GOP Doctors Caucus Co-Chair John Joyce (R-PA) and U.S. Rep. Greg Murphy (R-NC) on July 15 joined a bipartisan contingent of fellow lawmakers to introduce legislation that would modify certain physician payments under the Medicare program.
“The House of Medicine is at a crossroads. We can maintain the status quo that rewards more costly, less personalized care, or we can put our heads together to build a modern framework that addresses the challenges that impede physicians’ ability to care for their patients,” Rep. Joyce said. “We often talk about expanding access to high-quality care, but without meaningful Medicare reimbursement reform, that mission becomes nearly impossible to achieve.”
Rep. Joyce sponsored the bipartisan Patients First Act, H.R. 9693, alongside 27 original cosponsors, including Rep. Murphy and U.S. Reps. Buddy Carter (R-GA), Carol Miller (R-WV), Darin LaHood (R-IL), and Kim Schrier (D-WA).
The bill would reform the 2015 Medicare Access and CHIP Reauthorization Act to preserve access to primary and specialty care physicians, bolster incentives for independent practice, and reverse decades of consolidation that have driven up the cost of care, especially in rural and underserved communities.
“Putting patients ahead of politics, we worked together to develop this comprehensive legislation to address a system that has for far too long undermined patient access to affordable, physician-driven care within their communities. We can and must do better,” said Rep. Joyce.
If enacted, H.R. 9693 would tie physician reimbursement to an inflationary measure and establish a primary care hybrid payment pilot program that pays primary care physicians a per-member-per-month payment along with regular services, according to a bill summary provided by the lawmakers.
“Our current Medicare physician payment system is unsustainable. It has fueled consolidation, increased administrative burdens, and made it harder for independent physicians in rural communities to continue serving the patients who rely on them,” Rep. Murphy said. “The bipartisan Patients First Act delivers long-overdue reforms that strengthen independent practices, invest in primary care, and ensure physicians can spend more time caring for patients instead of navigating bureaucracy. When physicians succeed, patients receive better care, and that’s exactly what this legislation is designed to achieve.”
The bill also would create the POINTS program, which would establish a physician and clinician-led task force at the Centers for Medicare & Medicaid Services to develop quality metrics that are streamlined and reduce administrative burden.
Additionally, the measure would freeze A-APM (Advanced-Alternative Payment Model) participation thresholds for three years and create notice and comment periods for Center for Medicare and Medicaid Innovation mandatory models, and would increase the budget neutrality threshold from $20 million to $54.3 million, the summary says.
“This proposal deserves serious consideration because the future of patient care, the strength of our physician workforce, and the survival of independent practice all hinge on whether we choose to act rather than accept inaction,” added Rep. Joyce.