Senate Passes S.610 Bill, Averting PAYGO and Sequester Cuts From Taking Effect at the Beginning of 2022

Published in Government Relations on December 10, 2021

Yesterday, the Senate passed S.610 - Protecting Medicare and American Farmers from Sequester Cuts Act, delaying implementation of an additional 4% reduction in reimbursement for Medicare providers and suppliers as well as the 2% reduction in Medicare sequestration cuts. Congress had deferred the cuts during the COVID-19 public health emergency, but the deferral is scheduled to expire at the end of this year. S.610 extends the 2% freeze until March 31, 2022, and then reduces the freeze to 1% from April 1, 2022 to June 30, 2022.

Relief from 2% Medicare Sequester

The bill would eliminate for three months the 2% Medicare sequester cuts on hospitals and others providers that are scheduled to resume Jan. 1, 2022. In addition, the legislation would reduce the 2% sequester cut to 1% from April 1, 2022 through June 30, 2022. The package would be paid for by increasing the sequester percentage in 2030.

Halting Statutory PAYGO Sequester for 2022

The bill would stop the 4% PAYGO sequester from taking effect early next year. Any cuts mandated by a sequester order for the 2022 “PAYGO scorecard” would be delayed and added to the “2023 scorecard.” This does mean Congress will need to take action in late 2022 to eliminate these cuts. The Congressional Budget Office has estimated that a Statutory PAYGO sequester in fiscal year 2022 resulting from passage of the American Rescue Plan Act of 2021 would cause a 4% reduction in Medicare spending – or cuts of approximately $36 billion.

  • Provides a three-month delay of the Medicare sequestration reductions and a three-month, one percent reduction in Medicare sequestration payment reduction.
  • Provides a one-year increase in the Medicare physician fee schedule of 3 percent to support physicians and other health professionals in adjusting to changes in the Medicare physician fee schedule during 2022.
  • Provides a one-year delay of Medicare payment reductions to the clinical laboratory fee schedule and the private payer laboratory data reporting requirements.
  • Provides a one-year delay of the implementation of the Medicare radiation oncology model.
  • Increases funding for the Medicare Improvement Fund by $101,000,000.
  • Prevents Statutory PAYGO sequestration through 2022, preventing automatic across-the-board cuts to Medicare, farm programs, social services, student loans, resources for students and individuals with disabilities, among other programs.
  • The bill would create in law a one-time expedited process lasting through January 16, 2022, for the Senate to consider legislation increasing the debt limit by a specific dollar amount at a simple majority threshold.

Click here to view the bill summary. The bill now heads to President Biden’s desk for a signature.


TAGS

  1. covid-19
  2. medicare
  3. phe

From Our Experts

CMS Issues FAQ On DMEPOS Competitive Bidding Program thumbnail CMS Issues FAQ On DMEPOS Competitive Bidding Program The Centers for Medicare and Medicaid Services (CMS) has issued a DMEPOS CBP Frequently Asked Questions (FAQ) providing clarification on several points of the next round. Medicare Advantage Plans Are in Flux: What Providers Should Know thumbnail Medicare Advantage Plans Are in Flux: What Providers Should Know As reported by HME News WASHINGTON – Medicare Advantage (MA) plans will face new restrictions in 2026 that could force insurers to rethink their business models, according to payer relations experts. While these changes don't directly impact home medical equipment (HME) providers today, they could influence future plan design and reimbursement strategies. BOC Reinstated As Approved Accrediting Organization thumbnail BOC Reinstated As Approved Accrediting Organization As reported by HME News: Court grants company's motion for temporary restraining order against CMS OWINGS Mills, MD.—The Board of Certification/Accreditation (BOC) has been reinstated as an approved accrediting organization (AO) in all but four states, the company has announced. Click here to read the full article from HME News. The federal court has granted a temporary restraining order (“TRO”) in favor of BOC…thereby restoring BOC as an accrediting organization in all states except N DMEPOS Bills Gaining Momentum thumbnail DMEPOS Bills Gaining Momentum Fresh off a great House Energy & Commerce Health Sub-Committee hearing, now is the perfect time to reach out to your representative(s) and ask them to support the DMEPOS Relief Act, H.R. 2005; Choices for Increased Mobility Act of 2025, H.R. 1703; and the Supplemental Oxygen Access Reform Act of 2025, H.R. 2902. CMS Changes Competitive Bid Program Impacting Contracts and Bid Submission Requirements for Financial Documentation – What Providers Need to Know thumbnail CMS Changes Competitive Bid Program Impacting Contracts and Bid Submission Requirements for Financial Documentation – What Providers Need to Know The Centers for Medicare and Medicaid Services' (CMS) changes to the DMEPOS Competitive Bid Program as outlined in CMS-1828-F will reshape how suppliers prepare bids, qualify for contracts, and manage operational readiness. For DME suppliers, understanding both the changes to the contract awards and the bid submission is essential to understanding and preparing for the next bidding cycle. Meet The Candidates: VGM Hosts Rep. Randy Feenstra, Iowa Gubernatorial Candidate thumbnail Meet The Candidates: VGM Hosts Rep. Randy Feenstra, Iowa Gubernatorial Candidate Waterloo, Iowa – On Monday, VGM Group welcomed employees and local guests for another installment of its Meet The Candidates series. The featured guest was Rep. Randy Feenstra, current Congressman for Iowa's 4th District and a strong supporter of DMEPOS legislation. Energy & Commerce Health Subcommittee to Hold Hearing on Medicare Payment Policy Legislation – Thursday, Jan. 8 thumbnail Energy & Commerce Health Subcommittee to Hold Hearing on Medicare Payment Policy Legislation – Thursday, Jan. 8 The House Energy & Commerce Committee's Subcommittee on Health will hold a hearing titled “Legislative Proposals to Support Patient Access to Medicare Services” on Thursday, Jan. 8, at 10:15 a.m. (ET). CMS Releases CPI-U Adjustments for DMEPOS In 2026 And Fee Schedule Q1 thumbnail CMS Releases CPI-U Adjustments for DMEPOS In 2026 And Fee Schedule Q1 The Centers for Medicare & Medicaid Services (CMS) released the annual inflation factor to be applied to DMEPOS items effective January 1, 2026, with an implementation date of January 5, 2026. The breakdown of the adjustment is dependent upon whether the serviced items are included in the competitive bidding program (CBP) or are in formerly competitive bid areas (CBAs) such as rural and non-rural.