Lawmakers Introduce Legislation to Reform Medicare Physician Payment

Representatives Greg Murphy, MD, (R-NC) and Tom Suozzi (D-NY) introduced HR 8163, the Provider Reimbursement Stability Act, which provides the Centers for Medicare and Medicaid Services (CMS) with more flexibility to adjust physician payment while capping the volatility of year-to-year rate changes.

The bipartisan legislation focuses on reforming the Medicare budget's neutrality rules:

• Increase the budget neutrality threshold from $20 million to $54.3 million and tie it to the Medicare Economic Index (MEI) to prevent marginal cost increases from triggering across-the-board Medicare payment cuts that hinder patient access.

• Allow CMS to implement more effective budget neutrality corrections related to projected payment rates, preventing underpayment for services.

• Provide more consistent updates to direct costs used to calculate practice expense relative value units (RVUs) to ensure the reimbursement accurately reflects the actual costs of running a practice.

• Cap year-to-year fluctuations in the Medicare Physician Fee Schedule (MPFS) conversion factor at 2.5% to promote reimbursement stability that allows podiatry practices to plan long-term.

During APMA's recent Legislative Conference, Representative Murphy emphasized the importance of advancing reforms through Congress. Fixing the broken Medicare physician payment system remains one of APMA's top policy priorities. Last month, more than 100 podiatrists traveled to Capitol Hill to urge Congress to stabilize Medicare physician payments by tying them to practice cost inflation, reforming Medicare's budget neutrality requirements, and addressing the burdensome Merit-based Incentive Payment System (MIPS).

APMA continues to work with champions in Congress to develop other reform proposals.