Congress ditches doc fix in stopgap end-of-year funding bill

Congress has ditched a previously agreed-upon Medicare doc fix, passing a slimmed down continuing resolution on Friday to avert a government shutdown. 

Lawmakers last week had reached an agreement to add a 2.5% increase to the physician fee schedule, partially offsetting a 2.8% cut to the conversion factor. However, at the urging of President-elect Donald Trump and tech billionaire Elon Musk, members of Congress have now finalized a simpler measure to fund the government through March 14. 

Medicare beneficiaries will have continued access to telehealth services until April 1, with expiring healthcare programs extended through March. The Medical Group Management Association on Saturday celebrated this small victory while labeling the continuing resolution “a huge congressional failure to the detriment of the nation's Medicare patients and their physicians.”

“It is extremely disappointing that the incoming administration would upend a bipartisan agreement that prevented devastating cuts to the Medicare Physician Fee Schedule,” Linda Wilgus, MBA, co-executive director of the Radiology Business Management Association, said Friday. “These looming cuts will reduce patient access to care, limit investment in lifesaving technology, and drive consolidation across the entire healthcare ecosystem.”

Both RBMA and the MGMA said they’ll continue fighting for a permanent solution to this situation. Balance-budget provisions mean that spending increases in one part of the physician fee schedule necessitate cuts elsewhere. This has resulted in physicians facing Medicare cuts for five consecutive years, with no pay adjustments to offset inflation. 

Providers are set to see a 2.83% cut to the conversion factor used to calculate payments beginning in January. MGMA said it still hopes the new Congress will pass legislation that retroactively adjusts physician payments received in the first two months of 2025. 

Rep. Greg Murphy, MD, R-N.C., a trained doc who has fought for physician payment reform on the Hill, agreed. 

“I have been assured that physicians who see Medicare patients and have had their reimbursements cut by nearly 30% in the last 23 years will be taken care of in March,” Murphy said in a statement shared Dec. 20. “President Trump deserves to start in a strong position when he takes office, and I look forward to passing a conservative budget under his leadership."

The House passed the resolution in a 366-34-1 vote with all Democrats supporting it. The Senate then sent the legislation to President Biden’s desk with an 85-11 vote. 

Rep. Ami Bera, MD, D-Calif., another physician advocate for payment reform in Washington, supported the bill without a doc fix because he feared the alternative. 

“While this legislation does not include several key provisions in the original bill, I voted for it because the cost of shutting down the government is far too high and the need to deliver billions in disaster relief to communities in California recovering from extreme weather events is far too great,” he said Saturday.