Congress Must Act To Fortify Health Care System And Protect Access To Care

WASHINGTON—The final 2021 Medicare Physician Fee Schedule (MPFS) issued today by the Centers for Medicare & Medicaid Services (CMS) failed to provide relief from a significant shift in physician and non-physician payments expected to take effect on January 1, 2021.  Thousands of comments submitted by providers, patients, and Members of Congress highlighted the importance of mitigating payment cuts associated with budget neutrality requirements triggered by higher payment and modified reporting requirements for evaluation and management (E/M) services.

Due to CMS’s unresponsiveness to address these concerns, organizations representing more than 1 million physicians and nonphysician health care providers across the United States urge Congress to include legislation in any year-end package to prevent these arbitrary Medicare cuts in order to protect patient access to medically necessary services.  

In late 2019, CMS announced new Medicare payment policies for office and outpatient visits — also known as E/M services — billed by physicians and some nonphysician providers. These new payment policies will result in cuts of up to 10 percent or more for certain specialties. Due to Medicare’s budget-neutrality requirements, physician, nonphysician, and institutional providers billing under the PFS will experience substantial payment reductions to offset payment increases to physicians and other providers who primarily deliver office-based services. These cuts will be devastating to an already struggling health care system and may lead to reduced access to care for older Americans and Americans with disabilities. 

Similar concerns were relayed to CMS in a September 24, 2020 letter signed by 161 bipartisan members of the U.S. House of Representatives. However, the recent publication of the Final Rule confirmed CMS’ intent to move forward with implementation of the E/M changes without recognition that these payment reductions will have a net negative impact on the Medicare program.  As a result, our organizations are calling on Congress to include H.R. 8702, the Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020, in a forthcoming year-end legislative package. This critical legislation, supported by more than 300 national, regional, state and local organizations—including all 50 states, the District of Columbia and Puerto Rico—provides a necessary reprieve for a broad array of physicians and non-physician health care providers facing substantial payment reductions in the coming months, while also allowing payment increases to go forward for those who provide E/M services to Medicare beneficiaries in a stand-alone office visit or outpatient setting. 

If Congress fails to mitigate these cuts, decreases in Medicare payments will further exacerbate the problems occurring across the country with practices and institution-based providers furloughing or cutting staff and an increasing number closing their doors in response to the COVID-19 pandemic. Of great concern is the impact that this will have on access to needed health care services, especially for beneficiaries in rural and underserved areas. Our organizations stand united in highlighting that in the end, patients will suffer the most from implementation of these detrimental cuts. 

To arrange an interview with a representative, contact Shawn Farley at 703-648-8936 or [email protected].

National Medical Organizations Participating in This Coalition Statement:

Academy of Nutrition and Dietetics

Alliance for Physical Therapy Quality and Innovation

American Academy of Audiology

American Academy of Dental Group Practice

American Academy of Dermatology Association

American Academy of Ophthalmology

American Academy of Oral and Maxillofacial Pathology

American Academy of Oral and Maxillofacial Radiology

American Academy of Otolaryngology—Head and Neck Surgery

American Association of Neurological Surgeons

American Association of Nurse Anesthetists

American Association of Oral and Maxillofacial Surgeons

American Association of Orthopaedic Surgeons

American Chiropractic Association

American College for Surgeons

American College of Emergency Physicians

American College of Gastroenterology

American College of Mohs Surgery

American College of Obstetricians and Gynecologists

American College of Osteopathic Surgeons

American College of Radiation Oncology

American College of Radiology

American Gastroenterological Association

American Health Care Association

American Medical Association

American Occupational Therapy Association

‎American Optometric Association

American Physical Therapy Association

American Psychological Association

American Society for Gastrointestinal Endoscopy

American Society for Radiation Oncology

American Society for Surgery of the Hand

American Society of Anesthesiologists

American Society of Breast Surgeons

American Society of Cataract and Refractive Surgery

American Society of Colon and Rectal Surgeons

American Society of Echocardiography

American Society of Hand Therapists

American Society of Neuroradiology

American Society of Nuclear Cardiology

American Society of Plastic Surgeons

American Speech-Language-Hearing Association

Association for Quality Imaging

Association of Black Cardiologists

Association of Freestanding Radiation Oncology Centers

Association of Pathology Chairs

CardioVascular Coalition

Clinical Social Work Association

College of American Pathologists

Congress of Neurological Surgeons

Dialysis Vascular Access Coalition

Digestive Health Physicians Association

National Association for the Support of Long Term Care

National Association of Rehabilitation Providers and Agencies

National Association of Social Workers

National Association of Spine Specialists

National Center for Assisted Living

Private Practice Section of the American Physical Therapy Association

Radiology Business Management Association

Select Medical

Society for Cardiovascular Angiography and Interventions

Society of Interventional Radiology

Society of Nuclear Medicine and Molecular Imaging

The Society of Thoracic Surgeons

United Specialists for Patient Access