More Legislative Efforts Announced to Address Medicare Cuts 

20 Feb, 2024 F.J. Thomas

                               

Sarasota, FL (WorkersCompensation.com) – Physicians received a 3.4 percent cut in Medicare rates at the first of this year as a result of an ongoing decrease of the conversion factor used to calculate rates. For 2024, CMS set the conversion factor at $32.74, representing $1.15 decrease from $33.89 last year. 

According to a Fierce Healthcare report in December, the American Medical Association (AMA) summarized the issue in a statement, “the cost of running a practice will increase 4.6% in 2024, yet physicians are being subjected to a 3.37% cut next yea.r”  When explained in such a simple way, it’s easy to see that the current path of healthcare is not sustainable. 

The AMA has been active in lobbying for new legislation to stop the reimbursement cuts in to an attempt to rectify the track on which healthcare is headed. Backed by the AMA, H.R. 6683, the Preserving Seniors’ Access to Physicians Act, which eliminates the 2024 reductions, was introduced on December 7th of last year. The bill would increase payment by 4.62 percent, while current law provides for a 1.25 increase. 

While H.R. 6683 addresses reimbursement, a bipartisan group of senators announced last week their efforts to form a “Medicare payment reform working group” to address not only the Medicare reimbursement rates, but to also revise the Medicare Access and CHIP Reauthorization Act (MACRA) created in 2015. The group working on the legislation includes U.S. Senators Catherine Cortez Masto (D-Nev.), Marsha Blackburn (R-Tenn.), John Thune (R-S.D.), John Barrasso (R-Wyo.), Debbie Stabenow (D-Mich.), and Mark Warner (D-Va.). 

The goal of the working group, as stated in the announcement, is to make sure Medicare is on a sustainable path to “ensure financial stability for providers, improve patient outcomes, promote access to quality care, and incentivize the utilization of emerging health care technology.” The group acknowledges that while the focus has been to move towards a value-based payment system, more work is required to overcome the hurdles with reimbursement and move towards an incentive system in which payments are in alignment with patient outcomes. 

The announcement also states that they will be investigating the current Medicare fee schedule structure, and seeking feedback from stakeholders in their process of developing policies aimed at addressing physician reimbursement long-term. 

The AMA has stated that overall, physician reimbursement has dropped more than 26 percent since 2001. One specific area that has been impacted greatly by Medicare over the last several years has been Radiology. According to an August report from Radiology Business, radiologists have lost 31.9 percent in revenue since 2005, adjusting for inflation. The total is equal to $2.8 billion. 


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    About The Author

    • F.J. Thomas

      F.J. Thomas has worked in healthcare business for more than fifteen years in Tennessee. Her experience as a contract appeals analyst has given her an intimate grasp of the inner workings of both the provider and insurance world. Knowing first hand that the industry is constantly changing, she strives to find resources and information you can use.

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