Docs Support Bill to Reform Medicare Payments

New legislation in the House aims to boost physician Medicare payments using an inflation-based update.

On Monday, Rep. Raul Ruiz (D-Calif.) introduced the "Strengthening Medicare for Patients and Providers Act," which links the Medicare Physician Fee Schedule to the Medicare Economic Index -- a measure of inflation physicians are subjected to that relates to practice costs and wage levels.

Some physician groups say the move would even the playing field with other providers.

"Physician payment rates have been subject to a six-year payment freeze that will last until 2026, and even experienced 2% across-the-board cuts this January," the American Medical Association (AMA) said in a press release.

After adjusting for inflation, physician payments have fallen 26% from 2001 to 2023. If nothing changes, the statutory update for a majority of physicians will remain at 0.25% in 2026, "far below even normal rates of inflation," the AMA added.

In the press release, AMA President Jack Resneck Jr., MD, noted that "we are deeply worried that many practices will be forced to stop taking new Medicare patients -- at a time when access to care is already inadequate."

The Medicare Trustees report also predicted access issues to Medicare-participating physicians over the long term if no congressional action is taken, the AMA said.

In Ruiz's bill, which was co-sponsored by Reps. Larry Bucshon, MD (R-Ind.), Ami Bera, MD (D-Calif.), and Mariannette Miller-Meeks, MD (R-Iowa), physician payment updates in the Medicare Physician Fee Schedule would be based on a single conversion tied to the HHS Secretary's estimated percent increase in the Medicare Economic Index beginning in 2024.

The American Academy of Family Physicians (AAFP) praised the bill, with the organization's president, Tochi Iroku-Malize, MD, MPH, noting that "Medicare's current physician payment system is undermining physicians' ability to provide high-quality, comprehensive care -- particularly in primary care."

The changes in the bill "will help modernize Medicare physician payment, protect beneficiaries' access to care, and provide oversight of healthcare consolidation," Iroku-Malize added.

The American Association of Neurological Surgeons and the Congress of Neurological Surgeons also expressed their support for the bill.

"Neurosurgeons take care of some of the sickest patients with brain tumors, degenerative spine disease, stroke, and traumatic brain and spinal injuries. We agree with the Medicare trustees that access to Medicare-participating physicians will become a significant issue in the long term unless Congress takes steps to fix the payment system today," said Russell Lonser, MD, chair of the organizations' Washington Committee.

"While we are grateful that Congress has stepped in to mitigate steep Medicare cuts over the past few years, comprehensive reform of the physician payment system must be a priority for Congress this year," he added.

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