Coalition repping over 1M radiologists and other clinicians urges Congress to fix ‘systemic’ payment flaws
A coalition representing over 1 million radiologists and other clinicians is urging Congress to address “systemic” flaws in how Medicare pays providers.
Led by the American College of Radiology, 120 medical societies asked leaders in the U.S. House and Senate to pass legislation granting an annual inflationary pay update. Under the physician fee schedule released in July, the administration is proposing a 2.8% reduction to the conversion factor, which will impact “every single clinician providing care to Medicare beneficiaries.”
This comes while practices face rising costs, with the Medicare Economic Index (used to measure inflation) slated to increase 3.6% in 2025.
“Congress must take action to fix this unsustainable system so Medicare payments to physicians and other clinicians reflect the cost of practice and ensure Medicare beneficiaries have timely access to care,” ACR, the Radiology Business Management Association, the American Society of Neuroradiology, the Society of Interventional Radiology and others wrote Sept. 10.
When adjusting for inflation, Medicare physician payments plummeted 29% from 2001 to 2024, “clearly not sustainable trajectory.” Lawmakers have mitigated provider pay cuts since 2020 but not completely undone them, the groups noted. Physicians continue to work under the only Medicare payment system without an annual inflationary update. Many radiologists and other physicians are small business owners, they noted, facing a wide range of administrative burden, rising salaries, rent payments and the need to purchase new technology.
In recognition of these “systemic flaws,” members of Congress have introduced three bills to remedy the problem. They include:
- Strengthening Medicare for Patients and Providers Act: Proposed in April 2023, House Resolution 2474 would provide an annual Medicare physician payment update tied to inflation, as measured by the Medicare Economic Index.
- Provider Reimbursement Stability Act: Introduced in December 2023, HR 6371 would make statutory changes to the budget neutrality requirement to ensure payment stability under the physician fee schedule.
- Physician Fee Stabilization Act: Introduced in August, Senate Bill 4935 would similarly increase the budget neutrality threshold to $53 million with an update every five years to keep pace with inflation.
“The nearly 2 million Medicare beneficiaries in North Carolina expect timely access to quality care,” sponsor and Sen. Thom Tillis said in a statement issued Aug. 2. “This bipartisan legislation makes long-overdue changes to outdated policies to ensure physicians are adequately reimbursed, and seniors have uninterrupted access to care,” he added later.
“Congress must act before the end of 2024 to provide clinicians with the financial stability needed to ensure beneficiaries continue to have access to high-quality care,” the coalition’s letter concluded.
ACR also promoted the message in a news update published Sept. 11. Those signing the letter included the American Society for Radiation Oncology, the American Medical Association, American College of Radiation Oncology, the Association of Freestanding Radiation Oncology Centers, the American Academy of Oral and Maxillofacial Radiology and numerous others.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.