Yesterday, December 20, Congress released its end of year Omnibus legislation, anticipated to pass both the Senate and House by the end of the week. We are extremely disappointed to learn the bill provides only partial relief from the scheduled 4.5 percent cut to the Medicare Physician Fee Schedule (MPFS) Conversion Factor for 2023. The legislation includes a 2.5 percent positive adjustment, which results in a 2.0 percent cut to the 2023 Conversion Factor. This payment reduction, following two decades without positive updates to the MPFS, is completely unacceptable, and we will continue our strong advocacy in the new year for comprehensive physician payment reform.

AAPM&R has advocated extensively for lawmakers to eradicate the full proposed cut in their end of year legislation. We are so appreciative of the nearly 700 letters that members and #pmradvocates have sent to Congress over the past few days. Our advocacy efforts on this issue throughout the year have included member communications to Congress, meetings with legislators on Capitol Hill, comments to CMS and coalition letters to Congress alerting them to the importance of reasonable compensation for physiatrists and the entire physician community. We recognize physiatrists have gone too long without positive payment updates or adjustments for inflation and rising practice costs. Comprehensive reform is the only reasonable next step.

We also sincerely thank the many members who sent nearly 300 letters to Congress encouraging inclusion of legislation on prior authorization reform. We made significant efforts this year, in partnership with the Regulatory Relief Coalition, to advocate for the passage of the Improving Seniors' Timely Access to Care Act. Unfortunately, Congress chose not to address this issue in the end of year package. While highly discouraging, we are committed to keeping prior authorization reform as a top Academy advocacy priority in the coming year.

Despite our overall disappointment with Congress, there are several wins in the Omnibus language which should be noted:

• Congress has included language to extend a wide range of telehealth flexibilities through the end of 2024. This means that telehealth coverage for all Medicare patients in any geographic location and any originating site will extend for two more years, regardless of when the public health emergency ends. AAPM&R strongly supports making these telehealth flexibilities permanent and we recognize the two-year extension as being a positive first step in this direction.
• Congress has waived the 4 percent PAYGO sequestration cuts for 2023 and 2024. These cuts would have compounded the impact of the conversion factor cut, reducing physician payment drastically in the coming year.
• Congress has restored a portion of the positive update providers can obtain for participating in an Approved Alternative Payment Model. The 5 percent update was set to expire January 1, 2023, but a reduced update of 3.5 percent will continue for 2023.
• Congress included the Mainstream Addiction Treatment (MAT) Act in the end of year package. This legislation aims to remove federal red tape to increase access to buprenorphine with the goal of preventing overdoses and reducing stigma for individuals with opioid use disorder.
• Finally, the legislation includes $10 million in funding to the Agency for Healthcare Research and Quality for Long COVID research. Securing funding for Long COVID research was a significant advocacy priority for the Academy this year.

Academy staff will be monitoring the progress of the Omnibus legislation through the House and Senate, and we will alert members once it has been signed into law. We will also alert members to any major changes to the final language. Please contact healthpolicy@aapmr.org with any questions.