Many states across the US are seeing an uptick in COVID-19 cases which has led to a renewed shortage of PPE in several geographic regions. Some areas are also continuing to struggle with a shortage of COVID-19 tests. The AANEM policy department has received several emails and messages, primarily from smaller practices, asking for advice on obtaining both PPE and access to COVID-19 tests for non-symptomatic patients prior to EDX testing. In an effort to assist these members, we’ve compiled a list of current resources and suggestions based on research and conversations with other medical groups.
General Practice Advice
The American Medical Association has some great resources and advice for clinicians operating their practices during the pandemic. From financial considerations, to liability insurance issues, to administrative concerns, this
link contains guidance and suggestions on these topics and more:
https://www.ama-assn.org/delivering-care/public-health/tips-keeping-your-practice-business-during-covid-19-pandemic.
Medico-Legal Considerations
If you’re concerned about potential medico-legal issues related to COVID, be sure to contact your medical liability carrier about the current rules and regulations in your state with regards to immunity during the COVID-19 public health emergency. There’s an informative
podcast created by a couple of medical malpractice attorneys that discusses this issue in some depth:
https://podcasts.apple.com/us/podcast/special-episode-litigation-risk-and-covid-19/id1469155084?i=1000470557248
Waivers and Medical Policy Changes
Many government and commercial payers have instituted waivers and temporary changes to their medical coverage/payment policies during the COVID-19 public health emergency. The Centers for Medicare and Medicaid Services (CMS) have compiled a
list of all of their current waivers which can be found here:
https://www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf. Be sure to check this chart regularly as waivers are still being added and may also be removed (though most run through the public health emergency declaration). You will need to contact your individual commercial payers to see about any changes made to their policies. However, you may want to check with your state medical society as some states, such as the Texas Medical Association, have worked to compile
charts of waivers and policy changes made by government and commercial payers in their state (
https://www.texmed.org/TexasMedicineDetail.aspx?id=53538). But, again, you will need to check these waivers frequently – many waivers and temporary policy changes by commercial payers are set to expire much earlier than those set by CMS.
Personal Protective Equipment (PPE)
If you’re having trouble finding masks, eye protection, gloves, hand sanitizer or any other PPE in your area, here are a few different websites geared towards getting this equipment to medical professionals that you may want to look at:
Amazon -
https://business.amazon.com/en/work-with-us/healthcare/covid-19-supplies
(supplies masks, gloves and safety supplies for healthcare and government organizations)
Grassroots Movement for PPE -
https://getusppe.org/request/
Project N95 -
https://www.projectn95.org/
(national clearing house for PPE and medical supplies)
State Departments of Public Health
(contact yours to see if they are able to assist in obtaining PPE)
(If you have patients looking to donate materials, you can direct them to
https://findthemasks.com/ to find drop-off locations)
When the pandemic first started, AANEM looked into trying to purchase PPE for members, but quickly learned that nearly any mass order needed to go through Chinese distributors and there has been substantial quality control and outright fraud in those transactions. AANEM is continuing to work with the American Medical Association and Congress on increasing U.S. production of PPE.
COVID-19 Testing
Some members have asked about the availability of at-home tests or testing sites and insurance coverage of COVID-19 tests for non-symptomatic patients prior to EDX testing. Due to vast differences across geographic regions, you should start by contacting your state public health department and/or your state medical society. You may also want to contact local hospital systems in your area. While there are numerous at-home COVID tests available, only one has received emergency authorization from the FDA:
https://www.fda.gov/media/136148/download. However, the authorization is only for patients exhibiting COVID-19 symptoms. AANEM has contacted the testing company to see about expanding availability of the test to non-symptomatic patients when ordered by a physician prior to a procedure, but we have not yet received a response. Another option available in many areas are CVS Health testing sites:
https://cvshealth.com/covid-19/testing-locations.
If you are aware of any other good practice resources for handling the COVID-19 pandemic, please contact the AANEM policy department so that we can share them with the membership:
policy@aanem.org.
AANEM staff and member volunteers are continuing to work on creating additional educational materials related to NM medicine and EDX testing during the COVID-19 pandemic. We post our most up-to-date materials on our dedicated
COVID-19 webpage:
https://www.aanem.org/Practice/COVID-19-Guidance. Follow us on
Facebook and
Twitter for immediate announcements of release of new materials. If you have specific questions about your practice or handling specific types of patients, please post your question to
AANEM Connect. You may also contact the AANEM policy department with COVID-19 related questions:
policy@aanem.org.