Congress has signed a pared-down funding bill to prevent a government shutdown but failed to pass measures in a previously proposed bipartisan package that would have offset the 2.83% Medicare pay cut physicians face in 2025.
The Medical Group Management Association expressed relief over temporary extensions for telehealth flexibilities and the 1.0 work GPCI floor but criticized Congress for failing to avert the 2.83% Medicare physician reimbursement cut starting January 1.
"The previously agreed-upon [continuing resolution], while not perfect, would have critically averted most of the 2.83% cut to physician reimbursement in Medicare beginning January 1," Anders Gilberg, senior vice president of government affairs, said in a statement. "Now physician practices head into the new year facing uncertainty and financial shortfalls that not only negatively impact the viability of their Medicare business, but their commercial contracts tied to Medicare rates, as well as Medicaid reimbursement in states that use Medicare as a benchmark."
Physicians' Medicare pay rates have dropped 33% over 20 years, and Congress has ignored inflation adjustments, prior authorization reforms and rising care costs, according to the American Medical Association.
"For the fifth consecutive year, Congress has adjourned and allowed Medicare cuts. What will be the result? Patients struggling to access health care. Physicians closing or selling their private practices while others opt to leave the profession," AMA President Bruce Scott, MD, said.
The AMA also criticized lawmakers for missing a "golden opportunity" to improve patient care by failing to include prior authorization reform — which had bipartisan support in the House and the Senate — in the final package.
"Leaving it on the cutting room floor is an unnecessary gift to the insurance industry at the expense of our patients," Dr. Scott said. "Physicians have unique training and expertise when prescribing appropriate care, and we don’t need insurance companies delaying and interfering with our patients’ vital treatments."
The AMA and MGMA urged Congress to retroactively address the reimbursement cut and enact permanent Medicare payment reforms to support physicians, medical groups and patient care.