American College of Surgeons strongly opposes proposed Medicare physician fee schedule

Policy undermines patient care and further strains health care system weakened from COVID-19 pandemic

CHICAGO (August 4, 2020): The American College of Surgeons (ACS) strongly opposes the Medicare Physician Fee Schedule proposed rule released by the Centers for Medicare & Medicaid Services (CMS) for calendar year 2021 (CY2021), which hurts our health care system and surgical care at the expense of patients. Although the proposed rule takes steps to increase access to care through telehealth, it reduces patients’ access to surgical care.

In the fee schedule, general surgeons will see their Medicare payments cut by 7 percent for CY2021. The cuts, set to take place January 1, 2021, affirm and in some cases increase the cuts CMS announced last year. The proposed rule will reduce payments to nearly all surgical specialties, including up to 9 percent for cardiac surgery, 8 percent for thoracic surgery, 7 percent for vascular surgery, 7 percent for neurosurgery, and 6 percent for ophthalmology. This was a detrimental policy for patients even before the pandemic started, but could be even more harmful as our health care system continues to weaken under COVID-19.

“Today’s proposed rule from the Centers for Medicare & Medicaid Services is a big disappointment for patients and surgeons. We support steps to expand access to care, but this rule takes one step forward and several steps back by overlooking both patients and the surgeons who care for them,” said David B. Hoyt, MD, FACS, Executive Director of the American College of Surgeons. “Congress has a chance to stop these cuts by waiving Medicare’s budget neutrality requirement to protect patients. All we ask is that Congress protect America’s surgeons so we can continue to do our jobs.”

The ACS is a founding member of the Surgical Care Coalition, a group of 12 surgical professional associations that opposes these cuts and urges Congress to act now to preserve care for patients. The Surgical Care Coalition is proposing that Congress enact legislation to waive Medicare’s budget neutrality requirements for these E/M adjustments and to require CMS to apply the increased E/M adjustment to all 10- and 90-day global code values.

A recent survey of ACS and other coalition members found that one-in-three private surgical practices state that they are already at risk of closing permanently due to the financial strain of the COVID-19 crisis. In the same survey, it was found that nearly half of surgeons face more difficult financial decisions and are responding by either cutting their own pay or paying employees in the face of declining revenues. The proposed rule will likely force surgeons to take fewer Medicare patients, leading to longer wait times and reduced access to care for older Americans.

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