The proposed Medicare Physician Fee Schedule of 20222 is just another “mixed bag”, according to radiologists and doctors.
The Centers for Medicare & Medicaid Services explained that it aims to address the gaps in overall health equity that widened at the onset of the pandemic of Covid-19 and continues. Changes are likely to include increasing access to services like telehealth, enhanced measures for diabetes prevention, and improved quality of programs.
The American College of Radiology shared an analysis recently in which it revealed that it was “pleased” to move CMS plans forward with appropriate criteria for use in the case of advanced diagnostic and imaging. The said program was mandated under the 2014 Patient Access to Medicare Act, and the associated agency is planning to launch its penalty phase on January 1, 2023, or immediately after the end of this public healthcare emergency.
In the analysis done on July 12, the ACR reads, “CMS acknowledges the typical hardships that medical practices and hospitals are facing during this pandemic and the investment that several practices have made already in the systems appropriate to the criteria of usage.” The report also states, “When implemented completely, this AUC program shall be one of the most valuable tools to make sure that the Medicare patients are given proper imaging services on time.”
This rule, however, excludes variously fixed associated with issues of claim processing. The college revealed that they had delayed the implementation of the program. ACR called these solutions “one major step towards the correct direction,” but also plans for additional review before it issues a detailed response.
The Medical Group Management Association also revealed that it is “pleased” that the CMS chose to pause this punitive AUC phase, that was originally slated to start in 2022. This would also give some time to the physicians to practice and prepare, according to Ander Gilberg, Senior Vice President of the government affairs.” Nevertheless, this association that represents 55,000 practice forerunners across the United States, in different specialties including radiology, sees somewhat a “mixed bag” in certain parts of this proposal meant for physician practices. Gilberg along with his colleagues are now “highly concerned” about the possible impact of this proposed reduction of 3.75% in conversion factor as a result of budget neutrality. It also plans to ask for congressional intervention that may avert this cut.
CMS has estimated the conversion factor of 2022 to be $33.5848 in comparison to 2021 at $34.8931. The amount would result in a reduction of 2% in radiology, noted the ACR, and this would also reduce radiation oncology and nuclear medicine. Meanwhile, interventional radiology is likely to sustain a 9% aggregate drop.
“If the Congress doesn’t interfere, this percent aforementioned percent reduction could be much greater for the coming year 20222 for physicians, which includes radiation oncology and interventional radiology,” according to the ACR.
CMS further plans to review the Quality Payment Program, which aims to push providers towards greater value through a combination of both financial incentives as well as penalties. Particularly, this would need clinicians to satisfy the high-performance threshold that qualifies for a bonus.
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