New bipartisan bill would address systemic Medicare physician reimbursement issues
ACG applauds the release of the Patients First Act (H.R. 9693), a comprehensive set of reforms to Medicare physician reimbursement and the merit-based incentive payment system (MIPS).
The bill was introduced by the chairs of the GOP and Democratic Doctors Caucuses, Reps. John Joyce, MD (R-PA), Greg Murphy, MD (R-NC), and Kim Schrier, MD (D-WA).
ACG members: H.R. 9693 would bring long-overdue reforms and stability to the reimbursement system. Call your Representative today and urge them to co-sponsor!
The Patients First Act would:
- Provide an annual reimbursement update tied to inflation, by using the Medicare Economic Index (MEI) minus one point.
- Increase the decades-old budget neutrality threshold, which pits specialties against each other and limits innovation.
- Establish a physician-led task force at CMS to develop streamlined quality metrics that would replace MIPS, through a new system called Patient Outcome Improvement National Tabulation System (POINTS).
“ACG is grateful to the GOP and Democratic Doctors Caucuses for introducing the Patients First Act, a long-overdue effort which tackles many of the root causes of the current Medicare crisis,” said Stephen T. Amann, MD, FACG, Chair of ACG’s Legislative & Public Policy Council. “The reforms in this bill seek to increase patient access to care, provide much-needed stability for physicians, and reduce the administrative burden for independent practices who participate in the Medicare program.”
For years, ACG members have pushed Congress to address this broken system—including at our annual advocacy day in April, where Medicare reimbursement reform was a top priority. Several speakers from our advocacy day luncheons are co-sponsors of the bill, including: lead co-sponsors Reps. Joyce, Murphy, and Schrier, as well as Reps. Ami Bera, MD (D-CA), Herb Conaway, MD (D-NJ), Maxine Dexter, MD (D-OR), Andy Harris, MD (R-MD), Rich McCormick, MD (R-GA), and Mariannette Miller-Meeks, MD (R-IA).
Earlier this year, ACG was invited to comment on a draft of this bill and RFI from the two doctors caucuses, urging MEI-based updates, changes to the budget neutrality threshold, and quality metrics that actually measure patient outcomes.
We believe that a decade of the burdensome MIPS program has exacerbated healthcare consolidation trends and the decline of physician-led practices. POINTS, the proposed replacement in this bill, would eliminate the “meaningful use” of EHR legacy program and clinical improvement activities performance categories. POINTS would, however, retain the same MIPS exemptions for smaller, independent GI practices.
Unfortunately, ACG members across the country have experienced the consequences of inaction in Washington, D.C.: practice consolidation, physician burnout, and shrinking access to GI services across the country. Since 2019, the MEI has increased by 24%. Meanwhile, in the same period, Medicare reimbursement for diagnostic colonoscopy (CPT 45378) has decreased by a total of 15 percent. That widening gap between Medicare payments and the cost to provide care is felt most acutely by practices in rural and underserved areas.
The Patients First Act would be a meaningful first step to reverse these trends. ACG is committed to working with congressional leaders on finding solutions to pay for the bill. We urge the House of Representatives to bring this bill to a vote, and for the Senate to consider similar reforms.
Now, it’s on us to build support. Call your Representative today!
This week, just as this bill was introduced, CMS proposed another round of harmful Medicare cuts for 2027. The Patients First Act would provide much-needed stability and help us avoid this annual cycle of cuts and temporary fixes.
Reach out to your Representative and Senators today, urge them to co-sponsor H.R. 9693, and share your own story of how Medicare reimbursement cuts are affecting your patients and your practice. Nobody will advocate for GI care if we don’t.