APTQI Applauds Bipartisan Congressional Letter to HHS/CMS Urging Medicare to Delay or Mitigate Looming Specialty Provider Cuts

The letter, signed by more than 160 Representatives, urges HHS and CMS to find “fair and equitable payment solutions.”

Washington, DC, September 29, 2020 --(PR.com)-- Today the Alliance for Physical Therapy Quality and Innovation (APTQI) applauded a bipartisan letter signed by more than 160 House lawmakers urging the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) to take immediate actions to delay or mitigate significant Medicare cuts scheduled to go into effect on January 1, 2021, while allowing the scheduled E/M payment increases. Specifically, the lawmakers expressed deep concern that Medicare’s budget neutrality requirement will result in severe losses for many specialty providers who are already reeling from the financial and operational impacts of the COVID-19 pandemic.

The bipartisan letter, spearheaded by Representatives Roger Marshall, M.D. (R-Kan.), Bobby L. Rush (D-Ill.), Brad Wenstrup, D.P.M. (R-Ohio), Terri A. Sewell (D-Ala.), David McKinley (R-W.Va.), and Tom O'Halleran (D-Ariz.), detailed the severe financial challenges providers are facing as a result of the ongoing public health emergency and urged HHS and CMS to “engage with stakeholders in establishing fair and equitable payment solutions that address 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.”

“On both sides of the aisle, elected officials are rightly focused on turning back Medicare’s severe cuts to specialty providers who are working diligently to maintain patient access to critical services during the COVID-19 pandemic,” said Nikesh Patel, PT, Executive Director of APTQI. “During a time of unprecedented upheaval and uncertainty, it is inappropriate and irresponsible to allow these cuts to go into effect. APTQI commends these bipartisan lawmakers for fighting on behalf of specialty providers by urging HHS and CMS to delay these dangerous cuts.”

Under the CY 2021 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment Policies proposed rule, physical and occupational therapists are slated to incur a 9% Medicare reimbursement reduction on January 1. Other specialties facing reimbursement reductions under the rule include emergency medicine, interventional radiology, infectious disease, anesthesiology and cardiac surgery.

The cuts come on top of the major financial burdens imposed by COVID-19. According to the Medical Group Management Association, virtually all practices in the United States (97%) have experienced a negative financial impact directly or indirectly related to the ongoing pandemic, with practices reporting a 55% decrease in revenue and a 60% decrease in patient volume since the beginning of the crisis. More than one-third (38%) of physical therapy owners/partners report revenue drops between 76 to 100% in the early phases of the pandemic, with another one-third (34%) reporting declines of 51 to 75%.

“Finalizing the PFS without addressing certain inequities using other funding mechanisms will result in access issues for Medicare beneficiaries and further drive independent physicians and other health care providers towards market consolidation. In addressing this issue, we strongly encourage HHS and CMS to work collaboratively with stakeholders, where possible, and continue to make policies that results in better accessibility, quality, affordability, empowerment, and innovation,” the lawmakers wrote.

To read the bipartisan letter, click here.

About Alliance for Physical Therapy Quality and Innovation (APTQI)
The Alliance for Physical Therapy Quality and Innovation (APTQI) unites small, medium and large physical therapy practices to advocate for the physical therapy profession in the areas of payment reform, quality initiatives, outcomes and innovation projects. We are an aligned group of therapists and practices who share a common vision for the future of our profession. Our goal is to establish physical therapy as the treatment of choice and the best value for patients and payers. Learn more at aptqi.com.
Alliance for Physical Therapy Quality and Innovation
Ellen Almond
(703) 548-1163