Advocacy efforts by APTA and other organizations are gaining significant traction: A bipartisan majority of the U.S. House of Representatives is pressing house leaders to take action to address proposed cuts to Medicare payment that would affect a wide swath of providers, including PTs. The support for countering the cuts with additional funding comes in addition to a call for a longer-term effort to overhaul the entire physician fee schedule rule that governs payment under Medicare Part B.
The push for relief comes by way of a letter to house speaker Nancy Pelosi, D-Calif., and minority leader Kevin McCarthy, R-Calif., drafted by Reps. Ami Bera, D-Calif., and Larry Bucshon, R-Ind., and signed by 245 additional members of the 435-member House. The letter urges action to avert a payment cut proposed by the Centers for Medicare and Medicaid Services that, combined with other statutorily required cuts, could drop provider payments by as much as 9% in 2022. (This article provides details on the origins of the cut and what APTA is doing to fight it.)
What's needed immediately, according to the letter, is to address the effects of the looming cuts in ways similar to measures taken by Congress in late 2020. That year, lawmakers approved a 3.75% appropriation that softened much of the impact of CMS' first attempt at cuts enacted to pay for increases to codes associated with evaluation and management.
"We must act before the end of the year to avert the imminent cuts, including extending the 3.75% payment adjustment, and provide continued stability for physicians and other health care professionals," the letter states. "Otherwise, the profound exhaustion from the pandemic combined with stress of uncertainty in payments may lead to further retirements, office closures, or reduced staffing, ultimately limiting patient access to care."
The letter also stresses that the proposed cuts are part of a more fundamental problem: a physician fee schedule system that isn't working for providers or patients. That system, coupled with provisions in the Medicare Access and CHIP Reauthorization Act that fall short when it comes to providing adequate alternative payment models, "does not adequately incentivize high-quality care, and reimbursement has failed to keep up with inflation," write Bera and Bucshon.
"We believe broad systemic reforms to the payment system are critical to speed the transition to value-based care," the letter states. "We hope to work with you on broader, long-term reform to bring stability to the Medicare payment system, and we ask that you start that work as soon as possible."
"This letter makes it clear that most members of Congress understand the need to take action to not only address the proposed 2022 cuts, but to fix what's broken in the Medicare payment system," said Justin Elliott, APTA's vice president of government affairs. "Cuts like the ones proposed are becoming the rule more than the exception thanks to budget neutrality and other legal requirements that actually work against patient access to care. We are grateful to Representatives Bera and Bucshon for their leadership to address both the near-term and systemic problems."
Laura Keivel, APTA grassroots affairs specialist, believes that the strong congressional support for fighting the cuts underscores the power of advocacy at the individual level — advocacy that must remain strong until action is taken.
"Our advocacy efforts on Capitol Hill can educate legislators on the issues and provide guidance toward possible solutions, but what really matters to them are the voices of their constituents," Keivel said. "APTA's members and supporters have shown amazing energy and commitment around this issue, and now is definitely not the time to let up." APTA makes it easy to contact your lawmakers at its Patient Action Center, where sending a letter takes less than two minutes.