USPA’s vision is for fundamental reform of the Physician Fee Schedule that provides payment stability for office-based specialists.
Protecting Patient Access to Office-Based Specialty Care
Now – more than ever – patients need access to office-based specialty care.
The 2022 Medicare Physician Fee Schedule (PFS) final rule issued on November 2, 2021, cuts a broad array of office-based specialists as a result of so-called “budget-neutral” effects of the CMS policy to update clinical labor data in the PFS. These cuts will continue to accelerate the health system consolidation trend and exacerbate health inequities in a variety of diseases. “Budget-neutrality” also was the driver of massive cuts in the 2021 PFS Final Rule. These year-over-year “budget-neutral” cuts, being implemented during a pandemic, are causing significant disruption to the healthcare system and are being implemented without regarding to patient outcomes, actual PFS provider resource needs, or any other rationale policy.
In the near-term, we implore Congress not finalize these cuts to office-based specialists. Over the long-run, we urge CMS and Congress to work on fundamental reform to the PFS to provide reimbursement stability to office-based specialists, stop the troubling health system consolidation trend, and close health equity gaps.