Medicare & Medicaid

Bipartisan House majority backs move to avert possible E/M cuts

. 2 MIN READ
By
Kevin B. O'Reilly , Senior News Editor

What’s the news: Nearly 230 members of the House of Representatives—Democrats and Republicans—have co-signed a letter to Speaker Nancy Pelosi and House Minority Leader Kevin McCarthy calling on House leadership to pass legislation this year and prevent devastating cuts to many physician specialties.

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The cuts are posed by the application of budget neutrality to new evaluation and management code (E/M) changes and other policies proposed by the Centers for Medicare & Medicaid Services in the Medicare physician payment schedule set to take effect Jan. 1.

Why it’s important: While the new E/M payment policies include improvements for maternity care and much-needed payment increases for physicians delivering primary and complex office-based care, unfortunately a statutory budget neutrality rule requires that any increases in Medicare payments for these office visits must be offset by corresponding decreases across all services.

As a result, many specialists are now facing cuts of as high as 11% starting in January if Congress does not act. The number of signers for the letter—led by Reps. Ami Bera, MD, a California Democrat, and Larry Bucshon, MD, an Indiana Republican—exceeds the 218 members needed to pass legislation in the House, and it sends a powerful message to House leadership to act on this priority issue this year to avert the cuts. 

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The AMA worked closely with coalition partners in successfully encouraging a majority of House members to sign on to the letter. The AMA will continue to urge Congress to safeguard Medicare beneficiaries' access to care during the COVID-19 pandemic and pass legislation to prevent these draconian cuts.

Learn more: Congressional leaders also are hearing about another important step they should take on health care financing. The AMA, American Hospital Association, American Health Care Association and the National Association for Home Care and Hospice wrote congressional leaders urging them to extend the congressionally enacted moratorium on the application of the Medicare sequester cuts into 2021 and through the duration of the COVID-19 public health emergency.

The letter urges extension of the relief from the 2% sequester cut enacted in the Coronavirus Aid, Relief and Economic Security (CARES) Act, which afforded critical relief during the pandemic to all providers who participate in the Medicare program through the end of 2020.

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