A bipartisan coalition of 10 House lawmakers introduced legislation on Jan. 31 aimed at reversing a 2.83% Medicare physician payment reduction and implementing a 2% increase to help stabilize physician practices and protect patient access to care.
If enacted, the Medicare Patient Access and Practice Stabilization Act would retroactively nullify the 2.83% cut that took effect on Jan. 1, with changes set to take effect on April 1. A similar proposal garnered bipartisan, bicameral backing in December, but Congress ultimately failed to act on it before the end of the session.
The American Medical Association has strongly endorsed the measure, pledging to collaborate with lawmakers to incorporate it into forthcoming legislation to extend federal government funding beyond the March 14 deadline.
Other physicians have also voiced their support.
"Congress must act swiftly to pass this legislation to stabilize the Medicare payment system," Alexander Khalessi, MD, chair of the American Association of Neurological Surgeons and Congress of Neurological Surgeons Washington Committee said. "I commend our legislative champions for prioritizing this critical issue and value their collaboration with House and Senate leaders to address the cascading impact of Medicare Physician Fee Schedule changes on the U.S. health system. These trends have driven consolidation and limited access to care for America’s seniors. Neurosurgery is committed to working with Congress to develop sustainable, long-term solutions that foster a patient-centered health care future."
The proposal comes as House Republicans introduce broader healthcare policy changes — including major Medicaid cuts — which have raised concerns among physicians.
"I am very concerned about big healthcare budget cuts for patients and physicians," Sheldon Taub, MD, gastroenterologist at Jupiter (Fla.) Medical Center, told Becker's. "This may require states to tighten eligibility requirements, making it more difficult for Medicaid and Medicare patients to receive the appropriate care. Certain services, such as mental health services, prescription and drug coverage, and vision and dental care may be compromised. Furthermore, reimbursement rates to doctors and hospitals may be cut, causing fewer providers accepting these patients. For the providers who do accept these patients, there will be longer waiting times for patients and access to medical care will be compromised. Higher out-of-pocket copayments may make health care less affordable to low income individuals. With less access to medical care, this may cause more people to rely on emergency room care. This will cause overcrowding of emergency rooms and higher cost for hospitals. Physicians have already seen a 26% cut in Medicare since [the] early 2000s. How much more can they handle?"
The latest cuts follow CMS implementing a 1.25% reduction in overall physician reimbursement for 2024, setting the updated Medicare conversion factor at $32.74 — a 3.4% drop from the previous year. Some physicians face additional financial setbacks of up to 9% due to the cost-performance category under the Merit-Based Incentive Payment System.
"The CMS pay cut is a disgrace. As every industry in America is being forced to adjust their pricing due to the out of control inflation over the past 2-3 years, physicians are being hammered," Thomas Loftus, MD, neurosurgeon at the Austin (Texas) Neurosurgical Institute, told Becker's. "Not only are we not receiving inflation-adjusted increases in reimbursement, but the government is actually continuing to whittle away at our practice revenue overall.
Physician reimbursement per Medicare patient dropped approximately 2.3% between 2005 and 2021, according to a study from the Harvey L. Neiman Health Policy Institute, when adjusted for inflation. While some specialties have seen reimbursement increases, 16 specialties experienced declines—with 13 of these seeing reduced payments even as patient volumes increased.Specialties most affected include psychiatry, cardiology, urology, OB-GYN, internal medicine, pulmonology, radiology, gastroenterology and anesthesiology.
The proposed bill aims to provide immediate financial relief and prevent further reductions that could accelerate physician practice consolidation and restrict patient access to care. However, long-term solutions remain a key concern for healthcare leaders as the debate over Medicare physician payment reform continues.