The Centers for Medicare and Medicaid Services (CMS) has shared its proposed 2023 Medicare Physician Fee Schedule (MPFS), which is expected to decrease payments to cardiologists my approximately 1%. The proposed conversation factor would decrease from $34.60 to $33.08 on Jan. 1, 2023, if passed without any changes.
The American College of Cardiology (ACC) issued its initial reaction to the proposed MPFS, saying it “represents the continuation of a troubling trend.”
“The confluence of conversion factor cuts, statutory cuts on the horizon from sequestration and PAYGO rules, and a 0% payment update that fails to account for significant inflation in practice costs creates long-term financial instability in the Medicare physician payment system,” according to the ACC. “By working in concert with other medical societies, the ACC was able to forestall these cuts last year. The 2023 MPFS makes clear the need to redouble efforts to ensure patient access to Medicare-participating physicians and services is not threatened.”
The ACC noted that external extended ECG monitoring and cardiac ablation are just some of the cardiac services that could see work/value changes under the proposal. The organization also highlighted several other important aspects of the recent CMS proposals, noting that additional comments and information will follow “in the weeks ahead.”
The American Medical Association’s initial response
The American Medical Association (AMA) also shared its early thoughts on the proposal, saying it “threatens patient access” and could “create long-term financial instability” for all healthcare providers treating Medicare patients.
“It is immediately apparent that the rule not only fails to account for inflation in practice costs and COVID-related challenges to practice sustainability, but also includes a significant and damaging across-the-board reduction in payment rates,” AMA President Jack Resneck Jr., MD, said in a prepared statement.
Stop me if you’ve heard this one before: AUC penalties delayed again
On a related note, the penalty phase of the CMS Appropriate Use Criteria (AUC) Program has been delayed yet again; it will no longer begin on Jan. 1, 2023.
The AUC program was one of the key components of the Protecting Access to Medicare Act (PAMA) of 2014. According to PAMA, healthcare providers must consult clinical decision support (CDS) software when placing any advanced medical imaging orders. Penalties for failing to comply were originally scheduled to go into effect in 2017, but they’ve been delayed multiple times.
This update was technically not part of the proposed 2023 MPFS, but CMS made the announcement at the same time it shared that proposal. CMS has not provided an updated timetable on the beginning of this penalty phase. More information on the AUC program, specifically its impact on radiology providers, is available here.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.