Published December 10, 2021

Merry Medicare News: Congress Reverses Expected Payment Cuts

On December 9, 2021, the U.S. Senate approved the Protecting Medicare and American Farmers from Sequester Cuts Act, and the President is expected to sign the bill into law. The legislation is great news for healthcare providers. Here are the highlights:   

  1. Extension of the moratorium on 2% Medicare sequester cuts. Under the Consolidated Appropriations Act, the moratorium was set to expire December 31, 2021. Now, the moratorium will continue through March 31, 2022. From April 1 to June 30, 2022, the sequester cut will be reduced to 1%. The full 2% Medicare sequester cut will return on July 1, 2022.
  2. One-year delay in 4% Statutory PAYGO cut. Congress has delayed by one year the across-the-board 4% Statutory PAYGO cut in Medicare reimbursement that was set to take effect January 1, 2022. That 4% cut would have been in addition to the resumption of the 2% Medicare sequester cut mandated under the Budget Control Act.
  3. A 3% increase in Medicare Physician Fee Schedule reimbursement. For 2022, the Medicare Physician Fee Schedule conversion factor was set to decrease by 3.75%, from $34.89 down to $33.59. Congress now has authorized a 3% increase for 2022, meaning the conversion factor now will be $34.63. This congressional action does not impact changes in reimbursement due to the Centers for Medicare & Medicaid Services’ adjustments to relative value units assigned to specific codes. 
  4. Additional one-year delay for the Radiation Oncology Model. As it did last year in the Consolidated Appropriations Act, Congress has delayed the launch of the Radiation Oncology Model by another year, to January 1, 2023.
  5. A one-year delay in cuts to the Clinical Laboratory Fee Schedule. Payment reductions required under the Protecting Access to Medicare Act of 2014 (PAMA) will be delayed until January 1, 2023. Congress also delayed by one year certain lab reporting requirements imposed by PAMA. 
  6. No action on telehealth. Healthcare providers have been lobbying Congress to make permanent the expansion of Medicare telehealth coverage put in place for the duration of the COVID-19 public health emergency. Unfortunately, there’s no good news to share on this front.     

The PMAFSCA (not exactly an acronym that rolls off the tongue) also establishes a process for increasing the federal debt ceiling, thus avoiding the federal government’s default on its currently outstanding loans. Congress is expected to take action on this matter soon. 

If you would like additional guidance related to Medicare reimbursement or for assistance with any matter related to compliance, valuation, or strategy and integration, one of our executive contacts would be happy to assist. You may email them below, or call (800) 270-9629.

Executive Contacts

Interested in Learning More?

Sign Up for Our Latest Thought Leadership!



    Select Your Subscriptions