15 percent of the initial $3.6 billion request. We ask that HHS reserve a portion of the $75 billion that Congress provided in the Paycheck Protection Program and Health Care Enhancement Act to cover the remaining balance of the $3.6 billion request.
• On May 4, ACEP's Regulatory Affairs Director, Jeffrey Davis, gave a presentation to a group of ED physician directors in Colorado highlighting the available financial support options for emergency physicians. Listen to Mr. Davis' presentation and download his presentation with links to helpful resources.
• On March 30, the Centers for Medicare & Medicaid Services (CMS) announced a plethora of policies and waivers aimed at providing regulatory flexibility to health care practitioners during this crisis. Numerous policies are big wins for emergency medicine—and flexibilities that ACEP advocated hard for. Please find ACEP’s summary of the CMS policies here.
• On March 24, ACEP sent a letter to Congress requesting financial support so emergency physicians can treat patients, maintain readiness, and be fully prepared for patient surges. 
• Early in March, ACEP sent every member of Congress and other policymakers a series of key policy changes necessary to mitigate the impact and spread of the virus in the U.S. and support emergency physicians and other frontline responders to the epidemic. These were also shared with ACEP chapters to enhance state-level advocacy on this issue.
• We also engaged the ACEP membership to send their members of Congress an email urging them to ensure PPE is prioritized for frontline personnel.
• We recently convened a virtual briefing for Congressional health staffers with several ACEP members from WA ACEP to help inform Congressional efforts on the issue
• We sent the U.S. Secretary of Health & Human Services, Alex Azar, a letter outlining specific changes and regulatory waivers the Administration could immediately take to better protect emergency physicians and other frontline providers, while increasing access to and improving care for more patients with COVID-19.
• ACEP President Bill Jaquis represented the College at a White House meeting with Vice President Pence on March 18, where he asked the Administration to consider providing certain liability protections for emergency physicians and others on the front lines during this crisis. Dr. Jaquis noted that limited liability protections have recently been extended to manufacturers, distributors, certain health care providers, and other entities in relation to covered countermeasures. Extending similar temporary protections to emergency physicians will ensure greater ability and capacity to treat more patients.