Senators Introduce Bipartisan Provider Reimbursement Stability Act to Ensure Long-Term Access to Medical Care

WASHINGTON-U.S. Senators John Boozman (R-AR), Peter Welch (D-VT), Roger Marshall M.D. (R-KS), Angus King (I-ME), Thom Tillis (R-NC) and Jeanne Shaheen (D-NH) introduced the Provider Reimbursement Stability Act to modernize Medicare's Physician Fee Schedule (MFPS). The bipartisan, comprehensive legislation would create greater predictability in Medicare physician payments, preserve patient access to care and better reflect the actual cost of delivering medical services.

According to the American Medical Association (AMA), when adjusted for inflation, Medicare reimbursement for physician services has declined 33 percent since 2001. This reduction, attributed to the Medicare budget neutrality threshold last updated in 1992 and other factors, has failed to keep pace with the rising cost of care. The legislation reforms key structural components of the MPFS, helping preserve physicians' ability to care for Medicare patients.

"Providers should not face unpredictable payment cuts that make it more difficult to care for patients. Modernizing Medicare reimbursement is an important step toward ensuring long-term financial stability for our health care providers and preserving access to quality care. Our bill is a bipartisan solution that will more accurately reflect the costs of delivering quality care, which ultimately benefits patients in Arkansas and across our country," said Boozman.

"Outdated policies are creating instability for doctors and threatening access to care for Medicare patients in Vermont and across the country. Our commonsense, bipartisan bill will help ensure physicians can continue providing vital care to our communities," said Welch.

"For 25 years, I cared for patients in western Kansas. Like many, I didn't go into medicine to worry about Washington's payment formulas - I went into medicine to take care of people," said Marshall. "When doctors can't make the numbers work, patients lose access to care. This legislation is a commonsense step toward stabilizing physician reimbursement so doctors can spend more time caring for patients and less time worrying about whether they can afford to stay in practice."

"Accessible, reliable health care is essential for seniors across Maine, particularly in our rural communities where providers are already stretched thin," said King. "The Provider Reimbursement Stability Act would help ensure that Medicare providers are fairly reimbursed so they can continue delivering the full range of care that Maine seniors depend on for their healthcare needs. I'm proud to join my colleagues in supporting this commonsense bipartisan legislation to strengthen access to quality care for older Americans."

"More than two million Medicare beneficiaries in North Carolina depend on timely access to quality care," said Tillis. "Year after year, Medicare reimbursement cuts have made it harder for physicians to care for patients. This bipartisan legislation makes long overdue reforms to outdated policies to ensure physicians are fairly reimbursed and seniors continue to have access to the care they deserve."

"It's critical we do all we can to ensure that Granite Staters who rely on Medicare for health insurance have access to the quality, affordable care they need," said Shaheen. "This bipartisan bill would make sure physicians are fairly compensated and guarantee adequate reimbursement for providers, which would help strengthen Medicare's dependability for patients now and into the future."

The Provider Reimbursement Stability Act would:

• Increase the budget neutrality threshold from $20 million to $57.64 million and index it to the Medicare Economic Index (MEI) every five years, to address rising practice costs.
• Revise spending estimates and budget neutrality adjustments based on utilization rates derived from claims data.
• Provide updates to direct costs used to calculate practice expense relative value units (RVUs), including clinical wage rates, medical supplies and equipment, not less often than every five years.
• Limit year-to-year positive or negative variances in the conversion factor to no greater than 2.5 percent.

This legislation is supported by the American Medical Association, American Association of Neurological Surgeons, Congress of Neurological Surgeons, American Society for Radiation Oncology, Alliance of Specialty Medicine, American College of Rheumatology, American Academy of Otolaryngology - Head and Neck Surgery, College of American Pathologists, Society of Thoracic Surgeons, American College of Cardiology, American Osteopathic Association, National Organization of Rheumatology Management, American Academy of Dermatology Association, National Infusion Center Association, Obesity Medicine Association, American Academy of Family Physicians, American Psychological Association Services, American College of Surgeons, American Society of Plastic Surgeons, Emergency Department Practice Management Association, American Association of Orthopaedic Surgeons, American Society of Breast Surgeons, American Academy of Ophthalmology, Society for Vascular Surgery, American Medical Group Association, American Psychiatric Association, American College of Radiology, American Society of Echocardiography, American Optometric Association, American College of Physicians, American Gastroenterological Association, American College of Obstetricians & Gynecologists, American College of Emergency Physicians, Medical Group Management Association, American Association of Colleges of Osteopathic Medicine, American Academy of Neurology, American Academy of Allergy, Asthma and Immunology, and American Urological Association.

Companion legislation was introduced in the House of Representatives by Rep. Greg Murphy, M.D. (R-NC), and a bipartisan group of lawmakers.

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