Physician groups urge CMS to prevent payment cuts, protect telehealth
Dive Brief:
- The American Medical Association, in comments Tuesday on Medicare’s proposed Physician Fee Schedule for fiscal 2023, urged the CMS to reform and strengthen the program’s payment system, warning it is on an “unsustainable path” that jeopardizes patient access to care.
- In a 98-page letter to CMS Administrator Chiquita Brooks-LaSure detailing its concerns and recommendations, the AMA said it is advocating that Congress extend the 3% temporary increase in the Medicare Physician Payment Schedule and prevent proposed payment cuts that threaten serious disruption to physician practices. The American Medical Group Association and the MGMA, two associations representing medical groups, also submitted comments opposing Medicare payment reductions. Each of the three groups urged the CMS to protect access to telehealth visits.
Dive Insight:
Reforming the Medicare physician payment system is a top priority for the AMA. The group successfully lobbied Congress to delay a round of 4% cuts to Medicare rates until 2023 that were set to take effect at the end of last year.
In its letter to the CMS, the doctor group said it is “deeply alarmed” about the instability of the Medicare payment system as physician practices face growing financial uncertainties related to the pandemic, statutory payment cuts, lack of inflationary updates and administrative challenges.
“The resulting discrepancy between what it costs to run a physician practice and actual payment, combined with the administrative and financial burden of participating in Medicare, is incentivizing market consolidation,” the AMA said.
The group said it is asking Congress to provide relief for an additional 1.5% budget neutrality cut that is planned for 2023, end the statutory annual freeze in physician payments and provide an inflation-based update for the coming year and waive the 4% pay-as-you-go reductions in Medicare spending.
The AMGA, in its comments, zeroed in on proposed conversion factor cuts that it said would exacerbate the financial pressures already facing its members from inflation, increased supply costs and an unprecedented shortage in the healthcare workforce. The proposal would reimburse physician services 4% less in 2023 than in 2022, the AMGA said.
The AMA said the real increase in clinical labor costs for physician practices is not recognized in the update to the Medicare conversion factor. Both the AMA and the MGMA argued for Congress to provide a positive update to the conversion factor in 2023 and beyond.
The AMGA said it is also concerned that the CMS is moving to decrease payment rates for telehealth services. The CMS reimbursed telehealth visits at the same rate as in-office visits during the COVID-19 public health emergency but is now proposing to reduce payments for telehealth visits.
The MGMA said a poll conducted in August found 90% of medical practices said the projected reduction to 2023 Medicare payments will reduce access to care.