Bipartisan Medicare Physician Payment Legislation Introduced

Take action to support federal legislation to improve Medicare payment

The recently introduced Provider Reimbursement Stability Act, H.R. 8163, takes a major step in modernizing Medicare physician payment. Introduced by Rep. Greg Murphy, MD, (R-NC), and Rep. Tom Suozzi (D-NY), the bipartisan bill modernizes key budget neutrality rules, ensuring fairness and predictability for medical practices and stability for physicians and patients.

According to the American Medical Association, when adjusted for inflation, Medicare reimbursement for physician services has declined 33% from 2001 to 2026. Without capping these damaging cuts to physician Medicare reimbursement and other key reforms, doctors are unable to sustainably run their medical practices and are driven to retire or consider consolidating into larger groups, potentially leading to decreased access for patients in rural and underserved communities.

H.R. 8163 promotes reimbursement stability and protects physicians by updating the budget neutrality threshold; mandating that the Centers for Medicare and Medicaid Services evaluate the actual base costs for running a medical practice at least every five years; and revising how CMS addresses incorrect billing codes.

Currently, the budget neutrality threshold dictates that if spending increases exceed $20 million in one area, they must be offset by other costs in health care. The $20 million threshold has remained the same since the early 1990s and has never been adjusted for inflation. H.R. 8163 would modernize this outdated provision, providing a long overdue threshold increase to $54.3 million and indexing it every five years based on the cumulative percentage increase in the Medical Economic Index.

This bill requires CMS to regularly evaluate medical practice costs (i.e., clinical wage rates, equipment, medical supplies, etc.) to prevent large swings in payment rates. In addition, H.R. 8163 directs CMS to correct major errors in billing code estimates by reviewing actual claims data and making prospective rate adjustments, preventing deep, unnecessary cuts under current budget neutrality guidelines that stem from inaccurate utilization projections.

Make your voice heard: Contact your member of Congress and urge them to support commonsense Medicare payment reforms by cosponsoring H.R. 8163. This bill is a step in the right direction to promote viability of physician practices and patient access to care.