SHM Joins Sign-On Letter of Support for the Provider Reimbursement Stability Act

Dear Representatives Murphy and Suozzi,

The undersigned physician organizations representing national medical specialty societies and state medical associations write to express our strong support for H.R. 8163, the “Provider Reimbursement Stability Act.” This legislation represents a necessary step toward building a more rational, predictable Medicare physician payment system that preserves patient access to care and reflects the true cost of delivering high-quality medical services.

Medicare physician payment has eroded dramatically over the past two decades. When adjusted for inflation, physician practice payments from Medicare have fallen by approximately 33 percent since 2001, even as the costs of running a medical practice have continued to climb. Physicians are the only Medicare provider type that does not receive an annual payment update tied to inflation. At the same time, the budget neutrality requirements governing the Medicare Physician Fee Schedule (MPFS) have compounded this problem, triggering across-the-board conversion factor reductions that undermine the financial stability of physician practices year after year. These persistent payment cuts have real consequences for patient access to physician services. This important legislation directly addresses the structural flaws driving these outcomes and advances several targeted, complementary reforms to improve the stability and accuracy of the MPFS.

We strongly support the two-year look-back period for the Centers for Medicare & Medicaid Services (CMS) to prospectively correct utilization misestimates for newly unbundled codes. This targeted modification addresses statutory budget neutrality requirements within the MPFS, which currently implement certain services based on sometimes inaccurate utilization predictions, leading to compounding financial losses. Currently, there is no systematic process to reconcile the difference, meaning physicians may be penalized indefinitely for estimation errors that have nothing to do with the care they provide. We have long advocated for this type of correction mechanism, and we are pleased to see it incorporated into this legislation.

Clinical staff wage rates, medical supply prices, and equipment prices often reflect data that is years out of date, creating inaccurate signals about the relative resource costs of different services and leading to large, disruptive redistributions when updates eventually occur. By requiring CMS to update all categories of direct cost inputs simultaneously and at least once every five years, as well as mandating the Agency consult with physician specialty societies when undertaking this task, the bill introduces a systematic, transparent, and less disruptive approach to keeping practice expense data current and accurate. We strongly support this provision and encourage robust stakeholder engagement as CMS implements these updates.

The current $20 million threshold, unchanged since 1992, is woefully outdated and bears no relationship to the size and complexity of today’s MPFS. By raising the threshold to $54.3 million beginning in 2027 and indexing it every five years to the Medicare Economic Index (MEI), the legislation introduces long-overdue modernization.

The bill also includes a cap on year-to-year variance in the conversion factor at 2.5 percent, providing guardrails against dramatic swings in either direction. This limitation excludes statutory increases for the Merit-based Incentive Payment System or Alternative Payment Models and future MEI adjustments, offering a degree of predictability in the financial environment for physicians.

We strongly support the Provider Reimbursement Stability Act and urge its prompt passage. This legislation should be understood as part of a broader reform agenda, and we continue to call for an annual inflationary update to Medicare physician payments tied to the MEI. Together, these reforms would go far toward establishing a Medicare physician payment system that is adequate, stable, predictable, and reflective of the actual costs of delivering care.

We commend your leadership in introducing H.R. 8163 and urge your colleagues to cosponsor it and show strong House support for passage. Physicians and their patients cannot afford further delay. Thank you for your commitment to ensuring a stable, sustainable Medicare program. We look forward to working with you to advance this critical legislation.

Sincerely,

American Medical Association
American Society for Dermatologic Surgery Association
Society for Cardiovascular Magnetic Resonance
Association of American Medical Colleges
Academy of Physicians in Clinical Research
American Academy of Allergy, Asthma & Immunology
American Academy of Dermatology Association
American Academy of Facial Plastic and Reconstructive Surgery
American Academy of Family Physicians
American Academy of Hospice and Palliative Medicine
American Academy of Neurology
American Academy of Ophthalmology
American Academy of Otolaryngic Allergy
American Academy of Otolaryngology – Head and Neck Surgery
American Academy of Sleep Medicine
American Association for Geriatric Psychiatry
American Association of Hip and Knee Surgeons
American Association of Neurological Surgeons /
Congress of Neurological Surgeons
American Association of Orthopaedic Surgeons
American College of Allergy, Asthma and Immunology
American College of Cardiology
American College of Emergency Physicians
American College of Lifestyle Medicine
American College of Medical Genetics and Genomics
American College of Obstetricians & Gynecologists
American College of Physicians
American College of Radiology
American College of Rheumatology
American College of Surgeons
American Epilepsy Society
American Gastroenterological Association
American Geriatrics Society
American Orthopaedic Foot & Ankle Society
American Psychiatric Association
American Society for Clinical Pathology
American Society for Gastrointestinal Endoscopy
American Society for Laser Medicine and Surgery, Inc.
American Society for Radiation Oncology
American Society for Surgery of the Hand Professional Organization
American Society of Anesthesiologists
American Society of Cataract & Refractive Surgery
American Society of Echocardiography
American Society of Hematology
American Society of Interventional Pain Physicians
American Society of Neuroradiology
American Society of Nuclear Cardiology
American Society of Plastic Surgeons
American Society of Regional Anesthesia and Pain Medicine
American Society of Retina Specialists
American Society of Transplant Surgeons
American Urogynecologic Society
Association for Clinical Oncology
College of American Pathologists
Congress of Neurological Surgeons
Endocrine Society
Infectious Diseases Society of America
International Pain and Spine Intervention Society
Medical Group Management Association
National Association of Medical Examiners
National Medical Association
Outpatient Endovascular and Interventional Society
Post-Acute and Long-Term Care Medical Association
Renal Physicians Association
Society for Cardiovascular Angiography and  Interventions
Society for Vascular Surgery
Society of American Gastrointestinal and Endoscopic Surgeons
Society of Cardiovascular Computed Tomography
Society of Critical Care Medicine
Society of Hospital Medicine
Society of Interventional Radiology
The American Society of Dermatopathology
The Society of Thoracic Surgeons
Medical Association of the State of Alabama
Alaska State Medical Association
Arizona Medical Association
Arkansas Medical Society
California Medical Association
Colorado Medical Society
Connecticut State Medical Society
Medical Society of the District of Columbia
Medical Society of Delaware
Florida Medical Association
Medical Association of Georgia
Hawaii Medical Association
Idaho Medical Association
Illinois State Medical Society
Indiana State Medical Association
Iowa Medical Society
Kansas Medical Society
Kentucky Medical Association
Louisiana State Medical Society
Maine Medical Association
MedChi, The Maryland State Medical Society
Massachusetts Medical Society
Michigan State Medical Society
Minnesota Medical Association
Mississippi State Medical Association
Missouri State Medical Association
Montana Medical Association
Nebraska Medical Association
Nevada State Medical Association
New Hampshire Medical Society
Medical Society of New Jersey
New Mexico Medical Society
The Medical Society of the State of New York
North Carolina Medical Society
North Dakota Medical Association
Ohio State Medical Association
Oklahoma State Medical Association
Oregon Medical Association
Pennsylvania Medical Society
Rhode Island Medical Society
South Carolina Medical Association
South Dakota State Medical Association
Tennessee Medical Association
Texas Medical Association
Utah Medical Association
Vermont Medical Society
Medical Society of Virginia
Washington State Medical Association
West Virginia State Medical Association
Wisconsin Medical Society
Wyoming Medical Society

cc:

The Honorable John Joyce, MD
The Honorable Bob Onder, MD
The Honorable Mariannette Miller-Meeks, MD
The Honorable Brad Schneider
The Honorable Jimmy Panetta
The Honorable Kim Schrier, MD
The Honorable Robin Kelly