STOP CMS’22

WHAT IS THE PROBLEM?

Are you aware of the effect CMS Proposed Rules for 2022 will have on office-based specialty practices and your ability to serve venous & lymphatic patients? Nearly all venous & lymphatic codes will be cut by 20-24% due to a change in the Clinical Labor rate adjustments.

These cuts are expected to result in the closing of many office-based specialties in vein care over the next few years, impacting patient access to care.

WHAT IS THE AVLS RESPONSE?

AVLS intends to fight the CMS Proposed Rules for 2022 with all administrative, legislative and legal options available from September – December 2021. To fight e ectively, AVLS needs to address physician awareness on the CMS published position on venous and lymphatic disease while recruiting each physician it reaches to support the AVLS initiative, Stop CMS’22, with their volunteerism, advocacy and, most importantly, funding.

WHAT IS THE SOLUTION?

AVLS is seeking two things from Stop CMS’22 Physician Advocates:

1. Recruit & train a minimum of 300 Physician Advocates to educate CMS, legislators, other physicians and their Medicare patients about the CMS Proposed Rules for 2022 and the harmful effect these rules will have on venous and lymphatic medicine, including to restrict patient access, reduce patient’s seeking treatment, increase the financial burden on the healthcare system.

2. Solicit financial funding from each Physician Advocate at an average of $1,200 per donor, representing the average billable reimbursement from just one ablation per supporter.

HOW WILL THE STOP CMS’22 MONEY BE USED?

All Stop CMS’22 donations received will be earmarked by AVLS for the Board to spend on advocacy initiatives to combat the adoption, implementation and codification of the CMS Proposed Rules for 2022 in the areas of venous and lymphatic medicine.

WHAT INITIATIVES DOES AVLS HAVE IN MIND TO STOP CMS’22?

Fighting public policy is a process that involves many small fights and the ability to rapidly respond to such threats quickly to achieve a collective goal. Our initial goal is to prevent the proposed CMS cuts for venous and lymphatic medicine from taking effect on January 1st, 2022, with the long-term purpose of preserving equitable venous and lymphatic code valuation and coverage for all eligible patients.

Without a war chest to fund the rapid response needed or the ability to secure expertise or other data-driven resources, AVLS cannot advocate for its physician members. Those practices’ viability relies on public healthcare insurance coverages, and ultimately the treatment and care of venous and lymphatic patients serviced by them.

AVLS has developed and begun implementing the following actions:

• Phase 1 - Study the CMS Proposed Rules for 2022 with all societal & community motivated organizations impacted by them - Complete

• Phase 2 - Develop a direct response to CMS that addresses the identified concerns with the Proposed Rules to CMS formally by September 13th, 2021, hoping they will modify or suspend implementation of their proposed rules. In addition, we will develop support in Congress for the modification or delay of implementing of the Proposed Rule – Complete

• Phase 3 - Prepare for a rapid response to CMS’s final decision on implementing their Proposed Rule expected for release in early November. AVLS and others will have a short window of opportunity to stop any negative impact on our specialty – In Process

Each phase above will require projects, initiatives and contracting of resources not covered by the AVLS 2021 budget – so STOP CMS’22 is an extraordinary ask in response to an extraordinary act that will have a cataclysmic impact on venous and lymphatic patients and the professionals who treat them.

AVLS is working to develop the economic impact on the specialty and the potential impact on patient access to specialty care in the office-based setting.

• Baylor University Economics is studying the financial impact to the public healthcare system of the CMS Proposed Rules for 2022. The study models the effects on CMS expenditures using the assumption that patient care will shift from non-facility-based treatment (currently ~90% of all claims) to facility-based care. The financial impact of the proposed 20-22% venous revenue reductions effectively closes many practices (10% of current service sites).

• Braid-Forbes Health Research study analyzes the financial impact of the Proposed Rule on highly weighted venous medicine practices. CMS estimates a negative impact of 6% for Vascular Surgeons on average and 8% for Interventional Radiologists as the proposed reductions for certain codes are balanced by gains with others within their 2022 projections. The AVLS research project looks exclusively at a venous disease-specific practice & the practice impact using the majority of typical codes reimbursed at the proposed 20-22% reduction in the CMS proposal. AVLS provided over 700 physician NPI’s for this analysis as to their actual Medicare claims impact.

AVLS has also begun developing the legislative support in Congress to stop the implementation of the proposed rules:

• AVLS has founded and taken an Executive membership position with the United Specialists for Patient Access (USPA, www.uspaccess.org), a coalition of office-based specialties fighting to protect the payment structure of the Physician Fee Schedule led by Jason McKitrick and Liberty Partners, a contracted lobbying firm, targeting congressional education on the CMS Proposed Rules for 2022. AVLS has agreed to encourage large venous-related groups to also join the USPA effort.

• AVLS has developed and executed ongoing letter-writing campaigns directly to CMS for individual & influential organizations using print and digital submission options (www.myavls.org/cms22) for willing participants to express their concerns.

• AVLS has developed and executed ongoing letter-writing campaigns directly to congressional leadership. Print and digital submission options (www.myavls.org/cms22) are available for participants to request their elected leadership to investigate the impact of the proposed CMS 2022 Proposed Rule on their constituents’ access to patient care.

PHASE 3 – IN DEVELOPMENT

Depending on the final CMS ruling to be released in early November, we will potentially need to deploy aggressive tactics through Congress to prevent implementation. The response strategies are currently being explored by AVLS leadership and will be governed by the limitations of the funding developed by the STOP CMS’22 initiative. The number of donations made will dictate AVLS’s ability to advocate for its members’ interests, which will likely include exploring legal representation.

HOW DO I GET INVOLVED?

The AVLS webpage, www.myavls.org/cms22, provides information on the STOP CMS’22 initiative and a list of all the action steps available for venous practitioners.

In short, YOU can get involved by doing the simple three things below:

• Inform – Be sure you are informed about how the Proposed Rule will directly impact your patients and practice and know about STOP CMS’22 & AVLS’s e orts being taken to protect your future.

• Invest – Become an AVLS Physician Advocate and donate the encouraged amount of one typical ablation to the cause ($1,200).

• Involve – Take up the cause and volunteer to contact your peers and engage them as Physician Advocates challenging them to donate to the cause and to contact their legislators. Engage your members of Congress and convey your concerns for the future of your patients. Inform your Medicare patients and ask them to contact their legislators.

22% is an extreme cut that will only reduce the number of patients being treated for their venous or lymphatic condition or pass the burden of their care o to a higher healthcare cost structure (hospitals).

If we don’t take a stand – who will? Office-based venous care is a great value to the Medicare system, and caring for patients in the office setting benefits patients and the taxpayers who fund Medicare. The severity of the proposed cuts proves that. Stand and fight with AVLS and its Physician Advocates now!