125+ medical associations push for congressional action on Medicare physician payment
125+ medical associations push for congressional action on Medicare physician payment
In light of the upcoming congressional recess and the recently released CY 2025 proposed Medicare Physician Fee Schedule (MPFS) rule which proposes to cut Medicare physician payments by 2.8%, the AMA spearheaded a Federation letter (PDF) signed by all 50 state medical associations and 76 national medical specialty societies to congressional leadership.
The 2025 Medicare conversion factor is set to decrease for the fifth straight year by approximately 2.80% from $33.2875 to $32.3562. This cut is largely the result of the expiration of a 2.93% temporary update to the conversion factor at the end of 2024 and a 0% baseline update for 2025 under the Medicare Access and CHIP Reauthorization Act (MACRA). These cuts coincide with ongoing growth in the cost of practicing medicine as CMS projects the increase in the Medicare Economic Index (MEI) for 2025 will be 3.6%.
Physician practices cannot continue to absorb increasing costs with ever-increasing inflation rates, while their payment rates dwindle year after year. Both the Medicare Payment Advisory Commission (MedPAC) and the Medicare Trustees have issued warnings about access to care problems for America’s seniors and persons with disabilities if the gap between what Medicare pays physicians and what it costs to provide high quality patient care continues to grow. Committees of jurisdiction have started conversations on reforming MACRA, and the Federation letter urges them to continue these negotiations in earnest given the cuts in the latest proposed rule and enact priority legislation.
The letter urges leadership to act on bills or future legislation which reforms MACRA along 4 keys pillars:
- Enacting an annual, permanent inflationary payment update in Medicare that is tied to the MEI (H.R. 2474);
- Budget Neutrality reforms (H.R. 6371);
- An overhaul of MACRA’s Merit-based Incentive Payment System (MIPS); and
- Modifications to Alternative Payment Models (APM) (S. 3503/H.R. 5013).
These are well vetted, consensus reforms within the physician community. In addition to the Federation letter on MACRA reform, AMA has been meeting with the House and Senate leadership and committee staff to educate them on the importance of a permanent inflation-based update tied to the MEI, MIPs reform, Budget Neutrality reform, and the need for legislation modifying APMs in any end of year health care package. The MIPS reform proposal (PDF) which is designed to be budget neutral replaces the current tournament model of payment adjustments with a more sustainable approach tied to annual payment updates, incentivizes CMS to share data with physician in a timelier manner, and to improve the underlying reporting of measures to ease the administrative burden on practices.
The AMA urges all members to contact their members of Congress and have them cosponsor these priority bills and consider introducing legislation that would achieve the goals of the MIPs reform proposal.
As Congress returns home for the annual August recess, physician advocates have unique opportunities to engage with their members of Congress “back home” in the district. This summer, the AMA’s top federal priority is reforming Medicare’s broken physician payment system—and we need your help.
To make these interactions with legislators as impactful as possible, the AMA has developed an online “Advocacy Hub” for the August Congressional recess that is your one-stop shop for toolkits, legislative calls to action, and information on scheduling and preparing for legislative meetings and other in-district opportunities.
Additionally, join the AMA on Aug. 1 at 8 p.m. Eastern time for an informative webinar reviewing the current state of federal legislation and ways in which physician advocates can engage Congress during August and beyond.
During this webinar, Jason Marino, AMA director of congressional affairs, will provide an update on the current state of Medicare legislation and what lies ahead for the remainder of the 118th Congress. Advocacy expert David Lusk of Key Advocacy will discuss August recess advocacy best practices to help prepare for in-district legislative meetings, hosting members of Congress at site visits, and engaging with legislators online.
Register for the webinar and access the “Advocacy Hub” to take action.
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