Signs Joins Multi-Stakeholder Letter on Medicare Reimbursement

Download Letter   The Honorable Nancy Pelosi Speaker U.S. House of Representatives Washington, DC 20515 The Honorable Charles Schumer Majority Leader U.S. Senate Washington, DC 20510 The Honorable Kevin McCarthy Minority Leader U.S. House of Representatives Washington, DC 20515 The Honorable Mitch McConnell Minority Leader U.S. Senate Washington, DC 20510   Dear Speaker Pelosi, Majority Leader Schumer, Leader McConnell, and Leader McCarthy: The American Medical Association (AMA) and undersigned national specialty and state medical societies representing the vast majority of physicians practicing in the United States continue to be deeply alarmed about the mounting financial instability of the Medicare physician payment system. This instability is being driven by a confluence of fiscal uncertainties physician practices face related to statutory payment cuts, perennial lack of inflationary updates, significant administrative barriers, and the cumulative impact of the pandemic. The Medicare payment system remains on an unsustainable path threatening beneficiaries’ access to physicians. According to an AMA analysis of Medicare Trustees data, Medicare physician payment has been reduced 20% adjusted for inflation from 2001–2021. The Medicare physician payment system lacks an adequate annual physician payment update, unlike those that apply to other Medicare provider payments. Physicians are the only Medicare provider not receiving an inflationary update in 2023. In fact, a continuing statutory freeze in annual Medicare physician payments is scheduled to last until 2026, when updates resume at a rate of 0.25% per year indefinitely, well below inflation rates. The discrepancy between what it costs to run a physician practice and actual payment combined with the administrative and financial burden of participating in Medicare is incentivizing market consolidation. The physician community stands ready to work with Congress to develop long-term solutions to the systemic problems with the Medicare physician payment system and preserve patient access. We appreciate the action late last year that Congress took to delay a “perfect storm” of Medicare payment cuts that, if enacted, would have severely impeded patient access to care. Unfortunately, these delayed cuts, and some new ones, will take effect in 2023. Before the end of the year, we strongly urge Congress to:

• Provide relief from the scheduled -4.42 percent budget neutrality cut in Medicare physician fee schedule payments.
• End the statutory annual freeze and provide a Medicare Economic Index (MEI) update for the coming year.
• Extend the 5 percent Advanced Alternative Payment Model (AAPM) participation incentive and halt the impossible-to-meet revenue threshold increase for five years to encourage more physicians to transition from fee-for-service into APMs.
• Waive the 4 percent PAYGO sequester triggered by passage of the American Rescue Plan Act.

We appreciate your consideration and look forward to working with you and your colleagues to end the destructive cycle of annual Medicare cuts and to establish a permanent Medicare payment system that improves and preserves patient access to physician care. Sincerely,

American Medical Association AMDA – The Society for Post-Acute and Long-Term Care Medicine American Academy of Allergy, Asthma & Immunology American Academy of Dermatology Association 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 Physical Medicine & Rehabilitation American Academy of Sleep Medicine American Association of Clinical Urologists American Association of Hip and Knee Surgeons American Association of Neurological Surgeons American Association of Neuromuscular & Electrodiagnostic Medicine American Association of Orthopaedic Surgeons American College of Allergy, Asthma & Immunology American College of Cardiology American College of Chest Physicians American College of Emergency Physicians American College of Gastroenterology American College of Medical Genetics and Genomics American College of Obstetricians and Gynecologists American College of Osteopathic Internists American College of Physicians American College of Radiation Oncology American College of Radiology American College of Rheumatology American College of Surgeons American Epilepsy Society American Gastroenterological Association American Geriatrics Society American Medical Group Association American Society for Clinical Pathology American Society for Dermatologic Surgery American Society for Dermatologic Surgery Association American Society for Gastrointestinal Endoscopy American Society for Laser Medicine and Surgery American Society for Metabolic & Bariatric Surgery American Society for Radiation Oncology American Society for Surgery of the Hand American Society of Anesthesiologists American Society of Cataract and 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 Retina Specialists American Society of Transplant Surgeons American Thoracic Society American Urogynecologic Society American Urological Association American Vein & Lymphatic Society American Society of Addiction Medicine Association for Clinical Oncology College of American Pathologists Congress of Neurological Surgeons Endocrine Society Heart Rhythm Society International Society for Advancement of Spine Surgery Medical Group Management Association National Association of Spine Specialists Obesity Medicine Association Outpatient Endovascular & Interventional Society Society for Cardiovascular Angiography and Interventions Society for Vascular Surgery Society of Cardiovascular Computed Tomography Society of Hospital Medicine Society of Interventional Radiology Society of Thoracic Surgeons Spine Intervention Society 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 Delaware Medical Society of the District of Columbia Florida Medical Association Inc 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 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