October 26, 2023

House Committee Holds Hearing on Medicare Payment Proposals

ACR-Supported Legislation to Strengthen Community and Office-Based Providers Considered


The U.S. House of Representatives Energy and Commerce Subcommittee on Health hosted a hearing featuring American College of Radiology® (ACR®)-supported legislation entitled, “What’s the Prognosis? Examining Medicare Proposals to Improve Patient Access to Care & Minimize Red Tape for Doctors,” last week. Prior to the hearing, ACR joined other medical societies in a communication supporting H.R. 3674, the Providing Relief and Stability for Medicare Patients Act of 2023. Supported by ACR and the Clinical Labor Coalition (CLC), the legislation addresses the needs of specialty physicians practicing in community-based office settings that have been disproportionately impacted by the Centers for Medicare and Medicaid Services (CMS) clinical labor update policy.

The clinical labor update policy, finalized in the CY2022 Medicare Physician Fee Schedule (MPFS) final rule, recognized the need for increased salary rates for all types of clinical labor (e.g., nurses and technologists), but, due to the budget neutrality constraints in the MPFS, decreased reimbursement rates for those services with high supply and equipment costs when performed in a community-based office setting. H.R. 3674, introduced by Reps. Bilirakis (R-FL), Cardenas (D-CA), Murphy (R-NC) and Davis (D-IL), would provide critical relief for office-based specialists by increasing the non-facility/office-based practice expense relative value units negatively impacted by CMS’ clinical labor policy for the next two years.

ACR appreciates the subcommittee’s efforts to highlight this bipartisan legislation in the recent hearing and issued a statement with the CLC commending its inclusion in policy discussions aimed at mitigating forthcoming Medicare reimbursement cuts.

Another proposal discussed during the hearing was a discussion draft  put forward by Reps. Greg Murphy (R-NC), Brad Wenstrup (R-OH), and Michael Burgess (R-TX), working closely with Ways and Means committee chairman Jason Smith (R-MO). The discussion draft’s provisions offer improvements to the physician payment system by assuring that CMS payment policy is based on reality, not projections, and is based largely on a work product developed by the medical community, including ACR. Titled “The Provider Reimbursement Stability Act of 2023,” it seeks to reform the budget neutrality policies applied to the MPFS. While this is a key component of Medicare physician payment reform, it is important for medicine to continue pressing for other proponents of comprehensive reform, including: (1) automatic, annual inflation updates based on the Medicare Economic Index (MEI) as proposed by H.R. 2474 , an ACR-supported bill; (2) reducing administrative burden and improving the clinical relevance of the Merit-based Incentive Payment System (MIPS); and (3) maintaining a viable pathway for physicians to opt into alternative payment models.

While it is unclear if any of the proposals will be advanced, ACR looks forward to working with Congress to ensure policies to address Medicare reimbursement are included in any year-end legislative package. For more information, contact Ashley Walton, ACR Government Affairs Director.