The California Medical Association (CMA) on Friday submitted comments to the Centers for Medicare and Medicaid Services (CMS) on the proposed 2021 Medicare physician fee schedule.

In the comments, CMA strongly urged CMS to waive or mitigate the budget neutrality rule that will result in double digit payment cuts for many physicians. While there are many positive changes in the new payment policies for 2021—including improvements for maternity care and much-needed payment increases for physicians delivering primary and complex office-based care to some of our nation’s most vulnerable patients—CMS operates under a statutory “budget neutrality” rule that requires any increases in Medicare payments for these office visits to be offset by corresponding decreases.

CMA in its comments told CMS that 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. 

CMA urges all physicians to contact their Members of Congress to stop the Medicare payment cuts.

CMA’s comments also covered a number of other areas, including:

Telehealth: CMA urged CMS to make the expansion to telehealth services permanent (including audio-only visits), to remove the geographic and site-of-service barriers, and to ensure telehealth is reimbursed at in-person rates.

Regulatory Relief: CMA told CMS that the increasing administrative workload forced upon physicians is unsustainable, diverts time and focus away from patient care, and leads to additional stress and burnout among physicians. CMA believes that providing long over-due regulatory relief to physicians will decrease costs, improve quality of care, increase access to physicians, and allow physicians to spend more time with their patients.

Scope: CMS is proposing to make permanent changes implemented under the federal public health emergency that would allow certain non-physician practitioners – including nurse practitioners and physician assistants – to supervise the administration of diagnostic tests within their state scope of practice and applicable state laws. Although California law would not allow expanded authority to any category of nurse practitioner to supervise diagnostic procedures, CMA believes that permanent implementation of the rule would cause confusion and harm patients. Nurse practitioners  do not have the education and training to perform all diagnostic procedures, as broadly defined in the rule, or to provide clinical supervision for non-physician practitioners performing diagnostic procedures. 

Click here to view CMA’s comments.