The coronavirus pandemic has hit the country hard. Many Americans have been affected financially, and now Medicare-accepting doctors are going to be among those suffering a pay cut. A new rule that is set to go into effect January 1st will lower the reimbursement rates that doctors receive for treating patients covered by Medicare. The new 2021 physician fee schedule final rule will affect many types of physicians, and now they are fighting back.
The Pay Cut
Doctors practicing general surgery, emergency medicine, anesthesiology, and critical care medicine will be affected by the new rule. They will see a 10% cut in the “conversion factor,” which is used to determine their fee-for-service Medicare payment. The conversion factor is a multiplier that Medicare uses in order to calculate reimbursement for a particular service or procedure done by doctors. The conversion factor is multiplied by the relative value unit, RVU, which depends on the amount of work and type of work done by the physician.
The 2021 conversion factor will be $32.41, a decrease of $3.68 — or 10.2% — from the 2020 conversion factor of $36.09.
Doctors Voice Their Concerns
The Centers for Medicare and Medicaid Services (CMS) first proposed the pay cuts in the summer. When the rule was presented to the country, doctors immediately began to voice their concerns, pointing out that they put their lives on the line every day and shouldn’t be facing a cut in pay at this critical time.
“We come to work every day and we work long hours and we put our lives on the line and took risks on a daily basis and it’s a slap in the face to say here’s how we’re gonna reward you — we’re going to be paying you less,” Dr. Lisa Moreno, an emergency medicine physician and the president of the American Academy of Emergency Medicine (AAEM), said.
The American College of Emergency Physicians (ACEP) also joined the AAEM in criticizing the rule, saying they were disappointed and dismayed that CMS was cutting physicians’ pay simply because they were helping take care of Medicare patients. “Emergency physicians and other health care providers battling on the frontlines of the ongoing pandemic are already under unprecedented financial strain as they continue to bear the brunt of COVID-19,” ACEP President Mark Rosenberg, DO, said in a statement. “These cuts would have a devastating impact for the future of emergency medicine and could seriously impede patients’ access to emergency care when they need it most.”
In addition, the ACEP voiced their concerns that the new rule would have wide reaching effects, and would mean more than just a pay cut to some doctors. “CMS chose to finalize a cut that will reverberate beyond just Medicare to other payors including private insurance, which often structure their payments to emergency physicians and other providers based on these Medicare rates. This will result in significant reimbursement reductions as well as widespread uncertainty and disruption across the system.”
The Fight
After receiving backlash for cutting reimbursement pay, CMS responded by stating that they will be “increasing payments to physicians and other practitioners for additional time they spend with patients, especially those with chronic conditions.”
“We value the contributions of all providers caring for patients on the front-lines of this historic pandemic, but this action is designed to address fundamental problems in Medicare reimbursement that long predate the current public health emergency. It is also important to note that physicians that see a higher proportion of patients’ visits will see increases in payments compared to physicians that do fewer visits or more procedures,” CMS wrote.
The ACEP, along with other health care organizations, are lobbying to maintain reimbursement in Medicare at 2020 levels for the next 2 years.
“Emergency physicians have courageously faced a global pandemic that has shaken our healthcare system to its core, unwavering in their commitment to their patients despite potentially deadly exposure to the disease for themselves and their families,” said Rosenberg. “Congress must act now in order for them to continue playing this vital role in our communities.”
