A bipartisan bill introduced on March 30 by U.S. Reps. Greg Murphy (R-NC) and John Joyce (R-PA) would update the Medicare Physician Fee Schedule (MPFS) to improve stability for physicians and their patients.
“By updating the [MPFS] reimbursement policies, we can protect private practice and ensure access to affordable, high-quality care across the country for generations to come,” said Rep. Murphy, who sponsored the Provider Reimbursement Stability Act, H.R. 8163, alongside eight original cosponsors, including Rep. Joyce and U.S. Reps. Brad Schneider (D-IL) and Tom Suozzi (D-NY).
According to the lawmakers, certain MPFS reimbursement provisions have not been updated since the fee schedule was established in 1992.
“Physicians in America who see Medicare patients are being forced to close their doors because of increasing medical costs and persistent cuts to their reimbursements,” Rep. Murphy added. “With expenses for providing care continuing to rise, declining payments are forcing many doctors into retirement, to stop seeing Medicare patients, or to sell out to consolidated hospital systems, private equity, or even insurance companies just to keep practicing.
“As a result, access to care in rural and underserved communities is drying up,” he said. “In an era of a shortage of physicians, we cannot lose good doctors to these ever-increasing pressures.”
If enacted, H.R. 8163 would increase the budget neutrality threshold from $20 million to $54.3 million and index the threshold to the cumulative percentage increase in the MEI every five years.
Additionally, the bill would provide for budget neutrality corrections related to the estimated utilization of codes, as well as updates to direct costs used to calculate practice expense relative value units not less often than every five years, among other provisions.
Rep. Joyce said this proposal would reverse what he calls a “damaging trend” that negatively impacts healthcare providers nationwide.
“Under the current [MPFS], physicians face unpredictable and unsustainable payment cuts that undermine their ability to deliver consistent care,” said Rep. Joyce. “Stable Medicare reimbursement for physicians is essential to preserving reliable, accessible healthcare for our seniors — particularly those in the rural and underserved communities that I represent.”
The American Medical Association endorsed the measure, which is under consideration by both the U.S. House Energy and Commerce Committee and the U.S. House Ways and Means Committee.