As previously reported by ASGE, legislation, titled the Patients First Act ( H.R. 9693), has been introduced in the House by leaders of the GOP and Democratic Doctors Caucuses that would reform the Medicare physician payment system and Quality Payment Program. In a letter to the bill sponsors, ASGE described the bill as laying the groundwork for advancing payment reform and said it “represents a thoughtful and comprehensive approach, reflecting an iterative development process that incorporated feedback from the physician community.”
The bill addresses longstanding problems with the Medicare Physician Fee Schedule (PFS) by creating a permanent inflation-adjusted payment update tied to the Medicare economic index, replacing the Merit-based Incentive Payment System (MIPS) with a new quality program, and reforming fee schedule budget neutrality requirements. Despite these critical reforms, ASGE noted in its letter the bill does not resolve every issue with the Medicare PFS, including practice expense payment changes that took effect this year and which have a significant negative impact on gastroenterology.
ASGE has and will continue to work closely with other medical societies that operate clinical data registries to advocate for changes to MIPS and to ensure that clinical data registries can be utilized to their fullest extent for Medicare quality reporting. Many of the changes advocated by ASGE are reflected in the legislation.
While comprehensive reform of the Medicare PFS and quality programs will take time, ASGE is encouraging lawmakers to not delay modernization of Medicare's budget neutrality requirements, which are a significant source of payment instability under the Medicare PFS.
Read the bill’s section-by-section summary here.