Congress: Stop 2022 Medicare Cuts To Speciality Care: Protect Access For Our Medicare Seniors

FOR IMMEDIATE RELEASE
December 2, 2021

Contact: Grant Herring
(202) 552-1708‬

Congress: Stop 2022 Medicare Cuts To Speciality Care:
Protect Access For Our Medicare Seniors

Specialty Stakeholders URGE CONGRESSIONAL SUPPORT for H.R. 6048,
the Medicare Stability for Patients and Providers Act, sponsored by
U.S. Representatives Bobby L. Rush (D-Ill.) and Gus Bilirakis (R-Fla.)

On November 19, the Centers for Medicare & Medicaid Services (CMS) released the CY22 Physician Fee Schedule (PFS) final rule, which contains huge 20 percent cuts to specialty providers as a result of the so-called “clinical labor” update. These cuts follow on the heels of the CY21 PFS final rule which included an across the board cut to the conversion factor of 10 percent, a cut so large that Congress was obliged to step in and block the cuts as part of H.R. 133, the Consolidated Appropriations Act of 2021. As these combined cuts are phased-in over the next four years, they will do lasting damage to specialty providers under the PFS, accelerate health system consolidation, and further undermine the Part A Trust Fund as patients are forced to move to higher cost sites-of-service.

These reductions also disproportionately impact minority populations as exemplified in the table below.

Disease/Service	Health Inequity	Fully-Implemented Cuts*
Venous Ulcer / Endovenous radiofrequency ablation	Black patients present with more advanced venous insufficiency than white patients	Key Code (36475) cut by 23%
ESRD / Dialysis Vascular Access	Black and Latino patients start dialysis with a fistula less frequently despite being younger	Key Code (36902) cut by 18%
Cancer / Radiation oncology	Black men are 111 percent more likely to die of prostate cancer; Black women are 39 percent more likely to die of breast cancer	Key Code (G6015) cut by 15%
Peripheral Artery Disease / Revascularization	Black Medicare beneficiaries are three times more likely to receive an amputation; Latino are twice as likely	Key Codes (37225-37221) cut by 22%
Fibroid / Uterine Fibroid Embolization	Uterine fibroids are diagnosed roughly three times more frequently in Black women	Key Code (37243) cut by 21%

* Note: In the 2022 PFS Final Rule, CMS phases-in these cuts over 4 years. Cuts in this table are estimates based on the 2022 PFS Proposed Rule as CMS did not publish the effects of the cuts over the 4-year period.

Ongoing cuts to office-based specialists under the PFS also are weakening our healthcare system’s ability to deal with the ongoing COVID-19 pandemic. A key lesson learned since the start of the pandemic is that it is critical that hospitals be able to focus on our sickest pandemic patients. Yet many other patients dealing with cancer, end-stage renal disease, critical-limb ischemia, and other post-acute issues cannot wait for the cancer care, dialysis vascular access repair, limb salvage, imaging, physical therapy, etc. that is critical to keeping them alive or out of the hospital. Office-based care under the PFS provides a critical site-of-service outside of the hospital to deal with non-COVID cases so hospitals can focus on a resurging pandemic. Conversely, ongoing cuts to PFS providers threaten the resilience of our health care system to deal with this or any other pandemic. It is clear that any benefits of proceeding with the clinical labor policy at this time are far outweighed by the negative impacts on PFS specialists.

H.R. 6048, introduced by Congressman Bobby Rush (D-IL) and Congressman Gus Bilirakis (R-FL), would direct the Secretary of Health and Human Services to maintain current clinical labor data in the PFS database and report to Congress on fundamental reform of the PFS. Specialty care providers are urging all the members of Congress to work in a bipartisan fashion to halt the clinical labor cuts for 2022, support H.R. 6048, and work on fundamental reform of the Physician Fee Schedule.

Specialty provider societies and groups in support of H.R. 6048 include:

American College of Radiation Oncology
American Society of Diagnostic and Interventional Nephrology
American Society of Nuclear Cardiology
American Vein & Lymphatic Society
American Venous Forum
Alliance for Physical Therapy Quality and Innovation
Association of Black Cardiologists
CardioVascular Coalition
Dialysis Vascular Access Coalition
The Fibroid Coalition
Outpatient Endovascular and Interventional Society
Preventive Cardiovascular Nurses Association
Renal Physicians Association
Society for Cardiovascular Angiography & Interventions
Society of Interventional Radiology
Society for Vascular Medicine
United Specialists for Patient Access

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About the United Specialists for Patient Access (USPA): The mission of USPA is to unify and strengthen the voice of office-based specialists, enabling professionals and patient advocates to work collaboratively with Congress and the Administration and achieve near-term relief and long-term payment stability in the Physician Fee Schedule. For more information, please click here: https://www.uspaccess.org