MedPAC Report Slammed by Insurers and Docs over Medicare Advantage and Physician Reimbursement

Fierce Healthcare | By Noah Tong
 
Health plans and providers alike are disgruntled with a new report (PDF) to Congress released by the Medicare Payment Advisory Commission (MedPAC) Friday.
 
The American Medical Association (AMA) and the Medical Group Management Association (MGMA) said the recommendations it gives for physician payments are flawed, while America's Health Insurance Plans (AHIP) defended Medicare Advantage (MA).
 
"On the heels of Congress allowing a 1.69% cut to Medicare physician reimbursement to stand for the remainder of 2024, today's MedPAC recommendation to provide a 50% inflationary update for physician servics in 2025 is woefully inadequate," said Anders Gilberg, senior vice president of government affairs for the MGMA, in a statement. "I am mystified why MedPAC even bothers to make an annual recommendation while it ignores the signficant Medicare cuts to physicians in 2024 and recent years."
 
AMA President Jesse Ehrenfeld, M.D., praised the commission's opinion to tie physician payments to the Medicare Economic Index but said its current proposal is lacking.
 
"MedPAC’s decision recognizes that physician pay is lagging far behind the cost of practicing medicine," said Ehrenfeld in a statement. "Yet, an update tied to 50% of MEI—as MedPAC recommended—will cause physician payment to fall even further behind increases in the cost of providing care."
 
The AMA has wanted Congress to pass legislation requires the MEI to better reflect inflation, a contrast from the current environment where rates have continued to fall and providers are dealing with rising costs across the board, particularly after the COVID-19 pandemic.
 
MedPAC's recommendation calls for updating the base payment rate "by the amount specified in current law plus 50% of the projected increase in the MEI." It also wants to establish safety-net add-on payments under the physician fee schedule for services delivered to low-income Medicare members…

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