The ACR’s top priority before the end of the year is to have Congress address the additional 2.83% cut to physicians in the final physician fee schedule for 2025. Since 2001, doctors have seen a cumulative pay cut of 29%, according to the AMA. These cuts come on top of the increasing costs of operating a practice, which went up 39% due to inflation. Congress must act before the end of the year to avoid the additional cuts and to have physician reimbursements updated to reflect inflationary pressures, the same way all other Medicare schedules are.
Another ACR priority for the lame duck is extending telemedicine flexibilities. One silver lining from the COVID-19 pandemic was expanded use of telemedicine. It is estimated that 74% of practices now provide telemedicine services, but without action from Congress, Medicare will go back to the far more restrictive use of these services seen before the pandemic. Although telemedicine is not a replacement for essential face-to-face assessments, nearly five years since the start of the pandemic, more and more patients are coming to rely on the flexibility and ease of telehealth services.
Unfortunately, the election results will make these priorities less likely than before as the House majority will be inclined to hold off on legislating until 2025, when they have a majority in the Senate and a friendlier White House to work with. For most of our priorities, this means starting over by reintroducing bills in the new Congress. Medicare reimbursement and telemedicine, however, have important deadlines at the end of 2024, so this Congress must act before the year ends.
Checks & Balances
Starting in 2025, there will be new rules as well as a new administration. For the last 40 years, agencies have interpreted statutes and promulgated rules knowing that they would be given deference by the courts known as “Chevron deference.” The Supreme Court’s decision in Loper Bright Enterprises v. Raimondo changed that. The Loper decision holds that courts must “exercise independent judgment in determining the meaning of statutory provisions” and may not defer to an agency’s interpretation of an ambiguous statute. This is a substantial curtailment of the authority of the executive branch. Because courts will assume a broader role in interpreting ambiguous statutes, it is reasonable to expect that the next administration will have to deal with a potentially unprecedented number of legal challenges to rule changes and statutory interpretation that could stall and delay policy changes.
