Congress Must Act to Stop Devastating Cuts to OT and Other Healthcare Services
Updated 12/10/2021
On December 9th, the Senate passed S. 610 by a vote of 59 to 35, preventing major cuts to Medicare reimbursement in 2022. President Biden has signed S. 610 and it is now law.
Updated: 12/8/2021
On December 7th, the House of Representatives passed S. 610, the "Protecting Medicare and American Farmers from Sequester Cuts" Act, the first step in preventing a 9.75% cut to occupational therapy and other healthcare services under Medicare, beginning in 2022.
The bill voted on by the House included three major provisions to avert these cuts:
- Reduces by 3%, a scheduled 3.75% cut to the Medicare Part B conversion factor.
- Delays a mandatory 4% cut to Medicare and other federal spending programs, required under a budgetary process known as Pay-Go, until 2023.
- Delays implementation of a 2% Medicare "Sequestration" through March 2022, then phases the policy in at 1% through June.
| January - March 2022 | April - June 2022 | July - December 2022 | |
| Cuts to Medicare Part B without legislation | 9.75% | 9.75% | 9.75% |
| Cuts to Medicare Part A without legislation | 6% | 6% | 6% |
| Cuts to Medicare Part B with legislation | 0.75% | 1.75% | 2.75% |
| Cuts to Medicare Part A with legislation | 0% | 1% | 2% |
However, the Senate still needs to pass this legislation, and Congress still needs to act on pending cuts on services provided by occupational therapy assistants. We still need your help to make sure Congress acts before the end of the year. Contact Congress and ask them to take action on either of these issues today!
Original Article: 12/3/2021
Contact Congress
Occupational therapy services are facing major cuts under Medicare if Congress fails to act. AOTA has been working with Congressional leadership and our Congressional champions to stop these cuts, but we need your help.
Pending Fee Schedule Cuts
The 2022 Medicare Physician Fee Schedule (MPFS)—which determines Medicare Part B payments—included a 3.7% cut to payments for occupational and physical therapy services as well as similar cuts to other health care providers such as surgeons and radiologists. Last year, Congress took action to keep a portion of these cuts from taking effect during a time when health professionals were struggling under the weight of the COVID-19 pandemic. However, they have not taken similar action this year, despite ongoing challenges to health care providers. These cuts could easily lead to reductions in payments from other payers—such as TriCare, Medicaid, and private insurance—who often base rates on the MPFS conversion factor.
Reps. Ami Berra (D-CA) and Larry Bucshon (R-IN) have introduced H.R. 6020, legislation that would stop these cuts for another year. Similar legislation is being considered in the Senate, and more than 250 Members of the House wrote to leadership urging them to act on these cuts before the end of the year. But with 3 weeks left in the year, time is running out.
Congressional Budgetary Cuts
In addition to the MPFS cuts, other payment cuts—the result of Congressional budgetary gimmicks—also threaten both Medicare Part A and Part B payments. Previous Congresses put into place a 2% “sequester” of all Medicare payments as a way to pay for other health care spending. This sequester has been lifted during the COVID-19 public health emergency (PHE) but is set to go back into place for 2022. Additionally, a previous Congress put into place a policy called “Pay-Go” that—under certain circumstances—triggers across-the-board spending cuts to most federal programs. Pay-Go has been “triggered” for 2022, so without Congressional action there will be an additional 4% cut to Medicare payments.
If Congress does not act, outpatient Medicare therapy services will face up to a 10% reduction in 2022. This does not include the additional 15% reduction to occupational therapy assistant (OTA) services scheduled to begin in 2022. Find out more about the SMART Act—a bill to reduce the impact of these cuts to OTA services.
Contact Congress
Congress must act on all of these cuts before they leave at the end of December. Write to your Members of Congress and ask them to:
- Stop the Medicare Payment cuts to occupational therapy services by passing legislation such as H.R. 6020 and stopping the budgetary cuts from taking effect; and
- Pass the SMART Act to limit the impact of cuts to outpatient OTA services.
Our discussions with Congressional leadership give us hope that Congress will act and stop these cuts. But Congress MUST hear from you, so they understand that this is a priority and act.