December 20, 2022

Congress Comes Up Short on 2023 Medicare Conversion Factor Adjustment

The American College of Radiology® (ACR®) released the following statement in response to Congress’ year-end action in omnibus legislation that includes measures to reduce drastic Medicare physician pay cuts scheduled to take effect Jan. 1.

Despite continued advocacy efforts throughout the year from a united medical community to stop the cuts, Congress negotiated only a partial increase to the Medicare conversion factor of 2.5% for 2023 and a 1.25% adjustment for 2024, rather than providing the full 4.5% increase sought by providers.

This statement may be attributed to Jacqueline A. Bello, MD, FACR, chair of the ACR Board of Chancellors:

“At a still precarious time for practices coming off a pandemic, with increased inflation, and already declining reimbursement, we are disappointed Congress has not protected patient access to care by fully offsetting these added cuts. All of medicine must work with lawmakers in 2023 to enact Medicare payment reform that stabilizes the provider environment and safeguards patient access to lifesaving care in their communities.”

Additional Omnibus Provisions Supported by ACR

In addition to its efforts to stop the full 4.5% 2023 Medicare physician cut, the ACR pursued several other issues that were noted in the pending omnibus bill. Below are a few issues that were included in legislative language and as part of “Report Language”, which indicates Congress’s intent to address specific topics in which ACR supported:

Extension of Protecting Access to Lifesaving Screenings (PALS) Act – Sec. 223 of the bill extends the existing moratorium on current breast cancer screening guidelines from the United States Preventive Services Task Force (USPSTF) through December 31, 2024.

NIH Funding Increase - The bill provides $47.5 billion to NIH, an increase of $2.5 billion (5.6%). ACR, working with the Ad Hoc Group for Medical Research, supported this increase.

  • Included in the NIH increase is $7.3 billion for the National Cancer Institute (NCI), an increase of $407 million above the FY 2022 enacted level, including $216 million for the Cancer Moonshot Initiative.
  • Also included, $441 million to the National Institute of Biomedical Imaging and Bioengineering, an increase of $16 million above the FY 2022 enacted level.

Medicare Funded Residency Positions – Working with other stakeholders such as the Association of American Medical Colleges (AAMC), the ACR is pleased that the omnibus provides for the distribution of 200 new Medicare-supported graduate medical education (GME) slots, 50 percent of which are allocated for psychiatry and psychiatry subspecialties. In addition, ten percent of the 200 slots are to be distributed according to other categories such as hospitals in rural areas, states with new medical schools, and health provider shortage areas (HPSAS).

Colorectal Cancer and CT Colonography – Omnibus Report Language instructs the National Cancer Institute (NCI) to advance progress against colorectal cancer. In addition, there was also Report Language that specifically cited the need for the Centers for Medicare and Medicaid Services (CMS) to “consider existing evidence to determine whether CMS should cover CT Colonography as a Medicare-covered colorectal cancer screening test under section 1861 (pp)( 1) of the Social Security Act.” ACR is pleased that Congress has recognized its long-standing work to include CT Colonography as a covered Medicare service by including these instructions to CMS.

Alzheimer Diagnostics Payment Policy – As a direct result of ACR’s working with the Society of Nuclear Medicine and Molecular Imaging (SNMMI) and other partners to enact the Facilitating Innovative Nuclear Diagnostics (FIND) Act of 2021, Report Language was included that requires CMS to review its bundled payment policy for advance radiopharmaceuticals in the hospital outpatient setting. The current payment policy can make these diagnostic imaging services cost prohibitive for many hospitals and doctors, especially those providing care to racial and ethnic minorities, and patients in rural areas. The agreement directs CMS to review the utilization of AD diagnostics and consider potential modifications that could make access to advanced imaging for AD more equitable.