For years, medical professionals have complained about two particular issues with Medicare billing.

First, while Medicare participants receive annual inflationary updates, the Medicare Physician Fee Schedule (MPFS) has not kept up with inflation, meaning that physicians are frequently required to absorb additional costs themselves. Second, with the passage of every new budget, Congress threatens to make significant cuts to Medicare physician payments, either through direct cuts or through a failure to renew scheduled reductions.

At a time when America is still reeling from the consequences of the past year’s record inflation, these two issues have compounded to create a difficult and tumultuous environment for healthcare workers.

Now, a bipartisan group in Congress is working to resolve this problem.

A letter to House leadership is currently making its way through government, spearheaded by Representatives Ami Bera, MD (D-CA) and Larry Bucshon MD (R-IN). In the letter, the group urges leadership to promptly reform the Medicare payment system with the hope that additional reforms will come at some point this year.

Specifically, the letter asks that Congress establish a Medicare physician reimbursement system focused on the long-term, offering stability for both Medicare beneficiaries and physicians. This conversation comes attached to a bill that is also making its way through Congress: HR 2474.

The bill in question, sponsored by California Representative Raul Ruiz, is designed to improve the Medicare physician payment system by tying payments to inflation via the Medicare Economic Index, which tracks the changes in physician practice costs over time.

HR 2474 itself is succinct, but its impact could be massive for the industry. That said, rather than seeing this change as a drastic shift in Medicare payments, industry professionals have noted that the passage of this bill would simply put physicians on equal footing with a majority of other health care providers, who implement inflation-based updates with regularity.

The passage of this bill would resolve the aforementioned issues while implementing a new system that has the potential to bring stability to the Medicare payment system in the long-term.

In some ways, the passage and implementation of this bill is a continuation of a previous effort to improve the payment system for physicians’ Medicare payments.

Back in 2015, the Medicare Access and CHIP Reauthorization Act (MACRA) was enacted with the intention of shifting Medicare away from determining payments based on the number of services and toward paying for the quality of care provided.

While the intention was positive, the implementation has caused headaches for those working in the healthcare profession. Substantiating care has led to enormous administrative burdens for physicians, with many stating that the metrics provided by the system have little or nothing to do with the actual quality of care.

Moreover, given Congress’ propensity to offer only short-term plans and funding for programs related to Medicare — physician payment rates have recently faced 2% cuts in addition to being subject to a six-year payment freeze that is planned to last until 2026 — all of these aspects have built upon each other to make the continuation of the current Medicare system untenable.

Manifold healthcare organizations have already come out in favor of the latest attempt at reform, HR 2474. The American Medical Association (AMA), the American Association of Neurological Surgeons (AANS), the Congress of Neurological Surgeons (CNS) and the Medical Group Management Association (MGMA) have all voiced support for the bill, with the AMA citing a 26% decline in inflation-adjusted payments for physicians since 2001 as one of many reasons for their support of the bill.

This bill is still very much in the early stages of the Congressional process, and it’s unclear if changes will be made as it goes through Congress or if the bill will pass at all.

That said, given the desperate need for measures like these, it’s likely that Congress will have to act soon to resolve the lingering issues in the Medicare system, whether that solution is found in HR 2474 or another bill entirely. As always, we will monitor the journey of this bill and keep you updated as the situation unfolds.