Dive Brief:
- The Medical Group Management Association on Monday sent a letter to congressional leaders asking for a series of actions by the end of the year that it argues are needed to mitigate the impact of 2023 Medicare payment cuts to physicians.
- MGMA has been sounding the alarm for months about a projected 8.5% cut in Medicare payments next year, contending the reduction threatens the financial viability of group practices across the country. In a poll it conducted in August, 90% of medical practices reported that the expected payment cuts would reduce patient access to care, MGMA said.
- Since Medicare finalized the 2023 physician fee schedule this month, MGMA and other healthcare organizations have stepped up calls for Congress to intervene, with the American Medical Association pushing for systemic reforms to Medicare pay.
Dive Insight:
Congress appropriated billions of dollars in additional funding over two years to avoid cuts to Medicare payments during the COVID-19 pandemic. Provider groups last year successfully lobbied lawmakers to delay a 4.5% Medicare payment reduction until 2023.
The 4.5% across-the-board rate reduction, which the CMS attributes to budget neutrality requirements, is now slated to begin Jan. 1. Combined with a 4% Medicare sequester cut that also had been paused, the reductions would force physician practices to close and put further strain on those that remain open, AMA President Jack Resneck said in a statement after the rule was finalized.
“The rate cuts would create immediate financial instability in the Medicare physician payment system and threaten patient access to Medicare-participating physicians,” Resneck said.
The MGMA said action to avert the cuts cannot wait until the next Congress, while 46 senators sent a letter to Senate leaders expressing concerns about the stability of Medicare payments for physicians and support for long-term payment reform.
In its letter to congressional leaders, MGMA said 92% of medical groups indicated that Medicare reimbursement in 2022 did not adequately cover the cost of providing care. “Since reimbursement for these services already does not cover the cost of care provided, payment cuts of at least 8.5% will be catastrophic,” the group said.
MGMA urged Congress to offset the 4.47% reduction to the Medicare physician conversion factor, waive the 4% pay-as-you-go sequester, extend the 5% alternative payment model incentive pay for six years, pass the Improving Seniors Timely Access to Care Act to reform prior authorization, extend Medicare telehealth waivers, pass the Saving Access to Laboratory Services Act as a model for lab test reimbursement and provide additional funds to reward high-performing clinicians with incentive pay.