Led by the American Medical Association, a coalition of 62 healthcare organizations submitted a letter to congressional leaders calling on them to include four Medicare reforms in a year-end legislative package.
In addition to the American Medical Association, the coalition includes the American Academy of Family Physicians, the American College of Cardiology and the American Psychiatric Association.
The letter notes that Medicare physician payment has dropped by about 33% since 2001 when adjusted for inflation in practice costs.
“As payment falls further behind the cost of providing care, it becomes harder for physician practices, particularly those that are small, rural, and independent, to keep caring for Medicare patients,” the letter stated. “This payment disparity also drives up consolidation and increases health care costs, which have a real impact on patients and their access to care.”
Specifically, the coalition is urging Congress to:
- Extend the 2.5% physician payment update through 2027: The letter notes that CMS expects a 2.5% increase in practice costs next year. Congress approved a temporary 2.5% physician payment update for 2026, and the letter asks lawmakers to extend that increase through 2027.
- Pass the Provider Reimbursement Stability Act: This bill would require CMS to correct Medicare payment adjustments when projected service use differs significantly from actual utilization. The legislation aims to prevent physicians from facing permanent payment cuts based on spending that never occurred.
- Delay the modifier 25 payment reduction for a year: CMS finalized a policy reducing Medicare payments for the lower-valued service when physicians provide a separately identifiable office visit and certain procedures to the same patient on the same day. The coalition is urging Congress to delay the payment reduction for one year, arguing that it could financially burden independent medical practices.
- Cap Merit-based Incentive Payment System (MIPS) penalties at 2%: MIPS is a Medicare program that measures physician performance and can increase or decrease Medicare payments based on performance. The coalition is calling for a cap on financial penalties at 2% for physicians who do not meet performance requirements. They are also advocating for more timely and actionable performance data so physicians can identify areas for improvement and make changes to patient care during the performance year.
“Medicare patients need access to physicians, and physicians need a payment system that works. Congress has an opportunity to protect access to care and give physician practices the stability they need to keep serving Medicare patients,” said AMA President Dr. Willie Underwood III, in a statement. “These four reforms are practical, bipartisan steps Congress can take now to strengthen Medicare and protect patients.”
Photo: Vadzim Kushniarou, Getty Images
