In July, the Centers for Medicare and Medicaid Services (CMS) released two critical payment-related proposed rules for CY2023—the highly anticipated Medicare Physician Fee Schedule (MPFS) Proposed Rule followed by the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Proposed Rule.
Of note, in the MPFS, CMS is proposing to cut the Medicare conversion factor—the basic starting point for calculating Medicare payments—by approximately 4.5% for CY2023. In addition, payment reductions for many vascular surgeons are compounded by the second year of CMS’ phased-in implementation of its clinical labor pricing update, which was finalized in the CY2022 MPFS Final Rule.
“This year’s proposed rule is yet another example of how the current payment system fails to support physicians and the patients they serve,” said Matthew J. Sideman, MD, chair of the Society for Vascular Surgery (SVS) Advocacy Council. “These significant year-over-year payment cuts will most certainly jeopardize patient access to critical vascular healthcare. Congress must begin work in earnest to avert these cuts and establish a new payment system that will provide stability for both physicians and patients.”
In the OPPS rule, CMS is proposing to update payment rates by 2.7% for hospitals that meet applicable quality reporting requirements. This update is based on the projected hospital market basket percentage increase of 3.1%, reduced by a 0.4 percentage point for the productivity adjustment.
The SVS is analyzing both rules and will submit extensive comments to CMS. SVS members should be prepared to engage in these ongoing advocacy efforts through the remainder of the year, said Sideman.