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Physicians lobby Congress on Medicare pay cuts

Indiana lawmaker expresses hope that payment cuts to doctors are reversed in next spending bill

Rep. Larry Bucshon, R-Ind., told the American Medical Association that he was optimistic that cuts to doctors under a 2015 law could be reversed or partially reversed as part of the next spending bill.
Rep. Larry Bucshon, R-Ind., told the American Medical Association that he was optimistic that cuts to doctors under a 2015 law could be reversed or partially reversed as part of the next spending bill. (Bill Clark/ CQ Roll Call)

Rep. Larry Bucshon on Tuesday told doctors upset about Medicare reimbursement cuts that began in January that there’s a good chance at least part of those cuts could be addressed in a spending package Congress is supposed to pass next month. 

“Do I think we’ll get the full 3.4 percent?” the Indiana Republican said, referring to the level of cuts that doctors have dealt with this year, during an appearance before the American Medical Association’s national advocacy conference. “I don’t know, but people in both political parties and on both sides of the Capitol know this has to be fixed.”

Bucshon, a surgeon who is vice chair of the House Energy and Commerce Health Subcommittee, made the comments as about 400 physicians from around the country arrived on Capitol Hill to lobby to reverse those cuts, which were part of the 2024 Medicare Physician Fee Schedule and which took effect in January.

Those cuts were required by a 2015 federal law that says payments must not increase spending by more than $20 million a year.

Under that law, any increases to one group of physicians — like primary care — typically results in decreases to others, a practice known as budget neutrality. 

Congress has been stepping in annually since 2020 to avert at least some of the cuts. But they typically do so in December or January before Medicare begins processing claims for the new year.

But lawmakers have not acted on the issue this year because of a series of stopgap spending bills, and the cuts took effect Jan. 1.

Bucshon and others are hopeful that the cuts can be reversed in the next fiscal 2024 funding law. The current stopgap funding law will expire in two parts, with funding for some agencies expiring March 1 and others expiring March 8.

“We are interacting with the leadership on both sides of the aisle,” Bucshon said, adding “I think we’ll get most of those cuts mitigated at the end of this month or in March.”

Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure, who also spoke at the conference Tuesday, said the issue is out of the agency’s hands.

“We have very limited tools as an agency in terms of how we pay physicians,” she said.

In an interview, AMA President Jesse Ehrenfeld said Congress had an opportunity to reverse the cuts in the most recent continuing stopgap funding law, but didn’t.

“Congress continues to fail the American people and is unproductive and that is a little disheartening as we continue to work in a very challenging political environment,” he said, adding, “There’s not an office I go to where people say ‘Oh sure this [the cuts] makes sense.’ People understand this has to be addressed. It’s just the mechanics of Congress.”

“This is something that everybody knows that needs to be done,” he said.

The AMA, other physician groups and some members of Congress have been advocating for long-term fixes to the fee schedule that would tie payment updates to inflation and lift the budget neutrality rules from $20 million to $53 million.

But the short-term odds for long-term fixes is are “not great” because of “the cost,” said Bucshon, who is retiring after this Congress.

“It may take another one or two Congresses, so stay in the fight,” Bucshon told the physicians, adding that he hopes to influence the issue from the outside.

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