APTQI Calls for Congressional Action to Address Across-the-Board Medicare Physician Fee Schedule (MPFS) Cuts

Medicare again imposes deep payment cuts to physical, occupational and speech therapy despite broad opposition from bipartisan lawmakers and healthcare stakeholders

Washington, D.C. –– The Alliance for Physical Therapy Quality and Innovation (APTQI) today expressed deep disappointment in the Centers for Medicare & Medicaid Services’ (CMS) decision to finalize the Medicare Physician Fee Schedule (MPFS) Final Rule for CY2022, which once again includes deep, across-the-board payment cuts to physical, occupational, and speech therapy despite the serious implications it could have on seniors’ access to care. The final rule released yesterday includes a 3.75 percent cut to providers in CY2022, eventually adding up to a steep 9 percent payment cut by 2024. The final rule also includes a troubling 15 percent cut for services provided by physical and occupational therapy assistants.

Lawmakers and providers warned CMS that the latest cuts—on top of years of reduced reimbursement for therapy services—would undermine the ability of vulnerable seniors to access the vital care they need to manage their post-operative care, pain, mobility challenges, and risk of falling.

“It is troubling that CMS chose to include yet another round of cuts to therapy service providers in its final MPFS rule,” said Nikesh Patel, PT, Executive Director of APTQI. “Not only does the latest 3.75 percent reduction—which will eventually add up to a full 9 percent cut in 2024—and the 15 percent cut for services provided by physical and occupational therapy assistants affect therapy providers who have faced unprecedented challenges staying afloat during the pandemic, but it will threaten patients’ ability to access the outpatient therapy services they need. To ensure Medicare beneficiaries can continue receiving the timely specialty services their physicians prescribe, Congress must intervene to prevent these cuts from going into effect on January 1, 2022.”

Further, a broad coalition of lawmakers and stakeholders oppose these cuts and support longer-term reforms to the fee schedule:

  • On September 13, Representatives Bobby Rush, Gus Bilirakis, and 73 of their House colleagues sent a letter to CMS urging the agency not to finalize the cuts to specialty care providers included in the proposed 2022 Medicare Physician Fee Schedule (PFS).
  • On October 15, 247 Members of Congress led by Reps. Ami Bera (D-CA) and Larry Bucshon (R-IN)  sent a letter to House leadership urging them to begin working on long-term reform to prevent impending cuts and bring stability to the Medicare payment system.
  • On September 7, APTQI joined 14 healthcare organizations urging CMS to not finalize the 2022 MPFS proposed rule that would see payment cuts of more than 20 percent for specialty providers as a result of Medicare’s clinical labor policy.

Preserving access to physical therapy services is absolutely critical.  Physical therapy is  a safe, effective approach to helping patients manage both acute and chronic pain, as well as recover from serious illness and injury. Physical therapy plays a vital role in helping older Americans regain strength, increase mobility, and prevent falls which account for roughly 300,000 hip fractures, 800,000 hospitalizations, 27,000 deaths, and $50 billion in healthcare spending every year. As a nonpharmacological treatment for pain, physical therapy remains an important alternative to opioid-based painkillers at a time when America’s addiction and overdose crisis is accelerating.

It is now up to Congress to act to prevent the cuts from taking effect. Fortunately, there is precedent. Congress passed bipartisan legislation in December 2020 to ease the severity of the funding cuts to specialty providers – including physical, occupational, and speech therapists – which went into effect on January 1, 2021.

“Congress must act quickly to protect outpatient therapy practices and their patients from the potentially negative impacts of these continued payment cuts,” added Patel. “We look forward to again working with Congressional leaders to enact a legislative solution to mitigate these cuts and secure long-term reform of Medicare’s payment system.”

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