December 14, 2023

Will Congress Address Medicare Physician Payment Cuts?

The Centers for Medicare and Medicaid Services (CMS) finalized a 3.37% cut in Medicare physician payment in the Calendar Year 2024 Medicare Physician Fee Schedule (MPFS) final rule in November, which led to increased pressure by the American College of Radiology® (ACR®) and the physician community for Congress to stop the full cut.

Last month, the College led a coalition of physician and non-physician groups in a communication to congressional leadership, urging Congress to stop the full cut, which is the result of efforts to increase payments for primary care. In addition, ACR members have also been contacting their lawmakers through a call-to-action which urges lawmakers to address the cut.

Despite a year-long effort by the ACR and the house of organized medicine, it appears Congress will not address looming Medicare conversion factor cuts before the end of this calendar year. As such, the CMS-finalized -3.37% conversion factor reduction will likely go into effect beginning Jan. 1, 2024. We will continue to work with the entire provider community to pressure Congress to mitigate these planned cuts and expect the House and Senate will address this issue when the Congress debates the next government-wide funding Continuing Resolution (CR) that expires on Jan. 19, 2024. We anticipate that once Congress finally votes on this payment issue, claims will be adjusted retroactive to Jan. 1, 2024.

Although there is no congressional consensus yet, ACR is encouraged by the various proposals to address these cuts. On Nov. 8, the Senate Committee on Finance voted in favor of the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, which included a 1.25% increase to the 2024 Medicare physician payment conversion factor. Last week, the House Energy and Commerce Committee voted in favor of a similar proposal, H.R. 6545, the Physician Fee Schedule Update and Improvements Act, that also includes a 1.25% increase to the conversion factor. Lastly, a bipartisan group of legislators, led by Rep. Greg Murphy, MD (R-NC), introduced H.R. 6683, the Preserving Seniors' Access to Physicians Act—legislation, that if enacted, would completely eliminate the scheduled 3.37% physician payment cut. It’s possible that one of these proposals will be voted on and finalized in January.

Please stay tuned to updates on this highly fluid Congressional situation. For more information, contact Rebecca Spangler, ACR Senior Government Affairs Director.