After therapy providers endured deep cuts to Medicare reimbursement this year, Congressional lawmakers are taking steps to limit reductions in 2022.
A bill introduced on Tuesday would prevent 2% in Medicare sequestration — or at least curb deep cuts associated with the Calendar Year (CY) 2022 Physician Fee Schedule (PFS).
The U.S. House of Representatives passed the legislation 222-212 Tuesday night and is now headed to the Senate where it’s expected to pass this week, reports said.
The legislation would delay the 2% sequestration through March 31 of next year, followed by a 1% reduction for three months until June 30.
Should it pass, the legislation “will lessen the impact of upcoming Medicare cuts and protect providers from a revenue cliff coming January 1st,” analysts with Stifel wrote in a note issued Tuesday.
The Support Health Care Providers During the COVID-19 Pandemic Act has bipartisan support in the House and Senate, according to a report from Politico. Reps. Kim Schrier (D-Wash.) and Steven Horsford (D-Nev.) introduced the bill to avoid cuts to next year’s PFS, which is due to go into effect next month.
The Centers for Medicare and Medicaid Services (CMS) in November finalized the PFS for 2022, confirming a 1% cut to Medicare Part B physical and occupational therapy rates, down from the proposed 2% in July, and a 15% cut for services provided by therapy assistants.
These cuts follow a devastating 2021 calendar year, which included 9% in cuts to Part B before the Consolidated Appropriations Act of 2021 reduced reimbursement slashes to about 3%.
A 3.75% temporary Medicare payment increase is set to expire at the end of this year as well, according to the final rule, along with a 4% Medicare payment reduction resulting from the pay-as-you-go (PAYGO) law.
The law was triggered by a $1.9 trillion pandemic package that pushed spending above budget..
If the bill passes, providers will see a 37.5% smaller revenue impact for the year if the 2% cut is delayed, Stifel analysts wrote, providing support early in the year. Physicians would see a 0.75% cut to the fee schedule, rather than 3.75%. PAYGO would be delayed until 2023.
“We expect Ensign Group … to benefit directly from the new bill. Healthcare REITs with exposure to acute care hospitals, skilled nursing facilities, and other outpatient facilities would also benefit indirectly,” Stifel analysts wrote of players in the space.
Providers had hoped Congress would pass another spending bill further offsetting cuts to net zero for 2022.
Leaders with the National Association for the Support of Long-Term Care (NASL) feel the House “really heard” the organization, in terms of cuts to Part B services being unsustainable for long-term care providers at this point in the pandemic.
“We support the fixes included and are very appreciative. We are disappointed that it does not contain a delay to the cut for therapy assistant services but we did receive word that we can still address it in 2022 even though that cut goes into effect in January,” Cynthia Morton, executive vice president at NASL, told Skilled Nursing News in an email. “We will not stop fighting efforts that limit beneficiary access to therapy during the pandemic.”
The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) released a statement early Wednesday in support of the legislation as well.
“It is vitally important that the Senate stands with America’s seniors and passes this legislation,” Clif Porter, senior vice president of government relations at AHCA/NCAL, said in the statement. “This bill would temporarily reduce or delay cuts to Medicare scheduled for 2022 that would impact skilled nursing, as well as physicians, therapists, clinical labs, portable x-ray, and other providers who administer essential services to seniors in long term and post-acute care facilities.”
The bill would also provide a one-year increase to the Medicare physician fee schedule of 3% to adjust for changes and support health care providers dealing with burnout, delay reductions to the clinical laboratory fee schedule for one year, and pause the implementation of a radiation oncology model.
“As we confront a new variant of the COVID-19 virus, I urge my House and Senate colleagues to come together and help us pass Supporting Health Care Providers During the COVID-19 Pandemic Act before the new year,” Horsford said in a statement, referring to the omicron variant.
Rep. Schrier echoed Horsford’s sentiments, adding that a pandemic is not the time to be cutting patient access to doctors.
“This legislation will bring some stability to the Medicare payment system to ensure patients can keep seeing their doctors,” added Schrier in the same statement. ‘And doctors, who have been on the frontlines during this pandemic, can continue to keep their doors open.”
Companies featured in this article:
