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CardioVascular Coalition Warns Deep Cuts to Specialty Services in Physician Fee Schedule Proposed Rule Will Restrict Patient Access to Limb-Saving Interventions

Aug 6, 2020

Congressional action needed to waive budget neutrality requirements in E/M codes and block planned specialty provider cuts before January 2021

WASHINGTON – The CardioVascular Coalition (CVC) – a consortium of physicians, care providers, advocates, and manufacturers working to improve awareness and prevention of peripheral artery disease (PAD) – today expressed disappointment in the Centers for Medicare & Medicaid Services (CMS) proposal to deeply cut Medicare payment for specialty providers – including “vascular surgery,” “cardiac surgery,” and “interventional radiology” – contained in the proposed Physician Fee Schedule Proposed Rule for CY2021. If finalized as proposed, these specialties will be cut by seven to nine percent in 2021.

According to the CVC, now is not the time for severe Medicare cuts on specialties providers who frequently care for patients living with vascular disease, including PAD, which disproportionally impacts African Americans and other minority populations who have been hardest hit by the COVID-19 pandemic. If left untreated with proper vascular intervention, PAD can result in lower-limb amputation.

“We are deeply disappointed in the agency’s proposal, which hits specialty providers at a time when we are already operating under severe financial stress due to the current public health crisis. Now is not that time to inflict new payment cuts,” said Dr. Jeffrey Carr, founding and past president of the Outpatient Endovascular and Interventional Society (OEIS) and a member of the CVC.

Lawmakers and healthcare stakeholders alike oppose these significant cuts.

In May, dozens of bipartisan members of the U.S. House of Representatives sent a letter to Congressional leaders asking them to include a waiver for the budget neutrality requirements included in the 2019 “evaluation and management” (E/M) code rule in any relevant legislation moving through Congress. By waiving the budget neutrality requirements, Congress can prevent the specialty cuts from taking effect while still allowing for the E/M payment increases.

In a letter sent on June 18 to congressional leaders, the CVC and more than a hundred stakeholder groups urged Senate Majority Leader Mitch McConnell and House Speaker Nancy Pelosi to help stop harmful payment cuts to specialty healthcare providers, including vascular and cardiac surgery. The CVC, alongside the American Medical Association and hundreds of other specialty provider groups, have advocated for Congress to stop the pending Medicare cuts to specialty providers by waiving budget neutrality for the E/M code proposal for 2021.

“We will now work with lawmakers in Congress to stop these potentially harmful cuts by securing provisions in future legislation to waive the budget neutrality requirement driving this cut, while also allowing increases to the E/M codes to go into effect,” added Carr.

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