Led by Representative Bobby L. Rush (D-IL), 92 lawmakers sent a letter to House Speaker Nancy Pelosi (D-CA) and Minority Leader Kevin McCarthy (R-CA) calling on any upcoming legislation that moves through the House to waive budget neutrality for 2021 and 2022 for the emergency and management (E/M) code set scheduled for implementation on January 2021. The Centers for Medicare and Medicaid Services’ (CMS) Medicare Physician Fee Schedule rule published in November 2019 increased rates for the office-based E/M code set in CY2021.
The letter warned that because of the requirement for budget neutrality, this would result in a significant cut for many providers, across multiple physician and non-physician specialties, beginning on January 1, 2021. Budget neutrality is a government mandate that requires the Agency to offset the increases in E/M reimbursement with reductions to other providers to make up the difference. The letter also urged House Leadership to require CMS to study the impact on providers of failing to waive budget neutrality associated with the E/M policy, as well as a study on how COVID-19 has impacted access to critical health services in underserved urban and rural Health Professional Shortage areas.
Over three dozen provider types are facing reductions. Audiology is just one of the provider types facing reimbursement reductions along with PT/OT/SLP as well as radiology, emergency medicine and orthopedic surgery. The Academy has been active in a coalition to stave off these cuts and was part of the effort to secure the congressional letter cited above. In addition, the coalition created an accompanying fact sheet that details the amount of the cuts that each specialty is facing as well as the impact to each type of provider.