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The recent confirmation from CMS that it will move ahead with damaging Medicare payment cuts to 37 professions — including a 9% cut to physical therapy — means that it's now up to Congress to do something. Thanks in part to a historic advocacy effort by  APTA members and other professional groups, things are beginning to move in a positive direction, including in the U.S. Senate, where a bipartisan group of 50 senators has spoken out in favor of addressing the cuts. But now's not the time to let up on the pressure.

The positive news makes it more important than ever to contact lawmakers to express your support for a fix.

The Latest From Capitol Hill

A bill that would offset the cuts is still in play.
As previously reported, in late October, Reps. Ami Bera, MD, D-Calif., and Larry Buchson, MD, R-Ind, introduced legislation in the U.S. House of Representatives that would add funding to Medicare and direct CMS to essentially reset payment levels through additional temporary relief payments during 2021 and 2022. At time of publication, the bill has 89 bipartisan cosponsors.

The bill, H.R. 8702, known as the "Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020" is very much alive in the House, and is the focus of the bulk of APTA's advocacy work around the cut, which included a recent virtual rally to generate energy around contacting members of Congress about the bill — repeatedly, if necessary.

A companion bill is expected in the Senate.
In another sign of growing momentum, APTA has learned that a bill that parallels H.R. 8702 will be introduced in the U.S. Senate as early as Dec. 11. Details about the bill—and how to advocate for its adoption—will be shared in the days ahead.

50 senators want to do something about the payment cuts.
Fully half the members of the U.S. Senate have signed on to a bipartisan letter to Majority Leader Mitch McConnell, R-Ky., and Minority Leader Charles Schumer, D-N.Y., that presses for relief from the cuts. The letter asserts the cuts "will further strain our health care system, which is already stressed by the COVID-19 pandemic, and jeopardize patient access to medically necessary services over the long-term."

The letter acknowledges the "positive attributes" of some parts of the final CMS physician fee schedule but warns that now isn't the time to subject providers to severe cuts.

"Health care professionals across the spectrum are reeling from the effects of the COVID-19 emergency as they continue to serve patients during this global pandemic," the letter states. "The payment cuts finalized by CMS would pose a threat to providers and their patients under any circumstances, but during a pandemic the impact is even more profound."

Members of the Congressional Black Caucus call the cuts "ill conceived" and ask for a solution.
Writing in a Dec. 4 letter that even even without the planned Medicare cuts, "too many practices are struggling, even as patients need access to health care now more than ever," members of the Congressional Black Caucus urged House leaders Nancy Pelosi, D-Calif., and Kevin McCarthy, R-Calif., to include provisions in the year-end spending package to prevent the cuts from taking effect. The caucus members describe two bills as possible solutions: H.R. 8702, mentioned above, and H.R. 8505, which would allow a one-year waiver of the budget neutrality requirements that forced CMS to cut payment to the 37 profession to offset increases to evaluation and management visit payments.

A letter from 19 members of the House "doc caucus" pushes for a fix to the cut.
In a Dec. 3 letter to House leaders Pelosi and McCarthy, bipartisan House members who are also medical professionals warn that unless Congress does something, the CMS cuts will "dramatically limit patient access to care during the public health emergency and beyond." Similar to the Congressional Black Caucus letter, the letter from the doc caucus mentions H.R. 8702 and H.R. 8505 as possible, if temporary, solutions.

APTA Advocacy and Education

APTA never put the brakes on advocacy around the cut, even as CMS released the final physician fee schedule rule that moved ahead with the reductions. Instead, the association and its members focused their energies on Congress.

Those efforts are ongoing but were given special emphasis on Dec. 3, when APTA hosted a second virtual rally to galvanize grassroots action. And once again, APTA members and supporters responded enthusiastically, generating thousands of emails and phone calls to Congress.

Don't stop now — get on the phone (and use our call script).
The response to the virtual rally was encouraging, said Laura Keivel, APTA grassroots affairs specialist, but there's more work to be done.

"With so many moving parts in Congress and so little time left, it's crucial that we keep up the pressure," said Keivel. She's urging supporters to focus more on making phone calls than sending emails, given the urgency of the issue. APTA is making those calls as easy as possible by offering legislator contact information and a script that you can use when phoning Capitol Hill.

Stay informed.
Don't miss out on a steady stream of information from APTA on both the fee schedule and advocacy around the cut. Our latest addition: a 30-minute recorded webinar from APTA staff experts that includes a review of the rule, our legislative advocacy efforts to fight the 9% cut, and ways you and others can get involved in grassroots efforts. It's perfect for sharing with other PTs, PTAs, students, colleagues, family, and friends so they can be informed and engaged, too.


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