capitol hill report: congress acts on medicare cuts
March 11, 2024
Issue in Focus
On March 8, 2024, Congress passed a budget package which included, among other provisions, a partial fix to the 3.37 percent cut to the Medicare Physician Fee Schedule (MPFS) conversion factor. Starting March 9, the Medicare conversion factor was increased by 1.68 percent relative to what had previously been finalized for 2024. This fix is not retroactive, so it will only apply to services provided from March 9 through December 31, 2024. Extrapolated to account for the months in which this increase was not in place, it accounts for a 1.37 percent increase to the reduced conversion factor previously finalized for 2024.
Even this partial fix would not have been possible without the advocacy efforts of AAN members, staff, and other physician organizations. The AAN has sent several letters to Congress asking for the cut to be addressed, and members continuously made the need for immediate action clear by sending letters, bringing awareness to the issue on social media, and visiting their representatives in person at the AAN’s Neurology on the Hill. The partial fix underscores the importance of being engaged with AAN advocacy.
The 2024 MPFS already included some great wins for AAN members before any fix was proposed by Congress. Specifically, the G2211 complexity add-on code provides a substantial increase for outpatient E/M services and allows you to finally be reimbursed for the additional work required for serving as the focal point of care while treating a patient with a serious or complex condition. When you take the projected reimbursement from this new code into account combined with congressional action to partially offset the conversion factor cut, neurology as a specialty is projected to see a significant increase in reimbursement for 2024.
While this was not the complete fix the AAN advocated for, we expect this across-the-board increase and other changes to physician payment under the Medicare program to be a substantial net positive for neurology in 2024.
Latest Advocacy News
CMS Responds to Change Healthcare Cyberattack
In response to ongoing disruptions stemming from the cyberattack on Change Healthcare, the Centers for Medicare and Medicaid Services (CMS) announced that impacted physicians can apply for advanced Medicare payments to offset cash flow disruptions. More information can be found in the fact sheet released by CMS. The AAN is closely monitoring this ongoing situation and has participated in several meetings with leadership from CMS, Change, and UnitedHealth Group.
Congress Releases Government Funding Bills for FY24
Congress released the first set of government funding bills for FY24, which included the MilCon VA bill that funds the VA Neurology Centers of Excellence. These centers were given a $20 million increase over FY23 levels, bringing the total to $70 million for FY24.
AAN Urges CMS to Maintain Parity for Telehealth Evaluation
On February 28, the AAN submitted a letter to the CMS proactively urging the agency to maintain parity for in-person and telehealth evaluation and management services as the agency considers potential changes to telehealth policies as part of the upcoming 2025 Medicare Physician Fee Schedule. The AAN’s letter shared a concrete rationale as to why both work and practice expense should be valued the same regardless of modality, and provided the agency with evidence supporting equivalence of in-person and remote care for acute and routine assessment of various neurologic conditions.
AAN Joins Organizations in Support for the Healthcare Workforce Resilience Act (HWRA)
The AAN joined 52 organizations to send letters to the House and Senate thanking Senators Durbin (D-IL) and Cramer (R-ND), and Representatives Schneider (D-IL), Caraveo (D-CO), Bacon (R-NE), and Cole (R-OK) for introducing the Healthcare Workforce Resilience Act (HWRA). This bill allows for the recapture of up to 40,000 unused employment-based visas for international physicians and nurses over a three-year period, aimed at strengthening the workforce shortage and increasing access to care in rural and underserved communities. International physicians are an invaluable component of the US health care system, especially given the country is expected to face a shortage of up to 124,000 physicians over the next decade. The AAN has been working tirelessly to address workforce shortages in neurology and is a leader in the reauthorization and expansion of the Conrad 30 program.
What We're Reading
- All Drugmakers Send In Counteroffers In Medicare Price Negotiations (The Hill)
- Statistical Models Vs. Front-Line Workers: Who Knows Best How To Spend Opioid Settlement Cash? (KFF Health News)