The American Medical Association (AMA) led a coalition of more than 120 state medical societies and medical specialties in submitting a supporting letter on H.R. 2474, Strengthening Medicare for Patients and Providers Act.
Legislation Background
The bipartisan legislation was introduced by Representatives (and doctors) Raul Ruiz, Ami Bera, Larry Bucshon, and Mariannette Miller-Meeks in the United States House of Representatives on April 3, 2023, and referred to the Committee on Energy and Commerce and the Committee on Ways and Means. It attempts to modify certain adjustments to payment amounts under the Medicare physician fee schedule. Payments under the Medicare physician fee schedule are currently figured under separate conversion factors for (1) physicians that are qualifying participants in advanced alternative payment models and (2) other physicians starting in 2026, with annual increase of 0.75% and 0.25%, respectively.
The legislation would replace the separate conversion factors with just one conversion factor, and the update would be equal to the annual percentage increase in the Medicare Economic Index, starting in 2024.
Congressional Sponsor Statements
“All patients deserve timely access to healthcare from quality physicians in their communities. An inadequate mechanism for determining Medicare reimbursement adjustments is threatening that access and must be addressed. With that goal in mind, I am proud to introduce the Strengthening Medicare for Patients and Providers Act, which would tie annual Physician Fee Schedule updates to inflationary measurements—a move that is both fair and efficient. I am committed to working in a bipartisan way to obtain a Congressional Budget Office score for this bill and to find options for covering the cost. The current path toward further consolidation, physician burnout, and closure of medical practices must be corrected,” said Representative Bucshon, M.D.
“My physician’s heart always puts patients first. It is important to me that they get timely care and see the doctor they need when they need to, especially in medically underserved communities,” said Representative Ruiz, M.D. “I am deeply concerned about the impact the outdated Medicare physician payment rate is having on health care access for my constituents. That is why I am announcing legislation that will move us away from a system where every year seniors’ access to care is threatened due to uncertainty over potential cuts. My bipartisan bill, the Strengthening Medicare for Patients and Providers Act, will bring certainty to America’s seniors and improve access to care and health outcomes across the board.”
“As hospitals in small and rural areas continue to struggle, it’s imperative we take action to ensure these communities have access to timely and quality healthcare services,” said Representative Miller-Meeks, M.D. “Our bill, the Strengthening Medicare for Patients and Providers Act, will provide stability for physicians across the board. As a doctor, I understand how important it is to prioritize patients, and I’m proud to join in leading this important bipartisan effort.”
“At a time when our health care system is already strained, instability in our Medicare payment system creates further access and workforce issues,” said Representative Bera, M.D., former Chief Medical Officer for Sacramento County, California. “I’m proud to join my colleagues and fellow doctors in introducing legislation to provide an inflationary update to ensure that we can provide our nation’s physicians the stability they need to continue to provide the best possible care for their patients.”
Letter in Support
The supportive letter commended the representatives for introducing the legislation, noting that the legislation “advances the ongoing need to provide financial stability to physician practices in order to preserve access to care for Medicare beneficiaries.” It goes on to note that by establishing an annual inflation update equal to the Medicare Economic Index, it would help physician practices to “better absorb payment distributions triggered by budget neutrality rules, performance adjustments, and periods of high inflation” as well as help physicians be able to “invest in their practices and implement new strategies to provide high-value care.”
The letter states that the annual “stop the Medicare payment cut” process is partially because physician services do not receive the annual inflation update that most other Medicare providers rely on, and the COVID-19 pandemic highlighted the challenges that physicians face in the “current broken Medicare payment system.”
The AMA and others appreciate the patches Congress implemented through 2024 (reducing the cut to Medicare payments to 2% in 2023 and 3.25% in 2024), but “they are a distraction, exacerbate budgeting challenges for practices, and divert resources that both medicine and Congress could be spending on other meaningful health care policies and innovations.”
The AMA also created a chart showing the Medicare payment updates as compared to the rate of inflation from 2001 through 2023, showing that when adjusted for inflation in practice costs, Medicare physician payments declined 26% from 2011 to 2023. This has mostly impacted smaller physician practices and those that treat low-income or other historically minoritized or marginalized patient communities.
Signatories
Organizations that signed onto the letter included the American Academy of Neurology, American Academy of Family Physicians, American Academy of Cardiology, American College of Emergency Physicians, American College of Physicians, and the American Psychiatric Association. Medical Societies/Associations from all fifty states and the District of Columbia also signed the letter.
California Medical Association
The California Medical Association also released a statement on the legislation, saying, “Congress must shore up the viability of physician practices to meet the mountain of growing health care needs in our communities. We urge the California Congressional Delegation to prioritize and co-sponsor this vital legislation.”
Recovery Plan for America’s Physicians
The AMA has a Recovery Plan for America’s Physicians that outlines what the AMA views as important in rebuilding the health care industry after the COVID-19 pandemic. Some topics included in the Recovery Plan include reforming Medicare payments, fixing prior authorization, supporting telehealth, and reducing physician burnout.