Coalition Asks Congress for Help

Mar 08, 2022

23 Health Care Organizations Petition Congress for Help with Labor Cuts

ROSEMONT, Ill. – March 8, 2022 – The Society for Vascular Surgery, along with 22 other medical societies and associations, has asked Congress to address the new reductions in Medicare payments for procedures provided in the office-based setting that began Jan. 1. The cuts threaten Medicare patients’ access to health care.

The organizations represent a broad range of providers who care for Medicare beneficiaries in community-based office settings. The cuts are the result of the Centers for Medicare and Medicaid Services (CMS) increasing clinical labor rates in the Medicare Physician Fee Schedule (MPFS), which took effect Jan. 1. The net effect, however, decreases reimbursement rates for services that require high clinical labor and supply and equipment expenses.

“Due to the budget neutrality constraints in the MPFS, the dramatic rise in direct practice expense costs resulting from the increase in clinical labor rates decreases reimbursement rates for those services with high supply and equipment costs when performed in a community-based office setting,” said the letter. Certain procedures will see cumulative payment cuts from 8 to 16 percent over the next four years.

The end result, said the organizations, hurts patient care: “Such drastic cuts will result in many beneficiaries losing timely access to essential health care services.” These include society’s most at-risk, medically complex patients, already facing severe health outcomes from COVID-19, and who already faced delays in diagnosis and treatment because of the pandemic, coalition members said. 

The societies and associations urge Congress to act quickly to mitigate the cuts, to ensure Medicare patients are not harmed. The organizations asked Congress to add new funding to the MPFS for “explicit purpose of increasing the non-facility/office-based practice expense relative value units negatively impacted by CMS’ recent clinical labor policy.”   

Congressional leadership and staff have acknowledged the need to address the steep cuts created by the policy update and the organizations applaud Congress’ work to create greater stability within the fee schedule and to avoid disruptions in care for Medicare beneficiaries.

“Our organizations welcome the opportunity to work with Congress to address the long-term challenges associated with Medicare payment policy, especially the budget neutrality provision in the MPFS that has precipitated these steep cuts in community-based specialty care services,” the coalition members said.

Health care professionals did receive some protections from cuts scheduled to go into effect Jan. 1. However, the increase in clinical labor rates did take effect; conflating the impact of that policy are supply/equipment rate updates that began Jan. 1, 2019. Those updates shifted relative value units in the fee schedule, resulting in steep Medicare cuts to many of the same non-facility/office-based procedures impacted by the new clinical labor policy.