Medicare Payment Cuts Mostly Averted

12/10/2021 - Thanks to action taken by the Academy and its members, drastic cuts to Medicare payments for registered dietitians and other Medicare providers have been averted! The U.S. House of Representatives and U.S. Senate just passed the Protecting Medicare and American Farmers from Sequester Cuts Act, and the bill is anticipated to be signed into law by the President shortly

This bill addresses partially or in whole 3 separate cuts to Medicare payments that would have collectively resulted in a devastating 9.75% cut to ALL Medicare Part B provider payment rates starting January 1, 2022.

Key Takeaways from the Protecting Medicare and American Farmers from Sequester Cuts Act

  • The 2% sequestration from the Budget Control Act of 2011 has been pushed back through March. This long-standing cut has been suspended since the start of the pandemic and was set to go fully back into effect on January 1, 2022. After March, it will be gradually phased back in at 1% for 3 months (April-June) then the full 2% after July 2022.
  • The 4% Pay-As-You-Go  sequestration triggered by COVID-19 relief spending, resulting in an unprecedented 6% total sequester for all Medicare Part B providers, including RDNs, was pushed back 1 year. The Pay-As-You-Go Act of 2010 requires that legislation that increases the federal budget deficit be offset in other ways, such as through automatic cuts to mandatory programs like Medicare.
  • The 3.75% patch for a cut generated by Medicare budget neutrality rules will be extended at 3% for 1 year. When CMS decided to increase the payment rate for evaluation and management service codes, payments for other services were cut starting in 2021 due to budget neutrality rules. The impacts were blunted by Congress via a 3.75% increase to the conversion rate (the number that translates RVUs into dollars) for other services through 2021, which is extending at the slightly lower 3% rate for 2022.

Bottom Line: RDNs who are Medicare providers can anticipate a slight decrease in payments under the Medicare Physician Fee Schedule of approximately -0.16% for the first quarter of 2022, -1.16% in the second quarter, and -2.16% for the remainder of the year. Other Medicare providers are facing similar, if not larger, cuts as well. As always, the Academy will publish its 2022 Medicare Physician Fee Schedule for RDNs as soon as data files are available from CMS.

While we would prefer to see payment increases rather than payment decreases, passage of this bill is a major victory that mostly averts the estimated 9.75% cut to Medicare payments. In doing so, payment reductions have been avoided from the many public and private payers who base their reimbursement rates on the Medicare conversion rate. The threat of deep cuts will resurface again next year, however, as both the 4% PAYGO relief and the now 3% budget neutrality relief were only extended through 2022.

The Academy will continue to advocate for a permanent solution that will stop putting Medicare payments at risk and eliminate the need for these annual patches.

Thank you for taking action to help us achieve this success