Bill would restore Medicare physician reimbursement for 2025

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The year 2025 started with a reimbursement cut in the Medicare Physician Fee Schedule, but representatives hope to turn that around.

Doctors and their supporters in the House of Representatives have introduced the bipartisan Medicare Patient Access and Practice Stabilization Act, legislation that would cover the 2.83% cut. Bill co-sponsor Rep. Greg Murphy, MD (R-North Carolina) noted that decrease plus a projected practice cost increase of 3.6% would add up to a 6.43% cut unless Congress acts.

After years of Medicare reimbursement cuts, the future of private practice medicine “is in dire straits,” Murphy said in his announcement about the legislation. He noted it is the most cost-efficient and personalized form of health care, and the legislation would ensure it remains viable.

Rep. Greg Murphy, MD (R-North Carolina)

“Doctors see Medicare patients out of compassion, not for financial gain,” Murphy’s statement said. “The cost of caring for a Medicare patient far outpaces the reimbursement that physicians receive for seeing them.

“On top of that, the expense of providing care continues to rise due to medical inflation,” he said. “This inflation, coupled with declining reimbursement rates, creates enormous financial pressures on physicians, forcing many to retire early, stop accepting new Medicare patients, or sell out to larger, consolidated hospital systems, private equity, or even insurance companies.”

Voicing support

Murphy’s announcement included statements of support from other physicians and supporting co-sponsors in the House: Rep. John Joyce, MD (R-Pennsylvania); Rep. Raul Ruiz, MD (D-California); Rep. Mariannette Miller-Meeks, MD (R-Iowa); Rep. Kim Schrier, MD (D-Washington); Rep. Ami Bera, MD (D-California); Rep. Jimmy Panetta (D-California); Rep. Claudia Tenney (R-New York); Rep. Carol Miller (R-West Virginia); and Rep. Raja Krishnamoorthi (D-Illinois).

As word began to spread about the Jan. 31 introduction, the Medical Group Management Association (MGMA), the American Medical Association (AMA), and the Medical Society of the State of New York (MSSNY) all issued statements agreeing the bill is needed.

A threat to health care access

They and the lawmakers agreed that the Medicare reimbursement decline poses the greatest threats for independent practitioners in rural and underserved parts of the nation.

“With nearly 80% of all physicians now employed by facilities and larger entities, Medicare beneficiaries in areas of the country that rely solely on community-based medical practices are especially vulnerable to access issues,” said a statement from Anders Gilberg, MGMA senior vice president of government affairs. “Without immediate congressional action on this important legislation, more and more physician practices will be forced to close their doors, unable to keep up with rapidly rising staff salaries, rent, and administrative costs.”

The clock is ticking

MSSNY President Jerome C. Cohen, MD, thanked Tenney for her involvement, but called out Congress for failing to address the issue in the continuing resolution spending debate in late 2024.

“After facing Medicare cuts in each of the previous four years, and at a time when we are facing significant access to care issues across New York state, the lack of action by Congress to fix this problem has the potential to worsen seniors’ access to comprehensive care,” he said.

That resolution expires March 14, so the clock is ticking, said AMA President Bruce A. Scott, MD.

“Physicians are healers first, but we are asking them to become vocal advocates for their patients over the next 45 days by contacting their members of Congress and urging them to include this bill in the next spending package. Patients, particularly Medicare recipients and anyone with a family member on Medicare, should do likewise.”

AMA has repeated the physician reimbursement decrease is not just one year, but has been happening since 2001 for a total drop of 33%.