What’s the news: A bipartisan majority of the House of Representatives—233—has signed onto a letter that urges House leadership to “expeditiously pass legislative fixes” that stop a “harmful” 2.8% Medicare physician payment cut slated for Jan. 1 and give physicians a payment update “that takes into account the cost of actually delivering care to patients.”
Reps. Mariannette Miller-Meeks, MD (R-Iowa), and Jimmy Panetta (D-Calif.), along with a bipartisan group of physician representatives, initiated and acquired additional signatures for the letter addressed to House Speaker Mike Johnson (R-La.) and House Minority Leader Hakeem Jeffries (D-N.Y.). The AMA, thousands of physicians, and their state and specialty societies urged members of Congress to sign onto the letter before it was sent to leadership.
“As a physician, I am thrilled to lead more than 200 bipartisan House members in urging leadership on both sides to address the proposed doc reimbursement cuts,” Miller-Meeks said in a news release issued Tuesday. “The overwhelming, bipartisan support is a testament to the importance of fixing this issue to preserve patient access to quality care. Long-term payment reform is still desperately needed, but a temporary fix is also critical. In Congress, I will continue to lead the charge for better health access and outcomes for Americans.”
The letter notes that the 2.8% reduction proposed in the 2025 Medicare Physician Fee Schedule (MPFS) marks the fifth consecutive year that the Centers for Medicare & Medicaid Services’ (CMS) fee schedule proposal lowered payments to physicians and other clinicians.
“As physicians face yet another year of pending cuts stemming from the Medicare Physician Fee Schedule, the AMA appreciates that a majority of House members cosigned a letter urging Congress to stop this harmful cycle,” said AMA President Bruce A. Scott, MD. “This unsustainable onslaught of annual cuts must cease, and physicians must receive a long-overdue and desperately needed payment increase. We applaud Reps. Miller-Meeks and Panetta for their leadership and thank the more than 218 bipartisan members of Congress who recognized that the status quo is not an option. We need Congress to fix Medicare stat!”
In an AMA news release, Dr. Scott added that “we have an upcoming election and only a short time to act. But the good news is that instead of gridlock, we have agreement. Instead of conflict, we have compromise. Let’s get to work and pass these crucial policy changes before the end of the year.”
The AMA is leading the charge to reform the Medicare payment system.
Why it matters: The letter notes that “while Congress has stepped in the past four years to pass legislation to mitigate portions of these cuts, the fact remains that the MPFS is inherently broken. Continued payment cuts undermine the ability of independent clinical practices—especially in rural and underserved areas—to care for their community, which reduces patient access to care.”
The lower payments to physicians have resulted in practice hiring freezes, delayed system improvements and care model changes—including transitioning to value-based care systems—and cutting services offered to patients.
“Because health care often comprises a large percentage of employment in rural areas, the closure of independent practices not only lessens patient access to care, but also jeopardizes the livelihood of rural Americans,” the letter tells House leadership.
The letter also highlights the AMA’s research that shows that physician Medicare pay, when adjusted for inflation, has dropped by 29% since 2001 (PDF). And it informs congressional leaders that the MPFS itself highlights the fact that rent, paying staff and buying supplies are all expected to increase even more in 2025.
“This ever-widening gap between what Medicare pays physicians and other clinicians and the cost of delivering quality care to patients demands Congressional intervention,” the letter says.
The “dear colleague” congressional letter urges Speaker Johnson and Minority Leader Jeffries to pass proposed legislation that the AMA and the Federation of Medicine supports and has lobbied for, too, so that physicians will have the financial resources to keep providing care for the nation’s older and disabled adults.
Without changes to the system, the Medicare program is on an unsustainable path where access to care is threatened, the AMA has told Congress for a number of years. Temporary patches aren’t sustainable and a rational payment system would better meet Americans’ needs.
To fix the system, the AMA supports the bipartisan Strengthening Medicare for Patients Providers Act, that would provide physicians with an annual Medicare payment update tied to the Medicare Economic Index (MEI). It also supports the bipartisan Provider Reimbursement Stability Act, which would reform the Medicare payment schedule budget-neutrality policies by, among other things, requiring CMS to reconcile inaccurate utilization projections based on actual claims and prospectively revise the conversion factor accordingly.
The letter to the House leadership doesn’t name the bills before Congress by name, but it urges congressional leadership to move legislation to:
- Provide physicians and other clinicians with a permanent, annual inflationary update in Medicare equivalent to the MEI.
- Enact targeted reforms to the statutory MPFS budget, raise the current MPFS budget neutrality threshold to be reflective of 2024 dollars, and require CMS to cross-check utilization assumptions associated with a narrow set of newly unbundled codes that trigger budget neutrality cuts to correct any misestimates.
- Mandate that CMS review key elements of practice expense costs concurrently and no less often than every five years.
- Limit changes to the MPFS conversion factor to no more than 2.5% in a given year.
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“To prevent the very real scenario of insufficient access to physicians and other clinicians treating Medicare patients, Congress must stop the 2.8% payment cut from occurring in 2025, enact targeted reforms to statutory budget-neutrality requirements, and provide physicians with a payment update reflective of inflationary pressures,” the letter says. “We stand ready to work with you to pass crucial bipartisan legislative initiatives before the conclusion of the 118th Congress.”
Learn more: Find the resources you need to advocate for Medicare physician payment changes at the AMA’s Fix Medicare Now website, which includes a link to help you contact your elected officials.
Available resources include a printable Fix Medicare Now flyer (PDF) that can be hung in waiting areas to let patients know that the Medicare payment system is on an unsustainable path that threatens their access to physician. It includes a large QR code for patients to access FixMedicareNow.org where they can learn more about the physician Medicare payment issue, share their personal stories and contact their members of Congress to help ensure their continued access to high-quality care.
Also available for download is a printable, one-page document that spells out what patients should know (PDF) about Medicare payment reform, including an explainer on how the Medicare payment system works and why it is unsustainable. It also contains a QR code to the Fix Medicare Now site.
Editor's note: This story has been updated to reflect the correct number of members of Congress signing on to this "dear colleague" letter regarding Medicare physician payment. The AMA regrets the error.
