Specialty Physicians Frustrated by Anticipated Medicare Payment Cuts Amidst Increases for Other Providers.

In formal comments on the CY 2023 Medicare physician fee schedule (PFS) proposed rule, the Alliance of Specialty Medicine (“Alliance”) asked the Centers for Medicare and Medicaid Services (CMS) to “take steps to prevent/mitigate payment cuts in 2023 and work with Congress to ensure physicians receive fair and reasonable updates to their Medicare payments, similar to other providers, in CY 2023 and beyond” highlighting intense frustration with “the gross payment disparity between health care facilities, [Medicare Advantage] plans and physicians” that is “unconscionable and cannot be ignored any longer.” These sentiments were expressed in response to the anticipated cut of close to 4.5% in Medicare PFS payments due to statutory and regulatory policies and proposals, while other Medicare providers look toward increases as high as 8.5% in the same period.

The specialty coalition also urged the Agency to pause efforts to rebase and revise the Medicare Economic Index (MEI) while the American Medical Association (AMA) collects data on physician office practice expenses and to ensure other data inputs are updated on a more frequent and recurring basis.

The Alliance also expressed concern about the Quality Payment Program (QPP), including the new Merit-Based Incentive Payment System (MIPS) Value Pathways, or “MVPs,” that fail to address underlying issues in the MIPS program. The specialists called on CMS to make additional revisions to MIPS so that specialty physicians can more readily engage and to address issues with the Advance Alternative Payment Model (AAPM) track so that specialties may have more opportunities to engage.

Click here to access the letter.