Congress Must Act to Stop Cuts Threatening Specialty Physicians

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The COVID-19 pandemic has shaken the medical profession – placing health care providers of all types on the front lines of diagnosing and treating patients impacted by this pandemic. 

We have also weathered the Centers for Disease Control and Prevention (CDC)-recommended pausing of necessary, but non-urgent care. For radiologists, this means not being able to offer preventive screenings that detect early cancers and other diseases. For patients, it means forgoing potentially lifesaving diagnostic imaging. 

Thankfully, Congress stepped in to help keep small practices, providers, and their staffs afloat during the worst of the COVID-19 shutdown. Unfortunately, providers and patients alike are facing another hurdle – steep Medicare reimbursement cuts from the U.S. Centers for Medicare and Medicaid Services (CMS) that threaten to reduce access to a host of essential health care services, including radiology. With so much at stake, Congress needs to intervene to protect Americans’ access to critical health care services. Otherwise, joint federal efforts to keep medical practices open and available to patients may be wasted.  

If this comes as a shock to you, you are not alone. CMS made this drastic change using its rulemaking authority under the annual Medicare Physician Fee Schedule. This rule will result in a significant cut to reimbursement rates for providers across many specialties beginning January 1, 2021. These changes, if implemented, will dramatically reduce access to essential imaging for patients – especially America’s seniors, who rely on Medicare to see their providers.

Unfortunately, instead of supporting providers and patients during this unprecedented time, CMS has decided to move forward with the Medicare payment rule. As a result, many providers such as radiologists will experience an 11% reduction in 2021 if the rule is implemented as written. Other specialty providers who deliver critical care to patients, including clinical psychologists, neurology, and physical and occupational therapy, face similar cuts.

Medical professionals work every day to solve the complex health issues our patients face, and radiologists play a key role in diagnosing and treating these patients. Through preventive imaging and diagnostic screenings, radiologists help identify rare and complex medical conditions, diagnose common cancers, and research innovative treatments. The current health crisis is no exception, as radiologists have worked alongside other medical researchers to find new, better treatments for COVID-19 patients – swiftly innovating to keep Americans falling ill with COVID-19 alive. 

While the goals of CMS’ rule are understandable, they were created with a pre-pandemic outlook on our health care system. COVID-19 has changed the entire health care ecosystem and any policymaking needs to account for the current reality that providers and patients face today. This is simply not the case with the Medicare payment rule. 

It would be foolish to make any cuts to Medicare at a time when Americans are facing the worst public health crisis in decades. And though there is a solution in sight, it requires Congress to enact legislation to block these cuts from going forward. I hope that congressional leaders agree that protecting the stability of the health care system and continued access for America’s seniors is a worthwhile endeavor. 

Dr. Howard Fleishon is chair of the Board of Chancellors at the American College of Radiology (ACR). Fleishon has held numerous roles within the ACR, including vice chair, secretary-treasurer, Council speaker, vice chair of the Commission on Government Relations, and founder and former chair of the Radiology Advocacy Network (RAN). Fleishon is also division director of community radiology services in the Emory University Department of Radiology and Imaging Services in Atlanta, GA.

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