Request for Information: Strengthening the Medicare Physician Payment System

WASHINGTON, D.C. — Today, Rep. John Joyce, M.D. (PA-13), Rep. Greg Murphy, M.D. (NC-3), co-chairs of the GOP Doctors Caucus, and Rep. Kim Schrier, M.D. (WA-8), chair of the Democratic Doctors Caucus, issued a Request for Information (RFI), inviting stakeholders to share their insights and suggestions as the bill sponsors refine comprehensive legislation to reform physician reimbursement under the Medicare program.

For more than two decades, Medicare’s payments to physicians have failed to keep pace with the actual cost of providing care. This sustained underpayment has destabilized physician practices, accelerated consolidation across the health care system, and threatened patients’ access to care; particularly in the rural and underserved communities that can least afford to lose a physician. H.R. 9693, the Patients First Act, seeks to replace the current cycle of temporary, year-to-year payment patches with durable, structural reform: a predictable, inflation-based payment update; meaningful investment in primary care; and a simplified, physician-led approach to quality that returns time to patient care.

To ensure this legislation is as effective and fiscally responsible as possible, we invite stakeholders to provide written responses to the prompts below. Stakeholders should submit their responses to catherine.hayes@mail.house.gov and amy.zhou@mail.house.gov no later than August 21st. We request that written responses be no longer than 3,500 words and be provided in a Word document and a PDF. Supplemental data, reports, and case studies are also welcome.

The RFI’s requests and questions include:

I. Offsets and Fiscal Responsibility

Durable reform of the Medicare physician payment system requires identifying responsible ways to fund a stable, predictable payment update. The bill sponsors are committed to advancing this legislation in a fiscally responsible manner and welcome stakeholder input on potential offsets.

What specific offsets or “pay-fors” within the Medicare program or the broader health care system should the bill sponsors consider to fund a permanent, inflation-based physician payment update?

Are there any areas in the Medicare system where we systematically overpay for services that could be provided in a less expensive setting of care? Are there ways we could shift care to less expensive settings without compromising patient access?

II. Additional Information

Holistic reform of the Medicare physician payment system will benefit from all stakeholder perspectives. We therefore welcome any additional information that may be relevant to the bill sponsors as they develop this legislation.