The new spending bill passed by Congress on Monday night, which includes $900 billion in COVID-19 relief, also contains some respite for cuts to Medicare Part B that posed a significant threat to therapy operations in skilled nursing facilities.
The Consolidated Appropriations Act of 2021 is now awaiting President Trump’s signature, and it includes a range of supports for individuals and businesses.
And though nursing home provider groups expressed disappointment that the bill did not go further in providing direct aid for long-term care, it does contain some offsets to cuts to the physician fee schedule for 2021 that threatened to reduce Medicare Part B therapy payment rates by up to 9%.
According to an email to members of the National Association for the Support of Long-Term Care (NASL) sent to Skilled Nursing News by NASL executive vice president Cynthia Morton, the new bill includes “a partial fix to the fee schedule cuts.
“The bill’s fix is a three-year delay of the complexity code (G2211), which is a part of CMS’ Evaluation/Management (E/M) reform,” the email noted. “CMS had finalized this new code to be used by those practitioners that bill E/M codes to indicate the E/M office visit has additional complexity. CMS will recalculate the conversion factor and take into account the savings from the delay of this code. Congressional summaries estimate to mitigate about one third of the E/M related cuts.”
The bill also includes a $3 billion infusion of new funds into the physician fee schedule for 2021, which will increase payments by 3.75% “across the board” next year, according to the email. It also delays the 2% Medicare sequestration cuts that were suspended through December 31 in one of the earliest stimulus packages, for a value of approximately $3 billion over three months, according to NASL’s summary.
The cuts to the physician fee schedule, which were finalized on December 1, would have resulted in a reduction of about 9% to Medicare Part B reimbursement for physical therapy (PT) and occupational therapy (OT), with cuts associated with speech therapy as well. The cuts were poised to have a significant effect on the services for patients covered by Medicare Part B, several providers said, with the effect heightened because of the pandemic.
“These cuts occur at a critical time with an ever-increasing need to treat the long-term effects of COVID-19 in our seniors — many have lingering neurological, cardiac, and respiratory issues that affect their ability to function even after the acute phase of the illness has passed,” JoLynn Munro, division president at Infinity Rehab, told SNN. “Of note, nearly 60 million Americans have Part B coverage, so the scope of this cut is large.”