Advocacy Council endorses Fee Schedule fix

| December 18, 2023

Advocacy Council endorses Fee Schedule fix

The Centers for Medicare and Medicaid Services (CMS) finalized a 3.37% reduction to the Medicare Physician Fee Schedule (PFS) Conversion Factor (CF) for 2024, but the Advocacy Council has not given up the fight to “Stop Making Us the Cut.” CMS’ hands are tied due to the requirement for budget-neutral changes to the PFS. This means Congress must act to prevent this payment cut from taking effect.

The 3.37% reduction to the PFS CF is primarily caused by the normal budget neutrality adjustments, representing a larger impact this year due to CMS beginning to cover the G2211 add-on E/M service for longitudinal care management. Also contributing to the reduction is a policy passed by Congress that instituted a 2.5% increase to the CF for 2023, but only a 1.25% increase to the CF for 2024.

Several bills in Congress would address some or all of the 3.37% reduction. One bill being considered by the Senate Finance Committee would extend the full 2.5% increase that was in effect for 2023 to 2024. Another bill recently introduced in the House, H.R. 6683, would completely offset the 3.37% CF reduction. The Advocacy Council endorsed these bills but favors H.R. 6683 as it would provide a full offset.

The Advocacy Council has also endorsed other bills that would provide more sustainable solutions to the constant fight against Medicare cuts. The most notable of these bills is H.R. 2474, which would provide an annual inflation adjustment to the CF that would not be subject to budget neutrality. The nonpartisan Medicare Payment Advisory Commission (MedPAC) acknowledges the historic disparity between Medicare payments and inflation. MedPAC is expected to recommend a payment increase for physicians in its March Report to Congress.

Congress must pass legislation before the end of the year to prevent these cuts from taking effect on Jan. 1, 2024. It is unlikely that Congress will meet this deadline. Congress is too focused on other issues, such as foreign aid and border security, which will likely consume all of the oxygen on Capitol Hill for the rest of the year.

However, Congress will have an important opportunity to fix this issue early in 2024. Congress must pass legislation to extend funding for some of the Federal government by Jan. 19. We are targeting this funding extension as a legislative vehicle for a CF fix. If Congress does pass legislation in January that increases the CF, we expect CMS will automatically adjust payments retroactively for claims submitted in 2024 before the CF increase takes effect.

Allergists have already made their voices heard on this issue. More than 100 allergists volunteered to sign our advocacy letter to Congress supporting H.R. 2474 during the College’s Annual Meeting.

Now the Advocacy Council is continuing the fight to stop the cuts and fix Medicare payments once and for all. It’s not too late for you to join this effort, and it’s easy to do. Even if you signed the letter above during the Annual Meeting, this is a new bill – H.R. 6683 – that will completely eliminate the 3.37% cut. Go to the AMA Action portal. (AMA membership is not required. Select “other” under member type.) You can use the sample letter or submit your own. We’ll keep you updated on our progress.