AHA Comments on the CMS’ Physician Fee Schedule Proposed Rule for Calendar Year 2023

September 6, 2022

The Honorable Chiquita Brooks-LaSure
Administrator Centers for Medicare & Medicaid Services
7500 Security Blvd
Baltimore, MD 21244

Re: CMS-1770-P, Medicare and Medicaid Programs; CY 2023 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Medicare and Medicaid Provider Enrollment Policies, Including for Skilled Nursing Facilities; Conditions of Payment for Suppliers of Durable Medicaid Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS); and Implementing Requirements for Manufacturers of Certain Single-Dose Container or Single-Use Package Drugs To Provide Refunds With Respect to Discarded Amounts.

Dear Administrator Brooks-LaSure:

On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations; our clinician partners — including more than 270,000 affiliated physicians, 2 million nurses and other caregivers; and the 43,000 health care leaders who belong to our professional membership groups, the American Hospital Association (AHA) appreciates the opportunity to comment on the Centers for Medicare & Medicaid Services’ (CMS) physician fee schedule (PFS) proposed rule for calendar year (CY) 2023.

We appreciate CMS’s proposals in this rule that support care delivery and patient outcomes, particularly those that take steps to improve the stability and flexibility of the Medicare Shared Savings Program (MSSP) to better allow participants to provide care to beneficiaries. In addition, we support CMS’s proposal to delay implementation of its revised “split” or “shared” evaluation and management visit policy. Finally, the AHA also shares CMS’s commitment to advancing health equity, and supports the agency’s proposals to prioritize the use of health-equity-related measures in the Merit-based Incentive Payment System (MIPS), and implement a health equity adjustment for the MSSP.

However, we have strong concerns about CMS’s proposed changes to the Medicare Economic Index (MEI) and urge the agency to pause its update of the index. In addition, we continue to have concerns about the feasibility of the MIPS Value Pathways (MVPs), and believe much work remains to be done to ensure they result in fair, equitable performance comparisons across MIPS clinicians and groups. Finally, while we appreciate CMS’ proposals to improve access to behavioral health services, we question the utility and adequacy of the proposals related to family psychotherapy and chronic pain management.

We appreciate your consideration of these issues. Our detailed comments are attached. Please contact me if you have questions or feel free to have a member of your team contact Joanna Hiatt Kim, AHA’s vice president of payment policy, at jkim@aha.org, regarding the payment provisions, or Akin Demehin, AHA’s director of policy, at ademehin@aha.org, pertaining to the quality provisions.



Stacey Hughes
Executive Vice President


View the detailed comments below.