ASCRS Joins Over 60 Organizations Calling on Congress for Additional MPFS Funding to Offset Expected Medicare Cuts in 2022
On April 27, ASCRS joined 62 medical organizations in a letter to Congress requesting that legislation on the nation’s infrastructure include an additional $3 billion for the 2022 Medicare Physician Fee Schedule (MPFS) to mitigate expected reductions to the Medicare conversion factor, as the 3.75% increase to all MPFS payments is set to expire at the end of CY2021.
As a reminder, the 3.75% MPFS payment increase for CY2021 was a direct result of ASCRS and the medical community’s advocacy to help offset the impact of the budget neutrality cuts due to CMS increasing the standalone evaluation and management (E/M) office visit values. In addition, CMS did not increase the value of E/M post-operative services in 10- and 90-day global surgery codes. Our advocacy resulted in Congress passing the Consolidated Appropriations Act of 2021 that modified the CY2021 MPFS by providing an increase of 3.75% to all MPFS services for CY2021 and suspending the 2% sequestration through March 2021.
Unfortunately, this temporary measure did not address the ongoing structural problems with the MPFS, and the provider community is again expecting steep cuts in CY2022 if Congress does not intervene. In addition to the expiration of the 3.75% MPFS increase, the medical community is facing sequestration cuts. The moratorium on the 2% Medicare sequestration, which was recently extended by Congress, will expire at the end of CY2021. Additionally, the last COVID-19 relief package, the American Rescue Plan of 2021, triggered PAYGO rules, and a 4% sequestration cut to Medicare payments effective January 1, 2022.
ASCRS and the medical community continue to urge Congress to intervene to prevent these unsustainable payment cuts.
AMA Releases New Report on Impact of COVID-19 on Medicare Spending and Utilization; Ophthalmology MPFS Spending Down 22%
Recently, the American Medical Association (AMA) released a report, “Changes in Medicare Physician Spending During the COVID-19 Pandemic,” that summarizes the impacts of the COVID-19 pandemic on the spending and use of Medicare physician services through the first half of 2020. That report found that spending declined as much as 57% in April of 2020. While utilization of Medicare physician services began to increase later in the year, overall spending was still 8% less than expected at the end of September 2020. Ophthalmology was one of the hardest hit specialties by COVID-19. The cumulative reduction in Medicare Physician Fee Schedule (MPFS) spending for ophthalmology services from January to September 2020 was down 22%.
Ways and Means Subcommittee on Health Hears Expert Testimony on Access to Telehealth Services During COVID-19 Pandemic and the Future use of Telehealth in America
On April 28, 2021, the House Committee on Ways and Means Subcommittee on Health held a hearing entitled “Charting the Path Forward for Telehealth” to discuss the widespread adoption of telehealth during the pandemic and to explore barriers and ways to improve telehealth services. Witnesses providing testimony included: Sinsi Hernández-Cancio, JD, Vice President for Health Justice, National Partnership for Women and Families, Ellen Kelsay, President & CEO, Business Group on Health, Thomas Kim, MD, MPH, Chief Behavioral Health Officer, Prism Health North Texas, Ateev Mehrotra, MD, MPH, Associate Professor of Health Care Policy, Department of Health Care Policy, Harvard Medical School, and Joel White, Executive Director, Health Innovation Alliance.
Key takeaways from the hearing include Americans’ response to greater access to telehealth services during the COVID-19 pandemic. CMS data shows that early in the COVID-19 pandemic, the national weekly average of telehealth users jumped from 13,000 per week to around 1.7 million. This dramatic increase partly stems from an unprecedented increase in telehealth flexibilities. Additionally, witnesses discussed that there are still telehealth barriers that need to be overcome, including waste, fraud, and abuse. Internet access remains a significant obstacle in accessing telehealth services, especially for those in rural areas.
Open Payments Pre-publication Review and Dispute Now Available
Pre-publication Review and Dispute for the Program Year 2020 Open Payments data is available now through May 15, 2021.
The Centers for Medicare & Medicaid Services (CMS) will publish the Open Payments Program Year 2020 data and updates to the previous program years’ data in June 2021.
Physician and teaching hospital review of the data is voluntary, but strongly encouraged. Please keep in mind the following reminders:
- Disputes must be initiated by May 15, 2021 in order to be reflected in the June 2021 data publication. For more information on review and dispute timing and publication, refer to the Review and Dispute Timing and Data Publication Quick Reference Guide.
- CMS does not meditate or facilitate disputes. Physicians and teaching hospitals should work directly with reporting entities to resolve disputes.
- Registration in the Open Payments system is required in order to participate in review and dispute activities.
If you have never registered with Open Payments before:
Make sure you have your National Provider Identifier (NPI) number and State License Number (SLN). Initial registration is a two-step process:
- Register in the CMS Identity Management System (IDM);
- Register in the Open Payments system
For users who have previously registered: Users that have registered during previous program years do not need to re-register.
Please note: If the account has not been accessed for within the last 60 days the account will have been locked due to inactivity. To unlock an account, go to the CMS Enterprise Portal, enter your user ID and correctly answer all challenge questions to gain access to your account. You will be prompted to create a new password.
If the account has not been accessed for 180 days or more, the account will be deactivated. To reinstate the account, call the Open Payments Help Desk at 1-855-326-8366; (TTY Line:1-844-649-2766)
For more information about the registration process, visit the physician and teaching hospital registration page on the Open Payments website.
