Congress Releases Year-end Legislation, Addressing Medicare Cuts and Telehealth

Originally published in the December 22, 2022, issue of MGMA’s Washington Connection
Reprinted with permission from MGMA

Earlier this week, Congress released the text of their year-end spending package, which contains a handful of healthcare provisions that will impact medical groups.

Medicare physician payment: The legislation averts 6.5% of the scheduled 8.5% reduction to physician reimbursement in Medicare, resulting in an approximate 2% cut to the Medicare conversion factor for 2023. By way of background, in 2021, CMS shifted funds in the physician fee schedule to pay for an increase in work RVUs, which raised reimbursement for office visits. This shift resulted in a decrease to the conversion factor due to a statutorily mandated budget neutrality adjustment. Congress provided funds to offset the adjustment in 2021 and partially offset it again in 2022. Going into 2023, we expected a cut of 8.5%, resulting from both a decrease to the conversion factor (4.5%) and PAYGO cut (4%). For the third year in a row, we’ve urged Congress to address the de facto cuts — this year in the form of adding 4.5% back into the fee schedule and waiving PAYGO. Unfortunately, despite 10,000 letters from MGMA members, Congress did not have the appetite to fully waive budget neutrality requirements to address the slated 4.5% cut. Instead, Congress will only partially mitigate it by allowing a 2% cut in 2023. This is in addition to legislation waiving the 4% PAYGO for 2023 and 2024. MGMA has voiced its disappointment that Congress is allowing a 2% cut to occur in 2023 and will continue working to find a more sustainable and comprehensive solution.

Alternative Payment Models (APMs): The 5% incentive bonus is set to expire at the end of this year. The legislation would extend the bonus for an additional year, through 2023, at 3.5%.

Telehealth: Many telehealth waivers, including being able to treat a patient in their home, were extended through 2024. This is positive development supported by MGMA to ensure continuity from pandemic-era telehealth policies.

Lab cuts: Pending the passage of this legislation, practices will receive a one-year reprieve from the laboratory cuts of up to 15% that would have gone into effect in January 2023. This provision was also supported by #MGMAAdvocacy.

We expect Congress to pass this legislation into law by Friday. We will let you know if Congress modifies the current text.

Act Now: Only 17 Days Until Medicare Cuts Take Effect

Originally published in the December 15, 2022, issue of MGMA’s Washington Connection
Reprinted with permission from MGMA

With only 17 days remaining in 2022, time is rapidly running out for Congress to act to avert the 4.5% reduction to the Medicare conversion factor set to effect on Jan. 1. We know from our members that the impact of this cut, especially in light of current inflationary pressures and workforce shortages, will be devastating for medical groups nationwide.

As the Medicare physician fee schedule is the only Medicare payment system without an annual inflationary update, the 4.5% reduction will only exacerbate current financial concerns and is frankly untenable. Should these cuts take effect, medical groups may be forced to make difficult business decisions including reducing the number of Medicare patients served, limiting the number of services provided, laying off staff, and even selling their practices.

MGMA continues to advocate against this detrimental reduction and for permanent payment reforms. If you haven’t done so already, join in #MGMAAdvocacy today by sending a letter to your members of Congress to pass legislation to stop the full 4.5% payment reduction from taking effect.

Already sent a letter? The time is now to pick up the phone. Call your members of Congress immediately and implore them to protect beneficiary access to care by passing legislation to #StopTheFullCut. Already asked your colleagues to take action? Now is the time to ask your friends and loved ones — the health of our nation’s seniors depends on it.

MGMA and Partner Orgs. Urge Congress to Prevent Full 4.5% Cut to Medicare Payment Rates

Originally published in the December 8, 2022, issue of MGMA’s Washington Connection
Reprinted with permission from MGMA

On Monday, MGMA and over 100 other healthcare stakeholder organizations sent a letter to congressional leadership urging action to avert the entire 4.5% reduction to Medicare payment rates scheduled to take effect Jan. 1, 2023. The letter illustrates the severity of this pending cut and the negative impact it will have on practices, especially in light of current inflationary pressures. As the Medicare physician fee schedule is the only Medicare payment system without an annual inflationary update, the pending 4.5% reduction will only exacerbate current financial concerns.

MGMA is continuing to advocate against this harmful reduction and for permanent payment reforms. Join in #MGMAAdvocacy today by sending a letter to your members of Congress to pass legislation to stop the full 4.5% payment reduction from taking effect.

Call To Action: 31 Days Until Medicare Payment Cuts Take Effect

Originally published in the December 1, 2022, issue of MGMA’s Washington Connection
Reprinted with permission from MGMA

With just one month remaining in 2022, MGMA needs your immediate help urging Congress to take action to avert significant Medicare payment cuts set to take effect on Jan. 1. The time to act is now! Utilize our online portal to send a letter to your members of Congress today encouraging the passage of legislation to avert the 4.47% reduction to the Medicare conversion factor, waive the statutory 4% Pay-As-You-Go sequester, provide an inflationary update based on the Medicare Economic Index, and extend the alternative payment model 5% incentive payment.

Already sent a letter? Please share this link with everyone at your practice and ask them to do the same: www.congressweb.com/MGMA/67. Want to get the word out beyond your colleagues? Encourage others to get involved in this critical advocacy effort by sharing a post from our Medicare Cuts Advocacy Social Media Toolkit!

Without congressional action, these payment reductions will take effect and have a drastic impact on beneficiary access to care and group practice financial resiliency. Take a look at our survey results to see what others are saying about the payment cuts, including how they disrupt practice operations and overall investment throughout the healthcare industry. Join in #MGMAAdvocacy today calling for the swift passage of legislation to avert these devastating payment cuts!

Join in #MGMAAdvocacy to Prevent Medicare Payment Cuts

Originally published in the October 20, 2022, issue of MGMA’s Washington Connection
Reprinted with permission from MGMA

With just over two months left in 2022, MGMA needs your help urging Congress to take action to avert significant Medicare payment cuts set to take effect in 2023. Send a letter to your members of Congress today encouraging the passage of legislation to avert the 4.5% reduction to the Medicare conversion factor, waive the statutory 4% Pay-As-You-Go sequester, and provide an inflationary update based on the Medicare Economic Index. MGMA Government Affairs’ latest report on Medicare cuts showcases what medical groups around the country have to say about these proposed payment cuts, including how they would significantly disrupt patient access to care, practice operations, and overall investment throughout the healthcare industry.

The time to act is now! Join in #MGMAAdvocacy today by sending a letter to your members of Congress urging for the swift passage of legislation to avert these significant payment cuts!

MGMA to Congress: Expand Medicare telehealth beyond COVID-19 pandemic

Originally published in the August 6, 2020 issue of MGMA’s Washington Connection. Reprinted with permission from MGMA.

MGMA joined over 200 organizations in support of the Protecting Access to Post-COVID-19 Telehealth Act of 2020. If signed into law, this legislation would remove geographic restrictions on where a patient must be located to utilize telehealth services, enable patients to receive telehealth services in their homes, allow federally qualified health centers and rural health centers to furnish telehealth, and give the Secretary of Health & Human Services (HHS) permanent waiver authority for future emergency periods and for 90 days past the expiration of the current public health emergency. Absent congressional action, the ability for patients to utilize telehealth in nonrural settings and in their homes is only in effect during the public health emergency. MGMA urges Congress to act before the public health emergency ends to avoid a scenario where providers are abruptly unable to treat most Medicare beneficiaries via telehealth.

MGMA to Congress: Lift the ban on unique patient identifier

MGMA joined 68 leading healthcare organizations calling on Congress to reject the inclusion of outdated language in Fiscal Year 2021 Appropriations legislation that prohibits HHS from spending any federal dollars to adopt a national unique patient identifier (UPI). Last year, the US House of Representatives voted to remove the ban but the Senate opposed the measure. Removing the prohibition will permit HHS to evaluate a range of solutions that protects patient privacy and is cost-effective, scalable, and secure. Deployment of a UPI would allow practices to more effectively match patient records, decrease medical errors, and facilitate EHR interoperability.

Save the date: 2020 Washington Update and Policy Outlook webinar

MGMA Government Affairs invites you to join us for a member-exclusive webinar on Thursday, June 25 at 1:00 p.m. ET. With legislative and regulatory changes reshaping the healthcare landscape in response to the COVID-19 pandemic, this timely program will present a mid-year update on the current state of federal healthcare policy impacting medical groups. The session’s forward-looking agenda will also provide considerations for the future of medical group practices and potential new actions Congress and the Administration could take in response to the pandemic. In addition, attendees will learn about ongoing MGMA advocacy in support of medical groups. Attendees will also have a chance to ask their most pressing questions during a question and answer session. Don’t delay – register now to secure your place!

New draft legislation to amend PPP loans

After hearing from constituents, Congress identified several issues with the PPP as currently implemented. As a result, a number of bills were introduced to amend the PPP to provide borrowers with more flexibility. One of these bills, the Paycheck Protection Flexibility Act, is scheduled for a vote in the House of Representatives today. MGMA supports this legislation, which would allow loan forgiveness for expenses beyond the eight-week covered period, eliminate the restriction that limits nonpayroll expenses to 25% of the loan amount, extend the two-year maximum loan term requirement, and allow PPP borrowers to utilize the payroll tax deferment incentive established in the Coronavirus Aid, Relief, and Economic Security Act.

Congress passes aid package to assist healthcare providers and small businesses

Today, Congress passed an economic aid package to assist healthcare providers and small businesses. The Paycheck Protection Program and Health Care Enhancement Act (H.R. 266) includes $321 billion for the recently depleted Paycheck Protection Program (PPP), $60 billion for Economic Injury Disaster Loans (EIDL) loans and grants, $75 billion for hospitals and healthcare providers, and $25 billion for COVID-19 testing. If signed into law, the Small Business Administration can once again begin accepting PPP applications. The $75 billion for healthcare providers would be in addition to the original $100 billion in relief funds allocated under the CARES Act and distributed in the future by the Department of Health and Human Services (HHS). President Trump has signaled support and is expected to sign the bill into law.

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