NOV 17, 2022
Academy Aims at Key Priorities in Final Days of 117th Congress
While Congress focuses on end-of-year priorities during its lame duck final weeks of 2022, we are working to keep legislators’ attention on our top two priorities: relief from scheduled 2023 Medicare physician payment cuts and Senate passage of the much-needed prior authorization reform bill that cleared the House in September.
Since government funding expires Dec. 16, legislators will need to craft a year-end appropriations package over the next few weeks. The Academy is pushing to get our priorities into that package.
Rep. Michael Burgess, MD, R-Texas, a member of the House Committee on Energy and Commerce and the Subcommittee on Health, will offer his insights on the lame duck session and what it could mean for Medicare payment, prior authorization reform and health care in a special event of the 2022 OPHTHPAC® Speaker Series.
The event is open to all U.S. Academy members and will take place Nov. 30 at 8 p.m. ET.
Here is where things stand:
Medicare Physician Payment Cuts
The Academy and the Surgical Care Coalition are pressing legislators to address the nearly 8.5% Medicare payment cuts that start Jan. 1. Congress has until the end of the year to act. We are urging Congress to do three things.
- Stop the planned nearly 4.5% cut to the Medicare conversion factor — a critical element for calculating Medicare payments.
- Waive the looming 4% statutory requirement that new legislation not increase federal budget.
- Include a one-year payment update to account for inflation.
Prior Authorization Reform
The Academy is also pushing for the inclusion of our prior authorization reform bill in the year-end package. The Improving Seniors’ Timely Access to Care Act passed the House in September. It would reform prior authorizations in Medicare Advantage and has strong bipartisan support in the Senate. If Congress enacts it this year, the year-end package is the most likely legislative vehicle to do so.
However, some Senators have balked at the latest Congressional Budget Office estimate of the $16 billion cost. The Academy doesn’t think this estimate accurately captures what the bill’s implementation would cost. We’re working with legislative champions to identify actions that could substantially reduce the bill’s projected cost. Such changes would improve its chances of inclusion in a year-end package.