A coalition of 62 healthcare organizations sent a letter to Congress urging lawmakers to include four Medicare physician payment changes in any year-end legislative package.
“Medicare patients need access to physicians, and physicians need a payment system that works. Congress has an opportunity to protect access to care and give physician practices the stability they need to keep serving Medicare patients,” American Medical Association President Willie Underwood III, MD, said in a Nov. 12 AMA news release. “These four reforms are practical, bipartisan steps Congress can take now to strengthen Medicare and protect patients.”
The letter calls on Congress to:
1. Extend the 2.5% physician payment update through 2027. Medicare physician payment has fallen approximately 33% since 2001 when adjusted for inflation, according to the letter. The gap “jeopardizes patients’ access to care and practice sustainability,” the release said.
2. Enact the Provider Reimbursement Stability Act. The bill would prevent permanent payment cuts when CMS “overestimates changes in service use,” the release said.
3. Delay the Medicare physician fee schedule’s modifier 25 payment reduction for one year. The 2027 physician fee schedule cuts payment by 20% for a separately identifiable office visit billed on the same day as certain zero-day global procedures. This decision threatens independent, office-based practices, the release said.
4. Cap Merit-based Incentive Payment System penalties at 2%. The letter also asks Congress to require timely, actionable performance data so physicians can improve care rather than face penalties based on outdated information.
Congress opened its lame-duck session Nov. 9, and the continuing resolution funding the government expires Dec. 11. Without congressional action, the final 2027 physician fee schedule cuts the conversion factor 2.31% for most physicians starting Jan. 1.
The letter was signed by:
- American Academy of Allergy, Asthma & Immunology
- American Academy of Dermatology Association
- American Academy of Facial Plastic and Reconstructive Surgery
- American Academy of Family Physicians
- American Academy of Hospice and Palliative Medicine
- American Academy of Neurology
- American Academy of Ophthalmology
- American Academy of Otolaryngic Allergy
- American Academy of Otolaryngology Head & Neck Surgery
- American Academy of Pediatrics
- American Academy of Physical Medicine and Rehabilitation
- American Association of Neurological Surgeons
- American Association of Orthopaedic Surgeons
- American Clinical Neurophysiology Society
- American College of Allergy, Asthma and Immunology
- American College of Cardiology
- American College of Emergency Physicians
- American College of Gastroenterology
- American College of Mohs Surgery
- American College of Obstetricians and Gynecologists
- American College of Physicians
- American College of Radiology
- American College of Rheumatology
- American College of Surgeons
- American Gastroenterological Association
- American Geriatrics Society
- American Medical Association
- American Osteopathic Association
- American Psychiatric Association
- American Rhinologic Society
- American Society for Clinical Pathology
- American Society for Echocardiography
- American Society for Gastrointestinal Endoscopy
- American Society for Radiation Oncology
- American Society for Surgery of the Hand
- American Society of Anesthesiologists
- American Society of Breast Surgeons
- American Society of Cataract & Refractive Surgery
- American Society of Hematology
- American Society of Nephrology
- American Society of Nuclear Cardiology
- American Society of Plastic Surgeons
- American Society of Retina Specialists
- American Society of Transplant Surgeons
- Association for Clinical Oncology
- Association of American Medical Colleges
- Congress of Neurological Surgeons
- Endocrine Society
- Heart Rhythm Society
- Infectious Diseases Society of America
- International Pain and Spine Intervention Society
- Medical Group Management Association
- North American Spine Society
- Post-Acute and Long-Term Care Medical Association
- Renal Physicians Association
- Society for Cardiovascular Angiography and Interventions
- Society for Vascular Surgery
- Society of Cardiovascular Computed Tomography
- National Medical Association
- Society of Hospital Medicine
- Society of Interventional Radiology
- Society of Thoracic Surgeons
