Reversing Medicare payment cuts to doctors | Bills and Laws

The skinny

Lawmakers in Congress are pushing legislation that would block cuts in Medicare payments to doctors. The measure would offer physicians a bump.

U.S. Reps. Greg Murphy, R-N.C., left, a physician, and Jimmy Panetta, D-Calif., have sponsored a bill to reverse cuts in Medicare payments to doctors.

Sponsors

The two prime sponsors are U.S. Reps. Greg Murphy, a North Carolina Republican and a physician, and Jimmy Panetta, a Democrat from California.

Summary

Lawmakers say the legislation would avert a 2.83% reduction in Medicare reimbursements to doctors, which took effect Jan. 1. In addition, the measure would also provide a 2% increase in payments to doctors.

Analysis

Doctors and health systems blasted Congress for the cuts in Medicare payments, which come after years of reductions in reimbursements.

Healthcare advocacy groups thought they were on track to avert the payment cuts in a spending package approved by Congress in December. However, the short-term spending bill didn’t address the reductions, to the dismay of physicians and healthcare organizations.

“Physicians in America are facing unprecedented financial viability challenges due to continued Medicare cuts. Access to affordable and quality health care for millions of seniors is in severe jeopardy," Murphy, MD, said in a statement.

Several lawmakers, including some House members who are physicians, are backing the bill. The measure is dubbed the “Medicare Patient Access and Practice Stabilization Act.”

Panetta touted the importance of being fair to doctors and making sure seniors can find physicians. He said the bipartisan bill “would ensure that providers are not penalized by harmful cuts while adjusting reimbursements for inflation.”

Doctors and their advocates have long argued that continued cuts in Medicare reimbursements are posing hardships on practices. Some say it’s spurring doctors to opt against accepting Medicare patients. With many Americans already struggling to find primary care doctors, lawmakers say continued cuts will only make it more difficult for patients.

“The expense of providing care continues to rise due to medical inflation,” Murphy said in a news release touting the bill. “This inflation, coupled with declining reimbursement rates, creates enormous financial pressures on physicians, forcing many to retire early, stop accepting new Medicare patients, or sell out to larger, consolidated hospital systems, private equity, or even insurance companies.”

U.S. Rep. Raul Ruiz, a California Democrat and a physician, said Medicare payments need to account for the costs physicians are facing.

“Medicare is essential to ensuring seniors have access to care, especially in rural and under-resourced communities," Ruiz, MD, said in a statement. "Rising costs and administrative burdens make it clear that Medicare reimbursement policies must reflect the true costs of providing care.”

Supporters

The American Medical Association has strongly backed the bill. Bruce A. Scott, MD, president of the AMA, said the trend of cuts in payments “is unsustainable.”

“Patient access to care and practice sustainability are not partisan or geographical issues,” Scott said in a statement backing the bill. “It’s an urgent national issue that demands immediate attention from Congress.”

Anders Gilberg, senior vice president of government affairs for the Medical Group Management Association, is urging Congress to support the legislation.

Physician practices that aren’t part of larger health systems are particularly vulnerable to cuts, he said.

“Without immediate congressional action on this important legislation, more and more physician practices will be forced to close their doors, unable to keep up with rapidly rising staff salaries, rent, and administrative costs,” Gilberg said in a statement.

Beyond the current fight, healthcare groups have called on Congress for substantial changes in Medicare’s reimbursement policies. Doctors and other healthcare advocates have long argued that reimbursement rates should reflect the annual cost increases doctors and practices are facing each year.

Outlook

There’s clear bipartisan support for the measure, which isn’t quite common in Congress these days. It’s possible that there could be support to at least avert the cuts.

It’s less clear if Congress, and President Trump, would sign off on a bump in payments at a time when Trump is focused on spending less, not more.

The issue is coming to a head. Congress only approved a short-term spending plan to finance the government through March 14. The AMA and other advocates hope this is addressed in the next budget package, or elements of this measure are included in the broader spending plan.