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The Medicare 2021 Physician Fee Schedule – An Update

Contact Your Congressperson TODAY About H.R. 8505!

Have You Contacted Your Congressperson About H.R. 8505? It’s Fast, Easy, and Will Make a Difference! CLICK HERE and Ask Them to Co-Sponsor This Important Bill TODAY!


On October 5, 2020, the comment period regarding the Medicare 2021 Fee Schedule Proposed Rule closed. The MAC was one of several chiropractic organizations that submitted comments in opposition to the rule, which would result in a huge cut to reimbursement for chiropractic services in Medicare. In total, more than 31,000 comments were sent to CMS on the issue, most of them protesting the reduction in the conversion factor and RVUs for various services due to a budget neutrality requirement associated with raising fees for E/M services for many professions (but not chiropractors).

H.R. 8505

On October 2, 2020, Congressman Michael Burgess, MD (R-Texas), and Congressman Bobby Rush (D-Illinois) introduced H.R. 8505, legislation that would implement a one-year waiver of the budget neutrality adjustments under the Medicare Physician Fee Schedule (PFS), thereby stopping the massive cuts (almost 20% for chiropractors!) outlined in the Proposed Rule from taking place on January 1, 2021. The bill was referred to three committees:

  • Energy and Commerce
  • Ways and Means
  • Appropriations

As of October 30, 2020, the bill only had six additional co-sponsors. Not one of Michigan’s 14 congresspeople have signed on. The more co-sponsors a bill has, the more likely it is to pass, whether as stand-alone legislation or as part of a larger bill or package. That’s why we are asking you to contact your member of Congress to ask them to co-sponsor this important legislation.

Act Again – Today!

Even if you have already contacted your member of Congress on the Medicare 2021 Physician Fee Schedule issue, IT IS CRITICAL that you contact him or her again and ask them to SUPPORT H.R. 8505. We now have a specific bill we can ask them to co-sponsor. This is something concrete that they can do to show their support for chiropractic patients in the Medicare system. To contact your member of Congress, click here!

Other Legislative Efforts

Despite the lack of co-sponsors for H.R. 8505, there seems to be a desire on behalf of many members of Congress to fix this issue. On October 19, 2020, an updated letter on the 2021 Medicare Physician Fee Schedule (but not specifically referencing H.R. 8505), signed by a bipartisan coalition of 229 members of the U.S. House of Representatives, was sent to Speaker of the House Nancy Pelosi and House Minority Leader Kevin McCarthy. This represents more than half of the 435 members of the U.S. House of Representatives, showing a bipartisan majority is willing to tackle this issue. Regarding the 2021 Medicare Physician Fee Schedule Proposed Rule, they write:

“Payment cuts of this magnitude will surely strain a health care system that is already stressed by the COVID-19 pandemic and could jeopardize patient access to medically necessary services… In order to safeguard beneficiaries’ access to care during this pandemic, we as Congress should examine possible bipartisan solutions to address excessively steep cuts. We encourage you to incorporate the resulting policy changes in any upcoming legislation moving through the House… 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...”

Three Michigan members of Congress – Rep. Jack Bergman (R-Watersmeet), Rep. Haley Stevens (D-Rochester Hills), and Rep. Fred Upton (R-St. Joseph) signed on to the letter.

Collaboration Between Professions

On October 5, 2020, a group of 47 physician and health care organizations, including the ACA, sent a letter in opposition to the fee schedule Proposed Rule to CMDS Administrator Seema Verna, MPH. These professional organizations, representing an estimated 1.4 million physicians and nonphysician practitioners throughout the country, “strenuously object to the extraordinary budget neutrality reduction” found in the proposed rule, because, among other things, it would:

  • Cripple the recovery of the nation’s health care system by exacerbating revenue shortfalls that are already jeopardizing the financial viability of physician and non‐physician providers across the country.
  • Reduce access to medically necessary specialty services for those Americans who have delayed seeking specialty treatment due to the fear of contracting COVID‐19.
  • Institute a conversion factor that is only slightly more than half of the conversion factor applicable in 1994, adjusted for inflation.
  • Reduce Medicare payment for services provided in patients’ homes, physician offices, non‐physician practices, therapy clinics, skilled nursing facilities, hospitals and rehabilitation agencies — at a time when the spread of COVID‐19 remains unchecked.
  • Further exacerbate the problems occurring across the country with practices furloughing or cutting staff and an increasing number closing their doors. Of great concern is the impact that this will have on access to needed health care services, especially for beneficiaries in rural and underserved areas. Because, in the end, if these detrimental cuts are implemented, those who suffer the most will be patients.

The letter concludes:

“It is counter‐intuitive to put forth drastic reductions to reimbursement at a time when both Congress and HHS are focused on engaging patients, increasing the delivery of integrated, team‐based care, expanding chronic disease management, and reducing hospital admission/readmission rates for beneficiaries residing in the community as well as those in long‐term nursing facilities. CMS must recognize how the reimbursement reductions for our providers fail to align with CMS’ efforts to drive better patient access to care and management.”

Stay Tuned!

Things are moving fast, and without congressional action there is less than two months until the cuts outlined in the Proposed Rule become a reality. Stay tuned for updates on this critical legislation as they become available.

CFCU - Lukowski

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