Marshall Leads Letter Requesting Adjustments in Medicare Physician Fee Schedule

September 24, 2020
Press Release

WASHINGTON, D.C.—Today, U.S. Representatives Roger Marshall, M.D. (R-KS), Bobby L. Rush (D-IL), Brad Wenstrup, D.P.M. (R-OH), Terri Sewell (D-AL), David McKinley (R-WV) and Tom O'Halleran (D-AZ) led a bipartisan coalition of more than 160 members of Congress in asking Department of Health and Human Services Secretary, Alex Azar, and Centers for Medicare & Medicaid Services Administrator, Seema Verma, to use their regulatory authority to alleviate concerns with the CY 2021 Medicare Physician Fee Schedule reimbursement adjustments. They released the following statement:

“The COVID-19 public health crisis created unprecedented disruptions in our medical community. Our health care professionals have been on the frontlines, adjusting to new challenges and providing critical care to patients. Now is not the time for massive reimbursement cuts to specialists, including physical therapists, radiologists, pathologists, and surgeons, among other specialties. Instead, we need to work together to ensure a pathway forward that will empower health care professionals to recover from the last six months and to continue to offer essential health care services to America’s seniors.” 

The CY 2021 Medicare Physician Fee Schedule is a system for paying health care professionals for the services they provide to Medicare beneficiaries in a variety of settings, including independent practice groups, surgery centers, academic medical centers, nursing homes, imaging centers and clinical laboratories. Due to Medicare’s budget neutrality requirements, payment increases for certain services must be offset by decreases in other services. 

In the letter, the Representatives commend the agency for improving payments for primary care and other office-based practitioners, increasing telehealth access, and more. However, they express grave concerns that these increases will result in corresponding cuts to other health care professionals who have been among the hardest hit by the COVID-19 pandemic. If left unresolved, significant payment reductions will undermine timely access to needed care, especially for patients with acute and chronic conditions.

The Representatives are urging administration officials to engage with stakeholders, where possible, to expeditiously establish establishing a fair and equitable payment solution that addresses Medicare payment cuts at this time, while at the same time moving forward with policies to increase payments to primary care and other office-based specialties. This could be accomplished using funding sources outside of this fee schedule. 

To view a copy of the letter, click HERE

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