Medicare Compliance & Reimbursement

If you’re concerned about your bottom line in 2023, you’re not alone. Two legislators are trying to help.

Context: With Medicare payment decreases looming, U.S. Representatives Ami Bera, MD (D-CA) and Larry Bucshon, MD (R-IN) “introduced bipartisan legislation [in the House] to provide critical relief to physicians who are scheduled to receive Medicare payment cuts,” said Bera’s webpage. “The Supporting Medicare Providers Act of 2022 would ensure payments to these providers are kept stable and extend certain increases in payments for physicians’ services under the Medicare program through 2023.”

On Jan. 1, due to the combination of budget neutrality constraints and the end of the Consolidated Appropriations Act, 2021, conversion factor boost, Medicare providers are expected to see their take home pay go down significantly.

Industry organizations have weighed in on the legislation, too, and urge Congress to get involved.

“An imminent 4.42% physician payment cut as we emerge from a global pandemic will have a devastating impact on access and care for Medicare beneficiaries,” blasts Jack Resneck, Jr., MD, American Medical Association (AMA) president, in the brief. “Moving forward with this cut now is wrongheaded and inconceivable. Yet this is what is scheduled to take place.”

He adds, “The AMA commends Reps. Bera and Bucshon for acknowledging the disparity between what it costs to run a physician practice and what these cuts will mean for patient care in the Medicare program. Our patients are counting on Congress to agree to a solution, and the clock is ticking.”

Plus: Other groups would like the legislation to include relief from the 2 percent sequestration payment adjustment that was reinstated on July 1 as well as the 4 percent PAYGO sequestration adjustment.

“Now is not the time for reductions in Medicare payments to providers. Congress should pass legislation to again suspend Medicare sequester cuts, so that hospitals and health systems can continue to care for patients, families and communities,” observes the American Hospital Association (AHA) in a release.

Medical Group Management Association’s Senior Vice President for Government Affairs Anders Gilberg agrees. “Even with the stabilization offered by this bill, the Medicare conversion factor will be the lowest it has been in ten years at a time when medical groups face runaway inflation and significant workforce shortages," he says.

“Freezes to Medicare payment rates have caused reimbursement to fall far below the true cost of furnishing care,” Gilberg adds in a release on the bill. “MGMA additionally calls on Congress to provide an inflationary update based on the Medicare Economic Index (MEI) and address the 4% statutory Pay-As-You-Go (PAYGO) sequester.”

With COVID cases trending upward again, financial challenges are sure to ensue. Stay tuned to Medicare Compliance & Reimbursement as we continue to monitor this news and possible changes to 2023 Medicare payments.

Resource: Find the legislation at https://bera.house.gov/sites/evo-subsites/bera.house.gov/files/evo-media-document/ BERA_049_xml FINAL.pdf.