Congress reaches compromise on Medicare reimbursement cuts for physicians

Lawmakers are considering a proposal that would reduce the Medicare payment cuts to 2%, less than the 4.5% cuts expected in the Medicare Physician Fee Schedule payments in 2023.

The federal government’s 2023 spending plan will hurt seniors’ access to medical care when physician reimbursement for Medicare drops in 2023.

Meanwhile, physicians will continue receiving incentive payments for value-based care models, but more money would help in the accountable care organization (ACO) movement.

On Monday, the U.S. Senate Committee on Appropriations published the $1.7 trillion 2023 Omnibus Appropriations Bill with money for issues ranging from consumer inflation at home to the war in Ukraine.

On Tuesday, lawmakers unveiled the $1.7 trillion proposed spending package needed to avert a government shutdown by Friday if both chambers can pass the measure this week. 

According to reports, in the package Congressional leaders reduced the Medicare payment cuts to 2%, less than the 4.5% cuts expected in the Medicare Physician Fee Schedule payments in 2023 even though groups have urged congress to avoid cuts altogether, citing the ongoing financial challenges providers are facing because of the pandemic.

The package seeks to stave off about half of the expected reductions to Medicare reimbursement for physician services over the next two years. Physicians will face a 2 percent cut in the new year and a 3.5 percent cut in 2024.

The spending plan has some highlights. A statement from Committee Chairman Sen. Patrick Leahy, D-Vermont, included some health care and research programs among its highlights:

• $47.5 billion for the National Institutes of Health
• $9.2 billion for the U.S. Centers for Disease Control and Prevention
• $1.5 billion for the Advanced Research Projects Agency for Health (ARPA-H) fight against cancer
• $950 million for the Biomedical Advanced Research and Development Authority to bolster national health security

Medicare was not included on that highlight list, even though for weeks the Medicare Physician Fee Schedule has been target for health care organizations calling on Congress to take action to avoid reimbursement cuts for physicians, including ophthalmologists.

More than 100 House members penned a bipartisan letter to President Joe Biden and House and Senate leadership, urging swift action to head off looming Medicare cuts.

“We have heard from provider organizations that if these additional Medicare cuts are not prevented, medical groups and integrated systems of care would be forced to eliminate services, furlough staff, implement hiring freezes, and delay population health initiatives,” the lawmakers wrote.