ACA Fights to Stop Medicare Reimbursement Cuts in 2021

By Meghan O’Brien

Federal government relations is a complex and exciting field, especially for membership associations such as the American Chiropractic Association (ACA).  Not only do we represent our dedicated ACA members, but also their patients and, as an extension, the more than 30 million Americans who receive chiropractic care each year.  A critical component of ACA’s government relations work is safeguarding and advancing public trust in chiropractic—and this is at the forefront of our work with policymakers.

While we (rightfully!) publicize a lot about our work on H.R. 3654 (go to now and write a letter to your member of Congress) it is not the only government issue we work on.  A significant benefit of a robust ACA advocacy and government relations program is our ability and know-how to monitor both legislative and regulatory issues to identify any that have the potential to cause harm. As an example, in late 2019, the Centers for Medicare and Medicaid Services (CMS) released the final Physician Fee Schedule (PFS) Rule, which increased Medicare payment for office/outpatient evaluation and management (E/M) and CPT codes, while subjecting certain providers—including doctors of chiropractic—to significant and unjustifiable decreases in Medicare reimbursement.  The reductions in reimbursement were developed by CMS in an attempt to maintain budget neutrality for the Physician Fee Schedule (PFS) in 2021 and are scheduled to become effective on Jan. 1, 2021.

As with any federal budget change, we were not the only ones concerned by the harm these reductions would do to Medicare beneficiaries. Thankfully, ACA—as the only widely recognized chiropractic association on capitol hill and in the federal agencies—maintains collaborative and professional relationships with our colleagues who represent other physician and provider groups in Washington, D.C.   Since the release of the final rule, ACA has partnered with nearly 50 other organizations and has taken steps to stop the implementation of these reimbursement reductions.  We helped to form a powerful, diverse coalition of providers (which is an important part of government relations work) and met with CMS officials in Baltimore and Washington, D.C. The group brainstormed and collaborated on potential regulatory fixes and is now urging Congress to utilize its power to waive the budget neutrality requirements in the final rule before its implementation on Jan. 1, 2021.

While this is an on-going issue during an uncertain time, the silver lining is that things in Washington are never certain.  We are prepared and will continue to fight against this unjustifiable and arbitrary reduction in reimbursement for doctors of chiropractic to ensure that patients can access the services and care they need.

Meghan O’Brien is ACA’s associate director of federal government relations. She can be reached at [email protected].