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The expertise, experience, and perspective of physicians and physician
assistants practicing in Washington is crucial to helping to inform our
advocacy on your behalf. And, it's often crucial in helping to inform
legislators' decision-making on policy being debated at the state and
federal levels.
On this page, we'll highlight some of WSMA's top advocacy priorities where
lawmakers need to hear from physicians and PAs directly.
Action Alert on Physician Medicare Payment Cuts
Physicians are facing yet another round of Medicare payment cuts by the Centers for Medicare and Medicaid Services. Unless Congress acts by the end of the year, physician Medicare payments are planned to be cut by 8.42% in 2023, which would severely impede patient access to care due to the forced closure of physician practices, and put further strain on those that remained open during the pandemic.
These scheduled cuts will come in three forms:
- Centers for Medicare & Medicaid Services. CMS has proposed a 4.42% cut for all physician services in 2023 to offset payment policy improvements in office and facility-based visits.
- No inflationary update. Physicians are the only providers whose Medicare payments do not automatically receive an annual inflationary update; during this time of record inflation on the heels of a highly disruptive pandemic, this statutory flaw amplifies the impact of proposed payment cuts.
- PAYGO. Congressional Pay-As-You-Go (PAGO) rules have been triggered requiring an automatic 4% cut as a result of new federal spending having nothing to do with physicians. These cuts will kick in in 2023 unless waived by Congress.
Physicians simply cannot afford to operate under the current payment system. Congress must reform the Medicare physician payment system to make it simpler, more reflective of real-world physician practice costs and more predictable for both physicians and CMS before it's too late!
Recently, Representatives Ami Bera, MD (D-CA) and Larry Bucshon, MD (R-IN) introduced H.R. 8800, the Supporting Medicare Providers Act, to help address the flawed payment system and provide relief from the devastating cuts.
This is a great first step, it is critical that Congress act to pass it or any other legislation that will prevent these devastating cuts from going into effect. Please take a moment and contact your senators and representative to tell them to cancel the cuts!
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Action Alert on Prior Authorization
As Congress returns from the August recess there is still much work left to be done on the important health care issues facing the country including the broken prior authorization system.
Physicians complete an average of 41 prior authorizations per week. This unnecessary burden amounts to roughly 13 hours weekly that physicians and their staff must spend on administrative work instead of seeing and treating patients. If an insurance plan covers a treatment that would benefit a patient, physicians should not have to waste time ensuring access to it.
This flawed system must be fixed! Thankfully, the House of Representatives is expected to vote on the bi-partisan Improving Seniors' Timely Access to Care in the coming days. This legislation would require Medicare Advantage plans to adopt transparent prior authorization programs that adhere to evidence-based medical guidelines and hold plans accountable for making timely prior authorization determinations and providing rationales for denials.
The time is now to stand up to the big insurance companies and hold them accountable for the undue burden these excessive and unnecessary prior authorizations put on our country's physicians and their patients.
There are only a handful of legislative days left this year to get this legislation over the finish line, please join us in the fight today to get our health care system back on track by fixing the broken prior authorization system.
Please contact your member of Congress today and urge them to vote YES on the Improving Seniors' Timely Access to Care Act!
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