Recently, the Centers for Medicare & Medicaid Services (CMS) proposed a new Physician Fee Schedule for calendar year 2021, which includes drastic cuts to emergency medicine physicians and other vital medical specialties.
Specifically, due to the budget neutrality requirements under the Physician Fee Schedule, CMS is proposing to decrease reimbursement for lifesaving, emergency treatment care delivered to Medicare patients by 6 percent in 2021. These steep cuts will reverberate across health care as private insurance often structures its payments to emergency physicians and other providers based on these Medicare rates, creating widespread uncertainty and disruption across the system.
EMERGENCY CARE IS ALREADY STRAINED
Emergency physicians and other health care providers have battled on the frontlines of the ongoing pandemic, and already under unprecedented financial strain as they continue to bear the brunt of COVID-19. While some hospitals are stretched beyond capacity forcing emergency physicians to make excruciating decisions with the sparse resources available, others are grappling with devastating drops in patient volume by more than 40 percent due to the public’s fears of contracting the virus, resulting in pay cuts, furloughs, and even layoffs.
RELIEF FUNDING TO DATE DOESN’T REACH THE PHYSICIAN
Further exacerbating the financial burden, most emergency physicians are part of independent practice groups and are not directly employed by hospitals. Therefore, they have received little if any financial relief under the CARES Act Provider Relief Fund, which has mainly been distributed to hospitals rather than to emergency physician groups. It is estimated that emergency physician practices have received only 7 to 15 percent of what they need to make up for lost revenues and increased expenses due to COVID-19.
The ongoing financial challenges associated with the COVID-19 response continue to stress America’s already strained health care safety net. The proposed cuts to Medicare reimbursement coupled with the looming threat of damaging surprise billing legislation could have devastating ramifications for the future of emergency medicine and further restrict patients’ access to quality emergency care when they need it most.
WAIVE BUDGET NEUTRALITY
Emergency physicians have courageously faced a global pandemic that has shaken our health care system to its core, unwavering in their commitment to their patients despite potentially deadly exposure to the disease for themselves and their families. In order for them to be able to continue playing this vital role in our communities, Congress must act by passing legislation to waive Medicare's budget neutrality requirements.