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Nov 9, 2023

Contact: Grant Herring

USPA: Congress Must Mitigate Forthcoming Medicare Reimbursement Cuts

Office-based providers push for H.R. 3674

Washington, DC — Last week CMS has once again finalized cuts that jeopardize the financial sustainability of physician practices and the availability of essential treatments and procedures for seniors. USPA is expressing concern over the final Medicare Physician Fee Schedule (MPFS) for calendar year 2024 because it spells bad news for patients and office-based providers.

“Budget-neutrality” remains a driver of cuts within the fee schedule as the 2024 PFS Finalized Rule includes a carry-over 3.4% cut to the conversion factor from the 2021 PFS E/M policy and, the third-year of clinical labor cuts to office-based specialty relative value units (RVUs) from the 2022 PFS Clinical Labor policy that cuts some specialists by another 3%.

As a result of the finalized rule, certain office-based specialists will again be cut by another 6 - 7% in 2024 alone. These year-over-year cuts are being implemented without regard to patient outcomes, actual PFS provider resource needs, or any other rationale policy.

Physician payments under the MPFS = RVUs (relative value units) * conversion factor. H.R. 3674 addresses ongoing RVU cuts due to the clinical labor policy and other policies which have been the main source of office-based specialty cuts in recent years.

USPA has endorsed the Providing Relief and Stability for Medicare Patients Act of 2023 (H.R. 3674), introduced by Rep. Gus Bilirakis (R-FL-12), Rep. Tony Cardenas (D-CA-29), Rep. Greg Murphy, MD (R-NC-3), and Rep. Danny Davis (IL-D-7).

Together with the Strengthening Medicare for Patients and Providers Act (H.R. 2474), which addresses ongoing conversion factor cuts, H.R. 3674 will prevent major disruptions to care while addressing concerns about the future of Medicare physician payments.

Dr. Mark Garcia, USPA board member and CMO for American Vascular Associates, said, “It’s utterly shocking that CMS continues to go down this road of implementing Medicare cuts year over year because it is adding up to be a disaster for seniors. Specialized care provided in community settings is a vital component of our country's healthcare system. In its absence, we would see a spike in healthcare costs and a decline in the standard of care provided. The dramatic year-to-year swings are causing chaos across our healthcare system. We need Congress to right this wrong by passing H.R. 3674 by the end of the year.”

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