Late Friday afternoon, CMS released the 2025 Medicare Physician Fee Schedule final rule which announced a 2.83% decrease in the conversion factor – from $33.2875 to $32.3465.
The Advocacy Council will analyze the 3,000+ page rule and will provide a summary in the near future.
It’s official: allergists will receive a huge Medicare payment reduction in the new year unless Congress acts to prevent these cuts from taking effect. Specifically, allergists will face a 9% cut to their Medicare payments in 2025 from a variety of policies including:
- 4% reduction from failing to waive the statutory PAYGO requirement from the American Rescue Plan Act
- 2.8% reduction from the expiration of a 2024 statutory increase to the Medicare Physician Fee Schedule (PFS) Conversion Factor (CF)
- 2% reduction from sequestration
While Congress is expected to mitigate some – or all – of this cut before the end of the year, it is not clear exactly what action it will take. Recently, a new bipartisan bill to address these looming Medicare physician payment cuts was introduced in the House of Representatives.
Representatives Greg Murphy (R-NC-3), Jimmy Panetta (D-CA-19), Mariannette Miller-Meeks (R-IA-1), Ami Bera (D-CA-6), Larry Bucshon (R-IN-8), Raul Ruiz (D-CA-25), John Joyce (R-PA-13), and Kim Schrier (D-WA-8) introduced H.R.10073: “Medicare Patient Access and Practice Stabilization Act of 2024” on Oct. 29.
The bill would increase Medicare payments to physicians for 2025 in two ways. First, it would offset the 2.8% increase Congress passed for 2024 that expires at the year’s end. Second, it would provide an additional increase equal to half of the Medicare Economic Index (MEI), which is used to measure medical inflation. These two provisions would result in a 4.73% increase to the 2025 Physician Fee Schedule (PFS) Conversion Factor (CF).
Due in part to the relentless efforts of the Advocacy Council for a sustainable solution to the flawed Medicare payment formula, this bill provides proposals that will put a stop to the various year-end payment cuts. One proposal the Advocacy Council endorsed would annually update the PFS CF using MEI. While this proposal faces political headwinds over its cost, the new bill recently introduced this important advocacy priority.
Notably, the bill does not address the 4% PAYGO Medicare reimbursement cut set to take effect at the start of the new year. PAYGO cuts were designed to make up for government spending in other areas that raise the deficit. Under PAYGO, the American Rescue Plan Act of 2021 triggered these Medicare reimbursement cuts; however, the cuts have been delayed each year by Congress. If they go through, the net effect is an approximate 4% cut in our payments for 2025.
It is not yet clear if Congress will consider H.R. 10073. The College remains concerned that continued reductions in what allergists are paid to see Medicare patients will result in decreased access. The College proudly endorsed this bill and plans to advocate for it on Capitol Hill. In addition, we will also continue advocating for Congress to address the looming 4% PAYGO cut before the end of the year. Stay tuned for the latest updates.
It is clear that our practices cannot continue to absorb these costs. As the leader in advocacy for our profession, the Advocacy Council continues its work to lobby Congress – and you can help. Congress has the power to pass laws to change the projection of our reimbursement. During the College’s Annual Meeting in Boston, we asked members for support of our sign-on letter urging Congress to mitigate cuts to physician reimbursement and identify long-term solutions to this annual issue – and it’s not too late for you to join this effort.
Stay tuned for the latest updates.
The Advocacy Council – ADVOCATING FOR ALLERGISTS AND THEIR PATIENTS.
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