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On January 1, 2022, the Centers for Medicare and Medicaid Services will drastically reduce payments to physicians and certain other health care providers. If Congress does not act to stop these cuts, it will further strain practices that are still struggling to keep their doors open during the ongoing pandemic.
In what amounts to a “perfect storm” of payment cuts going into effect on January 1, physician practices face the following stack of Medicare financial hits amounting to a 9.75 percent cut. These include:
- Expiration of the current reprieve from the repeatedly extended 2 percent sequester stemming from the Budget Control Act of 2011. Congress originally scheduled this policy to sunset in 2021 but it will now continue into 2030.
- Imposition of a 4 percent Statutory PAYGO sequester resulting from passage of the American Rescue Plan Act. Should lawmakers fail to act, it will mark the first time that Congress has failed to waive Statutory PAYGO.
- Expiration of the Congressionally enacted 3.75 percent temporary increase in the Medicare physician fee schedule (PFS) conversion factor to avoid payment cuts associated with budget neutrality adjustments tied to PFS policy changes.
- A statutory freeze on annual Medicare PFS updates under the Medicare Access and CHIP Reauthorization Act (MACRA) which is scheduled to last until 2026 when updates resume at a rate of 0.25% a year indefinitely - a figure well below the rate of medical or consumer price index inflation.
These cuts, if allowed to go into effect, would lead to fewer primary care providers, limited access to specialists, a disruption in care and additional barriers to life-saving treatment.
In the face of this looming threat, Reps. Ami Bera, MD (D-CA) and Larry Bucshon, MD (R-IN) recently circulated a “Dear Colleague” letter highlighting the financial uncertainty within the Medicare payment system and the dangers facing the physician community if Congress fails to enact legislation to address these problems. Within a matter of weeks, 245 of their colleagues showed their support for fixing the problem by co-signing the letter.
Now is the time to build on that momentum and demand that Congress take action to address these devastating Medicare cuts before it’s too late. Please take a moment to contact Senators Lee and Romney and your representative and ask them to cancel the cuts.
(If you have already contacted your Congresspersons on this issue, thank you. You needn't do so again for now.)
Michelle S. McOmber, MBA CAE
Utah Medical Association
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