VIDEO: Medicare reimbursement reform critical to ‘keep our doors open’ to senior patients
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Without prompt reform of Medicare reimbursement, which has failed to keep pace with the rising operation costs of rheumatology practice, rheumatologists may have no choice but to opt out of the Medicare program, noted Christina Downey, MD.
“When rheumatologists don’t participate in Medicare, it closes access to a large swath of the population,” Downey, the chair of the ACR’s government affairs committee, told Healio in a video. “By helping us stay solvent, we can keep our doors open and keep serving our patients.”
On May 7, members of the ACR met with lawmakers on Capitol Hill to advocate for crucial reforms to the Medicare Physician Fee Schedule, most notably a conversion factor tying physician payments to inflation rates and a mandatory budget-neutrality requirement.
To address these two challenges, the ACR has thrown its support behind the passage of two bills: The Strengthening Medicare for Patients and Providers Act (H.R. 2474) and the Provider Reimbursement Stability Act (H.R. 6371).
According to Downey, these two bills could address physician payment disparities by:
- tying the conversion factor to the medical inflationary rate;
- re-examining budget neutrality and raising the ceiling for budget neutrality;
- re-evaluating how CPT codes are valued in 5-to-7-year intervals, in line with procedural codes;
“Together, [these] will help reform Medicare into a sustainable reimbursement system that rheumatologists can continue to participate in,” Downey said.
For more information on how to advocate for Medicare physician reimbursement reform on behalf of rheumatology providers and patients, please visit the ACR Legislative Action Center.