Issues & Insights

Specialty Providers, Facing Massive Cuts Amid Pandemic, Need A Lifeline

While Congress and the administration have remained divided on many issues, there has been general agreement by our political leaders that America’s health care system needs federal support if we are to successfully navigate the COVID-19 pandemic. This widespread support has translated into the rapid proliferation of critical financial aid and regulatory relief to assist front line health care workers and organizations.

Amid an unprecedented health crisis, federal relief – best exemplified by the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) – has been an important lifeline for providers across the country. But as the pandemic stretches into its seventh month, many specialty providers, ranging from radiologists to dermatologists, physical therapists to cardiovascular surgeons, are facing the prospect of severe Medicare cuts that will inevitably threaten their ability to continue delivering care to vulnerable patients in their communities. These Medicare cuts, which are set to take effect in January of next year, would deal a crushing blow to specialty providers already beleaguered by the impact of the public health emergency.

Absent any relief action from Congress or the administration, a broad cross section of health care practitioners will see Medicare reimbursements slashed, some as much as 11%. For example, physical therapy (-9%), emergency medicine (-6%), radiology (-11%), and general surgery (-7%) are all specialties on the chopping block. These severe cuts come on top of reduced patient volume and steep financial losses they have incurred during the pandemic. The Department of Health and Human Services (HHS) has the power – and obligation – to reverse these devastating cuts. Incredibly, however, the department has yet to waive the rules of budget neutrality to help these critical specialties.

Recognizing the danger to our health care system, more than 100 provider organizations, including the American Medical Association, the American College of Surgeons, and the American Nurses Association, have urged HHS to use its authority to waive budget neutrality requirements for Medicare’s office visit payment policy. This change would ensure family doctors, specialist surgeons and a whole host of crucial specialty providers can keep their doors open to patients in need of care. This approach also has the support of bipartisan members of Congress.

These providers are not asking for the hundreds of billions in financial relief that HHS has been charged with distributing. Instead, they are simply asking not to be undermined by payment reductions which were devised based on a pre-pandemic outlook of America’s health care landscape. Making this policy change would go a long way toward supporting countless providers – many of whom are already coping with another surge of COVID-19 in states across the country. After all, where would Americans go if specialty doctors are forced to close their doors? The lifeline HHS has the power to extend is fair, logical, and the right thing to do.

Let’s hope HHS sees the wisdom of this request and protects these critically important health care providers, who have already suffered severe economic losses, from any further harm. The sacred motto of the health care professional comes to mind here: “First, do no harm.” HHS would be wise to also follow it, and suspend these mandated cuts.

If HHS fails to hear the pleas of our country’s hardworking providers, then Congress must step up. Absent action at the agency level, lawmakers should pass legislation to protect a wide variety of specialty services from payment cuts while still allowing office visit payments to increase.

The pandemic is squeezing both health care providers and the patients who rely on them. HHS and Congress should extend a lifeline – and quickly.

Billy Tauzin served in the U.S. House of Representatives from 1980 to 2005.

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1 comment

  • There is no lifeline, folks. Entitlements alone now exceed all Federal revenues – about $3.5 trillion this year, and rising faster than revenues possibly can. 100% taxation could not “fix it,” it would merely choke the economy so badly that we would hit 50% unemployment. That money must be spent by law – before Congress votes for “little things” like running the government and military (about $1.4 trillion) – and the President cannot veto that spending.

    Our debt is approaching 125% of GDP. That’s up from only 64% in 2000. Somewhere around 200% of GDP, the house of cards collapses – and unlike small countries like Greece, there is nobody on this planet who could or would “bail us out.”

    BIG cuts are coming. Either Congress will make the cuts sensibly, which seems unlikely given Democrats’ pledge to increase rather than decrease spending, or within less than 15 years it will all collapse worse than the Great Depression.

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