Congress Must Act to Prevent Medicare Cuts
Conversion Factor Reduction Threatens Providers
Alexandria, VA – The decrease in the conversion factor in the CY 2022 Physician Fee Schedule proposed rule could undermine the ability of healthcare providers to continue to deliver high-quality care to their patients, and Congress needs to intervene to prevent a decrease in Medicare payments. This potential change in Medicare payment, along with the pending expiration of telehealth flexibilities and the looming threat of sequestration and PAYGO cuts, would adversely affect providers just as they are recovering from the COVID-19 pandemic.
“The proposed decrease in the conversion factor, the potential expiration of telehealth flexibilities, and the return of the sequester creates a confluence of events that will negatively impact providers at exactly the wrong time,” said AMGA President and CEO Jerry Penso, M.D., M.B.A. “The provider community is just now starting to recover from the COVID-19 pandemic. Unless Congress acts, the combination of these changes will prove needlessly disruptive to AMGA members and their ability to care for their patients.”
As part of its proposed rule for 2022, the Centers for Medicare & Medicaid Services (CMS) is proposing to reduce the physician fee schedule conversion factor by 3.75%, the same amount that Congress temporarily increased Medicare payments to help offset the effect of the COVID-19 pandemic. While the proposed rule is supportive of the increased payments for primary care services, statutory, and budget neutrality requirements would ultimately result in a change to the conversion factor that would cut payments to Medicare providers. Congress needs to act to prevent these cuts from occurring.
The effect of the change in the conversion factor will be compounded by the reimplementation of the Medicare sequester, which was delayed until 2022. Left unaddressed, the sequester would create an untenable situation for our members by further decreasing their Medicare reimbursements.
Congress also should acknowledge how the COVID-19 pandemic has shifted how patients access care. The telehealth statutory originating site and geographic restrictions inhibit AMGA providers from delivering care to patients in the most effective and efficient manner that reflects, patient preferences. While AMGA appreciates that CMS is proposing to keep select services on its telehealth list until December 2023, Congress needs to update the law so patients and providers can utilize telehealth regardless of their location.
“We all are trying to figure out what a post-COVID ‘new normal’ looks like,” said AMGA President and CEO Jerry Penso, M.D., M.B.A. “We’ve learned how telehealth can be a tool for all providers and patients, not just for those in rural areas. Congress has an opportunity to apply one of the lessons from the pandemic and ensure telehealth is a key benefit of the Medicare program going forward.”
AMGA is reviewing the proposed rule closely and will provide detailed comments.
AMGA is a trade association leading the transformation of health care in America. Representing multispecialty medical groups and integrated systems of care, we advocate, educate, innovate, and empower our members to deliver the next level of high performance health. AMGA is the national voice promoting awareness of our members’ recognized excellence in the delivery of coordinated, high-quality, high-value care. More than 175,000 physicians practice in our member organizations, delivering care to one in three Americans.
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