Act Now: Help Protect Patient Access to Medicare Services

Dec. 10, 2021, Update                  

This week legislation that provides a short-term fix to the substantial Medicare cuts facing clinicians as of Jan. 1 was passed in the House and Senate. The legislation now goes to President Biden for his signature.

Stopping these cuts has been the top priority for ACC Advocacy this year and was the #1 talking point at the 2021 Legislative Conference. While the legislation does not completely eliminate the cuts, it will provide relief from steep reductions and time to work with ACC’s partner societies and members of Congress to find a long-term solution:

  • A one-year positive adjustment of 3% to the Medicare Physician Fee Schedule (PFS) conversion factor to offset the scheduled 3.75% reduction
  • A six-month partial reprieve from the 2% Medicare sequester, which eliminates the 2% reduction in Q1 of 2022 and includes a 1% reduction in Q2. This reduction in the Medicare sequester next year would be paid for with an increase in sequester cuts slated in 2030
  • The reprieve from the 4% Medicare cut from statutory PAYGO in 2022, pushed to 2023
  • A one-year delay of pending clinical lab cuts and the Medicare radiation oncology model

The ACC Advocacy Team has worked closely with other health care societies and with members of the House and Senate, as well as key committee and leadership-level staff to get this across the finish line. Grassroots efforts by thousands of ACC members urging congressional action to stop the cuts have – and continue to be – instrumental in moving this forward. While more work is still needed, this is a major Advocacy success story as we head into the New Year.

On Jan. 1, 2022, physician practices face an array of significant reductions due to a series of statutory and regulatory cuts. These potential reductions exacerbate financial uncertainty and further threaten patient care at a time when cardiovascular clinicians are still on the frontlines of the COVID-19 pandemic and have seen many patients forgo or delay non-COVID care over the past 18 months.

Act Now: Help Protect Patient Access to Medicare Services

Individually, each of the following reductions would be painful; taken together, they would be devastating.

  • Expiration of the current reprieve from the 2% Medicare sequester created by the Budget Control Act of 2011, which now is expected to continue into 2031, despite being originally slated for sunset in 2021.
  • Imposition of a 4% Statutory PAYGO sequester resulting from passage of the American Rescue Plan Act of 2021.
  • Expiration of the congressionally enacted 3.75% temporary, public health emergency-linked increase in the Medicare physician fee schedule (PFS) conversion factor to avoid payment cuts associated with budget neutrality adjustments resulting from Medicare policy changes.
  • Substantial reduction of roughly 25% for electrophysiology ablation services resulting from updated physician work values included in the proposed 2022 Medicare Physician Fee Schedule (PFS).
  • Practice expense decreases ranging from 5% to 20% for services such as echocardiography, advanced imaging and office-based vein therapies resulting from a necessary adjustment to clinical labor rates included in the proposed 2022 PFS.

The ACC has been actively engaged in communicating with Congress to convey how detrimental these cuts will be to patient care.

Clinical Topics: Arrhythmias and Clinical EP, COVID-19 Hub, Noninvasive Imaging, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Echocardiography/Ultrasound

Keywords: Medicare, Public Health, COVID-19, Fee Schedules, Pain, Physicians, Budgets, Patient Care, Policy, Echocardiography, Electrophysiology, ACC Advocacy

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