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Legislation calls for relief to physicians affected by upcoming Medicare cuts

by John R. Fischer, Senior Reporter | November 04, 2020
A new bill could provide temporary relief to physicians affected by upcoming Medicare cuts in 2021
A new form of legislation has come before the U.S. House of Representatives, advocating for critical relief to physicians caring for COVID-19 patients and who are scheduled to receive cuts in Medicare payments starting next year.

Introduced by U.S. Representatives Dr. Ami Bera (D-CA.) and Dr. Larry Bucshon (R.-IN), the Holding Providers Harmless from Medicare Cuts During COVID-19 Act of 2020 aims to keep payments to these providers at 2020 levels for the next two years.

“Cutting payments for other physicians during the middle of a global pandemic will further strain our healthcare system and the ability for healthcare professionals to serve their patients,” said Bera. “I’m introducing this bipartisan bill with my good friend and fellow doctor Representative Bucshon, to prevent these cuts.”
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The Medicare Physician Fee Schedule Proposed Rule by CMS in 2021 calls for 10.61% cuts in reimbursement from the current relative value unit of $36.0896 to a proposed rate of $32.2605. The cuts are meant to keep budget neutral following CMS’ decision to approve increases for office/outpatient evaluation and management services. Among those affected are diagnostic radiology (11%); interventional radiology (9%); nuclear medicine (8%); and radiation oncology and therapy centers (6%).

The bill would provide temporary additional payment equal to the difference between 2020 and 2021 over the next two years.

“Absent congressional intervention, radiologists and other providers face a drastic Medicare reimbursement reduction starting Jan. 1, 2021,” said Dr. Howard Fleishon, chair of the American College of Radiology Board of Chancellors, in a statement. “Implementation of these cuts would jeopardize timely patient access to vital screening and diagnostic services and a host of other services. This new legislation also enables important pay increases for primary care and others while avoiding devastating, corresponding cuts for physician and non-physician providers.”

Other congressional leaders wishing to relieve providers of the challenges they face with the upcoming cuts include Rep. Michael Burgess, MD, R-Texas, and Rep. Bobby Rush, D-Ill. The two fproposed a bill that would waive the budget neutrality requirement for evaluation and management (E/M) CPT code increases mandated by the Medicare Physician Fee Schedule for one year. ACR and a coalition of other organizations have also voiced support for this bill.

“The new policy hurts physicians who do not often bill E/M services. With COVID-19’s financial impact on practices, this CMS action will harm providers and patient access to care,” said ACR.

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