The Underwater Biosimilars Coalition will meet with the Medicare Payment Advisory Commission to discuss concerns about inadequate reimbursement for certain biosimilars, which has limited beneficiary access to these lower-cost alternative therapies.
Urge Your Lawmakers to Support Critical Medicare Payment Reform
The recently introduced Physician Fee Stabilization Act (S. 4935) would raise the budget neutrality threshold from $20 million to $53 million and help alleviate the annual uncertainty providers face surrounding Medicare reimbursement rates.
The ACR Gets Rheumatologists Paid More
The implementation of the new G2211 code on Jan. 1 increases reimbursement for rheumatology visits, but the ACR continues to fight for retroactive repayment of the across-the-board Medicare physician reimbursement cuts implemented at the same time, as well as structural changes to the program to make serving Medicare patients sustainable for rheumatologists in the long term.
CMS Proposes Reimbursement Cuts for CY24
On July 13, the Centers for Medicare and Medicaid Services released the CY 2024 Medicare Physician Fee Schedule Notice of Proposed Rulemaking. This annual rule outlines policies related to provider reimbursement, coverage of telehealth services, review of specific codes, refinement of evaluation and management codes and updates to the Quality Payment Program.
ACR Provides Preliminary Analysis of CY23 Medicare Physician Fee Schedule Final Rule
On Nov. 1, the CMS finalized the Medicare Physician Fee Schedule for 2023. The rule finalizes many policies, significantly: a 4.5% decrease in the conversion factor, a delay in split/shared implementation, continued refinement of evaluation and management coding and documentation, and telehealth flexibilities that will remain in place through 2023. Thanks to ACR advocacy, the CMS reinstated five-minute pre- and post-service times for musculoskeletal ultrasound codes.
CMS Releases CY23 Medicare Physician Fee Schedule & Quality Payment Program Updates
If enacted as is, the proposed CY 2023 Medicare Physician Fee Schedule and Quality Payment Program would make significant cuts to reimbursement for evaluation and management services, creating financial instability for providers. On a positive note, it would extend some telehealth flexibilities 151 days beyond the official end of the public health emergency.
The Power of Advocacy
In 1916, a handful of conservation advocates successfully lobbied Congress to create the National Park Service, which now protects more than 85 million acres of U.S. land. Dedicated rheumatology advocacy has lasting effects, too, as evidenced by several policy wins in 2021 and efforts underway for 2022.
Congress Acts to Avert Nearly 10% Cut to Medicare Reimbursement Set for 2022
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…
ACR Works for Modifications to Build Back Better Act
The ACR has long supported efforts to reduce drug prices through many of the provisions included in the House-passed version of the Build Back Better Act. However, the current wording of one provision puts patient access to Medicare Part B treatments at risk.
Speak Up: Ask Congress to Block Medicare Reimbursement Cuts
Rheumatologists may need to downsize and restrict patient care if Congress doesn’t act to block significant cuts to Medicare reimbursement rates totaling 9.75% in 2022.