COVID-19 State Government Resources and Engagement

Fellows and members of the American College of Surgeons (ACS) who want to know how their state governments are responding to the COVID-19 pandemic can learn more using the following links to websites that are updated daily.

Comprehensive List of All State Actions: Stateside.com

Comprehensive State Data and Policy: Kaiser Family Foundation

Telehealth Policy: Center for Connected Health Policy

State Waiving Licensure Requirements/Renewals: Federation of State Medical Boards

Medicaid 1135 Waivers: Kaiser Family Foundation

State Resource Pages and Other Select State Actions: National Governors Association

COVID-19 State Legislation: Quorum

State Fiscal Responses: National Conference of State Legislators

Fellows and members who want to engage with their state officials and advocate specifically for state-based action, can refer to the following comprehensive list from the American Medical Association’s state advocacy center. Fellows may find the following issues from the list particularly pertinent:

Costs for Testing

• Prohibit cost-sharing for diagnostic testing and cost-sharing related to testing including hospital, emergency department, urgent care, and provider office visits.
• Prohibit prior authorization for testing and all services related to testing.
• Ensure coverage for testing and related services regardless of the provider's network status of the provider.

Access to Care

• Suspend any prior authorization requirements that apply to treatment and care related to COVID-19.  
• Ensure coverage for the cost of care related to confirmed or potential COVID-19 cases without regard to the network status of provider. 

Telehealth

• Ensure broad coverage and payment for all telehealth services by all plans and payors.  
• Temporarily allow coverage and payment for all telehealth modalities.   
• Suspend requirements that an existing patient-physician relationship must be established prior to the provision of telehealth services.

Expanding Medicaid Coverage 

• Expand Medicaid eligibility temporarily to any uninsured state resident with COVID-19-related diagnoses or symptoms.

Enforcement of Existing Responsibilities/Laws

• Verify that networks can handle the increase in need for health care services, including offering access to out-of-network services where appropriate and at the in-network cost-sharing level.
• Prohibit prior authorization for emergency care, regardless of whether the care is in- or out-of-network.

Workers' Compensation 

• Deem volunteer physicians not otherwise covered by the workers’ compensation laws of the state employees of the state for purposes of making a claim under the state’s workers’ compensation system.

Liability

• Provide immunity from civil liability for any harm caused by volunteer physicians acting in good faith in response to COVID-19.

Fellows can find contact information for their state governor on the National Governors Association website.

It is important to note that many state legislatures have adjourned or suspended sessions. Find the status of individual state legislatures.

Fellows can access contact information for their individual state legislators via SurgeonsVoice.

A list of state health departments and officials can be found on the CDC website and the ASTHO website.

ACS State Chapters provide an important resource for the dissemination of and collection of information happening in the state as well as communicating with state government leaders to influence policy decisions. The following are examples of ACS Chapters engaging state governments on behalf of Fellows and ACS members.

New York Letter to Governor Cuomo (3/28/20): The New York Chapter of the American College of Surgeons sent a letter to Governor Cuomo and shared with officials in the New York State Department of Health, New York Department of Financial Services, and the New York State legislature alerting them to the following items:

• Personal protective equipment
• Interpretation of immunity
• Crisis standards
• Maintenance of emergency access to critical medical and surgical care as essential public health services
• Liability relief
• Volunteer immunity

Additionally, the New York Chapter Board of Directors is meeting on a weekly basis to identify barriers, help our members navigate the outbreak and provide recommendations to policymakers.

Oklahoma Letter to Governor Stitt (4/21/20): The Oklahoma Chapter of the American College of Surgeons sent a letter April 17 to Gov. J. Kevin Stitt in response to his Executive Order to resume elective operations in the state starting April 24. The chapter leadership cautioned the governor and encouraged him to maintain the order to limit surgery until May 15. View an updated list of governors’ orders.

Oklahoma Letter to Governor Stitt (3/23/20): The Oklahoma Chapter of the American College of Surgeons joined other state physician and health care associations to send a letter urging him to issue an executive order that will implement a shelter-in place policy and close non-essential businesses.

For questions, requests for additional information, or to share experiences, email us at StateAffairs@facs.org.