Physician lawmakers try new approach to shield radiology from millions in Medicare cuts

Lawmakers from both sides of the aisle introduced legislation Friday aimed at averting reimbursement reductions to radiologists and other specialists, drawing praise from the physician community.

The “Holding Providers Harmless from Medicare Cuts During COVID-19 Act” would do so by providing docs with temporary additional payments, covering the difference between 2020 and 2021 for two years. Reps. Ami Bera, MD, D-Calif., and Larry Bucshon, MD, R-Ind., sponsored the bill, and are acutely aware of the headwinds physicians are facing during the pandemic.

“No doctor should have to worry about large pay cuts while they work to get back on their feet as they continue caring for patients and battling COVID-19 on the front lines,” Bucshon, a cardiothoracic surgeon in private practice before joining Congress, said in a statement. He called this new proposal “practical, commonsense legislation that will hold doctors harmless and stave off pay cuts as they continue to be the heroes we need during these challenging times.”

The Centers for Medicare and Medicaid Services has long planned to significantly boost pay for outpatient evaluation and management services beginning in January. But that requires roughly 10% cuts to others who do not bill for such services in order to balance the budget, lawmakers noted.

The American College of Radiology and other physician specialty groups have lobbied hard against these payment reductions in recent months. ACR praised the legislation on Friday.

“We strongly urge Congress to pass the provider and patient protections included in this vital legislation,” Howard Fleishon, MD, chair of the college’s board of chancellors, said in a statement.

Reps. Michael Burgess, MD, R-Texas, and Bobby Rush, D-Ill., introduced their own remedy in October, proposing to waive budget neutrality requirements for one year under the Medicare Physician Fee Schedule. Radiology advocates hope this new “hold harmless” proposal from Bucshon and others will gain favor in Congress.

“Given the ongoing concerns about the cost and precedent associated with an unrestricted waiver of budget neutrality, the more targeted approach of this bill should help encourage congressional leadership to include the legislation in a year-end legislative package,” Josh Cooper, ACR’s vice president of government relations, economics and health policy, told Radiology Business Friday.