Medicare physician reimbursement: ‘Stop attacking those who were heroes just a couple years ago’

© Andrea Izzotti

A 1.68% increase in Medicare funding for physicians is just not enough, said Rep. Greg Murphy, MD (R-North Carolina), co-chair of the GOP Doctors Caucus.

The U.S. Centers for Medicare & Medicaid Services (CMS) announced the 2024 Medicare Physician Fee Schedule would cut physician reimbursement by 3.37%. With rising costs and price inflation, reimbursement has become a red-hot issue for doctors in the nation’s capital.

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

The House of Representatives voted March 6 to restore a 1.68% increase to physicians in federal spending bills needed to avert a government shutdown. Physician groups panned the move, and Murphy, a career urologist and the only practicing surgeon in Congress, agreed.

Murphy spoke to Medical Economics on a variety of issues pending that could affect physicians and their patients. This transcript has been edited for length and clarity.

Medical Economics: What is the up-to-the-minute status of physician reimbursement in Congress?

Rep. Greg Murphy, MD: One of the reasons I still practice is because I care about the house of medicine. I care a lot, really most, about our patients the people who provide the care to them. When this mandatory cut was coming along … 3.37% I'm just tired of it, to be frank. I’m tired of physicians always being cut and expecting a cut every year, having to fight cuts when we see other parts of the government that are just making more and more money. It was a debate within the four corners, as they say, of the Republican and Democrat House leaders and the same thing in the Senate. It came out where only half the cut occurred. Truth be told, (Sen.) Bernie Sanders (I-Vermont) and Senator (Ron) Wyden (D-Oregon) wanted more money for community health centers and did not want to have plus up to baseline, not raises, just to baseline for physician pay. The bill just passed for this. I voted against it because it's time, way past time, that we stop attacking those who were heroes just a couple years ago, and now are being treated as demons. I'm not sure why, you know, I'm sorry to say this, but Senate Democrats, it's turned into a partisan issue in the payment of physicians and so I just don't understand that and so I have to draw a line in the sand and voting for any of these things.

(Editor’s note: Senate Democrats tied a full cut aversion to an increase in funding for community health centers. Murphy emphasized he is supportive of community health centers but in that vote solely focused on alleviating doctors.)

Medical Economics: The American Medical Association and other medical organizations have called for reforms to Medicare's physician payments in a bigger picture sense. Do you support reform and how exactly would you like to see that change?

Rep. Greg Murphy, MD: I absolutely support reform and that's one of the things that I'm desperately working on. We need to get back to the system where we have inflation adjusted payments. We also do a much, much, much better job by CMS of understanding utilization. Stop paying for things that we don't need to pay for. I'm personally not a fan of Medicare Advantage because they're bilking the Medicare system for billions and billions of dollars with prior authorizations and all these things that are absolutely (obstructing) care. We need to reform the system on so many different levels, I could probably talk for an hour on that one topic alone.

Medical Economics: Medicare Advantage is growing in popularity, but there have been reports critical about Medicare Advantage plans, ranging from overcharging taxpayers to improper denial of care for patients, to lack of transparency to regulators. What reforms to Medicare Advantage would you like to see?

Rep. Greg Murphy, MD: I'd personally like to see Medicare Advantage abolished, and restarted and begun again because it started out as a good program, thought to bring seniors and give seniors choice. But what it's done is actually limit choice, cost us consumers more, denied care and basically have burgeoning profits for insurance companies. And you know, they need to get back to the day where the doctor takes care of the patient. I know some of these insurance companies where they hire doctors that basically stamp 500 denials at a time never looking at them, and deny care. It’s gotten absolutely out of control. Medicare Advantage has been criticized for hypercoding, going in and upcoding individuals so that they can charge more. It's a bad system. It denies care and it's ruining our Medicare dollar.