Therapy Associations Call on Congress and CMS to Stop Medicare Payment Cuts

The impact of the COVID-19 pandemic on patient access to non-COVID-related therapy services has been swift and significant. Occupational therapy providers, physical therapy providers, speech-language pathologists, and audiologists are in dire financial predicaments and struggling to continue to provide services, particularly in rural and underserved areas. And now, they are facing even more hurdles on the road to recovery.

In the 2021 proposed Medicare Physician Fee Schedule rule released August 3, 2020, the Centers for Medicare and Medicaid Services (CMS) recommends significant payment reductions to more than three dozen health care provider groups. CMS is using the revenue from these cuts to offset payment increases for primary care physicians. Occupational therapy providers, physical therapy providers, speech-language pathologists, and audiologists are facing between a 7%–9% cut to Medicare payment, despite ongoing advocacy with Congress, the Department of Health and Human Services, CMS, and the Office of Management and Budget by the American Occupational Therapy Association (AOTA), the American Physical Therapy Association (APTA), and the American Speech-Language-Hearing Association (ASHA) throughout 2019 and 2020. The cuts will be effective January 1, 2021, when providers and patients will just be beginning to get back on their feet. This cut is the result of a Medicare statutory requirement known as “budget neutrality,” which requires that any increase in costs to the Medicare program must be offset by decreased spending elsewhere in the Medicare program.

A reduction in payment of this magnitude is misguided under typical circumstances, but it is truly damaging to patient access during a global pandemic. Upon discharge from the hospital, many COVID-19 patients require therapy for their long-term recovery. Moreover, therapy services remain crucial as 10,000 baby boomers turn 65 every day and want to age in place.

AOTA, APTA, and ASHA strongly oppose the cuts slated for 2021. Our organizations call on Congress and CMS to advance well-reasoned fee schedule payment policies and waive budget neutrality. While AOTA, APTA, and ASHA do not oppose payment increases for primary care physicians, we believe these increases can be implemented without imposing payment reductions on other providers. Our members serve a critical role in the health and vitality of this nation, frequently carrying out the therapy plans of care for older adults who require physical, cognitive and psychosocial functional stability to remain safe and independent within their communities. The federal government, as well as patients and taxpayers, are best served by ensuring that the Medicare program promotes accessible, high-quality, efficient treatment of our most vulnerable Medicare beneficiaries throughout their episode of care, not just during their initial physician office visit. These services will not be available if therapy practitioners, other members of the clinician team, and institutional-based providers are unable to sustain these cuts and close their doors permanently as a result of CMS’ proposal.

Tell your members of Congress to stop payment cuts for Medicare services!

See also: Joint Statement with Broad Physician and Nonphysician Coalition

Questions?

Learn more about potential 2021 Medicare Part B (outpatient) payment reductions or email reimbursement@asha.org.