A letter written by Representative Bobby Rush (D-IL) – and signed by 92 bipartisan members of the US House of Representatives – urges House leadership to waive budget neutrality rules in order to grant specialty providers a reprieve from severe Medicare cuts set to be implemented amid the ongoing COVID-19 pandemic. 

The letter – addressed to Speaker Nancy Pelosi (D-CA) and Minority Leader Kevin McCarthy (R-CA) – calls on Congress to waive budget neutrality for the Medicare payment changes for evaluation and management (E/M) services that the Centers for Medicare & Medicaid Services (CMS) plans to implement on January 1, 2021.

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Without this necessary change, the budget neutrality requirements would impose deep, across-the-board cuts on many specialty providers – including physical and occupational therapists – during the unprecedented COVID-19 public health emergency. As a result, providers who are already struggling after years of successive cuts will be at serious risk of closing their doors or scaling back services, which would be devastating for the millions of Medicare beneficiaries who depend on them, according to a media release from the Alliance for Physical Therapy Quality and Innovation (APTQI).

Now Is Not the Time for This

“If these cuts go into effect, they will be devastating for providers and will ultimately result in decreased access to care for patients,” 92 bipartisan lawmakers wrote in the letter. “Our healthcare system is already under tremendous financial strain, as it continues to grapple with both the economic and health consequences of the coronavirus. Now is not the time to implement these reckless cuts.”

The letter calls on House leaders to include a provision in upcoming legislation to waive budget neutrality for calendar years 2021 and 2022 for E/M codes scheduled for implementation on January 1, 2021. The lawmakers also request CMS reports to Congress on:

  1. The overarching effects of the COVID-19 public health emergency;
  2. The impact of the ongoing COVID-19 public health emergency on access to critical health services in underserved urban and rural Health Professional Shortage Areas; and
  3. The impact of failing to waive budget neutrality associated with the E/M policy on providers.

“Cutting health care during a health crisis is bad policy. We are living through an unprecedented pandemic that is stretching providers thin. The severe Medicare cuts, already damaging on their own, are slated to go into effect at the worst possible time and will significantly impact provider sustainability and patient access.

“I want to thank Representative Rush for his leadership in helping us protect Medicare beneficiaries’ access to care, and we commend this bipartisan group of lawmakers for urging House leaders to include budget neutrality for E/M services in relevant legislation moving forward.”

— Nikesh Patel, PT, Executive Director or APTQI

[Source: Alliance for Physical Therapy Quality and Innovation]