The Centers for Medicare & Medicaid Services (CMS) has finalized a 3.4 percent cut to physician Medicare payments for the upcoming year. This marks the second consecutive year of declining reimbursement rates for physicians. The cuts are part of the final Physician Fee Schedule, which details policy and reimbursement rates for the year.
Physician groups have begun lobbying Congress for a short-term fix immediately after the rule was announced. The Medical Group Management Association, for instance, has called for legislative action to stop the downward spiral in the Medicare program.
The CMS proposed a conversion factor of $32.74, which is a decrease of $1.15 from the current rate. This conversion factor is used to calculate a doctor’s expenses for providing services under Medicare.
In response, the Senate Finance Committee has proposed a 1.25 percent increase in doctor payments in a discussion draft, which, if enacted, would result in a net cut of 2.15 percent instead of 3.4 percent. Last year, Congress mitigated a 4 percent cut to 2 percent for this year and 1.25 percent for 2024 through a provision in an end-of-year spending package.
Additionally, the House Energy and Commerce Committee is considering more comprehensive reforms to how doctor payments are calculated, aiming to better reflect the increasing costs of running a practice, such as higher inflation.
The article also touches on other health policy news, including efforts to improve mental health access and pharmacy benefit manager (PBM) regulations, as well as the distribution of funds to hospitals participating in the 340B drug discount program to offset years of cuts.