ADVOCACY By Gregory K. Griggs, MPA, CAE NCAFP Executive Vice President
~ Working for You ~
Remembering the Positives During a Time of Turmoil In tough times, it can be easy to forget the good that is occurring around us. After two full years of a global pandemic, our state’s family physicians are tired. But there continue to be small victories. As a result, I wanted to provide updates on a few of the positive things that are happening in healthcare, particularly for Family Medicine. So here is a little good news. MEDICARE SEQUESTRATION AVOIDED Recently, Congress passed, and the President signed, S. 610, the Protecting Medicare & American Farmers from Sequester Cuts Act into law, a true positive for Family Medicine. As part of implementing S. 610, the Centers for Medicare & Medicaid Services (CMS) released an updated 2022 Medicare physician fee schedule conversion factor (i.e., the amount Medicare pays per relative value unit). The updated conversion factor will be $34.6062. That is less than the 2021 conversion factor of $34.8931 but more than the conversion factor of $33.59 that CMS planned to implement before passage of S. 610. Using the new conversion factor and accounting for other changes in S. 610, the American Medical Association (AMA) estimates family physicians will see no change in their total Medicare allowed charges in the first quarter of 2022, a substantial improvement over the -8.7% change the AMA estimates
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would have occurred in the absence of S. 610. The AMA estimates most other physician specialties will experience a decrease in their total Medicare allowed charges even with the changes made by S. 610. This represents a big victory for family physicians. And remember, in the previous year, family physicians received a substantial bump from Medicare with E&M codes receiving a higher RVU value. MEDICAID CHANGES While NCAFP still supports a broader coverage expansion to provide all North Carolinians access to affordable healthcare, the NC General Assembly did make some additions to Medicaid coverage last year. For example, post-partum mothers can now stay on Medicaid for a full 12 months. Previously, Medicaid coverage for mothers ended six weeks after delivery. Another change involved children of parents in the foster care system. Previously, parents of children in foster care automatically lost coverage. This meant if the reason the parent lost coverage was substance use, the parent also lost the opportunity to seek substance use treatment. Now, those parents will remain on Medicaid, so that they can get access to the appropriate treatment. Medicaid has also worked to incentivize getting recipients vaccinated for COVID-19. Medicaid recently increased the administrative fee you receive when providing a COVID-19 vaccine to $65 per immunization. That’s up from the $40 previously provided for COVID-vaccine administration. Even better, the administrative fee increase is retroactive to April 1,
The North Carolina Family Physician
