Congress moves to tackle Medicare physician pay cliff

There appears to be a pathway emerging in Congress to address a combined 9.75% in Medicare physician payment cuts, which amount to a physician payment cliff and were set to take effect Jan. 1, 2022.

The Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610) was considered by the House of Representatives. While the underlying bill is the Senate-passed Dr. Lorna Breen Health Care Provider Protection Act, the House passed its version of that bill separately under suspension of the rules.

Highlights of the physician-payment provisions include:

  • A delay in resuming the 2% Medicare sequester for three months (Jan. 1–March 31, 2022), followed by a reduction to 1% for three months (April 1–June 30, 2022).
  • A one-year increase in the Medicare physician payment schedule of 3%, which is 0.75% less than the conversion factor boost provided for 2021.
  • A one-year delay in the cuts to the clinical laboratory payment schedule.
  • A one-year delay in the Medicare radiation oncology demonstration.
  • Erasing the 4% Medicare pay-as-you-go (PAYGO) cut, and preventing any additional PAYGO cuts through 2022.

My latest for the AMA. The whole shebang.