Congressional deal meets docs halfway on pay, extends telehealth flexibility
Potential pay cut relief that addresses some physician and therapist concerns is tucked into a 4,000-page proposed 2023 spending bill announced Monday by members of Congress.
The draft bill would offset more than half of a key cut the Centers of Medicare & Medicaid Services planned to enact with the Medicare Physician Fee Schedule’s physician conversion factor starting January 1. The conversion factor could now be cut by just under 2%, rather than at the 4.47% cut CMS set earlier this year.
Skilled nursing and other provider advocates had lobbied for a full reversal of the 4.47% Conversion Factor reduction, arguing that with other cuts they could see about 10% in lost revenue amid soaring costs of doing business. For 2022, lawmakers reduced the cut by 3%, bringing it to .75%.
As reported by McKnight’s Home Care Tuesday, the bill prevents across-the-board 4% Medicare cuts for 2023 and 2024. The so-called PAYGO reductions are triggered automatically every year by an existing budget policy aimed at limiting the national deficit.
The text of the so-called omnibus spending deal, produced after months of negotiations and lobbying, could still change as congressional negotiators work to finalize an agreement by a Friday deadline.
As it stands, the bill also provides relief for the calendar year 2024 Physician Fee Schedule, giving 1.25% of relief toward the 2024 conversion factor yet to be calculated by CMS.
The bill does not provide any relief to providers of the 2% sequestration that Medicare providers are currently under, Cynthia Morton, executive vice president of long-term care lobbyist Advion, told McKnight’s Long-Term Care News Tuesday. It extends the mandatory Medicare payment reductions under sequestration for the first six months of fiscal year 2032, while revising Medicare sequestration percentages to 2% for fiscal year 2030 and fiscal year 2031.
“Advocates did not anticipate that Congress would give any relief here,” she said.
The Physician Fee Schedule as proposed by the CMS goes into effect Jan. 1. The congressional relief will be in effect if the bill passes and is signed by President Biden by the Dec. 23 deadline. The government spending authority runs out that day.
Neither of the two largest sector advocates, LeadingAge and American Health Care Association/National Center for Assisted Living, would comment on the bill Tuesday, citing the time necessary to pore through the text. Also meaningful for providers, the bill extends through the end of 2024 the pandemic flexibility to allow telehealth services to be billed by physicians and therapists.