Ask your Representative To Take Action and Stop the 20% reimbursement cuts to Medicare specialty providers!

The clock is ticking. Congress must take action to instruct the Centers for Medicare & Medicaid Services (CMS) not to implement deep, across-the-board 20% payment cuts to office-based specialty providers in the Physician Fee Schedule (PFS) Rule for CY2022.

If not addressed by the end of the year, these painful cuts will force the closure of specialists providing services to cancer patients, dialysis patients, limb salvage patients, women seeking fibroid embolization and many others. Each of these conditions disproportionately impact minority patients and the closure of these specialty providers will exacerbate health equity, health system consolidation, reduce Medicare beneficiary access and increase Medicare program costs and beneficiary copays.

USPA is asking providers to contact members of the Congressional Tri-Caucus – which is composed of the Congressional Black Caucus, the Congressional Hispanic Caucus, and the Congressional Asian Pacific American Caucus— and ask them to support the Congressional Tri-Caucus letter that urges Congress to direct CMS not to proceed with the implementation of the clinical labor update at this time. Click here to view a PDF of the letter.

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I write to express my grave concerns over devastating cuts of up to 9% to certain office-based specialists in the finalized Physician Fee Schedule (PFS) Rule for 2023.

The cuts in the 2023 PFS Finalized Rule are on top of cuts of 20 – 40% for many specialty providers since 2006 and more recent cuts in the 2021 PFS Rule and the 2022 PFS Rule that are now being phased in over the next few years.  The 2021 PFS Rule cut the conversion factor by 10% due to the “EM policy” – a cut so large that Congress intervened to phase in the cut with the next 3% reduction occurring on January 1, 2023.  The 2022 PFS Rule cut the direct adjustment factor by 24% due to the “clinical labor policy” – with the result that the regulation cut some office-based specialists by more than 20% through 2025.  Now the 2023 PFS Finalized Rule is implementing another 1.5% cut, which, when combined with the previous policies will result in a total cut to certain office-based providers of up to 9% in 2023 alone.

If not addressed, these painful cuts will force the closure of specialists providing services to cancer patients, dialysis patients, limb salvage patients, women seeking fibroid embolization, seniors seeking physical therapy and many others. Each of these conditions disproportionately impacts minority patients and the closure of these office-based specialty centers will exacerbate health equity, accelerate health system consolidation, reduce Medicare beneficiary access, increase Medicare program costs and beneficiary copays, and hasten the insolvency of the Medicare Part A Trust Fund.

I respectfully ask that you urge Congressional Leadership to stop ongoing clinical labor and EM cuts to office-based specialists in end-of-year Medicare legislation as Congress looks to undertake the serious work of fundamental reform to the Physician Fee Schedule.

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