There is a looming crisis that Congress must address by year's end to prevent a reduction in access to essential healthcare services for Medicare beneficiaries. Without action, seniors will have significantly less access to the services furnished by more than three dozen types of physician and nonphysician specialists, including those provided by the more than 740,000 audiologists, speech-language pathologists, physical therapy practitioners and occupational therapy practitioners our organizations represent.
The problem is that, in an effort to boost funding for certain primary-care services provided under Medicare, CMS has proposed slashing reimbursements for other services—not because they are too high—but because a provision of law requires that changes to payments result in a zero-sum game, i.e., for every increase there has to be an equal decrease. That means in order for the primary-care doctor to receive a higher payment for their services, specialty providers must receive less for the services they provide. The cuts, expected to be 6% for audiologists and 9% for speech-language pathologists, and physical therapy and occupational therapy practitioners, will cause many affected providers to close their doors or stop seeing Medicare beneficiaries, leaving fewer choices and less care when seniors need them most.
The good news is that a coalition of 300 national, regional, state and local provider associations has coalesced around bipartisan legislation sponsored by two physicians, U.S. Reps. Ami Bera (D-Calif.) and Larry Bucshon (R-Ind.). Their bill, the Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 (H.R. 8702), would provide relief payments in an amount that will ensure parity with current payment for impacted services for the next two years, keeping audiology and therapy providers' doors open until the next Congress and administration can develop a longer-term solution. The legislation follows a letter these members sent to House Speaker Nancy Pelosi (D-Calif.) and House Minority Leader Kevin McCarthy (R-Calif.) that was signed by 229 members—more than half the House—imploring the leaders to pass a bipartisan solution to solve this problem.
Failure to pass H.R. 8702 or otherwise address this issue will result in catastrophic consequences for America's seniors—especially those who live in rural and medically underserved areas—and others whose health insurers base their payment rates on Medicare's. It means hearing and balance problems will go undiagnosed, so seniors with hearing impairments will be further isolated and less able to communicate with family, friends and healthcare practitioners, while those with balance problems could fall and break bones or worse.
It means people with swallowing disorders or those who need speech-generating devices may not get the help they need before their conditions deteriorate and they become unable to communicate or feed themselves. It means former COVID patients with muscle weakness associated with post-intensive care syndrome won't get the physical therapy they need to regain their health and mobility. And it means seniors will not have access to the services they need to overcome the functional limitations that prevent them from safely completing meaningful day-to-day activities and living life to the fullest.
We're hopeful that the benefits to finding a solution to this problem will motivate elected representatives to overlook any partisan differences and pass the bill sponsored by Reps. Bera and Bucshon. Doing so would prove that bipartisan collaboration is still possible in our democracy and, more importantly, protect Medicare beneficiaries and others from the impact of cuts that will limit access to essential audiology, therapy and other critical healthcare services. Their lives could very well depend on it.
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December 03, 2020 at 02:31AM
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Stop Medicare cuts for specialty care - Modern Healthcare
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