SIR to CMS: Protect Access to Patient Care, Reverse Devastating Medicare Physician Fee Schedule Cuts

Medicare Physician Fee Schedule Cuts: Proposed cuts to physician reimbursements could shutter practices and leave thousands of medically vulnerable patients without access to care, the Society of Interventional Radiology said in a comment letter submitted to the Centers for Medicare and Medicaid Services (CMS) today.

The letter was submitted in response to the July 13 proposed rule for the 2022 Medicare Physician Fee Schedule (MPFS). Under the proposal, interventional radiologists could see an aggregate cut of 13% for all IR treatments, with certain procedures performed in office-based lab settings experiencing cuts greater than 20%. Treatments with the highest cuts include limb-saving peripheral arterial disease treatments, clot-busting venous treatments, venous stenting, and other vascular work.

“The rule represents a perfect storm resulting from CMS’s decision to allow their labor rates and product cost tables to lag behind inflation,” said SIR President Matthew S. Johnson, MD, FSIR, an interventional radiologist and Gary J. Becker Professor of Radiology Research at Indiana University School of Medicine in Indianapolis. “In many cases, practice costs have not been updated in 20 years. Due to purported budget neutrality, CMS made apparently arbitrary cuts rather than reimburse all practices and specialties at their true cost of care.”

While CMS considers such cuts “budget neutral” they disproportionately affect procedures performed by interventional radiologists in office-based settings, such as treatment of venous ulcers and dialysis access. More importantly, the services most affected treat diseases that disproportionately affect patients of color, such as peripheral artery disease, venous disease, renal disease and cancer.

“As a result, the profound cuts will negatively affect health equity in communities who have already been particularly hard hit by the COVID-19 pandemic,” said Johnson. “By making it difficult for outpatient, office-based labs to continue to operate, patients seeking care will have to do so in hospital settings, which are still reeling from COVID-19. For some patients, this could mean traveling hours outside of their community to receive treatment.”

Throughout the pandemic, office-based facilities have allowed hospitals to focus on the sickest COVID patients while allowing lifesaving cancer treatments and limb-saving vascular procedures to continue. The cuts may make some practices unsustainable, directly impacting readiness for future COVID surges or new pandemics. In addition, office-based lab facilities deliver quality care to patients far from major hospital centers. Community-based, outpatient care allows patients to return to their normal lives sooner.

“We must protect patients’ access to that crucial care and prevent private practices from closing down, especially in underserved areas,” said Johnson.

SIR is joining with other healthcare organizations, such as the American Medical Association, the American College of Radiology, the CardioVascular Coalition and other medical specialty societies, to combat these cuts and plead with CMS and Congress to:

  • Reverse the cuts
  • Suspend sequestration
  • Maintain for 2022 the COVID-19 related increase to the conversion factor to ensure that what is reimbursed better reflects the real cost of healthcare in a pandemic world.
  • Avoid implementing clinical labor pricing revisions at this time. If they must implement it, phase the new rates in over 4 years to minimize the effects on private practices.
  • Adopt RUC reimbursement recommendations for specialty and practice expense codes.

Read the SIR’s full letter to CMS.

Hot this week

Medtronic Expands AiBLE Spine Surgery Ecosystem with New Technologies and Siemens Healthineers Partnership

New advancements in the AiBLE Spine Surgery ecosystem build upon the company's commitment to procedural innovation and execution

Axlab, Danish Medtech Pioneer, expands to US with Advanced Robotic Tissue Sectioning for Pathology Laboratories

Kris Rokke, National Sales Director for Axlab in the US. "My team and I are extremely excited and honored about this unique opportunity to also offer this advanced technology to labs across the US and thus contribute to the pathology labs of tomorrow."

Spartan Medical Broadens Single-Use Sterile Instrument Portfolio to Improve Outcomes, Increase Efficiency, and Generate Cost Savings

Spartan Medical products portfolio of single-use, sterile med tech includes micro and minor surgical convenience kits, kerrison rongeurs, spinal and general surgical retractors, dural repair kits, synthetic biologics, and a wide range of orthopedic pre-sterilized implants and devices.

Recor Medical Supports European Society of Cardiology’s Hypertension Guidelines

Record Medical notes the new guidelines, "2024 ESC Guidelines for the management of elevated blood pressure and hypertension," have been published online and recommend the consideration of renal denervation (RDN) as a safe and effective treatment option for patients who have uncontrolled resistant hypertension or those that have uncontrolled hypertension with a higher risk of cardiovascular disease, who express a preference to undergo RDN.

ConTIPI Medical Selects EVERSANA to Support U.S. Commercialization of Non-Surgical Medical Device ProVate for Women with Pelvic Organ Prolapse

EVERSANA is a leading provider of global commercial services to the life sciences industry, to support commercialization for the ProVate device in the United States to help women experiencing pelvic organ prolapse.