March 18, 2020

Dear Vice President Pence, Speaker Pelosi, Leader McConnell, Leader McCarthy, and Leader Schumer:

America faces an unprecedented challenge with COVID-19. From expanding public health capacity, and access to and the availability of testing, to taking action to mitigate the economic and societal impact, we know these are serious and significant times. But we also know that immediate, collective action - by the private sector and all levels of government - to address the critical needs of capacity and supply can help resolve this challenge.

We represent the nation's doctors, hospitals, nurses and other health professionals, specialty and post-acute facilities, clinical laboratories, health insurance providers, biopharmaceutical manufacturers, pharmacy benefit managers, and distributors. We test, treat, cover, and serve patients. We develop, deliver, and manage medications. And we provide essential medicines, machines, treatments, and supplies to providers across the country. Today, we stand united.

Given the national and local insights we collectively bring, we offer the most important and immediate actions that must be taken right now in our fight against COVID-19. These solutions represent opportunities to immediately increase medical capacity and testing, enhance our national supply of critical medical equipment required to meet unprecedented demand, protect our front-line care providers and lab technicians, and improve treatment for patients.

The private sector will deploy every necessary resource to match this moment. It is absolutely essential for a coordinated government response to leverage the full force of the President's national emergency declaration. Specifically, we recommend the following mission-critical, time-sensitive actions to ensure that necessary resources are delivered to the communities most in need:

1. We must ensure a stable, continuous supply of needed medical supplies for clinical labs and technicians, health care providers and health care facilities. To meet unprecedented demand, the most critical supplies needed are equipment for testing, personal protection of care providers, and respiratory support for patient care. We recognize that the President has invoked the Defense Production Act and urge the federal government to expeditiously move to spur massive, increased production, distribution, and access to gowns, masks, gloves, testing kits, testing swabs, and respiratory

2. We must strengthen provider capacity and drive patients to appropriate alternative sites of care. This includes modifying existing facilities in and around hospitals, quickly constructing temporary units where needed, making use of surplus government property, and increasing patient beds to prioritize critical patient needs. Changes must go beyond acute care, including maximizing the appropriate role of telehealth, expanding provider capability to work at top of license, expanding provider capacity to practice and for distributors to more easily deliver across state lines, removing regulatory restrictions that limit in-home care, directing patients to appropriate care alternatives when hospitals are not required, and improving patient flow and information sharing between facilities to reduce the burden on acute care

3. We must ensure continued access to medications and avoid supply-chain disruptions. That means assuring that manufacturers can provide a continuous supply of medicines to patients by protecting the free flow of medicines, pharmaceutical ingredients and related goods, while avoiding mandates that could disrupt the supply chain. In addition, it is critical to provide regulatory flexibilities to facilitate safe and expedient patient access through home delivery and early refills where needed, while guarding against unnecessary stockpiling that could lead to drug

We are committed to working with state, federal and local officials in every way possible, from supporting our public health heroes, to offering specific policy and regulatory changes, to assisting governors, legislatures, the Congress and the Administration.

This moment challenges all of us. And we will do everything possible to ensure that the private sector and government collaborate and cooperate on behalf of the American people. We will deliver by working together.

America's Health Insurance Plans American Academy of Family Physicians American Clinical Laboratory Association American Hospital Association

American Medical Association American Nurses Association Association for Accessible Medicines

Association of American Medical Colleges Blue Cross Blue Shield Association

Catholic Health Association of the United States Children's Hospital Association

Federation of American Hospitals Healthcare Distribution Alliance Healthcare Leadership Council HIMSS

Partnership for Quality Home Healthcare Pharmaceutical Care Management Association