As 9%+ physician pay cut looms, Congress urged to take action

An Oct. 14 Congressional letter to House Speaker Nancy Pelosi, D-Calif., and House Minority Leader Kevin McCarthy, R-Calif., urged them to take action against CMS’ physician payment cuts in 2021.

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The letter, led by Reps. Ami Bera, MD, D-Calif., and Larry Bucshon, MD, R-Ind., called for systemic changes to the Medicare payment system, which “does not adequately incentivize high-quality care,” and highlighted how reimbursement has not kept up with inflation.

Broad, systemic reforms of the Medicare payment system are required to accelerate the transition to value-based care, according to the letter, which was signed by a bipartisan group of 247 members of Congress.

Healthcare providers face further pay cuts stemming from Physician Fee Schedule adjustments as well as the Medicare sequester and the Statutory Pay-As-You-Go (PAYGO) Act of 2010.

The Consolidated Appropriations Act, which contained a 3.75 percent payment increase for all Physician Fee Schedule services, will expire at the end of 2021, adding to cuts coming from the expiring moratorium on the 2 percent Medicare sequester and the 4 percent Medicare payment cut due to PAYGO.

Combined, these cuts will likely lead to providers facing at least 9 percent in cuts to CMS payment, according to the letter, which called for an extension of the 3.75 percent payment adjustment to Physician Fee Schedule, among other actions.

“Such an overwhelming showing on this letter to House leaders clearly demonstrates significant bipartisan support for Congress to act this year to protect Medicare beneficiaries’ timely access to care,” John Ratliff, MD, neurosurgeon and chair of the American Association of Neurological Surgeons/Congress of Neurological Surgeons Washington Committee, said in an Oct. 15 news release.

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