There’s a saying in many places that if you don’t like the weather, just wait a few minutes and it will change.
There’s a corollary to that with government regulations: If you think you have something good, take a closer look and you might find out you were wrong.
That, in a nutshell, is what happened this week when the much-anticipated 2022 Medicare Physician Fee Schedule proposed rule was issued. While quickly poring over the 1,747 pages that were released late Tuesday afternoon, the initial reaction in some quarters was that of pleasant surprise. After all, feared 8% to 9% cuts weren’t proposed again this year.
“Not looking too bad” was a phrase uttered by veteran legislation watcher Cynthia Morton, executive vice president of the National Association for the Support of Long-Term Care.
But upon further review, her hedging phrase — “looks like” — was most prescient.
The NASL team’s preliminary analysis gave way to some deeper insight with a little more math the next day. In brief, the 2% cuts that brought initial relief are going to be augmented by last year’s 3% cuts, along with 2% sequestration cuts that return Jan. 1.
“So in effect, we now have a 7% reduction,” Morton acknowledged Wednesday. There also will be 15% pay cuts for many services performed by physical or occupational therapy assistants.
“In itself, the [2%] cut could have been deeper, but when you add it up to where we are now, in full context, we don’t stand very good. It’s worrisome for patients,” Morton noted.
The NASL team is one of the sharpest around, and its observations about other parts of Tuesday’s big release were, of course, spot-on.
“The devil’s in the details,” Morton added about the doc fee proposal. Believe it or not, the behemoth is actually about 400 pages shorter than last year’s version.
“You have to read between the lines,” Morton said. “It makes it harder to interpret. It’s usually not this complicated.”
Partly convoluting calculations is the way Congress mitigated last year’s proposed pain. In part, it kicked the can down the road, which will amount to 3% to 4% cuts in another couple of years.
The big question from here is: Can provider advocates convince Congress to soften the blow again this year? Morton, who will be in the thick of the charge to get it done, believes so.
“I think the odds are good that Congress will listen,” she said. “We have to make our case and the coalition [of groups representing seniors and care providers] is gearing up to do that. Once Congress helps you once, they’ve listened and you have a decent chance of being helped again. But you have to do the advocacy work and show them the harm that could be done.”
Indeed, sometimes all it takes is a second look.
Follow Executive Editor James M. Berklan @JimBerklan.
The opinions expressed in McKnight’s Long-Term Care News columns are not necessarily those of McKnight’s.
