Updated Dec. 16, 2021: In response to advocacy from the ACR and other provider and patient groups, Congress passed legislation to avoid the nearly 10% “Medicare cliff” scheduled to take effect Jan 1. The ACR thanks all ACR/ARP members and patients who took the time to engage in this critical effort with us to protect the rheumatology community and patient access to care.
On Dec. 9, Congress passed the Protecting Medicare and American Farmers from Sequester Cuts Act, Medicare provider relief legislation that also raises the debt ceiling. This legislation phases in sequester cuts starting in March 2022, defers until 2023 the cuts related to the statutory PAYGO requirements triggered by the cost of the American Rescue Plan, and extends for another year the provider relief bump included in the 2020 Physician Fee Schedule at 80% of the 2021 level.
The ACR has pushed hard for lawmakers to address the 2% Medicare sequester cut, which was temporarily put on hold due to the COVID-19 pandemic but was set to go back into effect Jan. 1, 2022. The new bill extends the current sequester moratorium through the end of March 2022, then phases in the cut with a 1% sequester cut from April through June 2022 and the full 2% cut in effect beginning July 1. The ACR will continue to advocate for complete repeal or further delay of Medicare sequester cuts.
The cost of this measure is offset in the legislation by raising the sequester cut to 2.25% in January 2030 and to 3% beginning in July 2030. The legislation also pushes the 4% statutory PAYGO cuts to the 2023 balance sheet.
Last year, lawmakers stepped in and mitigated the impact of the pandemic by adding a 3.75% bump to Medicare reimbursements to providers for one year. As COVID-19 continues to impact our members, the ACR asked Congress to extend this aid. The Protecting Medicare and American Farmers from Sequester Cuts Act extends 3% of that reimbursement bump through 2022, leaving providers with a 0.75% cut beginning Jan. 1, 2022.
The bill passed in the House on Dec. 7. While the debt limit provision of this legislation needed a simple majority (51 votes) to pass in the Senate, the items related to Medicare required 60 votes to pass. This margin has been hard to attain in this Congress, but the ACR and the rest of the House of Medicine communicated to the Senate the importance of averting these cuts and are grateful that the Protecting Medicare and American Farmers from Sequester Cuts Act passed on Dec. 9. The legislation now goes to President Biden, who is expected to sign it into law before these cuts would go into effect on Jan. 1.
Although this legislation averts the immediate crisis, it pushes to the future smaller cuts that will have the same cumulative impact. The ACR is committed to an ongoing long-term campaign to reform this system by addressing flaws in the physician fee schedule system that lead to annual cuts, revisiting the sequestration policies specific to Medicare, and encouraging Congress to find cost savings in areas of healthcare beyond provider pay that do not risk patient access to care. At the very least, we will encourage Congress not to wait until the last minute to address this annual threat; automatic cuts and last-minute legislative actions highlight the need for substantive reforms. We will ask that Congress formulate a more efficient plan for doing the right thing when it reconvenes early next year.
