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LUGPA Policy Update - 2024 Medicare Physician Payment Cuts

Congress Releases Short-Term Funding Resolution, No Relief for MPFS Cut in 2024

Jan. 15, 2024

Last night, Congress released the text of a short-term resolution to fund the government through March 1 (for four agencies) and March 8 (for the remaining eight agencies). It’s important to note that this package contains NO relief concerning the 3.4% physician payment cut applicable for 2024. This package is expected to be voted on by both chambers this week.

We understand that mitigation of physician payment cuts remains at the forefront of Congressional health negotiations, and we expect that some relief will likely be included in the next government funding package by March 8. But given this news, we expect CMS to cease holding claims and implement the full 3.4% cut to physician payment. Further guidance from CMS is expected as soon as this week.

It is also our understanding that whatever mitigation Congress eventually passes for physicians will not be retrospective, but they are expected to increase the amount of relief slightly to account for what the relief amount would have been had the mitigation taken place beginning January 1, 2024.

We remain in close contact with all the key legislators and Congressional leadership on future mitigation efforts for physicians and will continue to share information as the negotiations evolve.

 

Update on the Medicare physician payment cuts that took effect on January 1st

Jan. 12, 2024
Negotiations to mitigate the physician payment cut have continued in earnest alongside those to maintain wholesale government funding. These have heated up recently and The House and Senate have been in active discussions about a healthcare package. Unfortunately, this is complicated by differences in opinion over the term for any Continuing Resolution (CR) (Congress is considering funds for anywhere from 4-8 weeks). 

It is auspicious that there has been broad bipartisan recognition that a conversion factor cut is untenable and robust discussions are ongoing among House and Senate negotiators about possible solutions. Still, it is far from clear how this will shake out. We are in frequent and active discussions with House and Senate leadership, key committee staff who are drafting these packages, as well as the Doctors' Caucus, who continue to apply helpful pressure with leadership, and recently met with the Speaker of the House to make sure physician relief is included in a meaningful way.

While CMS has not yet issued guidance on how or when they will process claims, given the 3.4 percent cut went into effect on January 1st, we are told that CMS can only hold claims for roughly two weeks. If Congress does not pass something by next week, we expect CMS to issue guidance with further details as we rapidly approach that deadline. 

It's crucial to note that any Congressional relief to these cuts will be, at best, partial and will not provide a durable solution nor would they address the fundamental challenges in Medicare reimbursement or achieve equity between hospital and independent physician reimbursement. LUGPA remains committed to collaborating with policymakers to tackle these issues, advocating for fair reimbursement, and ensuring the sustainability of practices, the U.S. healthcare system, and patient access to care.

LUGPA has also curated two essential resources for its members to provide further details regarding the payment cuts. The initial resource is a comprehensive Policy Brief that discusses the significant 3.34 percent reduction in the fee schedule's conversion factor and the challenges it brings. The second resource is a detailed Fact Sheet that illuminates CMS's upcoming implementation of HCPCS code G2211, scheduled for January 1, 2024.