As many American College of Radiology® (ACR®) members already know, the final 2021 Medicare Physician Fee Schedule rule (MPFS) establishes new office and outpatient evaluation and management (E/M) coding changes, which will increase E/M payments to primary care and other office-based providers. Due to statutorily mandated budget neutrality, these increases must be offset by reductions to non-E/M codes in the MFPS. Therefore, those providers who do not frequently, if ever, bill E/M will shoulder the cost of the increased payments.
These looming Medicare payment cuts to more than a million medical providers, including an impending 10% reduction to imaging, will have a significant negative impact on the practice of medicine as many are still reeling from the economic impact of COVID-19.
Over the past several months, ACR government relations staff, as well as ACR membership, have been contacting members of Congress to gather their support for enacting legislation to avert these cuts. As a result of these efforts, as well as other provider organizations, bipartisan lawmakers in both the U.S. Senate and U.S. House of Representatives agree. To date, 278 House members have cosponsored legislation and/or signed letters urging their leadership to act before the end of the year. Most recently, 51 senators, led by Senator Steve Daines (R-MT) and Senator Debbie Stabenow (D-MI) have signaled their support for resolving this issue in a year-end legislative package.
With the legislative calendar waning, healthcare professionals will continue to call on congressional leaders to include the Holding Providers Harmless From Medicare Cuts During COVID-19 Act (H.R. 8702), or similar language, in any must-pass, year-end legislative package. A group of Republican senators has now introduced legislation (S. 5007) that largely mirrors H.R. 8702. Should Congress fail to act, practices and institution-based providers might be forced to furlough, cut staff or close their doors — further reducing access to needed healthcare services for seniors, especially those in rural and underserved areas.