American Society of Plastic Surgeons
For Consumers
 

ASPS Fights Physician Fee Cuts, Legislative Fix Emerges

ASPS continues its aggressive advocacy efforts in opposition to a controversial proposed rule by CMS recommending cuts to 2021 Medicare E/M payments for plastic surgery by approximately 7%. While the fight to prevent the cuts is not yet over, the Society's efforts have spurred notable movement within the House of Representatives toward a legislative fix that would address the specialty's concerns.

Background

On August 3, CMS introduced a proposed rule, in which physicians would see a reduction to the conversion factor of more than 10 percent – from $36.09 in 2020 to $32.26, effective January 1, 2021. The proposed Medicare Physician Fee Schedule cuts will deal a devastating blow to both physicians and patients at a time when practitioners are facing increased financial strain due to the ongoing COVID-19 public health emergency.

Ongoing advocacy

With the proposed rule scheduled to take effect on January 1, 2021, ASPS has been working closely with coalition partners to apply pressure on both CMS and Congress to take immediate action to prevent the CY 2021 Medicare Physician Fee Schedule (PFS) cuts before the end of the year.

In order to effectively communicate the impact on physicians and patient care, ASPS staff prioritized and targeted physicians in Congress to help generate support for stopping the proposed cuts. Representative – now Senator – Roger Marshall (R-KS-1) provided a catalyst for physician opposition to the cuts with a "dear colleague" letter in September, and the Society contacted and urged members of Congress to sign on.

A new bipartisan letter soon emerged on the Hill, calling on Congressional leadership to suspend budget neutrality requirements for Medicare payments. This effort was led by physician Representatives Larry Bucshon, MD (R-IN-08) and Ami Bera, MD (D-CA-07). ASPS worked with the American College of Surgeons to garner support and secure signatures for the letter, which called for immediate action.

Legislative fixes emerge

The efforts of ASPS and other coalition partners began to bear fruit when legislation was introduced that would delay Medicare cuts for one year. Introduced Congressman Bobby Rush (D-IL-1) and Ranking Member Michael Burgess, MD (R-TX-26), the legislation would offer a reprieve, but did not propose to eliminate the planned cuts.

Meanwhile, ASPS mobilized its members on two grassroots letters to CMS and Congress. Through the campaign, 243 ASPS members urged both bodies to take immediate action to reverse the proposed CY 2021 Medicare cuts. Specifically, the Society requested that CMS take whatever steps necessary to prevent the cuts from taking effect on January 1. The letter to Congress urged lawmakers to pass legislation before the end of the year that would permit CMS to hold physicians harmless from the cuts.

On October 30, legislation was introduced by Representative Bera and Representative Bucshon that includes a hold harmless provision preventing the anticipated 7% cut to plastic surgery. This bill was the product of significant input and negotiations by ASPS staff, as well as coalition partners representing other specialties. If passed, the legislation would represent a tremendous victory on a long-fought issue with significant implications for the specialty.

Next steps

ASPS recently signed on to a coalition letter led by the American College of Surgeons in support of the legislation introduced by Representatives Bera and Bucshon. The Society also signed on to a specialty medicine letter led by the American College of Radiology in support of the bill.

ASPS will continue to support this legislative fix; working to maintain opposition to harmful physician fee cuts in this tumultuous environment.

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