House Bipartisan Group Urges Leadership to Reject Proposed PALTC Medicare Physician Fee Schedule Cuts

August 27, 2020
Policy Snapshot

Ninety three bipartisan members of the House of Representatives have called on House leadership to protect patients and medical professionals by waiving pending rate cuts to Medicare and Medicaid services. The letter also urged Speaker Nancy Pelosi (D-CA) and Minority Leader Kevin McCarthy (R-CA) to require the Centers for Medicare & Medicaid Services (CMS) to study how COVID-19 has impacted access to critical health services in underserved urban and rural Health Professional Shortage Areas.

“Through no fault of their own, millions of patients across America who rely on Medicare and Medicare will have their healthcare endangered due to arbitrary cuts to critical medical services,” said Rep. Bobby Rush (D.-IL), who leads the bipartisan coalition. “Moreover, thousands of healthcare specialists, particularly those in urban and rural areas, will be in danger of losing their jobs as a result. This is completely unacceptable, especially as our country continues to combat the COVID-19 pandemic.”

He continued: “Our healthcare system is already under immense pressure due to this dreaded disease, and the implementation of these reckless cuts could potentially be the straw that breaks the camel’s back. That is why I, joined by 92 of my Congressional colleagues, am urging House leadership to protect patients and take swift action to prevent such disastrous cuts. We must also more broadly consider how COVID-19 has impacted access to critical health services in underserved urban and rural Health Professional Shortage Areas.”

CMS’ Medicare Physician Fee Schedule (PFS) rule published in November 2019 increased rates for the office-based evaluation and management (E/M) code set in CY2021. Due to the requirement for budget neutrality, this would result in a significant cut for many providers, across multiple specialties, beginning on January 1, 2021.

The aforementioned letter also urges House leadership to require CMS to study the impact on providers of failing to waive budget neutrality associated with the E/M policy.

AMDA – The Society for Post-Acute and Long-Term Care Medicine opposes the nearly 10% cut to the nursing facility family of services proposed for CY2021. The Society has joined with other organizations  to discuss with Congress and CMS ways to prevent these cuts from being finalized. The groups would like to see increases to office-based E&M remain as proposed but have the budget neutrality rule waived so that other services do not see a dramatic decrease.

The Society signed onto several letters earlier this year asking Congress to waive budget neutrality and preserve increases in office-based E&M services.