Bipartisan Legislation Introduced to Avoid Decreased Medicare Reimbursement Rates

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Congressman Greg Murphy, MD, recently introduced the Medicare Patient Access and Practice Stabilization Act, which aims to support physicians and Medicare beneficiaries, in response to the CMS Proposed Rule that would decrease Medicare reimbursement for physician services by 2.8%, starting January 1, 2025.

Congressman Murphy and other sponsors of the legislation cite statistics from the AMA that say when adjusting for inflation, Medicare physician payment has decreased 29% since 2001.

Under the proposed legislation, the proposed Medicare Physician Fee Schedule conversion factor reduction would be eliminated and an update equivalent to half of the Medicare Economic Index for 2025 would be added, the first inflationary update to physician pay through Medicare in years. The payment increase proposed in the legislation is similar to a recommendation made by the Medicare Payment Advisory Commission (MedPAC).

Importantly, the final 2025 Physician Fee Schedule is slated to be released within days of the legislation being introduced. If the final cut to the conversion factor varies from the proposal, Congress may adjust the raise included in the legislation.

Support for the Legislation

Many doctors within Congress support the legislation, including Congressman Ami Bera, MD, Congressman Larry Bucshon, MD, and Congresswoman Kim Schrier. On top of bipartisan Congressional support, numerous organizations support the legislation as well, including the American Medical Association (AMA), American Psychiatric Association, American Association of Neurological Surgeons (AANS), and Congress of Neurological Surgeons (CNS).

Dana Smetherman, MD, MPH, MBA, FACR, CEO of the American College of Radiology, noted the organization’s support for the legislation, saying, “Before it adjourns at the end of the year, Congress must act on this bill to increase the conversion factor and help ensure that radiology practices and all healthcare providers can continue to offer high-quality care. In the face of increasing costs to provide care and declining reimbursement, ACR continues to lead a physician and non-physician provider coalition to support ongoing efforts that protect patient access to care through sensible reimbursement policies. As physician payment legislation continues to evolve, lawmakers must continue to work with the House of Medicine to enact this legislation and Medicare payment reform that stabilizes the practice environment and safeguards patient access to lifesaving care.”

“America’s physicians are at a breaking point and access to high-quality, affordable care is at risk for millions of Medicare patients,” said Congressman Greg Murphy, M.D. “When a physician sees a Medicare patient, they do so out of the goodness of their heart, not because it makes financial sense. Medical inflation is much higher and the cost of seeing patients continues to rise. Unfortunately, reimbursements continue to decline, putting immense pressure on doctors to retire, close their practices, forgo seeing new Medicare patients, or seek a less efficient employment position. This bipartisan legislation would stop yet another year of reimbursement cuts, give them a slight inflationary adjustment, and protect Medicare for physicians and patients alike.”

“Having an outdated Medicare reimbursement rate for physicians makes it harder for healthcare professionals to provide high-quality care, putting patients at risk,” said Congressman Ami Bera, M.D. “Physicians, unlike the rest of the players in health care, have never received an inflationary update and consistently received cuts. This bill ensures a more stable Medicare payment system, allowing providers to focus on delivering care rather than worrying about losing their practice. With this bipartisan effort, we are working toward a system that supports both patients and doctors.”

“All patients deserve timely access to healthcare from quality physicians in their communities,” said Congressman Larry Bucshon, M.D. “Inadequate Medicare reimbursement threatens that access. I have long fought to correct the current trend of cutting reimbursement levels year after year, and I am proud to join my bipartisan colleagues to introduce the Medicare Patient Access and Practice Stabilization Act. The current path toward further consolidation, physician burnout, and closure of medical practices must be corrected.”

“Over the past 22 years, adjusting for inflation, physicians have essentially taken a 26% pay cut from Medicare,” said Congresswoman Kim Schrier, M.D. “Their reimbursement has been flat or declining, while overhead costs have increased by about 47%: rent, labor, equipment, and insurance. I cannot think of another profession whose compensation has dropped by 26% over 2 decades. Physicians have been holding their breath, year after year, hoping that Congress will act to avert these devastating decreases in reimbursement. Without adequate reimbursement, solo and small practice physicians—most often in rural or underserved areas—are already closing their doors.  It’s up to Congress to ensure that physicians are fairly compensated and can continue to practice, so that all Medicare patients have access to high-quality, affordable care, and I am proud to co-sponsor legislation that will achieve just that.”

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