Congress Must Protect Physicians From Medicare Cuts: MGMA

This article originally appeared on Medical Economics^®.

Medicare cuts are coming and that’s bad news for physicians, but there is still time for federal lawmakers to act.

The Medical Group Management Association (MGMA) submitted its policy analysis on Medicare in comments for the House Committee on Energy & Commerce. The committee’s Subcommittee on Health has been meeting this month to discuss pending legislation, pressing issues in health care, and how federal regulations are affecting physicians, patients, and the health care sector.

Debate and testimony started in the hearing “What’s the Prognosis? Examining Medicare Proposals to Improve Patient Access to Care & Minimize Red Tape for Doctors.” MGMA Senior Vice President-Government Affairs Anders Gilberg submitted written comments for that hearing.

Anders Gilberg, senior vice president-government affairs, Medical Group Management Association

“While MGMA is supportive of a fiscally responsible Medicare system that puts patients first, we remain concerned that current policies place unnecessary administrative burdens on medical groups, thus impacting access to care,” said the letter from Gilberg to subcommittee Chair Representative Brett Guthrie, R-Kentucky, and Ranking Member Representative Anna Eshoo, D-California.

Next year could bring a 3.36% cut in the conversion factor, as proposed by CMS. Congress needs to work stop that, Gilberg said. From 2001 to 2023, Medicare physician payment has effectively decreased by 26% when adjusted for inflation, he said.

An alternative is in the bill known as the “Strengthening Medicare for Patients and Providers Act.” It would create a yearly Medicare physician payment update tied to inflation, based on the Medicare Economic Index, Gilberg said.

“Addressing the proposed conversion factor cut and providing sustainable reimbursement will allow medical groups to thrive and focus on providing high-quality care,” he said in the letter.

Bills That Could Help

MGMA members were nearly unanimous (97%) agreeing fewer regulatory burdens would allow them to dedicate more resources to patient care. MGMA is endorsing additional legislation to change health care for the better.

• The “Provider Reimbursement Stability Act of 2023” would improve Medicare’s budget neutrality requirement toward a more appropriate reimbursement system. MGMA member practices report they limit new Medicare patients, reduce charity care, reduce clinical staff, and close satellite locations, all due to potential cuts to Medicare payments.
• The “Improving Seniors’ Timely Access to Care Act of 2023” would alleviate burdensome prior authorization requirements that take time and effort away from patient care. Previous versions of this proposal have had wide bipartisan support in the House and Senate, and widespread industry support.
• The “Saving Access to Laboratory Services Act” (SALSA) would update Medicare payments to create sustainable support for clinical laboratory services. Without it, Medicare will lower reimbursement up to 15% for about 800 laboratory tests used to screen and manage diseases.
• The “Fewer Burdens for Better Care Act of 2023” would clarify the evaluation process for the Merit-based Incentive Payment System (MIPS). MGMA surveyed members and found 83% reported CMS’ feedback on MIPS quality members did not help them improve clinical outcomes.
• Amending Title XVIII of the Social Security Act would extend incentive payments for practices in transition from fee-for-service to alternative payment models (APMs). MGMA advocates making it easier for practices to participate in APMs, not more difficult, because Medicare aims to have every beneficiary in an accountable care arrangement by 2030.
• The “Telehealth Privacy Act of 2023” would allow physicians to provide telehealth services from home without making their home addresses public. Billing for work at home, but using a business address, was allowed during the COVID-19 pandemic but will change in 2024. The rule allows for greater security for health care practitioners.
• The “Small, Underserved, and Rural Support (SURS) Extension Act of 2023” would help small practices “comply with the complex and ever-changing MIPS program,” helping them develop infrastructure and knowledge to succeed through 2029.