The California Medical Association (CMA) submitted comments to the Centers for Medicare & Medicaid Services (CMS) urging the agency to work with Congress to address the current unsustainable Medicare physician payment system and the burdensome reporting requirements and harsh penalties for small, rural practices associated with the Merit-based Incentive Payment System (MIPS).

“CMA believes that fundamental changes are needed to fix Medicare physician payment, stabilize physician practices, and improve patient access to care – changes that can only be accomplished by Congress,” said CMA President Tanya W. Spirtos, M.D. “Therefore, we are urging CMS, as stewards of the Medicare program, to take a leadership role in actively calling on Congress to reform the physician payment system now by providing an annual inflation update, budget neutrality improvements, a MIPs overhaul, an extension of the expiring Alternative Payment Model incentives, and a permanent extension of the pandemic telehealth waivers.”

CMA’s comments echo those of the American Medical Association (AMA), particularly on the need for an annual inflation update for Medicare physician payments, which have declined 29% since 2001 when adjusted for inflation. Additionally, CMS projects that the cost to practice medicine as measured by the Medicare Economic Index (MEI) will increase by 4.6% in 2024 and by 3.6% in 2025. Both the Medicare Trustees and the Medicare Payment Advisory Commission have warned that failure to address the growing gulf between insufficient Medicare physician payment and the cost of practicing medicine will negatively impact seniors’ access to high-quality care.

In addition to the priorities requiring Congressional action, CMA has also requested that CMS take the following actions:

• Continue to delay the implementation of the 2022 practice expense reweighting proposal that would disproportionately harm physicians and patients in high-cost regions of the country like California.
• Implement the proposed reforms to the Medicare Shared Savings Program that provide Accountable Care Organizations with additional upfront resources and assistance for caring for Medicare-Medicaid dual eligible patients.
• Withdraw the new mandatory specialist Alternative Payment Model (APM) proposal based on the MIPS Value Pathways and instead provide opportunities for physicians of all specialties to participate in a greater variety of voluntary APMs.

For More Information

• CMA comment letter to CMS detailing CMA’s priorities for the 2025 Medicare physician fee schedule
• AMA comment letter to CMS on 2025 Medicare physician fee schedule