New bipartisan bill would stabilize Medicare physician pay for 2025: Now it has to pass | AMA Update Video | AMA

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As a direct result of AMA advocacy, a new bi-partisan bill was introduced in the U.S. House this week that would give physicians a positive Medicare payment update for next year. The American Medical Association's director of congressional affairs, Jason Marino, joins to provide an overview of the "Medicare Patient Access and Practice Stabilization Act," and why physicians must act now to help the bill pass. AMA Chief Experience Officer Todd Unger hosts.

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Unger: Hello and welcome to the AMA Update video and podcast. Today, we're talking about a big development in Congress on Medicare payment reform. And here to break down the news is Jason Marino, the director of congressional affairs for the AMA in Washington, DC.

I'm Todd Unger, AMA's chief experience officer in Chicago. Jason, welcome back.

Marino: Hi. Happy to be here and share some good news.

Unger: Well, excellent. Let's dive right in. Thanks to AMA advocacy, a new bipartisan bill was introduced in Congress earlier this week. What do physicians need to know about the bill?

Marino: Let me first step back and share some of the bad news first to set this up. Back in July, the CMS issued—they had to issue a physician rule every year, fee schedule rule, they call it. And in that rule in July, they said physicians are going to face a 2.8% cut, and this would be the fifth cut in a row for physicians in Medicare.

And they also said in that rule that the Medicare Economic Index, which is a measure of physician practice cost inflation, should be 3.6% in 2025. But instead, there's going to be a 2.8% cut. And that rule was proposed, but it's going to be finalized as soon as Friday, November 1, or at least sometime in early November, most likely. And then when that rule is finalized, that—and we don't expect it to change—that essentially locks in a 2.8% cut on January 1, 2025. So we are trying to stop that cut.

And I'm happy to say the good news is that yesterday we had a bill dropped, a bipartisan bill dropped, by Congressman Murphy, Congressman Panetta and several others, several physician members as well. And that bill is H.R.10073. It's called the Medicare Patient Access and Practice Stabilization Act of 2024.

And what that bill would do is wipe out that 2.8% cut, eliminate it, and in addition, provide a 1.8% payment update for physicians for 2025, which is half of the MEI, and so wipe out the cut and give an update that's long overdue. And so that was dropped, bipartisan, and now we're going to be pushing that in the lame duck session of Congress after the election.

Unger: Now, Jason, something big like this doesn't just happen. It's obviously the result of a lot of work behind the scenes and for a long time. Tell us a little bit about what it took to get here.

Marino: Let me step back to when we started this 118th Congress, 2023. Most members and staffers didn't even know what a MACRA is, very little understanding of what MEI is or the payment system in general. So the last two years has been a significant education of members of Congress and the staff.

And we've had national advocacy conferences. We've had many congressional hearings. We've had grassroots going for the last two years, where physicians are reaching out to members of Congress to tell them about this broken payment system.

And back in July, right when that—this recent July, when that rule came out with the cut, we sent a letter signed by all 50 states and the District of Columbia Medical Society and 70-plus medical specialty societies, all saying, we need to reform this broken payment system. We have solutions for it in detail to solve it.

It's not brain surgery here. We know how to fix this. And we definitely need inflationary update.

And then we took advantage of the August recess to educate members. And then we got a letter going called a "Dear Colleague." And this is where our champions on the House of Representatives sent a letter that would go to House leadership. And we got 233 members of Congress to put their name on this letter, saying "Hey, we need to replace this 2.8% cut with an inflationary update, and we need to fix this broken payment system."

And it's going to have consequences if we don't. And we need to do it this year, this year, and in the lame duck session, and that—and we had in that process 3,500 grassroots contacts that we tracked that went to members of Congress.

We hit every single House member, 435, 'Please sign this letter. This is very important.' And we got 233 members of Congress to sign on to this letter at, as you all know very tough, divided election season, when members of Congress can't even agree that fire is hot.

That's how—but what they can agree on is that they should fix this broken payment system. And 233 members of Congress, bipartisan, signed a letter during this time is a big deal.

And so we took that energy and said, well, we got to—now we got this letter. Let's turn this into a legislation, into a bill, exactly what we want to get done in this lame duck session. And the same supporters, all that momentum, flowed to this bill that we got dropped. And we hope this bill is a template for what can be done in the lame duck session of Congress.

Unger: Well, that's a pretty amazing story. What's clear here this is the power of advocacy in action because what you laid out there is proof that things like this just don't happen. They happen because we work together to make it happen.

And so that's really encouraging. Now, on the other end of this, the work's not done. Obviously, we still need to make sure that the bill becomes a law. How can physicians out there help to get this done?

Marino: The key thing is to keep your foot on the gas as far as advocacy, to keep reaching out to members of Congress. Just to give you some context, H.R.10073, because there's more than 10,000 bills that were introduced in the House of Representatives and over 5,000 in the Senate. So there's been 15,000 bills introduced this Congress.

Do you know How many are in law? 101. So less than 1% of all the bills introduced this Congress had gone to law. That's the least productive Congress right now since the Great Depression, since 1931 and 1933, that Congress.

So it's a tough slog in this Congress to get something into law. And it's great if you're trying to block bad bills that might be damaging, and a very unproductive Congress can be your friend. But that's not us. That's not the physician world.

We need a law. We need to stop this. We need them to come together and agree. And we have momentum from this bill and that "Dear Colleague" letter. And this is the time to put—keep the foot on the gas and really push it and talk to your members of Congress and tell them why it's so important and why they should not go home this year until this is addressed.

And we are ruffling some feathers in Washington. Some of them want to just give us a little fix, maybe reduce the cut a little bit, but still give us some cut and want us to go away. And this is not the time to shrink away. This is a time to be fully engaged with the Hill, with Congress and really push this issue.

We have a great awareness. Did you read the DC press today? We're all over it. This issue is all over it. This bill is being talked about, and we're getting a lot of attention in a good way.

Unger: All right, physicians. Just for those of you out listening, what Jason's saying, it is time to take action. Be sure to contact your representative as soon as you can and urge them to support this bill.

And you'll find more information about this in the episode description. And Jason, this bill is important for a number of reasons. It's not just physician payment issue. It goes beyond that. If the bill passes, how do you see it impacting both physicians and patients?

Marino: We're in a tough time in the physician world in that, since 2001, there's been a 29% loss to inflation when you factor in practice costs. So physician expenses for their equipment, for their staff, supplies, for insurance is going up. But the payments are not keeping up.

And you're seeing a lot of consolidation in the market. You're seeing a lot of small practices go away or a lot of forced retirements or a lot of—or less access for patients. Or there's a waiting list for new Medicare patients. It's all a very damaging trend line. And it's not good for patient access and for physicians to be able to keep the doors open.

And what does it mean for an oncology practice in a small community that has to go away and get bought by a hospital that's 150 miles away and you don't have that access right in your home, which is so important? And members are slowly starting to become more aware of that access issue. And these Medicare patients paid into the system their whole lives. When they get on Medicare, they deserve to be able to have access to a quality physician and get good quality care.

And so the stakes are high. And we are trying to get to a place where we pass this bill to stop the bleeding, so to speak, and get us on a path where there's some inflationary updates. And the next Congress, let's reform the whole system. We need to have an overhaul of the whole payment system.

And we have—the physician community has come with solutions. We know how to solve this. We just need the political will to make it happen. And passing this year sets us up in a good—it's a bridge to reform next year in the next Congress.

Unger: All right. It sounds promising but a lot of work to do. We've already put out the call to physicians out there to take action by calling your representatives. Jason, anything else physicians should do to stay up to date with all the advocacy efforts?

Marino: Yes. We have the AMA Advocacy Update, which we update with legislative developments that you should have access to.

We have the fixmedicarenow.org. It's a special website that we set up that has all the materials, all the charts, all the talking points, all the bills we've supported, that we're supporting.

And we keep that up to date. That's a great reference tool. You can pick what you want, what works best for you.

And we're going to have a lot of outreach to grassroots. We're going to run a very significant grassroots campaign during the lame duck session. And we're going to be asking physicians to heed the call.

And we can help with the template. But please respond to those email messages and reach out to your members. And we're going to help facilitate all of that.

Unger: So just to be clear, you can be part of that Physicians Grassroots Network and be one of those people that makes that call, and we'll help you do that. The AMA Advocacy Update, that's a newsletter that you can get by signing up for it on the AMA site. We encourage you to do that.

Jason, thank you so much for joining us today and being such a strong voice for physicians on Capitol Hill. Again, physicians, it's time to take action. Be sure to contact your representatives as soon as you can and urge them to support this bill. Again, you'll find more information on that in the episode description.

That wraps up today's episode and we'll be back soon with another AMA Update. Be sure to subscribe for new episodes and find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.

Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.

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