Tell Congress Not to Cut Medicare Physician Payments in FY 2018 Spending Bill February 5, 2018 Medicare AMA 0 UPDATE: Congress makes changes to proposed Medicare cuts in spending bill As you know, Congress is currently considering a FY2018 spending bill that contains a number of the Medicare and health related provisions. As a result of advocacy by the American Medical Association (AMA), other physician groups and grassroots activists such as yourself, language extending the misvalued code offset has changed for the better. Earlier reports were that Congress was considering two additional years of this policy which would result negative updates in 2020, threatening to reduce Medicare payments to below 2015 levels. However, as proposed, the policy is still expected to significantly reduce the statutory update of 0.5% for 2019. In view of the House change on the misvalued code policy we have suspended our call to action. Things are moving quickly with this package and we are fully engaged with members of the Senate to make further improvements. We will let you know if there are additional steps you can take to support further improvements. Learn more about the health care provisions included in the FY2018 bill Over the weekend, we learned that Congress is expected to vote this week on a Medicare extenders package as part of the most recent iteration of the FY 2018 spending package. Our current understanding is that this package will include a spending offset using a flawed, two-year mis-valued codes policy that would reduce the Medicare fee schedule conversion factor in 2019 and produce an actual conversion factor cut in 2020. This mis-valued codes policy has been used by Congress before as a convenient budgetary dial. The policy is as follows: Congress establishes a target for redistributing Medicare fee schedule work values; if the target is not achieved, the conversion factor is reduced across the board by an amount equal to the shortfall. Because the AMA/Specialty Society Relative Value Update Committee (RUC) has been examining and recommending changes in relative values annually for over a decade, only a small percentage of relatively low volume services remain in the fee schedule to review. Importantly, the across the board cuts that will occur as a result of this policy represent permanent reductions all physician fee schedule payments that would be used to provide a temporary extension of other policies. Equally important, this policy would undermine efforts to improve Medicare as envisioned by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). We are asking all Federation groups to urge their Senators and Representatives to weigh in with their leadership and ask them to abandon this policy proposal. Key points to make in your conversations and correspondence include the following: · The proposed Medicare extenders legislation expands a policy related to so-called mis-valued codes that has already reduced Medicare physician fee schedule updates each year from 2016-2018. · Expanding these cuts will permanently remove spending from the baseline to pay for temporary extension of other Medicare policies. · Temporary statutory updates under MACRA were intended to provide a period of stability as physicians made the necessary practice changes to participate in the new Merit-based Incentive Payment System (MIPS) or Alternative Payment Models (APMs). · Extension of the mis-valued codes policy for two years would cause Medicare payment rates to drop to levels below the 2015 rate prior to repeal of the sustainable growth rate (SGR) formula, completely erasing the investment Congress intended to make to help physician practice prepare for MACRA. · We urge Congress to reject these Medicare cuts and continue to support physicians’ efforts to transition Medicare to a system that is focused on quality and value. This budget legislation will be voted on in both the House and Senate no later than Thursday, so it is vital that you and your physician members express your opposition as soon as possible. Form letters will also be posted on the AMA grassroots web site, at https://physiciansgrassrootsnetwork.org/. Comments are closed.
