Doctor groups turn up heat on Congress to halt 2023 pay cuts after final CMS rule

Doctor groups are making a last gasp to get Congress to delay a 4.4% cut to Medicare payments after a payment rule finalized the adjustment. 

The Centers for Medicare & Medicaid Services (CMS) finalized the cut in its Physician Fee Schedule rule released Tuesday. Groups afterward implored lawmakers to act in an end-of-the-year spending package that must be passed by Dec. 16.

“Ninety percent of medical practices reported that the projected reduction to 2023 Medicare payment would reduce access to care,” said Anders Gilberg, senior vice president of government affairs for the Medical Group Management Association, in a statement. “This cannot wait until next Congress—there are claims processing implications for retroactively applying these policies.”

CMS was required to install the cut under budget neutrality rules, leaving groups to turn to lawmakers for help. Congress has previously stepped in to stave off Medicare cuts, and there is a bipartisan bill in the House to do just that. 

Groups are also hoping to get a delay to a 4% decrease to payments as part of the PAYGO law, which mandates cuts if federal spending reaches a certain threshold. 

Physicians say the cuts come amid lingering financial challenges.

“The final rule comes amid surging medical inflation and staff retention challenges practices are experiencing across the country,” said George Williams, senior secretary for advocacy for the American Academy of Ophthalmology, in a statement. “As the value of Medicare physician payments continues to plummet on an inflation-adjusted basis, the cuts will further diminish the financial support which surgical practices around the country rely on at a time when they need it most.”

The push to stave off the cuts is getting bipartisan support in Congress. Reps. Larry Bucshon, R-Indiana, and Ami Bera, D-California, introduced the Supporting Medicare Providers Act in September that halts the cuts.

So far, the bill has been referred to the House Energy and Commerce Committee but not advanced out of the panel. Advocacy groups have previously looked at a spending package that must be passed by Dec. 16 or the government runs out of money.

But the legislation has wide bipartisan support in the House with more than 70 co-sponsors. 

In addition, a group of 46 bipartisan senators wrote to leadership on Wednesday seeking to delay the cuts, according to a report in Politico. The senators also note that there needs to be a more sustainable system. 

Physician groups are hoping for a long-term fix that won’t require them going to Congress to get rid of any cuts. 

“This annual brinksmanship with Medicare payments is not sustainable and does not support better care for patients,” said Jerry Penso, M.D., president and CEO of AMGA, in a statement.