The voices of individual physicians and physician assistants are crucial in informing the decisions made at the state and federal levels.
Take Action
Medicare payment reform will not happen without sustained advocacy.
Please take a few minutes to contact your members of Congress and senators, whether that’s by attending a local town hall meeting, participating in a fundraiser, or sending them an email on the three calls to action on this page. We need their engagement and support on these important reforms.
Urge Congressional Action on CMS Modifier -25 Proposal
The WSMA is opposing a Medicare proposal currently before the Centers for Medicare & Medicaid Services, and we need members of our congressional delegation to intervene.
CMS has proposed reducing payment by 50% when a separately identifiable office/outpatient evaluation and management service reported with modifier -25 is furnished on the same day as a procedure with a 0-, 10-, or 90-day global period. Under the proposal, the highest-valued service would be paid at 100%, while other procedures or E/M services furnished on the same day would be paid at 50%.
The WSMA is urging CMS not to adopt this policy and is asking members of Congress to urge CMS to withdraw the proposal. Beyond the impact to physician reimbursement, this proposed policy could significantly impact patients’ access to care by requiring them to receive care over multiple appointments, rather than in a single visit.
Ask your members of Congress to urge CMS to withdraw the proposed 50% payment reduction and reconsider the policy in light of the concerns raised by physicians and medical organizations.
Urge Congress to Support The Provider Reimbursement Stability Act
The Provider Reimbursement Stability Act, H.R. 8163 and S. 5180, takes a major step in modernizing Medicare physician payment by modernizing key budget neutrality rules, ensuring fairness and predictability for medical practices and stability for physicians and patients.
H.R. 8163 and S. 5180 promote reimbursement stability and protects physicians by:
- Updating the budget neutrality threshold.
- Mandating that the Centers for Medicare & Medicaid Services evaluate the actual base costs for running a medical practice at least every five years.
- Revising how CMS addresses incorrect billing codes.
Contact your senators and representative in Congress and urge them to support common sense Medicare payment reforms by cosponsoring this bipartisan bill.
Urge Your Representative to Cosponsor The Patients First Act
The Patients First Act, H.R. 9693, would reform the Medicare physician payment system by providing greater stability, expanding opportunities for participation in payment models, and better aligning payment updates with the actual costs of care and inflation. Led by Reps. Greg Murphy, MD (R-NC), John Joyce, MD (R-PA), and Kim Schrier, MD (D-WA), this bipartisan bill would help create a more stable and predictable Medicare payment system so physicians can keep caring for patients in their communities.
H.R. 9693 would stabilize Medicare by:
- Providing a permanent annual payment update tied to the Medicare Economic Index to better reflect increases in practice costs.
- Modernizing budget neutrality policies, including provisions from H.R. 8163.
- Creating a physician-led process for developing simplified, clinically relevant quality measures.
- Expanding opportunities for physicians to participate in alternative payment models.
Contact your representative in Congress today and urge them to cosponsor the Patients First Act, H.R. 9693.