Doctors groups say spending bill isn't enough

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The House passed a spending bill to avert a partial government shutdown that included several health care-related provisions. The provision of most interest to doctors pertains to Medicare, which rolled back 1.68% of the 3.37% payment reduction required by the Medicare Fee Schedule.

Despite the reduction of the cut, physician groups say they don’t go nearly far enough.

“While we appreciate the challenges Congress confronted when drafting the current 2024 appropriations package, we are extremely disappointed that about half of the 2024 Medicare physician payment cuts will be allowed to continue,” said Jesse M. Ehrenfeld, MD, MPH, president, American Medical Association, in a statement. “There were many opportunities and widespread support to block the 3.37 percent Medicare cuts for physician services that took place Jan. 1, but in the end Congress opted to reverse only 1.68 of the 3.37 percentage payment reduction required by the Medicare Fee Schedule. The need to stop the annual cycle of pay cuts and patches and enact permanent Medicare payment reforms could not be more clear.”

Ehrenfeld added that the cuts will make it more difficult for patients to find doctors willing to take Medicare and that rural and underserved areas will be hit hardest.

“Physicians are the only providers who do not receive automatic inflation updates to their Medicare payments, and they are the only group experiencing a payment cut this year despite high inflation. Adjusted for inflation in practice costs, Medicare physician pay declined 30 percent from 2001,” Ehrenfeld said, adding that Congress needs to move beyond stopgap measures and focus on real reform.

Likewise, Steven P. Furr, MD, FAAFP, president of the American Academy of Family Physicians, said the remaining cuts are untenable.

“We’ve repeatedly told Congress that the 3.4% Medicare payment reduction that went into effect on January 1 is untenable for family physicians and threatens patients’ access to primary care,” Furr said in a statement. “With the passage of this legislation, Congress has offset 2.93% of that payment cut. We appreciate this temporary measure but continue to urge Congress to advance comprehensive, long-term Medicare payment reform.”

Furr pointed out that Congress has only reauthorized the Teaching Health Center Graduate Medical Education program through Dec. 31, 2024. THCGME is a program that encourages physicians to practice in rural and other underserved communities.

“Short-term extensions jeopardize access to care for millions of patients,” Furr said. “Without the stability of a multi-year reauthorization, family medicine residents face significant uncertainty about what their future looks like. This approach to funding discourages residents from choosing to practice in areas where health care access is already at risk.”

President Biden is expected to sign the bill today.