Letter to U.S. House Leadership: 245+ Bipartisan Members Urge Action on Upcoming Medicare Physician Payment Cuts

Letter to U.S. House Leadership: 245+ Bipartisan Members Urge Action on Upcoming Medicare Physician Payment Cuts

October 14, 2021

The Honorable Nancy Pelosi
Speaker of the House
U.S. House of Representatives
H-232, U.S. Capitol
Washington, DC 20515

The Honorable Kevin McCarthy
Minority Leader
U.S. House of Representatives
H-204, U.S. Capitol
Washington, DC 20515

Dear Speaker Pelosi and Leader McCarthy,

We write to bring your attention to the growing financial uncertainty within the Medicare payment system and to express our support for congressional action to address upcoming payment cuts to physicians, therapists, and health care professionals before the end of the year. The current Medicare payment system does not adequately incentivize high-quality care, and reimbursement has failed to keep up with inflation. We believe broad systemic reforms to the payment system are critical to speed the transition to value-based care. However, as Congress begins the complex process of identifying and considering potential long-term reforms, we must also create stability by addressing the immediate payment cuts facing health care professionals. These cuts will strain our health care system and jeopardize patient access to medically necessary services.

Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA) with the goal of moving away from a fee-for-service payment model to a system that ensures providers are paid for the work they do to keep patients healthy, not just treat them when they’re sick. However, most practices lack access to qualified, patient-centered alternative payment models under MACRA. We cannot achieve true high-quality, coordinated care without examining and addressing the existing barriers in MACRA. In addition, the Medicare Physician Fee Schedule (PFS) has failed to keep up with inflation and larger increases to some providers must be offset by cuts to other providers, even if there’s no evidence of overpayment, due to a budget neutrality provision in statute, further contributing to the financial pressure on health care professionals.

While we appreciate increased payments in the Calendar Year (CY) 2021 PFS to physicians delivering primary care and complex office-based care, we must ensure that any changes do not result in unintended consequences for specialty care. We hope to work with you on broader, long-term reform to bring stability to the Medicare payment system, and we ask that you start that work as soon as possible.

In the interim, health care professionals are facing imminent payment cuts stemming from PFS adjustments as well as the Medicare sequester and the Statutory Pay-As-You-Go (PAYGO) Act. We are grateful for the action taken by you and by Committee leadership in the Consolidated Appropriations Act, 2021 to mitigate the impact of payment cuts initiated by the CY 2021 PFS. As you know, the Consolidated Appropriations Act contained a 3.75 percent payment adjustment for all PFS services in CY 2021 as part of the congressional relief provided for the impending payment cuts. This payment adjustment afforded some short-term stability for health care professionals struggling with the impact of the COVID-19 pandemic.

This critical piece of congressional relief is expiring at the end of the calendar year and adds to impending cuts resulting from the expiring moratorium on the 2 percent Medicare sequester and the 4 percent Medicare payment cut due to PAYGO, which was triggered by the passage of the American Rescue Plan. The combined impact of the PFS cut, Medicare sequester, and PAYGO means that all health care professionals are likely facing at least 9 percent in cuts to Medicare payment, unless Congress takes action. As Congress considers a framework to ensure appropriate reimbursements and improve the Medicare payment system broadly, we must act before the end of the year to avert the imminent cuts, including extending the 3.75% payment adjustment, and provide continued stability for physicians and other health care professionals. Otherwise, the profound exhaustion from the pandemic combined with the stress of uncertainty in payments may lead to further retirements, office closures, or reduced staffing, ultimately limiting patient access to care.

We appreciate your consideration and historical support for this issue and look forward to continuing to work with you to strengthen our health care system in the near- and long-term.


Ami Bera, M.D.
Member of Congress

Larry Bucshon, M.D.
Member of Congress

Additional Member of Congress Signatories

Alma S. Adams, Ph.D.
Colin Z. Allred
Mark E. Amodei
Kelly Armstrong
Jake Auchincloss
Cynthia Axne
Brian Babin, D.D.S.
Don Bacon
Andy Barr
Gus M. Bilirakis
Sanford D. Bishop, Jr.
Lisa Blunt Rochester
Suzanne Bonamici
Mike Bost
Carolyn Bourdeaux
Brendan F. Boyle
Julia Brownley
Tim Burchett
Michael C. Burgess, M.D.
G. K. Butterfield
Salud Carbajal
Tony Cárdenas
André Carson
Earl L. “Buddy” Carter
Matt Cartwright
Ed Case
Kathy Castor
Liz Cheney
David N. Cicilline
Yvette D. Clarke
Emanuel Cleaver, II
Steve Cohen
Tom Cole
James Comer
Gerald E. Connolly
Jim Cooper
J. Luis Correa
Jim Costa
Angie Craig
Eric A. “Rick” Crawford
Dan Crenshaw
Charlie Crist
Jim Hagedorn
Josh Harder
Andy Harris, M.D.
Vicky Hartzler
Jahana Hayes
Jaime Herrera Beutler
Brian Higgins
Clay Higgins
J. French Hill
James A. Himes
Steven Horsford
Chrissy Houlahan
Richard Hudson
Ronny L. Jackson, M.D.
Chris Jacobs
Bill Johnson
Dusty Johnson
Mondaire Jones
David P. Joyce
John Joyce, M.D.
Kaiali’i Kahele
Marcy Kaptur
John Katko
William R. Keating
Fred Keller
Mike Kelly
Robin L. Kelly
Trent Kelly
Daniel T. Kildee
Derek Kilmer
Young Kim
Ron Kind
Ann Kirkpatrick
Raja Krishnamoorthi
Ann McLane Kuster
David Kustoff
Conor Lamb
Doug Lamborn
James R. Langevin
John B. Larson
Robert E. Latta
Jake LaTurner
Al Lawson, Jr.
Donald M. Payne, Jr.
Greg Pence
Ed Perlmutter
Scott H. Peters
Dean Phillips
Chellie Pingree
Stacey E. Plaskett
Mark Pocan
Bill Posey
David E. Price
Guy Reschenthaler
Kathleen M. Rice
Mike Rogers
John W. Rose
Deborah K. Ross
Lucille Roybal-Allard
Raul Ruiz, M.D.
C. A. Dutch Ruppersberger
Tim Ryan
Maria Elvira Salazar
John P. Sarbanes
Mary Gay Scanlon
Adam B. Schiff
Bradley S. Schneider
Kurt Schrader
Kim Schrier, M.D.
Austin Scott
David Scott
Pete Sessions
Terri A. Sewell
Mikie Sherrill
Michael K. Simpson
Albio Sires
Elissa Slotkin
Christopher H. Smith
Darren Soto
Abigail Davis Spanberger
Jackie Speier

Jason Crow
Henry Cuellar
John Curtis
Sharice L. Davids
Danny K. Davis
Rodney Davis
Madeleine Dean
Peter A. DeFazio
Diana DeGette
Antonio Delgado
Mark DeSaulnier
Ted Deutch
Mike Doyle
Neal P. Dunn, M.D.
Tom Emmer
Ron Estes
Dwight Evans
Randy Feenstra
Brian Fitzpatrick
Charles J. “Chuck” Fleischmann
Lizzie Fletcher
Bill Foster
Scott Franklin
Ruben Gallego
John Garamendi
Andrew R. Garbarino
Mike Garcia
Bob Gibbs
Carlos A. Gimenez
Louie Gohmert
Jimmy Gomez
Anthony Gonzalez
Vicente Gonzalez
Jenniffer González-Colón
Lance Gooden
Josh Gottheimer
Sam Graves
Mark E. Green, M.D.
H. Morgan Griffith
Raúl M. Grijalva
Glenn Grothman
Michael Guest
Barbara Lee
Susie Lee
Teresa Leger Fernández
Debbie Lesko
Mike Levin
Ted W. Lieu
Billy Long
Alan Lowenthal
Frank D. Lucas
Blaine Luetkemeyer
Stephen F. Lynch
Tom Malinowski
Nicole Malliotakis
Carolyn B. Maloney
Tracey Mann
Kathy E. Manning
Brian Mast
Lucy McBath
Betty McCollum
A. Donald McEachin
James P. McGovern
David B. McKinley
Grace Meng
Daniel Meuser
Mariannette Miller-Meeks, M.D.
John R. Moolenaar
Barry Moore
Joseph D. Morelle
Seth Moulton
Frank J. Mrvan
Markwayne Mullin
Gregory F. Murphy, M.D.
Grace F. Napolitano
Joe Neguse
Marie Newman
Donald Norcross
Eleanor Holmes Norton
Tom O’Halleran
Ilhan Omar
Steven M. Palazzo
Jimmy Panetta
Chris Pappas
Bill Pascrell, Jr.
Greg Stanton
Pete Stauber
Michelle Steel
W. Gregory Steube
Haley Stevens
Thomas R. Suozzi
Eric Swalwell
Glenn “GT” Thompson
Mike Thompson
Thomas P. Tiffany
William R. Timmons IV
Dina Titus
Paul D. Tonko
Norma J. Torres
Lori Trahan
David J. Trone
Fred Upton
David G. Valadao
Jefferson Van Drew
Beth Van Duyne
Juan Vargas
Marc Veasey
Filemon Vela
Nydia M. Velázquez
Ann Wagner
Tim Walberg
Debbie Wasserman Schultz
Maxine Waters
Bonnie Watson Coleman
Daniel Webster
Peter Welch
Bruce Westerman
Susan Wild
Nikema Williams
Joe Wilson
John Yarmuth
Don Young