Bipartisan bill would cap radiologist pay cuts in Medicare program
Members of the U.S. House on Monday proposed bipartisan legislation that would cap pay cuts for radiologists and other physicians under the Medicare program.
Lawmakers led by Rep. Greg Murphy, MD, R-N.C., are reintroducing the Provider Reimbursement Stability Act of 2026. Backed by the American Medical Association, the bill would limit annual fluctuations in the conversion factor to 2.5%.
Medicare reimbursement for physicians has fallen 33% since 2001 when adjusting for inflation, the AMA estimates. Murphy and colleagues hope their proposal can help counter annual reductions, necessitated by the federal payment program’s budget-neutrality rules.
"Physicians in America who see Medicare patients are being forced to close their doors because of increasing medical costs and persistent cuts to their reimbursements," Murphy, a practicing urologist, said in a statement March 31. "By updating the Medicare Physician Fee Schedule reimbursement policies, we can protect private practice and ensure access to affordable, high-quality care across the country for generations to come,” he added later.
In addition, the Provider Reimbursement Stability Act would increase the budget neutrality threshold from $20 million to $54.3 million. It also would index this threshold to the cumulative percentage increase in the Medicare Economic Index—a measure of practice cost inflation—every five years. It additionally would provide for budget neutrality corrections related to the estimated utilization of billing codes. Plus, the proposal would update the direct costs used to calculate practice expense relative value units, or RVUs, at least every five years.
The AMA and others note that certain Medicare Physician Fee Schedule reimbursement policies have not been updated since the MPFS was established in 1992.
"Economic forecasting is a dicey proposition," Bobby Mukkamala, MD, president of the American Medical Association, said in the same statement. "So, when CMS makes a forecast for the initial utilization of a new Medicare service, sometimes that forecast turns out to be inaccurate once claims data become available. There’s no reason that patients and physicians should have to bear the brunt of that miscalculation. This bill allows for a recalibration so that unnecessary cuts can be avoided. That’s good budgeting and good medicine."
Others co-sponsoring the bill include Reps. Tom Suozzi, D-N.Y., John Joyce, MD, R-Pa., Brad Schneider, D-Ill., Mariannette Miller-Meeks, MD, R-Iowa, Kim Schrier, MD, D-Wash., and Bob Onder, MD, R-Mo. The Medical Group Management Association also endorsed the proposal Tuesday, saying it looks forward to working with Congress on this “critical piece of legislation.”
MGMA noted that important increases to Medicare payment office-visit RVUs often result in reimbursement cuts to unrelated procedures, due to budget-neutrality rules.
“For too long the Medicare Physician Fee Schedule has been subject to antiquated budget neutrality requirements that trigger broad cuts to Medicare reimbursement to offset changes in relative value unit over a low threshold,” Anders Gilberg, MGMA’s senior VP of government affairs, said in a statement March 31. “These rules have destabilized Medicare payment over the years and undermined the ability of medical groups to continue treating Medicare beneficiaries,” he added later.
Murphy also previously proposed the Provider Reimbursement Stability Act in late 2023, with it failing to pass in Congress.
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.