ACP Advocacy to Prevent Physician Payment Cuts Continues

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Members are encouraged to email congressional representatives and urge them to prioritize addressing the payment cuts before the end of the year

Dec. 2, 2022 (ACP) — The American College of Physicians is working hard to convince Congress to take immediate action to prevent unprecedented cuts to federal reimbursement for medical care and is encouraging members to reach out to policymakers as well.

“ACP has been advocating throughout the year for Congress to prevent the looming payment cuts and also to address the longer-term systemic issues in Medicare that are impacting physicians,” said David Pugach, ACP vice president for governmental affairs and public policy. “These efforts have included direct lobbying, leadership engagement, collaboration with other stakeholders and grassroots physician advocacy. However, more outreach by members is needed to help policymakers understand the impact on physicians and access to care for patients in their communities.”

There are two looming Medicare payment cuts scheduled to take effect on Jan. 1 unless Congress takes action. “One is tied to Congressional budget rules, known as ‘pay-as-you-go’ or ‘PAYGO,’ that require the cost of legislation to be paid for,” Pugach said. “This represents a potential 4 percent cut to Medicare payment rates.”

The other cut is linked to restrictions on the Medicare program that require that payment rate increases in the Medicare Physician Fee Schedule be offset by corresponding decreases to ensure no overall increase in the total cost of the program. “This constraint on Medicare payment rates for physicians is known as budget neutrality and has been an issue for the past few years following revisions to outpatient evaluation and management rates in 2020,” Pugach said. “Congress has provided temporary funding each of the past two years to offset at least a portion of the budget neutrality cut, which will be nearly 4.5 percent in 2023 if Congress does not act again this year.”

Congress is expected to waive the PAYGO requirement and avoid the 4 percent cut because it would impact more than physician payment rates, Pugach said. “However, whether and to what extent Congress addresses the 4.5 percent Medicare budget neutrality cut to physicians is less certain,” he added.

ACP has been urging Congress to act to prevent both cuts from taking effect in January and to provide physician payment rates with an inflationary update based on the Medicare Economic Index. “Most members of Congress do not realize that Medicare payment rates for physicians haven't been updated to account for the rising cost of caring for patients and are facing cuts. They don't understand the impact that this can have on patients' access to care,” Pugach said. “The best way to help lawmakers better appreciate this issue is for them to hear directly from their constituents who care for patients in their communities and are directly impacted by this problem.”

ACP members can utilize the College's grassroots platform to email their congressional representatives. “It is important that the internal medicine community make its voice heard. Members of Congress need to hear from physicians in their communities about why addressing these cuts needs to be prioritized,” Pugach said.

“Looking ahead to next year,” he added, “ACP will be pushing for Congress to address the systemic challenges in Medicare that have put physicians in this untenable situation and have even kept physician payment rates from being updated for inflation.”

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