Budget neutrality reform bill introduced in Senate
On Aug. 1, Senators John Boozman (R-AR), Peter Welch (D-VT), Thom Tillis (R-NC), Angus King (I-ME), Roger Marshall, MD (R-KS) and Jeanne Shaheen (D-NH) introduced the “Physician Fee Stabilization Act.”
The AMA supports the bill (PDF) which would increase the budget neutrality threshold under the Medicare Physician Fee Schedule (MPFS) from $20,000,00 to $53,000,000 in 2026 and provide regular indexing to the Medicare Economic Index (MEI).
The House Energy and Commerce Committee acted in Dec. 2023 on legislation (H.R. 6545, the “Physician Fee Schedule Update and Improvement Act”) that included a similar budget neutrality threshold increase.
While these are important first steps, the AMA is strongly urging Congress to go further to fix the outdated budget neutrality process to ensure it is accurate, truly budget neutral and does not result in unjustified across-the-board cuts to physician payment based on inaccurate estimates moving forward. The AMA supports H.R. 6371, the “Provider Reimbursement Stability Act of 2023,” which includes additional key components:
- A two-year look-back period for the Centers for Medicare & Medicaid Services (CMS) to correct utilization misestimates prospectively. This targeted modification addresses statutory budget neutrality requirements within the MPFS, which currently implement certain services based on sometimes inaccurate utilization predictions, leading to compounding financial losses.
- That CMS make regular updates to key elements of direct practice costs (e.g., clinical wage rates, prices of medical supplies and equipment prices) simultaneously and no less often than every five years to maintain accurate reimbursement rates reflecting the actual costs incurred by physicians.
- Guardrails against dramatic positive or negative changes to the MPFS by capping the year-to-year variance in the conversion factor at 2.5%.
Fix Medicare Now site adds updated patient engagement materials
The AMA’s Fix Medicare Now site contains all of the resources you need to help guide your advocacy efforts on Medicare physician payment. New patient-focused materials include:
- Physician reception area flyer (PDF): This easy-to-print Fix Medicare Now flyer can be hung in patient waiting areas and contains a large QR code where your patients can access FixMedicareNow.org to learn more about the physician Medicare payment issue and easily take action to ensure their continued access to high-quality care.
- State medical societies: Interested in a co-branded physician reception area flyer with your logo? Contact [email protected] to learn more.
- Medicare payment reform: What patients should know (PDF): This printable one-page PDF provides your patients with easy-to-understand information on Medicare physician payment reform, how it may impact their access to care and what they can do about it—including a QR code to FixMedicareNow.org where there can learn more, share their personal stories and take action by contacting their members of Congress.
