Medicare

WTAS: Support Builds for Boozman-Welch Legislation to Protect Seniors’ Access to Healthcare

U.S. Senator John Boozman, AR

WASHINGTON –– U.S. Senators John Boozman (R-AR) and Peter Welch (D-VT) announced support from national health organizations for the Physician Fee Stabilization Act, legislation that ensures greater flexibility in determining pricing adjustments for medical services without triggering harmful annual payment cuts to Medicare-serving physicians.

The legislation is also cosponsored by Senators Thom Tillis (R-NC), Angus King (I-ME), Roger Marshall, M.D. (R-KS) and Jeanne Shaheen (D-NH). 

What They Are Saying

“Physicians cannot continue to be faced with large reductions in Medicare payment at the beginning of each year, threatening our practice operations and access to care for our nation’s seniors. The American College of Physicians supports the Physician Fee Stabilization Act that would help to ensure this doesn’t continue to happen by raising the threshold for the implementation of budget neutral payment cuts,” said Isaac O. Opole, MBChB, PHD, MACP, President, American College of Physicians.

“The Physician Fee Stabilization Act would provide a much-needed increase to the budget neutrality threshold, raising the trigger amount from $20 million, where it has been since 1992, to $53 million. It would then provide for inflationary increases every five years based on the Medicare Economic Index. As proposed, the $33 million increase is proportional to the growth of Part B spending since the implementation of the PFS,” said American College of Surgeons Executive Director and CEO Patricia L. Turner, MD, MBA, FACS. “This would be an important step forward to ensure greater flexibility in determining pricing adjustments for services without triggering re-occurring across-the-board cuts at the end of every year.”

“The Physician Fee Stabilization Act is a vital step toward ensuring stability and fairness in physician payment reform, especially for cardiologists who provide life-saving care. By raising the budget neutrality threshold, this legislation will help prevent annual cuts that threaten patients’ access to cardiovascular care. The American College of Cardiology commends Senators Boozman, Welch, Tillis, King, Marshall and Shaheen for their leadership and commitment to supporting our nation's cardiologists and their patients,” said American College of Cardiology President Cathleen Biga, MSN, FACC. 

“The Physician Fee Stabilization Act marks the Senate's first legislative solution this year to help ensure fair and consistent Medicare payments for physician services, and Congress should pass this bill to help ensure our nation’s seniors continue to have timely access to the physician of their choice. We applaud the bipartisan group of Senators leading this initiative and look forward to working with policymakers to advance additional long-lasting Medicare policy solutions,” said Russell R. Lonser, MD, FAANS, American Association of Neurological Surgeons and Congress of Neurological Surgeons.

“The American Academy of Dermatology Association sincerely thanks Senators Boozman and Welch for introducing the Physician Fee Stabilization Act, which would update the budget neutrality thresholds in the Medicare physician fee schedule,” said American Academy of Dermatology Association President Seemal R. Desai, MD, FAAD. “This bill is a crucial step in the fight to reform Medicare physician payment as it would revise budget neutrality policies that contribute to eroding reimbursement, which is not only a critical top priority for dermatologists, but for all physicians and most importantly the patients we serve.”

“The AAMC applauds Sens. Boozman and Welch for introducing the Physician Fee Stabilization Act. Physicians employed by teaching health systems and hospitals across the country are dedicated to both providing care to the most complex and vulnerable patients and training the next generation of physicians. These large, multispecialty practices are vital resources to their local communities, providing significant primary care and other critical services, including a large percentage of tertiary, quaternary, and specialty referral care in the community. However, their ability to continue to provide care in their communities is in jeopardy due to the threat of yearly cuts to their patient care payments,” said Danielle Turnipseed, JD, MHSA, MPP, Chief Public Policy Officer of the Association of American Medical Colleges. “The Physician Fee Stabilization Act would update the current budget neutrality threshold in the Medicare Physician Fee Schedule (PFS), and continue to update it every five years. While more is needed to ensure the stability and longevity of the PFS, this is a critical step, and we appreciate the bipartisan commitment of Sens. Boozman and Welch to addressing issues with the PFS and look forward to working to get this legislation passed.”

“The American Urological Association (AUA) applauds Senators John Boozman and Peter Welch, along with Senators Thom Tillis, Angus King, Roger Marshall, MD and Jeanne Shaheen, for their leadership in introducing S. 4935, the Physician Fee Stabilization Act,” said AUA Public Policy Council Chair Mark Edney, MD, MBA. “This bipartisan legislation takes the critical step of increasing the budget neutrality threshold from $20 to $53 million with adjustments every five years to keep pace with the MEI. The budget neutrality threshold has not been updated in more than 30 years and physicians are the only Medicare provider without inflationary payment updates. S. 4935 would fix this and bring much-needed stability to physician payment year after year, helping to ease the provision of urological care and countless other services to millions of Americans under Medicare.”

“The American Optometric Association (AOA) applauds Sens. Boozman and Welch, for the visionary direction S. 4935 sets for future growth of health care access,” said Steven Reed, O.D., AOA president. “For so many years, physicians of all types, including doctors of optometry, have long been impacted by stagnant Medicare reimbursement. The costs to deliver care continue to increase especially in regard to staffing and overhead costs, yet Medicare reimbursement has remained and proposed cuts only threaten to hamper physicians’ ability to provide valued care. S. 4935 takes a long-term forward-looking approach to a real solution – not a patch – to address this problem.”

Boozman, Welch lead letter calling for legislative solution to protect access to Medicare services

WASHINGTON – U.S. Senators John Boozman (R-AR) and Peter Welch (D-VT) along with 30 of their colleagues are calling on Senate leaders to advance a legislative solution to support access to Medicare services by ensuring health care providers who treat Medicare patients are adequately compensated for the care they deliver.

Medicare physician payments were cut 3.37 percent earlier this year. The rising costs to practice medicine and shortage of doctors have led some health care professionals to limit the number of Medicare patients they serve.

“It is anticipated that these cuts will be felt hardest by smaller, independent practices, like those in rural and underserved areas that continue to face significant health care access challenges,” the senators wrote to Majority Leader Chuck Schumer and Republican Leader Mitch McConnell. “The most important step that Congress can take to create stability in the Medicare program is to address the cut to Medicare payments. We as policymakers must ensure that healthcare providers who treat Medicare patients continue to have the necessary financial support to care for our nation’s seniors.”

Text of the letter can be found below and here.

Dear Majority Leader Schumer and Minority Leader McConnell:

We write to request that you urgently address the 3.37 percent cut to Medicare payments that went into effect on January 1, 2024. Failure to address these cuts will threaten the continued ability of physicians and other healthcare providers to care for their patients. 

We in Congress must continue our partnership with the healthcare provider community to ensure that Medicare patients retain access to quality care. The United States is experiencing a critical shortage of physicians and healthcare providers. Estimates highlight a projected shortfall of up to 124,000 physicians by 2034[1] and a shortfall of up to 73,310 allied health professionals by 2036[2]. A major contributing factor to this unfortunate reality is our Medicare physician payment system, which has failed to maintain physician reimbursement at levels that adequately incentivize high-quality care.

After three consecutive years of Medicare payment reductions, healthcare providers are at a breaking point and are struggling to maintain access to care for the Medicare beneficiaries they treat. Facing a nearly 10 percent reduction in Medicare payments over the past four years, rising practice costs, workforce shortages, and financial uncertainty resulting from the pandemic, some practices are already limiting the number of Medicare patients they see, or the types of services offered. It is anticipated that these cuts will be felt hardest by smaller, independent practices, like those in rural and underserved areas that continue to face significant health care access challenges.  

On behalf of patients and healthcare workers, Congress must urgently work together with the provider community to come up with long-term legislative solutions to reform the Medicare Access and CHIP Reauthorization Act (MACRA). These efforts are critical to supporting patients’ access to high-quality Medicare-covered services and bolstering our healthcare workforce. Specifically, we must ensure its intended goal of shifting towards value-based care is fulfilled.

In the interim, the most important step that Congress can take to create stability in the Medicare program is to address the cut to Medicare payments. We as policymakers must ensure that healthcare providers who treat Medicare patients continue to have the necessary financial support to care for our nation’s seniors. 

We appreciate your attention to this critical matter and look forward to working together on this issue.   

Sincerely,


[1] https://www.aamc.org/media/54681/download?attachment

[2] https://bhw.hrsa.gov/data-research/projecting-health-workforce-supply-demand

ACHI’s Dr. Joe Thompson on COVID, drug prescription negotiations

by Roby Brock (roby@talkbusiness.net)

Dr. Joe Thompson with the Arkansas Center for Health Improvement (ACHI) expects federal Medicare drug negotiations to expand in coming years as a more capitalistic and competitive approach to healthcare emerges.

This past week, the Biden administration announced 10 drugs that will be negotiated for price discounts in Medicare, a first for the program.

“This is a very significant change for the federal Medicare program. Medicare is what we care for elderly in our nation. Since 1965 when Medicare was first put in place, it did not cover prescription drugs. The Part D program that went in place after the turn of the century did cover prescription drugs, but it did not allow the federal government to negotiate price on prescription drugs. So this is the first time Medicare, our federal insurance program for the elderly, has been able to negotiate price with pharmaceutical companies for now 10 drugs that are some of the most expensive drugs for people to pay,” Thompson said.

https://talkbusiness.net/2023/09/achis-dr-joe-thompson-on-covid-drug-prescription-negotiations/

Federal agency asks states to pause Medicaid unwinding; DHS says request does not apply to Arkansas

KUAR | By Tess Vrbin / Arkansas Advocate

The U.S. Centers for Medicare and Medicaid Services (CMS) sent a letter to all 50 states Wednesday, asking some to restore coverage for people who were recently disenrolled for procedural reasons.

The request does not apply to Arkansas, Department of Human Services spokesman Gavin Lesnick said in an email.

DHS conducts Medicaid eligibility reviews on an individual basis and does not require eligibility information for every member of someone’s household to provide benefits to that person, he said.

https://www.ualrpublicradio.org/local-regional-news/2023-08-31/federal-agency-asks-states-to-pause-medicaid-unwinding-dhs-says-request-does-not-apply-to-arkansas

Daniel Breen/Little Rock Public Radio

Members of the group Arkansas Community Organizations protest the state's Medicaid unwinding process at the State Capitol on Aug. 22, 2023.

U.S Sen. John Boozman introduces bill aiming to address physician shortage

KUAR | By Ronak Patel

U.S Sen. John Boozman, R-Arkansas, is supporting the Resident Physician Shortage Reduction Act, which aims to increase the amount of residency programs available for medical students.

Currently, there is a cap on the amount of residency program positions that Medicare can fund and this bill would raise that cap. Boozman said the cap needs to be raised because it limits the number of physicians in Arkansas.

“As you graduate from medical school, you need to find a spot in a residency program. Sadly there’s not enough of those,” Boozman said in an interview. “As a result, you might have individuals who simply get through medical school and can’t find a residency and have to wait until one opens. All the while, we’ve got a huge shortage in medical providers.”

https://www.ualrpublicradio.org/local-regional-news/2023-05-03/u-s-sen-john-boozman-introduces-bill-aiming-to-address-physician-shortage

Michael Hibblen/KUAR News

U.S Senator John Boozman, R-Arkansas, is working with Republicans and Democrats on a bill they believe will help address the shortage of physicians. The bill has the support of Senate Majority Leader Chuck Schumer, D-New York.

Rural Emergency Hospital bill expected to help financial crisis for some

by Ronak Patel (rspatel.personal@gmail.com)

Rep. Lee Johnson, R- Greenwood, filed a bill aimed at helping rural hospitals in financial distress. HB 1127, the Rural Emergency Hospital Act, would grant the Arkansas Department of Health (ADH) the authority to license hospitals as “rural emergency hospitals.”

In an interview with Talk Business & Politics, Johnson explained this type of licensure can help hospitals in rural areas with their finances.

“It [Rural Emergency Act] provides a pathway for rural hospitals in Arkansas to take advantage of a new designation that was created by CMS [Center for Medicare & Medicaid Services] at a federal level. This new designation would allow qualifying rural hospitals to get reimbursed at a higher rate for outpatient services and procedures,” he said.

https://talkbusiness.net/2023/01/rural-emergency-hospital-bill-expected-to-help-financial-crisis-for-some/

Arkansas DHS preparing for new community-based health initiatives

KUAR | By Daniel Breen

The Arkansas Department of Human Services is preparing to roll out new public health services as part of ARHOME, the state’s Medicaid expansion program.

DHS officials say they soon expect to receive approval from the federal Centers for Medicare and Medicaid Services for their Life360 HOME initiative to provide more services to populations most at risk of negative health outcomes.

In a webinar Thursday hosted by Arkansas Advocates for Children and Families, Nell Smith, assistant director of the DHS Division of Medical Services, said the department will contract with local hospitals to provide care for three categories of Medicaid recipients.

https://www.ualrpublicradio.org/local-regional-news/2022-10-27/arkansas-dhs-preparing-for-new-community-based-health-initiatives

Arkansas Center For Health Improvement/Achi.Net

A map shows the potential location of Life360 Homes under the Arkansas Department of Human Services ARHOME Medicaid expansion program.