Nearing a ‘breaking point’: Cardiologists support legislation designed to mitigate Medicare cuts to office-based services

The American College of Cardiology (ACC), CardioVascular Coalition, Outpatient Endovascular and Interventional Society, Society for Cardiovascular Angiography and Interventions (SCAI) and Society of Thoracic Surgeons (STS) are just some of the groups supporting new bipartisan legislation designed to mitigate Medicare reimbursement cuts for certain office-based services.

The Providing Relief and Stability for Medicare Patients Act of 2023 (HR 3674) was introduced by U.S. Reps. Gus Bilirakis (R-Florida), Tony Cárdenas (D-California), Greg Murphy (R-North Carolina) and Danny Davis (D-Illinois) to ensure healthcare specialties such as interventional cardiology, interventional radiology, vascular surgery, radiation oncology and urology are not negatively impacted by recent Medicare Physician Fee Schedule (MPFS) changed implemented by the U.S. Centers of Medicare and Medicaid Services (CMS). The legislation, once signed into law, would result in increases to non-facility practice expense relative value units (PE RVUs) for procedures performed in an office-based setting that require high-tech equipment. It is the belief of the policymakers behind the legislation that these increases could help temporarily offset some of the cuts contained in the MPFS.

“My primary goal is to ensure all Medicare patients have access to quality care in a setting that maximizes their opportunities for a successful outcome,” Bilirakis said in a prepared statement.  “Continued year-over-year cuts has taken a toll on many specialty care providers’ ability to participate in the Medicare program and provide care to seniors in need.”

“As a practicing surgeon of over 30 years, I understand the disastrous impacts that Medicare cuts have on physicians and beneficiaries’ access to services,” added Murphy.  “Due to the budget-neutral nature of the physician fee schedule, specialties with high direct costs will see overall decreases in reimbursement with increases in clinical labor wages. This inevitably results in physicians’ offices closing, increased consolidation, and ultimately, Medicare beneficiaries seeking care in a higher-cost setting.”

Cardiology groups step forward and show support

Twenty-four U.S. healthcare groups have crafted a new letter of thanks to Bilirakis, Cárdenas, Murphy and Davis for introducing the legislation and supporting the country’s physicians. If Congress does not act, the groups wrote, it could have a negative impact on patient care.

“As you are aware, the discrepancy between what it costs to run a physician practice and actual payment combined with the administrative and financial burden of participating in Medicare is incentivizing market consolidation,” according to the letter. “We are concerned that the ongoing severity of these cuts … will result in a breaking point for many physicians. Absent additional Congressional intervention via passage of HR 3674, the result will be more providers leaving the field (either through retirement or career adjustment), more practices being closed or sold, and a significant number of patients losing access to a variety of healthcare service in their communities.”

Read the full letter of support here.  

Michael Walter
Michael Walter, Managing Editor

Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.

Around the web

Several key trends were evident at the Radiological Society of North America 2024 meeting, including new CT and MR technology and evolving adoption of artificial intelligence.

Ron Blankstein, MD, professor of radiology, Harvard Medical School, explains the use of artificial intelligence to detect heart disease in non-cardiac CT exams.

Eleven medical societies have signed on to a consensus statement aimed at standardizing imaging for suspected cardiovascular infections.