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GOP Doctors Caucus Co-Chairs Issue Statement on CMS Final Rule to Reduce Physician Reimbursement

Washington, D.C. -Today, the GOP Doctors Caucus issued the following statement in response to the Centers for Medicare and Medicaid Services (CMS) finalizing its rule to decrease Medicare reimbursement for physician services by 3.4 percent:

“This decision will have an outsized impact on independent physicians, small businesses, and patients in rural communities throughout the nation," said Congressman Greg Murphy, M.D. “Amidst increased practice expenses and workforce shortages, decreasing rates will further drive physicians out of independent practice, consolidating sites of service and leaving patients without accessible patient-centered care. Congress must act to ensure a sustainable Medicare system that delivers for the 65 million Medicare beneficiaries in the nation.”

“Many physicians and providers I have spoken to have had to stop accepting Medicare, and in some cases shutter their practices, because of decisions in Washington to decrease reimbursement rates. These rates are not keeping up with the increased costs medical practices contend with,” said Congressman Brad Wenstrup, D.P.M. “This country faces critical shortages in access to quality health care, particularly in rural and underserved areas, and this CMS decision will only further hurt these patients. It’s time for Congress to act to protect them and ensure Medicare remains sustainable in the future for both patients and providers.”

“The GOP Doctors Caucus stands united in opposition to the Centers for Medicare and Medicaid Services' decision to decrease Medicare reimbursement for physician services. This adjustment will disproportionately affect physicians and small independent practices that serve as a lifeline for rural areas and communities across America,” said Congressman Michael C. Burgess, M.D. “Ultimately, a reduction in reimbursement combined with physician burnout, a limited health care workforce, and practice consolidation will have detrimental effects on the health care ecosystem. We will remain committed to working towards improving the reimbursement system and empowering physicians to continuing to serve American seniors.”

Background

The Centers for Medicare and Medicaid Services finalized its proposed rule to reduce the CY 2024 PFS conversion factor to $32.75, a decrease of 3.4% from the current conversion factor.

Rising costs and shrinking reimbursement rates threaten Medicare beneficiaries’ access to health care, exacerbate vertical consolidation, and drive patients toward higher cost service sites. Last month, the GOP Doctors Caucus released a discussion draft of legislation to address these issues by reforming the Medicare Physician Fee Schedule (MPFS) in the following ways:

  • Changing the threshold for applying budget neutrality from $20 million to $53 million to reflect the increase in the Medicare Economic Index since the threshold was last updated. 
     
  • Creating a lookback period for overestimates or underestimates in MPFS spending to ensure that any over or underpayments are not carried over into future rates and require that CMS use the best data available when creating a prospective payment adjustment.
     
  • Updating prices for direct expenses related to budget neutrality adjustments to more frequently and accurately update the costs used to calculate the Relative Value Units (RVUs.)
     
  • Limiting year-to-year variance in the conversion factor by 2.5% to provide stability for the MPFS.