WISCA works closely with our national association partner – the Ambulatory Surgery Center Association (ASCA) – on advocacy and other issues important to our members. In fact, the WISCA Government Affairs Team joins a national ASCA state chapter call twice a month for a federal regulatory and legislative briefing and closely follows their published Government Affairs Updates. Here is the latest federal government affairs news from ASCA:
· Medicare Physician Fee Schedule
On November 2, CMS released the Medicare Physician Fee Schedule (MFPS) final rule. The rule finalizes a 2024 conversion factor of $32.74, a roughly 3.4 percent reduction from 2023. Notably, CMS finalized the implementation of a new g-code, G2211, beginning on January 1, 2024. This code was first proposed in the 2020 rulemaking cycle but has been delayed due to the Consolidated Appropriations Act of 2021. The code is contentious because it triggers a significant budget neutrality adjustment that is the main factor in the overall negative conversion factor reduction. CMS estimates that G2211 is driving 90 percent of the negative 2.2 percent budget neutrality adjustment. ASCA opposed its implementation in comments responding to the CY 2024 MPFS proposed rule. There will likely be a significant lobbying push from the physician community to oppose the implementation of the code before the end of the year. On November 6, ASCA was one of 54 health organizations that signed-on to a letter (see below) to Congressional leadership opposing the implementation of G2211:
o On behalf of the 54 organizations representing physicians and other health care providers across the United States, we write to urge Congress to stop the 3.4% cut in Medicare physician payment that the Centers for Medicare & Medicaid Services (CMS) recently finalized in the Calendar Year 2024 Medicare Physician Fee Schedule (PFS) final rule. The agency acknowledges in the final rule that, due to budget neutrality requirements, the majority of the cut is created by the decision to increase payments for primary care services through the creation of the new G2211 code.
We acknowledge policymakers’ desire for additional investments in primary care, however these increases are being paid for by an across-the-board cut to all clinicians. It is imperative that Medicare patients have access to the full range of essential health care services, including primary and specialty care. Further, clinicians are facing these cuts when they are expecting a 4.6% increase in medical practice cost inflation in 2024, as measured by the Medicare economic index.
Therefore, in the absence of long-term reform, Congress must stop the full 3.4% cut.
· General Update on 2025 Proposed Payment Rule
The Centers for Medicare & Medicaid Services (CMS) has provided more information regarding the new recommendation process for the ASC Covered Procedures List (ASC-CPL). This process enables interested parties to submit codes for consideration to be added to Medicare's ASC-CPL. The submission period will start on January 1, 2024, and conclude on March 1, 2024, for 2025 rulemaking. ASCA will continue to advocate for the addition of complexity-adjusted code combinations and alignment with the Hospital Market Basket to update reimbursement rates. If you have specific procedures you would like ASCA to advocate for, please contact Kara Newbury.
