On December 2, Congress passed legislation to avert a government shutdown and provide enough funding for federal programs through February 18. While the CAP and other physician associations lobbied lawmakers to use this funding bill to stop Medicare cuts in 2022, Congress neglected to do so. With little time left in the calendar year, congressional leaders are exploring options to address the cuts—including a vote in the House of Representatives later this week.

Mitigating the Medicare cuts has been a top priority for the CAP’s Advocacy throughout the year. The CAP and 10 other medical professional groups expressed disappointment in the fact Congress took no action on the cuts on December 2. At the same time, a strong, bipartisan majority in Congress support providing physicians with relief from the cuts and protecting Medicare beneficiary access to services. In addition, Congress has an historic record of stopping Medicare cuts to physicians for several years.

The CAP is tracking the pathways for Congress to address this issue. While it is preferrable that Congress pass legislation before the cuts are implemented, lawmakers may also retroactively mitigate the cuts later in 2022.

Finding a Legislative Vehicle

In years past, Congress has opted to include legislative language to stop or mitigate the Medicare cuts in larger legislative bills or omnibus packages. On December 6, House Majority Leader Steny Hoyer’s (D-MD) calendar indicated the House could vote on December 8 on several year-end business items, which included the Medicare cuts and raising the debt limit.

The Build Back Better bill, which Democrats hope to enact over the next several weeks, could also serve as a “legislative vehicle.”

Pass a Standalone Bill

Another option is for Congress to pass legislation introduced by Reps. Ami Bera, MD (D-CA) and Larry Bucshon, MD (R-IN). The bill is called the Supporting Medicare Providers Act of 2021. Sens. John Boozman (R-AR), Alex Padilla (D-CA), and Roger Marshall, MD, (R-KS) will be introducing legislation to provide the same relief in the Senate.

In December 2020, Congress passed legislation providing a 3.75% Medicare payment increase, which mitigated Medicare cuts due to budget neutrality requirements stemming from the Centers for Medicare & Medicaid Services’ policy to increase payment for evaluation and management services, for the 2021 Medicare Physician Fee Schedule and pausing budgetary sequestration cuts. The CAP has supported this relief be extended for another year. The Supporting Medicare Providers Act of 2021 would do just that by extending the 3.75% adjustment for an additional year.

Mitigating the Medicare Cut Retroactively

In the event Congress can’t address the cut by December 31, elected officials can opt to stop the cut retroactive to January 1, 2022. Congress has done this in previous years, including several times when Medicare’s sustainable growth rate (SGR) threatened steep decreases to physician reimbursement on a routine basis.