Medicare Fee Cuts Delayed… Again

In a whirlwind of activity last week, both the House and Senate passed S.610, which addresses the looming Medicare payment cuts. On Friday, President Biden signed the bill into law. This means that the cuts have now been delayed, but only for a while.

Here is what the new law addresses:

Advertisement

• The 2% sequestration has been delayed again through March 2022. Beginning on April 1, 2022, 1% sequestration will begin and it will increase to 2% on July 1, 2022.
• A 3% increase will take effect that mostly offsets the expiration of the 2021 3.75% “increase.” The overall impact of this change will still result in a .75% reduction in reimbursement.
• 4% PAYGO cuts are delayed through December 31, 2022.
• Other changes to laboratory fee cuts and oncology radiation cuts were also delayed through 2022.

This means that the currently published fee schedule will change. As a result of these pending changes to the Medicare fee schedule, we are recommending the following:

Participating Providers:  If you are a participating provider for Medicare, we encourage you to continue to bill Medicare at your normal fees.  Your bills will be processed based on the appropriate fee schedule, once it is released.

Non-Participating Providers: If you are NOT a participating provider for Medicare, we recommend that you wait to submit your bills until the correct schedule is released.  However, based on the information we have, you may be able to process your claims using the currently published 2022 rates and inform your patients that additional amounts may be owed or require refunding.

As we have observed in previous years, these are only temporary fixes to a systemic problem with Medicare reimbursement. We continue to advocate that Congress address these needed fee schedule reforms and adopt appropriate policies for chiropractic physician coverage and reimbursement, as addressed in H.R. 2654. Please continue to take action on this, and contact your Congressperson today.