Several groups of doctors are mounting a new effort to persuade Congress to intervene and prevent a nearly 4% cut in Medicare payments to doctors from taking effect in 2022.
The 2022 Physician Fee Schedule, released Tuesday night by the Centers for Medicare and Medicaid Services, proposes to reduce the Medicare conversion factor, used to calculate Medicare reimbursements, by 3.75% in 2022 Congress had prevented the 3.75% cut from taking effect by 2021, but that moratorium ends after this year.
“In acting to mitigate reimbursement cuts for surgical care, Congress recognized how flawed and devastating CMS’s policies are for patients,” Alan Speir, Board Member of the Society of Thoracic Surgeons, said in a statement. “Congress must step in again to ensure that patients can access the care they need to save lives.”
Medicare pays doctors based on a conversion factor. The 2022 Physician Fee Table proposed a conversion factor of $ 33.58, a decrease of $ 1.31 from the 2021 total.
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The Surgical Care Coalition, an advocacy group for 13 surgical associations, said in a statement that the conversion factor updates have not kept up with inflation.
“The result is that the conversion factor is only about 50% of what it would have been if it had been indexed to headline inflation as it had been before 1998,” the coalition said in a statement Tuesday.
Payments on the Physician Fee Schedule must be budget neutral, which means that any increase in pay for one specialty must be accompanied by cuts in another.
Congress included an additional $ 3 billion for the Physician Fee Schedule in a late 2020 spending package to fund the 3.75% increase in the conversion factor, but the funds are depleted by the end of this year.
If the 3.75% cut goes into effect in 2022, it will affect all specialties, Christian Shalgian, director of health policy and advocacy for the American College of Surgeons, said in an interview with Fierce Healthcare. The association is one of the members of the Surgical Care Coalition.
Other groups of doctors have asked Congress to intervene again. The Medical Group Management Association said in a statement Tuesday that it will also seek “congressional intervention to prevent the cut.”
The American Medical Group Association also warned that the cuts could be a major hit to physicians’ finances, especially as payment cuts made under the kidnapping could resume. Congress had stopped the kidnapping cuts last year to help providers struggling financially due to COVID-19, but the moratorium on the cuts also expires at the end of 2021.
Shalgian said medical groups have urged Congress to consider not just a temporary solution.
“We need to have these talks about a permanent solution, so we are not doing this every year,” he said. “Private payers tie their rates to Medicare so there is always that instability about what the practice will look like from a financial perspective.”
Shalgian added that other healthcare sectors get inflationary adjustments in their pay changes, but “we are just trying to fight the freeze. We are not even getting an inflationary adjustment. “