The U.S. House Addressed the Bulk of the Medicare Cuts
Senate Approval Needed | A 9.75% Cut Becomes a .75% Cut


Dear TOA Member:

As always, TOA promises to keep these e-mail updates to a minimum and limited to important news. Coming soon: An e-mail from TOA within the next week or two regarding the state's proposed rule for the new prior authorization law in Texas.

The U.S. House passed a stand-alone Medicare package on December 7 that would address a significant portion of the 9.75% physician Medicare cuts that are scheduled to go into effect on January 1, 2022. In short, the 9.75% Medicare cut would become a .75% cut on January 1, 2022.

The bill now moves to the Senate for its consideration.

The national medical societies largely supported the legislation due to the fact that it would eliminate the majority of the Medicare cuts.

Perhaps Congress will re-visit the issue again in 2022. It's clear that all physicians in Texas need to build relationships with Texas members of Congress so that Medicare is a top priority for all 36 Texas members of Congress.
Running the Numbers on the Medicare Cuts

As you can see from the Tweets below that summarize the bill, the 9.75 percent has not been completely wiped out. In addition, the cuts have been simply pushed to the future and will need to be addressed again in 2022.

In terms of the December 7 legislation:

  • 3.75% Conversion Factor Cut Would Become a .75% Cut in 2022. Under the legislation, the 3.75% cut will become a .75% cut in 2022.
  • 2% Medicare Sequester Cut: It's Complicated. The 2% cut would be eliminated from January 1 to March 31, 2022. It would become a 1% cut from April 1, 2022, to June 30, 2022. The 2% cut would return beginning on July 1, 2022.
  • 4% PAYGO Eliminated in 2022. The 4% PAYGO offset to pay for the American Rescue Plan Act (ARPA) of 2021 would be eliminated for 2022 and go back into effect in 2023.
What's Next on the Medicare Cuts?

The House legislation will now go to the U.S. Senate for final consideration, and that may close out the issue for 2021.

Two cuts will be lingering in the first few months of 2022 - the .75% conversion factor and the return of the Medicare sequester in April. As a result, Congress may try to consider those in the first few months of 2022.

Also, last night's bill does not include provisions related to the clinical labor policy changes that CMS made in the 2022 Physician Fee Schedule. CMS will update the clinical labor pricing through a four-year transition period to ease cuts for some physician specialties. Click here to read AAOS's comments on the issue (page 4).

As always, stay tuned to AAOS on these issues.
A Look at the "Fix"
TOA's 2022 Annual Conference: April 22-23 in Austin

Make plans to join TOA's 2022 Annual Conference this April 22 and 23 at the AT&T Conference Center in Austin. The morning of Friday, April 22 will tackle a number of practice-related issues.

Click here for preliminary details.
Bobby Hillert | Texas Orthopaedic Association
Bobby@toa.org | 214.728.7672 m