ACP policy update 2025: Medicare appeal delays could strain practice operations

At the American College of Physicians (ACP) Internal Medicine Meeting 2025 in New Orleans, Brian Outland, PhD, director of regulatory affairs at the ACP, discussed the potential downstream effects of merging Medicare appeals offices and cutting staff — particularly for primary care practices dependent on timely reimbursements.

“Many physicians, even now, are not reimbursed at the levels they should be,” Outland said. “The physician payment has not kept pace with inflation for the last several years and probably a decade or more. So they are already working on a shoestring budget, as it were.”

He warned that appeals-related delays could worsen financial pressures on already struggling practices. “Right now, it’s probably 60 to 90 days for those reimbursements to come in, but it could be even longer,” Outland said. “Making it even tougher for them to be able to meet the requirements … to keep their offices running.”

The consolidation of appeals and administrative processes under a reduced federal workforce is one of several proposed changes under the Department of Health and Human Services (HHS) reorganization, raising concerns about operational bottlenecks across the health care system.