The Alliance of Specialty Medicine submitted a statement for the record to the House Energy and Commerce Committee’s Subcommittee on Health for its hearing entitled, “What’s the Prognosis?: Examining Medicare Proposals to Improve Patient Access to Care & Minimize Red Tape for Doctors.”
In its testimony, the Alliance discussed the system-wide impacts of the recent volatility of the Medicare Physician Fee Schedule while noting that the Centers for Medicare and Medicaid Services has proposed another 3.4% reduction in physician reimbursement. It also laid out some proposed solutions to bring stability to the fee schedule including:
- In the short term, avert the reimbursement reduction proposed for Calendar Year 2024.
- Adopt the Strengthening Medicare for Patients and Providers Act of 2024 (R. 2474), bipartisan legislation — led by Energy and Commerce Committee members, Reps. Raul Ruiz, MD (D-CA), Larry Bucshon, MD (R-ID) and Mariannette Miller-Meeks, MD (R-IA) — annually updating the MPFS based on the MEI.
- Increase the threshold at which budget neutrality is triggered (which has never been updated since it was first established in the early nineties) and then provide reasonable, periodic inflationary updates to that threshold. The Provider Reimbursement Stability Act of 2023 incorporates such a provision.
- Direct CMS to establish a consistent and regular approach to updating direct and indirect practice expenses. As noted above, CMS is in the third year of a four-year phase-in of clinical labor price updates, a policy that has created significant reimbursement challenges for many specialties, again due to the budget-neutral nature of the MPFS. In fact, some Alliance specialties will be cut by as much as 22.04% for critical services they deliver due to this policy once fully implemented. These reductions were exacerbated by the fact that CMS had not updated these inputs in 20 years. The Provider Reimbursement Stability Act addresses this problem as well.
