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Expressing "grave concerns" about a proposed cut in Medicare reimbursements in 2021, 157  bipartisan members of the U.S. House of Representatives are urging the U.S. Centers for Medicare & Medicaid Services to do something to stop or blunt them, even if it's a temporary reprieve that would buy time to allow Congress to evaluate longer-term solutions. The proposed cuts outlined in the 2021 physician fee schedule include an estimated 9% drop in payment to PTs, and have been the focus of intense advocacy efforts by APTA and multiple other provider organizations.

The letter, sent to CMS administrator Seema Verma and U.S Department of Health and Human Services Secretary Alex Azar on September 23, is the largest such sign-on letter yet — a signal that participation in APTA's #FightTheCut initiatives that drove nearly 50,000 messages to lawmakers is having an impact on Capitol Hill.

The latest letter characterizes the proposed cuts as a damaging move made worse by CMS' insistence that they be instituted beginning Jan. 1, 2021, while many providers are still struggling to recover from losses incurred during the coronavirus pandemic.

"Due to the COVID-19 pandemic, physicians and other health care providers continue to face unprecedented public health and economic challenges," the letter states. "Many face difficult financial decisions and are responding by either cutting their pay, taking on debt, or laying off or furloughing employees."

The House members also point out that the damage isn't limited to physicians, writing that "38 percent of physical therapy owners/partners reported that revenue had decreased 76 to 100 percent in the early phases of the pandemic, with another 34 percent reporting declines of 51 to 75 percent."

While acknowledging the budget neutrality constraints faced by CMS and applauding the agency's move to increase reimbursement for evaluation and manage codes, the House members write that they have "grave concerns that these increases result in a corresponding loss of reimbursement for those physician specialties, therapists, and other health care providers who have been among the hardest hit by the COVID-19 pandemic."

"While we understand that legislative action may also be required to address this issue, given the January 1, 2021 effective date, we would ask you to take immediate actions to delay or mitigate these cuts while allowing the scheduled increases to go into effect," the letter states. "This approach will give Congress sufficient time to develop a meaningful solution and to address these looming needs."

The letter to CMS comes just as APTA is encouraging members and stakeholders to turn their focus to Medicare and flood the agency with letters opposing the proposed cuts. The association's "Take #FightTheCut to Medicare" effort will begin with a virtual kickoff rally on Sept. 30 at 7 p.m., ET followed by a push to generate as many letters as possible on Oct. 1. The deadline for comments is Oct. 5.

"The most recent letter from this bipartisan group of House members clearly shows that they get it — these cuts would be a bad idea at any time, but coming amid a pandemic, they're likely to have brutal consequences," said Justin Elliott, APTA vice president of government affairs. "Chances are that Congress will wait until the lame duck session after the November 3 election to address Medicare cuts. We need to keep up the pressure on both CMS and Congress while there's still time."

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