AMA's New Year's resolution for Congress: Cancel the Medicare pay cut
MGMA: Since plans often benchmark their rates based on the Medicare Physician Fee Schedule, the low rates underscore the negative impact of the cuts.
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The American Medical Association has said that its New Year's resolution for Congress is to cancel the Medicare pay cut for physicians in 2024.
The AMA strongly supports a bill introduced in Congress this month that would completely eliminate the 3.37% Medicare physician pay cut that's scheduled to take effect on January 1.
The bipartisan House bill called the Preserving Seniors' Access to Physicians Act of 2023, was referred to the Committee on Energy and Commerce and to the Committee on Ways and Means.
Though the bill didn't pass before legislators recessed for 2023, the AMA said that Congress will consider a package of healthcare bills when it returns as part of a federal appropriations package in mid-January to fund the government in fiscal year 2024.
A bill did pass the Senate Finance and the House Energy and Commerce Committees that would provide partial relief of 1.25% from the Medicare cuts.
The scheduled Medicare physician pay cut "threatens healthcare access for seniors as well as the viability of physician practices, including many in rural and underserved areas," said AMA President Dr. Jesse Ehrenfeld. "Canceling the cut is a good New Year's resolution."
WHY THIS MATTERS: KEY DATES
The MGMA (Medical Group Management Association) has also been advocating for Congress to avert the full cut.
"Unfortunately, political issues related to legislation to fund the operations of the federal government and its agencies have prevented Congress from addressing critical end-of-year Medicare policies impacting medical groups," MGMA said.
The organization sent a letter to Congress this month outlining legislative recommendations to support medical groups in 2024, including the Preserving Seniors' Access to Physicians Act of 2023.
"Without stopping this full cut, medical groups will endure an untenable further reduction to physician reimbursement that will compound other financial pressures such as staffing shortages and rising operational costs -- practices may have to consider limiting the number of new Medicare patients, reducing charity care, reducing the number of clinical staff and closing satellite locations," MGMA said.
"Should the reduction go into effect on Jan. 1, 2024, and then later be remedied, medical groups will face administrative turmoil if CMS pays out claims prior to the enactment of a fix and later has to reprocess them," MGMA added. "Further, commercial plans often benchmark their rates based off the Medicare Physician Fee Schedule. It is our understanding that in previous iterations of these cuts being retroactively adjusted, these commercial plans did not go back and change their contracts, but kept the artificially low rates. This underscores the cascading negative impact these cuts have on medical groups."
Upcoming key dates, as posted by MGMA include:
- Dec. 31: 3.5% APM incentive payment expires
- Jan. 1: Cut of 3.37% to the Medicare conversion factor takes effect
- Jan. 1: Medicare begins paying for G2211 complexity add-on code
- Jan. 1: Qualifying APM Participant threshold increases for the 2024 performance year
- Jan. 19: Partial federal government shutdown deadline
- Jan. 19: 1.0 work GPCI floor expires
- Feb. 2: Second federal government shutdown deadline
THE LARGER TREND
The Centers for Medicare and Medicaid Services finalized a 3.37% pay cut in the 2024 Medicare Physician Fee Schedule earlier this year.
Twitter: @SusanJMorse
Email the writer: SMorse@himss.org
