CMS released its annual payment updates for physicians and outpatient and home health services for 2022 on Nov. 3, prompting healthcare leaders and medical associations around the country to speak out against the rule.
Although CMS is increasing outpatient payment rates by 2 percent in 2022 for hospitals that meet applicable quality reporting requirements, the final rule halts elimination of the inpatient only list and adds back most of the services that were removed from the list in 2021. CMS will continue paying hospitals 22.5 percent less than the average sales price for certain drugs and biologics purchased through the 340B program.
Below are nine statements and reactions to the changes:
Editor's note: This is not an exhaustive list.
America's Essential Hospitals said the rules, namely the 340B Drug Pricing Program and 2022 Outpatient Prospective Payment System, "endanger the healthcare safety net."
The American Medical Group Association and American College of Surgeons called on legislators to act to prevent significant cuts to Medicare payments.
The American Society for Radiation Oncology objected to CMS launching major changes in radiation oncology reimbursement starting in January 2022, citing concerns that the cuts will jeopardize access to treatment, and added they will continue to advocate for legislative changes to support the specialty.
Gerald E. Harmon, president of the American Medical Association, said, "While the American Medical Association (AMA) will thoroughly analyze the 2,400+ page rule, it is a reminder of the financial peril facing physician practices at the end of the year. The final rule includes a reduction in the 2022 Medicare conversion factor of about 3.85 percent. The AMA is strongly advocating for Congress to avert this and other looming cuts to Medicare physician payments that, overall, will produce a combined 9.75 percent cut for 2022. This comes at a time when physician practices are still recovering the personal and financial impacts of the COVID public health emergency. Congress is beginning to recognize that this financial instability could limit health care access for Medicare patients. The clock is ticking."
Joanne Cunningham, executive director of the Partnership for Quality Home and Healthcare, said, "While we continue to have concerns over the implementation of the behavioral adjustment cuts, the slight uptick in the payment rate for 2022 takes a modest step in recognizing the increased labor costs home health providers are continuing to experience. ... We note CMS’ commitment in the final rule to consider all alternative approaches to the budget neutrality methodology and we look forward to working with them to properly address this in future rulemaking."
Premier Healthcare Alliance shared concerns regarding the accountable care organization's measurement strategy failing to support the Innovation Center’s strategy refresh to move all Medicare beneficiaries into a total cost of care payment model by 2030.
Scott Whitaker, president and chief executive officer of AdvaMed, said, "The unfortunate effect of the physician payment cuts made by this rule will be a decrease in patient access to high-quality care, especially in rural and underserved areas, and possibly even the shuttering of clinic doors altogether, and it will undermine doctors’ ability to effectively serve their Medicare patients. We look forward to working with Congress to address this threat to patient care."
Stacey Hughes, executive vice president of American Hospital Association, said, "Today’s final Medicare outpatient rule contains a number of important policies that will help hospitals and health systems better provide care. We are pleased that CMS recognized the unique role that hospital outpatient departments play in caring for patients by rolling back two problematic policies it put forth last year...However, we remain disappointed that CMS will continue deep payment cuts to 340B hospitals, which threatens their ability to care for their patients and communities and goes against Congress’ intent in establishing the 340B program nearly 30 years ago."