Medicare Program: BIO's Comments on the Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for Calendar Year 2013; Proposed Rule

Re:  Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule; Proposed Rule [CMS-1590-P]

Dear Acting Administrator Tavenner:

            The Biotechnology Industry Organization (BIO) appreciates this opportunity to comment on the Centers for Medicare & Medicaid Services’ (CMS) proposed rule regarding payment policies under the physician fee schedule (PFS) and other revisions to Part B for calendar year (CY) 2013 (the “Proposed Rule”).[1]  BIO represents more than 1,100 biotechnology companies, academic institutions, state biotechnology centers, and related organizations in the United States.  BIO members are involved in the research and development of health care, agricultural, industrial, and environmental biotechnology products.

            BIO represents an industry that is devoted to discovering new treatments and ensuring patient access to them.  Accordingly, we continue to monitor changes to Medicare’s reimbursement rates and payment policies for their potential impact on innovation and patient access to drugs and biologicals.  Toward this end, BIO is greatly concerned that physicians once again face a substantial, negative update to the conversion factor.  The estimated cut of 27 percent in physician payment rates,[2] in addition to payment reductions due to sequestration, simply cannot be implemented without dire consequences to patient care.  We agree with CMS that a long-term solution to avert future negative updates is critical,[3] and we urge CMS to work with Congress to reform the methodology.  Until such reform is enacted, CMS should do anything in its power to mitigate these cuts and ensure that Medicare beneficiaries continue to have access to high quality care in 2013 and beyond.

[1]77 Fed. Reg. 44722 (July 30, 2012).

[2]CMS (Center for Medicare and Medicaid Services). 2012. Estimated Sustainable Growth Rate and Conversion Factor, for Medicare Payments to Physicians in 2013. Baltimore, MD: CMS,

[3]77 Fed. Reg. at 45032.

Read the full comment letter (PDF)