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Provider breaks in Congress: Sequestration delayed, cut to 1%; PAYGO delay saves another 4%

Good news for providers still reeling from the nearly 4% conversion factor cut in the recent Physician Fee Schedule rule: a bill passed in the Senate on Dec. 9 is expected to avert 5% in further cuts (PBN blog 10/14/21).

Passed on a 59-35 vote, the “Protecting Medicare and American Farmers from Sequester Cuts Act” pushes restoration of the sequestration cut -- a 2% cut which has been in effect since 2013, but temporarily suspended since passage of the CARES Act in March 2020, and which was due to resume on Jan. 1, 2020 -- to April 1, 2022. Bonus: At that time the cut will be knocked down to 1%. (The Senate bill pays for this by upping the sequestration cut to as high as 3% in 2030 -- that’s two thousand thirty, not a typo).

Also, the 2022 PAYGO “scorecard” for program debt that can require payment cuts to providers, and was expected to cost providers 4% in 2022, has been postponed to 2023.

The Senate bill also increases the Medicare Improvement Fund from $56 million to $101 million and delays the start of the Medicare Radiation Oncology Model until 2023.

The bill now goes to committee for reconciliation with the House version before heading to President Biden, who is expected to sign. Stay tuned to Part B News for further word on how this legislation affects you. 
UPDATE: The final version of this bill, signed by President Biden on Dec. 10, combines rollbacks of sequester, PAYGO, and PFS conversion factor cuts to restore about 9% of general provider reimbursement. Part B News subscribers can read the details here
Blog Tags: CMS, fee schedule
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