ASA Submits Comments on CMS's Proposed Rule for the CY2023 Medicare Physician Fee Schedule/Quality Payment Program

Today, ASA submitted comments to the Centers for Medicare & Medicaid Services (CMS) opposing significant payment cuts to anesthesiologists while providing comprehensive and detailed solutions on a wide range of issues surrounding physician payment and the agency’s quality programs. ASA’s comments were issued in response to CMS’ CY2023 Medicare Physician Fee Schedule and Quality Payment Program proposed rule, released in July 2022.

ASA’s comments expressed concern about the magnitude of Medicare payment cuts and the cuts to the Anesthesia Conversion Factors. The proposed rule underscored how the Medicare payment system is broken, especially during a time when anesthesia groups are faced with inflation pressures and the COVID-19 pandemic. ASA asked CMS to work with Congress and other policymakers to resolve this issue and mitigate any negative impacts on physician practices and clinical patient outcomes. ASA will continue to advocate to legislative stakeholders and regulatory agencies to minimize and reverse these cuts that negatively impact anesthesiologists.

ASA met with CMS representatives in August to convey concerns with the proposed valuations of the recently reviewed Somatic Nerve injection codes. ASA reiterated these concerns in the comment letter to CMS and urged the agency to consider RUC recommended values.

Other recommendations in ASA’s letter include support for establishing coding and billing to describe chronic pain management services; a request to delay revisions to the Medicare Economic Index until after the COVID-19 Public Health Emergency; a push for more frequent updates to indirect practice expense data; and support for adjustments in the physician fee schedule for the purchase of domestically made and approved N95 surgical respirators.

On the Quality Payment Program section of the rule, ASA supported policies that will maintain a 75-point threshold for the Merit-based Incentive Payment System (MIPS) and the implementation of the anesthesia MIPS Value Pathway for 2023. ASA opposed the removal of MIPS76: Prevention of Central Venous Catheter (CVC)-Related Bloodstream Infections and asked CMS to delay onerous testing requirements on Qualified Clinical Data Registry measures. ASA also requested CMS to establish policies that will prevent physicians from being excluded in alternative payment models and aid the transition from legacy and paper records to electronic health records.

Final regulations will be issued on or around November 1, and unless otherwise noted, policies will be effective January 1, 2023.

For more information on the Quality Payment Program, please contact the ASA Department of Quality and Regulatory Affairs (QRA) at [email protected].

For more resources:

ASA Washington Alert on 2023 proposed rule

Proposed rule

Medicare PFS proposed rule fact sheet

QPP fact sheet