
Medicare Reimbursement for Doctors is in Critical Condition
Doctor’s offices are the front door of the American healthcare system. We owe it to them to support H.R. 2474 and put an end to annual Congressional stop-gap spending bills.
Doctor’s offices are the front door of the American healthcare system. We owe it to them to support H.R. 2474 and put an end to annual Congressional stop-gap spending bills.
CMS issued its proposed rule for next year’s Medicare physician fee schedule, revealing plans to cut payment rates by 2.8%. Industry groups swiftly expressed their outrage, arguing that reimbursement rates need to keep up with the pace of inflation.
CMS finalized updates to its physician fee schedule for 2024, as well as finalized the rule for next year’s Outpatient Prospective Payment System (OPPS). Provider groups are displeased with the updated rules, arguing that both physicians and provider organizations need more monetary relief than what the agency is offering.
CMS recently revealed its proposals to raise reimbursement rates for hospital outpatient departments and cut payments for physicians. Next year, the agency is planning to decrease physicians’ pay by 1.25% and increase outpatient payment rates by 2.8%. Provider groups are unhappy with the news — AMA President Dr. Jesse Ehrenfeld said the new physician fee schedule will be “almost biblical in its impact.”
We again need Congress to intervene in order to protect patients and providers and stop any further cuts to specialty care.
The Centers for Medicare and Medicaid Services dropped its physician fee schedule for next year. It would bolster coverage of telehealth visits for behavioral health and vaccine payments, but would also reduce the conversion factor used to calculate fee-for-service payments.
To ensure effective cost mitigation, employers can’t wait for the market to adjust — they have to punch first.
In the 1,747-page rule, which will be finalized later this year, CMS proposes expanding access to telehealth for behavioral healthcare, including for the first time allowing Medicare to pay for mental health virtual visits when they are provided by rural health clinics and federally qualified health centers and letting providers offer audio-only telehealth visits for certain services.