Congress passes bill that eases Medicare payment cuts to radiology

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The U.S. Senate has passed legislation that will mitigate significant payment cuts to the Medicare Physician Fee Schedule (MPFS) that were to go into effect on January 1 -- and would have affected radiology reimbursement by more than 10%.

The "Protecting Medicare and American Farmers from Sequester Cuts Act" passed in the U.S. House of Representatives on Tuesday with a vote of 222 to 212 and on Thursday in the Senate with a vote of 59 to 35.

The legislation averts payment cuts of more than 10% in 2022 in a variety of ways. It does the following:

  • Delays a 2% Medicare sequester payment reduction through March 31 and another of 1% through June
  • Avoids a 4% spending cut from the pay-as-you-go (PAYGO) budget neutrality sequester
  • Increases reimbursement 3% for the Medicare Physician Fee Schedule to offset cuts of 3.75% that were to be implemented because of budget neutrality requirements

The bill also delays to 2023 private-payor reporting requirements and a radiation oncology payment model (RO Model) proposed by the U.S. Centers for Medicaid and Medicare Services (CMS) that would have reduced reimbursement through bundling radiation therapy payments rather than paying for individual treatment episodes.

The American College of Radiology lauded the bill's passage, noting that "without Congressional action, these cuts would have exacerbated already existing healthcare disparities in rural and urban areas and threatened patient access to healthcare services."

But ACR board of chancellor chair Dr. Howard Fleishon also urged Congress to tackle healthcare payment instability long-term -- and not at the last minute.

"We are thankful Congress intervened to provide stability within the healthcare system for both patients and healthcare providers," he said. "However, we must begin to look beyond these short-term fixes. The ACR looks forward to working with Congress to address the ongoing structural problems associated with Medicare's broken payment system."

It's expected that President Biden will sign the legislation.

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