After each presidential election, Congress holds its lame duck session before the new congressional term begins. This time is used by lawmakers to resolve unfinished business from a regular session or deal with specific and/or urgent items.
This year, Congress will need to address several issues, including the 12 major appropriation bills that fund and keep the federal government open past December 20th, and other policy issues that require some kind of action or face expiration of various legislative authorities at the end of the calendar year.
For physicians, no issue is more urgent than the Medicare Physician Fee Schedule (MPFS) and the current proposed 2.8% physician pay cut. Slated to go into effect on January 1, 2025, the cut marks the fifth consecutive year that the Centers for Medicare and Medicaid Services (CMS) has lowered payments to physicians and other clinicians.
This situation is in part the result of payment reforms made in the 2015 Medicare Access and CHIP Reauthorization Act (MACRA). Among other provisions, MACRA did not account for annual inflation of physician payments, based on an assumption that physicians would be able to earn bonuses through the Merit-based Incentive Payment System (MIPS). Because MIPS has not produced the anticipated bonuses, the 2.8% proposed pay cut would be detrimental to physician practices already grappling with high inflation rates.
A bipartisan majority of the House of Representatives—232—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 January 1 and give physicians a payment update “that takes into account the cost of actually delivering care to patients.”¹ It is hoped that the inflation adjustment issue can also be addressed. However, this may be difficult in the year-end session and may carry over into 2025 when
a more comprehensive reform of physician pay can be considered.
There has already been a lot of work done to lay a foundation for action. The issue carries strong bipartisan support and therefore, a strong likelihood of obtaining a desirable outcome—eventually.
Gabriela Villanueva is CAP’s Government and External Affairs Analyst. Questions or comments related to this article should be directed to GVillanueva@CAPphysicians.com.
¹Henry, Tanya A, House majority urges leadership to fix Medicare now, American Medical Association, October 15, 2024, https://www.ama-assn.org/practice-management/medicare-medicaid/house-ma…