Washington, D.C.-Today, the GOP Doctors Caucus Co-Chairs released adiscussion draftof legislation seeking to reform the Medicare Physician Fee Schedule (MPFS).
Rising costs and shrinking reimbursement rates continue to threaten Medicare beneficiaries’ access to health care, exacerbate vertical consolidation, and drive patients toward higher cost service sites. By accurately accounting for the cost of services rendered, reconciling pricing adjustments, and requiring timely updates, we provide for an efficient payment system that works for doctors. These updates are vital to promote sustainability in reimbursement and ensure access to high quality health care for American seniors.
This draft legislation seeks to help remedy these serious issues by making the following changes to the Medicare Physician Fee Schedule:
- 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.
“Patients around the country, particularly in rural and underserved areas, face critical shortages when it comes to access to quality health care, "said Rep. Brad Wenstrup, D.P.M.“I have talked to many physicians and providers who have had to refer patients elsewhere, or stopped taking Medicare, because of serious issues with payment from CMS. Our caregivers should receive proper and timely compensation for the incredible jobs they do for patients, and these modest reforms are a starting point to do just that.”
“Physicians across the country, particularly in rural communities, are feeling the burden of declining Medicare reimbursements, "said Co-chair Rep. Greg Murphy, M.D.“To ensure the sustainability of Medicare and access to care for elderly Americans, we must provide certainty and stability of remuneration for physician services. The current Medicare Physician Fee Schedule is outdated and failing. Without making necessary reforms, independent physicians and rural practices will continue to dry up and yield their market share to enormous vertically integrated systems, which are more expensive for taxpayers and patients.”
“Our goal is to ensure a stable reimbursement structure by making it easier for physicians to participate in a payment system that best serves them, "said Co-chair Rep. Michael C. Burgess, M.D.“By updating the budget neutrality threshold, reconciling pricing adjustments, and requiring timely updates to direct practice expenses, we're paving the way for a health care system that can be flexible while guaranteeing sustainability. This draft will help us modernize and recalibrate by providing for stability that physicians need to continue to serve American patients without constraints of outdated measures. It’s a fundamental aspect of ensuring that our health care system evolves in tandem with the ever-changing needs and expectations of both medical professionals and patients alike.”
