December 09, 2020
Area(s) of Interest: Public Health Public Payors
As Congress is working to complete the final legislation of the year, the California Medical Association (CMA) is urging physicians to contact their members of Congress to ask that they take immediate action to ensure the stability of physician practices. The worsening COVID-19 health crisis has put a massive strain on physician practices in our country that threatens to fundamentally alter the long-term stability of our health care system.
CMA is urging physicians to contact their members of Congress and tell them:
Medicare Payment Cuts
While the 2021 Medicare physician fee schedule makes many positive changes for physicians delivering primary and complex office-based care, under the statutory budget neutrality rules, any increases in Medicare payments must be offset with corresponding decreases. As a result, many specialist physicians now face double digit payment cuts beginning on January 1, 2021, unless Congress intervenes to stop the cuts. (See this table for impacts by specialty.)
Physician practices cannot sustain such significant payments cuts while they are already struggling due to the COVID-19 pandemic. Cuts of this magnitude will seriously jeopardize access to care when patients need physicians more than ever.
Congressmen Ami Bera, M.D., (D-CA) and Larry Bucshon, M.D., (R-IN) have introduced a bill – H.R. 8702, the “Holding Providers Harmless from Medicare Cuts During COVID-19 Act of 2020” – to stop the looming Medicare payment cuts while protecting the primary care payment increases. CMA is urging physicians to contact their Members of Congress to cosponsor H.R. 8702.
More Pandemic Relief
CMA is also urging Congress to commit an additional $100 billion to the Provider Relief Fund for physicians and hospitals to ensure every provider receives funding commensurate with their additional COVID-19 related expenses and revenue losses. Given the ongoing pandemic and the acute revenue losses and increased costs being experienced by physician practices, physicians need additional funding to remain accessible to patients in their communities.
Surprise Medical Billing
There is a last-minute effort in the U.S. House of Representatives to include surprise medical billing legislation that favors insurers over physicians and patients in the year-end legislative package. A rushed effort on surprise billing could threaten access to care and devastate the ability of physicians to fully respond to the COVID-19 resurgence that is overwhelming California right now. CMA has partnered with the California Hospital Association to oppose this 11th hour effort (see our coordinated message points).
CMA agrees that surprise billing must end, but the proposals being considered reward insurance companies by stripping nearly $20 billion from providers on the front lines fighting the pandemic. COVID-19 patients are already protected from surprise medical bills during the pandemic because providers agreed to not balance bill as a condition of accepting Provider Relief Fund payments.
Please urge your representatives not to include harmful surprise billing legislation in any end-of-year legislation.
For More Information
For more details on these issues, see CMA’s lame duck session priorities in the attached letter.