The Centers for Medicare and Medicaid Services (CMS) will soon propose the 2027 Medicare Physician Fee Schedule. While recent fee schedules have included a minimal increase to physician payment through a small increase in the conversion factor and an efficiency adjustment that will positively impact cognitive specialties, recent gains do not do enough to make up for a 33% decrease in reimbursement rates since 2001.

The ACR has long urged Congress to work towards long-term, sustainable reforms to Medicare physician reimbursement to protect patient access to care. The Provider Reimbursement Stabilization Act, led by Representatives Greg Murphy (R-NC) and Tom Suozzi (D-NY) would promote reimbursement stability and protect physicians by: 1) updating the budget neutrality threshold, 2) mandating that CMS evaluate the actual base costs for running a medical practice at least every five years, and 3) revising how CMS addresses incorrect billing codes.

Currently, budget neutrality dictates that if spending increases exceeds $20 million in one area, then that must be offset by other costs in healthcare. The $20 million budget neutrality threshold has remained the same since the early 1990s and has never been adjusted for inflation. H.R. 8163 would modernize this outdated provision, providing a long overdue threshold increase to $54.3 million, and indexing it every five years based on the cumulative percentage increase in the Medical Economic Index (MEI).  

Congress must act to pass policy changes that will address the impact of inflation and budget neutrality requirements on patients’ access to care. America’s physicians and patients deserve better – please contact your members of Congress today and urge them to co-sponsor H.R. 8163! Take a moment to send your letter today!