Advocacy in Action Newsletter
Your Go-To Monthly Health Policy Newsletter
This monthly newsletter rounds up the latest legislative, regulatory, and reimbursement news that may impact your practice and delivers it directly into your inbox.
November 2024
Spotlight
HRS Reports on CMS 2025 Medicare Physician Fee Schedule and Outpatient Hospital/ASC Final Rules
On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS)published the final rules for the calendar year 2025 Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System.
As HRS does every year, the Society submitted comments to CMS on the proposed rules in September. A summary of HRS proposed rule comments and CMS final rule actions related to those comments appears below, with greater detail in the text summaries that follow.
Legislative Updates
HRS Voices Support for Medicare Physician Payment Fix
HRS endorsed the Medicare Patient Access and Practice Stabilization Act of 2024 to prevent the across-the-board 2.83% cut to the MPFS conversion factor set to take effect on January 1, 2025.
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HRS Joins Federal Lawmakers Urging Congress to Halt Physician Pay Cuts
HRS, lawmakers, and other stakeholders continue to press for action to avert the impending physician conversion factor pay cut before the end of the year. A bipartisan coalition of 233 House members has written to House Speaker Mike Johnson (R-La.) and Minority Leader Hakeem Jeffries (D-N.Y.) urging Congress “to expeditiously pass legislative fixes that not only stop another damaging round of cuts to Medicare payments, but also provide greater certainty and stability for clinicians serving Medicare beneficiaries.”
HRS Continues to Monitor MedPAC as it Continues Deliberations on Recommendations to Congress
On October 11 and 12, 2024, the Medicare Payment Advisory Commission (MedPAC)held the second meeting of its 2024/2025 meeting cycle. As it prepares to issue recommendations to Congress in Spring 2025, the Commission discussed several topics at this meeting, including several issues related to Medicare Advantage, highlighting that more than half of all Medicare beneficiaries are enrolled in Medicare Advantage plans rather than traditional Medicare fee-for-service.
Regulatory Update
CMS Expands 2024 MIPS Automatic Exception
CMS recently announced that clinicians impacted by Hurricanes Helene (FL, GA, NC, SC, TN) and Francine (LA.) will qualify for the MIPS automatic Extreme and Uncontrollable Circumstances (EUC) Exception for the 2024 performance year. CMS previously announced that this policy would apply to clinicians impacted by Hurricanes Debbie (FL) and Beryl (TX). MIPS eligible clinicians in designated areas within these states will be automatically identified and have all 4 MIPS performance categories reweighted to 0%, which will result in a neutral payment adjustment for the 2026 MIPS payment year.