Scrap Proposed Medicare Pay Cuts, House Members Ask of HHS


September 14, 2021 6:50 pm

More than 70 bipartisan House members have joined a slew of medical organizations in calling for the Biden administration to nix portions of a proposed rule that would cut Medicare payment rates for some specialists by up to 20% next year.

The lawmakers say the cuts in the proposed 2022 Medicare Physician Fee Schedule would undermine Health and Human Services Department efforts to improve health equity by cutting reimbursements for specialists who treat cancer, kidney failure, artery disease, and other diseases that disproportionately affect Black and Latino beneficiaries.

In a letter sent on Monday to Meena Seshamani, deputy administrator and director of the Center for Medicare within the Centers for Medicare & Medicaid Services, the lawmakers blamed the proposed cuts on the “budget-neutrality effects of a CMS proposal to update clinical labor data.”

The fee schedule requires that any pay increases be offset by payment reductions of equal amounts elsewhere.

“Because of the aforementioned physician fee schedule ‘budget-neutrality,’ the incorporation of new clinical labor data actually results in massive cuts of up to 20 percent to critical services,” the lawmakers wrote. “These impacts also will have profoundly negative effects on health equity.”

The letter, led by U.S. Representatives Bobby L. Rush (D-Ill.) and Gus Bilirakis (R-Fla.), urges the CMS not to finalize the fee schedule’s clinical labor policy and to “work with Congress on fundamental reform to the physician fee schedule.”

Some reimbursement updates currently proposed include a 23% cut for a venous ulcer treatment; a 22% cut for certain treatments for peripheral artery disease; a 21% pay cut for a uterine fibroid treatment; an 18% pay cut for certain kidney failure treatments; and a 15% cut for radiation oncology treatments.