Provider Groups Pressure Congress to Act Against Medicare Payment

Following the release of the Centers for Medicare & Medicaid Services (CMS) 2023 Medicare physician fee schedule on November 1, provider and physician advocacy groups have focused their lobbying activities on getting Congress to pass legislation to avert proposed payment cuts outlined in the final regulations. Meanwhile, a bipartisan group of 46 U.S. Senators wrote a letter to Senate leaders Chuck Schumer (D, NY) and Mitch McConnell (R, KY) on November 2, stressing the need for Congress to act before the end of the year to avert what amounts to an 8.5 percent Medicare payment cut.

In the 2023 final rule, CMS finalized a 4.5 percent decrease in the 2023 Medicare PFS conversion factor. Absent an act of Congress, on January 1, 2023, Medicare payment rates will also be reduced by an additional 4 percent due to sequestration issues. In their letter, the group of senators stated, “Congress must address these vital payment challenges before the end of 2022 to ensure seniors continue to have access to care through a wide network of providers.”. The immediate release of this letter by nearly half of all U.S. Senators demonstrates the impact of these lobbying efforts and the potential for a strong bi-partisan response. However, the exact content and timing of legislation to address any payment cuts remains uncertain. As Congress faces a December 16 government funding deadline, one likely outcome would appear to be a Medicare payment bill attached to funding legislation. (See here and here for more details.)

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