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Congress Passes Legislation to Prevent Steep Medicare Payment Cuts

Before adjourning, Congress passed, and President Biden signed into law the Protecting Medicare and American Farmers from Sequester Cuts Act (P.L. 117-71) — legislation that would avert steep Medicare payment cuts scheduled to take effect on Jan. 1. Neurosurgeons had anticipated cuts of 9% or more due to several factors:

  • Expiration of the 3.75% payment adjustment to the Medicare Physician Fee Schedule (MPFS) conversion factor (CF);
  • Expiration of the moratorium on the 2% Medicare payment sequester; and
  • Implementation of a 4% statutory Pay-As-You-Go (PAYGO) Act cut.

During the year, the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS) led several coalition efforts, including the Surgical Care Coalition, to advocate for legislation to prevent these cuts. The final package incorporated the following relief to mitigate the cuts:

  • A one-year 3% increase in the Medicare CF to offset the expiration of the MPFS 3.75% payment adjustment;
  • A delay in resuming the 2% Medicare sequester cut for three months (Jan. 1–March 31), followed by a reduction to 1% for three months (April 1–June 3); and
  • A one-year delay of the 4% PAYGO cuts.

In the Surgical Care Coalition’s press release following passage, John K. Ratliff, MD, FAANS, chair of the AANS/CNS Washington Committee, stated, “By delaying significant cuts to surgical care, this bill will help protect patient access to care across the country. Still, physicians continue to face these same payment cuts year after year. We look forward to working with Congress to reform the Medicare payment system so that it invests in health care providers and ensures that they can be there for patients when and where patients need them.”

The AANS and the CNS will continue to press Congress to adopt longer-term solutions to fix the broken Medicare payment system to prevent future payment crises.