Will CMS physician pay cuts ever happen?

Potential Medicare pay cuts associated with the 2010 sequestration have loomed large on Capitol Hill for the last decade, but lawmakers continue to kick the can down the road.

The initial pay cuts were implemented in 2013 as part of the sequester cuts, with Medicare cutting physician pay 2 percent. But the cuts have been stalled to avoid lowering physician pay. Physicians again dodged the across-the-board reimbursement reductions set for Jan. 1 when President Joe Biden signed a bill protecting current pay rates through March 31.

Will the cuts ever go through? Or will they continue to be used as leverage in budget discussions perpetually?

"These automatic cuts should remind members of the needed reforms. Congress can get a head start on doing the right thing when it reconvenes early next year," American Medical Association President Gerald Harmon, MD, said in December.

The sequester cuts are now coupled with other reimbursement reduction efforts, totaling about 9 percent, if legislators don't act to avoid them.

It seems Congress and the president are content to use the pay cuts as a bargaining chip, with big consequences if they are implemented.

Richard Menger, MD, assistant professor of neurosurgery and assistant professor of political science at the University of South Alabama, argued in an editorial published by The Hill that reducing physician pay, which comprises 20 percent of Medicare spending, would force more consolidation in the industry. Especially amid the pandemic, when many independent physician practices with tight margins suffered financially, CMS pay cuts would be devastating.

The Biden administration hasn't been particularly friendly to ASCs or independent physicians this year.

"CMS penalized the healthcare industry by shifting procedures safely performed at ASCs to the hospital without much clinical evidence or outcome data," said Chhaya Patel, MD, medical director of ambulatory anesthesia and assistant professor at Emory School of Medicine in Atlanta, told Becker's. "Another gut punch to the physicians [would be] the physician payment cuts in the midst of this pandemic at a time when physician practices are still recovering the personal and financial impacts of the COVID-19 public health emergency. We must continue to advocate for our patients to provide safe, accessible and cost-efficient care."

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