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Congress asked to renew temporary increases to Medicare Physician Fee Schedule payments enacted last year

Medical organizations have launched an effort to again enlist Congress's help to prevent large payment cuts in the Medicare Physician Fee Schedule (MPFS). The American College of Radiology, the American Medical Association, the Radiology Business Management Association, and a long list of others – a total of 108 medical organizations representing over 1 million health care providers – have written a coalition letter to the leaders of Congress to make the case for additional funding for calendar years 2022 and 2023.

The letter renews a campaign for Congressional assistance that occurred last year. Last December, Congress adopted the Consolidated Appropriations Act, 2021, which acted to provide a temporary 3.75% increase in the physician fee schedule conversion factor (CF) to avert a sizable portion of Medicare payment cuts for radiologists and other physician specialists. The payments cuts would have stemmed from a significant increase in the valuation of Evaluation and Management (E&M) codes and budget neutrality requirements in MPFS payments for other non-E&M services. Since last year's Congressionally-adopted conversion factor increase will expire on January 1, 2022, payments are again slated to be cut dramatically overall.

The joint letter urges Congress to maintain the 3.75% increase to the CF through at least calendar years 2022 and 2023. 

In addition to their critical, short-term request for additional funding of MPFS payments, the medical societies recommend that discussions about a longer-term fix commence. "Moving forward, Congress must recognize the need for critical reforms to the MPFS system, including addressing the budget neutrality requirement, which can lead to arbitrary reductions to reimbursement unrelated to the cost of providing care. The primary goal of the MPFS must be to encourage broad participation of health care providers to deliver appropriate and timely quality care to meet the health needs of Medicare beneficiaries."

As the letter notes, this campaign is not unlike the annual Congressional intervention that had to take place for over a decade to avoid direct cuts to MPFS reimbursements caused each and every year by the sustainable growth rate formula (SGR) until a more permanent fix was adopted in 2015. 

This current initiative is a critically important one, and will require significant grassroots campaign outreach to individual members of Congress to assure this additional funding is enacted.

The ACR will work with these organizations to explore more opportunities to educate Congress about the need to extend the CF increase, protecting access to timely healthcare.

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health care & life sciences, diagnostic radiology, medicare, mpfs

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