The Centers for Medicare & Medicaid Services (CMS) issued the 2021 Medicare Physician Fee Schedule (PFS) final rule on December 1, 2020. The final rule contains significant cuts that will further strain an already stressed health care system. These cuts threaten physician practices while potentially creating additional risks to patient access to care during this unprecedented Covid-19 pandemic and resulting economic downturn. Without Congressional action, CMS will implement these cuts on January 1, 2021. SCAI is urging Congress to stop these cuts before they go into effect AND NEEDS YOUR HELP.

SCAI is intensifying pressure on lawmakers to stop the cuts, maintain current Medicare funding levels, and to preserve access to patient care in the wake of the COVID-19 public health emergency. The Society for Cardiovascular Angiography and Interventions Political Action Committee (SCAI PAC) supports the work that we do by raising awareness of candidates about the value of the procedures you offer as an interventional cardiologist. SCAI PAC is the only political organization solely devoted to educating Members of Congress on issues important to invasive and interventional cardiologists. Your support is critical to the future of your practice and your specialty.

At SCAI we believe that unless we ACT NOW these cuts will continue. By working together our voices are more powerful. We are asking you to add your voice to all of the interventional cardiologists we represent. Let's stop the bleeding. Let’s bring about change, together. The future of your practice and your specialty may be at stake. We make it easy for you to take action. Join us—add your voice to ours and amplify our message—interventional cardiology saves lives.

Action Requested

  • Support SCAI PAC by donating now! SCAI PAC directly raises awareness with Members of Congress on issues important to interventional cardiologists. Your support for SCAI PAC is critical.
  • Use our resources to connect with your members of Congress and ask them to support H.R. 8505 and H.R. 8702, bills to stop the cuts (links provided below).
  • Remind your Member of Congress that these cuts go into effect on January 1, 2021, and must act now to attach at least one of these measures to the next available legislative vehicle before it is too late. Please use the link provided here to find your elected officials.

For questions, contact Curtis Rooney, Vice President, Government Relations, crooney@scai.org. Tell us what your Congressional office says.

 

Background

In 2019, CMS finalized broad changes related to evaluation and management (“E/M”) services to reduce administrative burden, improve payment rates, and reflect current clinical practice. The health care community-supported restructuring and revaluing the office-based E/M codes, which will increase payments for primary care and other office-based services. Unfortunately, by law, any changes to the PFS technically cannot increase or decrease total expenditures significantly. As a result, any increases must, therefore, be offset by corresponding decreases.

Reimbursement for coronary stent and balloon angioplasty codes have been reduced by more than 40% since 2000 under Medicare. Interventional Cardiologists face another 10.6% drop in Medicare reimbursement starting January 1, 2021. These cuts are on top of the already steep revenue losses due to patient fears of treatment related to COVID-19. No one would begrudge primary care physicians for proposed increases by the Centers for Medicare and Medicaid Services (CMS). But with years of medical education, additional training, board certification and hard-won experience interventional cardiologists shouldn’t be punished for providing a skill set of services that deliver outstanding care to your patients.

CMS estimates that the 2021 policies that increase payments for evaluation and management procedures enough that a 10.2% budget neutrality adjustment will have to be made on all procedures. SCAI maintains that the cuts to Medicare will harm physicians, their practices, and most importantly, their patients. Compounding the problem is the fact that Medicare payments have failed to keep up with inflation since the inception of the PFS in 1992. This decrease in the 2021 conversion factor will be below the 1994 conversion factor of $32.9050—which is worth approximately $58.02 today!