#20 - MGMA Director of Government Affairs Claire Ernst explains Congress’ last minute passing of waivers and delays to looming reimbursement cuts to Medicare for 2022


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All practices, hospitals, and health systems this is a critical and timely episode. Claire Ernst, Director of Government Affairs breaks down the legislation passed last night by Congress which waived and delayed several looming cuts to Medicare reimbursement for 2022. She covers the PAYGO 4% cuts, conversion factor changes, sequester delays and phased reinstitution, telehealth coverage for 2022 and more! Tune in for essential updates to your 2022 reimbursement outlook!

What you’ll get out of this episode:

  • What portion of the previously delayed 2021 budget neutrality adjustments were mitigated for the Medicare physician fee schedule conversion factor through CY 2022
  • The status of the imposition of the 4% statutory pay-as-you-go sequester resulting from the American Rescue Plan Act through CY 2022;
  • The new plan for the reinstatement of the existing 2% Medicare sequester through March 2022 and more!


“Statutory PAYGO has actually never been triggered before for Medicare…we were getting down to the wire and it wasn’t getting done” @ClaireErnstJD

“Anyone who has a physician office lab would want to pay attention to this, the protecting access to medicare act (PAMA) passed in 2014 basically redid the formula for data reporting and coming up with the calculation for reimbursing labs which led certain labs to face up to 15% in cuts…many of those cuts were delayed for a year by the CURES Act through the end of this year”@ClaireErnstJD

“We went from expecting 9.75% cuts in Medicare reimbursement to removing 9% of those cuts” @ClaireErnstJD

“There is momentum [regarding audio only telehealth] if it’s something that’s important to you and your practice, especially if you are in a rural area, get in contact with your members of congress and provide them that data or those anecdotes you may have” @ClaireErnstJD

Recommended Resources

  • MGMA Washington Connection
  • CMS Newsroom

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