Medicare Rule for 2024 Sets Cut at 3.4%; Please Urge Congress to Act
With the announcement by CMS that the Final 2024 Medicare Payment Rule will include a 3.39% conversion factor cut, physicians are again urged to contact Senators Schumer and Gillibrand, as well as their respective Member of Congress to urge that they take action from the AMA’s Fix Medicare Now site to prevent this cut, including through enactment of HR 2474. This legislation would provide a permanent, annual update equal to the increase in the MEI and allow physicians to invest in their practices and implement new strategies to provide high-value care.
The AMA’s initial summary of the Payment rule notes that CMS did not lower the budget neutrality impact of adding the new E&M add-on code, G2211, which was finalized in 2021 but then delayed for three years by Congress. Specifically, CMS maintained the estimated utilization assumption of the add-on code at the proposed rule’s estimate of 38% when initially implemented in 2024. The AMA highlighted several anticipated barriers to implementing this code that would lower its utilization. Although the utilization assumption was greatly reduced compared to when it was initially proposed in 2021, the add-on code will still lead to an additional across-the-board cut to the conversion factor due to budget neutrality requirements. Recently, the House GOP Doctors Caucus advanced discussion draft legislation to reform the budget neutrality policies applied to the Medicare physician payment schedule in 2025 and future years, for which AMA, MSSNY and many other groups recently sent a letter of support.
Following strong opposition from the AMA, CMS did not finalize its proposal to increase the performance threshold to avoid a penalty in the Merit-based Incentive Payment System (MIPS) from 75 points to 82 points. Instead, the performance threshold will remain at 75 points in 2024. The AMA expressed serious concern with CMS’ proposal as MIPS has been largely paused since 2019 due to the significant disruptions caused by the COVID-19 pandemic.
Finally, due to AMA advocacy, CMS finalized its proposal to delay mandatory electronic clinical quality measure (eCQM) adoption by Medicare Shared Savings Program (MSSP) participants, who may continue to utilize the CMS Web Interface in 2024. As finalized in previous rulemaking, MSSP participants would have been required to report their quality measures electronically starting in 2024. CMS appears to concur that the lack of maturity with HIT standards to seamlessly aggregate data from EHRs from physicians who practice at multiple sites and/or are part of an Accountable Care Organization would have made implementation challenging in 2024.
Additional links include:
- CMS Press Release: https://www.cms.gov/newsroom/press-releases/cms-finalizes-physician-payment-rule-advances-health-equity
- CMS Fact Sheet on the 2024 Medicare Physician Payment Schedule final rule: https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2024-medicare-physician-fee-schedule-final-rule
