ASGE previously reported that legislation recently introduced in the U.S. House of Representatives would make improvements to budget neutrality requirements within the Medicare physician fee schedule (PFS). Specifically, that bill, the Provider Reimbursement Stability Act (H.R. 8163) raises the existing $20 million budget neutrality trigger to $54.3 million, and, starting in 2032, requires this figure to be increased by the cumulative Medicare Economic Index (MEI) no less frequently than every five years.
Budget neutrality is a statutory mechanism created in1989. Under current law, increases of $20 million or more to the Medicare PFS — created by upward payment adjustments or the addition of new procedures or services — must be offset by cuts elsewhere in the PFS. This results in lower, across-the-board payment rates for physicians, creating financial pressure as costs outpace reimbursement.
This legislation represents a major component of overhauling the Medicare physician payment system. ASGE members are urged to take just a few minutes to send an email through the ASGE Action Center where a template letter is available to personalize.