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ASCRS NEWS continued from page 30 for specialty physicians practicing in a rural setting. It would include payment of 1/6 princi- pal and interest paid annually for each year of full-time service in a practice in a rural setting. Payments total up to $250,000. Prior authorization Another priority issue for the Alliance is regu- latory hassle, costs, and delays and denials of care. H.R. 3107, the Improving Patients' Timely Access to Care Act, seeks to establish an elec- tronic prior authorization process, to minimize the use of prior authorization for services that are routinely approved, to prohibit additional prior authorization for medically necessary services performed during a surgical or inva- sive procedure that already received or did not initially require prior authorization, to require plans to report on the extent of their use of pri- or authorization and the rate of delays and de- nials, to ensure prior authorization requests are reviewed by qualified medical personnel, and to ensure that plans adhere to evidence-based medicine guidelines. Step therapy Step therapy can delay effective treatments to patients, but there are bills in both the House and Senate to establish exceptions to step therapy protocols. The Alliance is encouraging members of Congress to cosponsor the Safe Step Act (H.R. 2279/S. 2546). Surprise medical bills Insured patients can get hit with unanticipated medical bills. There is currently legislation, with four committees taking action in Congress, to prevent surprise medical bills. These include: the Senate Health, Education, Labor & Pensions Committee's S. 1895, the Lower Health Care Costs Act; the House Energy and Commerce Committee's H.R. 3630, the No Surprises Act; the House Education and Labor Committee's H.R. 5800, the Ban Surprise Billing Act; and the House Ways and Means Committee's H.R. 5826, the Consumer Protections Against Surprise Medical Bills Act. The medical community pre- fers the option from the House Ways and Means Committee. Efforts will continue to include SMB legisla- tion in any year-end omnibus spending and/or COVID-19 relief package. MD (D-CA), and Larry Bucshon, MD (R-IN), the Holding Providers Harmless From Medicare Cuts During COVID-19 Act. The Alliance is urg- ing representatives to cosponsor H.R. 8702 and is asking for action before the end of the year to prevent significant Medicare physician payment cuts. COVID-19 relief Lawsuits: Because of the current situation with the pandemic, some patients may be treated by practitioners outside the scope of their special- ty/practice area. Lack of protective safety gear and lack of essential medical equipment could also impact care. Though 35 states have some protections in place, these may vary. There is currently federal legislation to halt COVID-19 lawsuits in the form of H.R. 7059, the Coronavirus Provider Protection Act, which has 37 cosponsors. This would provide liability protection for healthcare providers for harm caused by an act or omission in the course of arranging for or providing healthcare services during the COVID-19 PHE period plus 60 days. The provider must be acting in good faith to benefit from the liability protections. Another bill, S. 4317, the Safe to Work Act, has 24 cosponsors and offers similar protec- tions, but immunity from the suit extends from December 1, 2019, through October 1, 2024 (or later if the PHE remains in effect). Financial support: There are efforts to extend the Paycheck Protection Program to allow small businesses to take advantage of the remaining $138 billion in allocated funds and to expand the expenses eligible for loan for- giveness to include COVID-19 prevention and retrofitting expenses. There are also requests for members of Con- gress to cosponsor the Small Business PPE Tax Credit Act (H.R. 7216), which would allow a tax credit of up to $25,000 for the cost of qualified PPE (gloves, facial masks, protective gear, and cleaning supplies). Additionally, there are efforts to extend sequestration cut relief. The CARES Act provid- ed relief from reimbursement cuts pursuant to sequestration, but relief only goes through the end of 2020. Student loan forgiveness: Members of Congress are being asked to cosponsor H.R. 5924, the Rural Physician Student Loan Forgive- ness bill, which would repay student loan debt 32 | EYEWORLD | DECEMBER 2020

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