Since early 2023, ACOI, alongside the entire physician community, has been calling on Congress to stop the entire cut. Over the past six months, ACOI members sent more than 750 messages to Congress asking for payment cut relief.
CMS Finalizes Rule to Curb Prior Authorization Abuse
On January 17, the Centers for Medicare and Medicaid Services (CMS) released a long-awaited final rule that makes improvements to prior authorization practices used by health insurers. Under the rule, Medicare Advantage (MA) organizations, state Medicaid and Children’s Health Insurance Program (CHIP) Fee-for-Service (FFS) programs, Medicaid managed care plans, CHIP managed care entities, and Qualified Health Plan (QHP) issuers on the Federally Facilitated Exchanges (FFEs) will be required to streamline prior authorization processes.
Senate Lawmakers Want to Tackle Physician Payment Reform
A bipartisan group of senators have joined together to tackle Medicare physician payment reform. The senators have committed to investigating shortcomings of the physician fee schedule (PFS) and the Medicare Access and CHIP Reauthorization Act (MACRA) to propose long-term reforms. The announcement of the working group comes as physicians are suffering a 3.37% Medicare payment reduction that took effect on January 1, 2024. Congress still has the opportunity to reverse or mitigate the cut. ACOI encourages our members ask lawmakers to intervene.
Still No Action from Congress on Medicare Payment Cut
ACOI is renewing its Call to Action and encouraging every ACOI member to ask their members of Congress to make physician payment relief a priority. With the payment cut already in place, if lawmakers do not hear from physicians, they may construe the silence as a signal the 3.37 percent cut is not being felt by physicians and will not harm beneficiary access to care.
ACOI Congratulates Jennie H. Kwon, DO, MSCI on PACCARB Appointment
ACOI was honored to help support Dr. Kwon’s nomination to PACCARB.
“Dr. Kwon has an impressive track record of antimicrobial resistance research (AMR),” said ACOI President Robert T. Hasty, DO, FACOI, FACP. “PACCARB is fortunate to have the value of her expertise, including her work on strategies to prevent transmission of AMR.”
The CY 2024 Medicare Physician Fee Schedule (PFS) final rule released on November 3 finalizes a 2024 conversion factor — the starting point for calculating physician payments — of $32.74, a decrease of $1.15 (or 3.37%) from the CY2023 conversion factor of $33.89. Roughly 90 percent of the cut is attributed to fee schedule budget neutrality requirements triggered by the impending January 1, 2024, implementation of G2211, an office/outpatient evaluation and management visit complexity add-on code.
ACOI Asking CMS and Congress for Payment Cut Relief
The ACOI has submitted comments to the Centers for Medicare and Medicaid Services (CMS) in response to its proposed payment policies for 2024. In the letter, ACOI re-stated its concerns about Medicare payments that are not keeping pace with inflation. Next year the Medicare conversion factor — the basic starting point for calculating Medicare physician payments — will be reduced by more than 3 percent. While Congress has provided a 1.25 percent positive adjustment for 2024, it is half of the 2.5 percent provided for 2023. The remainder of the cut is due to requirements of budget neutrality triggered by the proposed implementation of office/outpatient evaluation and management visit complexity add-on code G2211 that begins on January 1, 2024.
ACOI Joins in Call for Congress to Reform Medicare Payment System
ACOI recently joined numerous medical societies in sending a letter to all Senate and House lawmakers asking for congressional hearings and collaboration with stakeholders to explore long-term solutions to the broken Medicare physician payment system.
Congressional Action on Physician Payment Cut Falls Short
The Senate has passed an end-of-year spending deal that falls well short of providing physicians full relief from a 4.5 percent Medicare physician fee schedule cut.
