AMA: Extend Telehealth, Prevent Pay Cuts In Reconciliation

Inside Health Policy

September 10, 2021 2:30 pm

The American Medical Association is pushing for Congress to continue telehealth flexibilities past the COVID-19 public health emergency and postpone physician payment cuts set to go into effect in January by adding provisions to Democrats’ emerging reconciliation package.

The House Ways & Means and Energy & Commerce committees both released their proposed contributions to the reconciliation package earlier this week. Neither package includes the AMA’s stated priorities. The Senate Finance Committee has not yet unveiled its legislative language, but AMA’s priorities haven’t been touted as reconciliation priorities by congressional leaders so far.

AMA supports permanently getting rid of originating site and geographic restrictions on telehealth use for Medicare beneficiaries, AMA Executive Vice President and CEO James Madara said in a Thursday (Sept. 9) statement.

“The omission of retaining telehealth services for Medicare beneficiaries in the budget resolution is glaring,” Madara said.

Other telehealth advocates have said Congress needs to act on telehealth before the end of the year. The PHE flexibilities that make telehealth coverage so expansive at the moment will expire at the end of the emergency period, which Biden has currently only indicated he’ll extend until the end of 2021. However, the PHE could be extended past that, which would give Congress more time to continue coverage.

AMA also wants Congress to use the reconciliation package to prevent what could be up to a 9.75% payment cliff for physicians from kicking in Jan. 1, 2022, and potential Merit-based Incentive Payment System penalties from rising to 9%.

CMS has proposed cutting Medicare physician payment by 3.75% in 2022. This would be on top of the reprieve of the 2% sequester expiring and the burden of a 4% pay-as-you-go (PAYGO) sequester from the American Rescue Plan Act. The 3.75% temporary physician fee schedule conversion factor increase tied to avoiding pay cuts related to budget neutrality adjustments in the physician fee schedule will also expire in 2022, and there’s a pause in annual Medicare physician fee schedule updates under the Medicare Access and CHIP Reauthorization Act. AMA estimates all these elements together will lead to a 9.75% drop in payment.

Congress should “draft and mark up legislation that will provide a clear pathway to preventing these cuts from taking place,” Madara said.