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Congress Passes Legislation to Mitigate Steep Medicare Payment Cuts

Before adjourning in 2022, Congress passed legislation to mitigate a combined 8.5% Medicare physician payment cut (a 4.5% Medicare Physician Fee Schedule (MPFS) and a 4% Statutory Pay-As-You-Go Act (PAY GO) of 2010 cut). The Consolidated Appropriations Act, 2023 (P.L. 117–328) provided partial relief from the cuts as follows:

  • 2.5% positive adjustment to the MPFS conversion factor (CF);
  • 1.25% positive adjustment to the CF in 2024; and
  • Postponement of the 4% PAYGO cut for two years.

Despite this action, neurosurgeons face a 3% pay cut in 2023 (a 2% reduction in the MPFS CF and 1% due to changes in work values) and a minimum 1.25% cut in 2024.

In the immediate run-up to passage of the omnibus spending bill, the AANS and the CNS engaged in a variety of advocacy activities urging Congress to stop the full cut, including:

  • A Surgical Care Coalition letter urging Congressional leaders to prevent the entire Medicare physician payment cut. Subsequently, John K. Ratliff, MD, FAANS, former chair of the AANS/CNS Washington Committee, was quoted in a press release about the letter, stating, “During a time when neurosurgical practices are facing steep inflation coupled with a system that fails to keep pace with the costs of delivering care, it would be Congressional malpractice if lawmakers fail to prevent the entire 4.5% Medicare physician payment cut.”
  • Collaborating with bipartisan members of Congress on several letters to congressional leadership urging action to prevent the Medicare payment cuts, including a letter led by Reps. Susan Wild (D-Pa.) and Mariannette Miller-Meeks, MD, (R-Iowa) and a letter from the Doctors Caucus.
  • A letter from the Alliance of Specialty Medicine to Sen. John Kennedy (R-La.) expressing support for the Protecting Medicare Patients and Physicians Act (S. 5194), which would have prevented the 4.5% MPFS cut. Similar legislation, the Supporting Medicare Providers Act (H.R. 8800), was introduced by Reps. Ami Bera, MD, (D-Calif.) and Larry Bucshon, MD, (R-Ind.) in September 2022.
  • A Surgical Care Coalition letter to congressional leaders expressing disappointment that the omnibus bill failed to prevent the entire cut.
  • An Alliance of Specialty Medicine letter to congressional leadership expressing disappointment with Congress’ failure to stop the full Medicare cuts.